African Medical and Research Foundation (AMREF) HEALTH AND HEALTH RELATED ISSUES IN FOUR WOREDAS IN SOUTH OMO, SNNPR, ETHIOPIA: FINDINGS OF A BASELINE SURVEY, 2008 Conducted By Birhan Research and Development Consultancy (BRDC) PHYSICAL LOCATION KIRKOS SUBCITY, KEBELE 07, HOUSE NO. 227B ETHIOPIAN EVANGELICAL CHURCH MEKANE YESUS BUILDING 6TH FLOOR, GUINEA CONAKRY ST. Telephone 251-1-53-84-95 OR 95 Mobile 251-91-122-96-21 Fax: 251-1-53-84-95 P. O. Box 20653 Code 1000 Addis Ababa, Ethiopia February 2007 Addis Ababa 1 Table of Contents LIST OF TABLES 5 LIST OF FIGURES 7 CHAPTER I .................................................................................................. 8 INTRODUCTION .......................................................................................... 8 1.1 BACKGROUND 8 1.2 Objectives 9 1.3 Research design 10 Methodology 10 Study Population ......................................................................................... 10 Quantitative Approach ................................................................................ 10 Sampling 10 Sample Size Determination ........................................................................ 10 Sampling Frame ¡Error! Marcador no definido. Qualitative Approach................................................................................... 11 Key Informant Interviews ............................... ¡Error! Marcador no definido. Focus Group Discussions .............................. ¡Error! Marcador no definido. Protocol Visits ¡Error! Marcador no definido. Study Instruments ....................................................................................... 12 1.4 Recruiting and Training of Field Staff 13 1.5 Field Data Collection 15 1.6 Data Management 15 Key Informant Interviews 15 Individual household questionnaire 15 Focus Groups Discussion 16 1.7 Data Analysis 16 1.8. Organization of the Report 16 Part I- Benna Tsemay and Selamago Project Woredas 17 CHAPTER II ............................................................................................... 18 BACKGROUND CHARACTERISTICS OF THE STUDY POPULATION ..... 18 2.1 Socioeconomic Background 18 2.2 Demographic Background 13 CHAPTER III............................................................................................... 34 HOUSEHOLD WATER SOURCES, PERSONAL HEALTH AND SANITATION .............................................................................................. 32 3.1 Water Sources 32 3.2 Health and Sanitation 36 3.3 Personal Hygiene 38 CHAPTER IV .............................................................................................. 41 MALARIA .................................................................................................... 41 1 4.1 Major health problem in the study area 41 4.2 Symptoms Of Malaria 42 4.3 Knowledge Of Means Of Getting Malaria 43 4.4 Knowledge of Preventing Malaria 44 4.5 Malaria related sickness 45 4.6 Knowledge And Use Of Mosquito Net 47 CHAPTER V ............................................................................................... 50 KNOWLEDGE, ATTITUDE AND BEHAVIOR (KAB) OF HIV/AIDS ............. 50 5.1 Knowledge of STIs 50 5.2 Knowledge and source of information about HIV/AIDS 51 5.3 Voluntary Counseling and Testing (VCT) 57 5.4 Risk Perception 60 5.5 Action Taken To Prevent Getting HIV/AIDS 61 5.7 Knowledge of PMTCT 62 5.8 Knowledge of ART 63 5.9 Extramarital Sex 63 5.10 Age At Fist Sexual Debut 64 CHAPTER VI .............................................................................................. 65 REPRODUCTIVE HEALTH ........................................................................ 65 6.1 Pregnancy and childbearing 65 6.1.2 Fertility 66 6.1.3 Age at first birth 69 6.1.4 Desire For More Children 69 6.2 Family Planning 71 6.2.1 Knowledge of FP 72 6.2.2 Ever Use Of Family Planning 74 6.2.3 Current Use Of Family Planning 75 6.2.4 Reason For Not Using Family Planning 76 6.3 Use of Antenatal and postnatal care 77 6.3.1 Facility based delivery 77 6.3.2 Use Of Postnatal Care 78 CHAPTER 7 80 HARMFUL TRADITIONAL PRACTICES 78 7.1 Major Harmful Traditional Practices 80 7.2 Experience of Harmful Traditional Practices 83 7.3 Support For the Discontinuation Of HTPs 83 7.4 Knowledge and experience About Fistula 84 CHAPTER 8 ............................................................................................... 87 GENDER ISSUES ...................................................................................... 87 8.1 Decision making 87 8.2 Wife Beating 89 CHAPTER 9 ............................................................................................... 90 CHILD HEALTH .......................................................................................... 90 9.1 Knowledge of and Source Of information about Vaccination 90 9.2 Last Child Vaccinated 91 2 9.3 Reason For Not Vaccinating Last Child 91 9.4 Child Morbidity 92 CHAPTER 10.............................................................................................. 94 TUBERCULOSIS ........................................................................................ 94 10.1 Knowledge about TB 94 10.2 Presence of TB patient in household 95 CHAPTER XI 98 SUMMARY, CONCLUSION AND RECOMMENDATION 98 11.1 SUMMARY 98 11.2 Conclusion 103 11.3 Recommendation 107 Part II- Malle and South Ari Project Woredas-----------------------------------------109 CHAPTER II ............................................................................................................ 111 BACKGROUND CHARACTERISTICS OF THE STUDY POPULATION ........ 111 2.1 Socioeconomic Background 111 2.2 Demographic Background 116 CHAPTER III .......................................................................................................... 126 HOUSEHOLD WATER SOURCES, PERSONAL HEALTH AND SANITATION .................................................................................................................................. 126 3.1 Water Sources 126 3.2 Health and Sanitation 128 3.3 Personal Hygiene 130 CHAPTER IV .......................................................................................................... 133 MALARIA ............................................................................................................... 133 4.1 Major health problem in the study area 133 4.2 Symptoms Of Malaria 133 4.3 Knowledge Of Means Of Getting Malaria 134 4.4 Knowledge of Preventing Malaria 135 4.5 Malaria related sickness 136 4.6 Knowledge And Use Of Mosquito Net 139 CHAPTER V ............................................................................................................ 142 KNOWLEDGE, ATTITUDE AND BEHAVIOR (KAB) OF HIV/AIDS .............. 142 5.1 Knowledge of STIs 142 5.2 Knowledge and source of information about HIV/AIDS 143 5.3 Voluntary Counseling and Testing (VCT) 148 5.4 Risk Perception 151 5.5 Action Taken To Prevent Getting HIV/AIDS 152 5.7 Knowledge of PMTCT 153 5.8 Knowledge of ART 154 5.9 Extramarital Sex 154 5.10 Age At Fist Sexual Debut 155 CHAPTER VI .......................................................................................................... 157 3 REPRODUCTIVE HEALTH .................................................................................. 157 6.1 Pregnancy and childbearing 157 6.2.1 Fertility 158 6.1.3 Age at first birth 161 6.1.4 Desire For More Children 161 6.2 Family Planning 69 6.2.1 Knowledge of FP 70 6.2.2 Ever Use Of Family Planning 72 6.2.3 Current Use Of Family Planning 166 6.2.4 Reason For Not Using Family Planning 74 6.3 Use of Antenatal and postnatal care 75 6.3.2 Facility based delivery 76 6.3.4 Use Of Postnatal Care 77 CHAPTER 7 78 HARMFUL TRADITIONAL PRACTICES 78 7.1 Major Harmful Traditional Practices 78 7.2 Experience of Harmful Traditional Practices 81 7.3 Support For the Discontinuation Of HTPs 82 7.4 Knowledge and experience About Fistula 82 CHAPTER 8 .............................................................................................................. 85 GENDER ISSUES ..................................................................................................... 85 8.1 Decision making 85 8.2 Wife Beating 87 CHAPTER 9 .............................................................................................................. 88 CHILD HEALTH ...................................................................................................... 88 9.1 Knowledge of and Source Of information about Vaccination 88 9.2 Last Child Vaccinated 89 9.3 Reason For Not Vaccinating Last Child 89 9.4 Child Morbidity 90 CHAPTER 10 ............................................................................................................ 92 TUBERCULOSIS ...................................................................................................... 92 10.1 Knowledge about TB 92 10.2 Presence of TB patient in household 93 CHAPTER XI 95 SUMMARY, CONCLUSION AND RECOMMENDATION 96 11.1 SUMMARY 96 11.2 Conclusion 103 11.3 Recommendation 105 4 LIST OF TABLES Table 2.1.1 Religion and Ethnicity composition: Percent distribution of women by religion, ethnicity …………………………………………………………………………………………...19 Table 2.1.2 Work Status of Women and husband: Percent distribution of women by type of work/occupation, Husbands’ occupation……………………………………………………….….20 Table 2.1.3 Educational Status of women: Percentage of women by educational status ….... 21 Table 2.1.4 Women exposure to mass media: Percentage of women who have access to radio media………………………………………………………………………………………..……..22 Table 2.2.1 Women