Background Globally, approximately 15 million babies are born preterm every year. Complications of prematurity are the leading cause of under-five mortality. There is overwhelming evidence from low, middle, and high-income countries supporting kangaroo mother care (KMC) as an effective strategy to prevent mortality in both preterm and low birth weight (LBW) babies. However, implementation and scale-up of KMC remains a challenge, especially in lowincome countries such as Ethiopia. This formative research study, part of a broader KMC implementation project in Southern Ethiopia, aimed to identify the barriers to KMC implementation and to devise a refined model to deliver KMC across the facility to community continuum. Methods A formative research study was conducted in Southern Ethiopia using a qualitative explorative approach that involved both health service providers and community members. Twenty-fourin-depth interviewsand 14 focus group discussions were carried out with 144study participants. The study applied a grounded theory approach to identify,examine, analyse and extract emerging themes, and subsequently develop a model for KMC implementation. Results Barriers to KMC practice included gaps in KMC knowledge, attitude and practices among parents of preterm and LBW babies;socioeconomic, cultural and structural factors; thecommunity’s beliefs and valueswith respect to preterm and LBW babies;health professionals’ acceptance of KMC as well as their motivation to implement practices; and shortage of supplies in health facilities. Conclusions Our study suggests a comprehensive approach with systematic interventions and support at maternal, family, community, facility and health care provider levels. We propose an implementation model that addresses this community to facility continuum.
Background COVID-19 is highly infectious viral disease that can lead to main clinical symptoms like fever, dry cough, fatigue, myalgia, and dyspnea. Since there is no drug to cure the disease, focusing on improving community awareness related to prevention methods is crucial. But there was no regional level study addressing the reach of information, community knowledge and attitude related to COVID-19 and its prevention, and this study was done to inform and assist communication related to the disease responses during early introduction of the disease to the setting. Methods Community based cross sectional study was conducted in selected ten towns of SNNPR, Ethiopia. Multi-stage sampling was used to select 1239 participants. Semi-structured questionnaire was designed, pre-tested and uploaded to SurveyCTO data collection system with security patterns. Knowledge was assessed considering awareness about signs and symptoms, confirmatory test (laboratory test), what to do if there is a suspect, availability of drug to cure the disease, mechanisms of transmission, prevention methods and most at risk groups. Attitude was assessed using 11 statements including seriousness of disease, being at risk, possibility of prevention, and benefits of staying at health facilities. Descriptive statistics and binary logistic regression were performed to manage data using SPSS version 25. Results Almost all respondents (99.8%) heard about the disease. The mean score of knowledge was 52.3% (SD = 18.9) while the mean score attitude was 80.8% (SD = 6.48). Educational status, housing condition and marital status were associated with having good knowledge while occupation, housing condition, age and overall knowledge were associated with having positive attitude. Conclusion Even though almost all respondents had heard about the COVID-19, knowledge and attitude related to COVID-19 and its prevention were low. Awareness creation should be intensified using different local languages to improve community awareness, overcome misconceptions and minimize consequences of the disease.
Background Access to and the use of accurate, valid, reliable, timely, relevant, legible and complete information is vital for safe and reliable healthcare. Though the study area has been implementing standardized Health Management Information System (HMIS), there was a need for information on how well structures were utilizing information and this study was designed to assess HMIS data utilization. Methods Facility based retrospective study was conducted in Southern Nations Nationalities and People's Region (SNNPR) in April, 2017. We included data from 163 sample facilities. Data use was evaluated by reviewing eight items from performance monitoring system that included activities from problem identification to monitoring of proposed action plans. Each item reviewed was recoded to yes or no and summed to judge overall performance. Results About half (52%) of woredas, 26.2% health centers (HCs), 25% hospitals and 6.2% health posts (HPs) reviewed their performance monthly but only 20% woredas, 6.2% HCs, 1.5% HPs and no hospital prepared action plans after reviewing performance. Summary of 8 items assessed showed that majority of facilities (87.5% hospitals, 81.5% HPs and 70.8% HCs) were poor in data utilization. Conclusions Only about half of woredas and below one-fifth of health facilities were utilizing HMIS data and a lot to move to catch-up country's information revolution plan. Lower health care systems should be supported in evidence-based decision-making and progress should be monitored routinely quantitatively and/or qualitatively.
ObjectiveTo assess community practices related to COVID-19 prevention and its associated factors during the early introduction of the disease to the study area.Setting and participantsA community-based cross-sectional study was conducted in Southern Nations, Nationalities and People’s Region, Ethiopia. Ten zonal towns with high population density and mobility and 1239 participants were included in the study.Outcome measureA semistructured questionnaire was uploaded to SurveyCTO data collection system with security patterns. Mask usage was assessed by observation, while social distancing and handwashing were assessed by interview. Data were collected by health professionals who have Bachelor of Science degree and above and analysed using SPSS V.25. Descriptive statistics and binary logistic regression were performed.ResultsFrom 1239 individuals, about half, 657 (53%), of respondents were women and about two-thirds, 795 (64.2%), were married. Nearly 9 out of 10 (90.3%) and about 8 out of 10 (82.0%) respondents reported that they frequently wash hands with soap and/or use sanitiser and keep social distancing as means to prevent COVID-19, respectively. Less than three-fifths (57.8%) of respondents wore masks during the interview. In summary, about half (48.9%) of respondents were practising the three recommended methods (social distancing, handwashing and wearing masks). Sex, educational status, family size and overall knowledge about COVID-19 were associated with practising COVID-19 prevention measures.ConclusionCOVID-19 prevention practice was low as only about half of participants were practising social distancing, handwashing and wearing masks. Although awareness creation has been implemented through different forms of media, it should be strengthened in different local languages. Concerned government bodies should strictly follow using masks in public gatherings.
Background A growing body of evidence demonstrating that individuals with Non-Communicable Disease (NCD) are more likely to have severe forms of COVID-19 and subsequent mortality. Hence, our study aimed to assess the knowledge of vulnerability and preventive practices towards COVID-19 among patients with hypertension or diabetes in Southern Ethiopia. Objective To assess the knowledge and preventive practices towards COVID-19 among patients with hypertension or diabetes mellitus in three zones of Southern Ethiopia, 2020. Methods A community-based cross-sectional study design was used with a multi-stage random sampling technique to select 682 patients with hypertension or diabetes mellitus from 10th -17th July 2020 at the three zones of Southern Ethiopia. Logistic regression analysis with a 95% confidence interval was fitted to identify independent predictors of knowledge and preventive practices towards COVID-19. The adjusted odds ratio (AOR) was used to determine the magnitude of the association between the outcome and independent variables. P-value <0.05 is considered statistically significant. Results The Multi-dimensional knowledge (MDK) analysis of COVID-19 revealed that 63% of study subjects had good knowledge about COVID-19. The overall preventive practice towards COVID -19 was 26.4%. Monthly income (AOR = 1.42; 95% CI: 1.04, 1.94) significantly predicted knowledge towards COVID-19. Ninety-five percent of the study subjects knew that the COVID-19 virus spreads via respiratory droplets of infected individuals. One hundred and ten (16.2%) of study subjects correctly responded to the questions that state whether people with the COVID-19 virus who do not have a fever can infect the other. Knowledge about COVID-19 (AOR = 1.47; 95% CI: 1.03, 2.1) became the independent predictor of preventive practice. Conclusions In this study, the knowledge of the respondents towards the COVID-19 pandemic was good. But the preventive practice was very low. There was a significant gap between knowledge and preventive practices towards the COVID-19 pandemic among the study subjects. Monthly income was significantly associated with knowledge of COVID-19. Knowledge of COVID-19 was found to be an independent predictor of preventive practice towards COVID-19. Community mobilization and improving COVID-19- related knowledge and practice are urgently recommended for those patients with hypertension or diabetes mellitus.
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