Background. Antenatal care is a care that links the woman and her family with the formal health system, increases the chance of using a skilled attendant at birth, and contributes to good health through the life cycle. Inadequate care during this time breaks a critical link in the continuum of care and affects both women and babies. Therefore, the main aim of this study was to determine the quality of ANC in Hadiya Zone, Southern Ethiopia. Method. A longitudinal facility-based study design was conducted among 1123 mothers whose gestational age of less than 16 weeks was identified and followed until birth and 40 days after birth to detect whether they gained the acceptable standard of quality of ANC from July 2017 to June 2018. A structured, predefined, and pretested observation check list and Likert scales were employed to obtain the necessary information after getting both written and verbal consent from the concerned bodies and study participants. Data was entered into Epi Info version 3.5 and transferred to STATA Version 14 software and cleaned by reviewing frequency tables, logical errors, and checking outliers. Generalized estimating equation (GEE) analysis was applied to get the average response observation of each visit of quality of ANC in the health facilities. Result. This study showed that the overall magnitude of good quality of antenatal care service that was provided in the whole visit at Hosanna Town’s public health facilities was 1230 (31.38%). The most frequently identified problems were inability to take full history, lack of proper counseling, poor healthcare provider and client interaction, and improper registration and there was a variation in providing quality of care in each visit. Quality of antenatal care was significantly associated with residence, educational status gravidity, parity, and visit. In conclusion, the overall quality of antenatal care is low, so the health facilities need further modification on the identified problems.
背景。产前保健是一种将妇女及其家庭与正规卫生系统联系起来的保健，增加在分娩时使用熟练助产士的机会，并有助于在整个生命周期中保持良好健康。在此期间，护理不足打破了持续护理的关键环节，并影响到妇女和婴儿。因此，本研究的主要目的是确定埃塞俄比亚南部Hadiya地区ANC的质量。方法。在2017年7月至2018年6月期间，对1123名胎龄小于16周的母亲进行了一项基于设施的纵向研究设计，并随访至出生和出生后40天，以检测她们是否达到了ANC的可接受质量标准。在获得相关机构和研究参与者的书面和口头同意后，采用结构化、预定义和预先测试的观察检查表和李克特量表来获取必要的信息。将数据输入Epi Info 3.5版本，并转移到STATA version 14软件中，通过检查频率表、逻辑错误和异常值进行清理。应用广义估计方程(Generalized estimation equation, GEE)分析，得到卫生机构ANC质量每次来访的平均反应观察结果。结果。该研究表明，在和散那镇公共卫生设施的整个访问中，提供优质产前保健服务的总体规模为1230(31.38%)。最常见的问题是无法了解全部病史、缺乏适当的咨询、医疗保健提供者和客户互动不良、登记不当以及每次就诊提供的护理质量存在差异。产前保健质量与居住地、教育状况、妊娠、胎次和就诊显著相关。总之，产前保健的总体质量较低，因此保健设施需要对已发现的问题进行进一步修改。
{"title":"Assessment of Quality of Antenatal Care Services and Its Determinant Factors in Public Health Facilities of Hossana Town, Hadiya Zone, Southern Ethiopia: A Longitudinal Study","authors":"Trhas Tadesse Berehe, Lebitsi Maud Modibia","doi":"10.1155/2020/5436324","DOIUrl":"https://doi.org/10.1155/2020/5436324","url":null,"abstract":"Background. Antenatal care is a care that links the woman and her family with the formal health system, increases the chance of using a skilled attendant at birth, and contributes to good health through the life cycle. Inadequate care during this time breaks a critical link in the continuum of care and affects both women and babies. Therefore, the main aim of this study was to determine the quality of ANC in Hadiya Zone, Southern Ethiopia. Method. A longitudinal facility-based study design was conducted among 1123 mothers whose gestational age of less than 16 weeks was identified and followed until birth and 40 days after birth to detect whether they gained the acceptable standard of quality of ANC from July 2017 to June 2018. A structured, predefined, and pretested observation check list and Likert scales were employed to obtain the necessary information after getting both written and verbal consent from the concerned bodies and study participants. Data was entered into Epi Info version 3.5 and transferred to STATA Version 14 software and cleaned by reviewing frequency tables, logical errors, and checking outliers. Generalized estimating equation (GEE) analysis was applied to get the average response observation of each visit of quality of ANC in the health facilities. Result. This study showed that the overall magnitude of good quality of antenatal care service that was provided in the whole visit at Hosanna Town’s public health facilities was 1230 (31.38%). The most frequently identified problems were inability to take full history, lack of proper counseling, poor healthcare provider and client interaction, and improper registration and there was a variation in providing quality of care in each visit. Quality of antenatal care was significantly associated with residence, educational status gravidity, parity, and visit. In conclusion, the overall quality of antenatal care is low, so the health facilities need further modification on the identified problems.","PeriodicalId":30619,"journal":{"name":"Advances in Public Health","volume":"235 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2020-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76104806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background. Ethiopia has experienced a significant reduction of under-five mortality over the past few decades. But still, the country is far from the Sustainable Development Goals (SDGs) of 2030. This study aims to identify the potential associated factors of under-five mortality in the Afar region, Ethiopia. Methods. Data from a national representative cross-sectional survey of Ethiopian Demographic and Health Survey of the year 2016 were used. Data were collected from the population of all under-five children in randomly selected enumeration areas of the Afar region of Ethiopia. Chi-squared and binary logistic regression analyses were employed. Results. The result revealed that twin child [(AOR = 5.37; 95%CI: 2.12–13.62)], age of mothers at first birth [(AOR = 0.47; 95%CI: 0.35–0.62) of greater than 16], current breastfeeders (AOR = 0.41; 95%CI: 0.32–0.54), rural residents (AOR: 2.54; 95%CI: 2.49–2.58), used current contraceptive methods (AOR = 0.38; 95%CI: 0.15–0.94), vaccinated the child (AOR = 0.40; 95%CI: 0.27–0.59), family size [(AOR = 0.65; 95%CI: 0.41–0.92) for 4–6 household members and (AOR = 0.49; 95%CI: 0.29–0.80) for seven and more household members], rich households (AOR = 0.03; 95%CI: 0.01–0.16), mother’s age group [(AOR = 3.24; 95%CI: 1.90–5.54) (age 20–29), (AOR = 12.43; 95%CI: 6.86–22.51) (age 30–39), and (AOR = 46.31; 95%CI: 21.74–98.67) (age 40 and above), and antenatal visits ((AOR = 0.48; 95%CI: 0.31–0.74) (1–3 visits) and (AOR = 0.44; 95%CI: 0.24–0.81) (4 and more visits)) significantly determined the under-five mortality. Conclusions. The study showed that giving birth at an early age, low coverage and quality of health access, unimproved breastfeeding culture, nonaccessibility to contraceptive methods, absence of awareness of mothers on vaccination of a child, low economic status of households, and low status of mothers’ antenatal visits lead to the highest under-five mortality in the area. Therefore, community-based educational programs and public health interventions focused on improving the survival of children by providing awareness to the community and specifically to mothers should be improved.
{"title":"Factors Associated with U5M in the Afar Region of Ethiopia","authors":"Shewayiref Geremew Gebremichael, Setegn Muche Fenta","doi":"10.1155/2020/6720607","DOIUrl":"https://doi.org/10.1155/2020/6720607","url":null,"abstract":"Background. Ethiopia has experienced a significant reduction of under-five mortality over the past few decades. But still, the country is far from the Sustainable Development Goals (SDGs) of 2030. This study aims to identify the potential associated factors of under-five mortality in the Afar region, Ethiopia. Methods. Data from a national representative cross-sectional survey of Ethiopian Demographic and Health Survey of the year 2016 were used. Data were collected from the population of all under-five children in randomly selected enumeration areas of the Afar region of Ethiopia. Chi-squared and binary logistic regression analyses were employed. Results. The result revealed that twin child [(AOR = 5.37; 95%CI: 2.12–13.62)], age of mothers at first birth [(AOR = 0.47; 95%CI: 0.35–0.62) of greater than 16], current breastfeeders (AOR = 0.41; 95%CI: 0.32–0.54), rural residents (AOR: 2.54; 95%CI: 2.49–2.58), used current contraceptive methods (AOR = 0.38; 95%CI: 0.15–0.94), vaccinated the child (AOR = 0.40; 95%CI: 0.27–0.59), family size [(AOR = 0.65; 95%CI: 0.41–0.92) for 4–6 household members and (AOR = 0.49; 95%CI: 0.29–0.80) for seven and more household members], rich households (AOR = 0.03; 95%CI: 0.01–0.16), mother’s age group [(AOR = 3.24; 95%CI: 1.90–5.54) (age 20–29), (AOR = 12.43; 95%CI: 6.86–22.51) (age 30–39), and (AOR = 46.31; 95%CI: 21.74–98.67) (age 40 and above), and antenatal visits ((AOR = 0.48; 95%CI: 0.31–0.74) (1–3 visits) and (AOR = 0.44; 95%CI: 0.24–0.81) (4 and more visits)) significantly determined the under-five mortality. Conclusions. The study showed that giving birth at an early age, low coverage and quality of health access, unimproved breastfeeding culture, nonaccessibility to contraceptive methods, absence of awareness of mothers on vaccination of a child, low economic status of households, and low status of mothers’ antenatal visits lead to the highest under-five mortality in the area. Therefore, community-based educational programs and public health interventions focused on improving the survival of children by providing awareness to the community and specifically to mothers should be improved.","PeriodicalId":30619,"journal":{"name":"Advances in Public Health","volume":"19 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2020-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84840309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Senait Gebreslasie Gebremeskel, T. Gebru, S. Kassahun, B. Gebrehiwot
Background. Prelacteal feeding is an obstacle to optimal breastfeeding practices in developing countries. It directly or indirectly affects the health of the infants. Despite its importance, this issue has received little attention in Ethiopia. As a result, this study aimed to assess prelacteal feeding and associated factors among mothers of children aged less than 12 months in the rural eastern zone, Tigray, Ethiopia.Methods. Community-based cross-sectional study design was employed. The final sample size was 828, and the multistage sampling technique was used. Pretested and structured interviewer-administered tool was used for data collection. Data were entered, coded, and cleaned by Epi-Info version 7 and analyzed by using SPSS 22.0. Multivariable logistic regression was used to control the effect of confounding.Results. Eight hundred three mothers participated in this study. During the first three days after birth, 198 (24.7%) mothers practiced prelacteal feeding. Parity (AOR: 1.52, 95% CI: 1.04–2.23), late initiation of breastfeeding (AOR: 1.83, 95% CI: 1.30–2.59), and colostrum discard (AOR: 1.57, 95% CI: 1.06–2.33) were strongly associated with prelacteal feeding practice.Conclusion and Recommendation. One-fourth of participants practiced prelacteal feeding. Late initiation of breastfeeding, colostrum discard, and parity were significant determinants of prelacteal feeding. Awareness creation and health education concerning the advantages of early initiation of breastfeeding and the importance of colostrum during their health visits is necessary.
{"title":"Magnitude of Prelacteal Feeding and Its Associated Factors among Mothers Having Children Less than One Year of Age: A Community-Based Cross-Sectional Study in Rural Eastern Zone, Tigray, Ethiopia","authors":"Senait Gebreslasie Gebremeskel, T. Gebru, S. Kassahun, B. Gebrehiwot","doi":"10.1155/2020/4926890","DOIUrl":"https://doi.org/10.1155/2020/4926890","url":null,"abstract":"Background. Prelacteal feeding is an obstacle to optimal breastfeeding practices in developing countries. It directly or indirectly affects the health of the infants. Despite its importance, this issue has received little attention in Ethiopia. As a result, this study aimed to assess prelacteal feeding and associated factors among mothers of children aged less than 12 months in the rural eastern zone, Tigray, Ethiopia.Methods. Community-based cross-sectional study design was employed. The final sample size was 828, and the multistage sampling technique was used. Pretested and structured interviewer-administered tool was used for data collection. Data were entered, coded, and cleaned by Epi-Info version 7 and analyzed by using SPSS 22.0. Multivariable logistic regression was used to control the effect of confounding.Results. Eight hundred three mothers participated in this study. During the first three days after birth, 198 (24.7%) mothers practiced prelacteal feeding. Parity (AOR: 1.52, 95% CI: 1.04–2.23), late initiation of breastfeeding (AOR: 1.83, 95% CI: 1.30–2.59), and colostrum discard (AOR: 1.57, 95% CI: 1.06–2.33) were strongly associated with prelacteal feeding practice.Conclusion and Recommendation. One-fourth of participants practiced prelacteal feeding. Late initiation of breastfeeding, colostrum discard, and parity were significant determinants of prelacteal feeding. Awareness creation and health education concerning the advantages of early initiation of breastfeeding and the importance of colostrum during their health visits is necessary.","PeriodicalId":30619,"journal":{"name":"Advances in Public Health","volume":"71 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2020-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83972320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Darmawati Darmawati, T. Siregar, Hajjul Kamil, Teuku Tahlil
Introduction. Anemia during pregnancy is one of the commonest issues in pregnancy. Cultural belief is among the contributing factors to this problem. This study aims to explore the cultural leaders’ perception on Acehnese culture regarding anemia in pregnancy. Methods. The qualitative study was conducted using three in-depth interviews and a focus group discussion with Acehnese cultural leaders. Data analysis was conducted by the inductive content analysis method. Results. Four themes emerged from interviews and discussion: (1) cultural beliefs about anemia; (2) locally resourced food; (3) husband participation in preventing anemia during pregnancy; (4) do’s and don’ts. Conclusion. Our findings provide insight into how cultural leaders’ perceptions of anemia are in pregnancy and how they are integrated strongly into Acehnese people’s lives. These findings would assist in developing culturally adapted strategic policy to prevent anemia during pregnancy.
{"title":"Acehnese Cultural Leaders’ Perspective on Anemia in Pregnant Women: A Qualitative Study","authors":"Darmawati Darmawati, T. Siregar, Hajjul Kamil, Teuku Tahlil","doi":"10.1155/2020/8710254","DOIUrl":"https://doi.org/10.1155/2020/8710254","url":null,"abstract":"Introduction. Anemia during pregnancy is one of the commonest issues in pregnancy. Cultural belief is among the contributing factors to this problem. This study aims to explore the cultural leaders’ perception on Acehnese culture regarding anemia in pregnancy. Methods. The qualitative study was conducted using three in-depth interviews and a focus group discussion with Acehnese cultural leaders. Data analysis was conducted by the inductive content analysis method. Results. Four themes emerged from interviews and discussion: (1) cultural beliefs about anemia; (2) locally resourced food; (3) husband participation in preventing anemia during pregnancy; (4) do’s and don’ts. Conclusion. Our findings provide insight into how cultural leaders’ perceptions of anemia are in pregnancy and how they are integrated strongly into Acehnese people’s lives. These findings would assist in developing culturally adapted strategic policy to prevent anemia during pregnancy.","PeriodicalId":30619,"journal":{"name":"Advances in Public Health","volume":"62 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2020-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84228697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Kweku, Hubert Amu, M. Adjuik, E. Manu, F. Y. Aku, E. Tarkang, J. Komesuor, Geoffrey Adebayo Asalu, N. Amuna, L. Boateng, J. S. Alornyo, R. Glover, A. Bawah, T. Letsa, J. Awoonor-Williams, S. Kachur, J. Phillips, J. Gyapong
Background. The Community-based Health Planning and Services (CHPS) initiative is Ghana’s flagship strategy for achieving universal health coverage (UHC). Community involvement in and perceptions of CHPS capacity to improve health outcomes of communities are examined. Methods. This community-based descriptive cross-sectional study recruited 1008 adults aged 18 years and above in two System Learning Districts of the CHPS+ project. Data collected were analysed using descriptive and inferential statistics. Results. The level of community involvement in CHPS activities was 48.9% of the population studied. The overall level of positive perception of CHPS services was 51.7%. Community members who were involved in identifying resources (AOR = 1.86 (95% CI = 1.17, 2.97), p=0.009), organising durbars (AOR = 2.09 (95% CI = 1.12, 3.88), p=0.020), and preparing sites for outreach services (AOR = 3.76 (95% CI = 2.23, 6.34), p<0.001) were significantly more likely to have positive perceptions of the relevance of CHPS to improving the health status of communities compared to those who were uninvolved. Conclusion. The level of community involvement in CHPS services is low. Ghana may not be able to attain the UHC goal by 2030 through CHPS implementation unless its level of community involvement is markedly improved. Ghana’s health sector stakeholders should implement community engagement mechanisms that foster improved worker outreach, expanded use of community gatherings, and more active participation of traditional leaders and grassroots political representatives.
背景。以社区为基础的卫生规划和服务(CHPS)倡议是加纳实现全民健康覆盖的旗舰战略。对社区参与卫生防护中心改善社区健康结果的能力和看法进行了审查。方法。这项以社区为基础的描述性横断面研究在CHPS+项目的两个系统学习区招募了1008名18岁及以上的成年人。收集的数据使用描述性和推断性统计进行分析。结果。社区参与卫生防护中心活动的人数占研究人口的48.9%。对卫生保健服务的整体正面评价为51.7%。参与资源识别(AOR = 1.86 (95% CI = 1.17, 2.97)， p=0.009)，组织durbars (AOR = 2.09 (95% CI = 1.12, 3.88)， p=0.020)，以及准备外展服务场所(AOR = 3.76 (95% CI = 2.23, 6.34)， p<0.001)的社区成员与未参与的社区成员相比，更有可能对CHPS与改善社区健康状况的相关性有积极的看法。结论。社区参与卫生保健服务的程度较低。除非加纳的社区参与水平得到显著提高，否则它可能无法通过实施卫生保健服务到2030年实现全民健康覆盖的目标。加纳卫生部门的利益攸关方应实施社区参与机制，促进改善工作人员的外联，扩大社区聚会的利用，以及传统领导人和基层政治代表的更积极参与。
{"title":"Community Involvement and Perceptions of the Community-Based Health Planning and Services (CHPS) Strategy for Improving Health Outcomes in Ghana: Quantitative Comparative Evidence from Two System Learning Districts of the CHPS+ Project","authors":"M. Kweku, Hubert Amu, M. Adjuik, E. Manu, F. Y. Aku, E. Tarkang, J. Komesuor, Geoffrey Adebayo Asalu, N. Amuna, L. Boateng, J. S. Alornyo, R. Glover, A. Bawah, T. Letsa, J. Awoonor-Williams, S. Kachur, J. Phillips, J. Gyapong","doi":"10.1155/2020/2385742","DOIUrl":"https://doi.org/10.1155/2020/2385742","url":null,"abstract":"Background. The Community-based Health Planning and Services (CHPS) initiative is Ghana’s flagship strategy for achieving universal health coverage (UHC). Community involvement in and perceptions of CHPS capacity to improve health outcomes of communities are examined. Methods. This community-based descriptive cross-sectional study recruited 1008 adults aged 18 years and above in two System Learning Districts of the CHPS+ project. Data collected were analysed using descriptive and inferential statistics. Results. The level of community involvement in CHPS activities was 48.9% of the population studied. The overall level of positive perception of CHPS services was 51.7%. Community members who were involved in identifying resources (AOR = 1.86 (95% CI = 1.17, 2.97), p=0.009), organising durbars (AOR = 2.09 (95% CI = 1.12, 3.88), p=0.020), and preparing sites for outreach services (AOR = 3.76 (95% CI = 2.23, 6.34), p<0.001) were significantly more likely to have positive perceptions of the relevance of CHPS to improving the health status of communities compared to those who were uninvolved. Conclusion. The level of community involvement in CHPS services is low. Ghana may not be able to attain the UHC goal by 2030 through CHPS implementation unless its level of community involvement is markedly improved. Ghana’s health sector stakeholders should implement community engagement mechanisms that foster improved worker outreach, expanded use of community gatherings, and more active participation of traditional leaders and grassroots political representatives.","PeriodicalId":30619,"journal":{"name":"Advances in Public Health","volume":"68 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2020-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89438312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background. Ethiopia is one of the countries with high out-of-pocket payments leading to catastrophic health expenditure. The government of Ethiopia introduced social health insurance (SHI) scheme with the overall objective of achieving universal health care access. Studying health professionals’ acceptance to pay for social health insurance is crucial for the successful implementation of the scheme. Therefore, this study aimed to assess the acceptance of social health insurance and its associated factors among health professionals in government hospitals, Mekelle city, North Ethiopia. Methods. An institution-based cross-sectional study design was used. The study participants were selected using systematic random sampling. Data were collected using a structured interviewer-administered questionnaire and analyzed using SPSS version 20. Bivariable and multivariable logistic regression models at a 5% level of significance, and odds ratios with 95% CI level were used to determine the association between the health professionals’ acceptance of health insurance and explanatory variables. Results. The study revealed that 62.5% of the respondents were willing to participate in the SHI scheme in which 74.9% were willing to pay 3% or more of their monthly salary. Health professionals’ acceptance for SHI significantly associated with monthly salary (AOR = 9.49; 95% CI: 2.51, 35.86), awareness about SHI (AOR = 3.89; 95% CI: 1.05, 14.28), history of difficulty in covering medical bills (AOR = 6.2; 95% CI: 2.42, 15.87), attitudes towards social health insurance (AOR = 7.57; 95% CI: 3.14, 18.21), and perceived quality of health care services if SHI implemented (AOR = 2.89; 95% CI: 1.18, 7.07). Conclusion. The study indicated that there were still a high proportion of health professionals who were not willing to pay for SHI. Therefore, strengthening awareness creation, creating awareness about SHI, promoting the scheme using the different channels of communication to bring about favorable attitude, and providing health care services with required standard quality could help to increase the acceptance of SHI by health professionals.
{"title":"Acceptance for Social Health Insurance among Health Professionals in Government Hospitals, Mekelle City, North Ethiopia","authors":"Alemtsehay Tewele, Mezgebu Yitayal, A. Kebede","doi":"10.1155/2020/6458425","DOIUrl":"https://doi.org/10.1155/2020/6458425","url":null,"abstract":"Background. Ethiopia is one of the countries with high out-of-pocket payments leading to catastrophic health expenditure. The government of Ethiopia introduced social health insurance (SHI) scheme with the overall objective of achieving universal health care access. Studying health professionals’ acceptance to pay for social health insurance is crucial for the successful implementation of the scheme. Therefore, this study aimed to assess the acceptance of social health insurance and its associated factors among health professionals in government hospitals, Mekelle city, North Ethiopia. Methods. An institution-based cross-sectional study design was used. The study participants were selected using systematic random sampling. Data were collected using a structured interviewer-administered questionnaire and analyzed using SPSS version 20. Bivariable and multivariable logistic regression models at a 5% level of significance, and odds ratios with 95% CI level were used to determine the association between the health professionals’ acceptance of health insurance and explanatory variables. Results. The study revealed that 62.5% of the respondents were willing to participate in the SHI scheme in which 74.9% were willing to pay 3% or more of their monthly salary. Health professionals’ acceptance for SHI significantly associated with monthly salary (AOR = 9.49; 95% CI: 2.51, 35.86), awareness about SHI (AOR = 3.89; 95% CI: 1.05, 14.28), history of difficulty in covering medical bills (AOR = 6.2; 95% CI: 2.42, 15.87), attitudes towards social health insurance (AOR = 7.57; 95% CI: 3.14, 18.21), and perceived quality of health care services if SHI implemented (AOR = 2.89; 95% CI: 1.18, 7.07). Conclusion. The study indicated that there were still a high proportion of health professionals who were not willing to pay for SHI. Therefore, strengthening awareness creation, creating awareness about SHI, promoting the scheme using the different channels of communication to bring about favorable attitude, and providing health care services with required standard quality could help to increase the acceptance of SHI by health professionals.","PeriodicalId":30619,"journal":{"name":"Advances in Public Health","volume":"63 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2020-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86139715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Akakpo, E. G. Imbeah, F. Agyarko-Wiredu, K. Awlavi, Kwame Baah-Amoh, L. Derkyi-Kwarteng
Objective. Mortality data from hospitals in Ghana suggest a changing mortality trend with noncommunicable diseases (cardiovascular disorders) replacing communicable diseases as the leading cause of death. Our objective was to find out the causes of deaths in the communities of the Central Region of Ghana and raise awareness of these causes of deaths while highlighting the differences that exist between data obtained from the community and that obtained from the hospital. Method. Mortality data from Coroner’s autopsies mostly provide data about the causes of deaths in the community (out of hospital). A retrospective descriptive study of Coroner’s autopsy data at the Cape Coast Teaching Hospital was carried out over a six-year period. The various causes of death were categorized according to broad headings (accidents/injuries/poisoning, cardiovascular, infections, metabolic, neoplasms, and others). Results. A total of 1187 autopsies were reviewed of which 990 (83.4%) were Coroner’s cases. Of these Coroner’s cases, 719 (72.6%) were male and 271 (27.4%) were female. 521 (52.6%) of victims were young adults (18–44 years), and majority of deaths were unnatural (due to accidents, injuries, and poisoning) (64.1%), followed by the general category of others (15.3%). Cardiovascular deaths (6.6%) were fourth after infections (9.8%). In the leading category, most deaths were due to road traffic accidents (50.4%) as occupants of vehicles and motorcycles (28.7%) and as pedestrians (21.7%). Deaths due to road traffic accidents were followed by deaths due to drowning (14.96%). Conclusion. Although noncommunicable diseases are still the leading causes of death outside the hospital, most of the deaths are due to road traffic accidents and drowning. This is at variance with hospital data that suggest that the leading noncommunicable diseases are cardiovascular disorders and cancer. Again, like data derived from hospitals, infections remain a major cause of death in the Central Region of Ghana. Studies combining the causes of death derived from Coroner’s autopsies and communities and from medical certificates of cause of death will present a better picture of the leading causes of death in the Central Region and reveal the true nature of noncommunicable diseases that currently form our largest disease burden.
{"title":"Community Causes of Death in the Central Region of Ghana, the Missing Piece in Mortality Data","authors":"P. Akakpo, E. G. Imbeah, F. Agyarko-Wiredu, K. Awlavi, Kwame Baah-Amoh, L. Derkyi-Kwarteng","doi":"10.1155/2020/2714616","DOIUrl":"https://doi.org/10.1155/2020/2714616","url":null,"abstract":"Objective. Mortality data from hospitals in Ghana suggest a changing mortality trend with noncommunicable diseases (cardiovascular disorders) replacing communicable diseases as the leading cause of death. Our objective was to find out the causes of deaths in the communities of the Central Region of Ghana and raise awareness of these causes of deaths while highlighting the differences that exist between data obtained from the community and that obtained from the hospital. Method. Mortality data from Coroner’s autopsies mostly provide data about the causes of deaths in the community (out of hospital). A retrospective descriptive study of Coroner’s autopsy data at the Cape Coast Teaching Hospital was carried out over a six-year period. The various causes of death were categorized according to broad headings (accidents/injuries/poisoning, cardiovascular, infections, metabolic, neoplasms, and others). Results. A total of 1187 autopsies were reviewed of which 990 (83.4%) were Coroner’s cases. Of these Coroner’s cases, 719 (72.6%) were male and 271 (27.4%) were female. 521 (52.6%) of victims were young adults (18–44 years), and majority of deaths were unnatural (due to accidents, injuries, and poisoning) (64.1%), followed by the general category of others (15.3%). Cardiovascular deaths (6.6%) were fourth after infections (9.8%). In the leading category, most deaths were due to road traffic accidents (50.4%) as occupants of vehicles and motorcycles (28.7%) and as pedestrians (21.7%). Deaths due to road traffic accidents were followed by deaths due to drowning (14.96%). Conclusion. Although noncommunicable diseases are still the leading causes of death outside the hospital, most of the deaths are due to road traffic accidents and drowning. This is at variance with hospital data that suggest that the leading noncommunicable diseases are cardiovascular disorders and cancer. Again, like data derived from hospitals, infections remain a major cause of death in the Central Region of Ghana. Studies combining the causes of death derived from Coroner’s autopsies and communities and from medical certificates of cause of death will present a better picture of the leading causes of death in the Central Region and reveal the true nature of noncommunicable diseases that currently form our largest disease burden.","PeriodicalId":30619,"journal":{"name":"Advances in Public Health","volume":"50 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2020-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84703386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background. Undernutrition is one of the most widespread public health problems that affect both developed and developing countries. In Ethiopia, it is one of the factors leading to unacceptable high morbidity and mortality among women. However, little is documented on undernutrition among lactating women particularly in such a purely pastoral community. Therefore, this study was designed to assess prevalence of undernutrition and its associated factors among lactating women living in pastoral community of Moyale District, Borena Zone, Southern Ethiopia, 2018. Methods. A community-based cross-sectional study was conducted. Data were collected from a random sampled 545 lactating women using structured interviewer-administered questionnaire. Height and weight measurements of the study participants were also taken to compute body mass index. Data were entered in to Epi info version 7 and then exported to SPSS version 21 software for analysis. Descriptive statistics like frequency, mean, and percentage were computed to describe characteristics of the sample. Multivariable analysis was carried out, association between independent and dependent variables were measured using adjusted odds ratios, and its 95% confidence interval and P value below 0.05 were considered statistically significant. Results. This study showed that prevalence of undernutrition among lactating women was 17.7%. Dietary diversity (AOR = 2.49, 95% CI: 1.43–4.36), monthly income (AOR = 5.22, 95% CI: 1.40–19.40), extra meal taking (AOR = 2.76, 95% CI: 1.43–5.29, delivery place (AOR = 2.65, 95% CI: 1.24–5.65), and household food insecurity (AOR = 6.57, 95% CI: 3.50–12.34) were independent variables showing statistically significant association with undernutrition of lactating women. Conclusion and recommendations. The study revealed that magnitude of undernutrition among lactating women was high. Dietary diversity, monthly income, extra meal, delivery place, and household food insecurity were found to be predictor of undernutrition. Finally, we recommend that governmental and nongovernmental organizations should organize timely interventions targeting lactating women.
{"title":"Undernutrition and Associated Factors among Lactating Women: Community-Based Cross-Sectional Study in Moyale District, Borena Zone, Southern Ethiopia","authors":"H. Bekele, G. H. Jima, Ashenafi Habtamu Regesu","doi":"10.1155/2020/4367145","DOIUrl":"https://doi.org/10.1155/2020/4367145","url":null,"abstract":"Background. Undernutrition is one of the most widespread public health problems that affect both developed and developing countries. In Ethiopia, it is one of the factors leading to unacceptable high morbidity and mortality among women. However, little is documented on undernutrition among lactating women particularly in such a purely pastoral community. Therefore, this study was designed to assess prevalence of undernutrition and its associated factors among lactating women living in pastoral community of Moyale District, Borena Zone, Southern Ethiopia, 2018. Methods. A community-based cross-sectional study was conducted. Data were collected from a random sampled 545 lactating women using structured interviewer-administered questionnaire. Height and weight measurements of the study participants were also taken to compute body mass index. Data were entered in to Epi info version 7 and then exported to SPSS version 21 software for analysis. Descriptive statistics like frequency, mean, and percentage were computed to describe characteristics of the sample. Multivariable analysis was carried out, association between independent and dependent variables were measured using adjusted odds ratios, and its 95% confidence interval and P value below 0.05 were considered statistically significant. Results. This study showed that prevalence of undernutrition among lactating women was 17.7%. Dietary diversity (AOR = 2.49, 95% CI: 1.43–4.36), monthly income (AOR = 5.22, 95% CI: 1.40–19.40), extra meal taking (AOR = 2.76, 95% CI: 1.43–5.29, delivery place (AOR = 2.65, 95% CI: 1.24–5.65), and household food insecurity (AOR = 6.57, 95% CI: 3.50–12.34) were independent variables showing statistically significant association with undernutrition of lactating women. Conclusion and recommendations. The study revealed that magnitude of undernutrition among lactating women was high. Dietary diversity, monthly income, extra meal, delivery place, and household food insecurity were found to be predictor of undernutrition. Finally, we recommend that governmental and nongovernmental organizations should organize timely interventions targeting lactating women.","PeriodicalId":30619,"journal":{"name":"Advances in Public Health","volume":"2 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2020-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83679591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. S. Simelane, Mduduzi Colani Shongwe, K. Vermaak, E. Zwane
Worldwide, millions of people still die from diseases associated with inadequate water supply, sanitation, and hygiene, despite the fact that the United Nations recognized access to clean drinking water and sanitation as a human right nearly a decade ago. The objective of this study was to describe the determinants of access to improved drinking water sources in Eswatini in 2010 and 2014. Using the Eswatini Multiple Indicator Cluster Surveys (EMICSs), data for 4,819 households in 2010 and 4,843 in 2014 were analyzed. Bivariate and multivariate complementary log-log regression analyses were conducted to identify the determinants of households’ access to improved drinking water sources. The study found that households’ access to improved drinking water sources significantly improved from 73.1% in 2010 to 77.7% in 2014 (p<0.0001). In 2010, households whose heads were aged 35–54 and 55 years had lower odds of having access to improved drinking water sources than those with younger ones. In 2014, female-headed households had lower odds, while, in 2010, sex of the household head was not associated with access to improved drinking water sources. In both years, an increase in the number of household members was negatively associated with access to improved drinking water sources compared to those with fewer members. In both years, the odds of access to improved drinking water sources increased with an increase in the wealth index of the household, and households located in urban areas had higher odds of access to improved drinking water sources compared to those in rural settings. In both years, households from the Shiselweni and Lubombo regions had lower odds of access to improved drinking water sources. The government and its partners should continue to upscale efforts aimed at increasing access to improved drinking water, especially in rural areas, to reduce the disparity that exists between urban and rural households.
{"title":"Determinants of Households’ Access to Improved Drinking Water Sources: A Secondary Analysis of Eswatini 2010 and 2014 Multiple Indicator Cluster Surveys","authors":"M. S. Simelane, Mduduzi Colani Shongwe, K. Vermaak, E. Zwane","doi":"10.1155/2020/6758513","DOIUrl":"https://doi.org/10.1155/2020/6758513","url":null,"abstract":"Worldwide, millions of people still die from diseases associated with inadequate water supply, sanitation, and hygiene, despite the fact that the United Nations recognized access to clean drinking water and sanitation as a human right nearly a decade ago. The objective of this study was to describe the determinants of access to improved drinking water sources in Eswatini in 2010 and 2014. Using the Eswatini Multiple Indicator Cluster Surveys (EMICSs), data for 4,819 households in 2010 and 4,843 in 2014 were analyzed. Bivariate and multivariate complementary log-log regression analyses were conducted to identify the determinants of households’ access to improved drinking water sources. The study found that households’ access to improved drinking water sources significantly improved from 73.1% in 2010 to 77.7% in 2014 (p<0.0001). In 2010, households whose heads were aged 35–54 and 55 years had lower odds of having access to improved drinking water sources than those with younger ones. In 2014, female-headed households had lower odds, while, in 2010, sex of the household head was not associated with access to improved drinking water sources. In both years, an increase in the number of household members was negatively associated with access to improved drinking water sources compared to those with fewer members. In both years, the odds of access to improved drinking water sources increased with an increase in the wealth index of the household, and households located in urban areas had higher odds of access to improved drinking water sources compared to those in rural settings. In both years, households from the Shiselweni and Lubombo regions had lower odds of access to improved drinking water sources. The government and its partners should continue to upscale efforts aimed at increasing access to improved drinking water, especially in rural areas, to reduce the disparity that exists between urban and rural households.","PeriodicalId":30619,"journal":{"name":"Advances in Public Health","volume":"6 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2020-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88318676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background. Although nutritional problems are among the Ethiopian government’s priorities, the progress of nutritional indicators in the pastoral/agro-pastoral community is below the national figure. This could be because of poor food choice decisions, which remains poorly understood. Therefore, this study aimed to explore the drivers of food choice among the pastoral/agro-pastoral community of Somali Regional State, Eastern Ethiopia. Materials and Methods. A qualitative study was conducted among 16 Focused Group Discussions (FGDs) and six Key Informant Interviews (KIIs) from May 7 to 27, 2018. Participants were selected purposefully. Native speakers of Somali language, who had previous qualitative data collection experience, collected the data. The overall collected data were cleaned, coded, sorted, categorized, and analyzed line-by-line. Content analysis was used to drive the key themes and sub-themes. Results. The study found that the commonest food item usually consumed by the community was porridge (“Shurow”), which is made from wheat or corn flour. The porridge is sometimes mixed with milk or butter. Besides, they consume boiled bean, wheat or sorghum (“Garaw”) that is mixed with oil or sugar. However, the consumption of fruits and vegetables was rare and seasonal. These all indicate that their feeding habit was monotonous with poor food choice decisions. The reported driving factors of food choice included drought, income, cost, availability and quality of foods, market access, familiarity with new foods, knowledge of nutritious foods, and health status of individuals. Conclusions. The food choice of the community was poor in the study area. Therefore, the health and agricultural sectors should work together to improve the feeding habits of this community by improving their knowledge and the availability of nutritious foods.
{"title":"Drivers of Food Choice among Pastoral/Agro-Pastoral Community in Somali Regional State, Eastern Ethiopia","authors":"Berhe Gebremichael, Abiyot Asfaw","doi":"10.1155/2019/1472487","DOIUrl":"https://doi.org/10.1155/2019/1472487","url":null,"abstract":"Background. Although nutritional problems are among the Ethiopian government’s priorities, the progress of nutritional indicators in the pastoral/agro-pastoral community is below the national figure. This could be because of poor food choice decisions, which remains poorly understood. Therefore, this study aimed to explore the drivers of food choice among the pastoral/agro-pastoral community of Somali Regional State, Eastern Ethiopia. Materials and Methods. A qualitative study was conducted among 16 Focused Group Discussions (FGDs) and six Key Informant Interviews (KIIs) from May 7 to 27, 2018. Participants were selected purposefully. Native speakers of Somali language, who had previous qualitative data collection experience, collected the data. The overall collected data were cleaned, coded, sorted, categorized, and analyzed line-by-line. Content analysis was used to drive the key themes and sub-themes. Results. The study found that the commonest food item usually consumed by the community was porridge (“Shurow”), which is made from wheat or corn flour. The porridge is sometimes mixed with milk or butter. Besides, they consume boiled bean, wheat or sorghum (“Garaw”) that is mixed with oil or sugar. However, the consumption of fruits and vegetables was rare and seasonal. These all indicate that their feeding habit was monotonous with poor food choice decisions. The reported driving factors of food choice included drought, income, cost, availability and quality of foods, market access, familiarity with new foods, knowledge of nutritious foods, and health status of individuals. Conclusions. The food choice of the community was poor in the study area. Therefore, the health and agricultural sectors should work together to improve the feeding habits of this community by improving their knowledge and the availability of nutritious foods.","PeriodicalId":30619,"journal":{"name":"Advances in Public Health","volume":"13 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2019-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82260385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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