IPHC-E publications

The effect of health education on hypertension, diabetes mellitus, and cervical cancer screening service utilization among eligible adults in a district around Bahir Dar city, Ethiopia: a cluster randomized controlled community trial

Wed, 01 Jan 2025 00:00:00 GMT

The effect of health education on hypertension, diabetes mellitus, and cervical cancer screening service utilization among eligible adults in a district around Bahir Dar city, Ethiopia: a cluster randomized controlled community trial Yeshalem Mulugeta Demilew, Gizachew Tadesse Wassie , Habtamu Alganeh Guadie, Mulusew Andualem Asemahagn , Tadele Fentabel Anagaw , Getu Degu Alene and Getnet Mitike Kassie Background While screening service utilization is a proven strategy for early detection of noncommunicable diseases, population-based health checkup service utilization is very low in Ethiopia. This study aimed to assess the effect of health education in improving hypertension, diabetes mellitus, and cervical cancer screening service utilization in a district around Bahir Dar City, Ethiopia in 2024. Methods A cluster randomized controlled community trial was conducted in a district around Bahir Dar City among 214 adults in the intervention and control groups each. The intervention was health education. Trained parent-teacher association members provided a 30 min to 1 h education for the community using the existing social structures. Adults in the control group continue receiving the routine education through the health care system A structured interviewer-administered questionnaire was used to collect data. MacNemar’s test was used to assess the intervention effect. Binary logistic regression was also used to assess the intervention effect after controlling confounders. Results Overall difference in knowledge level of adults between the intervention and control groups was 34.4% (P<0.005). This difference persists after controlling potential confounders. Respondents in the intervention group had 2.2 times better knowledge about noncommunicable diseases compared with respondents in the control group [AOR=2.22, 95% CI: (1.4, 3.4)]. The overall difference in utilization of screening services for targeted NCDs between the intervention and control groups was 28.1% (P<0.001). This difference persists after potential confounders were controlled. Respondents in the intervention group were 4.8 times more likely to utilize screening services compared with respondents in the control group [AOR=4.83, 95% CI: (2.7, 8.5)].

Safer Baby Bundle intervention for reducing perinatal mortality in Ethiopia: a quasi-experimental study

Tue, 05 Aug 2025 00:00:00 GMT

Safer Baby Bundle intervention for reducing perinatal mortality in Ethiopia: a quasi-experimental study Mesfin Tadese, Solomon Hailemeskel , Alemayehu Moges , Saba Desta Tessema , Michael Amera Tizazu, Getnet Mitike Kassie Objective To assess the effect of the Safer Baby Bundle (SBB) of care in reducing perinatal mortality in Ethiopia. Design A quasi-experimental study design was implemented from February to August 2024. The intervention group received the five SBB care package adapted for Ethiopia; improving detection and management of fetal growth restriction, raising awareness and improving care for women with decreased fetal movements, improving awareness of maternal safe going-to-sleep position, improving decision-making about timing of birth for women with risk factors for stillbirth and effective fetal monitoring during labour, and the control group received the standard care. Log-binomial regression analysis was performed to compare the outcome variables. Setting Four hospitals in North Shewa Zone, Ethiopia. Participants 841 women attending antenatal care were included. Outcome measures Stillbirth is the death of a baby before or during birth after 28 weeks of gestation in singleton pregnancies without lethal fetal congenital anomalies, whereas, early neonatal death is the death of a newborn occurring before hospital discharge. Results In this study, the overall stillbirth rate decreased by 24.8%, from 28.6 to 21.5 per 1000 live births, and neonatal mortality reduced by 19.9%, from 35.7 to 28.6 per 1000 live births, although these results were not statistically significant. Additionally, the intervention significantly reduced the incidence of non-reassuring fetal heart rate patterns during labour (adjusted risk ratio (aRR)=0.78, 95% CI 0.64 to 0.95), low birth weight (aRR=0.77, 95% CI 0.60 to 0.98) and the need for neonatal resuscitation (aRR=0.59, 95% CI 0.37 to 0.94). However, there was a concurrent increase in neonatal intensive care unit admissions (aRR=1.42, 95% CI 1.19 to 1.69). Conclusion The implementation of the SBB, adapted for Ethiopia, was associated with improvements in perinatal health outcomes. Further implementation research to identify causal effects and assess feasibility in Ethiopia and other low-income and middle-income countries is crucial.

PHC monograph

Thu, 01 May 2025 00:00:00 GMT

PHC monograph IPHC-E The monograph is prepared by the PHC Think Tank of the International Institute for Primary Health Care-Ethiopia with the intention of clarifying the conceptual understanding and operationalization of Primary Health Care (PHC) in Ethiopia. The discussions will ultimately contribute to the goal of enhancing health system effectiveness, achieving Universal Health Coverage (UHC) and meeting targets of the Sustainable Development Goals (SDGs).

Stakeholder mapping for a complex and diverse population: methodology for identifying leaders across sub-Saharan Africa

Fri, 16 May 2025 00:00:00 GMT

Stakeholder mapping for a complex and diverse population: methodology for identifying leaders across sub-Saharan Africa Katherine Banchoff, Sualiha Abdulkader Muktar, Kelly E. Perry, Kendra N. Williams, Malanto Rabary, Choolwe Jacobs, Rosemary Morgan & Anna Kalbarczyk Stakeholder-related methodologies for low- and middle-income countries (LMICs) have primarily focused on stakeholder engagement or identification of specific, well-defined populations. Current stakeholder mapping research methods do not provide sufficient sampling processes for defining and implementing a sampling frame for poorly defined populations. In this paper we develop a unique stakeholder mapping methodology and apply it to the Transforming health: The role and impact of women's leadership in the health sector (THRIVE) study, aimed at generating evidence to support investment in women’s leadership in global health decision-making in reproductive, maternal, newborn, child, and adolescent health, and nutrition (RMNCAH-N) and immunization across sub-Saharan Africa (SSA). Though current literature has examined challenges women have faced to reach leadership roles, there are no methods for systematically identifying women leaders, and leaders in RMNCAH-N and immunization have not been uniformly well-defined or systematically documented. Consequently, understanding the impact of women’s leadership on health and healthcare policies is lacking.