ABSTRACT

Women in rural southwest Ethiopia who have limited personal experience with facility delivery nonetheless value health facility attributes that indicate high technical quality: availability of drugs and equipment and physician providers. Well-designed policy experiments that measure the contribution of quality improvements to facility delivery rates in Ethiopia and other countries with low health service utilisation and high maternal mortality may inform national efforts to reduce maternal mortality.

BackgroundIn Ethiopia, the utilization of long-lasting insecticide-treated bed nets (LLITN) is hampered by behavioural factors such as low awareness and negative attitude of the community. The aim of this study was to present the design and baseline results of a cluster randomized trial on the effect of training of household heads on the use of LLITN.MethodsThis baseline survey was undertaken from February to March, 2009 as part of a randomized cluster trial. A total of 11 intervention and 11 control Gots (villages) were included in the Gilgel Gibe Field Research Centre, south-west Ethiopia. House to house visit was done in 4135 households to collect information about the use of LLITN and socio-demographic variables. For the diagnosis of malaria and anaemia, blood samples were collected from 2410 under-five children and 242 pregnant women.ResultsOne fourth of the households in the intervention and control Gots had functional LLITN. Only 30% of the observed LLITN in the intervention and 28% in the control Gots were hanged properly. Adults were more likely to utilize LLITN than under-five children in the control and intervention Gots. The prevalence of malaria in under-five children in the intervention and control Gots was 10.5% and 8.3% respectively. The intervention and control Gots had no significant difference concerning the prevalence of malaria in under-five children, [OR = 1.28, (95%CI: 0.97, 1.69)]. Eight (6.1%) pregnant women in the intervention and eight (7.2%) in the control Gots were positive for malaria (P = 0.9). Children in the intervention Gots were less likely to have anaemia than children in the control Gots, [OR = 0.75, (95%CI: 0.62, 0.85)].ConclusionThe availability and utilization of LLITN was low in the study area. The prevalence of malaria and anaemia was high. Intervention strategies of malaria should focus on high risk population and vulnerable groups.

Background: Knowledge about the modes of transmission and preventive measures of malaria are important preceding factors for the acceptance and use of proven control tools by the community. Objective: To assess knowledge, attitude and practices (KAP) about modes of malaria transmission and preventive methods in the study areas. Methods: A cross-sectional study was conducted in three urban areas of Assosa zone, Western Ethiopia from January to February, 2006. Data analysis was carried out using SPSS for windows version 12.0.1. Adjusted odds ratio and 95% confidence intervals were employed to test the strength of association. Results: About 48% of the study participants were aware that malaria can be transmitted by mosquito bites. Thirty percent (30%), of respondents were aware that mosquitoes carry disease causing microorganism, 95% were aware that mosquitoes bite during night, and 61% were aware that mosquitoes rest at dark places inside the house. Sleeping under a mosquito net and eliminating mosquito-breeding sites were identified by 58% and 52% of respondents, respectively, as major malaria preventive measures. Respondents' education and wealth status were associated with comprehensive knowledge on malaria preventive measures (OR= 2.42, 95% CI: 1.09, 5.4 and OR= 3.89, 95% CI: 1.99, 7.6, respectively). Conclusion: Knowledge of the role of mosquitoes in malaria transmission and comprehensive knowledge about malaria prevention strategies among the study population were observed to be lower than 50%. Comprehensive behavioral change and communication is required to improve the knowledge of the mode of malaria transmission and its preventive and control measures.

Child development in this setting is strongly associated with child age and maternal depression. If these findings are replicated elsewhere, they may suggest that interventions aimed at improving maternal depression may have an important role to play in efforts to improve child development and to mitigate the intergenerational transmission of poor health in sub-Saharan Africa.