BackgroundIn sub Saharan Africa little progress has been made towards achieving the Millennium Development Goals. Lack of achievement of MDGs is reflected in only minor changes in maternal mortality and child health – this is especially true in Ethiopia. Perinatal depression is common in developing countries where one in three women has a significant mental health problem during pregnancy and after childbirth. Perinatal depression is associated with inadequate prenatal care and poor maternal weight gain, low infant birth weight, and infant growth restriction. This study determined the prevalence of perinatal depression and its associated factors among reproductive age group women at Goba and Robe town of Bale zone; Oromia Region, South East Ethiopia. A cross sectional study with Simple Random sampling was employed to include 340 eligible subjects. The WHO self reporting questionnaire with 20 items with a cut off point 6 and above was used to separate non-cases/cases of perinatal depression. Data were collected by trained data collectors. Descriptive analysis was done using SPSS Version 16. Multivariate logistic regression was used to identify independent predictors of perinatal depression at 95% CI and P value of ≤ 0.05.ResultsPrevalence of perinatal depression was about 107(31.5%). About 20(5.9%), 86(25.3%) were current smokers and alcohol consumers respectively. Two hundred seventy seven (71.2%) of the respondents reported husband support during their pregnancy and after birth and 195(59.3%) were reported support from the husband’s family/relatives. Maternal perceived difficulty of child care, family History of mental illness, family visit during the perinatal period, history of child death and husband smoking status were found as independent predictors of perinatal depression.ConclusionThis study found that 1 in 3 women in this region of Ethiopia have depression. Depression screening is not currently routine care, but should be given due attention due to the high prevalence of depression in these populations. Public health agencies could organize special training events for Health care workers, including Health Extension workers on Mental Health and has to provide screening service to strengthen mental health in the pregnant and postpartum family.
Background: A responsive and well-functioning newborn referral system is a cornerstone to the continuum of child health care; however, health system and client-related barriers negatively impact the referral system. Due to the complexity and multifaceted nature of newborn referral processes, studies on newborn referral systems have been limited. The objective of this study was to assess the barriers for effective functioning of the referral system for preterm, low birth weight, and sick newborns across the primary health care units in 3 contrasting regions of Ethiopia. Methods: A qualitative assessment using interviews with mothers of preterm, low birth weight, and sick newborns, interviews with facility leaders, and focus group discussions with health care providers was conducted in selected health facilities. Data were coded using an iteratively developed codebook and synthesized using thematic content analysis. Results: Gaps and barriers in the newborn referral system were identified in 3 areas: transport and referral communication; availability of, and adherence to newborn referral protocols; and family reluctance or refusal of newborn referral. Specifically, the most commonly noted barriers in both urban and rural settings were lack of ambulance, uncoordinated referral and return referral communications between providers and between facilities, unavailability or non-adherence to newborn referral protocols, family fear of the unknown, expectation of infant death despite referral, and patient costs related to referral. Conclusions: As the Ethiopian Federal Ministry of Health focuses on averting early child deaths, government investments in newborn referral systems and standardizing referral and return referral communication are urgently needed. A complimentary approach is to lessen referral overload at higher-level facilities through improvements in the scope and quality of services at lower health system tiers to provide basic and advanced newborn care.
Background. Human schistosomiasis is one of the neglected tropical diseases caused by Schistosoma mansoni. Children in the developing countries live in areas with poor sanitation and most often spend time swimming or bathing in the water bodies contaminated with cercariae, the infective stages of schistosomiasis, which results in growth retardation and poor school performance. Thus, having effective control of the disease requires assessment of prevalence and risk factors. Objective. This study was aimed at assessing the prevalence of S. mansoni and its associated factors among primary schoolchildren in Wondo district, West Arsi Zone, Ethiopia, 2018. Methods. A cross-sectional study was carried out between January and March 2018. Stool samples from 298 schoolchildren, who were selected by simple random sampling, were examined for the ova of S. mansoni using Kato–Katz technique. Information on sociodemographic factors and other risk factors was obtained using questionnaires. The data were cleaned, coded, and entered into SPSS 22.0 statistical software and analyzed. Bivariable and multivariable logistic regression analysis was done to identify factors associated with S. mansoni infection. Adjusted odds ratio (AOR) with 95% confidence interval (CI) was calculated, and the level of significance was declared at p values of less than 0.05. The result was presented using tables, figures, and text form. Result. A total of 298 study participants were involved in this study resulting in a response rate of 96.4% (298/309). The prevalence of S. mansoni infection was 11.4% (34/298). The prevalence was 8% (12/140) among males while it was 13% (22/158) among females. Swimming in rivers or ponds (AOR: 9.592; 95% CI: 1.972–46.655; P=0.005), latrine availability at household level (AOR: 0.075; 95% CI: 0.13–0.422; P=0.003), and awareness about schistosomiasis (AOR: 0.058; 95% CI: 0.004–0.409; P=0.007) were the factors independently associated with S. mansoni infection at p value < 0.05. Conclusion. The prevalence of S. mansoni was moderate as per the World Health Organization standard, since it was in the range of 10%–50%. This implies that schistosomiasis is still among major health problems. Thus, intensified effort is needed to address risk factors contributing to infection and control disease. Additionally, biannual mass drug administration with praziquantel is required according to the WHO standard.
This study assesses the quality of care for preterm, low birth weight (LBW), and sick newborns across the public health care system levels in 3 regions of Ethiopia. Qualitative data based on the WHO framework to assess provision and experience of care was collected using in-depth interviews and focus group discussions with women who recently delivered preterm, LBW, and sick newborns, as well as health care providers and health extension workers, and facility administrators associated with study health facilities. This qualitative approach revealed perspectives of patients, health care providers and facility administrators to assess what is actually happening in facilities. Clinical guidelines for the care of preterm, LBW, and sick newborns were not available in many facilities, and even when available, often not followed. Most providers reported little or no communication with parents following hospital discharge. Human resource challenges (shortage of skilled staff, motivation and willingness, lack of supervision, and poor leadership) inhibited quality of care. Participants reported widespread shortages of equipment and supplies, medication, physical space, water, electricity, and infrastructure. Economic insecurity was a critical factor affecting parents’ experience. Acceptance by users was impacted by the perceived benefits and cost. Users reported they were less likely to accept interventions if they perceived that there would be financial costs they couldn’t afford. The quality of care for preterm, LBW, and sick newborns in Ethiopia as reported by recently delivered women, health care providers and facility administrators is compromised. Improving quality of care requires attention to process of care, experience of care, and health system capacity, structure, and resources.
among 198 symptomfree food handlers. Data on sociodemographic variables were collected through face-to-face interview using a structured questionnaire. Stool samples were collected immediately after the interview using labeled wide-mouthed plastic container and clean wooden applicator. Direct wet-mount method and formal-ether concentration techniques were performed to identify intestinal parasites. e data were analyzed using SPSS version 21.0. Descriptive statistics and crude and adjusted odds ratios with 95% confidence interval (CI) were calculated. p value of <0.05 was considered to declaration level of significance. Result. e response rate was 98% (198/202). e overall prevalence of intestinal parasites was 25.3% (50/198). e top three intestinal parasites found in this study were Ascaris lumbricoides 7.6% (15/198), Entamoeba histolytica/dispar 7.6% (15/198), and hookworm 5.6% (11/198). Inadequate handwashing practice (AOR: 13.876; 95% CI: 4.129, 46.632), inadequate knowledge about foodborne diseases (AOR: 3.596; 95% CI: 1.438, 8.989), lack of training on proper food handling (AOR: 5.960; 95% CI: 1.450, 24.497), and untrimmed fingernail (AOR: 2.939; 95% CI: 1.368, 6.135) were independent predictors of intestinal parasitic infection. Conclusion. High prevalence of intestinal parasites was observed among symptom-free food handlers who could be unobservable source of disease transmission. Inadequate handwashing, untrimmed fingernail, inadequate knowledge, and lack of training were independent predictors of intestinal parasitic infection in this study. is implies the need for timely and adequate training and enforcement of regular medical checkup system for food handlers.
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