Background:In low-and middle-income countries, it is challenging to provide basic healthcare services even before the COVID-19 pandemic outbreak. The purpose of this study was to evaluate the early indirect impact of COVID-19 on the utilization of reproductive, maternal, and newborn health services at government health facilities in South West Ethiopia, and its consequences. Methods: A comparative cross-sectional study was employed. The collected data were entered into Microsoft excel 2010 and then exported to SPSS 25 and R3.5.0 software for analysis. Independent sample t-test and two-sample test of proportion were computed, and the results were presented in text, tables, and graphs. P-value <0.05 was considered statistically significant. Results: This study showed that there was a significant reduction in mean utilization of antenatal care (943.25 visits vs 694.75 visits), health facility birth (808.75 births vs 619 births), family planning (4744.5 visits vs 3991.25 visits), and newborn immunization (739.5 given vs 528.5 given) between March-June 2019 and March-June 2020. However, there were significant increases in proportion of teenage pregnancy (7.5% vs 13.1%), teenage abortion care user (21.3% vs 28.5%), institutional stillbirth (14% vs 21.8%) and neonatal death (33.1% vs 46.2%) during the same period. Conclusion and Recommendation:This study showed that utilization of reproductive, maternal, and newborn health-care services was affected by the pandemic with deterioration of maternal and perinatal outcomes. An increase in the proportion of teenage pregnancy who seeks abortion care and the rising cesarean section rate with no improvement in perinatal outcome is a great concern that needs further investigation. Further research is also needed to explore the main reason for an increase in teenage pregnancy, abortion care users, stillbirth, and neonatal death during COVID-19.
Background The worldwide COVID-19 pandemic is overstressing health systems and Essential health services and vaccination services are disrupted. Immunization is a confirmed gizmo for governing and even eliminating communicable diseases. Objective This study aims to assess the challenge and status of immunization during COVID-19 and associated factors among children aged 10–23 months south Nation Nationality and People Region Ethiopia. Methods and Materials: community-based mixed quantitative and qualitative cross-sectional study was done in southwest Ethiopia. Data was collected using semi-structured questionnaires and in-depth interviews. After that, the data were edited, coded, and move in into Epi info version 7.2 for data management then transported to SPSS version 25 for analysis. The analyzed data were presented by tables, graphs, figures, and text form. Results According to this study, the prevalence of incomplete immunization was found to be 809 (62.2%) with (95% CI: 59.5, 64.8). In multivariable analysis waiting time at a health facility (AOR=0.04, 95% CI 0.0001,0.004), education (AOR=5.08,95% CI2.31,11.14), place of delivery (AOR=2.34,95% CI 4.96,6.089), fearing of COVID-19 (AOR=3.62,95% CI 1.72,7.64) and do not understand the separation care of COVID-19 and other health services (AOR=2.85,95% CI1.38,5.9) were significantly associated factors. Conclusion The prevalence of incomplete immunization among children aged 10–23 months was very high in this study as compared to the other studies done in a different pocket of Ethiopia. Consecutively, reducing waiting time at a health facility, avoiding unnecessary fear of COVID-19, and promoting immunization in a different area of southwest Ethiopia along with health extension workers are recommended.
Background: Many women with diabetes mellitus experience high rates of unintended pregnancies, infant morbidity and mortality and preventable birth defects.Thus, preconception care offers the potential for earlier risk assessment and intervention that can benefit women before pregnancy and ensure the healthiest possible start for the newborn child. The aim of this study is to assess the knowledge and experience of preconception care and associated factors among pregnant mothers with pre-existing diabetes mellitus. Methods: Facility based quantitative cross-sectional study design was employed among 142 conveniently selected pregnant women between March 11and April 12, 2018. Logistic regression including bivariate and multivariate analysis considering 95% CI was utilized to examine association between dependent and independent variables. P-value < 0.05 was considered statistically significant. Result: this study found that 67(42.7%) of pregnant women with pre-existing diabetes mellitus had good knowledge on preconception care. Educational level, occupation and duration of diabetes was associated with knowledge about preconception care AOR= 0.24 [0.065, 0.828], AOR= 0.042[0.102(0.011-0.918] and AOR= 0.035 [3.599(.095-11.833] respectively. Conclusion: women’s knowledge on preconception care in this study is low. Education, occupation and duration of diabetes were factors associated with knowledge of preconception care. Establishment of preconception care strategies addressing all components of the care and increasing women’s knowledge about preconception care is an important component to ensure prevention of potential risks.
Background Mothers in rural Ethiopian communities prefer giving birth at home. In developing countries, traditional birth attendants play an important role in reducing the maternal mortality rate. In Ethiopia, however, their role during pregnancy, childbirth, the postnatal period, and their integration with health professionals is not clearly defined. This study aimed to explore the role of traditional birth attendants in feto-maternal care during pregnancy, childbirth, and the postnatal period, and integration with health professionals in the West Omo Zone, southern Ethiopia. Methods A qualitative descriptive design was used with triangulation of methods and data sources. We conducted in-depth interviews with traditional birth attendants, key informant interviews with health care professionals and community or religious leaders, and two focus group discussions with multiparous pregnant women. Each interview and focus group discussion was tape-recorded and the data obtained were transcribed and translated into English for analysis. The analysis was done based on thematic analysis framework. Results Traditional birth attendants stated that they used herbal remedies to treat nausea and vomiting, decrease pain during labor, and increase pregnant women's desire to push. The absence of incentives for their work, shortage of logistics, and lack of training was mentioned as challenges to the continuity of their roles. All study participants explained the importance of training traditional birth attendants on maternal and child health in rural communities. However, health care professionals reported that few traditional birth attendants advised mothers about traditional practices such as milk tooth extraction and uvulectomy. Conclusion and recommendation Traditional birth attendants continued their roles despite the existing challenges. There was no integration between TBA and the formal health care system. The need for training traditional birth attendants has been emphasized by all study participants and its impact on reducing feto-maternal death was recognized by health care professionals. Therefore, the federal ministry of health should works better for the development of TBAs to scale up their skills across all regions in the country.
Background Cervical cancer is the fourth most frequently diagnosed and found to be the leading cause of cancer death in women, especially in low and middle-income countries. Even though cervical cancer is a preventable disease, its preventive measures have not been equitably implemented across and within different countries; especially in low and middle-income countries, due to different contributing factors. Objective This study aimed to assess cervical cancer screening utilization and its’ predictors among Women in Bench Sheko Zone, Southwest Ethiopia. Method A community-based cross-sectional study design was employed in Bench Sheko Zone from February 2021 to April 2021. Using a multi-stage stratified sampling method, a total of 690 women in the age range of 30–49 years were included in the study. The logistic regression analysis was used considering a 95% confidence interval and a P-value of < 0.05. Results Ninety-six (14.2%) of the participants have utilized cervical cancer screening. Predictors like; age between 40–49 years (AOR = 5.35, 95% CI = [2.89, 9.90]), partner educational status of certificate and above (AOR = 4.36, 95% CI = [1.65, 11.51]), first sexual intercourse before eighteen years (AOR = 4.85, 95% CI = [2.29, 10.26]), ever used of alcohol (AOR = 3.99, 95% CI = [1.23, 12.89]), good knowledge (AOR = 8.98, 95% CI = [4.06, 19.89]), favorable attitude (AOR = 3.56, 95% CI = [1.78, 7.09]), and high perceived benefit (AOR = 2.94, 95% CI = [1.48, 5.84]) were strongly associated with cervical cancer screening utilization. Conclusion In this study, cervical cancer screening utilization was relatively low. Therefore, promotion of the perception of women towards cervical cancer screening, and provision of health-related information towards different behavioral-related factors should have to be addressed at each level of health care.
ObjectiveTo assess the time to development of anaemia and its predictors among women of reproductive-age receiving antiretroviral therapy (ART) in public hospitals, Southwest Ethiopia.DesignHospital-based retrospective follow-up studySettingMizan-Tepi University Teaching Hospital, and Gebretsadik Shawo General Hospital Southwest Ethiopia.ParticipantsA total of 389 records of women living with HIV/AIDS at public hospitals were reviewed using a systematic sampling method. The data were entered using Epi-Data Manager V.4.2 and exported to STATA V.14 for data analysis. A Cox-regression model was used and variables with a p-value of <0.05% and 95% confidence level in multivariable analysis were declared as statistically significant predictors for anaemia.Primary outcomeTime to development of anaemia and its predictors among women of reproductive-age on ART in public hospitals.ResultsOf 370 records of women of reproductive-age, 203 (54.86%, 95% CI (49.77% to 59.96%)) were anaemic with an incidence rate of 12.07 per 100 person months of observation, and the overall median survival time of 60 months. The total of 2.97%, and 80.26% of women were developed anaemia within the first 6 months and the last 6 months period of follow-up, respectively. Moreover, non-employed women, women with advanced WHO stage, women with baseline opportunistic infections and women who were on ART for long-duration were significantly associated with anaemia among women living with HIV/AIDS.ConclusionIn this study, the incidence rate of anaemia was significantly high. The development of anaemia among women on ART was also increased with increased follow-up time. The risk of anaemia is increased in women living with HIV/AIDS due to advanced baseline WHO staging, presence of OIs at baseline, an increased duration on ART and low occupational status. Therefore, early identification and treatment of opportunistic infections and other coinfections are required to decrease the incidence of anaemia among women living with HIV/AIDS.
Background: The third United Nations Sustainable Development Goal includes a commitment to end HIV. In lined with the Sustainable Development Goal, Option B+ programs hold great promise for preventing transmission of HIV and moving towards an “AIDS-free generation. However, an estimated 110,000 AIDS-related deaths occurred among children in 2015. The Global Plan also identified Ethiopia as one of 22 high priority countries for improved prevention of mother to child HIV transmission services. But, there is a scarcity of data on the contributors of loss to follow up and mortality after option B+ guideline implementation in the Amhara regional state, Ethiopia. Methods: This study conducted in five zones of the Amhara regional state, Ethiopia. The study considers mothers that admitted to the 5-referral hospitals’ PMTCT departments, midwifery professionals who work in the respective hospital’s PMTCT departments, and HIV officers. The period for data collection was from March 21 to May 18/2019. An in-depth qualitative interview employed to gain access to the participants’ experiences and conducted an inductive qualitative content analysis.Results: Mothers, health professionals, and HIV officers were asked about the contributors of lost to follow up in the Amhara region. The participants’ suggestions on the causes categorized into a health facility, stigma and discrimination, and socioeconomic status themes. On the prevention of loss to follow up, the views of study participants were categorized into health facility improvement, psychosocial support, and loss to follow up retention mechanisms. On the causes of HIV related mortality, participants’ views categorized into vertical HIV transmission, carelessness of parents, and poor socioeconomic status themes. In the recommendations to prevent loss to follow up and mortality, participants forwarded their suggestions for health facilities and professionals and civic societies. On the prevention of mortality, participants’ views categorized into health care and mothers’ awareness.Conclusions: The participants were emphasizing the health facilities, health care professionals, and awareness of families to prevent loss to follow up and mortality among exposed infants after admission to the PMTCT program. Hence, concerned bodies mainly minister of health should outline on improving the service provided in the PMTCT department.
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