BackgroundDiabetes mellitus is a chronic disease that requires lifelong medical treatments and a life style adjustment. To prevent serious morbidity and mortality, it requires dedication to demanding self-care behaviors in multiple domains. The objective of this study was to identify predictors of self care behaviors among patients with diabetes.MethodsFrom a total of 425 follow up diabetic patients, a quantitative cross sectional study was conducted among 222 of them from three different hospitals in Harar town, from March to April, 2011. The sample was taken using simple random sampling method. Data was collected using pretested questionnaire. Descriptive statistics multiple logistic regression analysis were also used to assess the predicators of self care behaviors among patients with diabetes.ResultMajority of the study respondents 134 (60.4%) were female and the mean age was 49.7 (SD±14.7) years. More than half 147(66.2%) of them were medically diagnosed with type-2 diabetes. 208(93.7%) had general knowledge about diabetes and specific knowledge about diabetes self care 207(93.2%). Large proportion of them had moderate perceived susceptibility 174(78.4%) and severity 112(50.5%). More than half of the respondents 149(67.1%) had less perceived barrier while only 30 (13.5%) of them had high self efficacy to self care practices related to diabetes mellitus. Only 87(39.2%) followed the recommended self care practices on diabetes.ConclusionsPatients with less frequent information were less likely to take diabetes self care. Patients who were more educated, middle income, had high perceived severity of diabetes and less perceived barrier to self care were more likely to take diabetes self care. To increase the self care behavior, diabetes messages should focus on severity of diabetes and how to overcome barriers for self care by segmenting the audiences based on income and educational status with increasing the frequency and reach of message on diabetes.

BackgroundStigma and discrimination against people living with human immunodeficiency virus (HIV) are obstacles in the way of effective responses to HIV. Understanding the extent of stigma / discrimination and the underlying causes is necessary for developing strategies to reduce them. This study was conducted to explore stigma and discrimination against PLHIV amongst healthcare providers in Jimma zone, Southwest Ethiopia.MethodsA cross-sectional study, employing quantitative and qualitative methods, was conducted in 18 healthcare institutions of Jimma zone, during March 14 to April 14, 2011. A total of 255 healthcare providers responded to questionnaires asking about sociodemographic characteristics, HIV knowledge, perceived institutional support and HIV-related stigma and discrimination. Factor analysis was employed to create measurement scales for stigma and factor scores were used in one way analysis of variance (ANOVA), T-tests, Pearson’s correlation and multiple linear regression analyses. Qualitative data collected using key-informant interviews and Focus Group Discussions (FGDs) were employed to triangulate with the findings from the quantitative survey.ResultsMean stigma scores (as the percentages of maximum scale scores) were: 66.4 for the extra precaution scale, 52.3 for the fear of work-related HIV transmission, 49.4 for the lack of feelings of safety, 39.0 for the value-driven stigma, 37.4 for unethical treatment of PLHIV, 34.4 for discomfort around PLHIV and 31.1 for unofficial disclosure. Testing and disclosing test results without consent, designating HIV clients and unnecessary referral to other healthcare institutions and refusal to treat clients were identified. Having in-depth HIV knowledge, the perception of institutional support, attending training on stigma and discrimination, educational level of degree or higher, high HIV case loads, the presence of ART service in the healthcare facility and claiming to be non-religious were negative predictors of stigma and discrimination as measured by the seven latent factors.ConclusionsHigher levels of stigma and discrimination against PLHIV were associated with lack of in-depth knowledge on HIV and orientation about policies against stigma and discrimination. Hence, we recommend health managers to ensure institutional support through availing of clear policies and guidelines and the provision of appropriate training on the management of HIV/AIDS.

BackgroundMalaria remains one of the major public health concerns in Ethiopia. Use of long- lasting insecticidal nets (LLINs) is the country’s key malaria prevention and control strategy. This study intended to determine access to and usage gap of LLINs in malaria endemic settings in Southwestern Ethiopia.MethodsData were collected from 798 households in three districts (Mana, Kersa and Goma) of Jimma Zone, Southwestern Ethiopia, from December 2013 to January 2014. The data were analyzed using SPSS software package version 17.0. LLINs ownership, access and utilization gap were determined following the procedure developed by Survey and Indicator Task Force of the Roll Back Malaria Monitoring and Evaluation Reference Group. To complement the quantitative data, focus group discussions and interviews were conducted with community groups and key informants.ResultsIn this study, 70.9 % (95 % CI: 67.8–74.1 %) of the surveyed households had at least one LLIN, and 63.0 % (95 % CI: 59.6–66.3 %) had sufficient LLINs for every member of the household. With respect to access, 51.9 % (95 % CI: 50.5–53.5 %) of the population had access to LLIN. Only, 38.4 % (95 % CI: 36.9–39.9 %) had slept under LLIN the previous night with females and children having priority to sleep under LLIN. This gave an overall use to access ratio of 70.2 % which resulted in behavior-driven failure of 29.8 %. Of the households with sufficient LLIN access, females (AOR = 1.52; 95 % CI:1.25–1.83; P = 0.001) and children aged 0–4 years (AOR = 2.28; 95 % CI:1.47–3.53;P = 0.001) were more likely to use LLINs than other household members. Shape of nets, sleeping arrangements, low risk perception, saving nets for future use, awareness and negligence, and perception of low efficacy of the LLINs contributed to behavioral failures.ConclusionsLLIN use was hampered by lack of ownership and most importantly by behavioral driven gaps. This calls for designing and implementing appropriate behavioral change communication strategies to address behavioral failure. Improving access to LLINs also needs attention. Further, it requires moving beyond the traditional messaging approach for evidence based intervention to address specific needs and gaps.

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Background Ethiopia has shown incredible success in malaria morbidity, mortality, and control. Community empowerment is a milestone to meet the ambitious plans of eliminating malaria by 2030. Objectives This study aimed to evaluate school-based malaria social behavior change communication (SBCC) in terms of community message exposure, acceptance, knowledge, and practices. Methods A community-based pre-posttest study was conducted in five districts of the Jimma Zone, Ethiopia. 762 and 759 households were sampled for baseline and end-line, respectively. The intervention engaged students from primary schools on participatory peer education within small groups, followed by exposing parents with malaria messages aimed to influencing ideation and preventive practices. The data were analyzed using Statistical Package for Social Sciences (SPSS) version 20.0. Proportion/mean differences were computed to compare both surveys on exposure, knowledge, perceptions, and practices at p <0.05. Finally, a regression analysis was conducted between key changes and school-based exposure. Results The study revealed a sharp increase in exposure to malaria messages with effect size (ES) of 65.7%, p <0.001. School specific exposure has grown to 57.8% (ES = 44.5%). Comprehensive knowledge about malaria increased to 39.1% (ES = 14.8%). Identifying mosquito bites as a cause of malaria was increased by ES = 20.8%. A slight reduction in risk