Background: Ethiopia is one of the countries with the highest Human Immune-deficiency Virus (HIV) and Tuberculosis (TB) infection rates in the world. To improve TB/HIV Programs outcomes through Public Private Partners...Background: Ethiopia is one of the countries with the highest Human Immune-deficiency Virus (HIV) and Tuberculosis (TB) infection rates in the world. To improve TB/HIV Programs outcomes through Public Private Partnership Mix (PPM) approach was in place since 2006. But the status of its implementation has never been assessed. Methods: In this cross sectional study we employed mixed methods;we interviewed 272 tuberculosis patients, reviewed their records, and facilitated six in-depth interviews and four focus group discussions. The survey was conducted from January through March 2014 in Addis Ababa. Result: Among the interviewees 51.5% were males and the mean age was (32.7 ± SD 12.4) years. PPM facilities were offering HIV counseling for all TB patients;whereas 87.5% of TB patients have received HIV testing services. The TB/HIV co-infection rate was 45.4%. And only 72.2% TB/HIV patients were enrolled into chronic disease care services, 64.8% were put on Cotrimoxazol Preventive Therapy (CPT) and 50% were put on standard highly active anti-retro viral therapy (HAART) services. All PPM facilities don’t have IPT (Isoniazid Prophylaxis Therapy). The TB/HIV collaborative services strongly linked with the public health sector which was documented by developing inclusive work plan which create access to supplies and conducting joint supportive supervisions. However, the majorities of PPM facilities don’t have Multi-Disciplinary Team and lacks some essential supplies. The predictor for uptake of CPT were: being females TB patients was 86% lower than their counter part males (AOR = 0.14;95% CI = 0.04 - 0.92 P = 0.002), patients who has attended their TB/HIV care at private for the profit facilities were 84% lower than those attend in private not for profit facilities (AOR = 0.16;95% CI = 0.49 - 0.55, P = 0.003). Conclusions: The TB/HIV collaborative services at program level are stronger but only half of patients didn’t get the comprehensive TB/HIV collaborative services to achieve recommended quality of care. Strengthening the services and ensuring the availability of essential supplies was highly recommended.展开更多
Background: After a live birth, there is much unsatisfied interest in, and unmet family planning need for contraception. Waiting at least for 24 months before attempting the next pregnancy was recommended to reduce th...Background: After a live birth, there is much unsatisfied interest in, and unmet family planning need for contraception. Waiting at least for 24 months before attempting the next pregnancy was recommended to reduce the risk of adverse maternal, perinatal and infant outcomes. The purpose of this study was to assess the determinants of long acting reversible contraception method use among mothers in extended postpartum period in Durame Town, Southern Ethiopia. Methods: A community based cross sectional study was conducted in Durame Town, Southern Ethiopia in December, 2014. Systematic random sampling technique was employed to recruit a total 460 study participants. Structured and pretested questioner was used to collect the data. Descriptive statistics was employed to characterize the study population using frequencies and proportions. Bivariate logistic regression analysis was conducted to identify all possible factors affecting utilization of LARC method. Multivariable logistic regression model was developed to control the confounding variables. Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was computed in identifying the real factors associated with use of LARC methods. Results: In this study we found that the prevalence of LARC method use among mothers during their extended postpartum period was 36.7% (95%CI: 32.2, 41.0). The unmet family planning need of mothers in the extended postpartum period was 123 (27.9%). The odds of using LARC by literate mother were four fold higher than their counterpart illiterate mothers (AOR 4.09 95%CI: 1.68, 9.58, P value < 0.001). The odds of mother who had pervious experiences of using LARC were up to eight folds higher than mother never used LARC methods (AOR 7.84 95% CI: 3.78, 16.23, P value< 0.001). Mother who received counseling service on LARC methods during delivery was up to three times more likely to utilize the services than not counseled (AOR 3.29 95% CI: 1.53, 7.03, P value < 0.001). And odds of mothers who received counseling service on LARC during immediate postpartum period were up to five fold more likely to opt method than never got the counseling service (AOR 4.55 95 % CI: 1.94, 10.66, P value < 0.001). Conclusions: In the study area, about one third of mothers utilized LARC methods during their extended postpartum period. Another one third of mother had unmet need for family planning. Participant’s education, previous history of using LARC methods, receiving counseling services on LARC during delivery and immediate postpartum periods were found major determinant for LARC use. Educating women, providing counseling service on LARC methods during antenatal, delivery and postnatal were recommended.展开更多
文摘Background: Ethiopia is one of the countries with the highest Human Immune-deficiency Virus (HIV) and Tuberculosis (TB) infection rates in the world. To improve TB/HIV Programs outcomes through Public Private Partnership Mix (PPM) approach was in place since 2006. But the status of its implementation has never been assessed. Methods: In this cross sectional study we employed mixed methods;we interviewed 272 tuberculosis patients, reviewed their records, and facilitated six in-depth interviews and four focus group discussions. The survey was conducted from January through March 2014 in Addis Ababa. Result: Among the interviewees 51.5% were males and the mean age was (32.7 ± SD 12.4) years. PPM facilities were offering HIV counseling for all TB patients;whereas 87.5% of TB patients have received HIV testing services. The TB/HIV co-infection rate was 45.4%. And only 72.2% TB/HIV patients were enrolled into chronic disease care services, 64.8% were put on Cotrimoxazol Preventive Therapy (CPT) and 50% were put on standard highly active anti-retro viral therapy (HAART) services. All PPM facilities don’t have IPT (Isoniazid Prophylaxis Therapy). The TB/HIV collaborative services strongly linked with the public health sector which was documented by developing inclusive work plan which create access to supplies and conducting joint supportive supervisions. However, the majorities of PPM facilities don’t have Multi-Disciplinary Team and lacks some essential supplies. The predictor for uptake of CPT were: being females TB patients was 86% lower than their counter part males (AOR = 0.14;95% CI = 0.04 - 0.92 P = 0.002), patients who has attended their TB/HIV care at private for the profit facilities were 84% lower than those attend in private not for profit facilities (AOR = 0.16;95% CI = 0.49 - 0.55, P = 0.003). Conclusions: The TB/HIV collaborative services at program level are stronger but only half of patients didn’t get the comprehensive TB/HIV collaborative services to achieve recommended quality of care. Strengthening the services and ensuring the availability of essential supplies was highly recommended.
文摘Background: After a live birth, there is much unsatisfied interest in, and unmet family planning need for contraception. Waiting at least for 24 months before attempting the next pregnancy was recommended to reduce the risk of adverse maternal, perinatal and infant outcomes. The purpose of this study was to assess the determinants of long acting reversible contraception method use among mothers in extended postpartum period in Durame Town, Southern Ethiopia. Methods: A community based cross sectional study was conducted in Durame Town, Southern Ethiopia in December, 2014. Systematic random sampling technique was employed to recruit a total 460 study participants. Structured and pretested questioner was used to collect the data. Descriptive statistics was employed to characterize the study population using frequencies and proportions. Bivariate logistic regression analysis was conducted to identify all possible factors affecting utilization of LARC method. Multivariable logistic regression model was developed to control the confounding variables. Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was computed in identifying the real factors associated with use of LARC methods. Results: In this study we found that the prevalence of LARC method use among mothers during their extended postpartum period was 36.7% (95%CI: 32.2, 41.0). The unmet family planning need of mothers in the extended postpartum period was 123 (27.9%). The odds of using LARC by literate mother were four fold higher than their counterpart illiterate mothers (AOR 4.09 95%CI: 1.68, 9.58, P value < 0.001). The odds of mother who had pervious experiences of using LARC were up to eight folds higher than mother never used LARC methods (AOR 7.84 95% CI: 3.78, 16.23, P value< 0.001). Mother who received counseling service on LARC methods during delivery was up to three times more likely to utilize the services than not counseled (AOR 3.29 95% CI: 1.53, 7.03, P value < 0.001). And odds of mothers who received counseling service on LARC during immediate postpartum period were up to five fold more likely to opt method than never got the counseling service (AOR 4.55 95 % CI: 1.94, 10.66, P value < 0.001). Conclusions: In the study area, about one third of mothers utilized LARC methods during their extended postpartum period. Another one third of mother had unmet need for family planning. Participant’s education, previous history of using LARC methods, receiving counseling services on LARC during delivery and immediate postpartum periods were found major determinant for LARC use. Educating women, providing counseling service on LARC methods during antenatal, delivery and postnatal were recommended.
