Population and Family Health

Effectiveness of Couple-Based Violence Prevention Education on Intimate Partner Violence during Pregnancy in Rural Districts of Hadiya Zone, Central Ethiopia: A Cluster Randomized Controlled Trial

Thu, 18 Dec 2025 00:00:00 GMT

Effectiveness of Couple-Based Violence Prevention Education on Intimate Partner Violence during Pregnancy in Rural Districts of Hadiya Zone, Central Ethiopia: A Cluster Randomized Controlled Trial Zeleke Dutamo Agde; Muluemebet Abera; Nega Assefa; Jeanette H. Magnus Background: Intimate partner violence (IPV) during pregnancy is closely associated with adverse maternal and fetal outcomes. A substantial proportion of women in Ethiopia experience IPV during pregnancy. Research has consistently highlighted the importance of engaging men (perpetrators) in efforts to prevent IPV as a pivotal and effective means of addressing IPV. There is limited evidence on interventions that involve men that aimed at preventing violence during pregnancy in Ethiopia. Therefore, this study was aimed to evaluate the effectiveness of couple based violence prevention education in reducing IPV during pregnancy in rural districts of Hadiya Zone, central Ethiopia. Methods: The couple-based violence prevention education study was conducted in four rural districts (Soro, Lemo, Analemo, and Duna) of Hadiya zone, central Ethiopia region from December 5, 2022, to April 30, 2024. This study employed a mixed study design (sequential exploratory design) was employed. It consisting of 1) a qualitative exploratory study involving 77 participants (pregnant women, religious leaders, community leaders, male partners, and women‘s development army); 2) a baseline cross-sectional study with 432 couples; and 3) a cluster randomized controlled trial, which included a total of 432 couples (216 couples in the intervention group and 216 couples in the control group). A cluster random sampling was employed to select study participants in the quantitative study, while a purposive sampling method was used to select study participants for the qualitative study. The intervention, couple based violence prevention education was implemented for six months for the intervention groups. Pre-tested interview questionnaires were used to collect quantitative data at baseline and endline assessments. Topic guides were used to collect data in in-depth interviews (IDIs) and focus group discussions (FGDs). The SPSS version 25 and ATLAS.ti 7.1 were used for quantitative and qualitative data analysis, respectively. For the experimental study, the chi-square test and sample t-test were used to test the statistical significance at baseline in the intervention and control groups for the categorical and continuous variables, respectively. Moreover, the McNemar test was then employed to compare the outcomes of interest between the intervention and control groups, both before and after the intervention. Intention-to-treat (ITT) analysis approach was employed to analyze data. xiii A difference-in-difference (DiD) analysis was conducted to determine the net effect of the intervention while Generalized Estimating Equation (GEE) model to determine the odds of the outcomes between the intervention and control groups. Finally, the qualitative data were analyzed thematically, with codes, categories, and themes emerging from the data. Results: A total of 58 codes, 22 categories, and four themes emerged from the qualitative data of community perspectives towards IPV during pregnancy. The themes include: threats to the health of the mother and the fetus, contributing factors of IPV during pregnancy, coping strategies for IPV during pregnancy, and the need for intervention. The baseline cross-sectional assessment revealed that early marriage, being uneducated, lower autonomy, partners‘ cigarette smoking and alcohol consumption, male partners‘ poor knowledge of IPV, and partners‘ non involvement in antenatal care (ANC) were found to be the predictors of IPV during pregnancy. It was also shown that 53.0% of women and 58.4% of men had good knowledge of IPV. A significant proportion of pregnant women (56.0%) and male partners (65.6%) held supportive attitude towards IPV. Moreover, it was revealed that couple-based violence prevention education was effective in improving male partners‘ knowledge and changing their attitude and controlling behavior related to IPV. Knowledge of IPV nearly quadrupled among male partners in the intervention groups (AOR = 3.7; 95% CI 2.6-5.4). Moreover, the intervention reduced the male partners' attitude and controlling behavior related to IPV by 67.6% (AOR = 0.324; 95% CI 0.229-0.459) and 56.4% (AOR = 0.436; 95% CI 0.317-0.600), respectively. Subsequently, the intervention led to a substantial and statistically significant reduction in the proportion of IPV and its different forms (psychological, physical, and sexual) among mothers in the intervention group. The intervention led to a net reduction of 23.6% in any IPV during pregnancy and a 74.1% decrease in the likelihood of experiencing any IPV (AOR = 0.259; 95% CI: 0.161–0.417). Conclusion and recommendation: The couple-based violence prevention education led to a significant improvement in knowledge of IPV and a reduction of supportive attitudes towards wife beating and controlling behavior among male partners. Overall, the intervemtion was effective in reducing any IPV among the study participants in the study area. Tailoring the couple-based violence prevention education that address healthy communication in marital relationships, promoting mutual respect among couples, challenging harmful gender norms and xiv power imbalances, and promoting joint decision-making that are crucial in preventing IPV in pregnancy. Therefore, scale-up the intervention and adaptation to similar settings are recommended.

Cervical Cancer Screening Uptake and its Associated Factors among Rural Health Extension Workers of Jimma Zone, South West Ethiopia

Tue, 06 Jan 2026 00:00:00 GMT

Cervical Cancer Screening Uptake and its Associated Factors among Rural Health Extension Workers of Jimma Zone, South West Ethiopia Kidist Mussie; Anteneh Dirar; Gali Nega Background: Cervical cancer is the uncontrolled multiplication of normal cells of the cervix that arises from the squamous columnar junction. It is one of the major public health problems in Ethiopia. Despite efforts to improve the cervical cancer program in recent years, the uptake and utilization of cervical cancer screening remain very low. This study aimed to assess the prevalence of cervical cancer screening utilization and identify determinant factors affecting it among Jimma zone rural health extension workers. Methods: A facility-based cross-sectional study design was conducted in selected six districts of Jimma Zone from May 1 to 15 2025. A total of 266 health extension workers were recruited using a simple random sampling technique from each district after a proportional allocation of study samples for each district. Data was collected using a pretested questionnaire, entered into Epidata version 4.6, and then exported to SPSS version 27. Bi-variable and multivariable logistic regression analyses were employed to see the association between cervical cancer screening uptake and the explanatory variables. Variables with P value < 0.25 were selected as candidate variables for multi-variable logistic regression. The outputs from the regression analysis were reported at P-Value < 0.05 using an Adjusted Odds Ratio with their 95% CIs. Results: The mean age of the respondents was 32.96 years, with a standard deviation of ±2.81 years. The prevalence of cervical cancer screening uptake in Jimma Zone among rural health extension workers was 33.8% (95%CI: 28.2-39.9). Health extension workers aged 40–49 years (AOR = 4.81; 95% CI: 1.01–12.8), work experience (AOR = 8.69; 95% CI: 1.66–15.6), received formal training (AOR = 2.71; 95% CI: 1.14–6.46), and having good knowledge (AOR = 2.47; 95% CI: 1.05–5.83) were identified as factors associated with cervical cancer screening uptake among rural health extension workers in the Jimma Zone, Southwest Ethiopia. Conclusion: The overall cervical cancer screening uptake rate among rural health extension workers was low compared to national and global strategy for cervical cancer elimination. Screening is more common among rural health extension workers whose age is 40-49, those with longer work experience, received formal training and having good knowledge. To improve uptake, we recommend rural health extension worker focused training and awareness creation.

Sexual and reproductive health literacy Level and Associated Factors Among Undergraduate Female Students at Jimma University, Southwest Ethiopia, 2025

Sun, 11 Jan 2026 00:00:00 GMT

Sexual and reproductive health literacy Level and Associated Factors Among Undergraduate Female Students at Jimma University, Southwest Ethiopia, 2025 Mohammed Kelbesa; Muluemebet Abera; Gali Nega Sexual and reproductive health literacy refers to the ability to understand and apply knowledge related to sexual and reproductive health. Limited SRH in young adult hood also increases the risk of unsafe abortion, cesarean sections, social isolation, reduced likelihood of completing higher education, diminished economic stability, and services, absenteeism from school, and vulnerability to HIV/AIDS and other Moreover, there has been a lack of research on sexual and reproductive health literacy among university students in the local area populations. Objective: To assess sexual and reproductive health literacy levels and associated factors among undergraduate female students at Jimma University in 2025. Method: The study was conducted from March 3 to April 5, 2025, using a facility-based quantitative cross-sectional design among sampled adolescent girls at Jimma University. A total of 481 students were recruited through simple random sampling by using their email addresses of students obtained from the department. Sexual and reproductive health literacy was measured using the Health Literacy Measure for Adolescents tool. Data were analyzed using SPSS version 26. Binary logistic regression was performed to identify associated factors. Variables with a p-value <0.25 in bivariable analysis were entered into multivariable logistic regression. Model fitness was confirmed using the Hosmer–Lemeshow goodness-of-fit test, and statistical significance was declared at p <0.05. RESULT: In this study, 467 female students responded to the questionnaires, resulting in a response rate of 97%. The overall prevalence of limited SRH among female students was 43.47% CI (0.389,0.481) preferred source of information about SRH (AOR =7.701(3.184, 18.625)), awareness of SRH services available (AOR =3.846(2.011, 7.355)), and presence of health care provider in the family (AOR=0.508(.307,.841)) were statistically significant factors CONCLUSION: Less than half of the respondents had limited SRH literacy. factors like academic department and family background influenced their knowledge levels. To improve outcomes, policymakers should provide monitored health information, inclusive education, and targeted outreach for those in non-health.

Depressive Disorder and Associated Factors among Youths Receiving Antiretroviral Therapy at Public Health Facilities in Jimma City

Sun, 11 Jan 2026 00:00:00 GMT

Depressive Disorder and Associated Factors among Youths Receiving Antiretroviral Therapy at Public Health Facilities in Jimma City Aisha Abajebel; Iman Jihad; Bekelu Teka Background: Depressive Disorder is a common mental health problem and growing public health concern in HIV-positive people. This co-occurrence can result in unfavourable health effects, poor levels of adherence to antiretroviral therapy and further load on physical health. Youth with depressive disorders may struggle to manage their health due to reduced motivation and energy. This, in turn, can lead to an increased rate of hospitalization, which contributes to the economic burden and more medical costs. Objective: The aim of this study was to assess the prevalence of depressive disorder and associated factors among antiretroviral therapy user youths in Jimma City public health facility ART clinics, southwest Oromia, Ethiopia, 2025 Methods: An institutional-based cross-sectional study was conducted from April 2025 to June 2025. Interviewer -administered questionnaire was used to collect the data. The Sample size was calculated using a single population proportion formula and data was collected from 379 on antiretroviral therapy user youths out of 386 sample size with response rate of 98.2% all youths attending ART follow-up visits until the required sample size was reached, using the Kobo Toolbox. Data were cleaned, checked, coded, and exported into SPSS version 27 for analysis. Bivariate and multivariable logistic regression analyses were conducted to assess the association between depressive disorder prevalence and the independent variables. Variables with P value < 0.25 were selected as candidate variables for multi-variable logistic regression. The outputs from the regression analysis were reported at P-Value < 0.05 using an Adjusted Odds Ratio with their 95% CI to show significant association without come variable. Results: 379 study participants were involved, with a response rate of 98.2%,the prevalence of depressive disorder among antiretroviral therapy user youths attending ART clinics in Jimma City public health facilities was 52% (95%CI: 47.6-57.9). Those aged 20–24(AOR=1.83, 95% CI: 1.16–2.87), being female (AOR=1.61, 95% CI: 1.02–2.55), HIV medication improper use (AOR=4.73, 95% CI: 2.47–9.03), low social support (AOR=1.66, 95% CI: 1.04–2.64), and youths who experienced perceived stigma (AOR=1.59, 95% CI: 1.02–2.49) were significantly associated with depressive disorder. II Conclusion: Nearly half of HIV-positive youth attending ART clinics were found to have depressive disorder 197(52%). The study identified that older age (20–24 years), female sex, poor adherence to ART medications, low social support, and perceived HIV-related stigma were significantly associated with increased odds of depressive disorder