Male involvement in prevention of mother-to-child transmission of HIV in the context of partner testing in Goba town, Ethiopia: A facility-based cross-sectional study

Background. Antenatal care (ANC) is an entry point for the prevention of mother-to-child transmission (PMTCT), particularly when a man accompanies his spouse for voluntary counselling and testing (VCT), even though this seldom happens in Ethiopia.Objective. To study the role of male partners in improving PMTCT/ANC, which is essential to prevent HIV/AIDS transmission in this country. Our study focused on identifying barriers for the low involvement in PMTCT/ANC among male partners whose spouses received ANC.Methods. A total of 422 male partners in Goba town, Oromia regional state, Ethiopia, were recruited in September - October 2014 and enrolled by a systematic sampling method. A facility-based cross-sectional study and two focus group discussions (FGDs) were conducted. Binary logistic regression and odds ratios were calculated to ascertain sociodemographic and other important information compared with the outcome variable and PMTCT/ANC, while the findings of the FGDs were grouped according to the emerging themes and analysed manually by means of a thematic approach.Results. The percentage of male partners (22.7%) accompanying their spouses for HIV testing and counselling at antenatal clinics improved three-fold when an invitation letter was introduced as a new initiative to increase male participation. Individuals in the age group 15 - 29 years (adjusted odds ratio (AOR) 5.4, 95% confidence interval (CI) 1.66 - 17.85), and whose duration of marriage was ˂5 years (AOR 5.6, 95% CI 1.83 - 17.30), were more likely to be tested than their referent groups. Men without a higher education (AOR 0.1, 95% CI 0.02 - 0.50), who disagreed with legal enforcement (AOR 0.1, 95% CI 0.07 - 0.32), were less likely to be tested, while those who did not notify their partners (AOR 8.4, 95% CI 1.92 - 37.12) were more likely to use the service. Being busy, proxy testing, fears of testing HIV-positive, neglecting the importance of VCT, and inadequate knowledge about the PMTCT/ANC programme were other barriers that came to the fore in the FGDs.Conclusion. Identified barriers have to be addressed, and helpful practices, such as using invitation letters to increase the uptake of the service by male partners, have to be instituted

Utilization of antenatal care services among teenagers in Ethiopia: a cross sectional study

Background: Teenaged women suffer from a disproportionate share of reproductive health problem. The purpose of this study was to estimate the utilization of antenatal care (ANC) services among teenagers (13-19 years) during delivery in Ethiopia. Methodology: Raw data collected from all part of the country on child bearing aged women using stratified cluster sampling method by the Ethiopian Demographic Health Survey 2005 was used. From the large dataset of women; a total of 994 teenage women at the time of their most recent childbirth five years prior to the survey was selected and analyzed. Both bivariate and multivariate analyses were performed to determine the differentials of ANC by explanatory variables. Result: Most (60) of the subjects were in the age group between 18 and 19 years. The vast majority (90) was from the rural settings and most (87) were in marital union. Almost three out of four (72.4) of those who had given birth has no any form of formal education. Over a quarter (27.3) of most recent childbirths had at least one ANC service; of this; 21had started their first antenatal visit in the first trimester of pregnancy. The majority (80.4) of the women who attended ANC delivered at home without being assisted. The major deriving factors for the utilization of ANC service were education level of women and their male partners; better wealth index and urban residence. Conclusion: Education of partners; rich wealth index and urban residence seemed to encourage teenagers to utilize ANC. Appropriate interventions targeting teenaged women with poor socioeconomic status is recommended with more emphasis on the rural underserved segment of population. [Ethiop. J. Health Dev. 2010;24(3):221-225]

Iron Deficiency Anaemia among Women of Reproductive Age in Nine Administrative Regions of Ethiopia

Background: Iron deficiency anaemia (IDA) is one of the most common causes of nutritional problem; and is of great public health significance affecting children; adolescents and women of reproductive age world wide. The magnitude of IDA in the general population of Ethiopia has not yet been well documented. Objective: To estimate the magnitude of IDA among women of reproductive age in nine administrative regions. Methods: A cross-sectional study of analytical nature was conducted in 270 clustered villages drawn from 9 administrative regions of the country between June and July 2005. A total of 22;861 women of reproductive age (15-49 years) were examined clinically for pallor and 5of these subjects were systematically selected and assessed further for their haemoglobin (Hgb) and serum ferritin (SF) status. Results: The prevalence rate of clinical anaemia; anaemia; ID (iron deficiency) and IDA were 11.3; 30.4; 49.7and 17.0respectively. The majority of anaemic women were in the category of mild (19.3) to moderate (10.3) and severe anaemia was 0.9. A significantly higher proportion of clinical anaemia [26.7(95CI: 24 to 28)]; anaemia (Hgb) [79.4(95CI: 72 to 86)]; ID [65.1(95CI: 72 to 86)] and IDA [58.0(95CI: 55 to 76)] was observed in Afar signifying distinct regional variation. The most affected age groups were those between 36-49 years and the difference noted was statistically significant. Conclusion: This study substantiates the existence of mild to moderate form of IDA among women of reproductive age and underlines the need for iron supplementation to all reproductive women during the antenatal period with more attention to the most affected regions

Determinants of exclusive breastfeeding practices in Ethiopia

Background: Despite the demonstrated benefits of breast milk; the prevalence of breastfeeding; in-particular exclusive breastfeeding (EBF); in many developing countries including Ethiopia is lower than the international recommendation of EBF for the first six months of life Objective: To assess the practice of EBF and explore its determinants in Ethiopia and provide policy makers and NGOs with relevant information for future planning and interventions. Methods: Raw data collected from nine regions and two city administrations using stratified cluster sampling method by the Ethiopian Demographic Health Survey (EDHS) 2005 were used to study the practice and determinants of EBF countrywide. Analysis was based on children whose age was less than six months and alive at the time of interview that was extracted from the women's database. Results: The overall rates of exclusive and full breastfeeding were 49.0and 68.2respectively. Maternal education; marital status; wealth index and age of the child were closely associated with EBF practices; nonetheless; in the hierarchical analysis; being not married; middle/ richer/ richest wealth index; and child age 0-1and 2-3 month were retained as the predictors of EBF (P0.05). Conclusion: A range of maternal and child health attributes such as marital status; economical status and child age were found to influence the practice of EBF in Ethiopia. Actions to empower women and promotion of EBF campaignare recommended to achieve the fourth millennium development goal

Infant Feeding Practice of HIV Positive Mothers and its Determinants in Selected Health Institutions of Addis Ababa; Ethiopia

Background: Avoidance of all breast-feeding by HIV infected mothers is recommended when replacement feeding is acceptable; feasible; affordable; sustainable; and safe. Whereas for women whose HIV status is unknown or negative; exclusive breastfeeding for the first six months is the single infant feeding option recommended. Objective: To assess the infant feeding practice of HIV positive mothers and its determinants. Methods: A cross sectional study with analytical component was conducted in 13 purposively selected health institutions with ART and PMTCT facilities in Addis Ababa during March; 2008. A total of 327 HIV positive mothers with their young infants visiting the respective health institutions were recruited in order of arrival; and assessed for their infant feeding practices. Results: Exclusive replacement feeding (ERF); exclusive breastfeeding (EBF) and mixed feeding (MF) were 46.8; 30.6; and 15.3respectively. The predictors for choosing ERF were mode of delivery (p0.05); household income (p0.05) and disclosure of HIV status to spouse (p0.01). The predictor for EBF; was mode of delivery (p0.05) while for MF; disclosure of HIV status to spouse (p0.05); parental infant feeding attitude (p0.01) and infant illnesses (p0.01) were the predictors. Furthermore; sticking to mothers' informed safer feeding options is challenged by some social factors. Conclusion: The present study delineated the predictors involved in making safer choices for infant-feeding options. To achieve success in exclusivity of feeding options; mothers' decision should be respected and pressure from the family/neighbors to introduce other food to the infant needs to be discouraged. Furthermore; the risks involved in each infant feeding option should be communicated and advocated to the mother/father during PMTCT to make informed choices

VCT Uptake and Associated Factors among Teachers from Harari Administrative Region

Background: Although HIV/AIDS is affecting most productive segments of the population; the basic education sector which is vital to the creation of human capital is also equally affected. The loss of skilled and experienced teachers due to the problem is increasingly compromising the provision of quality education in most African countries and thus; needs appropriate intervention measures that reverse the current trend. Objectives: To assess the prevalence and determining factors of VCT uptake among teachers of Harari Administrative Region. Methods: A cross sectional study design with analytic component was conducted among 566 teachers drawn from 20 randomly selected schools of Harari Administrative Region from March to April 2009. Self administered questionnaire; adapted from previous relevant studies was used to estimate the prevalence of VCT uptake and the various socio-demographic and psychological factors. Data were entered and analyzed using bi-variate and multivariate models. Results: A total number of 497 teachers responded to the questionnaire adequately making the response rate of 87.8. The mean age of the participants was 34.68 ranging from 18 - 61 years. There were more teachers from urban areas (72.0) and most of them were males (62.2). About half (54.1) were married and few (5.2) were divorced. The vast majority (98.6) heard about the confidential VCT service and their major sources of information were mass media (85.3) and health workers (56.2). The prevalence of VCT uptake was 46.3. The odds of utilizing VCT significantly increased with being younger age group; female and first and second cycle teachers' category.Conclusions: The major factors identified for increased uptake of VCT are gender; age and salary category. Actions targeting the males; non-youth age group and low grade teachers' are necessary to follow their peer groups to utilize the VCT service in order to achieve the goal of education set for 2015