Publications by authors named "Teketo Kassaw Tegegne"

10 Publications

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Risk factors for COVID-19 infection, disease severity and related deaths in Africa: a systematic review.

BMJ Open 2021 02 18;11(2):e044618. Epub 2021 Feb 18.

Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia.

Objective: The aim of this study was to provide a comprehensive evidence on risk factors for transmission, disease severity and COVID-19 related deaths in Africa.

Design: A systematic review has been conducted to synthesise existing evidence on risk factors affecting COVID-19 outcomes across Africa.

Data Sources: Data were systematically searched from MEDLINE, Scopus, MedRxiv and BioRxiv.

Eligibility Criteria: Studies for review were included if they were published in English and reported at least one risk factor and/or one health outcome. We included all relevant literature published up until 11 August 2020.

Data Extraction And Synthesis: We performed a systematic narrative synthesis to describe the available studies for each outcome. Data were extracted using a standardised Joanna Briggs Institute data extraction form.

Results: Fifteen articles met the inclusion criteria of which four were exclusively on Africa and the remaining 11 papers had a global focus with some data from Africa. Higher rates of infection in Africa are associated with high population density, urbanisation, transport connectivity, high volume of tourism and international trade, and high level of economic and political openness. Limited or poor access to healthcare are also associated with higher COVID-19 infection rates. Older people and individuals with chronic conditions such as HIV, tuberculosis and anaemia experience severe forms COVID-19 leading to hospitalisation and death. Similarly, high burden of chronic obstructive pulmonary disease, high prevalence of tobacco consumption and low levels of expenditure on health and low levels of global health security score contribute to COVID-19 related deaths.

Conclusions: Demographic, institutional, ecological, health system and politico-economic factors influenced the spectrum of COVID-19 infection, severity and death. We recommend multidisciplinary and integrated approaches to mitigate the identified factors and strengthen effective prevention strategies.
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http://dx.doi.org/10.1136/bmjopen-2020-044618DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7896374PMC
February 2021

Spatial variations and associated factors of modern contraceptive use in Ethiopia: a spatial and multilevel analysis.

BMJ Open 2020 10 12;10(10):e037532. Epub 2020 Oct 12.

School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.

Objective: To assess spatial variations in modern contraceptive use and to identify factors associated with it among married women in Ethiopia.

Design: Cross-sectional analysis of population-based and health facility data.

Setting: Ethiopia Demographic and Health Survey data linked to Service Provision Assessment data.

Population: 8473 married women and 1020 facilities that reported providing family planning services.

Methods: A linked secondary data analysis of population and health facility data was carried out. Both multilevel and spatial analyses were conducted to identify key determinants of women's use of modern contraceptive and spatial clustering of modern contraceptive use.

Main Outcome Measure: Modern contraceptive use.

Results: About 24% of the variation in the use of modern contraception was accounted for by location. A one-unit increase in the mean score of health facilities' readiness to provide short-term modern contraceptives in a typical region was associated with a 20-fold increase in the odds of modern contraceptive use (adjusted OR (AOR) 20.49, 95% CI 1.44 to 29.54). In the spatial analysis, it was found that Addis Ababa and the Amhara region had high clusters of modern contraceptive use rates. On the other hand, low rates of contraceptive use were clustered in the Afar and Somali regions.

Conclusion: There were significant variations in the use of modern contraceptives across the different regions of Ethiopia. Therefore, regions with low contraceptive rates and high fertility rates should be targeted for scaling up and tailoring of services to the culture and lifestyles of the population of those regions.
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http://dx.doi.org/10.1136/bmjopen-2020-037532DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7552846PMC
October 2020

Antenatal care use in Ethiopia: a spatial and multilevel analysis.

BMC Pregnancy Childbirth 2019 Nov 1;19(1):399. Epub 2019 Nov 1.

Research Centre for Generational Health and Ageing, Hunter Medical Research Institute, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.

Background: Accessibility and utilization of antenatal care (ANC) service varies depending on different geographical locations, sociodemographic characteristics, political and other factors. A geographically linked data analysis using population and health facility data is valuable to map ANC use, and identify inequalities in service access and provision. Thus, this study aimed to assess the spatial patterns of ANC use, and to identify associated factors among pregnant women in Ethiopia.

Method: A secondary data analysis of the 2016 Ethiopia Demographic and Health Survey linked with the 2014 Ethiopian Service Provision Assessment was conducted. A multilevel analysis was carried out using the SAS GLIMMIX procedure. Furthermore, hot spot analysis and spatial regressions were carried out to identify the hot spot areas of and factors associated with the spatial variations in ANC use using ArcGIS and R softwares.

Results: A one-unit increase in the mean score of ANC service availability in a typical region was associated with a five-fold increase in the odds of having more ANC visits. Moreover, every one-kilometre increase in distance to the nearest ANC facility in a typical region was negatively associated with having at least four ANC visits. Twenty-five percent of the variability in having at least four ANC visits was accounted for by region of living. The spatial analysis found that the Southern Nations, Nationalities and Peoples region had high clusters of at least four ANC visits. Furthermore, the coefficients of having the first ANC visit during the first trimester were estimated to have spatial variations in the use of at least four ANC visits.

Conclusion: There were significant variations in the use of ANC services across the different regions of Ethiopia. Region of living and distance were key drivers of ANC use underscoring the need for increased ANC availability, particularly in the cold spot regions.
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http://dx.doi.org/10.1186/s12884-019-2550-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6825362PMC
November 2019

Service environment link and false discovery rate correction: Methodological considerations in population and health facility surveys.

PLoS One 2019 18;14(7):e0219860. Epub 2019 Jul 18.

Research Centre for Generational Health and Ageing, Hunter Medical Research Institute, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.

Background: Geospatial data are important in monitoring many aspects of healthcare development. Geographically linking health facility data with population data is an important area of public health research. Examining healthcare problems spatially and hierarchically assists with efficient resource allocation and the monitoring and evaluation of service efficacy at different levels. This paper explored methodological issues associated with geographic data linkage, and the spatial and multilevel analyses that could be considered in analysing maternal health service data.

Methods: The 2016 Ethiopia Demographic and Health Survey and the 2014 Ethiopia Service Provision Assessment data were used. Two geographic data linking methods were used to link these two datasets. Administrative boundary link was used to link a sample of health facilities data with population survey data for analysing three areas of maternal health service use. Euclidean buffer link was used for a census of hospitals to analyse caesarean delivery use in Ethiopia. The Global Moran's I and the Getis-Ord Gi* statistics need to be carried out for identifying hot spots of maternal health service use in ArcGIS software. In addition to this, since the two datasets contain hierarchical data, a multilevel analysis was carried out to identify key determinants of maternal health service use in Ethiopia.

Results: Administrative boundary link gave more types of health facilities and more maternal health services as compared to the Euclidean buffer link. Administrative boundary link is the method of choice in case of sampled health facilities. However, for a census of health facilities, the Euclidean buffer link is the appropriate choice as this provides cluster level service environment estimates, which the administrative boundary link does not. Applying a False Discovery Rate correction enables the identification of true spatial clusters of maternal health service use.

Conclusions: A service environment link minimizes the methodological issues associated with geographic data linkage. A False Discovery Rate correction needs to be used to account for multiple and dependent testing while carrying out local spatial statistics. Examining maternal health service use both spatially and hierarchically has tremendous importance for identifying geographic areas that need special emphasis and for intervention purposes.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0219860PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6638937PMC
March 2020

The impact of geographic access on institutional delivery care use in low and middle-income countries: Systematic review and meta-analysis.

PLoS One 2018 30;13(8):e0203130. Epub 2018 Aug 30.

Research Centre for Generational Health and Ageing, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.

Background: Geographic access to obstetric care facilities has a significant influence on women's uptake of institutional delivery care. However, this effect was not consistent across studies. Some studies reported that geographic access to obstetric care facilities had no influence on the use of facility delivery. Therefore, this systematic review and meta-analysis synthesized and pooled the influence of geographic access on institutional delivery service uptake in low and middle-income countries.

Methods: Multiple combinations of search terms were used to search articles from six databases and a hand search of reference lists performed. We included observational studies conducted in low and middle-income countries which reported the influence of geographic access on delivery care use. The pooled effects of geographic access on institutional delivery care use were calculated using a random-effects model with a 95% confidence interval.

Findings: In this study a total of 31 studies were included. Among these studies, 15 met criteria for inclusion in the meta-analyses, while the remaining 16 were summarized using qualitative synthesis. Studies included in the analysis where women had to walk 60 minutes or less to access a health facility delivery were significantly heterogeneous. Having access to obstetric care facilities within five kilometres was significantly associated with institutional deliveries (pooled OR = 2.27; 95% CI = 1.82, 2.82). Similarly, a travelling time of 60 minutes or less was significantly associated with higher odds of health facility delivery (pooled OR = 3.30; 95% CI = 1.97, 5.53). Every one-hour and one-kilometre increase in travel time and distance, respectively, was negatively associated with institutional delivery care use.

Interpretation: Geographic access measured in either physical distance and/or travel time was significantly associated with women's use of facility delivery. The greater the distance and/or travel time to obstetric care facilities, the greater the barrier and the lesser the service uptake.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0203130PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6117044PMC
February 2019

Level of partograph utilization and its associated factors among obstetric caregivers at public health facilities in East Gojam Zone, Northwest Ethiopia.

PLoS One 2018 12;13(7):e0200479. Epub 2018 Jul 12.

Department of Public Health, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia.

Introduction: The discrepancy regarding maternal mortality continues to be a health concern between developing and developed countries. The majority of global maternal deaths occur in developing countries, specifically, in the sub-Sahara African region which alone accounts for more than half of these deaths. It has been indicated that utilization of the partograph was significantly associated with improved maternal and neonatal outcomes of labour and that is why the World Health Organization recommends the universal use of the tool during labour. Therefore, this study has assessed the level of partograph use and its associated factors among obstetric caregivers in East Gojam Zone, Northwest Ethiopia.

Methods: A health facility based cross-sectional study was conducted among randomly selected obstetric caregivers in Northwest Ethiopia. The data were collected using a self-administered questionnaire and a clinical observation checklist. The data were entered into Epidata version 3.1, and cleaned and analyzed using SPSS version 24.0 statistical software.

Result: About three quarters, or 198 (72.53%), of the obstetric caregivers, had attained diploma level of education. However, 153 (56.04%) of the obstetric caregivers had what was considered to be good knowledge about the partograph, but utilization of the tool was slightly lower than their level of knowledge, 147 (53.85%). Utilization of the partograph was significantly higher among obstetric caregivers holding a Bachelor of Science degree and above, than Diploma holders (AOR (95% C.I) 2.07 (1.15-3.75)) and the use was higher among those who were regularly working in the delivery ward compared to those regularly working in the Adult Outpatient Department (AOR (95% C.I): 2.25 (1.07-4.72)). Moreover, caregivers who had a good knowledge about the partograph and who had received on the job training in obstetric care were also more likely to use the partograph during labour and delivery (AOR (95% C.I): 1.79 (1.05-3.06) and 4.85 (2.63-8.96)) respectively.

Conclusion: The results of this study revealed that although more than half of obstetric caregivers had a good knowledge of the partograph, the actual utilization of the tool was slightly lower than the knowledge they had. Therefore, in this study, we suggest that providing on the job obstetric care training for obstetric caregivers, about the partograph in particular, would improve partograph utilization.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0200479PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6042737PMC
January 2019

Minimum dietary diversity and associated factors among children aged 6-23 months in Addis Ababa, Ethiopia.

Int J Equity Health 2017 10 12;16(1):181. Epub 2017 Oct 12.

Department of Public Health, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia.

Background: Dietary diversity has long been recognized as a key element of high quality diets. Minimum Dietary Diversity (MDD) is the consumption of four or more food groups from the seven food groups. Globally, only few children are receiving nutritionally adequate and diversified foods. More than two-thirds of malnutrition related child deaths are associated with inappropriate feeding practice during the first two years of life. In Ethiopia, only 7 % of children age 6-23 months had received the minimum acceptable diet. Therefore, the main aim of this study was to determine the level of minimum dietary diversity practice and identify the associated factors among children aged 6-23 months in Addis Ababa, Ethiopia.

Methods: A health facility based cross sectional study was undertaken in the three sub-cities of Addis Ababa from 26th February to 28th April, 2016. A multi-stage sampling technique was used to sample the 352 study participants or mothers who had children aged 6-23 months. Data were collected by using a structured and pretested questionnaire, cleaned and entered into Epi info 7 and analyzed using SPSS 24 software. Logistic regression was fitted and odds ratio with 95% confidence interval (CI) with p-value less than 0.05 was used to identify factors associated with minimum dietary diversity.

Result: In this study, the overall children with minimum dietary diversity score were found to be 59.9%. Mother's educational attainment and a higher household monthly income were positively associated with the minimum dietary diversity practice. Similarly, mothers' knowledge on dietary diversity and child feeding was positively associated with minimum dietary diversity child feeding practice, with an adjusted odds ratio of 1.98 (95% CI: 1.11-3.53).

Conclusion: In this study, the consumption of minimum dietary diversity was found to be high. In spite of this, more efforts need to be done to achieve the recommended minimum dietary diversity intake for all children aged between 6 and 23 months.
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http://dx.doi.org/10.1186/s12939-017-0680-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5639776PMC
October 2017

Child and Adolescent Health From 1990 to 2015: Findings From the Global Burden of Diseases, Injuries, and Risk Factors 2015 Study.

Authors:
Nicholas Kassebaum Hmwe Hmwe Kyu Leo Zoeckler Helen Elizabeth Olsen Katie Thomas Christine Pinho Zulfiqar A Bhutta Lalit Dandona Alize Ferrari Tsegaye Tewelde Ghiwot Simon I Hay Yohannes Kinfu Xiaofeng Liang Alan Lopez Deborah Carvalho Malta Ali H Mokdad Mohsen Naghavi George C Patton Joshua Salomon Benn Sartorius Roman Topor-Madry Stein Emil Vollset Andrea Werdecker Harvey A Whiteford Kalkidan Hasen Abate Kaja Abbas Solomon Abrha Damtew Muktar Beshir Ahmed Nadia Akseer Rajaa Al-Raddadi Mulubirhan Assefa Alemayohu Khalid Altirkawi Amanuel Alemu Abajobir Azmeraw T Amare Carl A T Antonio Johan Arnlov Al Artaman Hamid Asayesh Euripide Frinel G Arthur Avokpaho Ashish Awasthi Beatriz Paulina Ayala Quintanilla Umar Bacha Balem Demtsu Betsu Aleksandra Barac Till Winfried Bärnighausen Estifanos Baye Neeraj Bedi Isabela M Bensenor Adugnaw Berhane Eduardo Bernabe Oscar Alberto Bernal Addisu Shunu Beyene Sibhatu Biadgilign Boris Bikbov Cheryl Anne Boyce Alexandra Brazinova Gessessew Bugssa Hailu Austin Carter Carlos A Castañeda-Orjuela Ferrán Catalá-López Fiona J Charlson Abdulaal A Chitheer Jee-Young Jasmine Choi Liliana G Ciobanu John Crump Rakhi Dandona Robert P Dellavalle Amare Deribew Gabrielle deVeber Daniel Dicker Eric L Ding Manisha Dubey Amanuel Yesuf Endries Holly E Erskine Emerito Jose Aquino Faraon Andre Faro Farshad Farzadfar Joao C Fernandes Daniel Obadare Fijabi Christina Fitzmaurice Thomas D Fleming Luisa Sorio Flor Kyle J Foreman Richard C Franklin Maya S Fraser Joseph J Frostad Nancy Fullman Gebremedhin Berhe Gebregergs Alemseged Aregay Gebru Johanna M Geleijnse Katherine B Gibney Mahari Gidey Yihdego Ibrahim Abdelmageem Mohamed Ginawi Melkamu Dedefo Gishu Tessema Assefa Gizachew Elizabeth Glaser Audra L Gold Ellen Goldberg Philimon Gona Atsushi Goto Harish Chander Gugnani Guohong Jiang Rajeev Gupta Fisaha Haile Tesfay Graeme J Hankey Rasmus Havmoeller Martha Hijar Masako Horino H Dean Hosgood Guoqing Hu Kathryn H Jacobsen Mihajlo B Jakovljevic Sudha P Jayaraman Vivekanand Jha Tariku Jibat Catherine O Johnson Jost Jonas Amir Kasaeian Norito Kawakami Peter N Keiyoro Ibrahim Khalil Young-Ho Khang Jagdish Khubchandani Aliasghar A Ahmad Kiadaliri Christian Kieling Daniel Kim Niranjan Kissoon Luke D Knibbs Ai Koyanagi Kristopher J Krohn Barthelemy Kuate Defo Burcu Kucuk Bicer Rachel Kulikoff G Anil Kumar Dharmesh Kumar Lal Hilton Y Lam Heidi J Larson Anders Larsson Dennis Odai Laryea Janni Leung Stephen S Lim Loon-Tzian Lo Warren D Lo Katharine J Looker Paulo A Lotufo Hassan Magdy Abd El Razek Reza Malekzadeh Desalegn Markos Shifti Mohsen Mazidi Peter A Meaney Kidanu Gebremariam Meles Peter Memiah Walter Mendoza Mubarek Abera Mengistie Gebremichael Welday Mengistu George A Mensah Ted R Miller Charles Mock Alireza Mohammadi Shafiu Mohammed Lorenzo Monasta Ulrich Mueller Chie Nagata Aliya Naheed Grant Nguyen Quyen Le Nguyen Elaine Nsoesie In-Hwan Oh Anselm Okoro Jacob Olusegun Olusanya Bolajoko O Olusanya Alberto Ortiz Deepak Paudel David M Pereira Norberto Perico Max Petzold Michael Robert Phillips Guilherme V Polanczyk Farshad Pourmalek Mostafa Qorbani Anwar Rafay Vafa Rahimi-Movaghar Mahfuzar Rahman Rajesh Kumar Rai Usha Ram Zane Rankin Giuseppe Remuzzi Andre M N Renzaho Hirbo Shore Roba David Rojas-Rueda Luca Ronfani Rajesh Sagar Juan Ramon Sanabria Muktar Sano Kedir Mohammed Itamar S Santos Maheswar Satpathy Monika Sawhney Ben Schöttker David C Schwebel James G Scott Sadaf G Sepanlou Amira Shaheen Masood Ali Shaikh June She Rahman Shiri Ivy Shiue Inga Dora Sigfusdottir Jasvinder Singh Naris Silpakit Alison Smith Chandrashekhar Sreeramareddy Jeffrey D Stanaway Dan J Stein Caitlyn Steiner Muawiyyah Babale Sufiyan Soumya Swaminathan Rafael Tabarés-Seisdedos Karen M Tabb Fentaw Tadese Mohammad Tavakkoli Bineyam Taye Stephanie Teeple Teketo Kassaw Tegegne Girma Temam Shifa Abdullah Sulieman Terkawi Bernadette Thomas Alan J Thomson Ruoyan Tobe-Gai Marcello Tonelli Bach Xuan Tran Christopher Troeger Kingsley N Ukwaja Olalekan Uthman Tommi Vasankari Narayanaswamy Venketasubramanian Vasiliy Victorovich Vlassov Elisabete Weiderpass Robert Weintraub Solomon Weldemariam Gebrehiwot Ronny Westerman Hywel C Williams Charles D A Wolfe Rachel Woodbrook Yuichiro Yano Naohiro Yonemoto Seok-Jun Yoon Mustafa Z Younis Chuanhua Yu Maysaa El Sayed Zaki Elias Asfaw Zegeye Liesl Joanna Zuhlke Christopher J L Murray Theo Vos

JAMA Pediatr 2017 06;171(6):573-592

Institute for Health Metrics and Evaluation, University of Washington, Seattle.

Importance: Comprehensive and timely monitoring of disease burden in all age groups, including children and adolescents, is essential for improving population health.

Objective: To quantify and describe levels and trends of mortality and nonfatal health outcomes among children and adolescents from 1990 to 2015 to provide a framework for policy discussion.

Evidence Review: Cause-specific mortality and nonfatal health outcomes were analyzed for 195 countries and territories by age group, sex, and year from 1990 to 2015 using standardized approaches for data processing and statistical modeling, with subsequent analysis of the findings to describe levels and trends across geography and time among children and adolescents 19 years or younger. A composite indicator of income, education, and fertility was developed (Socio-demographic Index [SDI]) for each geographic unit and year, which evaluates the historical association between SDI and health loss.

Findings: Global child and adolescent mortality decreased from 14.18 million (95% uncertainty interval [UI], 14.09 million to 14.28 million) deaths in 1990 to 7.26 million (95% UI, 7.14 million to 7.39 million) deaths in 2015, but progress has been unevenly distributed. Countries with a lower SDI had a larger proportion of mortality burden (75%) in 2015 than was the case in 1990 (61%). Most deaths in 2015 occurred in South Asia and sub-Saharan Africa. Global trends were driven by reductions in mortality owing to infectious, nutritional, and neonatal disorders, which in the aggregate led to a relative increase in the importance of noncommunicable diseases and injuries in explaining global disease burden. The absolute burden of disability in children and adolescents increased 4.3% (95% UI, 3.1%-5.6%) from 1990 to 2015, with much of the increase owing to population growth and improved survival for children and adolescents to older ages. Other than infectious conditions, many top causes of disability are associated with long-term sequelae of conditions present at birth (eg, neonatal disorders, congenital birth defects, and hemoglobinopathies) and complications of a variety of infections and nutritional deficiencies. Anemia, developmental intellectual disability, hearing loss, epilepsy, and vision loss are important contributors to childhood disability that can arise from multiple causes. Maternal and reproductive health remains a key cause of disease burden in adolescent females, especially in lower-SDI countries. In low-SDI countries, mortality is the primary driver of health loss for children and adolescents, whereas disability predominates in higher-SDI locations; the specific pattern of epidemiological transition varies across diseases and injuries.

Conclusions And Relevance: Consistent international attention and investment have led to sustained improvements in causes of health loss among children and adolescents in many countries, although progress has been uneven. The persistence of infectious diseases in some countries, coupled with ongoing epidemiologic transition to injuries and noncommunicable diseases, require all countries to carefully evaluate and implement appropriate strategies to maximize the health of their children and adolescents and for the international community to carefully consider which elements of child and adolescent health should be monitored.
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http://dx.doi.org/10.1001/jamapediatrics.2017.0250DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5540012PMC
June 2017

Knowledge and Attitude of Obstetric Care Providers on Partograph and Its Associated Factors in East Gojjam Zone, Northwest Ethiopia.

Adv Med 2016 14;2016:6913165. Epub 2016 Jun 14.

Department of Nursing, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia.

Introduction. Universal use of partograph is recommended during labor, to improve maternal and fetal outcome. The aim was to assess knowledge and attitude of obstetric caregivers about partograph and associated factors. Methods. Facility based cross-sectional study was conducted on 273 study participants. Study facilities and study units were selected using simple random sampling technique. Midwives, Nurses, Public Health Officers, Medical Doctors, and masters in Emergency Surgery and Obstetric were included in the study. Epi-data and SPSS statistical software were used. Results. About 153 (56.04%) and 150 (54.95%) of the obstetric caregivers had good knowledge and favorable attitude about partograph, respectively. Knowledge of partograph was significantly higher among obstetric caregivers that learnt about partograph during their College and who had received partograph on job training (AOR: 2.14, 95% C.I (1.17-3.93)) and (AOR: 2.25, 95% C.I (1.21-4.19)), respectively. Favorable attitude towards partograph was significantly higher among obstetrical caregivers who had training and learnt about partograph during their college (AOR: 3.37, 95% C.I (1.49-5.65)) and (AOR: 2.134, 95% C.I (1.175-3.877)), correspondingly. Conclusion. Above half of obstetric caregivers had good knowledge and a favorable attitude on partograph. The provision of on preservice and job training is necessary to improve caregivers' knowledge and attitude.
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http://dx.doi.org/10.1155/2016/6913165DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4923564PMC
July 2016

Menstrual hygiene management and school absenteeism among female adolescent students in Northeast Ethiopia.

BMC Public Health 2014 Oct 29;14:1118. Epub 2014 Oct 29.

School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.

Background: Adolescence in girls has been recognized as a special period marked with the onset of menarche. Even though menstruation is a natural process, it is associated with misconceptions, malpractices and challenges among girls in developing countries. However, much is not documented; school-absenteeism and dropout are a common problem among girls in rural Ethiopia. Focusing among school girls, this study has examined knowledge about menstruation, determinants of menstrual management and its influence on school-attendance in Northeast Ethiopia.

Methods: We conducted a mixed-method research combining quantitative and qualitative methods in Northeast Ethiopia. The quantitative study was conducted among 595 randomly selected adolescent school girls. Nine in-depth interviews; five school-dropout girls and four female teachers, and four focus group discussions among school girls were conducted in 2013.

Results: The mean age at menarche was 13.98 (±1.17) years. About 51% of girls had knowledge about menstruation and its management. Only a third of the girls used sanitary napkins as menstrual absorbent during their last menstruation. Girls from urban areas, had mothers of secondary and above education and, families of higher monthly expenditure had more chance of using sanitary napkins than their counterparts. More than half of the girls reported to have been absent from school during their menstruation period. Those who did not use sanitary napkins were more likely to be absent from school [AOR-95% C.I: 5.37 (3.02 - 9.55)]. Fifty eight percent of girls reported that their school-performance had declined after they had menarche. In addition, the qualitative study indicated that school-dropout was common among girls who experienced teasing and humiliation by classmates when their clothes were stained with blood as they do not use sanitary napkins.

Conclusion: Though there is an effort to increase girls' school enrollment, lack of basic needs, like sanitary napkins that facilitate routine activates of girls at early adolescence are observed to deter girls' school-attendance in rural Ethiopia. Special support for girl students, especially when they have their first menstruation and separate functioning sanitary facilities are necessities that should be in school at all times if gender equality and girls empowerment is to be achieved.
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http://dx.doi.org/10.1186/1471-2458-14-1118DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4232635PMC
October 2014