BackgroundIntegrating mental health into primarily health care and studying risk for mental health particularly depression needs assessment of different factors including those that impede diagnosis and treatment of mental disorders. But so far the numbers of literature for local context to analyze risk factors for depression and its treatment are scare. The objective of this study was to assess risk factors and health service attendance for depression among adults, in Ethiopia.MethodsFor this analysis, data from the Ethiopian National health survey was used. The Ethiopian national health survey studied 4,925 adults aged 18 years and older to obtain among other things, data on depression episodes, socio-demographic, chronic diseases, life style factors and treatment receiving for depression episodes in the past twelve months using questionnaire from world health organization (WHO). Prevalence of Depression in respondents based on ICD-10 criteria was estimated and logistic regression analysis was used to identify risk factors for depression and treatment receiving.ResultsThe prevalence of depressive episode was 9.1% (95% CI: 8.39-9.90). In a Univariate analysis, residence, age, marital status, educational status, number of diagnosed chronic non communicable diseases (heart diseases, diabetic mellitus and arthritis) and alcohol drinking status were associated with depression. After full adjustment for possible confounding, odds ratios for depression were significantly higher only for older age, divorced and widowed, number of diagnosed chronic non communicable diseases and alcohol drinking status. The proportion of attending health service among those with depression episodes was 22.9%. After full control for all socio-demographic variables the only predictor variable was educational status, being in grade 5–8 had a higher odds (OR=2.6, 95% CI: 1.23-5.43) and 9–12 grade (OR=1.8 95% CI: 1.45-6.12) of attending service for depressive episodes.ConclusionsAge, marital status, number of diagnosed chronic non communicable diseases and alcohol consumption were the most important risk factors for depressive episodes. Generally there was lower use of health service for depressive episodes and low educational status was found to be barriers for service use. There is a need to formulate policy for mental health and training of primary health care workers in mental health to early identify and treat cases with depression episodes, so as to decrease prevalence of depression episodes and to improve accessibility of service use.

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BackgroundLow coverage of Skilled Birth Attendance (SBA) is one of the major drivers of maternal mortality in many low- and middle-income countries (LMICs) including Ethiopia. We conducted a cluster-randomized controlled community trial to assess the effect of deploying trained community based nurses to rural communities on the uptake levels of SBA in Ethiopia.MethodsA three-arm, parallel groups, cluster-randomized community trial was conducted to assess the effect of deploying trained community based reproductive health nurses (CORN) on the uptake of SBA services. A total of 282 villages were randomly selected and assigned to a control arm (n = 94) or 1 of 2 treatment arms (n = 94 each). The treatment groups differed by where these new service providers were deployed, a health post (HP) or health center (HC). Baseline and end line surveys were conducted to document and measure the effects of the intervention. Program impacts on SBA coverage were calculated using difference‐in‐difference (DID) analysis.ResultsAfter nine months of intervention, the coverage of SBA services increased significantly by 81.1% (from 24.61 to 44.59) in the HP based intervention arm, and by 122.9% (from 16.41 to 36.59) in the HC arm, respectively (p <0.01). Conversely, a small and non-significant (2%) decline in SBA coverage were observed in the control arm (P >0.05). The DID estimate indicated a net increase in SBA coverage of 21.32 and 20.52 percentage points (PP) across the HP and HC based intervention arms, respectively (p < 0.001).ConclusionsDeployment of trained reproductive health nurses to rural communities in Ethiopia significantly improved utilization of SBA services. Therefore; in similar low income settings where coverage of SBA services is very low, deployment of trained community based nurses to grassroots level could potentiate rapid service uptake. Additional cost-effectiveness and validation studies at various setups are required, before scale-up of the innovation, however.Trial registrationclinicaltrails.gov NCT02501252.

BackgroundDespite improvements since 1990 to 2014, maternal mortality ratio (MMR) remains high in Ethiopia. One of the key drivers of maternal mortality in Ethiopia is the very low coverage of Skilled Birth attendance (SBA) in rural Ethiopia. This cluster randomized trial piloted an innovative approach of deploying trained community reproductive nurses (CORN) to hard to reach/unreachable rural Ethiopia to improve the coverage of SBA.MethodsWe used a three-arm cluster randomized trial to test the effect of deploying CORN in rural communities in South Ethiopia to improve SBA and other maternal health indicators. A total of 282 villages/clusters (94 from each arm) were randomly selected in the three districts of the zone for the study. The intervention was implemented in four consecutive phases that aimed at of provision of essential maternal, neonatal and child health (MNCH) services mainly focusing on SBA. The CORN were trained and deployed in health centres (arm 1) and in the community/health posts (arm2). A third arm (arm 3) consisting control villages without the intervention. A baseline and end line assessment was conducted to compare the difference in the proportion of SBA and other MNCH service uptake across the three arms Data was entered into computer, edited, cleaned, and analyzed using Epi-data statistical software. The presentation followed the Consolidated Standards of Reporting Trials (CONSORT) statement guidelines for cluster-randomized trials.DiscussionThis trial is designed to test the impact of an innovative and newly designed means of distribution for the national health extension program strategy with additional service package with no change to the target population. The focus is on effect of CORN in revitalizing the Health Extension Program (HEP) through improving SBA service uptake and other maternal health service uptake indicators. The study findings may guide national policy to strengthen and shape the already existing HEP that has certain limitations to improve maternal health indicators. The competency based training methodology could provide feedback for health science colleges to improve the national nursing or midwifery training curriculum.Trial registrationclinicaltrails.gov NCT02501252 dated on July 14, 2015.

BACKGROUND፡ Street youth are exposed to situations that make them vulnerable to sexual and reproductive health problems. The majority of street youth are living in conditions of severe deprivation, which place them at all kinds of health risks. Street youth have risky sexual behaviors that increase the likelihood of adverse sexual and reproductive health consequences. Therefore, this study aimed to identify the prevalence and associated factors of risky sexual behavior among street youth in Dilla town, Gedeo zone, South Ethiopia, 2018.METHODS: A cross-sectional study was conducted among 279 randomly selected street youth after locating and identifying them through census using a structured pre-tested questionnaire. Descriptive and binary logistic regression analyses were used. Statistically significant was declared at alpha<0.05.RESULTS: The prevalence of risky sexual behavior among street youth in Dilla town was53.9% (95% CI –(48, 60.2)). Female sex (AOR=9.57, 95% CI- (1.76, 52.07)), age (AOR=1.23, 95% CI-(1.08, 1.39)), educational level (AOR=3.00, 95% CI- (1.08, 8.33)) and alcohol intake (AOR=2.27, 95% CI – (1.11, 4.68)) were statistically significant with risky sexual behavior.CONCLUSION: A substantial number of street youths were engagedin risky sexual behavior, while female sex, increase in age, educational level, and alcohol intake of street youth were found to contribute to aggravate the problem. This calls formobilizing interventions considering the above factors to bring behavioral change in reducing risky sexual practices.