Knowledge, attitude and practices of the resident community about visceral leishmaniasis in West Armachiho district, Northwest Ethiopia.

Visceral leishmaniasis (VL) or kala-azar is a tropical disease, which is caused by an obligate intracellular parasite of the genus Leishmania. It is transmitted by the bite of an infected phlebotomine sand fly. The disease is endemic in northwest part of Ethiopia particularly in areas bordering Sudan. Assessing the knowledge, attitude and practices (KAP) of the community is helpful to design and implement appropriate control and prevention strategies. A cross-sectional study was conducted to assess the KAP of the resident community on VL in West Armachiho district, northwest Ethiopia. Data were collected by using pretested and well-structured questionnaire. Two villages (Abderafi and Abrehajira) were selected randomly. Households engaged in the study were selected by systematic random sampling method and then finally, simple random sampling was used to engage a maximum of two individuals per household. A total of 422 participants were engaged in the study. Almost all participants heard about VL. The source of information was mainly from friends (80.8%). The highest proportion (88.2%) of participants thought that persistent enlargement of liver and spleen (enlargement of the abdomen) was the main symptom of VL. Of all participants, only 52.1% knew sand fly as the vector of the disease. The overall assessment of participants indicated that 21.1% were knowledgeable, 53.6% had positive attitudes and 14.9% had optimal practices on VL. In conclusion, the survey indicated that participants had better attitude about VL. However, there were a large gap in knowledge and practices. The misunderstanding and incorrect practices may remain serious concerns in the control and prevention of the disease. It is recommended that health education program should be strengthened to increase peoples' awareness and improve their practices on VL in the district and further studies are strongly suggested for better understanding of the dynamics of the disease in the area.

Nursing care documentation practice: The unfinished task of nursing care in the University of Gondar Hospital.

INTRODUCTION: Even though nursing care documentation is an important part of nursing practice, it is commonly left undone. The objective of this study was to assess nursing care documentation practice and the associated factors among nurses who are working at the University of Gondar Hospital. METHODS: An institution-based cross-sectional study was conducted among 220 nurses working at the University of Gondar Hospital inpatient wards from March 20 to April 30, 2014. Data were collected using a structured and pre-tested self-administered questionnaire. Data were entered into Epi Info version 7 and analyzed with SPSS version 20. Descriptive statistics, bivariate, and multivariate logistic regression analyses were carried out. RESULTS: Two hundred and six nurses returned the questionnaire. Good nursing care documentation practice among nurses was 37.4%. A low nurse-to-patient ratio AOR = 2.15 (95%CI [1.155, 4.020]), in-service training on standard nursing process AOR = 2.6 (95%CI[1.326, 5.052]), good knowledge AOR = 2.156(95% CI [1.092, 4.254]), and good attitude toward nursing care documentation AOR = 2.22 (95% CI [1.105, 4.471] were significantly associated with nursing care documentation practice. CONCLUSION: Most of the nursing care provided remains undocumented. Nurse-to-patient ratio, in-service training, knowledge, and attitude of nurses toward nursing care documentation were factors associated with nursing care documentation practice.

Obstacles to implementation of an intervention to improve surgical services in an Ethiopian hospital: a qualitative study of an international health partnership project.

BACKGROUND: Access to safe surgical care represents a critical gap in healthcare delivery and development in many low- and middle-income countries, including Ethiopia. Quality improvement (QI) initiatives at hospital level may contribute to closing this gap. Many such quality improvement initiatives are carried out through international health partnerships. Better understanding of how to optimise quality improvement in low-income settings is needed, including through partnership-based approaches. Drawing on a process evaluation of an intervention to improve surgical services in an Ethiopian hospital, this paper offers lessons to help meet this need. METHODS: We conducted a qualitative process evaluation of a quality improvement project which aimed to improve access to surgical services in an Ethiopian referral hospital through better management. Data was collected longitudinally and included: 66 in-depth interviews with surgical staff and project team members; observation (135 h) in the surgery department and of project meetings; project-related documentation. Thematic analysis, guided by theoretical constructs, focused on identifying obstacles to implementation. RESULTS: The project largely failed to achieve its goals. Key barriers related to project design, partnership working and the implementation context, and included: confusion over project objectives and project and partner roles and responsibilities; logistical challenges concerning overseas visits; difficulties in communication; gaps between the time and authority team members had and that needed to implement and engage other staff; limited strategies for addressing adaptive-as opposed to technical-challenges; effects of hierarchy and resource scarcity on QI efforts. While many of the obstacles identified are common to diverse settings, our findings highlight ways in which some features of low-income country contexts amplify these common challenges. CONCLUSION: We identify lessons for optimising the design and planning of quality improvement interventions within such challenging healthcare contexts, with specific reference to international partnership-based approaches. These include: the need for a funded lead-in phase to clarify and agree goals, roles, mutual expectations and communication strategies; explicitly incorporating adaptive, as well as technical, solutions; transparent management of resources and opportunities; leadership which takes account of both formal and informal power structures; and articulating links between project goals and wider organisational interests.

Knowledge and utilization of information communication technology (ICT) among health science students at the University of Gondar, North Western Ethiopia.

BACKGROUND: Despite the relatively huge ICT investment and policy deployment in higher institutions in Ethiopia, there is still scant information about the success of implementation of the Information Communication Technology (ICT) in the higher education. This study, therefore, was carried out with an aim to assess knowledge and utilization of Information Communication Technology (ICT) among medicine and health science students and its associated factors in Gondar College of Medicine and Health sciences, University of Gondar. METHODS: A cross-sectional study was conducted at the College of Medicine and Health Sciences, University of Gondar, Ethiopia. Data regarding socio-demographic characteristics of the students, level of knowledge and utilization of ICT were collected by means of a self-administered questionnaire. Data was analyzed using SPSS version 13. RESULTS: A total of 1096 students responded giving a response rate of 97.8%. The mean age of the study participants was 20.3 (±1. 3) years. Females constitute only 26% of the respondents. The majority (79%) were fulltime students. Only half of the respondents (51%) had ICT knowledge and only 46% students utilized ICT while 47% of the respondents never used electronic communication (e.g. email or chat room) and 39% of the respondents never used Microsoft office (e.g. word (®) or WordPerfect (®)). ICT knowledge [AOR = 2.5, 95% CI: 1.7-3.5], family educational background [AOR = 4.36, 95% CI: 2.16-8.80], and perceived quality of training [AOR = 1.9, 95% CI: 1.3-2.8] showed strong and positive associations with ICT utilization. Students from urban areas were more likely to utilize ICT compared with those from rural areas [AOR = 2.7, 95% CI: 2.097, 3.497], and information technology training was found to be positively associated with ICT utilization [AOR = 2. 07, 95% CI: 1.18, 3.62]. CONCLUSIONS: The result showed that students' knowledge was inadequate and utilization of ICT was poor. Therefore, the university should sustain professional development to improve teaching, to raise student performance and equip the college with student centered ICT computer labs to increase students' ICT utilization.

Age at menarche and the menstrual pattern of secondary school adolescents in northwest Ethiopia.

BACKGROUND: Population studies on normal and dysfunctional characteristics of menstrual cycles are scarce in Ethiopia. In addition variability in menarcheal age and menstrual characteristics are common. Knowledge on this variability is necessary for patient education and to guide clinical evaluation. METHODS: A cross sectional study was conducted in two small towns called Dabat and Kola Diba, northwest Ethiopia between April and May 2007. Systematic sampling method was used to select 622 school girls from two secondary schools. A pretested questionnaire prepared in Amharic was used to gather data. Selected girls cooperated in answering the questionnaire in their classrooms under the supervision of the research team. Only 612 of the adolescent females were included in the final analysis, of which 305 were from Koladiba High School and 307 from Dabat. RESULTS: The age of the study subjects ranges between 14 and 19 with a mean (standard deviation) of 16.9 +/- 1 years. About 92.2% had attained menarche by the time the survey was conducted. The probit analysis of the status quo data yielded a median (CI) age at menarche of 14.8 (13.9-15.3) years. The average age at menarche by recall method was 15.8 +/- 1 years. The mean age at menarche was 0.3 years younger for urban females compared with rural ones (p < 0.001). A cycle length between 21 and 35 days was observed in 70.3% of the girls. The mean duration of flow was 4 +/- 1.3 days with a range of 2-7 days. The menstrual cycles were irregular in 42.8% of the subjects. The overall prevalence of dysmenorrhoea was 72% among these subjects. Premenstrual symptoms were present in 435 of the females (75.4%). The leading sources of menarcheal information to the adolescents were mothers (39.7%), followed by their friends (26.6%) and teachers (21.8%). CONCLUSION: In this study age of menarche was found to be delayed which is even higher than the findings indicated similar studies conducted in Ethiopia and other African countries. A significant number of students complain of abnormal menstrual cycle, dysmenorrhoea and premenstrual symptoms which call for appropriate counselling and management.