Prevalence of Hepatitis B Virus Infection and Associated Factors Among High School Students in Shinshicho Town, Southern Ethiopia.

Background: Early identification of people living with hepatitis B virus infection is required to initiate treatment and care, prevent community transmission, and expand vaccination. However, only an estimated 10% of people living with chronic hepatitis B infection are diagnosed, and only 2% are on treatment globally. This study aimed to assess the prevalence of hepatitis B virus infection and its associated factors among high school students in Shinshicho Town, southern Ethiopia. Methods: An institutional-based cross-sectional study was conducted among 380 high school students in Shinshicho Town, southern Ethiopia, from September to October 2022. A laboratory investigation of hepatitis B surface antigen was done to determine infection status. An odds ratio with a 95% confidence interval was used to declare statistical significance. Results: The prevalence of hepatitis B virus infection among high school students in Shinshicho town was observed to be 7.6% (95% CI: 5.5, 10.5%). Age 20 to 24 years [AOR: 2.7; 95% CI: (1.0-7.0)], rural residence [AOR: 3.4; 95% CI: (1.3-8.9)], and history of unprotected drug injection [AOR: 11.3; 95% CI: (3.7-34.8)] were independently associated with hepatitis B virus infection. Conclusion: A high prevalence of hepatitis B virus infection was observed among high school students in this study. Therefore, strengthening the school-based screen-and-treat program, especially targeting students from rural areas and young adults, and conducting awareness campaigns about the importance of practicing safe behaviors, such as avoiding unprotected drug injections, could contribute to the prevention and control of hepatitis B virus infection among high school students.

Disparities in Postpartum Depression Among Urban and Rural Mothers in Hadiya Zone Shashogo District Southern Ethiopia Community-Based Comparative Cross-Sectional Study.

Introduction: Postpartum depression (PPD) is a nonpsychotic depressive state that begins after childbirth. In Ethiopia, there was limited evidence about the prevalence and factors associated with PPD in terms of residence. Objective: To assess disparities in PPD among urban and rural mothers in the Shashogo district, Hadiya zone southern Ethiopia 2022. Methods: Community-based comparative cross-sectional study design was employed from May 3 to July 3, 2022. A sample size of 556 (185 from urban and 371 from rural) was calculated using a double population proportion approach and mothers in the postpartum period were randomly selected from both urban and rural settings using stratification followed by single stage and the systematic random sampling method. Data were gathered by trained data collectors using an interviewer-administered questionnaire and analyzed using SPSS Version 25. Statistical significance was declared at a P value of < .05. Results: One hundred forty-four (26.6%) mothers in the postpartum period with 95%CI [23-30] were depressed, of which 37 (19.8%) with 95% CI [14-26] in urban and 107 (30%) with 95% CI [25-35] found in a rural setting. Unplanned pregnancy, low maternal social support, assisted delivery, no antenatal care (ANC) follow-up, no postnatal care (PNC) follow-up, and low household income were independent predictors of PPD in rural residence whereas unplanned pregnancy, low maternal social support, assisted delivery, and antenatal depression were independent predictor of PPD in urban. Conclusion: PPD was found to be high in the study area as compared to national/global burden. Unplanned pregnancy, low maternal social support, and assisted delivery were predictors for both urban and rural. Low income, no ANC, and PNC follow-up were associated with PPD in rural settings only whereas antenatal depression is a predictor of PPD in urban settings.

Decomposition Analysis of Antenatal Care Utilization Inequities in Kembata Tembaro Zone, Southern Ethiopia.

Background: Health equity has emerged as a global issue in the post-2015 Sustainable Development Goals, and Ethiopia is no exception. Despite positive improvements, inequities in maternal health service utilization among demographic groups continue to be one of Ethiopia's significant challenges in decreasing maternal mortality. This study focuses on antenatal care service discrimination among a local poor group known as the "golden hands" community in Ethiopia's Kembata Tembaro zone. The subgroup community consists of outcast artesian groups known as "golden hands," formerly known as "Fuga," who face discrimination in all aspects of life owing to their living conditions and ethnic background. Methods: A community-based comparative cross-sectional study was conducted in Ethiopia's Kembata Tembaro, zone in the Southern Nations, Nationalities, and Peoples' Region (SNNPR), from January to February 2022. The study focused on two groups, "golden hands" and "non-golden hands," consisting of women aged 15-49 years. Using stratified and multistage cluster sampling, 1,210 participants were selected, with 440 from golden hand communities and 770 from non-golden hand communities. Data was collected through translated questionnaires, and data quality was rigorously monitored. The concentration curve and index, as well as logistic-based decomposition analysis, were used to examine inequality. The statistical significance threshold was set at p < 0.05 with a 95% confidence interval. Result: This study comprised 1,210 eligible participants, 440 of whom were golden hand community members. Discrimination accounted for 60.23% of the decreased antenatal care (ANC) service use by the golden hand community. Age, urban residence, and wealth index were the most important independent factors with statistically significant contributions to changes owing to differences in effects (discriminated difference). Conclusion: Since ANC service discrimination is prevalent, the government and nongovernmental organizations should take steps to ensure that marginalized groups in society, such as golden hand women, the poor, the uneducated, and rural people, have equal access to service utilization opportunities.

Preconception care in sub-Saharan Africa: A systematic review and meta-analysis on the prevalence and its correlation with knowledge level among women in the reproductive age group.

Objective: Preconception care is aimed to promote optimal health in women before conception to reduce or prevent poor pregnancy outcomes. Although there are several published primary studies from sub-Saharan African countries on preconception care, they need to quantify the extent of preconception care utilization, the knowledge level about preconception care, and the association among women in the reproductive age group in this region. This systematic review and meta-analysis aimed to estimate the pooled utilization of preconception care, pooled knowledge level about preconception care, and their association among women in the reproductive age group in sub-Saharan Africa. Methods: Databases including PubMed, Science Direct, Hinari, Google Scholar, and Cochrane library were systematically searched for relevant literature. Additionally, the references of included articles were checked for additional possible sources. The Cochrane Q test statistics and I 2 tests were used to assess the heterogeneity of the included studies. A random-effect meta-analysis model was used to estimate the pooled prevalence of preconception care, knowledge level of preconception care, and their correlation among reproductive-aged women in sub-Saharan African countries. Results: Of the identified 1593 articles, 20 studies were included in the final analysis. The pooled utilization of preconception care and good knowledge level about preconception care among women of reproductive age were found to be 24.05% (95% confidence interval: 16.61, 31.49) and 33.27% (95% confidence interval: 24.78, 41.77), respectively. Women in the reproductive age group with good knowledge levels were greater than two times more likely to utilize the preconception care than the women with poor knowledge levels in sub-Saharan African countries (odds ratio: 2.35, 95% confidence interval: 1.16, 4.76). Conclusion: In sub-Saharan African countries, the utilization of preconception care and knowledge toward preconception care were low. Additionally, the current meta-analysis found good knowledge level to be significantly associated with the utilization of preconception care among women of reproductive age. These findings indicate that it is imperative to launch programs to improve the knowledge level about preconception care utilization among women in the reproductive age group in sub-Saharan African countries.

The uptake of key Essential Nutrition Action (ENA) messages and its predictors among mothers of children aged 6-24 months in Southern Ethiopia, 2021: A community-based crossectional study.

BACKGROUND: Essential nutrition action(ENA) is a framework for managing advocacy, establishing a foundation, and implementing a comprehensive package of preventive nutritional activities. Essential Nutrition Actions study studies provide current information on each nutrition action, allowing health systems to focus more on nutrition, which is critical in tackling the "double burden" of malnutrition: underweight and overweight. Hence, this study aimed at assessing the level of ENA practice and its predictors among mothers of children aged 6 to 24 months in southern Ethiopia. METHODS: A community-based cross-sectional study was conducted from May 1 to 30, 2021 among randomly selected 633 mothers of children aged 6-24 months. A multi-stage sampling technique was used to access study participants. Data were collected by using a pretested, structured interviewer-administered questionnaire. To identify predictors of ENA practice, bivariable and multivariable logistic regression were used. The strength of the association was measured using an adjusted odds ratio with 95 percent confidence intervals. The statistical significance was declared at a p-value less than 0.05. RESULTS: A total of 624 participants took part in the study, with a response rate of 98.6%. The uptake of key ENA messages among mothers was measured using 27 items, and it was found to be 47.4% (95% CI: 43.8, 51.4). Complementary feeding was the commonest ENA message practiced by 66.7% of respondents, while prevention of iodine deficiency disorder was practiced by only 33.7% of respondents. Variables namely, mother's education level of college and above [AOR: 3.90, 95% CI: 1.79, 8.51], institutional delivery [AOR: 2.75, 95% CI: 1.17,6.49], having PNC service [AOR: 2.95, 95% CI: 1.91, 4.57], being knowledgeable on ENA message [AOR: 2.37, 95% CI: 1.81, 3.26] and being a model household [AOR: 3.83,95% CI: 2.58, 5.69] were positively associated with a good uptake of key ENA messages. On the other hand, primiparity [AOR: 0.32, 95% CI: 0.21,0.56] was identified as a negative predictor. CONCLUSION: The overall practice of key Essential nutrition action messages in the study area was low as compared to studies. Stakeholders must step up their efforts to improve and hasten the utilization of maternal and child health services, especially institutional delivery and Postnatal care by focusing on uneducated women to promote compliance to key ENA messages. Furthermore, health workers need to focus on awareness-raising and model household creation.

Towards universal health coverage: The level and determinants of enrollment in the Community-Based Health Insurance (CBHI) scheme in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: Community-based health insurance (CBHI) is a risk-pooling approach that tries to disperse health expenditures across families with varying health profiles to provide greater access to healthcare services by allowing cross-subsidies from wealthy to poor populations. It is crucial to assess the level of CBHI enrolment and its determinants in Ethiopia, where government health spending is limited to less than 5% of GDP, far below the Alma Ata Declaration's benchmark of 15%. Although various epidemiological studies on CBHI enrolment status and its determinants have been undertaken in Ethiopia, the results have been inconsistent, with significant variability. However, no nationwide study assessing the pooled estimates exists today. Furthermore, the estimated strength of association at the country level varied and was inconsistent across studies. Hence, this systematic review and meta-analysis aimed at estimating the pooled prevalence of CBHI enrolment and its determinants in Ethiopia. METHODS: A comprehensive search of studies was done by using PubMed, EMBASE, Science Direct, HINARI, Scopus, Web of Science, and the Cochrane Library. The database search was complemented by google scholar and some repositories for grey literature. The search was carried out from February 11 to March 12, 2022. The relevant data were extracted using a Microsoft Excel 2013 spreadsheet and analyzed using STATATM Version 16. Studies reporting the level and determinants of CBHI enrolment in Ethiopia were considered. A weighted DerSimonian Laired random effect model was applied to estimate the pooled national prevalence of CBHI enrolment. The Cochrane Q test statistics and I2 tests were used to assess the heterogeneity of the included studies. A funnel plot, Begg's and Egger's tests, were used to check for the presence of publication bias. RESULTS: Fifteen studies were eligible for this systematic review and meta-analysis with a total of 8418 study participants. The overall pooled prevalence of CBHI enrolment in Ethiopia was 45.5% (95% CI: 32.19, 58.50). Affordability of premium for the scheme[OR = 2.58, 95% CI 1.68, 3.47], knowledge of respondents on the CBHI scheme[OR = 4.35, 95% CI 2.69, 6.01], perceived quality of service[OR = 3.21, 95% CI 2.04, 4.38], trust in the scheme[OR = 2.32, 95% CI 1.57, 3.07], and the presence of a person with a chronic disease in the household [OR = 3.58, 95% CI 2.37, 4.78] were all found to influence CBHI enrolment. CONCLUSION: Community health workers (CHWs) need to make a high effort to improve knowledge of CBHI in rural communities by providing health education. To deal with the issue of affordability, due emphasis should be placed on building local solidarity groups and strengthening local initiatives to aid poor members. Stakeholders in the health service delivery points need to focus on the dimensions of high service quality. The financial gap created by the adverse selection of households with chronically ill members should be rectified by implementing targeted subsidies with robust plans.

Predictors of uncircumcised primary school girls' intention to genital cutting in South Ethiopia: Application of theory of planned behavior.

BACKGROUND: Female genital cutting (FGC) is still among the most common harmful traditional practices, especially in Africa and Asia. Despite the existence of rich evidence on the prevalence of FGC, information about the primary target audiences' (girls') intention toward FGC is limited. Therefore, this study aimed to identify the predictors of primary school girls' behavioral intention toward female genital cutting. METHODS: An institution-based cross-sectional study was conducted from May 08 to 28, 2019 in Dunna district, South Ethiopia. A two-stage sampling technique was used to select 354 uncircumcised female students. A self-administered pre-tested structured questionnaire was used for data collection. Data were entered into Epi data manager version 4.0.2 and exported to STATA version 16.0. Descriptive analyses such as frequency, percentage, mean and standard deviation were performed as necessary. Univariable and multivariable linear regression analyses were conducted to identify predictors of primary school girls' intention to experience FGC. RESULTS: The mean age of the respondents was 13.09±1.69 years with an age range of 10 to 18 years. Of the 354 respondents, 156 (44.1%) intended to experience FGC. The model accounted for 76.58% of the variance in primary school girls' intention to experience FGC. Among socio-demographic characteristics, mothers' educational level of ≤8 grade (ß = 1.95, p<0.001) and the age of the respondents (ß = -0.23, p = 0.036) predicted primary school girls' intention toward FGC. Among the constructs of the theory of planned behavior (TPB), direct perceived behavioral control (ß = 0.47, p = 0.015), indirect perceived behavioral controls (ß = 0.05, p = 0.002), and direct subjective norms (ß = 0.18, p = 0.039) predicted primary school girls' intention to experience FGC. CONCLUSIONS: In this study, we found that primary school girls' intention toward FGC was high. The educational level of mothers and the age of the respondents had a great influence on primary school girls' intention to experience FGC. Perceived lack of power and social pressure also predicted primary school girls' intention to engage in genital cutting. The findings suggest that FGC is mainly performed by the decision of the parents irrespective of the girls' preferences. Therefore, behavioral change communication interventions such as media campaigns, peer education and community dialogue guided by the TPB for empowering girls to confront FGC and reducing the influence of referents need to be focused.

Prevalence and associated factors of intimate partner violence among pregnant women attending health care facilities, Northern Ethiopia: comparative cross-sectional study.

Intimate partner violence (IPV) is a major public health problem. While it is high among pregnant women in Ethiopia, the cases are under-reported, and the true extent of the issue is uncertain. The study is intended to determine the prevalence and determinants of IPV among pregnant women seeking antenatal care (ANC). A comparative cross-sectional survey was conducted in healthcare facilities, Northern Ethiopia, in 2019. A sample of 324 pregnant women visiting ANC service was selected by systematic sampling. Binary logistic regression was conducted to identify significant determinants. The prevalence of IPV during pregnancy was 36.3%. Lack of formal schooling, rural life, husband's additional sexual partners, lack of shared decisions, and partners' alcohol intake were identified as a predictor of IPV. It is important to consider raising awareness, enhancing women's decision-making abilities, and educating women. Furthermore, partner involvement should be addressed to minimize violence against women in the community.IMPACT STATEMENTWhat is already known on this subject? Intimate partner abuse (IPV) is a global public health problem as well as a significant violation of human rights, and Ethiopia has the world's highest rates of physical and sexual IPV. The immediate effect of IPV during pregnancy (sexually transmitted infections (STI), intrauterine growth retardations (IUGR), preterm labour, miscarriage, abortion, antepartum haemorrhage, perinatal death) was known.What do the results of this study add? Even though the outcome of IPV among pregnant women was recognised, the underlying factors of the violence were not well understood. As a result, this research will contribute to our understanding of the determinants of IPV among pregnant women.What are the implications of these findings for clinical practice and/or further research? In this research, we revealed that the majority of the determinants of IPV among pregnant women were linked to their husband's behaviour, and that women's decision-making capacity and educational level were also root causes of the violence. Therefore, Women empowerment and partner participation during antenatal care would offer outstanding feedback to reduce partner violence. Aside from that, more research in family health would provide in-depth knowledge about the root cause of the violence.

Factors associated with childhood underweight among orphaned preschool children: A community-based analytical cross-sectional study in Southern Ethiopia.

BACKGROUND: Childhood underweight is one of the major public health problems in Ethiopia. In Ethiopia, most of the available evidence is related to the general community children, which had different risk and severity levels than orphan children. Even though under-five orphan children have a higher risk of being underweight, they are the most neglected population. OBJECTIVE: The study aims to determine the prevalence and factors associated with childhood underweight among orphaned preschool children in Southern Ethiopia. METHODS: A community-based analytical cross-sectional study was conducted among 367 orphans. The burden of childhood underweight was assessed using World Health Organization standard cutoff points below -2 SD using z-scores. All variables with a p-value of < 0.25 during binary logistic regression analysis were entered into a multivariate logistic regression analysis to identify predictor variables independently associated with underweight at a p-value of 0.05 with 95% CI. RESULTS: In this study, the prevalence of underweight among orphan children was 27.4%. The main factors associated with underweight were female child (adjusted odds ratio (aOR) = 5.29, 95% confidence interval (CI) (2.83-9.92)), adult food as type of first complementary food (aOR = 2.47; 95% CI (1.24-4.94)), food insecurity (aOR = 1.98; 95% CI (1.23-3.21)), and child age from 24-59 months (aOR = 7.19; 95% CI (3.81-13.60)). CONCLUSION: Childhood underweight is a public health problem in the study area. The sex of a child, type of first complementary food, household food security status, and child age were the major predictors of underweight. Therefore, appropriate dietary interventions, nutrition education, and increased food security status of orphan children are highly recommended.

Process Evaluation of Skilled Delivery Service in Hadiya Zone in Southern Nations, Nationalities, and Peoples Region, Ethiopia.

Pregnancy-related death is a cause for maternal and newborn mortality and morbidity as well as an obstacle for economic growth. Three-quarters of mothers' lives can be saved if women have access to a skilled health worker at delivery and emergency obstetric care. This evaluation was conducted to assess skilled delivery service implementation level by using three dimensions (availability, compliance, and acceptability) and identify major contributing issues for underutilization of the service. The evaluation design is cross-sectional. The study included 846 mothers who gave birth in Hadiya zone within one year prior to study period, using one year delivery records. Epi Info 3.5.3 and SPSS version 16 were employed for data analysis. Based on selected indicators, resource availability was inadequate for health facilities, human resource medical equipment, and rooms. On the compliance dimension, skilled delivery service coverage (34.8%), active management of third stage labor (32.7%), and health information at discharge and in postnatal care (PNC) visit (7.1%) critically complied with or poorly agreed to the guidelines and targets. Regarding skilled delivery service acceptability, welcoming, privacy keeping, reassurance during labor pain, follow-up, baby care, comfortability (rooms, beds, and clothing), cost of service, and episiotomy (without local anesthesia) were not acceptable.

Household Food Insecurity and Its Association with Nutritional Status of Children 6-59 Months of Age in East Badawacho District, South Ethiopia.

Background. Ethiopia has one of the highest child malnutrition rates in the world. Food insecurity is one of the determinant factors of malnutrition in developing countries; however its role remains unclear. Objective. To assess household food insecurity and its association with the nutritional status of children 6-59 months of age in East Badawacho District, South Ethiopia. Methods. A community based cross-sectional study was conducted from February 20 to 30, 2014 on a sample of 508 mother/child pairs of 6-59-month-old children. Sample households with eligible children were selected using systematic random sampling technique. Both bivariate and multivariate analysis were used to identify factors associated with nutritional status of children. P value of <0.05 was considered as statistically significant. Result. The prevalence of household food insecurity was 75.8%. The prevalence rates of stunting, underweight, and wasting among children were 45.6%, 26.3%, and 14.6%, respectively. Household food insecurity was significantly associated with underweight (AOR = 3.82; CI = 1.78-8.19) and stunting (AOR = 6.7; CI = 3.71-12.1) but not with wasting. Conclusion and Recommendation. Household food insecurity and the prevalence rates of stunting, underweight, and wasting, among children 6 to 59 months, were high. Intervention programs should focus on improving household food insecurity and nutritional status of children.