Practical contribution of women development army on growth monitoring and promotion service at Dembya and Gondar Zuria districts, Central Gondar Zone, North West Ethiopia: a community based mixed study

BACKGROUND

The United Nations' Sustainable Development Goal (SDG)-2 aims to eliminate child hunger or end all forms of child malnutrition by 2030. To achieve this goal the cost-effective method is the implementation of growth monitoring and promotion service with the contribution of Women Development Army (WDA) as community volunteers. However, According to the data, the program's implementation varies throughout the country and lack of evidence on the practical contribution of the WDA to enhancing child nutritional care outcomes. Therefore this study aimed to determine practical contribution of WDA and associated factors on growth monitoring and promotion service in two rural districts of central Gondar zone, Northwest Ethiopia.

METHODS

A community based mixed study was conducted from March 6 to April 7, 2022 among 615 Women Development Army. Multistage sampling technique was used to select study participants. A structured questionnaire was used to collect quantitative data and in-depth interview were used to generate qualitative information. Qualitative data were coded and grouped and discussed using identified themes. Binary logistic regression was fitted, odds ratio with 95% confidence interval was estimated to identify factors of practical contribution of WDA and qualitative data was analyzed using thematic analysis.

RESULTS

In this study practical contribution of WDA on growth monitoring was 31.4% (95% CI: 28.0-35.3%). Having GMP training (AOR = 4.2, 95%CI: 1.63, 10.58), regular community conversation (AOR = 6.0, 95%CI: 3.12, 11.54), good knowledge about GMP (AOR = 2.1, 95%CI: 1.17, 3.83) and not having regular schedule of GMP service in the area (AOR = 0.04, 95%CI: 0.02, 0.09), were statistically significantly associated with practical contribution of growth monitoring. During in-depth interview, lack of training, low motivation or commitment among WDA and low communication between WDA and health extension workers were mentioned among the problems faced during growth monitoring service.

CONCLUSION

In this study, practical contribution of growth monitoring among WDA was low. GMP training regular community conversation, knowledge about GMP and regular schedule of GMP service in the local area were significantly associated for practical contribution of growth monitoring service. Lack of training, low motivation or commitment among WDA and low communication between WDA and health extension workers were reasons for did not contribute effectively for GMP service. Therefore, giving training for WDA and improving community conversation at kebeles level are important to improve GM service. .

Exploring barriers to diversified dietary feeding habits among adolescents in the agrarian community, North West Ethiopia

Introduction

Adolescence is a critical and neglected age group of the population in any form of nutritional intervention. A comprehensive study that assesses barriers that influence their diversified feeding habit is not well investigated in qualitative approaches. Therefore, this study was conducted to fill this gap by providing evidence on exploring barriers to diversified feeding habits of adolescents in the agrarian community, North West Ethiopia.

Objective

The aim of the study was to explore barriers to diversified feeding habits of adolescents in the agrarian community, North West Ethiopia.

Methods

A phenomenological qualitative study design was conducted among adolescents in the age group of 10-19 years, and adults in the age range of 25 to 64 years (representatives of farmers, agricultural, health, and education sectors). We conducted 24 in-depth interviews (12- adolescents, 4-health, 2- agricultural extension, 3-education, and 3-farmer representative) among purposively selected community groups. In-depth interview guides and observation checklist were utilized for data collection. The audio-recorded qualitative data were transcribed word by word into English. Finally, the translated data were exported to ATLAS ti version 7.1 software for thematic analysis based on inductive content analysis. All coded quotations, including memos written throughout the coding process, were then analyzed to identify themes inductively.

Results

Dietary habit of adolescents in the study area was predominantly plant-based cereals with low protein, vitamins, and mineral contents. Adolescents have limited consumption of fruits, vegetables, and animal source foods. Adolescents with these feeding habits had suboptimal intake of micronutrients and proteins, which are crucial for their rapid growth stage. Individual-level barriers, family-level influence, dietary tradition of community, agricultural practice (poor agroforestry practice of the community, and poor agricultural practice to produce year-round diverse food items), and week multi-sectorial collaboration for nutritional intervention all influenced adolescent dietary habits.

Conclusion

Multiple layers of barriers influenced the diverse dietary habits of adolescents in the study setting. These multiple and interconnected influences ranged from individual level to multi-sectorial collaboration. Nutritional interventions should be implemented at the individual, family, agricultural, and multi-sectorial levels to improve adolescents' diverse dietary habits.

Validation of in-house liquid direct agglutination test antigen: the potential diagnostic test in visceral Leishimaniasis endemic areas of Northwest Ethiopia

Background

Visceral leishmaniasis in Ethiopia is a re-emerging threat to public health, with increased geographical distribution and number of cases. It is a fatal disease without early diagnosis and treatment; thus, the availability of affordable diagnostic tools is crucial. However, due to delays caused by import regulations, procurement and late delivery of imported test kits, accessibility remains a problem in the control program. Therefore, we aimed to produce and evaluate the performance of an in-house liquid (AQ) direct agglutination test (DAT) antigen.

Result

The AQ-DAT was produced at the Armauer Hansen Research Institute, using Leishmania donovani strain (MHOM/ET/67/L82). Sera from 272 participants; 110 microscopically confirmed cases of VL, 76 apparently healthy and 86 patients who had infectious disease other than VL were tested with AQ-DAT, and standard kits: Freeze-dried DAT (FD-DAT) and rK39. Taking microscopy as a gold standard; the sensitivity and specificity of the AQ-DAT were 97.3 and 98.8%, respectively. It had high degrees of agreement (k > 0.8), with a significant (P < 0.05) correlation compared to microscopy, FD-DAT, and rK39.

Conclusion

Although further standardization is required, the in-house AQ-DAT could improve diagnostic accessibility, minimize intermittent stock outs and strengthen the national VL control program.

TNF-α (-308) Gene Polymorphism and Type 2 Diabetes Mellitus in Ethiopian Diabetes Patients

BACKGROUND

Type 2 diabetes mellitus (T2DM) is a metabolic disorder resulting from insulin insufficiency or function. Predisposing factors for T2DM are mainly genetic and environmental. Genetic polymorphism of cytokines like tumor necrosis factor-alpha (TNF-α) is suggestive of interference with insulin-sensitive glucose uptake and induces insulin resistance that ultimately could lead to T2DM. In this study, we assessed the effect of TNF-α (-308) G/A gene polymorphism and its association with the development of T2DM in an Ethiopian population.

METHODS

An institutional-based cross-sectional study was conducted on study subjects with T2DM and non-diabetic healthy controls. DNA was extracted and genotyping was carried out by using amplification refractory mutation system polymerase chain reaction. A genetic-polymorphism on TNF-α (-308) G/A with T2DM was evaluated by logistic regression and Student's t-test. A P-value <0.05 was considered as statistically significant.

RESULTS

In the present study, we observed a significant association between T2DM and TNF-α (-308) gene polymorphism's GG genotype [χ2 test P = 0.005, OR (95% CI) =2.667 (1.309-5.45d8)]. In contrast, no statistically significant differences were observed in the frequencies of genotypes AA and AG (χ2 test P=0.132 and 0.067, respectively). Moreover, T2DM individuals had higher concentrations of lipid profiles for those carrying the TNF-α (-308) GG genotype as compared to the control group.

CONCLUSION

TNF-α (-308) genetic polymorphism may be implicated in the genetic susceptibility for, as well as the development of T2DM and lipid metabolism in the Ethiopian population. Therefore, a large-scale study and early screening of TNF-α (-308) genetic polymorphism may help in early management and control of diabetes and related outcomes.

Knowledge, attitude and practice towards cervical cancer among women in Finote Selam city administration, West Gojjam Zone, Amhara Region, North West Ethiopia, 2017

Introduction

Cancer of the cervix is the leading cause of cancer-related death among women, especially in developing countries affecting women at a time of life when they are critical to social and economic stability.

Method

The study was conducted at Finote Selam City Administration from February 01 to March 01, 2017 using a community-based cross-sectional study design. The representative sample size was selected using multistage sampling technique. The data were collected using an interviewer-administered questionnaire adapted from the previous study. Data were entered using EpiData Version 3.1 statistical software and analyzed using SPSS version 20 statistical package.

Result

One hundred seventy (23.1%) were knowledgeable about cervical cancer whereas 63% of participants had a negative attitude and only 7.3% had ever screened for the disease. Logistic regression analysis showed that age, marital status, religion, experienced sexual intercourse and age at 1^st sexual intercourse were found to be significantly associated with the knowledge of cancer of the cervix.

Conclusion

Ministry of health in collaboration with other concerned bodies should design a strategy to give education about cervical cancer including information on risk factors, signs and symptoms; and availability of screening should be provided for women and as well as for the public.

Level of modern health care seeking behaviors among mothers having under five children in Dangila town, north West Ethiopia, 2016: a cross sectional study

Background

Health seeking behavior is an action taken by an individual who perceive to have a health problem. In most developing countries including Ethiopia the health of the children is strongly dependant on maternal health care behavior. Most childhood morbidities and mortalities are associated with low level of mothers health care seeking behavior. Therefore, the objective of this study was to assess level of modern health care seeking behavior among mothers having under five children in Dangila town, North West Ethiopia.

Methods

Community based quantitative cross-sectional study was conducted from April 15 to May 15, 2016. Systematic random sampling technique was used to select study participants. A total of273 mothers with children less than five years were included in this study. The data was collected from all five Kebeles using interviewer administered questionnaire. Descriptive and inferential statistics were used to present the data. Both bivariate and multivariate logistic regression analyses were used to identify factors associated with level of modern health care seeking behavior.

Results

Prevalence of modern health care seeking behavior was 82.1%. Age of mothers (AOR = 2.4(1.1, 5.3), age of the child (AOR = 6.7(2.8, 22.2), severity of illness (AOR = 5.2(1.2, 22.6) and family number (AOR = 6.4(2.1, 20.2) were predictors of modern health care seeking behavior among mothers.

Conclusions

Majority of the mothers preferred to take their children to modern health care when they got illness. Age of children, age of mother, number of family and severity of illness were the determinant factors for modern health care seeking behavior. Therefore, health care services should be strengthened at community level through community integrated management of childhood illness, information, education communication / behavioral change communication strategies to improve mothers health care seeking behaviors.

Implementation of nursing process in clinical settings: the case of three governmental hospitals in Ethiopia, 2017

Objective

The purpose of this survey was to evaluate the implementation of the nursing process at three randomly selected governmental hospitals found in Amhara Region North West Ethiopia.

Result

From the total 338 reviewed documents, 264 (78.1%) have a nursing process format attached with the patient’s profile/file, 107 (31.7%) had no nursing diagnosis, 185 (54.7%) of nurses stated their plan of care based on priority, 173 (51.2%) of nurses did not document their interventions based on plan and 179 (53.0%) of nurses did not evaluate their interventions. The overall implementation of nursing process among Felege Hiwot Referal hospital, Debretabor general hospital and Finoteselam general hospitals were 49.12, 68.18, and 69.42% respectively. Nursing professionals shall improve documentation required in implementing the nursing process. Nursing managers (matron, ward heads) shall supervise the overall implementation of nursing process. Hospital nursing services managers (matrons) shall arrange and facilitate case presentations by the nursing staffs which focus on documentation and updates on nursing process. Hospitals need to establish and support nursing process coordinating staff in their institution.

Women's social networks and use of facility delivery services for uncomplicated births in North West Ethiopia: a community-based case-control study

BACKGROUND

High maternal mortality has remained an unmet public health challenge in the developing world. Maternal mortality in Ethiopia is among the highest in the world. Since most maternal deaths occur during labor, delivery, and the immediate postpartum period, facility delivery with skilled birth attendants is recommended to reduce maternal mortality. Nonetheless, the majority of women in Ethiopia give birth at home. Individual attributes and availability and accessibility of services deter service utilization. The role of social networks that may facilitate or constrain service use is not well studied.

METHODS

Community-based case-control study was conducted between February and March 2014 in Jabi Tehinan District, North West Ethiopia. Retrospective data were collected from 134 women who had uncomplicated births at health facilities and 140 women who had uncomplicated births at home within a year preceding the survey. Interviews were held with eight women who had uncomplicated births at health facilities and 11 who had uncomplicated births at home. The quantitative data were entered and analyzed using SPSS for Windows versions 16.0 and hierarchical logistic regression model was used for analysis. The qualitative data were transcribed verbatim and data were used to substantiate the quantitative data.

RESULTS

The results indicated that social network variables were significantly associated with the use of health facilities for delivery. Taking social networks into account improved the explanation of facility use for delivery services over women's individual attributes. Women embedded within homogeneous network members (Adjusted OR 2.53; 95% CI: 1.26-5.06) and embedded within high SBA endorsement networks (Adjusted OR 7.97; 95% CI: 4.07-12.16) were more likely to deliver at health facilities than their counterparts. Women living in urban areas (Adjusted OR 3.32; 95% CI: 1.37-8.05) and had better knowledge of obstetric complications (Adjusted OR 3.01; 95% CI: 1.46-6.18) were more likely to deliver at health facilities.

CONCLUSION

Social networks facilitate SBA utilization by serving as a reference for the behavior to deliver at health facilities. These findings inform health professionals and other stakeholders regarding the importance of considering women's social networks in designing intervention to increase the proportion of women who deliver at health facilities.