This empirical study was designed to assess prevalence and associated factors of harmful traditional practices (HTP) on children less than 15 years in the Fentale District, Oromia Region.
Harmful traditional practices encompass a range of abuse which results in physical and psychological harm, disability and even death for significant numbers of women. Following forced marriage, a woman may be abused by her husband and sometimes, by her in-laws. The health consequences are considerable and can include physical, emotional and psychological harm which can be chronic or acute. While child marriages are declining on girls under age 15, fifty million girls could still be at risk of being married before 15th birth day in this decade ,complications of pregnancy and child birth are the main causes of death on adolescent girls age 15-19 years old in developing countries and 30 million girls are at risk of undergoing Female Genital Mutilation(FGM) in the next decade half of the countries where FGM Is practiced; majority of girls were cut before age 5.
In Ethiopia more than one-third of ever-married women (35 percent) report that they have experienced physical emotional or sexual violence from their husband, sixty-five percent of women age 15-49 are circumcised,8% of girls married before age 15 and 84.3% of children’s are experiencing uvulectomy. As a result of high prevalence of HTPs in Ethiopia many health consequences like hemorrhage, damage to nearby structures, tetanus, heavy scarring ,recurrent infections, HIV/AIDS, obstructed labor, fistulae, depression, suicide, and even death occurs in significant number of women’s and children’s.
In this research, a community based cross-sectional study design with multistage sampling technique was undertaken. Data was collected by trained college students using a structured face to face interview and data collected was entered in to Epi info version and transferred to statistical package for social sciences( SPSS Version 21) for bivariate and multivariate analysis.
Table of Contents
ACKNOWLEDGEMENT
ACRONYMS
LISTS OF TABLE
LISTS OF FIGURES
ABSTRACT
1. INTRODUCTION
1.1. Background
1.2. Statement of the Problem
1.3. Justification of the study
2. LITERATURE REVEIW
2.1. Magnitude of the problem
2.2 Sociological factors to harmful traditional practices
2.4. Conceptual Frame Work
3.0 OBJECTIVES
3.1. General Objective
3.2. Specific Objective
4.0. METHODS AND MATERIALS
4.1. Study design and period
4.2. Study area
4.3. Source and Study population
4.3.1. Source population
4.3.2. Study population
4.4. Sample size and sampling procedures
4.4.1. Sample size determination
4.4.2. Sampling procedure
4.5. Variables of the study
4.5.1. Dependant variable
4.5.2. Independent variables
4.6. Operational definitions
4.7. Data collection procedures
4.8. Data quality assurance
4.9. Data processing and analysis
4.10. Ethical considerations
4.11. Dissemination of results
5. RESULTS
6. DISCUSSION
7. STRENGTHEN AND LIMITATION
8. CONCLUSION AND RECOMMENDATION
9. REFERENCES
10. ANNEXES
ARSI UNIVERSITY
COLLEGE OF HEALTH SCIENCES DEPARTMENT OF PUBLIC HEALTH
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December, 2018
Asella, Ethiopia
ACKNOWLEDGEMENT
First of all I would like to gratify almighty God for all his blessings and endurance for overcoming all the challenges encountered.
I would like to thank Arsi university department of public health post graduate study for offering and facilitating such an opportunity to write this thesis.
Without taught full suggestion and valuable comments of my esteemed advisors Dr. Legessa Tadesse and Mr. Aman Jima this research thesis would not have reached this stage.
I would also like to express my heartfelt gratitude to Fentale Woreda Administration, Fentale Woreda Health Office and others all who helped me from starting up to completion of this research thesis.
I especially thank participants of this study and data collectors for their willingness and contribution.
Last but not least I would also like to thank Ato Girma Hailu Fentale Woreda Health Office Head, my sister Meirema Kufa and my Family members for their invaluable support.
ACRONYMS
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LISTS OF TABLE
Tables
Table1. Socio demographic and maternal practice versus practice of HTPs on children
Table2-Socio Demographic Characteristics of study population on HTP, on children less than 15 years in Fentale Woreda, East Shoa, Oromia Region, Ethiopia, 2018
Table3-Prevalence and information on HTP, on children less than 15 years in Fentale Woreda, East Shoa, Oromia Region, Ethiopia, 2018
Table4-Consequences and reason given to HTP, on children less than 15 years who involved in the study on HTP in Fentale Woreda, East Shoa, Oromia Region, Ethiopia, 2018
Table5-Current and future practices of Harmful tradition, on children less than 15 years in Fentale Woreda, East Shoa, Oromia Region, Ethiopia, 2018
Table6-Comparison of selected Socio Demographic Characteristics with practice of HTP on children less than 15 years in Fentale Woreda, East Shoa Zone, Oromia Region, Ethiopia, 2018
Table7- Comparison of information, current and future factors with practice of HTP on Children less than 15 years in Fentale Woreda, East Shoa, Oromia Region, Ethiopia, 2018
LISTS OF FIGURES
Figures
Fig1. Conceptual Framework for associated factors of harmful traditional practice on children less than 15 years in Fentale Woreda East Shoa Zone, Oromia, 2018
Fig2: Schematic presentation of sampling stage
Fig3- Age at first marriage and pregnancy of mothers of children less than 15 years in the study on HTP in Fentale Woreda, East Shoa, Oromia Region, Ethiopia, 2018
Fig4- Practice of HTP, on children less than 15 years who involved on the study of HTP in Fentale Woreda, East Shoa, Oromia Region, Ethiopia, 2018
Fig5-Reasons given by parents who involved in the study on HTP for not practicing Harmful tradition on their children less than 15 years in Fentale Woreda, East Shoa, Oromia Region, Ethiopia, 2018
Fig6- Future Practices of HTP on children less than 15 years who involved in the study of HTP in Fentale Woreda, East Shoa, Oromia Region, Ethiopia, 2018
ABSTRACT
Introduction: Harmful traditional practices encompass a range of abuse which results in physical and psychological harm, disability and even death for significant numbers of women.
World Health Organization suggest that: 100–140 million girls and women worldwide are living with the consequences of harmful traditional practice; approximately 3.3 million girls are at risk of female genital mutilation each year and according to Ethiopian demographic health survey (2016) one third of ever married women in Ethiopia report violence from their husband and 65% of women age 15-49 are circumcised; but there is no adequate information in the study area that the study wanted to provide.
Objectives: To assess prevalence and associated factors of harmful traditional practices on children less than 15 years in Fentale Woreda from April1-October 30 /2018.
Methods: A community based cross-sectional study design with multistage sampling technique was undertaken; data was collected by 5 trained college students using a structured face to face interview and data collected was entered in to Epi info version7 and transferred to statistical package for social sciences( SPSS Version 21) for bivariate and multivariate analysis and 95% confidence interval and adjusted odds ratios was computed and level of statistical significance was set at P<0.05;goodness of fit of the final model was checked using Hosmer and Lemeshow test of goodness of fit considering good fit at p-value >0.05 level of significance.
Results: Out of the total respondents 83.3% were females, the mean age was 33.3years, 70.6% of mothers of children had no formal education and 45% of them married before age 18. About 48.4% of parents had performed Harmful traditions on their children and the most prevalent form of Harmful tradition performed on children were Uvula cutting(84.7%) followed by Female genital mutilation (59.7%), Milk teeth extraction(14.5%) and Tribal mark on skin(10.2%).The main reason given by parents of children who performed the harmful practices was thinking harmful traditional practice beneficial. Those who have monthly income <1000 ETB, living inside thatched roof, currently practicing harmful traditions and have no son’s/daughters learning at high school are more likely to perform harmful tradition on their children.
Conclusion and Recommendation: Monthly income, Housing condition, current practices and presence of Sons/Daughters learning at high school had significant association with Harmful traditional practices and strong community sensitization and training Traditional Healers is essential to alleviate these problem.
Key Words: Female Genital Mutilation, Uvula cutting, Milk teeth extraction, Ethiopia
1. INTRODUCTION
1.1. Background
Tradition represents the sum total of all behaviors that are learned, shared by a group of people and transmitted from generation to generation. It includes language, religion, types of food eaten, and methods of their preparation, child caring practices and all other values that hold people together and give them a sense of identity and distinguish them from other groups.
To evaluate a traditional practice as harmful/beneficial we might use the objective instruments based on the knowledge gained from social and natural sciences; therefore harmful traditional practices are forms of violence which have been committed primarily against women and children’s in certain communities and societies for so long that they are considered, or presented by perpetrators, as part of accepted cultural practice (1).
Most harmful traditional practice affects primarily women and girls, although it can also affect boys, especially in the developing world where one in three girls will most likely be married before they are 18 years old and one out of nine girls was married before they are 15 and majority of these girls are poor, under-educated, and live in rural areas of Africa ,As many recent research results show that over 125 million women and girls alive today have been subjected to some form of female genital mutilation (FGM) in 29 countries in Africa and Middle East (2).
Most parents have their own justifications for practicing harmful traditional practices; in many countries studied, evidence shows that parents want what is best for their children. It is this most basic value that motivate parent’s decision to perform HTPs, since failure to comply with the social convention brings shame and social exclusion to girls and their families once an alternative to the social convention becomes possible within a community and people realize that the community might be better off jointly abandoning the practice, it is this most basic value to do what is best for their children , that also motivates communities to abandon the harmful practice (5, 6).
A number of factors contribute to the practice of child marriage as well as FGM in Ethiopia, on which patriarchal attitudes and the values attached to the girl child and women, the desire to control women’s sexuality and decision making power and the socio economic subordination of women are some of the key factors. Both practices have strong and positive correlation with the social norm, religion and traditional values as well as the persistent poverty with all its ramifications (5).
1.2. Statement of the Problem
Harmful traditional practices(HTP) encompass a range of abuse which results in physical and psychological harm, disability and even death for significant numbers of women.
Following forced marriage, a woman may be abused by her husband and sometimes, by her in-laws. The health consequences are considerable and can include physical, emotional and psychological harm which can be chronic or acute(1).
While child marriages are declining on girls under age 15, fifty million girls could still be at risk of being married before 15th birth day in this decade ,complications of pregnancy and child birth are the main causes of death on adolescent girls age 15-19 years old in developing countries and 30 million girls are at risk of undergoing Female Genital Mutilation(FGM) in the next decade half of the countries where FGM Is practiced; majority of girls were cut before age 5(2).
In Ethiopia more than one-third of ever-married women (35 percent) report that they have experienced physical emotional or sexual violence from their husband , sixty-five percent of women age 15-49 are circumcised,8% of girls married before age 15 and 84.3% of children’s are experiencing uvulectomy (3).
As a result of high prevalence of HTPs in Ethiopia many health consequences like hemorrhage, damage to nearby structures, tetanus, heavy scarring ,recurrent infections, HIV/AIDS, obstructed labor, fistulae, depression, suicide, and even death occurs in significant number of women’s and children’s(4).
Even though there are numerous types of HTPs like throat piercing, giving kosso to pregnant, plucking finger nails ,keeping babies out of sun, rectal ulceration , cupping, bloodletting, tattooing etc ; that affect women and children the most prevalent forms of HTPS in Ethiopia are Female Genital Mutilation (FGM), uvulectomy, milk teeth extraction, early marriage/ arranged marriage, marriage by abduction and food taboos(4).
Even though many efforts were made by Federal Ministry of Health (FMOH) to eliminate this HTPS the problem still exists in rural areas of the country and the root cause for the problem varies from place to place: in Fentale District even if many efforts were made by Health professionals, Health extension workers and many stakeholders; still the practice of harmful tradition exists.
As many studies indicate reasons given by parents for practicing harmful traditions on their children vary from parents to parents, as well as from community to community, since the root causes for performing these harmful traditional practices vary from place to place.
There is no clearly identified reason for the factors associated with harmful traditional practices in the study area.
Hence, this study was designed to assess prevalence and associated factors of harmful traditional practices on children less than 15 years in Fentale District, Oromia Region.
1.3. Justification of the study
As many evidences and studies indicate that the practice of harmful tradition is mostly common in countries/areas were the populations are in a poor living condition, uneducated and economically weak; according to our country those conditions are largely manifested in areas where the population is pastoralist compared to other areas, Fentale Woreda is one of semi-pastoralist areas found in east shoa zone.
So this study could have the following uses:-
Serve as a baseline for further studies,
Used to identify root causes and factors that should be addressed
Increase peoples need and understanding about impacts of harmful tradition
Hence, this was one of the problems worth studying.
2. LITERATURE REVEIW
2.1. Magnitude of the problem
Report by United Nations (UN) on the impact of harmful traditional practices on the girl child suggests that the origin of FGM predates Islam and Christianity while it continues to take its toll largely in Africa according to studies on prevalence undertaken by organizations like WHO and Inter-African Committee on Traditional Practices at least 28 African countries are affected by the practice in varying degrees and ratio but the total number of victims rises to over 100 million(6).
While child marriages are declining on girls under age 15, 50 million girls could still be at risk of being married before their 15 birthday in this decade complications of pregnancy and childbirth are the main causes of death on adolescent girls ages 15-19 years old in developing countries 30 million girls are at risk of undergoing FGM in the next decade half of the countries where FGM is practiced the majority of girls were cut before age 5 and in the rest of the countries, most cutting occurs between 5 and 14 years of age(2).
In a recent survey done in Bangladesh of 850 families 93 per cent of parents preferred a son as a blessing to families and the country in which 96 per cent felt that the birth of a daughter would be a “problem” to the family and the State(7).
The Demographic and Health Survey done in Bangladesh also found that 5 per cent of the 10-4 age group and 48 per cent of the 15-19 age group were married and the median age of marriage was found to be 15.3 years with wide urban-rural differentials of 19 and 15 years, respectively(7).
World Health Organization (WHO) indicates that there are population-based data on FGM prevalence from all African countries in which the practice has been documented. Estimates suggest that: 100–140 million girls and women worldwide are living with the consequences of HTP; approximately 3.3 million girls are at risk of FGM each year(8) .
The findings of study done in Zamfara State of Nigeria agree with the World Bank Review Report (1995) which indicates that developing nations have the largest number of children who don’t have access to primary education. In Zamfara State, the finding of this study has revealed a very slow progress in girl-child participation over the years due to cultural traditions and practice of the parents. The enrollment has been in favor of the boys, which is a clear expression of male dominance in academic activities and a rift in the gender issue (9). UNESCO study aligns with this study proving that 64% of women in Africa girl-child inclusive, are illiterate and can neither read nor write (9).
According to EDHS 2016 More than one-third of ever-married women (35 percent) report that they have experienced physical, emotional, or sexual violence from their husband or partner at some point in time. Twenty-four percent of women report that they experienced emotional violence, 25 percent experienced physical violence, and 11 percent experienced sexual violence. Experience of physical, emotional, or sexual violence from a husband or partner is higher on older women 40-49 (38 percent), formerly married women (45 percent), those living in rural areas (36 percent), and women in Oromia (39 percent), Harari (38 percent), and Amhara (37percent)(3).
Sixty-five percent of women age 15-49 are circumcised, 8% of girls married before age 15 and 84.3% of children’s are experiencing uvulectomy: out of those circumcised 3 percent of women had cutting with no flesh removed, 79 percent had cutting with flesh removed, and 7 had their genital area sown closed after cutting. The proportion of circumcised women is lowest on Orthodox women (54 percent) and highest on Muslim women (82percent). Female circumcision is most prevalent on the ethnic groups of Afar and Somali (98 percent and 99 percent, respectively), followed by Welaita and Hadiya women (92 percent for both). Fifty-four percent of urban women are circumcised, as compared with 68 percent of women in rural areas. FGM is less prevalent on women with higher education and those in the highest wealth quintile(3).
Polygamy and early marriage are also the most prevalent cultural practices in Ethiopia; the results of EDHS 2011 also suggest that eleven percent of married women in Ethiopia are in polygamous unions, with 9 percent having only one co-wife and 2 percent having two or more co-wives and the percentage of women in polygamous unions tends to increase with age, from 3 percent on women age 15-19 to 17 percent on women age 40-49.
The extent of polygamy has declined only slightly over the past six years, from 12 percent in the 2005 EDHS to 11 percent in the 2011 EDHS.The median age at first marriage on women age 25-49 is 16.5 years, a slight increase from the 16.1 years reported in the 2005 EDHS. The proportion of women married by age 15 has declined over time; from 39 percent on women currently age 45-49 to 8 percent on women currently age 15-19(20).
Study done in four locations of Ethiopia ( Afar, Kambata, wolaita, Amhara) reveals that FGM/C, including infibulations, is prevalent on Afar. Most of the girls in this region are circumcised in early infancy before reaching their first birthday In fact, it is said that “no Afar Woman or girl escapes from mutilation of one or another form without consequences.”
Traditional birth attendants circumcise and even practice the most severe form of infibulations on infants between 7-40 days after their birth(10).
Another cross sectional study done in Axum Town on factors associated with Harmful traditional practices show that Out of the 752 respondents 746(99.2%) had information on at least one harmful traditional practices in which 301 (40%) of them had information on all of the mainly recognized HTPs (uvula cutting, milk teeth extraction, FGM and eye borrow incision), 108(14.4%) about uvula cutting and 69 (9.2%) about female genital mutilation. From the total number of participants 660(87.8%) had performed at least one HTPs on their children. On the HTPs performed on children, uvula cutting was practiced on 654 (86.9%) children followed by milk teeth extraction 95(12.5%) children and eye borrows incision 18(2.4%) children(11).
2.2 Sociological factors to harmful traditional practices
Harmful traditional practices involve different forms of exploitation mostly performed on children’s and women’s; which results in significant health consequences and complications (1).
Report by General Assembly suggests that early pregnancy, nutritional taboos and practices related to child delivery can have harmful consequences for both young mothers and their babies. According to UNICEF, no girl should become pregnant before the age of 18 because she is not yet physically ready to bear children. Babies of mothers younger than 18 tend to be born premature and have low body weight; such babies are more likely to die in the first year of life (16).
Besides increasing risk and poor health to young mothers obstructed labour is also an additional risk which provokes vesico vaginal fistulas especially when birth assisted by traditional birth attendant(16).
Contested understandings and practices of female child marriage and circumcision in Ethiopia highlight that in many (although not all) communities the two practices have strong cultural roots and a clear cultural logic, which suggests that they may not be necessarily very amenable to reform. This logic embodies two key elements. First, the families and kin group have a strong vested interest in the productive and reproductive capacity of women, articulated through the regulation by older generations of their sexuality and sexual conduct. Second, child marriage and circumcision are seen to ensure girls’ social integration and thereby their protection and their moral and social development (15).
The findings of the study done in Bedele Oromia on factors that affect women participation in leadership and decision making showed that the major factors that hinder women’s participation in public leadership and decision making positions are various and observed interrelated. These include: lack (absence of adequate) educational status required from women, absence of commitment by the concerned (top decision making) body, backward socio cultural attitudes, lack of sufficient experiences from women to hold the leading positions, overburden of domestic responsibilities, as well as negative attitudes of men towards women, and lack of confidence from women themselves(18).
Study done in Dale wabera woreda oromia region indicates that residence was one of the factors independently associated with magnitude of FGM given that the chance of being mutilated was higher in students from rural area compared to those urban residents (12).
The other factor independently associated with FGM was mother occupation. The odds of practicing FGM was higher on female students whose mothers were housewives and merchants compared to those with government employee mothers after adjusting for age, grade, and residence respectively(12).
WHO Work and experiences in combating FGM in Addis Ababa Ethiopia indicates that harmful traditional practices are carried out for a variety of reasons, which are not fully documented and vary from place to place and from culture to culture; according to materials of WHO the reasons given by families for HTP include psychosexual, sociological ,hygienic, aesthetic ,myths and religious reasons (14).
2.3. Behavioral factors to harmful traditional practices
Studies done by UNICEF in many countries show that parents want what is best for their children, it is this most basic value that motivate parent’s decision to perform HTP, since failure to comply with the social convention brings shame and social exclusion to girls and their families, once an alternative to the social convention becomes possible within a community and people realize that the community might be better off jointly abandoning the practice, it is this most basic value to do what is best for their children that also motivates communities to abandon the harmful practice(13).
The belief in many African countries is that a non-excised girl will run loose from high sexual desire and if uvula not cut child will get sick; hence cutting part of her body will reduce the tendency to promiscuity and enhance her loyalty to the husband. Ensuring fertility, cleanliness and preventing illness are also justification in the practicing countries. Parents subject their children to FGM and Uvula cutting with the best intentions not knowing a better alternative to marriage and prevent illness respectively(6).
Study done in Nigeria discovered variously that people get infected with HIV due to certain traditional behaviors that increase the risk of its infection.
The use of same instrument on many children’s without sterilization can cause the spread of HIV/AIDS and other communicable disease like tetanus (17).
Cross sectional study on factors associated with harmful traditional practices on children less than 5 years in Axum town suggests multiple logistic regressions showed very strong association between HTPs performed on the mothers themselves and practice of HTPs to their children. Those mothers who had traditional practices performed on themselves practiced HTPs on their children 24 times than those who didn’t have any HTPs performed on them (11)
Therefore, studies conducted in different parts of Ethiopia showed that the factors associated with HTP differ from region to region of the country and from district to district within the same region depending on many factors.
In pastoralist and semi pastoralist areas of the country even if a lot of efforts were made to alleviate this problem of harmful tradition still there are a lot practices related to Harmful tradition. Hence, Fentale Woreda is one of the pastoralist areas of the country were this study was designed to assess the prevalence of harmful traditional practices and associated factors on children less than 15 years in Fentale Woreda East Shewa Zone, Oromia Region, Eastern Ethiopia.
2.4. Conceptual Frame Work
The issue of HTP in health aspect of each individual is very much valuable and its linkage with overall Health aspects through the productivity of individual is quite a lot. Presence of Health facilities and infrastructure will not, on its own, ensure their optimal use or avoid their impact on individual health; so in order to prevent complications arising from HTP it’s important to ensure peoples need and understanding about factors associated with those practices.
The conceptual framework of this study was developed based on the literatures and the personal observation of the study area.
As many literatures suggest that those factors like poverty, educational status, residence, attitudes, socio economic subordination, social norm, religion and traditional values have association with practice of harmful traditional practices.
Fig1. Conceptual Framework for associated factors of harmful traditional practice on children less than 15 years in Fentale Woreda East Shoa Zone, Oromia, 2018
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3.0 OBJECTIVES
3.1. General Objective
To assess prevalence and associated factors of harmful traditional practices on children less than 15 years in Fentale Woreda East Shewa Zone, Oromia, Ethiopia 2018 from April1-October 30 /2018.
3.2. Specific Objective
To determine prevalence of harmful traditional practices on children less than 15 years.
To identify factors associated with harmful traditional practices on children less than 15 years.
4.0. METHODS AND MATERIALS
4.1. Study design and period
A community based cross sectional study was conducted from July 15 to August 7, 2018.
4.2. Study area
Fantale Woreda is one of the ten woredas located with the Great Rift Valley on the eastern side in East Shoa Zone with Pastoral communities geographically located in lowlands where rainfall is scanty. In the woreda there are 5 Health centers, 18 Health Posts ,1 Hospital ,34 primary schools, 1 Secondary schools and 1 Technical College.
Regarding Religion and Ethnicity of dwellers most of them are Muslims and Oromo.
The population of the woreda is estimated to be 81,988 living in a total of 17,081 households and 36,714 number of under 15 years age children from census done by Woreda Finance and Economic Development (WOFED) in year 2009(19). The dwellers were settled in a total 19 kebeles of the woreda of which 18 of them are rural and the remaining 1 semi-urban.the woreda covers area of 86, 120 hectare.
It is 193 km east of Addis Ababa on the main high way that joins the Ethiopia and Djibouti. The woreda is boarded on the South East by the Arsi Zone, on the South West by Boset Woreda, on the North West by the Amhara Region and on the North East by the Afar region. Concerning the topography and climate, 100% of the the woreda is low land and desert (21).
4.3. Source and Study population
4.3.1. Source population
All parents who have children <15 years in the woreda were source Population for this study.
4.3.2. Study population
Sampled parents who have children <15 years in the woreda were study population for this study.
Inclusion criteria:-
All selected parents who have children <15 years and have willingness and ability to give response were included.
Exclusion criteria :-
Generally parents who have no willingness and ability to give response like those who are mentally impaired, unable to hear and talk, seriously ill and refuse to respond were excluded from the study.
4.4. Sample size and sampling procedures
4.4.1. Sample size determination
Sample size for the first objective
The sample size was determined using single population proportion formula with prevalence estimates of 65%(3), with a margin of error of 0.05% at the 95% confidence level.
Based on this assumption, the actual sample size for the study was computed using single population proportion formula as indicated below.
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Since multi- stage sampling technique was applied, to correct the design effect;
We multiply the value of n by 2;
The total sample size was 2 x 349 = 698 finally, we add 10% for non- response rate; then the final sample size was found to be 768.
Sample size for the second objective
- Using a cross sectional study done on factors associated with harmful traditional practices on children less than 5 years in Axum Town, North Ethiopia, 2013(11).
- Is calculated by using online open epi software taking Confidence level 95%, power 80%, case control ratio(7:1),Percent controls exposed 4.31 and percent of cases exposed 17.13 with AOR 3.91
Table1. Socio demographic and maternal practice versus practice of HTPs on children
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Hence, the sample size for the first objective is greater than the sample size for second objective our final sample size was 768.
4.4.2. Sampling procedure
A multistage sampling technique was employed to select the study participants.
First of all five kebeles and their respective zones/ketenas were selected by simple random sampling using lottery method out of the 19 kebeles of Fentale Woreda. Then, the sample size 768 was allocated using sample size proportional to population size (PPS) to each of the selected kebeles and zones/ketenas. After identifying Households who have children less than 15 years; systematic sampling method (kth) interval was used for selecting study participants. After determining the Kth interval, the first study participant was selected randomly. The next study participant was identified systematically onwards by adding cumulatively Kth intervals to the first.
Fig2: Schematic presentation of sampling stage
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4.5. Variables of the study
4.5.1. Dependant variable
Harmful Traditional Practice
4.5.2. Independent variables
Socio demographic factors like age, sex, educational status, religion, occupation, marital status, monthly household income, Housing Condition, presence of media materials, family size, age at first marriage, age at first pregnancy , presence of sons/daughters learning at high school and parents occupation.
4.6. Operational definitions
Female Genital Mutilation: traditional operation that involves cutting away parts of the female external genitalia or other injuries to the female genitalia for cultural reasons.
Uvulectomy: is a procedure involving the cutting of the uvula and sometimes the near-by Structures such as the tonsils.
Milk teeth extraction: is the procedure of pulling out the early teeth of children.
Early Marriage: is marriage that occurs before the age of eighteen
Son Preference;- selecting one child over the other depending on their sex.
4.7. Data collection procedures
The data was collected using a structured face-to-face interview questionnaire, which includes socio-demographic and other characteristics that will measure the prevalence of HTP and associated factors.
Five (5) College students was hired to collect the data and two days training on the objective of the study, content, ethical procedures, methods of data Collection and interviewing technique was provided to data collectors. The supervision was done at each step of data collection by principal investigator.
4.8. Data quality assurance
The questionnaire was prepared in English first and then translated in to the local language, Afan Oromo and translated back to English by another linguistic individual to ensure the consistency of the thought of the questions following reviewing relevant literatures.
10 days prior to the actual data collection period pretest(5%) was undertaken in neighbor woreda and based on the finding, minor modifications of questions, wordings, phrases and time required to interview a respondent was made. During data collection time, a clear introduction that explains the ethics, purpose and objectives of the study was provided to respondents.
A close supervision, honest communication and on spot decisions based on respect and trust was conducted during data collection period.
4.9. Data processing and analysis
Data was collected from study respondents and was checked for consistency and entered into Epi info version7.
The entered data was transferred to Statistical Package of Social Sciences (SPSS) version 21.0.
Descriptive statistics like frequency, distribution and percentage calculation was done for most of the variables.
Bivariate and multivariate logistic regression analyses were performed to identify the factors affecting HTP. Finally, 95% confidence interval (CI) and adjusted odds ratios (AORs) was computed in order to identify statistically significant associations between Prevalence of HTP and associated factors. The level of statistical significance was set at P<0.05. The goodness of fit of the final model was checked using Hosmer and Lemeshow test of goodness of fit considering good fit at P-value>0.05 level of significance.
[...]
- Citation du texte
- Abdela Kufa (Auteur), 2018, Harmful traditional practices (HTP). An analysis of its prevalence of and associated factors among children in Ethiopia, Munich, GRIN Verlag, https://www.grin.com/document/461602
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Téléchargez vos propres textes! Gagnez de l'argent et un iPhone X. -
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Téléchargez vos propres textes! Gagnez de l'argent et un iPhone X. -
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Téléchargez vos propres textes! Gagnez de l'argent et un iPhone X. -
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Téléchargez vos propres textes! Gagnez de l'argent et un iPhone X. -
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Téléchargez vos propres textes! Gagnez de l'argent et un iPhone X. -
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Téléchargez vos propres textes! Gagnez de l'argent et un iPhone X. -
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Téléchargez vos propres textes! Gagnez de l'argent et un iPhone X. -
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Téléchargez vos propres textes! Gagnez de l'argent et un iPhone X. -
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Téléchargez vos propres textes! Gagnez de l'argent et un iPhone X. -
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Téléchargez vos propres textes! Gagnez de l'argent et un iPhone X.