BackgroundDespite its prominence, intimate partner violence (IPV) against women has received little attention in Ethiopia. And as many of sub-Saharan African countries, maternal health care services utilization remains poor. Full access and utilization of maternal health care services is a key to significant reduction in maternal and child mortality, and eliminate new HIV infection in infants. Identifying the factors that contribute to the poor access and utilization should aid the design of appropriate policy and intervention strategies. Thus the objective of this study was to examine the association between IPV and use of maternal health care services in Addis Ababa, Ethiopia.MethodsA cross sectional study on couples (N = 210; male/female pairs) with an infant less than 6 months of age was conducted. The dependent variable was use of maternal health care services and the main independent variable was IPV. Data was collected using face-to-face self-reported questionnaires and analyzed using SPSS version 20.0. Bivariate and multivariate logistic regression models were used to examine the relationship between the dependent and independent variables.ResultsThe mean age of the women was 28.7 years (SD = 5.4), on average women were 7.4 years (SD = 7.4) younger than their partners. Although most of the women (95.2%) had at least one antenatal care (ANC), only 35 (2%) had ≥4 ANC visits and about half (49.0%) had their first ANC visit within the first trimester. Women who experienced emotional IPV in their relationship were less likely to have their 1st ANC within three months of pregnancy (AOR = 0.69; 95%CI = 0.49–0.96). Women who reported physical IPV in their relationship were less likely to use ≥4 ANC (AOR = 0.48; 95%CI = 0.21–0.71), be tested for HIV (AOR = 0.26; 95%CI = 0.09–0.79), have skilled delivery attendant (AOR = 0.31; 95%CI = 0.12–0.98), and deliver in a health facility (AOR = 0.35; 95%CI = 0.14–0.88). Likewise, women experienced sexual IPV or partner control in their relationship were less likely to use ANC ≥4 times (AORsexual-IPV = 0.91; 95%CI = 0.84–0.98 and AORpartner-control = 0.38; 95%CI = 0.17–0.85 respectively).ConclusionsIPV is prevalent among couples in Addis Ababa, Ethiopia where three out of four women reported having experienced one or more type of IPV in their current relationship. And all types of IPV showed significant association with poor utilization of one or more maternal health care services. Thus efforts to sustain the recent success in maternal health and further improvement should give due consideration to IPV.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2121-7) contains supplementary material, which is available to authorized users.

BackgroundEthiopia has recorded substantial progress in maternal health recently. However, poor utilization of maternal health care services is challenging further improvement. Although male partners are decision-makers in households, the impact of their involvement on maternal health care services has not been well studied. Thus, the objective of this study was to examine the association between male partners’ involvement in maternal health care on utilization of maternal health care services.MethodsA community-based cross-sectional study was conducted on male/female couples with a baby less than 6 months old (N = 210) in Addis Ababa, Ethiopia. The main independent variable of the study was male partners’ involvement in maternal health care. Two structured questionnaires were used to collect the data from men and women. Bivariate and multivariate logistic regression models were used to examine the relationship between the dependent and independent variables.ResultsMean age in years was 28.7 (SD = 5.4) for women and 36.2 (SD = 8.8) for men. Half of the men (51.4%) have accompanied their partner to antenatal care (ANC) at least once. However, only 23.1% of them have physically entered the ANC room together. Overall involvement of male partners was poor in 34.8% of the couples (involved in two or fewer activities). After controlling for other covariates, the odds of having 1st ANC visit within the first trimester of pregnancy and skilled delivery attendant at birth were higher in women whose male partners took time to know what happened during ANC visits (AOR = 1.93; 95%CI = 1.04–3.60; AOR = 2.93; 95%CI = 1.24–5.6.90, respectively). Similarly, the odds of having at least one ANC visit, first ANC visit within twelve weeks, HIV testing, skilled birth attendant, and birth in a health facility were higher in couples with higher overall male partner involvement.ConclusionThe study demonstrated significant associations between male partners’ involvement in maternal health care and utilization of some maternal health care services by female partners.

To assess the influence of health education for type 2 diabetic patients with and without coexisting hypertension in routine primary care where intensive educational consultations were absent. Methods: A longitudinal cohort was constructed from 342 diabetic subjects who previously had regular exposure to face-to-face health education delivered quarterly during 2016-2017 under the national basic public health (BPH) service provision in an urbanised township in China. Clinical parameters were retrieved electronically from computerised BPH data platform at prior checkups (2016-2017) and at the most recent checkup (2019). Results: The satisfactory clinical improvements upon health education were not sustained during subsequent observational years among study subjects. A significant increase in total cholesterol (0.28 mmol/L for between-group net changes, 95% confidence interval [CI] = 0. 01-0.55 mmol/L, p = 0.039) were observed in diabetic subjects with coexisting hypertension. Older patients (adjusted odds ratio [aOR] = 0.87, 95%CI = 0.83-0.91, p less than 0.001), males

A common diabetes-related microvascular complication is diabetic retinopathy (DR), yet associations between blood pressure (BP) and risks for DR in diabetic patients with normal BP received inadequate attention. This may lead to ‘clinical inertia’ in early DR prevention. We aimed to assess whether the extent to which systolic BP levels were associated with DR in patients with type 2 diabetes (T2DM) and normal BP were similar to that in those with concurrent hypertension. Data were collected from patients with T2DM attending ophthalmic check-up with primary care referral (n = 2510). BP measurements, clinical laboratory tests, and dilated fundus examination were conducted according to gold standard of diagnosis and routine clinical procedure. Of all subjects, over 40% were normotensive and one fifth were clinically diagnosed with DR. Systolic BP levels increased across DR categories of escalated severity irrespective of the coexistence of hypertension. Ordinal logistic regression analysis showed that an increased systolic BP was independently and significantly associated with DR (adjusted odds ratio [aOR] = 1.020, p < 0.001 for hypertensives; aOR = 1.019, p = 0.018 for normotensives), after adjusting for diabetes duration, sex, lifestyles, and haemoglobin A1c levels. Regular monitoring of systolic BP should not be neglected in routine diabetes management even when BP falls within the normal range. (200 words)

Background and objectiveSexual violence is a common and serious public health issue affecting millions of women at all stages of their lives. Studies have shown that women in Ethiopia are among the highly affected. There is no study in the literature as yet on the prevalence and factors associated with sexual violence among female students of Debre Berhan University (DBU), Ethiopia. In light of this, this study aimed to assess the prevalence of sexual violence and associated factors among female students at DBU. MethodsA Cross-sectional institution-based study was conducted in May 2016 among female regular undergraduate students of DBU. Data was collected using a self-administered questionnaire. Descriptive, binary, and multivariable logistic regression analyses were carried out. ResultsA total of 627 female students completed the questionnaire (response rate: 91.5%). The mean (SD) age of the students was 20.7 (1.65) years. More than half (54.9%) of the students have been victims of sexual violence in their life. More than one-third (35.6%) of the students have experienced rape, attempted rape, or sexual harassment while they are in DBU. Sexual harassment was the most common form of sexual violence ever experienced by female students (51.8%) followed by attempted rape (12.8%) and rape (9.8%). More than half of the rape victims (35, 57.3%) did not share their experiences with anyone. Multiple logistic regression analyses revealed that Khat-chewing habit and marital status were significantly associated with rape. ConclusionSexual violence, in general, is high among female students at DBU. Most of the sexual violence occurs outside of the campus and the perpetrators are mostly known to the victims and are trusted and loved by them. Further broad and longitudinal studies are needed to determine the predictors of the problem among female students at DBU and Ethiopia as a whole.

AimsTo assess longitudinal changes in blood pressure (BP) and fasting plasma glucose (FPG) in primary care patients with concomitant hypertension and type 2 diabetes mellitus (T2DM), and to explore factors associated with patients' inability to improve BP and FPG at follow-up.MethodsWe constructed a closed cohort in the context of the national basic public health (BPH) service provision in an urbanised township in southern China. Primary care patients who had concomitant hypertension and T2DM were retrospectively followed up from 2016 to 2019. Data were retrieved electronically from the computerised BPH platform. Patient-level risk factors were explored using multivariable logistic regression analysis.ResultsWe included 5,398 patients (mean age 66 years; range 28.9 to 96.1 years). At baseline, almost half [48.3% (2,608/5,398)] of patients had uncontrolled BP or FPG. During follow-up, more than one-fourth [27.2% (1,467/5,398)] of patients had no improvement in both BP and FPG. Among all patients, we observed significant increases in systolic BP [2.31 mmHg, 95% confidence interval (CI): 2.04 to 2.59, p &lt; 0.001], diastolic BP (0.73 mmHg, 0.54 to 0.92, p &lt; 0.001), and FPG (0.12 mmol/l, 0.09 to 0.15, p &lt; 0.001) at follow-up compared to baseline. In addition to changes in body mass index [adjusted odds ratio (aOR)=1.045, 1.003 to 1.089, p = 0.037], poor adherence to lifestyle advice (aOR = 1.548, 1.356 to 1.766, p &lt; 0.001), and unwillingness to actively enrol in health-care plans managed by the family doctor team (aOR = 1.379, 1.128 to 1.685, p = 0.001) were factors associated with no improvement in BP and FPG at follow-up.ConclusionA suboptimal control of BP and FPG remains an ongoing challenge to primary care patients with concomitant hypertension and T2DM in real-world community settings. Tailored actions aiming to improve patients' adherence to healthy lifestyles, expand the delivery of team-based care, and encourage weight control should be incorporated into routine healthcare planning for community-based cardiovascular prevention.

Introduction: Treatments with targets of systolic blood pressure (BP) <140 mmHg reduce the onset, or decrease the progression of diabetic retinopathy (DR) - a most common microvascular complication in type 2 diabetic patients with established hypertension. However, the debate on further intensive vs. standard BP control targets in limiting the onset and progression of diabetic microvascular complications remains to be an area of controversy. We aimed to explore whether the extent to which systolic BP levels were associated with the presence of DR in type 2 diabetic patients with normal BP were similar to that in patients with coexisting hypertension. Hypothesis: We assessed the hypothesis that systolic BP levels were not associated with DR in normotensive patients. Methods: This was a baseline analysis of a cohort of adult Chinese patients diagnosed with type 2 diabetes who attended ophthalmoscopic exam with primary care referral in the context of a Specialist-Generalist Working Alliance in Guangzhou, China. A hospital-based, standardised investigation included a dilated, comprehensive eye examination, a measurement of BP values and anthropometric parameters, and a clinical laboratory test for haemoglobin A1c and lipid profiles. A binary logistic regression analysis was conducted to examine patient-level risk factors associated with DR. Results: The mean age of all study participants (N=2,510) was 64.8 years, and more than half were females. More than one in three patients (40.4%) were normotensive. The average duration of diabetes was 8.6 years, and one in five patients were clinically diagnosed with DR. A higher systolic BP level was significantly associated with DR (adjusted odds ratio [aOR]=1.019, 95%CI: 1.012-1.027; p<0.001 for hypertensives, and aOR=1.020, 95%CI: 1.005-1.036; p=0.009 for normotensives), after adjusting for diabetes duration, sex, lifestyle behaviours, and HbA1c levels. Conclusions: In conclusion, we found that increased systolic BP level was an independent, significant risk factor associated with DR in both hypertensive and normotensive diabetic patients. Physicians, patients and caregivers are recommended to maintain regular monitoring of BP in all diabetic patients irrespective of the coexistence of hypertension.