Intention to shift from short-acting to long-acting methods of contraceptives and its associated factors in Gondar city, northwest Ethiopia: Using the theory of planned behavior.

Background: Despite its effectiveness, the intention, and utilization of long-acting contraceptive methods are very low in many developing countries, and the use of long-acting contraceptive methods has not kept pace with that of short-acting methods such as oral contraceptives and injectables. Therefore, this study aimed to assess the intention of using long-acting contraceptive methods and associated factors among women currently using short-acting contraceptive methods. Methods: Institution-based cross-sectional study was conducted from March 19 to April 19, 2017. The study included 515 short-acting contraceptive users found in Gondar city who were selected from the study population using a systematic random sampling technique. A structured pre-tested questionnaire based on the theory of planned behavior was used to collect data. Both descriptive and analytical statistical procedures were used. Simple and multiple linear regression analyses were carried out. SPSS version 20 was used for the analysis of the data. Multiple linear regression was carried out to see the association between intention and sociodemographic variables, past contraception experience, attitude, subjective norm, and perceived behavioral control, and with 95% CI and a p-value of <0.05 was used to detect statistical significance. Results: The magnitude of intention to use long-acting contraceptive methods was 39.8%. Intention to use long-acting contraceptive methods was higher for women whose husbands were farmers when compared to women whose husbands were government employees (ß =0.49, 95% CI: 0.41, 0.72). Number of children wanted (ß = -0.19, 95% CI: -0.28, -0.1), attitude (ß = 0.34, CI: 0.23, 0.46), subjective norm (ß = 19, 95% CI: 0.12, 0.27) and perceived behavioral control (ß = 0.18, 95% CI: 0.06, 0.3) were factors significantly associated with intention to use long-acting contraceptive methods. Conclusions: Intention to use long-acting contraceptive methods was low. Interventions that focus on women's attitudes toward long-acting contraceptive methods and support groups, peer education, social mobilization, and persuasive communication could promote the intention to use long-acting contraceptive methods.

Understanding the risk perception of visceral leishmaniasis exposure and the acceptability of sandfly protection measures among migrant workers in the lowlands of Northwest Ethiopia: a health belief model perspective.

BACKGROUND: Visceral leishmaniasis (VL) is the leading cause of health concerns among Ethiopian migrant workers. Understanding risk perception and health-protective behavior are significant challenges in the prevention and eradication of the disease. As a result, studies are required to assess these important epidemiological factors, which will provide guidance on how to assist migrant workers in taking preventive measures against VL. METHOD: We conducted qualitative research among migrant workers on seasonal agricultural farms in Northwest Ethiopia between June and November 2019 to assess their perception of the risk of contracting VL and their willingness to use protective measures against the disease. Seventeen focus group discussions and 16 key informant interviews were conducted to study migrant workers' risk perception in relation to sandfly bite exposure and use of sandfly control measures. For analysis, all interviews were recorded, transcribed, and translated. ATLASti was used to perform qualitative content analysis on the data. RESULT: Migrant workers are fearful of VL because of previous exposure and the disease's prevalence in the area. They believe, however, that VL is a minor illness that is easily treated. While Insecticide Treated Nets (ITNs) are widely accepted as a protective measure, there are still reservations about using them due to the seasonality of the transmission, difficulties in hanging them on farm areas, and a preference for alternative traditional practices. Regardless of perceived self-efficacy, the central cues were the message delivered by the health workers and an increase in sandfly bite irritation. Based on the findings, three levels of intervention modalities are suggested: 1) increasing pre-arrival awareness through outdoor media (posters, stickers, billboards), 2) encouraging proper use of protective measures upon arrival at farm camps, and 3) informing departing workers on disease recognition and best practices for health-seeking continuous use of protective measures at home. CONCLUSION: This finding suggests that VL prevention interventions should focus on individuals' perceptions in order to promote consistent use of protective measures. The findings are highly useful in planning effective interventions against VL.

Does Patients' Perception Affect Self-Care Practices? The Perspective of Health Belief Model.

BACKGROUND: Poor lifestyle choices contribute to the continued growth of chronic illness and disability. Patients with diabetes require continuous self-care choices and management to minimize the short- and long-term impact of the disease. This study aimed at assessing the use of the health belief model to describe self-care practices among patients with diabetes. METHODS: An institutional-based cross-sectional study was conducted from February to March 2019 in Gondar City, Northwest Ethiopia. A total of 396 diabetics patients were selected using a systematic random sampling technique. Pretested, structured, and interview administered questionnaire was used for data collection. The collected data were analyzed using STATA 14. Bivariate and multivariate logistic regression models were fitted to identify the factors associated with self-care behavior. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and p-values <0.05 were used to declare statistical association. RESULTS: Health belief model described 48% of the variance in self-care practices of patients with diabetes. More than half (55.6%) of diabetic patients had good self-care practice. Of the participants, 45.8% and 49.9% had low perceived susceptibility and perceived severity, respectively. The strongest correlation was found between cues to action and perceived severity of health belief model constructs (P<0.001). Formal education, longer duration of diabetes, high social support, high perceived severity, and high self-efficacy contributed to good self-care practices, whereas comorbidities, high perceived benefit, and high perceived barrier were associated with poor self-care practices. CONCLUSION: Self-care practice of diabetes patients in Gondar City was considerably low. Health professionals need to strengthen delivering tailored health messages on the benefit self-care practices and means of overcoming the potential barriers. Health communication programs are also better to consider for individuals with comorbidities, lack of social support, and lower education.

Magnitude of home delivery and associated factors among child bearing age mothers in Sherkole District, Benishangul Gumuz regional state-Western-Ethiopia.

BACKGROUND: The World Health Organization estimates that globally only 43% of women have access to skilled care during deliveries and the rest are exposed to unskilled delivery service. A recent Ethiopian Demographic and Health Survey report stated that maternal death was 412 per 100,000 in 2016.This still indicates that maternal health remains a major public health problem in Ethiopia irrespective of the government's measure to institutional delivery. Therefore, the aim of this study was to assess the magnitude of home delivery and associated factors among women of child bearing age in Sherkole district, Western Ethiopia. METHODS: A community based cross sectional study was conducted among women aged 15-49 years in Sherkole district, Benishangul Gumuz region from January to June 2018. A total of 451 randomly selected women were included in the study. Stratified sampling followed by simple random sampling technique was used to select the study participants. Data were collected using pretested and structured questionnaires. Bivariate and multivariate logistic regression models were fitted to identify factors associated with home delivery among women in the child bearing age. An adjusted odds ratio with a 95% confidence interval was computed to determine the level of significance. RESULTS: The magnitude of home delivery was 353 (80%) and were assisted by non-skilled birth attendants. Mothers whose husband chooses the place of delivery [AOR: 5.6, 95% CI (2.1-15.2), Mothers' occupation ([AOR: 0.21 95% C I (0.08-0.57), ANC visit [AOR: 95 CI: 5.1(1.6-15.8), decision making [AOR: 95 CI: 0.3(0.01-0.7)] and traditional remedies [AOR: 95%CI: 0.03 (0.01-0.09)] were significantly associated with home delivery. CONCLUSIONS: Based on the findings of the survey, it was concluded that the overall magnitude of home delivery was found to be high. Therefore, it is recommended that the promotion of antenatal care follow-up with maternal and child health information particularly on delivery complications or danger signs needs due attention and remedial actions. In addition, it is indispensable introducing defaulter tracing mechanisms in ANC services, by learning from experiences of settings that have already adopted it.

Prevalence of sexually transmitted infections and associated factors among the University of Gondar students, Northwest Ethiopia: a cross-sectional study.

INTRODUCTION: Globally, sexually transmitted infections (STIs) remain a major public health problem. University students tend to practices sex which predisposes them to sexually transmitted infections, unwanted pregnancies, and unsafe abortions due to their freedom from families. Therefore, the study aimed to assess the prevalence of sexually transmitted infections and associated factors among the University of Gondar students, northwest Ethiopia. METHODS: An institution based cross-sectional study was conducted on 845 the University of Gondar students selected using the multistage sampling technique from March 7-10, 2016. The data were collected using a structured, pre-tested self-administered questionnaire. Bivariate and multivariable logistic regression analyses were employed through SPSS version 20 to identify factors associated with sexually transmitted infections. Odds ratio with a 95% confidence interval was computed to determine the level of association. In the multivariable analysis, variables with p-value less than 5% were considered as statistically significant association between covariates and sexually transmitted infections. RESULT: Sexually transmitted infections among university students were found to be 18.20% (95%CI,15.40,20.80). Previous history of sexually transmitted infections (AOR = 2.1; 95%CI: 1.04, 4.38), multiple sexual partners in life (AOR = 2.7; 95%CI:1.70, 4.40), not use of condoms during sexual intercourses (AOR = 2.4; 95%CI:1.50,3.75) and poor knowledge of sexually transmitted infections (AOR = 3.3; 95%CI:1.09,5.32) were significantly associated with sexually transmitted infections. CONCLUSION: The prevalence of STIs was high among university students. The previous history of sexually transmitted infections, multiple sexual partners, not using condoms during sexual intercourse and poor knowledge of sexually transmitted infections were found to be associated with the infections. Opening and strengthen reproductive health centers on the campuses, popularizing sexual, and reproductive health information and education, particularly on STI modes of transmission, prevention, and health-seeking behaviors, and providing information on accessing of condoms is recommended to reduce sexually transmitted infections.

Prevalence and associated factors of active trachoma among childeren aged 1-9 years in rural communities of Gonji Kolella district, West Gojjam zone, North West Ethiopia.

BACKGROUND: Trachoma is the leading infectious cause of blindness worldwide. Though trachoma can be treated with antibiotic it is still endemic in most part of Ethiopia. METHODS: A community based cross-sectional study was conducted among 618 children 1-9 years of age from December 2013 to June 2014. A multistage systematic sampling technique was applied. Data were collected using pretested and structured questionnaire and also observation by using binocular loupe to differentiate active trachoma cases. The World Health Organization's simplified classification scheme for assessing trachoma in community based surveys was used for the purpose. Bivariate and multivariate logistic regression model was fitted to identify factors associated with trachoma among children aged 1-9 years. An adjusted odds ratio with 95 % confidence interval was computed to determine the level of significance. RESULTS: The overall prevalence of active trachoma among children aged 1-9 years were 23.1 % (Trachomatous inflammation-Follicular, in 22.5 % (95 % CI: 22.3-22.69 %); Trachomatous inflammation-Intense, in 0.6 % (95 % CI: 0.4-0.79 %). Family size (>5) (AOR = 14.32, 95 % CI = 6.108-33.601), number of children under 10 years of age within household (AOR = 25.53, 95 % CI = 9.774-66.686), latrine utilizations (AOR = 10.274, 95 % CI = 4.274-24.968), route of waste disposal (AOR = 3.717, 95 % CI = 1.538 to -8.981), household literacy (AOR = 2.892, 95 % CI = 1.447-5.780), cattle housing practice (AOR = 4.75, 95 % CI = 1.815-12.431), time to collect water (AOR = 25.530, 95 % CI = 8.995-72.461), frequency of face washing practice (AOR = 6.384, 95 % CI = 2.860-14.251) and source of water (AOR = 2.353, 95 % CI = 1.134-4.882) were found to be associated with the presence of active trachoma in this study population. CONCLUSION: The prevalence of active trachoma among rural communities of children aged 1-9 years was found to be high in reference to WHO recommended thresholds to initiate trachoma control recommendation (>10 % prevalence), which indicates that active trachoma is still a major public health concern in the study area. Therefore, it is recommended that coordinated work on implementing the WHO endorsed SAFE strategy in particular and enhancing the overall living conditions of the community is crucial.