RESUMO
BACKGROUND: Voluntary counseling and testing (VCT) is a vital response to human immunodeficiency virus (HIV) infection among adolescents in sub-Saharan Africa. Determining the status of VCT services is important to link HIV care and antiretroviral therapy. METHODS: An institutional cross-sectional study design was conducted among 841 young students at Gondar College of Teachers' Education. A self-administered questionnaire was used to gather the data. Descriptive statistics were performed. Bivariate and multivariable binary logistic regressions were used to identify factors associated with the use of VCTs. The adjusted odds ratio (AOR) with 95% confidence was used to report statistical significance. RESULTS: The majority (71%) were aware of VCT services. More than one-third (37.8%, 95% CI: 34.6-41.2) participants had used VCT services. Having peer groups used VCT (AOR=2.04, 95% CI: 1.31-3.20), having partner (AOR: =1.6, 95% CI: 1.04-2.45), desiring to have VCT in the future (AOR=3.58, 95% CI: 1.98-6.50), being aware of VCT (AOR= 1.98, 95% CI: 1.20-3.34), knew infected/dead individuals with HIV/AIDS (AOR=1.67, 95% CI: 1.07-2.61), know test sites (AOR=2.01, 95% CI: 1.29-3.13) were positively associated, whereas being married (AOR=0.36, 95% CI: 0.20-0.63) and fear of confidentiality (AOR=0.23, 95% CI: 0.10-0.52) were major barriers to use. CONCLUSION: Low use of VCTs, which was far away from the 90:90:90 WHO goal, has been noted. The use of VCT services was associated with having peer groups that used VCT, having a partner, wanting to have VCT in the future, knowing the infected/dead individual with HIV/AIDS, fear of confidentiality of results, knowing the test sites, and having awareness of VCT. Efforts are needed to strengthen the health system that also needs to pay attention to education about HIV and VCT.
RESUMO
OBJECTIVE: Postnatal care (PNC) is essential for preventing maternal and newborn deaths; however, it still remains less well recognised in low-income and middle-income countries. This study was aimed to explore geographical patterns and identify the determinants of PNC usage among women aged 15-49 years in Ethiopia. METHODS: A secondary data analysis was conducted using the 2016 Ethiopian demographic and health survey data. A total of 7193 women were included in this analysis. We employed spatial scan statistics to detect spatial inequalities of PNC usage among women. A multilevel binary logistic regression model was fitted to identify factors associated with women's PNC. RESULTS: The prevalence of PNC usage among women was 6.9% (95% CI 6.3% to 7.5%). The SaTScan spatial analysis identified three most likely clusters with low rates of PNC use namely southwestern Ethiopia (log likelihood ratio (LLR)=18.07, p<0.0001), southeast Ethiopia (LLR=14.29, p<0.001) and eastern Ethiopia (LLR=10.18, p=0.024). Women with no education (Adjusted Odd Ratio (AOR)=0.55, 95% CI 0.37 to 0.84) and in the poorest wealth quantile (AOR=0.55, 95% CI 0.39 to 0.78) were less likely to use PNC, while women aged 35-49 years (AOR: 1.75, 95% CI 1.01 to 3.04) and with at least four antenatal care (ANC) visits (AOR=2.37, 95% CI 1.71 to 3.29) were more likely to use PNC. CONCLUSION: PNC usage remains a public health problem and has spatial variations at regional levels in the country. Low prevalence of PNC was detected in the Somali, Oromia, Gambella and Southern Nations, Nationalities, and People's Region (SNNPR) regions. Women with low educational status, old age, being in poorest wealth quantile and history of ANC visits were significantly associated with PNC usage. Hence, it is better to strengthen maternal health programmes that give special emphasis on health promotion with a continuum of care during pregnancy.
