BackgroundTrachoma is widely considered a disease of poverty. Although there are many epidemiological studies linking trachoma to factors normally associated with poverty, formal quantitative data linking trachoma to household economic poverty within endemic communities is very limited.Methodology/Principal FindingsTwo hundred people with trachomatous trichiasis were recruited through community-based screening in Amhara Region, Ethiopia. These were individually matched by age and gender to 200 controls without trichiasis, selected randomly from the same sub-village as the case. Household economic poverty was measured through (a) A broad set of asset-based wealth indicators and relative household economic poverty determined by principal component analysis (PCA, (b) Self-rated wealth, and (c) Peer-rated wealth. Activity participation data were collected using a modified ‘Stylised Activity List’ developed for the World Bank’s Living Standards Measurement Survey. Trichiasis cases were more likely to belong to poorer households by all measures: asset-based analysis (OR = 2.79; 95%CI: 2.06–3.78; p<0.0001), self-rated wealth (OR, 4.41, 95%CI, 2.75–7.07; p<0.0001) and peer-rated wealth (OR, 8.22, 95% CI, 4.59–14.72; p<0.0001). Cases had less access to latrines (57% v 76.5%, p = <0.0001) and higher person-to-room density (4.0 v 3.31; P = 0.0204) than the controls. Compared to controls, cases were significantly less likely to participate in economically productive activities regardless of visual impairment and other health problems, more likely to report difficulty in performing activities and more likely to receive assistance in performing productive activities.Conclusions/SignificanceThis study demonstrated a strong association between trachomatous trichiasis and relative poverty, suggesting a bidirectional causative relationship possibly may exist between poverty and trachoma. Implementation of the full SAFE strategy in the context of general improvements might lead to a virtuous cycle of improving health and wealth. Trachoma is a good proxy of inequality within communities and it could be used to target and evaluate interventions for health and poverty alleviation.
Background: Preventing unintended pregnancies among HIV positive women is one component of HIV prevention strategies. However, programs to prevent mother-to-child transmission (PMTCT) of HIV started in antenatal care. The objective of this study was to examine the status of family planning integration to HIV care from client and facility perspectives and identify factors associated with current family planning use. Methods: A facility-based cross-sectional study was conducted from December 2017 to April 2018. Data were coded and double entered into EPI Info version 3.5.4 and exported to STATA version 14 for analysis. Bi-variable and multivariable logistic regression analyses were conducted to assess the association of variables with the current family planning use. Results: A total of 518 HIV-positive women were included in the study. Among HIV-positive women, 35.3% had an unmet need for family planning, and 21.4% responded that their pregnancies were unwanted. About two-thirds (68.1%) of women were using a modern family planning method at the time of the study. Among women who were currently using family planning, 88.8% got the service from a family planning clinic in the same facility, and only 1.1% got the service from the HIV care unit. Women who were not knowledgeable on PMTCT (AOR 0.47, 95% CI = 0.24-0.90), divorced or separated women (AOR 0.19, 95% CI = 0.10-0.37) and women in the age group of 25-34 years (AOR 0.42, 95% CI = 0.20-0.88) and 35-49 years (AOR 0.41, 95% CI = 0.17-0.99) were less likely to use modern family planning methods compared with those women who were knowledgeable, married and women in the age group of 15-24 years. Besides, women with higher income (AOR 2.12, 95% CI = 1.26-3.57) were more likely to use modern family planning methods compared with women with lower incomes. Conclusion: This study indicated that there is a high unmet need for family planning among HIV-positive women and low family planning services integration in the PMTCT/ART clinics. Efforts should be strengthened to tackle the factors which hinder the use of modern family planning and improve family planning service integration.
Background: Competency assessment has a key role in the assurance of quality professionals in every discipline. Competency assessment is a method by which we can verify that our employees are competent to perform tasks timely. To derive the greatest benefit from the application of competency assessment in the health professionals, we must be sure that we are addressing areas where our efforts are utilized to optimize the patient care. There is no research done on the competency assessment so far except the report send by Technical Vocational and Educational Training. Objectives: To assess knowledge, attitude and practice of health professionals towards competency assessment and factors were associated with competencies at Debre Birhan Health Science College, 2013. Methods: A facility based cross sectional study was conducted using interview technique. Study participants were all students taking competency assessment in all departments at Debre Berhan Health Science College in two rounds. The percentage of participants who were competent was computed. Factors associated with competency were assessed using bivariate and multivariable logistic regression. Results: Among the total participants (n = 287), (57.8 percent) were female. Among the (n = 287) study participants, 226 (78.7%) were competent. Of these, 88.5% of the candidates were learned at governmental institution. Predictors of competency were department of the respondent AOR [95%]; 0.05 [0.01, 0.45], expectation of the results [AOR (95% CI) = 0.13 (0.02, 0.85)], number of competency taken [AOR (95% CI) = 0.11 (0.01, 0.88)] and candidates' knowledge of their right and obligations AOR [95%]; 3.7 [1.3, 10.3]. Conclusions: Significant numbers of candidates were not yet competent due to various factors at different level. Therefore, comprehensive work should be done on the instructors, students and the center to make the candidates competent.
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