Post-natal care is a care given to the mother and the newborn during post-natal period. This period is crucial to save the lives of the mother and the newborn. Despite its importance, the utilisation of this service is very low in Ethiopia. This study was conducted to establish the views and experiences of women and health care workers on post-natal care services and determine the factors influencing its utilisation with the ultimate purpose of developing guidelines to improve uptake and quality of the services in South West Shoa Zone of Oromia Region, Ethiopia. The objectives of the study were to explore and describe the women’s views and experiences on utilisation of post-natal care service. Furthermore, the study sought to explore and describe health care workers views and experiences on provision of the services and to assess the factors facilitating or hindering to the utilisation of it. Ultimately, the study had intended to develop guidelines that would contribute towards improving the uptake and quality of the post-natal care services. The study used a qualitative descriptive and explorative research design to address the research questions. Qualitative data were collected from 19 women who gave birth in the past six months and from 24 health care workers providing post-natal care services (health care workers and health extension workers) and coordinating the overall maternal, neonatal and child health services in the study area (Zone and district health officials; primary health care units heads). The study used in-depth interview guides to collect data from the aforementioned study participants. Inductive thematic analysis was performed on the verbatim transcriptions using the Atlas ti version 8 qualitative data analysis software. Overall, the emerged themes from the analysis are categorised into women’s views and experiences on utilisation of PNC services, views and experiences of health care workers on PNC and factors facilitating and hindering the utilisation of PNC services. The study identified wide range of socio-cultural, knowledge and attitude related, physical, health facility related and health care workers related factors affecting the utilisation of post-natal care services. Consequently, after a systemic review of literature and stakeholders consultation the researcher used the findings of the study to develop guidelines to improve the uptake and quality of post-natal care services. The developed guidelines were also validated by maternal, neonatal and child health service providers and program leaders and the researcher strongly recommend the use of the developed guidelines that would improve the uptake and quality of post-natal care services. / Health Studies / Ph. D. (Public Health)

Indiana University-Purdue University Indianapolis (IUPUI) / Objectives: To determine (1) whether prescribed and delivered energy and protein intakes during the first two weeks of life met Ziegler’s estimated requirements for Very Low Birth Weight (VLBW) infants, (2) if actual energy during the first week of life correlated with time to regain birth weight and reach full enteral nutrition (EN) defined as 100 kcal/kg/day, (3) if growth velocity from time to reach full EN to 36 weeks’ postmenstrual age (PMA) met Ziegler’s estimated fetal growth velocity (16 g/kg/day), and (4) growth outcomes at 36 weeks’ PMA. Study design: Observational study of feeding, early nutrition and early growth of 40 VLBW infants ≤ 30 weeks GA at birth in three newborn intensive care units NICUs. Results: During the first week of life, the percentages of prescribed and delivered energy (69% [65 kcal/kg/day]) and protein (89% [3.1 g/kg/day]) were significantly less than theoretical estimated requirements. Delivered intakes were 15% less than prescribed because of numerous interruptions in delivery and medical complications. During the second week, the delivered intakes of energy (90% [86 kcal/kg/day]) and protein (102% [3.5 g/kg/day]) improved although the differences between prescribed and delivered were consistently 15%. Energy but not protein intake during the first week was significantly related to time to reach full EN. Neither energy nor protein intake significantly correlated with days to return to birth weight. The average growth velocity from the age that full EN was attained to 36 weeks’ PMA (15 g/kg/day) was significantly less than the theoretical estimated fetal growth velocity (16 g/kg/day) (p<0.03). A difference of 1 g/kg/day represents a total deficit of 42 - 54 grams over the course of a month. At 36 weeks’ PMA, 53% of the VLBW infants had extrauterine growth restriction, or EUGR (<10th percentile) on the Fenton growth grid and 34% had EUGR on the Lubchenco growth grid. Conclusions: The delivered nutrient intakes were consistently less than 15% of the prescribed intakes. Growth velocity between the age when full EN was achieved and 36 weeks’ PMA was 6.7% lower than Ziegler’s estimate. One-third to one-half of the infants have EUGR at 36 weeks’ PMA.

Text in English / This study aimed at exploring Barriers to compliance with exclusive breastfeeding and timely introduction of complementary feeding practices in Ofla District, Tigray Region in Ethiopia. A quantitative exploratory descriptive study was conducted to explore and describe the barriers that restrict mothers /caregivers to comply with exclusive breast feeding practice until six months and with introduction of solid, semi-solid and soft foods at six months in Ofla District. Data were collected using structured questionnaire, from a total of 112 samples of which 75 mothers and care givers with children aged 0-5 months and 38 children aged 6-8 months participated. The data were entered into a computer and analysed though the Statistical Package for Social Sciences (SPSS) software. The findings revealed that there are barriers related Doer mothers and Non-Doer mothers perceived susceptibility, perceived severity, perceived benefits, perceived barriers, perceived self-efficacy, cues for actions, perceived social acceptability and positive and negative attitudes towards exclusive breastfeeding and initiation of complementary feeding. On the other hand, the participant’s perception of both groups with regard to perception of Divine (God’s) Will on two child feeding practices was insignificantly the same. Both groups perceived that children could get sometimes malnourished because of spiritual or supernatural causes. / Health Studies / M.A. (Public Health)

Text in English / Breastfeeding is particularly important in resource-poor regions of the world, where limited access to clean water increases the risk of diarrhoeal disease if replacement feeding is used. However, human immunodeficiency virus type 1 (HIV-1) is transmitted through human milk. Purpose of the study The purpose of this study was to describe the determinants contributing to exclusive breastfeeding in HIV-infected mothers of infants aged 0 to 6 months who attend an NGO Health Centre in Elandsdoorn Village. Methods A quantitative research approach using a non-experimental cross-sectional study was undertaken to conduct this study. A self-reported study questionnaire was used to collect data from study participants. Purposive sampling was used to sample 75 mothers from 18 to 45 years of age who were HIV-positive. SPSS version 23 was used to analyse the data. Results The study results indicated that there are determinants contributing to exclusive breastfeeding and a need to establish a more comprehensive approach to educating pregnant women on reproductive health issues, and exclusive breastfeeding in particular. Factors contributing to low levels of exclusive breastfeeding included breast problems, societal influence, maternal health concerns, insufficient support, fear of stigmatisation, and babies’ health concerns. This caused mothers to discontinue exclusive breastfeeding. Conclusions The intention of this study was to reveal the determinants of exclusive breastfeeding affecting mothers who are HIV-infected and breastfeeding their infants. / Health Studies / M.P.H.

Text in English / The study was conducted to determine the knowledge and to describe attitudes of HIV positive women on exclusive breastfeeding in Mopani District (the Greater Letaba Sub-District, Limpopo), South Africa. A quantitative, exploratory and descriptive design was adopted in this study to describe the knowledge and attitudes of HIV positive women on exclusive breastfeeding. The researcher used a self-developed structured questionnaire to collect data. Descriptive and inferential statistics were used to describe data. The SPSS software version 21.0 was used to analyse data and this were displayed in tables and figures. A total of 123 participants were included in the study. The study concluded that HIV positive women have good knowledge and positive attitude on exclusive breastfeeding. / Health Studies / M.P.H.