Access to basic water, sanitation, and hygiene (WASH) facilities and associated factors in Ethiopia: evidence from demographics and health surveys

In low- and middle-income countries, ensuring water, sanitation, and hygiene (WASH) facilities for households remains a major public health concern. Therefore, this study aimed to assess households' access to WASH services and associated factors in Ethiopia. A cross-sectional study was conducted among 16,650 and 8,663 households in the 2016 Ethiopian Demographic Health Survey (EDHS) and 2019 Mini-EDHS, respectively. The households were selected using a stratified two-stage cluster sampling technique. Multivariable logistic regression analysis was performed to identify factors associated with basic WASH services. Households' access to basic water services was 65.2% (95% CI: 64.5–65.9%) and 68.7% (95% CI: 68.01–69.4%) in the 2016 EDHS and 2019 Mini-EDHS, respectively. Only 25.9% (95% CI: 25.2–26.62%) in the 2016 EDHS and 27.5% (95% CI: 26.34–28.3%) in the 2019 Mini-EDHS households had access to basic sanitation services. Moreover, only 38% (95% CI: 37.25–38.8%) of households had access to basic hygiene services in the 2016 EDHS. Female-headed households, urban residents, having education, family members ≥7, presence of soaps or detergents, and having a better wealth index were the most likely to have access to basic WASH services. The findings in general suggest the need for effective WASH interventions.

Knowledge, Attitudes, and Misconceptions About COVID-19 Prevention Practices Among High and Preparatory School Students in Dessie City, Ethiopia.

Background: Knowledge, attitudes, and misconceptions of students about COVID-19 (coronavirus disease) prevention have been examined in relatively few studies. This study aimed to assess the knowledge, attitudes and misconceptions about COVID-19 prevention practices among high and preparatory school (grades 9 to 12) students in Dessie City, Ethiopia. Methods: This school-based cross-sectional study used a pre-tested structured questionnaire and direct observations from March 1 to 30, 2021 in 5 high and preparatory school students in Dessie City, Ethiopia. The sample size was proportionally allocated in each school based on the number of students registered in the first semester, stratified by grade level, and section. Data analysis employed 3 binary logistic regression models (Models I, II and III) with 95% CI (confidence interval). Bivariate analysis (crude odds ratio [COR]) and multivariable analysis (adjusted odds ratio [AOR]) were used. Variables with P-values <0.3 in the bivariate analysis were retained in the multivariable logistic regression analysis for each model. Variables with significance levels P<0.05 in the multivariable analysis of each model was identified as significant factors. Results: The levels of good knowledge, positive attitudes, and low misconceptions were 74.8%, 60.2%, and 56.1%, respectively. After adjusting for the covariates, grade 12, positive attitude and living in households with more than 5 members were identified as factors significantly associated with good knowledge about COVID-19 prevention practices. Good knowledge of COVID-19 prevention practices, household size >5, infection prevention and control (IPC) training, and low level of misconceptions were factors significantly associated with positive attitudes, whereas students age ≥18 years, positive attitude, and IPC training were factors significantly associated with less misconceptions about COVID-19 prevention measures. Conclusion: The prevalence of good knowledge, positive attitude, and low level of misconceptions of prevention practices for COVID-19 among students was relatively low. Therefore, Dessie City Health and Education Department and each high and preparatory school should implement continuous monitoring programs to ensure high prevention awareness and promote preventive behavior towards COVID-19.

Prevention Practice of COVID-19 Using Personal Protective Equipment and Hand Hygiene Among Healthcare Workers in Public Hospitals of South Wollo Zone, Ethiopia.

Objective: The use of personal protective equipment and hand hygiene are often the most recommended line of defense against coronavirus disease-19 (COVID-19). The purpose of this study is to determine the magnitude of compliance and associated factors of personal protective equipment (PPE) utilization and hand hygiene practice among healthcare workers in public hospitals of South Wollo Zone, Northeastern Ethiopia. Methods: A hospital-based cross-sectional study was conducted among 489 healthcare workers in public hospitals of South Wollo Zone, Northeastern Ethiopia from June 15 to July 30, 2021. Proportional sample size allocation to each selected hospital followed by simple random sampling techniques were used to select the study participants using human resource records from each hospital. A pre-tested and structured self-administered questionnaire with WHO's standardized hand hygiene and PPE utilization observational checklist were used to collect data. Bivariate and multivariable analyses with 95% CI and p-value < 0.05 were employed to identify the associated factors of personal protective equipment utilization. Results: About 32 and 22.3% of healthcare workers were compliant with personal protective equipment utilization and hand hygiene practice, respectively. Feedback for safety (AOR = 2.05; 95% CI: 1.26-3.35), training on COVID-19 prevention (AOR = 3.43; 95% CI: 2.01-5.86), and perception to infection risk (AOR = 1.98; 95% CI: 1.18-3.33) were significant factors of good compliance with personal protective equipment utilization. Conclusion: The magnitude of good compliance with personal protective equipment utilization and hand hygiene was low. Interventions to promote personal protective equipment utilization and hand hygiene should focus on feedback for safety, training on COVID-19 prevention, and perception of infection risk.

COVID-19 Prevention Practices and Determinant Factors Among Healthcare Professionals Working in Hospitals of South Gondar Zone, Northwestern Ethiopia.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has been a global public health crisis since December 2019. Health care professionals (HCP) are highly vulnerable for contracting the disease. Due to the absence of known treatment, prevention is the best option for controlling its transmission. OBJECTIVE: The study aimed to assess COVID-19 prevention practices and determinant factors among HCP working in hospitals of South Gondar ZoneH, Northwestern Ethiopia. METHODS: Institution-based cross-sectional study design was used from July 1 to 30, 2020 among 372 HCPs. The participants were selected on random sampling technique basis. Data were entered into Epi data version 3.1 and exported to Statistical Package for Social Science (SPSS V.25) software for data cleaning and analysis. Binary logistic regression analysis was used to assess the association between independent variables and prevention practice of COVID-19. RESULTS: A total of 372 HCPs participated in the study with a response rate of 94.9%. Less than one-third 112 (30.1%) of the participants were females. About 308 (82.8%), 285 (76.6%), and 224 (60.2%) of the participants had good knowledge, positive attitude, and good prevention practice towards COVID-19, respectively. Being male (AOR =2.68; 95% CI (confidence interval): 1.50,4.81), 2-5 years working experience (AOR= 4.61; 95% CI: 1.70,12.47), greater than five years working experience (AOR= 5.86; 95% CI: 2.01,17.05), age of 31-40 years old (AOR= 2.49; 95% CI; 1.41,4.41), above 40 years (AOR= 6.94; 95% CI: 2.33-20.71), use of COVID-19 guideline (AOR= 4.79; 95% CI: 2.17-10.53), and using peers as sources of information about COVID-19 (AOR= 2.06; 95% CI: 1.07-3.94) were factors of COVID-19 prevention practices. CONCLUSION: Less than two-thirds of the participants had good COVID-19 prevention practices. Sex, work experience, age, use of COVID-19 guideline, and using peers as sources of information were factors of COVID-19 prevention practices. Hence, continuous information dissemination and experience sharing on COVID-19 prevention should be done continuously.

Knowledge, Attitude, and Preventive Practices Towards COVID-19 Among Students of Ethiopian Higher Education Institutions.

INTRODUCTION: COVID-19 has been a global public health problem since December 2019. Higher education institutions are risky areas for the transmission of COVID-19. But, still there is insufficient information on the prevention of the disease in this setting. OBJECTIVE: To assess knowledge, attitude, and prevention practices towards COVID-19 among students of Ethiopian higher education institutions. METHODS: Institutin  -based cross-sectional study design was conducted from December 1 to 30, 2020 among randomly selected 407 undergraduate students from higher education institutions in Ethiopia. The outcome variables were knowledge, attitude, and practices towards COVID-19. Binary logistic regression models at 95% confidence interval (CI) were used to determine the factors affecting knowledge, attitude, and practices towards COVID-19. In multivariable analysis, variables with a p-value of less than 0.05 were considered statistically significant and independently associated with outcome variables at 95% CI. RESULTS: About 75.9% (95% CI: 72.2-79.9%) of University students had a good knowledge, 62.4% (95% CI: 58.2-67.1%) had a positive attitude, and 56.8% (95% CI: 52.6-61.9%) had a good COVID-19 prevention practices. Students over the age of 30 (AOR=5.8; 95% CI: 1.5, 10.6), third-year students (AOR=3.1; 95% CI: 1.1, 8.9), and being health science students (AOR=4.4; 95% CI: 2.2, 8.9) were significantly associated with a good knowledge towards COVID-19. Urban residents (AOR=0.6; 95% CI: 0.3-0.9), having an average family monthly income of $75USD (AOR=3.5; 95% CI: 1.8-6.7), use of at least one type of social media (AOR=4.7; 95% CI: 1.7-12.9), and having a positive attitude (AOR=2.2; 95% CI: 1.3-3.5) were significantly associated with COVID-19 prevention practices. CONCLUSION: Despite three-fourths of the participants had a good knowledge, the attitude and prevention practices were low. Age, study year, College of study, presence of chronic illnesses, use of social media, family income, and residence were factors of knowledge, attitude, and prevention practices towards COVID-19. Hence, multiple information dissemination strategies using multiple media outlets should be implemented continuously.

COVID-19 Prevention Practices and Associated Factors among Diabetes and HIV/AIDS Clients in South-Wollo Zone, Ethiopia: A Health Facility-Based Cross-Sectional Study.

BACKGROUND: Coronavirus-2019 (COVID-19) is affecting many people. Chronic patients are highly vulnerable to contracting an infection. Most people recover within a week, but chronic patients can face severe illness or death. The increasing of cases, complications, and mortality demands compulsory preventive measures. Therefore, this study was designed to identify major preventive practices and associated factors. METHODS: A facility-based cross-sectional study was employed from November to December 2020 among diabetics and HIV/AIDS follow-up clients in Dessie referral hospital. Data were entered into EpiData manager 4.6.0 version and exported to Statistical Package for Social Science (SPSS) version 25.0 for data cleaning and analysis. Logistic regression analysis was done and an adjusted odds ratio (AOR) with its 95% confidence interval (CI) was used for determining the strength of association. RESULTS: Data were collected from 426 participants with a mean age of 46.54 years. The overall poor prevention practice rate of COVID-19 among diabetic and HIV/AIDS follow-up clients was 68.8% 95% CI (64.6-72.8%). Factors significantly associated with poor prevention practice were femaleness (AOR; 1.61; 95% CI; 1.03-2.51), illiterate [AOR; 2.59; 95% CI; 1.33-5.09]), family size greater than four (AOR; 2.06; 95% CI; 1.32-3.23), absence of health professional in the household (AOR; 1.79; 95% CI; 1.13-2.84), not having health insurance (AOR; 1.85; 95% CI; 1.18-2.89) and urban residence (AOR; 0.38; 95% CI; 0.18-0.79). CONCLUSION: The overall proportion of prevention practice towards COVID-19 among diabetic and HIV/AIDS follow-up clients was poor. Illiteracy, having a family size greater than four, not having health professionals in the household, not having health insurance and urban residency were associated with poor prevention practices. Therefore, continuous health educations about good preventive behavioral practice should be enhanced by the health professionals.

Knowledge, attitude, and preventive practices towards COVID-19 and associated factors among adult hospital visitors in South Gondar Zone Hospitals, Northwest Ethiopia.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is currently the critical health problem of the globe, including Ethiopia. Visitors of healthcare facilities are the high-risk groups due to the presence of suspected and confirmed cases of COVID-19 in the healthcare setting. Increasing the knowledge, attitude, and practices towards COVID-19 prevention among hospital visitors are very important to prevent transmissions of the pandemic despite the lack of evidence remains a challenge in Ethiopia. Therefore, this study was designed to investigate the status of knowledge, attitude, and preventive practice towards COVID-19 and associated factors among hospital visitors in South Gondar Zone Hospitals, Northwest Ethiopia. METHODS: A facility-based cross-sectional study design was employed during August 1 to 30, 2020 from randomly selected 404 adult hospital visitors in South Gondar Zone Hospitals, Northwest Ethiopia. The data was collected using interviewer-administered questionnaire. The outcome of this study was good or poor knowledge, positive or negative attitude and good or poor preventive practice towards COVID-19. Three different binary logistic regression models with 95% CI (Confidence interval) was used for data analysis. For each mode, bivariable analysis (crude odds ratio [COR]) and multivariable analysis (adjusted odds ratio [AOR]) was used during data analysis. From the bivariable analysis, variables with a p-value <0.25 were retained into the multivariable logistic regression analysis. From the multivariable logistic regression analysis, variables with a significance level of p-value <0.05 were taken as factors independently associated with knowledge, attitude and preventive practices towards COVID-19. MAIN FINDINGS: About 69.3% of the respondents had good knowledge, 62.6% had a positive attitude, and 49.3% had good preventive practice towards the prevention of COVID-19. We found that factors significantly associated with good knowledge about COVID-19 were educational status who can read and write (AOR = 2.78; 95%CI: 1.18-6.56) and college and above (AOR = 6.15; 95%CI: 2.18-17.40), and use of social media (AOR = 2.96; 95%CI: 1.46-6.01). Furthermore, factors significantly associated with a positive attitude towards COVID-19 includes the presence of chronic illnesses (AOR = 5.00; 95%CI; 1.71-14.67), training on COVID-19 (AOR = 3.91; 95%CI: 1.96-7.70), and peer/family as a source of information (AOR = 2.45; 95%CI: 1.06-5.63). Being a student (AOR = 7.70; 95%CI: 1.15-15.86) and participants who had a good knowledge on COVID-19 (AOR = 4.49; 95%CI: 2.41-8.39) were factors significantly associated with good practice towards COVID-19. CONCLUSION: We found that knowledge, attitude, and preventive practices towards prevention of COVID-19 among adult hospital visitors were low. Therefore, we recommended that different intervention strategies for knowledge, attitude and preventive practices are urgently needed to control the transmission of COVID-19 among adult hospital visitors. Health education of those who could not read and write about COVID-19 knowledge issues and advocating use of social media that transmit messages about COVID-19 are highly encouraged to increase the good knowledge status of adult hospital visitors. Furthermore, providing training about COVID-19 prevention methods and using various sources of information about COVID-19 will help for improving positive attitude towards COVID-19 prevention, whereas for increasing the status of good preventive practices towards COVID-19, improving the good knowledge about COVID-19 of adult hospital visitors are essential.