Prevalence and determinants of contraceptive utilization among married women at Dabat Health and Demographic Surveillance System site, northwest Ethiopia.

BACKGROUND: Despite the enormous benefits of family planning services, the contraceptive utilization still remains low in Sub-Saharan Africa. There is regional variation in modern contraceptive utilization in Ethiopia. Therefore, this study was aimed to determine the prevalence of modern contraceptive utilization and determinants in Dabat demographic and health surveillance system site, northwest Ethiopia. METHODS: A re-census was carried out in Dabat Health and Demographic Surveillance System (HDSS) site from October to December 2014. Data of 8271 married women collected in the re-census was used. The outcome variable was current utilization of any modern contraceptive methods whereas socio demographic and economic variables were the potential determinants considered. Bi-variable and multivariable binary logistic regression along with odds ratio and 95% confidence interval were used to describe the strength of association. RESULTS: Prevalence of modern contraceptive utilization among married women in Dabat DHSS site was found to be 32.5% (95%CI: 31.5, 33.5%). After adjusting for covariates; the odds of using modern contraceptive were 2.35 times, 1.91 times, and 1.39 times higher among women of secondary and above educational level, urban residents, and women having six and above living children, respectively. CONCLUSION: Modern contraceptive utilization was found to be very low. Effort has to be applied to improve women's educational level that increases their understanding of reproductive health issues. It is also important to give special emphasis for rural residents, those aged 20-40 years, and those with six or more living children while serving for modern contraceptive methods.

Prevalence of disability and associated factors in Dabat Health and Demographic Surveillance System site, northwest Ethiopia.

BACKGROUND: Despite the high burden of disability in Ethiopia, little is known about it, particularly in the study area. Hence, this study aimed to investigate the prevalence and factors associated with disability at Dabat Health and Demographic Surveillance System (HDSS) site, northwest Ethiopia. METHOD: A population-based study was conducted from October to December 2014 at Dabat HDSS site. A total of 67,395 people were included in the study. The multivariable binary logistic regression analysis was employed to identify factors associated with disability. The Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI) was estimated to show the strength of association. A p-value of <0.05 was used to declare statistical significance. RESULTS: One thousand two hundred twenty-eight individuals were reported to have a disability giving a prevalence rate of 1.82%, of which, about 39% was related to a vision disability. The high odds of disability were observed among the elderly (≥50 years) [AOR: 4.49; 95% CI: 1.95, 10.33], severely food in-secured [AOR: 2.11; 95% CI: 1.59, 2.80], and separated marital status [AOR: 7.52; 95% CI: 1.18, 47.84]. While having a paid job [AOR: 0.46; 95% CI: 0.28, 0.77], being in the richest quintile [AOR: 0.55; 95% CI: 0.41, 0.75], and high engagement in work-related physical activities [AOR: 0.36; 95% CI: 0.27, 0.49] were inversely associated with the disability. CONCLUSION: Disability is a major public health problem, and the burden is noticeable in the study area. Vision disability is the highest of all disabilities. Thus, efforts must be made on educating the public about disability and injury prevention. Measures that reduce disability should target the elderly, the poorer and the unemployed segment of the population.

The prevalence of non-communicable diseases in northwest Ethiopia: survey of Dabat Health and Demographic Surveillance System.

OBJECTIVE: The main objective of this study was to investigate the magnitude and associated factors of non-communicable chronic diseases (NCDs) at the Dabat Health and Demographic Surveillance System (DHDSS) site in the northwestern part of Ethiopia. DESIGN: A population-based cross-sectional study was conducted from October to December 2014. SETTING: HDSS site, Ethiopia. PARTICIPANTS: A total population of 67 397 living in 16 053 households was included in the study. MEASURES: Structured interviewer-administered questionnaire was used to collect data. Self-reported morbidity was used to ascertain NCD. A binary logistic regression model was employed to identify the determinants of NCDs. RESULT: One thousand one hundred sixty (1.7%) (95% CI 1.62 to 1.82) participants were found with at least one type of NCD. Heart disease and hypertension which accounted for 404 (32.2%) and 401 (31.9%), of the burden, respectively, were the most commonly reported NCDs, followed by 347 (27.7%) asthma, 62 (4.9%) diabetes mellitus and 40 (3.2%) cancer cases. Advanced age (≥65 year) (adjusted OR (AOR)=19.6; 95% CI 5.83 65.70), urban residence (AOR=2.20; 95% CI 1.83 to 2.65), household food insecurity (AOR=1.71; 95% CI 1.37 to 2.12) and high income (AOR=1.28; 95% CI 1.02 to 1.59) were significantly associated with the reported history of NCDs, whereas low (AOR=0.36; 95% CI 0.31 to 0.42) and moderate (AOR=0.33; 95% CI 0.22 to 0.48) alcohol consumption, farming occupation (AOR=0.72; 95% CI 0.57 to 0.91), and work-related physical activities (AOR=0.66; 95% CI 0.50 to 0.88) were inversely associated with NCDs. CONCLUSION: There is a high burden of NCDs at the Dabat HDSS site. Promotion of regular physical exercise and reducing alcohol consumption are essential to mitigate the burden of NCDs. In addition, preventive interventions of NCDs should be strengthened among urban dwellers, older age people and people of higher economic status.

Tuberculosis and HIV are the leading causes of adult death in northwest Ethiopia: evidence from verbal autopsy data of Dabat health and demographic surveillance system, 2007-2013.

BACKGROUND: Reliable data on causes of death form the basis for building evidence on health policy, planning, monitoring, and evaluation. In Ethiopia, the majority of deaths occur at home and civil registration systems are not yet functional. The main objective of verbal autopsy (VA) is to describe the causes of death at the community or population level where civil registration and death certification systems are weak and where most people die at home without having had contact with the health system. METHODS: Causes of death were classified and prepared based on the International Classification of Diseases (ICD-10). The cause of a death was ascertained based on an interview with next of kin or other caregivers using a standardized questionnaire that draws information on signs, symptoms, medical history, and circumstances preceding death. The cause of death, or the sequence of causes that led to death, is assigned based on the data collected by the questionnaire. The complete VA questionnaires were given to two blinded physicians and reviewed independently. A third physician was assigned to review the case when disagreements in diagnosis arose. RESULTS: Communicable diseases (519 deaths [48.0%]), non-communicable diseases (377 deaths [34.8%]), and external causes (113 deaths [10.4%]) were the main causes of death between 2007 and 2013. Of communicable diseases, tuberculosis (207 deaths [19.7%]), HIV/AIDS (96 deaths [8.9%]) and meningitis (76 deaths [7.0%]) were the most common causes of death. CONCLUSION: Tuberculosis, HIV/AIDS, and meningitis were the most common causes of deaths among adults. Death due to non-communicable diseases showed an increasing trend. Increasing community awareness of infections and their interrelationships, tuberculosis case finding, effective local TB programs, successful treatment, and interventions for HIV are supremely important.

Correlates of early neonatal feeding practice in Dabat HDSS site, northwest Ethiopia.

BACKGROUND: Delaying the start of breastfeeding and giving prelacteal feeding leads to a significant increase in neonatal and infant deaths, particularly in a resource limited countries, like Ethiopia. Therefore, this study aimed to assess early neonatal feeding practice and its determinants in Dabat HDSS site, northwest Ethiopia. METHODS: The census for the reconciliation of the surveillance of the Dabat Health and Demographic Surveillance System (HDSS) site was conducted from October to December 2014. Data were entered into the Household Registration System (HRS) version 2.1 and analyzed using Stata version 14. A total of 6,761 mother-child pairs were included in the study. Sociodemographic factors, maternal health care and early neonatal feeding practices (early initiation of breastfeeding and prelacteal feeding) were collected by interviewing the mothers. The prevalence of early/timely initiation of breastfeeding was computed as the ratio of children put to the breast within one hour of delivery to the total number of children. Prelacteal feeding was defined as giving anything to drink other than breast milk in the first three days following birth. Binary logistic regression models were used to identify variables which were associated with the dependent variable. A multivariable logistic regression analysis was carried out to identify factors associated with early initiation of breastfeeding. RESULTS: The prevalence of early initiation of breastfeeding was 43.9% (95% CI, 41.6, 46.2). More than half (56%) of the mothers gave prelacteal feeds. An urban residence (Adjusted Odds Ratio [AOR] 1.47, 95% Confidence Interval [CI] 1.25. 1.73) and antenatal care (AOR 1.41, 95% CI 1.24, 1.59) were correlated with early initiation of breastfeeding. Similarly, increased odds of timely initiation of breastfeeding were observed among mothers who didn't give prelacteal feeds (AOR 5.72; 95% CI, 5.12, 6.40). CONCLUSION: Delayed initiation of breastfeeding and prelacteal feeding still remain public health concerns in this community. The promotion of improved infant and young child feeding (IYCF) practices and the utilization of antenatal care services should be intensified.