Mulusew Andualem Asemahagn

Bio: Mulusew Andualem Asemahagn is an academic researcher from Bahir Dar University. The author has contributed to research in topics: Medicine & Health facility. The author has an hindex of 6, co-authored 17 publications receiving 196 citations.

Factors determining the knowledge and prevention practice of healthcare workers towards COVID-19 in Amhara region, Ethiopia: a cross-sectional survey

Abstract: Healthcare workers (HWs) are at the highest risk of getting CIVID-19. This study aimed to assess factors determining the knowledge and prevention of HWs towards COVID-19 in the Amhara Region, Ethiopia. A cross-sectional online survey was conducted among 442 HWs using email and telegram addresses. The knowledge and practice of HWs were estimated using 16 knowledge and 11 practice questions. A multivariable logistic regression analysis was used on SPSS version 25 to identify factors related to the knowledge and prevention practice of HWs on COVID-19. Significance was determined at a p value of < 0.05 and association was described by using odds ratio at 95% CI. Of 442 HWs, 398 (90% response rate) responded to the online interview questionnaire. From 398 HWs, 231(58%), 225(56%), 207(53%), and 191(48%) were males, from rural area, aged ≥ 34 years and nurses, respectively. About 279(70%) HWs had good knowledge of COVID-19 followed by 247(62%) good prevention practices. Age < 34 years (AOR = 2.14, 95% CI = 1.25–3.62), rural residence (AOR = 0.44, 95% CI = 0.26–0.70), access to infection prevention (IP) training (AOR = 2.4, 95% CI = 1.36–4.21), presence of IP guideline (AOR = 2.82, 95% CI = 1.64–4.62), and using social media (AOR = 2.51, 95% CI = 1.42–4.53) were factors of knowledge about COVID-19. Whereas, rural residence (AOR = 0.45, 95% CI = 0.31–0.75), facility type (AOR = 0.40, 95% CI = 0.28–0.89), access to IP training (AOR = 2.32, 95% CI = 1.35–4.16), presence of IP guidelines (AOR = 2.10, 95% CI = 1.21–3.45), knowledge about COVID-19 (AOR = 2.98, 95% CI = 2.15–5.27), having chronic illnesses (AOR = 2.0, 95% CI = 1.15–3.75), lack of protective equipment (PPE) (AOR = 0.42, 95% CI = 0.32–0.74), and high workload (AOR = 0.40, 95% CI = 0.36–0.87) were factors of COVID-19 prevention. In this study, most of the HWs had good knowledge but had lower prevention practice of COVID-19. Socio-demographic and access to information sources were factors of knowledge on COVID-19. Similarly, residence, shortage of PPE, high workload, comorbidities, knowledge, and access to IP training and guideline were factors limiting prevention practices. Thus, a consistent supply of PPE and improving health workers’ knowledge, making IP guidelines and information sources available, and managing chronic illnesses are crucial to prevent COVID-19 among HWs.

Determinants of exclusive breastfeeding practices among mothers in azezo district, northwest Ethiopia.

Abstract: Exclusive breastfeeding (EBF) is a very important, long lasting and cost effective intervention to help reduce the morbidity and mortality of infants. However, a large proportion of infants are not exclusively breastfed as recommended by the World Health Organization. The study aim was to assess the exclusive breastfeeding practices and identify determinants among mothers in Azezo District, Ethiopia. A community based cross-sectional study was conducted among 346 mothers with infants aged between 0–6 months. Data were collected using a pretested, interviewer administered questionnaire. Descriptive statistics and logistic regression analysis were used to describe the study objectives and identify the determinants of EBF in the previous 24 h. Associations between the study and outcome variables were described using odds ratios and 95 % confidence intervals (CI). Any breastfeeding and exclusive breastfeeding in the previous 24 h were 99 and 79 %, respectively. The mean number of exclusive breastfeeds in the 24 h period was 6.5. Exclusive breastfeeding rates were highest among mothers aged ≥ 30 years (Adjusted odds ratio [AOR] 1.75; 95 % CI 1.14, 3.42). Infants whose mothers were unemployed were more likely to be exclusively breastfed than infants whose mothers were employed (AOR 1.62; 95 % CI 1.03, 2.95). Mothers earning ≤ 1000 birr (US $47.62) monthly were 77 % less likely to practice EBF (AOR 0.23; 95 % CI 0.13, 0.44). Mothers who delivered at the healthcare facility practised more exclusive breastfeeding than those who delivered at home (AOR 2.18; 95 % CI 1.22, 4.35). Mothers who received antenatal and postnatal care had better rates of EBF (AOR 2.24; 95 % CI 1.18, 5.76 and AOR 1.62; 95 % CI 1.09, 3.21) and mothers not practicing prelacteal feeding were more likely to exclusively breastfeed compared with mothers practicing prelacteal feeding (AOR 2.16; 95 % CI 1.16, 4.06). Any breastfeeding and exclusive breastfeeding rates in the previous 24 h are relatively high in the study area compared with previous studies. Maternal factors (age, education, income, employment, antenatal care, prelacteal feeding), infants’ age, delivery place and information access were independent predictors to EBF in previous 24 h. Improving the mother’s knowledge, income, information access, nutritional counselling, quality of antenatal and postnatal care service, place of delivery and avoiding prelacteal feeding practices are important to improving the exclusive breastfeeding rate in the previous 24 h.

Willingness to receive text message medication reminders among patients on antiretroviral treatment in North West Ethiopia: A cross-sectional study

Abstract: Non-adherence to Antiretroviral Treatment (ART) is strongly associated with virologic rebound and drug resistance. Studies have shown that the most frequently mentioned reason for missing ART doses is the forgetfulness of patients to take their medications on time. Therefore using communication devices as reminder tools, for example alarms, pagers, text messages and telephone calls could improve adherence to ART. The aim of this study is to measure access to cellphones, willingness to receive text message medication reminders and to identify associated factors of ART patients at the University of Gondar Hospital, in North West Ethiopia.

Factors determining the knowledge and prevention practice of healthcare workers towards COVID-19 in Amhara region, Ethiopia: a cross-sectional survey

Abstract: Healthcare workers (HWs) are at the highest risk of getting CIVID-19. This study aimed to assess factors determining the knowledge and prevention of HWs towards COVID-19 in the Amhara Region, Ethiopia. A cross-sectional online survey was conducted among 442 HWs using email and telegram addresses. The knowledge and practice of HWs were estimated using 16 knowledge and 11 practice questions. A multivariable logistic regression analysis was used on SPSS version 25 to identify factors related to the knowledge and prevention practice of HWs on COVID-19. Significance was determined at a p value of < 0.05 and association was described by using odds ratio at 95% CI. Of 442 HWs, 398 (90% response rate) responded to the online interview questionnaire. From 398 HWs, 231(58%), 225(56%), 207(53%), and 191(48%) were males, from rural area, aged ≥ 34 years and nurses, respectively. About 279(70%) HWs had good knowledge of COVID-19 followed by 247(62%) good prevention practices. Age < 34 years (AOR = 2.14, 95% CI = 1.25–3.62), rural residence (AOR = 0.44, 95% CI = 0.26–0.70), access to infection prevention (IP) training (AOR = 2.4, 95% CI = 1.36–4.21), presence of IP guideline (AOR = 2.82, 95% CI = 1.64–4.62), and using social media (AOR = 2.51, 95% CI = 1.42–4.53) were factors of knowledge about COVID-19. Whereas, rural residence (AOR = 0.45, 95% CI = 0.31–0.75), facility type (AOR = 0.40, 95% CI = 0.28–0.89), access to IP training (AOR = 2.32, 95% CI = 1.35–4.16), presence of IP guidelines (AOR = 2.10, 95% CI = 1.21–3.45), knowledge about COVID-19 (AOR = 2.98, 95% CI = 2.15–5.27), having chronic illnesses (AOR = 2.0, 95% CI = 1.15–3.75), lack of protective equipment (PPE) (AOR = 0.42, 95% CI = 0.32–0.74), and high workload (AOR = 0.40, 95% CI = 0.36–0.87) were factors of COVID-19 prevention. In this study, most of the HWs had good knowledge but had lower prevention practice of COVID-19. Socio-demographic and access to information sources were factors of knowledge on COVID-19. Similarly, residence, shortage of PPE, high workload, comorbidities, knowledge, and access to IP training and guideline were factors limiting prevention practices. Thus, a consistent supply of PPE and improving health workers’ knowledge, making IP guidelines and information sources available, and managing chronic illnesses are crucial to prevent COVID-19 among HWs.

Addressing barriers to exclusive breast-feeding in low- and middle-income countries: a systematic review and programmatic implications.

Abstract: Objective Despite numerous global initiatives on breast-feeding, trend data show exclusive breast-feeding (EBF) rates have stagnated over the last two decades. The purpose of the present systematic review was to determine barriers to exclusive breast-feeding in twenty-five low- and middle-income countries and discuss implications for programmes. Design A search of Scopus, MEDLINE, CINAHL and PsychINFO was conducted to retrieve studies from January 2000 to October 2015. Using inclusion criteria, we selected both qualitative and quantitative studies that described barriers to EBF. Setting Low- and middle-income countries. Subjects Following application of systematic review criteria, forty-eight articles from fourteen countries were included in the review. Results Sixteen barriers to EBF were identified in the review. There is moderate evidence of a negative association between maternal employment and EBF practices. Studies that examined EBF barriers at childbirth and the initial 24 h post-delivery found strong evidence that caesarean section can impede EBF. There is moderate evidence for early initiation of breast-feeding and likelihood of practising EBF. Breast-feeding problems were commonly reported from cross-sectional or observational studies. Counselling on EBF and the presence of family and/or community support have demonstrated improvements in EBF. Conclusions Improving the counselling skills of health workers to address breast-feeding problems and increasing community support for breast-feeding are critical components of infant and young child feeding programming, which will aid in attaining the 2025 World Health Assembly EBF targets. Legislation and regulations on marketing of breast-milk substitutes, paid maternity leave and breast-feeding breaks for working mothers require attention in low- and middle-income countries.

Breastfeeding practices and determinants of exclusive breastfeeding in a cross-sectional study at a child welfare clinic in Tema Manhean, Ghana

Abstract: Exclusive breastfeeding is important for child health and growth, but its practice is low in many developing countries. This study aimed at determining the breastfeeding practices and examining the sociodemographic characteristics that influence exclusive breastfeeding among mothers attending child welfare clinic at Manhean, in the Tema East Sub-Meteropolitan area of Greater Accra region of Ghana. This was a cross-sectional study that employed a structured questionnaire to collect data among 355 mothers of children aged 0–24 months selected through simple random sampling, attending a child welfare clinic from May to June, 2016. Breastfeeding practices were assessed based on the practices in the last 24 h prior to the study as defined by the World Health Organization. There was a universal awareness and high knowledge about exclusive breastfeeding among mothers, but prevalence among infants less than 6 months was 66.0% (n = 138/209). Mothers currently breastfeeding were 263 (74.0%); 225 (63.4%) initiated breastfeeding within the first hour after delivery and 289 (81.0%) of the mothers offered colostrum to babies after delivery. Continued breastfeeding rate at 1 year was 77.3% (n = 17/22). Only 33.7% (n = 31/92) of infants aged 6–8 months had started receiving complementary foods. For infants aged less than 24 months, 30.1% (n = 98/326) were bottle feeding. Mothers aged 20–24 (Adjusted odd ratio [AOR] 9.80; 95% confidence interval [CI] 2.11, 45.46), 25–29 (AOR 9.49; 95% CI 2.07, 43.47) and 30–34 (AOR 6.02; 95% CI 1.41, 25.65) were more likely to practice exclusive breastfeeding. Mothers who had tertiary education were less likely to practice EBF than those with no education (AOR 0.18; 95% CI 0.36, 0.85). Mothers from ethnic groups in northern Ghana were less likely to exclusively breastfeed their infants compared to those of Ghanaian (Ga) ethnicity (AOR 0.29; 95% CI 0.09, 0.96). Exclusive breastfeeding and timely complementary feeding practices are suboptimal. Educational status, age and ethnicity of mothers strongly predicted maternal practice of exclusive breastfeeding. Interventions emphasizing a practical education should therefore be targeted at addressing factors that influence exclusive breastfeeding.

Exclusive breastfeeding and associated factors among mothers in Gozamin district, northwest Ethiopia: a community based cross-sectional study.

Abstract: Exclusive breastfeeding is defined as feeding infants only breast milk, be it directly from breast or expressed, except drops or syrups consisting of vitamins, mineral supplements or medicine. Exclusive breastfeeding is one of the essential actions for infant development and survival. However, the prevalence of exclusive breastfeeding in Ethiopia has been estimated at 52% which is far less than the World Health Organization (WHO) recommendations. Moreover, there are inconsistencies among estimates in different districts of the country. Therefore, this study aimed to assess the prevalence and associated factors of exclusive breastfeeding among mothers in Gozamin district, northwest Ethiopia. Using the simple random sampling technique, seven kebeles (lowest administrative units) were selected as the primary sampling unit of the district. Sample mother-infant pairs were then selected using the systematic random sampling technique that involved our moving from house to house in each village. Data were collected from 506 mother-infant pairs using interviews. Factors associated with exclusive breastfeeding were determined using logistic regression. The measure of association used was the odds ratio, and statistical tests with p-values of less than 0.05 were considered as statistically significant. In this study, the prevalence of exclusive breastfeeding among mothers was 74.1% (95% CI 70.80, 79.10). For government employee mothers, the odds of exclusive breastfeeding were reduced by half compared to housewives (AOR 0.49, 95% CI 0.26, 0.94). Mothers who did not receive breastfeeding counseling after delivery were 0.43 times less likely to practice exclusive breastfeeding compared with mothers who received the services (AOR 0.43, 95% CI 0.25, 0.72). Mothers who gave birth at health institutions were more likely to practice exclusive breastfeeding. Even though the estimated prevalence is relatively high, more effort to meet WHO recommendations is still necessary. Therefore, we suggest health institutions encourage hospital birthing and increase breastfeeding counseling after delivery, and employers needs to give longer maternity leave to improve exclusive breastfeeding practice.

Exclusive breastfeeding practice in Ethiopia and its association with antenatal care and institutional delivery: a systematic review and meta-analysis

Abstract: Despite the World Health Organization recommendation of exclusive breastfeeding (EBF) for the first six months of life, the rate remains low both in developed and developing countries. In Ethiopia, findings regarding the prevalence of EBF have been highly variable. Antenatal care and institutional delivery are the most important factors contributing to the practice of EBF however; their effect has not been investigated in Ethiopia. In this systematic review and meta-analysis, international databases were systematically searched. All observational studies reporting the prevalence of EBF and its association with antenatal care and institutional delivery in Ethiopia were considered. Two authors independently extracted all necessary data using a standardized data extraction format. A random effects meta-analysis model was computed to estimate the pooled prevalence of exclusive breastfeeding. Moreover, the association of antenatal care and institutional delivery with EBF was determined. After reviewing 619 studies, 32 studies fulfilled the inclusion criteria and were included in the meta-analysis. The pooled prevalence of EBF in Ethiopia was 59.3% (95% Confidence Interval [CI] 53.8, 64.8). The subgroup analysis indicated that the highest prevalence was observed in Afar region (65.6%), followed by SNNP (63.8%), and then by Oromia (61.8%). Additionally, mothers who attended antenatal visits were 2.1 times more likely to practice EBF compared to their counterparts (Odds Ratio [OR] 2.1; 95% CI 1.5, 2.8). Moreover, mothers who gave birth at a health institution were 2.2 times more likely to practice EBF compared to mothers who gave birth at home (OR 2.2; 95% CI 1.3, 3.5). Exclusive breastfeeding in Ethiopia was significantly lower than the global recommendations. There was evidence that mothers who attended antenatal visits and who gave birth at health institutions had better EBF practices. Based on our findings, we strongly recommended that the utilization of antenatal care and institutional delivery should be improved through health extension workers.