BackgroundThe Community-Based Newborn Care (CBNC) program is a comprehensive strategy designed to improve the health of newborns during pregnancy, childbirth, and the postnatal period through health extension workers at community levels, although the implementation has not been evaluated yet. Therefore, this study aimed to evaluate the process of the CBNC program implementation in Geze Gofa district, south Ethiopia.MethodsA case study evaluation design with a mixed method was employed from May 1 to 31, 2017. A total of 321 mothers who gave birth from September 01, 2016 to February 29, 2017, were interviewed. Similarly, 27 direct observations, six-month document reviews, and 14 key informant interviews were conducted. The quantitative data were entered into Epi-Data version 3.1 and exported to SPSS version 20 for analysis. In the multivariable logistic regression analysis, variables with < 0.05 p-values and Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were used to declare factors associated with maternal satisfaction. The qualitative data were transcribed, translated, coded, and analyzed using thematic analysis. The overall process of program implementation was measured based on pre-determined judgmental criteria.ResultsThe overall level of the implementation process of the CBNC program was 72.7%, to which maternal satisfaction, availability of resources, and healthcare providers’ compliance with the national guideline contributed 75.0, 81.0, and 68.0%, respectively. Essential drugs and medical equipment, like vitamin K, chlorohexidine ointment, neonatal resuscitation bags, and masks used in the program were out of stock. Very severe diseases were not treated according to the national guidelines, and the identification of neonatal sepsis cases was poor. Trading occupation (AOR: 0.16, 95% CI: 0.03–0.97) and low wealth status (AOR: 3.11, 95% CI: 1.16–8.36) were factors associated with maternal satisfaction.ConclusionThe process of CBNC program implementation was relatively good, although the compliance of healthcare providers with the national guideline and maternal satisfaction with the services was low. Some essential drugs and medical equipment were out of stock. Merchant and low wealth status affected maternal satisfaction. Therefore, healthcare offices should provide crucial medicines and equipment for better program implementation and improve the wealth status of mothers to enhance maternal satisfaction.
Background Malnutrition especially undernutrition is the main problem that is seen over people living with HIV/AIDS and can occur at any age. Multiple factors contributed to undernutrition of HIV/ AIDS patients and it need immediate identification and prompt action. The objective of this study was to assess the nutritional status of patients and identify factors associated with undernutrition among HIV/AIDS patients on follow-up care in Jimma medical center, Southwest Ethiopia. Methods A cross-sectional study design was conducted from March-April 2016. Data were collected retrospectively from clinical records of HIV/AIDS patients enrolled for follow up care in ART clinic from June 2010 to January 2016. Bivariate and multivariate logistic regression analysis were performed to identify independent predictor of undernutrition. Results Data of 1062 patients were included in the study. The prevalence of undernutrition (BMI<18.5 kg/m 2) and overweight or obesity were 34% and 9%, respectively. Out of undernourished patients, severely malnourished patients (BMI<16 kg/m 2) accounted of 9%. Undernutrition was more likely among widowed patients (AOR = 1.7, 95% CI, 1.03-2.79), patients with no access to water supply (AOR = 1.69, 95% CI, 1.16-2.47) and patients in the WHO clinical stage of three (AOR = 2.0, 95% CI, 1.33-2.97) and four (AOR = 3.0, 95% CI, 1.74-5.07). Moreover, the odds of undernutrition was more likely among patients with CD4 cell count of <200 cells/mm 3 (AOR = 2.0, 95% CI, 1.38-2.47) and patients with a functional status of bedridden (
Background: Malnutrition especially under nutrition is the main problem that is seen over people living with HIV/AIDS and can occur at any age. Multiple factors contributed to malnutrition of HIV/AIDS patients and it need immediate identification and prompt action. The objective of this study was to assess the nutritional status of patients and identify factors associated with malnutrition among HIV/AIDS patients on follow-up care in Jimma medical center, Southwest Ethiopia. Methods: A cross-sectional study design was conducted from March-April, 2016. Data was collected retrospectively from clinical records of HIV/AIDS patients enrolled for follow up care in ART clinic from June 2010 to January 2016. Binary and multiple variable logistic regression was done to identify independent predictor of malnutrition. Results: Data of 971 patients were included in the study. The prevalence of under nutrition (BMI<18.5) was (36.8%) (95% CI: 33.8%-39.8%) and out of which severe malnutrition accounts 9.7%. Overweight and obese was 8.6%. Malnutrition was more likely among widowed patients (AOR=1.7, 95% CI, 1.034-2.798), patients in the WHO clinical AIDS staging of three (AOR=2.3, 95% CI, 1.392-3.693) and four (AOR=3.2, 95% CI, 1.667-5.943), patients with CD4 cell count of <200 cells/mm3 (AOR=2.0, 95% CI, 1.463-2.837) and patients with a functional status of bedridden (AOR=4.677, 95% CI, 1.761-12.419) and ambulatory (AOR=2.763, 95% CI, 1.833-4.165). Conclusion: Both under nutrition and overweight are prevalent among HIV/AIDS patients in Jimma Medical Center, Ethiopia. Malnutrition was significantly associated with clinical outcome of patients. Hence, nutritional assessment, care and support should be strengthened. Critical identification of malnourished patients and prompt interventions should be undertaken.
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