Effectiveness of curriculum-based sexual and reproductive health education on healthy sexual behaviors among year one students at Arba Minch University: A quasi-experimental study.

INTRODUCTION: Curriculum-based sexual and reproductive health education (CBSRHE) is one of the preventive strategies targeting youth in higher institutions to protect them from sexual and reproductive health problems, despite never assessing the effect in Ethiopia. Therefore, this study aimed to assess the effect of CBSRHE on knowledge and attitude about SRH services to have safer sexual behaviors among first-year students of Arba Minch University. METHOD: We conducted a quasi-experimental study among purposively selected campuses. The campuses were allocated to (i) an intervention arm consisting of curriculum-based sexual and reproductive health, or (ii) a control arm for those who were free from intervention. Data was collected, at baseline and immediately after the intervention ended by using a structured self-administered questionnaire. To compare differences in the change from baseline to post-intervention between the two arms we use the chi-square test and independent-samples t-test. To see the effect of the CBSRHE by controlling the effect confounding inverse probability-weighted analysis was conducted. RESULT: A total of 832 and 820 students participated in a baseline and post-test respectively. The proportion of youth who practice receptive penetrative sex decreases from 40.9% to 28.3% in the intervention arm compared to 37.6% to 37.3% in the non-intervention arm between baseline and end line, with statistically significant differences between groups. However, there are statistically significant differences between the intervention and control groups in terms of changes in contraception utilization (X2 = 1.21; P>0.05). Furthermore, there were significant improvements in knowledge and attitude among the intervention arm a comprehensive knowledge of HIV/AIDS (ATE = 0.22,95% CI, 0.14 to 0.29; p < 0.01), an average change of attitude toward HIV/AIDS(ATE = 1.32, 95% CI, 1.18 to 1.47; p < 0.01), comprehensive condom knowledge score (ATE = 0.23, 95% CI, 0.13 to 0.33; p < 0.01) and the average change of attitude toward condom score (ATE = 1.83, 95% CI, 1.19 to 2.77; p < 0.01). CONCLUSION AND RECOMMENDATION: It was found that there was a significant difference in knowledge and attitude toward a disk sexual behaviors among r one student. This implies that the educational authority o the country can gain through the adoption of courses to all universities across the country, besides doing further comparative studies to determine the long-term effect of the course supported with models and/or theories like the theory of change.

Prevalence of Milk Teeth Extraction and Enabling Community Factors Among Under Five-Year-Old Children in Alle Special Woreda, SNNPR, Ethiopia, 2022: Community-Based Cross-Sectional Study; Based on Theory of Planned Behavior Model.

Background: Milk tooth extraction (MTE) is one of the most common harmful traditional practices performed by traditional healers without anesthesia and unsterile materials. The acute and chronic complications of this practice greatly affect the health of children. In order to develop effective preventive measures towards this harmful practice, the extent of the problem and factors contributing to the practice should be verified. The objective of this study was to assess the prevalence and associated factors of MTE among under five-years-old children in Alle special Woreda. Methods: A community-based cross-sectional survey was undertaken at Alle Special Woreda among 363 women using a multi-stage stratified sampling method. Data was collected using semi-structured questionnaires and data entry was done with Epi-data version 4.4.3.1, while data management and analysis were done with STATA version 14.0. Univariate and multivariate binary logistic regression models were used while model's fitness was checked by Hosmer and Lemeshow test. Variables having a p-value of less than 0.05 were declared statistically significant in the final model. Result: Milk teeth extraction was practiced on 58.68% (95% CI:0.5,0.6) of children. Age of the child less than 12 months, AOR:1.27 (95% CI:1.02,1.6), maternal occupation (housewife) AOR:1.3 (95% CI:1.04,65), paternaleducational, level (illiterate) AOR:1.4 (95% CI:1.2,1.9), residence (rural) AOR:3.6 (95% CI:1.08,12.4), positive attitude AOR:1.65 (95% CI:1.01,2.8) and intentions AOR: 1.82 (95% CI:1.1,3.3) towards MTE practice showed statistically significant association with MTE practice. Conclusions and Recommendations: It was found that milk teeth extraction practice was the most common practice in the study area, with a prevalence of 58.68%. Age of the child, maternal occupation, paternal educational level, residence, having a positive attitude and intentions toward MTE practice all had a statistically significant (P value less than 0.05) association with MTE practice. Society's barriers, such as knowledge, attitude, and practice (KAP) related, health facility related, and peer and social pressure-related factors, were identified. All stakeholders should put great emphasis on the elimination of this harmful practice.

Perceived Social Support and Associated Factors Among Adults Living with HIV/AIDS Attending ART Clinic at Public Hospitals in Gamo Zone, Southern Ethiopia 2021.

Background: HIV/AIDS remains one of the world's serious public health challenges. Patients with limited support from their family and community often experience social damage, poor adherence, compliance and are prone to additional psychosocial problems. This study aimed to assess the level of perceived social support and factors among adults living with HIV/AIDS. Methods: Facility-based mixed study (sequential explanatory) design was conducted among 423 adults living with HIV/AIDS attending chronic care follow-up at public hospitals in Gamo zone, southern Ethiopia. Respondents were selected by systematic sampling technique. The bivariable and multivariable ordinal logistic regression was used to determine associated factors. All assumptions applied to ordinal logistic regression including multicollinearity, proportional odds, model fitness and pseudo R2 were checked. Level of significance was declared at p-values <0.05 and 95% CI. Results: Proportion of perceived social support of participants was 128 (30.7%), 197 (47.2%) and 92 (22.1%) with low, moderate and high levels of perceived social support, respectively. Females [(APOR = 2.42, 95% CI:(1.63-3.58), P < 0.001)], no formal education [(AOR = 0.49, 95% CI: (0.30-0.789), P = 0.004)], fair adherence [(APOR = 2.07, 95% CI: (1.17-3.49), P = 0.006)], no comprehensive knowledge about HIV [(APOR = 0.40, 95% CI: (0.26-0.62), P < 0.001)], and no disclosure status [(APOR = 0.64, 95% CI: (0.43-0.95), P = 0.028] were significantly associated with perceived social support. Qualitative findings revealed that disclosure and adherences involving income generation activities are beneficial to perceived social support. Conclusion: This study showed that one from three of the participants had low perceived social support. Low perceived social support was associated with adherence, disclosure status of individual, educational status and knowledge about HIV/AIDS. Family, friends, health care providers and significant others should provide necessary support and inform people living with HIV/AIDS (PLWHA) about social support.

Community Based Essential Newborn Care Practices and Associated Factors among Women Who Gave Birth at Home in Last 12 Months in Amaro Woreda, Southern Ethiopia, 2019.

Community based newborn care is a means of bringing life-saving care to mothers and newborns at the community level. However, the practice is challenging within the Ethiopian health system. The aim of this study was to assess prevalence of community based newborn care practices and associated factors among women who gave birth at home in Amaro Woreda, southern Ethiopia, 2019. Across-sectional study design and simple random sampling technique was employed to select study participants. Data was collected through face-to-face interview; EpiData version 3.1 and SPSS version 20 software were used for analysis. Bi-variable and multivariable logistic regression was employed to analyze the associated factors. In this study 29% practiced community based essential newborn care. Educational status of father (AOR = 2.28; 95% CI: 1.07-4.84), last delivery assisted by relative (AOR = 3.58; 95% CI: 1.66-7.73), having awareness about community based newborn care (AOR = 3.49; 95% CI: 2.11-5.77), awareness about newborn danger sign (AOR = 2.18; 95% CI: 1.29-3.68) were some of identified factors associated with community based newborn care practice. In conclusion, community based newborn care practice was low. Therefore, promotion of information at community level, women empowerment, and strengthening health extension program were recommending.

Exploring Barriers to Effective Implementation of Public Health Measures for Prevention and Control of COVID-19 Pandemic in Gamo Zone of Southern Ethiopia: Using a Modified Tanahashi Model.

BACKGROUND: Since the occurrence of the COVID-19 pandemic, different public health measures have been implemented to prevent and control the further spread of the disease. However, barriers that influence the effective implementation of public health measures were not explore in Ethiopia especially in study Area. Therefore, this study tried to fill this gap by exploring the barriers to effective implementation of public health measures for prevention and control of the COVID-19 pandemic in the Gamo Zone of southern Ethiopia. METHODS: The study employed a qualitative study with a phenomenology approach among purposely selected 30 individuals in the community and selected institutions. Key informant interview was used to collect the data. The data were transcribed verbatim and translated into the English language. The transcribed data were read several times to clearly understand the content for further analysis. The analysis of the data was conducted based on the modified Tanahashi framework. RESULTS: The study identified different barriers under five main themes: accessibility, acceptability, availability, contact and use, and effective implementation of public health measures related to barriers. The main barriers to effective implementation of public health measures were resistance to change, negligence, lack of community engagement, insufficient training for front line workers, poor supportive supervision, poor law enforcement, and lack of continuous community awareness creation. Beside, acceptability related barriers like cultural and religious norms and availability related barriers like shortage of personal protective equipment and shortage of skilled health professional have also lion share barriers for implementation of the public health measures. CONCLUSION: The study identified different personal, institutional, and societal level barriers for effective implementation of public health measures for the COVID-19 pandemic. Therefore, proper and targeted continuous community awareness creation with further mandatory law enforcement activities should be implemented by the concerned bodies to mitigate individual and societal level barriers. In addition, the government with relevant stakeholders should give due attention to equip and protect the frontline professionals by availing the necessary logistic and provision of continuous capacity-building activities.

Community Perception and Attitude Towards People with Schizophrenia Among Residents of Arba Minch Zuria District, Arba Minch Health and Demographic Surveillance Sites System (AM-HDSS), Ethiopia: Cross-Section Study.

BACKGROUND: Mental health disorders have identified as being one of the public health issues throughout the world. Recent evidence reveals that more than 21 million people diagnosed with schizophrenia. However, there is little information about community perception and attitude towards people with Schizophrenia in Ethiopia. OBJECTIVE: The aim of this study was to assess the community perception and attitude towards people with Schizophrenia among residents of Arba Minch Zuria Districts, Southern Ethiopia. METHODS: A community-based cross-sectional study was conducted among 617 randomly selected adults. Interviewer-administered standard tool was used to collect the data. Descriptive statistics like frequency, mean, and median computed. A binary logistic regression model used to identify factors affecting community perception and attitude towards people with schizophrenia. RESULTS: Of the study population, 469 (76%) of respondents had good perception and 390 (63.2%) had positive attitudes towards people with schizophrenia. The study participants identified talkativeness and self-neglect behaviors as the most common manifestations of schizophrenia. Besides, this study identified substance misuse and head injury as the perceived cause and spiritual or traditional methods as a preferred treatment for people with schizophrenia. Moreover, the study participants preferred spiritual or traditional methods for the treatment of schizophrenia. Young age [AOR=2.03, 95% CI: 1.21, 3.40], females [AOR=2.32, 95% CI: 1.58, 3.41], good perception towards people with schizophrenia [AOR=4.95, 95% CI: 3.25, 7.54] and no formal educational status [AOR=2.75, 95% CI: 1.33, 5.70], and primary education [AOR=3.72, 95% CI: 1.87, 7.39] were significantly associated with the attitude towards people with schizophrenia. CONCLUSION: The findings of this study indicate that approximately one-third of the residents had unfavorable attitudes towards people with schizophrenia. Therefore, giving special attention to male, elders and those who were educated, and individuals who have poor perceptions of people with schizophrenia is crucial.

Maternal Delays for Institutional Delivery and Associated Factors Among Postnatal Mothers at Public Health Facilities of Gamo Zone, Southern Ethiopia.

BACKGROUND: Maternal health delays like delay in deciding to seek care, reaching a health facility, and receiving appropriate care were identified as the main contributing factors for maternal mortality and morbidity in many developing countries including Ethiopia. However, little is known about the magnitude and factors predisposing for maternal health delays in Ethiopia especially in a rural part of the country. Therefore, the aim of this study is to assess the magnitude of maternal delays for institutional delivery and associated factors among mothers attending post-natal service at public health facilities of the Gamo zone, Southern Ethiopia. METHODS: A cross-sectional study was conducted in rural districts of Gamo zone. Eleven public health centers in the two districts were selected randomly. The Systematic random sampling method was used to select study participants from each public health centers. A total of 394 postnatal mothers were selected every secondly and interviewed in a separate room. Face to face interview methods were used to collect the data. Binary and multivariable logistic regression analyses were conducted to identify the associated factors for the three delays. RESULTS: The magnitude of first, second and third maternal delays were 46.80%, 44.00%, and 31.70%, respectively. Unemployed women [AOR: 2.20, 95% CI (1.15, 4.16)], birth preparedness [AOR: 2.70, 95% CI (1.29, 5.71)], husband's decisions making [AOR: 6.00, 95% CI (2.87, 12.42)] were found to be significantly associated with first delay. Distance to health facility [AOR: 7.00, 95% CI (3.58, 13.71)], and means of transportation [AOR: 3.30, 95% CI (1.13, 9.54)] were found to be significantly associated with the second delay. Availability of obstetric drugs [AOR: 8.40, 95% CI (3.76, 18.76)], and availability of skilled health provider [AOR: 10.40, 95% CI (4.24, 25.69)] were found to be significantly associated with the third delay for institutional delivery. CONCLUSION: The magnitude of first, second and third maternal delays were high which indicates that most mothers were not receiving institutional delivery services at the recommended time. Maternal socio-economic, obstetric factors and health-care system factors affected the three delays in this study. Therefore, improving women empowerment and resource availability at health facilities is vital.

Determinants of Implant Utilization among Married Women of Childbearing Age in Chencha Town, Southern Ethiopia, 2017: A Case-Control Study.

Globally, 53% of women in reproductive age group use modern methods of contraception, with less than one percent of which using implants. In Ethiopia and other parts of sub-Saharan Africa, short-term contraceptive methods have been more utilized than long-acting methods like implants. Despite their effectiveness, implants have been underutilized due to various reasons. There is a dearth of stronger evidences on those factors in the country in general and the study area in particular. Therefore, this study aimed to identify determinants of implant utilization among married women of reproductive age at Chencha town, Gamo Gofa Zone, Southern Nations, Nationalities, and Peoples' Region (SNNPR) of Ethiopia. A community-based case-control study design was conducted among 324 women of reproductive age, 90 cases (users of implants) and 234 controls (users of short-acting contraceptives) from July to August 2017. Data were collected using a pretested, structured questionnaire through face-to-face interview. The data were entered and coded using Epi info 3.5.1 and then exported to Statistical Package for Social Sciences (SPSS) version 20 for cleaning and analysis. Descriptive analysis was done to quantify proportions, means, and standard deviations of variables. Bivariate and multivariable logistic regressions were done to identify the determinants of implant utilization. A total of 324 married women of reproductive age group were interviewed with response rate of 98%. In this study, the major determinants for implant utilization were desire to have 3-4 children {AOR = 0.104, 95% CI (0.03, 0.4)}, husband disproval {AOR = 0.11, 95% CI (0.038, 0.314)}, joint decision {AOR = 3.11, 95% CI (1.02, 9.48)}, and decision by other persons {AOR = 0.065, 95% CI (0.012, 0.352)}. This study found out that desire to have more children, husband disapproval, joint decision making, and decision by other persons were determinants of implant utilization among the target women. Implant utilization would improve through strengthening existing interventions targeting women with high fertility desire, transformation of gender norms in household decisions, and counseling for informed decisions.

Community Perception and Attitude towards people with Depression among Adults Residing in Arba Minch Health and Demographic Surveillance Site (AM-HDSS), Southern Ethiopia.

BACKGROUND: Negative perception and attitude of community prevents many people with depression and their caregivers from seeking help and receiving adequate treatment due to fear of social reaction and may try to hide the illness. The reasons for negative attitudes are not consistent across communities or cultures. Therefore, understanding the level of community perception and attitude towards people with depression is important to develop an intervention to reduce the impact of mental illness. METHODS: A community-based cross-sectional study was conducted among 617 randomly selected adults. The data was collected using structured, pre-tested, and interviewer-administered questionnaires. Descriptive statistics like frequency, mean, and median were performed. Bi-variable and multivariable logistic regression analyses were performed to identify the factors that affect the community attitude towards people with depression. RESULTS: Of the study population, 325(52.7%) had a good perception and 246(39.9%) had a positive attitude towards people with depression. The majority of study participants frequently identified as the perceived cause of depression was substance misuse, loss of loved one, and conflict within a family. In addition, psychosocial treatment was the most preferred treatment for people with depression in the study area. Marital status and educational status were significantly associated with the community attitude towards people with depression. CONCLUSION: Giving special attention to people with substance misuse, loss of loved one, and conflict within a family is very vital for the prevention of depression. In addition, future mental health promotion activities should focus on cause and common manifestation of depression to improve the attitude toward people with depression.

Prevalence Of Undernutrition And Associated Factors Among Adults Receiving First-Line Antiretroviral Treatment In Public Health Facilities Of Arba Minch Town, Southern Ethiopia.

INTRODUCTION: Access to antiretroviral drugs for all infected persons in need is a global health priority. The primary goals of initiating antiretroviral drugs are to suppress human immunodeficiency virus viral replication and to restore immune function. However, adequate nutrition is necessary to manage opportunistic infections and to maintain the immune system. Therefore, this study aimed to determine the recent prevalence of undernutrition and associated factors among HIV patients receiving first-line antiretroviral therapy in public health facilities of Arba Minch town, Gamo zone, Southern Ethiopia. METHODS: Institution-based cross-sectional study was used among 333 adult patients receiving first-line antiretroviral therapy at public health facilities of Arba Minch town. A simple random sampling technique was used to select the study subjects. Data were collected through interviewer-administered questionnaires. Binary and multivariable logistic regression analyses were used to identify factors associated with undernutrition. A p-value <0.05 with a 95% confidence level was used to declare statistical significance. RESULTS: The overall prevalence of undernutrition among adult patients receiving first-line antiretroviral therapy is 23.72% (95% CI: 19.13-28.27%). Current substance use (AOR=1.83, 95% CI:1.09-3.08), duration on antiretroviral therapy (AOR=1.87, 95% CI:1.06-3.30), not taking cotrimoxazole preventive therapy (AOR=2.09, 95% CI:1.15-3.82), advanced WHO clinical stages (AOR=5.1, 95% CI: 2.9-7.7), CD4 count less than 350 cell/mm3 (AOR=1.83, 95% CI: 1.09-3.05) and active tuberculosis (AOR=1.89, 95% CI: 1.02-3.53) were factors significantly associated with undernutrition among respondents who were enrolled on first-line antiretroviral therapy. CONCLUSION: This study shows that the prevalence of undernutrition was high among adult patients on first-line antiretroviral therapy. Therefore, this finding shows the need to implement nutrition programs to improve the nutritional status of adults living with HIV in the study area. The interventions should emphasise those patients who use the substance, who are in advanced WHO clinical stage and have active tuberculosis. Besides, emphasis should be given for patients to undertake cotrimoxazole preventive therapy and to regularly follow their CD4 count.

Predictors of Time to Viral Load Suppression of Adult PLWHIV on ART in Arba Minch General Hospital: A Follow up Study.

BACKGROUND: Access to antiretroviral drugs for all infected persons in need is a global health priority. The viral load and CD4 counts should be monitored regularly. The plasma viral load should be reduced by as much and for as short as possible. Identifying factors that predict time to viral load suppression of patients on antiretroviral therapy regimens is thus vital to optimizing therapeutic success. Therefore, this study aimed to estimate the time to viral load suppression and identify predictors of time to viral load suppression of patients on antiretroviral therapy at Arba Minch general Hospital. METHODS: This study was observational study using data abstracted from medical records, patient interviews and laboratory work-up during 6 months of follow up. The data were collected from 152 naive to anti-retro viral drug patients. The univariable and multivariable Cox proportional hazard regression analyses were done to identify predictors. RESULT: The median survival time of viral load suppression among adult patients living with HIV was 3 months with 95% CI (2.68, 3.32). The Cox-proportional hazard analysis shows baseline CD4 count of <200cells/mm3 (AHR=0.683, CI:0.471, 0.990), baseline viral load of <10,000 copies/ml (AHR=4.135, CI:1.835, 9.317), having baseline Cotrimoxazole preventive therapy (AHR=1.997, CI:1.108, 3.600), having baseline Isoniazid preventive therapy (AHR=3.085, CI:1.721, 5.529) and good adherence level to ART (AHR=2.648, CI: 1.202, 5.834) significantly predict the time to viral load suppression. CONCLUSION: Early improvement and maintenance of CD4 count and viral load to normal level should be attained through streamlining and strengthening monitoring and counseling of patients on adherence to ART, Cotrimoxazole and Isoniazid drugs.

Effects of comprehensive sexuality education on the comprehensive knowledge and attitude to condom use among first-year students in Arba Minch University: a quasi-experimental study.

OBJECTIVE: To assess the effect of comprehensive sexuality education on the comprehensive knowledge and attitude to condom use among first-year students at Arba Minch University. RESULTS: A total of 832 students participated at a baseline, and 820 students participated at the posttest. This study found that there was a significant effect on changing students' knowledge and attitude towards a condom. In the education group, the students' average change of comprehensive condom knowledge score was 0.229 higher than the average score of students' in the control group (ATE = 0.229, 95% CI 0.132 to 0.328; p < 0.001). The average change of attitude toward condom score of students' in the education group was 1.834 higher than the average change score of students' in the control group (ATE = 1.834, 95% CI 1.195 to 2.772; p < 0.001).This study provides further evidence on the effectiveness of comprehensive sexuality education in terms of knowledge and attitude towards a condom. Therefore, the implementation of this education should be strengthened in order the prevent youths from STI/HIV and unintended pregnancies.