Introduction: World Health Organization recommends screening of household contact as a key to improve detection of tuberculosis cases. Ethiopia’s current tuberculosis household contact investigation strategies rely on symptomatic contacts attending health facilities for investigation. This approach has not led to the detection of additional tuberculosis (TB) cases; alternative approaches have to be considered. The purpose of the research was to develop guidelines in endorsing the implementation of a community based household contact investigation program in Addis Ababa. Methods: A mixed method research using sequential exploratory design was conducted in Addis Ababa. In the first phase, qualitative data collection and analysis methods were used to formulate intervention approach and in the second phase, a quantitative random controlled trial was conducted, with the purpose of comparing the proposed intervention measures with routine household contact tuberculosis investigation. Frequencies and logistic regression analyses were used to determine the relative risk and associated factors. Thematic analysis was used for qualitative data analysis. Results: The in-depth interview and focus group discussion findings identified themes namely household contact investigation (HHCI) implementation, misconceptions on HHCI, challenges with HHCI Approaches, opportunities for HHCI provision, contributing factors associated with household involvement, strategies for effective HHCI service and partnerships with health bureau. In phase two, the study reported that the prevalence of TB was 7.1% among the intervention group compared to 1.9% in the control groups at the end of first year follow-up. Nine guidelines were developed to support the household contact investigation system. Conclusion: The passive case detection strategy of contact investigation did not find more cases, and tuberculosis patients and their family contacts were not satisfied with this method. However, the proposed community-based strategy shows that more TB cases can be detected by using existing medical staff. Therefore, an approach that makes the service more accessible is significant and the recommended community based TB household contact tracing approaches needs to be scaled up for its performance towards identified missed cases and enhance patient and their household contacts involvement. / Health Studies / D. Litt. et Phil. (Public Health)

A quantitative, descriptive, explorative survey was conducted to explore and describe nurses’ perceptions of disclosure to children of their HIV positive status in Addis Ababa. 100 nurses working in six conveniently sampled health centres participated by completing a self-administered questionnaire. The findings revealed that the majority of participants were of the opinion that children have the right to know their HIV status, participate in their own treatment, and that disclosure contributes towards improved adherence. Forty-one of the participants said that it is nurses’ role to support caregivers in the disclosure process. But 56.3% felt they lacked the training to disclose to children that they are infected with HIV. Accordingly, it is recommended that relevant and applied training is required to equip nurses with the knowledge and skills to disclose to children their status. The importance of nurses’ proactive role in disclosure to children of their HIV status needs to be emphasised. / Health Studies / M.A. (Public Health)

Voluntary HIV counselling and testing (VHCT) is one of the key strategies in the prevention of HIV in Ethiopia. However, utilization of the VHCT services among adolescents has been reported as low by previous studies. The purpose of this study was to investigate adolescents’ knowledge and attitudes towards VHCT services among adolescents attending high school in Addis Ababa, the capital city of Ethiopia. A cross-sectional school-based design using quantitative methods was employed to attain the objectives of the study. Data collection was done using self-administered structured questionnaires among 378 adolescent high school students. Data was analysed using the Statistical Package for Social Sciences (SPSS). The findings revealed that 75.7% of students are aware of the voluntary HIV counselling and testing services; 62.2% use the services and suggested that VHCT services should be located in schools and youth clubs for better access by adolescents. Thirty-two percent of respondents rated themselves at risk of HIV infection and 35.2% were not willing to disclose their HIV positive status to anybody. The findings of the study clearly indicate a need for a more accessible voluntary HIV counselling and testing services for adolescents. / Health Studies / M.A. (Public Health)

The purpose of this study was to explore and describe the EcoHealth markers and health promotion interventions in the behaviour and practices of vegetables growers in Addis Ababa. The objectives were to assess the urban and peri-urban community members’ knowledge and practices on the existing environmental health policies/regulations/guidelines, assess the perspectives of women and youth on urban and peri-urban EcoHealth promotions and protections and evaluate the development and implementation of the health promotion activities on waste water use by applying an ecological model aimed at changing behaviour and by providing Bio-sand filter to promote hand wash practice which helps to reduce potential health risks among urban vegetable growers. Both quantitative and qualitative descriptive researches were conducted to identify the urban and peri urban community members’ knowledge and practices of the existing environmental health regulators and the perspectives of women and the youth on EcoHealth. Additional quasi experimental method; multiple baseline survey along with the EcoHealth Stress Process promotion method was employed to identify stressors, measure changes in environmental health promotion intervention and use of hand wash (biosand filter for hand wash). Six woredas from two subcities of the Addis Ababa City Administration were purposely selected, and a total of 845 (98.9% response rate) households participated in the quantitative study, while 142 community members (public sector offices, factories and establishments’ management and employee), participated in the qualitative survey. For quasi experimental method, six settings/blocks (of which 3 sites were provided with a bio-sand filter for hand washing) cultivated by 6 to 8 vegetable growers and their family members, were included in the intervention (multiple baseline survey). The findings revealed that about 77 percent of participants reported, knowledge of one or more of the selected environmental health and EcoHealth regulations. Ownership of assets and education tend to influence the public awareness of selected EcoHealth and environmental health regulations. Women and youth found to be significant contributors to better urban and peri-urban EcoHealth conditions and were the ones primarily affected by environmental hazards. The intervention study results also indicated evidence-based IEC interventions and ecological health promotion methods proved useful in promoting EcoHealth in an urban environment. Moreover, the biosand filter used to provide evidence of health promotion was found to be valuable for wastewater treatment and significantly reduced chemical, physical and biological contaminates from the wastewater. / Health Studies / D. Litt. et Phil. (Health Studies)

In this study semi-structured, in-depth individual interviews were conducted with sixteen female street children aged 15 to 18, who were engaged in commercial sex work. These children were conveniently selected to explore the social dislocation of and social support for female street children engaged in commercial sex work. In addition, two focus group discussions consisting of nine female street children each, as well as seven key informant individual interviews, were conducted. This study found that female children engaged in commercial sex work experienced a high degree of social dislocation and that the children who participated in this study tended to create their own communities and isolated themselves from the broader community in which they lived. This study further found that different support programmes had been introduced to alleviate the problems experienced by these children and that a number of organisations delivered support services to address their needs. / Sociology / M. A. (Sociology)

M.A. (Public Health) / Anti-Retroviral Therapy (ART) adherence is a crucial component of the patient management framework for people living with Human Immune Deficiency Virus (HIV). Trait emotional intelligence is “the constellation of behavioural-dispositions and self-perceived abilities to recognise, process, and utilise emotion-laden information”. The purpose of the study was to determine whether there was a correlation between ART adherence behaviour and behavioural-dispositions related to trait emotional intelligence among HIV/AIDS infected people receiving ART at the regional public hospitals in Addis Ababa. The study used observational, analytical, and cross-sectional research design. The participants were selected through a proportionally stratified systematic random sampling method. Data collection was through a structured self-report questionnaire format. The findings showed that 79.1% had optimal ART adherence behaviour; 84.4% had average trait emotional intelligence. The research finding showed a statistically significant positive correlation between ART adherence behaviour and behavioural-dispositions related to trait emotional intelligence at (r =0.417, n=392, P<0.001). / Health Studies

In this study semi-structured, in-depth individual interviews were conducted with sixteen female street children aged 15 to 18, who were engaged in commercial sex work. These children were conveniently selected to explore the social dislocation of and social support for female street children engaged in commercial sex work. In addition, two focus group discussions consisting of nine female street children each, as well as seven key informant individual interviews, were conducted. This study found that female children engaged in commercial sex work experienced a high degree of social dislocation and that the children who participated in this study tended to create their own communities and isolated themselves from the broader community in which they lived. This study further found that different support programmes had been introduced to alleviate the problems experienced by these children and that a number of organisations delivered support services to address their needs. / Sociology / M. A. (Sociology)

Voluntary HIV counselling and testing (VHCT) is one of the key strategies in the prevention of HIV in Ethiopia. However, utilization of the VHCT services among adolescents has been reported as low by previous studies. The purpose of this study was to investigate adolescents’ knowledge and attitudes towards VHCT services among adolescents attending high school in Addis Ababa, the capital city of Ethiopia. A cross-sectional school-based design using quantitative methods was employed to attain the objectives of the study. Data collection was done using self-administered structured questionnaires among 378 adolescent high school students. Data was analysed using the Statistical Package for Social Sciences (SPSS). The findings revealed that 75.7% of students are aware of the voluntary HIV counselling and testing services; 62.2% use the services and suggested that VHCT services should be located in schools and youth clubs for better access by adolescents. Thirty-two percent of respondents rated themselves at risk of HIV infection and 35.2% were not willing to disclose their HIV positive status to anybody. The findings of the study clearly indicate a need for a more accessible voluntary HIV counselling and testing services for adolescents. / Health Studies / M.A. (Public Health)

This study aimed to assess the magnitude, trends and determinants of intrapartum stillbirths in the public health facilities in Addis Ababa. A case-control study design was used along with quantitative data collection methods. Obstetric care data on key variables were collected from medical records of 728 cases and 1551 controls in the public health facilities during July 1, 2010 and June 30, 2015. Data were analysed using SPSS version 24 to determine associations and risk factors against intrapartum stillbirth. HMIS data from different sources were further analysed for the same period to determine trends of stillbirth in the public health facilities of Addis Ababa. Findings from this study showed a staggering high prevalence of stillbirth at an average rate of 28 per 1000 births during the period 2010-2015. This figure was comparable with the population level prevalence of prenatal death in Addis Ababa which was 30 per 1000 birth (Central Statistical Agency 2011:115). No statistically significant associations were revealed against the effects of maternal medical conditions including diabetes, hypertension, cardiac and renal diseases and key socio-demographic variables including age, parity and marital status, and intrapartum stillbirth. On the contrary, HIV and syphilis infections, foetal presentations, multiple pregnancy and the frequency of ANC visits during the index pregnancy had statistically significant associations with intrapartum stillbirth. Furthermore, low FHR, non-vertex foetal presentations and ruptured cervical membrane on admission to labour were among risk factors for intrapartum stillbirth. Similarly, women in the stillbirth group received substandard care regarding the timely assessment of foetal decent, cervical dilatation, labour induction, and episiotomy care compared to women in the livebirth group. Obstetrical complications including obstructed labour, eclampsia and preeclampsia were more common among women in the intrapartum stillbirth group indicating that the above variables were key determinant of intrapartum stillbirth. These findings suggest that poor quality of obstetric care during labour and childbirth were the underlying risk factors for intrapartum stillbirth. In conclusion, strategies to overhaul the obstetric care practices in the public health facilities through skills building, accurate use of labour monitoring tools, close supervisions, accurate classification of stillbirth, proper documentation, and ongoing research efforts. / Health Studies / D. Litt. et Phil. (Health Studies)

Anti-Retroviral Therapy (ART) adherence is a crucial component of the patient management framework for people living with Human Immune Deficiency Virus (HIV). Trait emotional intelligence is “the constellation of behavioural-dispositions and self-perceived abilities to recognise, process, and utilise emotion-laden information”. The purpose of the study was to determine whether there was a correlation between ART adherence behaviour and behavioural-dispositions related to trait emotional intelligence among HIV/AIDS infected people receiving ART at the regional public hospitals in Addis Ababa. The study used observational, analytical, and cross-sectional research design. The participants were selected through a proportionally stratified systematic random sampling method. Data collection was through a structured self-report questionnaire format. The findings showed that 79.1% had optimal ART adherence behaviour; 84.4% had average trait emotional intelligence. The research finding showed a statistically significant positive correlation between ART adherence behaviour and behavioural-dispositions related to trait emotional intelligence at (r =0.417, n=392, P<0.001). / Health Studies / M. A. (Public Health)