Ethiopian Journal of Health Development https://www.ajol.info/index.php/ejhd <p><span lang="EN-US">The Journal publishes analytical, descriptive and methodological articles, as well as original research, on public health problems, management of health services, health care needs and socio-economic and political factors related to health and development. More specifically, the Journal focus on important topics in health development that include: health policy and health politics; health planning, monitoring and evaluation; health administration and organization of health services; hospital administration; health manpower, including training; health economics, financing, and health development; health statistics and health information systems; maternal and child health, including family planning; environmental health and water; food and nutrition; health education; epidemiology and communicable diseases including HIV/AIDS, TB and STI; community involvement and inter-sectoral approaches to primary health care; drug supply and distribution; socioeconomic factors related to health and health services, medical geography, broader topics on scientific work on health care technologies; rights and obligations of communities in participation in health care; and international health organizations and technical cooperation among developing countries.</span></p> <p>Other websites related to this journal:&nbsp;<span lang="EN-US"><a title="www.ejhd.org" href="http://www.ejhd.org/" target="_blank" rel="noopener">www.ejhd.org</a></span></p> en-US Copyright for articles published in this journal is retained by the journal. editorejhd@yahoo.com (Mirgissa Kaba) mirgissk@yahoo.com (Mirgissa Kaba) Fri, 30 Jul 2021 13:39:12 +0000 OJS 3.1.2.4 http://blogs.law.harvard.edu/tech/rss 60 Towards Building Resilience within and beyond the Health Systems https://www.ajol.info/index.php/ejhd/article/view/211466 <p>The phrase <em>Health Systems Resilience</em> has become a buzz word, especially within the past year following the COVID-19 pandemic. The term resilience is used in different forms and meanings. It in general refers to reinstating back quickly to the before-the -crisis state, by tirelessly combating the crisis at present. The concept has its origins in the fields of engineering, environmental sciences, and ecology, developed to suggest that systems respond to shocks in a variety of ways: by absorbing them and returning to their original equilibrium or reaching a new equilibrium which makes them more resilient (1). In clinical psychology and mental health, resilience is manifested as the ability of the individual to adapt to adverse conditions such as trauma, or stress (2).</p> Adamu Addissie Copyright (c) https://www.ajol.info/index.php/ejhd/article/view/211466 Thu, 29 Jul 2021 00:00:00 +0000 The value of a novel percutaneous lung puncture clamp biopsy technique in the diagnosis of pulmonary nodules https://www.ajol.info/index.php/ejhd/article/view/211467 <p><em><strong>Background</strong></em>: Computed tomography-guided percutaneous lung biopsy is a crucial method to determine pulmonary anomalies, and is highly accurate in detecting evidence of malignancies, allowing medical practitioners to identify the stage of malignancy and thus help to plan the treatment regimens of patients.<br><em><strong>Objective:</strong></em> To explore the clinical application of a new computed tomography-guided percutaneous lung puncture clamp biopsy technique in the diagnosis of pulmonary nodules, characterized by ground-glass opacity on chest computed tomography images.<br><em><strong>Methods:</strong></em> A unique instrument named ‘combined percutaneous lung biopsy forceps’, consisting of a biopsy forceps, a 15-gauge coaxial needle and needle core, was designed. The new tool was used to obtain specimens in nine patients with pulmonary ground-glass opacity. The specimen volumes and the safety of using the instrument were measured. The samples obtained were also assessed to see if they were sufficient for conducting histological tests.<br><em><strong>Result:</strong></em> Samples were obtained in all nine patients – a success rate of 100%. Consistently, the volume of each specimen was sufficient to make a histological diagnosis. No serious complications, such as pneumothorax – primary spontaneous pneumothorax or secondary spontaneous pneumothorax – occurred during the biopsy.<br><em><strong>Conclusions:</strong></em> The application of this new tool in obtaining tissue specimens in patients with pulmonary ground-glass opacity under the guidance of chest computed tomography was invaluable in terms of its high accuracy and safety. Moreover, its effect was better compared to using a fine-needle aspiration biopsy or a cutting-needle biopsy. Therefore, this instrument can be used for histological diagnosis.<em> [Ethiop. J. Health Dev. 2020; 35(2):000-000]</em></p> Dongyong Yang, Zhixing Zhu, Huihuang Lin, Zhenwei Lin, Yi Wang, Chi Cai, Jimin Fan, Yiming Zeng Copyright (c) https://www.ajol.info/index.php/ejhd/article/view/211467 Thu, 29 Jul 2021 00:00:00 +0000 Urinary screening of elementary school students in Taicang, China https://www.ajol.info/index.php/ejhd/article/view/211468 <p><em><strong>Background:</strong></em> Chronic kidney disease in children is a severe progressive disease that influences the growth, development, and life quality of patients. This study aimed to explore the detection rate of proteinuria and hematuria in elementary school students in Taicang, China.<br><em><strong>Materials and methods</strong></em>: From 2015 to 2019, urine specimens were selected from 11,753 pupils in Taicang. The samples were tested for proteinuria and hematuria by applying single urine tests and urine sediment microscopic examinations. The observation results were divided into three groups: hematuria, proteinuria, and co-existing hematuria and proteinuria. In addition, kidney biopsies were carried out.<br><em><strong>Results:</strong></em> The positive rate of urinary abnormalities was 0.842% (99 cases), of which there were 51 cases (0.433%) of proteinuria, 42 cases (0.357%) of hematuria, and six cases (0.051%) of co-existing proteinuria and hematuria. In terms of gender, of the 99 cases, 63 were female students (1.142%) and 36 were male students (0.577%). Additionally, the age distribution results indicated that the prevalence of urine abnormalities in each age group from age 7 to age 13 were 11.11%, 12.12%, 12.12%, 16.16%, 29.29%, 18.18% and 3.03%, respectively. Furthermore, one immunoglobin A nephropathy case was certified by renal biopsy assay in the follow-up at six months.<br><em><strong>Conclusions:</strong></em> The urine screening revealed that abnormal proteinuria was the main form of urinary abnormalities in elementary school students from Taicang. Urine screening is necessary for early detection and intervention of kidney disease.<em> [Ethiop. J. Health Dev. 2020; 35(2):000-000]</em></p> Lishan Jia, Xiaozhong Li, Zhihua Chen, Hai Jiang, Baoqin Zhang, Min Zhang, Guimei Shan, Yueqin Gu Copyright (c) https://www.ajol.info/index.php/ejhd/article/view/211468 Thu, 29 Jul 2021 00:00:00 +0000 Leadership, Management and Governance (LMG) Practices in Ethiopian Public Hospitals: 2018–and 2019 https://www.ajol.info/index.php/ejhd/article/view/211469 <p><em><strong>Background:</strong> </em>Optimal Leadership, Management and Governance (LMG) practices are essential to ensure effective, efficient, and high-quality health service that contributes to good health conditions of the population. The aim of this study was to determine the level of LMG practices and identify factors associated with it at public hospitals in the years 2018 and 2019. A total of 250 hospitals (Tertiary hospitals, General hospitals, and Primary hospitals) were included in the study.<br><em><strong>Methods:</strong> </em>The study used hospital self-assessment reports which were reported in Districts Health Information System II (DHIS2) using quantitative national tools developed by the Ministry of Health. The data was collected by officers that have experience of working in hospitals (that means, those who were familiar with DHIS2) and whom we trained in how to use the data collection tools. The data was cleaned and analyzed using SPSS software. Descriptive statistics was used to measure level of LMG practices and cross-tabulation to identify factors associated with LMG practices.<br><em><strong>Results:</strong> </em>- The national mean score of LMG practices by hospital standard was 67% in 2018 and 65% in 2019. Overall mean scores were 52.6% and 52.1 for Tertiary hospitals. 72.8% and 69.3% for General hospitals and 65.2%, 67.2% for Primary hospitals, in 2018 and 2019, respectively. Out of the 250 public hospitals, studied, 49% had a well-functioning Health Development Army (HDA) is teams within the department/unit of a hospital. Only 50% of the public hospitals had evaluated the LMG practices of their Chief Executive Officers (CEOs) against the minimum standards set in EHSTG.<br><em><strong>Conclusion</strong></em>: the entire variable in the assessment tools was a minimum standard to be fully complied with in all the public hospitals. The results of this study revealed that the LMG practices were below the minimum standard. Well-functioning health development army was missing in many of the hospitals, and this suggests that there remains a lot to improve in health service s delivery in public hospitals. Not evaluating hospital performance against annual plan was found to be a cause of misunderstanding the challenges and not targeting them in future direction to meet requirement. <em>[Ethiop. J. Health Dev. 2020; 35(2):000-000]</em></p> Yalemzewoud Ayalew Copyright (c) https://www.ajol.info/index.php/ejhd/article/view/211469 Thu, 29 Jul 2021 00:00:00 +0000 Adherence to Antiretroviral Treatment among Adult People Living with HIV/AIDS Attending Highly Active Antiretroviral Therapy at Adare Hospital, Southern Ethiopia https://www.ajol.info/index.php/ejhd/article/view/211471 <p><strong><em>Background:</em> </strong>Adherence to antiretroviral therapy (ART) has paramount advantages for programmatic success, including its good treatment outcomes and reduced risk of resistant viral strains transmission to the general population. There is limited evidence on the magnitude and associated factors of adherence to ART among adult PLWHA attending highly active ART (HAART) at Adare General Hospital, Southern Ethiopia.<br><em><strong>Objective:</strong></em> This study aimed to determine the magnitude and associated factors of adherence to ART among adult PLWHA attending (HAART) at Adare General Hospital, Southern Ethiopia.<br><strong><em>Methods:</em></strong> A hospital-based cross-sectional study was conducted from January 01/2018 to February 30/2018 at Adare Hospital. The participants were 370 adult people living with HIV/AIDS taking ART and who were selected by systematic random sampling technique. The data were collected by trained health professionals using a pre-tested interviewer-administered structured questionnaire. The data collected was entered into a computer and analysed using SPSS version 19. Descriptive statistics and multiple logistic regressions were applied. The significance level of association was considered at p-value &lt;0.05.<br><em><strong>Results:</strong> </em>The magnitude of retrospectively self-reported combined adherence (measured by dose, schedule and dietary instructions) to ART in the past seven days before the interview was 80.3%. In multivariate analysis, Sidaamu Afoo language (AOR=0.5, 95%CI: 0.21-0.99), monthly income &lt;1,000 Ethiopian Birr (AOR=0.08; 95%CI: 0.03-0.26), not disclosing HIV status to others (AOR=0.18; 95%CI: 0.07-0.50), taking ART pills comfortably while others looking (AOR=6.0; 95%CI: 2.54-13.91) and no utilisation of reminders (AOR=0.08; 95%CI: 0.03-0.21) were factors significantly associated with combined adherence. Forgetfulness and not wanting to take ART while others are looking were major reasons to miss pills.<br><em><strong>Conclusion</strong></em>: Adherence to ART among adult PLWHA attending HAART at Adare Hospital was suboptimal, but still comparable with that of resource-limited settings. To maximise treatment success, considering emphasised translation to Sidaamu Afoo language, encouraging patients to be involved in any income-generating system and to reveal their HIV status for others is helpful.<em> [Ethiop. J. Health Dev. 2020; 35(2):000-000]</em></p> Muse Rike, Eskindir Loha, Andargachew Kassa Copyright (c) https://www.ajol.info/index.php/ejhd/article/view/211471 Thu, 29 Jul 2021 00:00:00 +0000 A Mediation Analysis of Determinants of New-born Care Practices in Four Regions of Ethiopia https://www.ajol.info/index.php/ejhd/article/view/211560 <p><em><strong>Background:</strong> </em>Despite a substantial decline in under-five mortality in Ethiopia, neonatal mortality declined steadily and the contribution of the insignificant decline of neonatal mortality to under-five mortality grew from 29.5% in 2000 to 43.3% in 2016. The slow fall of neonatal mortality implies the need for an approach that addresses the main causes of new-born deaths. The World Health Organization recommends essential new-born care practices to save new-borns from morbidity and mortality. The aim of this study was to assess determinants of new-born care practice in the four regions of Ethiopia.<br><strong><em>Method</em></strong>: The study is part of an intervention project that attempts to investigate the impact of Optimising Health Extension Project on health service utilisation of mothers and children below the age of five years. Data for 590 births that occurred in the twelve months preceding the survey was extracted from the main study data and utilized for the present study. The outcome variable of our study is the number of new-born care practices performed by women that delivered recently. Thus, Poisson regression analysis was used, and a goodness of fit test showed that the model fits the data well. Maternal healthcare utilisation is considered as a mediating variable and a difference approach was used to test whether the effects of socio-economic and demographic variables were mediated. STATA 14 was used for data management and analysis and 5% level of significance was used to declare statistical significance.<br><strong><em>Results:</em></strong> Clothing (88.1%) and drying (75.2%) are the most frequently accomplished thermal care practices. Cutting the cord with a clean and sharp material was practiced for 83.0% of the births. For more than two third of the births (68.5%), timely initiation of breastfeeding was performed as a new-born care practice. Immunization of the new-born for polio 0 was the least performed new-born care practice for 25.8% of the births. Maternal healthcare utilisation beyond ANC was observed to be beneficial to new-born care practice. The total effect of birth preparedness and complication readiness (0.15 (0.08, 0.22)) was split to direct and indirect effect. Both the direct (0.08 (95% CI (0.01, 0.15))) and indirect (0.07 (95% CI (0.02, 0.12))) effects were statistically significant. The predictive power of birth preparedness and complication readiness through its influence on maternal healthcare utilization accounted for 45.3% (95% CI (15.6, 75.0)) of its total effect.<br><em><strong>Conclusion</strong></em>: New-born care practice is inadequate in general. However, birth preparedness and complication readiness have dual benefit of enhancing both maternal healthcare utilization and new-born care practices. Therefore, women shall be provided with information on benefits of facility delivery and getting professional assistance during delivery to improve new-born care practices.<em>[Ethiop. J. Health Dev. 2021; 35(2):000-000]</em></p> Alemayehu Hunduma, Gurmesa Tura, Lelisa Sena, Yemisrach Okwaraji Copyright (c) https://www.ajol.info/index.php/ejhd/article/view/211560 Fri, 30 Jul 2021 00:00:00 +0000 Socio-demographic and Haematological Determinants of Breast Cancer in a Tertiary Health Care and Teaching Hospital in Addis Ababa, Ethiopia https://www.ajol.info/index.php/ejhd/article/view/211562 <p><strong><em>Background</em></strong>: Breast cancer is the major cause of cancer deaths among women globally. Socio-demographic and haematological characteristics are among the determinants of breast cancer, and these characteristics are supposed to be monitored during early diagnosis and treatment of cases.<br>Objective: The objective of this study was to assess socio-demographic and haematological profile of patients with breast cancer at Tikur Anbessa Specialized Hospital.<br><em><strong>Methods</strong></em>: Case controlled study was conducted among 230 cases and 230 controls from May 2018 to June 2019. Descriptive analysis was made to assess socio-demographic characteristics and independent sample t- test was performed to compare the mean haematological parameters.<br><em><strong>Results:</strong></em> The mean age was 42.8 + 12.1 years and 39.3 + 11.1 years for cases and controls, respectively. About 43.5% of the cases and 14.8% of the controls were not able to read and write. About 76.1% of the cases and 67.4% of the controls were married. The mean values of Haemoglobin, Red Blood cell, Packed Cell Volume for the cases were 13.1 + 1.6g/dl; 4.6 + 0.54x1012/L; and 38.7 + 4.5 %, respectively. These were significantly lower than those of the controls (14.0 + 1.3g/dl, 4.8 + 0.47 x 1012/L, 40.5 + 3.5%, respectively). Mean platelet count was higher among the cases, whereas total White Blood cell count was almost similar.<br><strong><em>Conclusion and recommendations</em></strong>: Majority of the cases were less than 40 years of age and were not able to read and write. Most of the RBC parameters of cases were significantly lower than the controls. Therefore, attention should be given for exposed groups and those with the designated haematological abnormalities.<em> [Ethiop. J. Health Dev. 2020; 35(2):000-000]</em></p> Fatuma Hassen, Fikre Enquselassie, Ahmed Ali, Adamu Addisse, Girma Taye, Mathewos Assefa, Aster Tsegaye Copyright (c) https://www.ajol.info/index.php/ejhd/article/view/211562 Fri, 30 Jul 2021 00:00:00 +0000 Community-Based Assessment of People with Chronic Diseases and Conditions Worsening the Severity of COVID-19 in Addis Ababa City Administration https://www.ajol.info/index.php/ejhd/article/view/211563 <p><em><strong>Background</strong></em>: the COVID-19 pandemic stayed in a sporadic form for a long time after introducing the coronavirus in the country, later appearing in clusters within communities. During such sporadic and clustered spread of the disease, the government of Ethiopia started identifying suspects through active surveillance for COVID-19. This study aimed to describe people who have chronic illnesses that could be underlying conditions for increased severity of COVID-19.<br><em><strong>Methods:</strong> </em>A survey was conducted in May 2020 using active community-based case surveillance in 30 randomly selected woredas in Addis Ababa City. Data were collected from each household member by assessing for general conditions and diseases expected to increase their risk of suffering higher severity from COVID-19. Data were stored in M.S. Excel and analyzed using SPSS-version 26 for windows. Descriptive analysis was conducted to know the proportion of persons with chronic diseases, and thus the population with a higher risk of suffering more severity from COVID-19 by place, person, and time. The results are presented using tables and graphs as appropriate.<br><em><strong>Results:</strong> </em>The point prevalence of flu-like syndrome was 51.9 per 100,000 persons, and the prevalence was higher among older people. The study showed that 11,600 per 100,000 households have at least a member with chronic diseases that worsen the severity of COVID-19 morbidity. The survey also found 6,939 and 5,140 households per 100,000 households have diabetes mellitus and hypertension, respectively, and about 1950 per 100,000 households were with bronchial asthma. Nearly a quarter of the households have people with two or more chronic diseases that worsen their risk of facing a more severe course of COVID-19 than it would be for people without those underlying conditions.<br><strong><em>Discussion:</em></strong> High proportion of households have people with chronic diseases that worsen their risk of suffering a more severe course of COVID-19 than it would be for people without those underlying conditions. The Ministry of Health should devise and implement mechanisms to safeguard people with chronic diseases from contracting the diseases.<em> [Ethiop. J. Health Dev. 2020; 35(2):000-000]</em></p> Bekele Chaka, Alemayehu Mekonnen, Tesfa Demilew, Yusuf Abdo, Filmona Bisrat, Abdulnasir Abagero Haji, Negussie Deyessa Copyright (c) https://www.ajol.info/index.php/ejhd/article/view/211563 Fri, 30 Jul 2021 00:00:00 +0000 Pulmonary Tuberculosis and Associated Factors among Diabetic Patients Attending Health Care at Debre Tabor General Hospital, Northwest Ethiopia https://www.ajol.info/index.php/ejhd/article/view/211568 <p><em><strong>Introduction</strong></em>: Tuberculosis (TB) is a chronic infectious disease. It is a major cause of morbidity, and mortality in developing countries such as Ethiopia. The burden of TB on Diabetes mellitus (DM), which is one of the most common non-communicable public health problems, is one of the contributing factors for severities of DM. There is no clear scientific data on prevalence of pulmonary tuberculosis (PTB) among DM patients at Debre Tabor, Ethiopia. The aim of this study was to determine the prevalence and associated factors of smear positive PTB among DM patients who had follow up at Debre Tabor General Hospital, Northwest Ethiopia.&nbsp; &nbsp;</p> <p><strong><em>M</em><em>ethods:</em></strong> Hospital-based cross-sectional study was conducted from March 2019 to May 2019. Simple random sampling technique was used to recruit a total of 258 study subjects. Spot-morning-spot sputum specimens were collected and examined for acid-fast bacilli using direct microscopy by Ziehl-Nelson staining technique. SPSS software version 20 was used for data analysis. Descriptive and logistic analyses were performed. P-value ≤ 0.05 were considered as statically significant. Results were interpreted contextually.</p> <p><em><strong>Results:</strong></em> From the total study subjects, 55.8% were males, and 54.2% were females. Close to two-fifth (or 37.6%) of the study participants were between the age of 36–45 years. Most (i.e., 64.3%) of the respondents were urban dwellers. The prevalence of smear positive PTB among DM patients was 2.71%. Patients with DM for less than 5 years showed lower odds of developing PTB (AOR: 0.028; 95% CI: 0.031–0.817) compared with patients with DM for more than 10 years.</p> <p><em><strong>Conclusion:</strong></em> In the present study, the prevalence of smear-positive TB was 2.71%, prevalence lower than the national average. Duration of patients with DM was more associated with the prevalence of TB. DM patients should be screened for <em>Mycobacterium tuberculosis</em> (MTB). Pulmonary Tuberculosis and Associated Factors among Diabetic Patients Attending Health Care at Debre Tabor General Hospital, Northwest Ethiopia. <em>[Ethiop. J. Health Dev. 2020; 35(2):000-000]</em></p> Tesfaye Andualem, Ephrem Malede Copyright (c) https://www.ajol.info/index.php/ejhd/article/view/211568 Fri, 30 Jul 2021 00:00:00 +0000