Programmatic Correlates of Maternal Healthcare Seeking Behaviors in Ethiopia

Background: Considerable improvement in maternal healthcare use has been observed since the inception of the health extension program (HEP) in Ethiopia in 2003. Objective: This paper evaluates the influence of HEP outreach strategies on maternal healthcare use. Method: Cross-sectional survey of 2;916 women with children 0 to 11 months from Amhara; Oromiya; Southern Nations; Nationalities and People's; and Tigray regions; obtained between December 2008 and January 2009; were analyzed using regression models to assess the impacts of HEP strategies on maternal health outcomes. Result: The analyses found that communities (i.e.; kebeles) with relatively high prevalence of model families; higher rate of household visits by health extension workers; and higher rate of household visits by voluntary community health workers were associated with improved antenatal care use; tetanus toxoid vaccination coverage; and receiving postnatal care visits; but the strategies were not associated with deliveries attended by health professionals. Conclusion: Although the impacts of HEP strategies on maternal healthcare use were statistically significant; they were not optimum to reach the maternal mortality reduction targets of the government of Ethiopia. The HEP needs to review and strengthen its community based strategies in order to reach its goals

In Vivo Anti-Malarial Activities of Clerodendrum Myricoides; Dodonea Angustifolia and Aloe Debrana against Plasmodium Berghei

Background:Malaria caused by the parasite Plasmodium falciparum is an acute disease which kills an estimated 863;000 people per year according to the WHO report of 2009. The fight against malaria is faced with the occurrence of widespread resistance of P. falciparum. The search for plant-derived antimalarial drugs has great importance in this regard. Thus this study evaluates the toxicity and antimalarial activity of extracts of Clerodendrum myricoides; Dodonia angustifolia and Aloe debrana. Method: Acute and sub acute toxicity studies of the extracts were carried out by giving up to 3000mg/kg to noninfected mice. Weight loss; change in general behavior and mortality were used as indicators of toxicity. Doses of 200; 400 et 600mg/kg/day of each extract of C.myricoides; D. dodonia and A.debrana were given orally to Plasmodium berghei infected mice following the four-day suppressive test procedure. Results: None of the extracts caused symptoms of toxicity at the given doses. Each extract showed variable level of parasitaemia suppression in dose related manner. Methanol extract of C. myricoides leaves exerted 82.50suppression at the dose of 600mg/kg. The methanol extract of the root of D. angustifolia showed the highest (84.52) suppression of parasitaemia at the dose of 600mg/kg. Furthermore; methanol extract of A. debrana induced 73.95suppression; whereas its water extract exerted 54.36suppression of parasitaemia. Conclusion: Crude extracts of C. myricoides; D. angustifolia and A.debrana caused strong activities against P. berghei indicating that they contain some chemical constituents that possibly lead to antimalarial drug development

Levels of Outpatient Satisfaction at Selected Health Facilities in Six Regions of Ethiopia

Background: Satisfaction is one of the meaningful indicators of patient experience of health care services. Asking patients what they think about the care and treatment they have received is an important step towards improving the quality of care; and to ensuring that local health services are meeting patients' needs. Various studies have reported that satisfied patients are more likely to utilize health services; comply with medical treatment; and continue with the health care provider. Objective: to assess and estimate the perceived levels of satisfaction with health services rendered at government health facilities in selected regions of Ethiopia. Methods: A cross-sectional study that involved an exit interview was conducted in purposively selected government health centers and general hospitals in six regions of Ethiopia. Data were collected using structured questionnaire between June and September 2004. Variables used in the study were grouped and summarized into three components; namely providers' characteristics; services characteristics and cleanliness of the health facilities. Each variable was scored on a 5 point Likert-like scale; ranging from 1 (very dissatisfied) to 5 (very satisfied). The mean score 2.5 is considered as a cut-off point and scores equal and above 2.5 are taken as an indicator of users' perceived satisfaction. Both bivariate and multivariate methods of data analyses were used as deemed necessary. Results: All the three components of investigated variables have reliability coefficients ranging from 0.57 to 0.82. Results of bivariate analyses depicted that the percentage for high mean score satisfaction with health providers' characteristics ranged from 77.25to 93.23; with service characteristics 68.64to 86.48; and satisfaction with cleanliness ranged from 76.50to 90.57. Results of multivariate analysis showed that relatively more explanatory variables were found to be significant ininfluencing cleanliness (cleanliness of waiting place; examination room and medical equipment). Most of the explanatory variables in service characteristics were not statistically significant as compared to other components. Conclusion: The investigators believe that improved service delivery in health facilities could be achieved by to proper and sustainable implementation of the newly initiated civil service reform program in civil service institutionsin the country. Furthermore; periodic assessment of health services and further study; especially from the user's satisfaction perspective is recommended as a fundamental initiative in the improvement of the performance of health facilities