Background All women require access to high-quality care during pregnancy, labor, and after childbirth. The occurrence of delay at any stage is one of the major causes of maternal mortality. There is, however, a scarcity of data on women’s access to maternal health services during the COVID-19 pandemic. Therefore, the goal of this study was to assess the magnitude of delays in maternal health service utilization and its associated factors among pregnant women in the Ilubabor zone during the COVID-19 pandemic. Methods A facility-based cross-sectional study was conducted among 402 pregnant women selected by systematic random sampling. Data were analyzed using IBM SPSS Statistics version 26. Descriptive and summary statistics were used to describe the study population. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with the outcome variables. Adjusted odds ratio with respective 95% CI was used to report significant covariates. Results A total of 402 pregnant women participated in this study. The median age of the respondents was 25 years (IQR = 8). On average, a woman stays 1.76 hours (SD = 1.2) to make a decision to seek care. The prevalence of first, second and third delay were 51%, 48%, and 33.3%, respectively. Being unmarried [AOR (95% CI)], [0.145 (0.046–0.452)], being unemployed [AOR (95% CI)], [4.824 (1.685–13.814)], age [AOR (95% CI)], [0.227 (0.089–0.0579)], fear of COVID-19 [AOR (95% CI)], [1.112 (1.036–1.193)], urban residence [AOR (95% CI)], [0.517 (0.295–0.909)], and lack of birth preparedness [AOR (95% CI)], [6.526 (1.954–21.789)] were significantly associated with first delay. Being unmarried [AOR (95% CI)], [5.984 (2.930–12.223)], being unemployed [AOR (95% CI)], [26.978 (3.477–209.308)], and age [AOR (95% CI)], [0.438 (0.226–0.848)] were significantly associated with second delay. Having lengthy admission [AOR (95% CI)], [7.5 (4.053–13.878)] and non-spontaneous vaginal delivery [AOR (95% CI)], [1.471 (1.018–1.999)] were significantly associated with third delay. Conclusion This study identified a significant proportion of mothers experiencing delays, although there were no data to suggest exacerbated delays in utilizing maternal health services due to fear of the COVID-19 pandemic. The proportion of maternal delay varies with different factors. Improving the decision-making capacity of women is, therefore, essential.
Introduction: Fear of COVID-19 makes tuberculosis (TB) patients seek health care after complications of the case. This can be the reason for serious illness, increased length of infectiousness, poor treatment outcomes, and economic crisis for families and the health system. Despite this, no study has been conducted in Ethiopia and in other African countries with the factor “fear of COVID-19.” Identified preventable factor and other covariates are used to reduce the healthcare-seeking delay. Objective: This study assessed the association of fear of COVID-19 with healthcare-seeking delay among TB patients in Ilu Ababor Zone health facilities, south-western Ethiopia. Methods and materials: A health institution-based cross-sectional study was conducted among TB patients from October 15, 2020, to March 1, 2021. Using a systematic sampling method, 403 TB patients were selected for face-to-face interviews. The association of fear of getting COVID-19 with healthcare-seeking delay was assessed by a chi-square test. Variables with a p-value <0.25 in the bi-variable binary logistic regression were entered into the multivariable binary logistic regression model. The level of statistical significance in multivariable binary logistic regression was declared at a p-value <0.05. Result: In this study, the proportion of patient healthcare-seeking delay was 46.7%. Chi-square test of the association of fear of COVID-19 with healthcare-seeking delay among TB patients showed a significant association ( p-value = 0.042). After controlling for covariates, patients living in rural area (adjusted odds ratio (AOR) = 2.437, 95% confidence interval (CI): 1.385–4.286), patients with poor knowledge (AOR = 3.300, 95% CI: 1.792–6.078), earning monthly income <200 Ethiopian birr (ETB) (AOR = 3.912 95% CI: 1.951–7.841), traveling greater than 30 min (AOR = 2.127, 95% CI: 1.301–3.476), and fear of COVID-19 pandemic (AOR = 3.124, 95% CI: 1.029–9.479) were significantly associated with patient healthcare-seeking delay. Conclusion: The study found that healthcare-seeking delay among TB patients was substantial. Patient healthcare-seeking delay was significantly associated with fear of COVID-19.
Background The main target of tuberculosis control and prevention is to detect incident cases as quickly as possible and also to prevent the occurrence of disease. It is also the responsibility of the health facility to screen the contacts, identifying children for prophylactic therapy. However, the target is difficult to meet due to issues within health facilities that cause health system diagnostic delays. Despite this, there is no information explored why health system diagnostic delays among tuberculosis patients. Method A qualitative study was conducted by using different data collection methods and sources. Seventeen DOT providers, five laboratory professionals, six program managers, and seven Tuberculosis patients were interviewed. In addition, 22 governmental health facilities were observed for the availability of resources. Data obtained from the in-depth interviews was transcribed, coded, categorized, and thematized manually. Result Health system Diagnosis delays reasons were related with sample collection procedures, poor competency of health professionals, in addition to absences or scarcity of health professionals, medical products, and basic infrastructure. We found 18 health facilities without skilled personnel in the OPD, 7 health facilities with a broken microscope, and almost all health facilities without a separate room for sputum examination. Furthermore, 12 (54.5%) and 14 (63.6%) health facilities lacked access to water and electric power, respectively. Conclusion Many reasons for TB diagnosis delays have been identified in the study area. Poor competence of health workers and scarcity of resources were identified. Depending on the finding, we suggest strengthening the health workers’ training. Concrete strategies need to be designed to retain professionals. Training on human resource planning and budget preparation is needed for front-line managers. Managers have to work on the maintenance of diagnostic tools and facilitate transportation. The rural health facilities need to use another alternative power source.
Background Home birth preference is the need of pregnant women to give birth at their home with the help of traditional (unskilled) birth attendants. Homebirth with unskilled birth attendants during childbirth is the main leading indicator for maternal and newborn death. In Ethiopia, numbers of women prefer homebirth which is assisted by unskilled personal. However, there is no information regarding the problem in the Arba Minch zuria woreda. Therefore, it is important to identify prevalence of preference of homebirth and associated factors. Objectives This study aimed to assess the preference of home birth and associated factors among pregnant women in Arba Minch health and demographic surveillance site. Method and materials A community-based cross-sectional study was conducted among pregnant women in Arba Minch health and demographic surveillance site, from May 1 to June 1, 2021. Using simple random sampling technique, 416 study samples were selected. Data were collected by interviewer-administered questionnaire. Data were coded and entered into Epi-Data version 4.4.2.1 computer software and exported to Statistical Package for Social Sciences software version 25 for analysis. Bi-variable binary logistic regression for the selection of potential candidate variables at p-value < 0.25 for multivariable analysis and multivariable binary logistic regression to identify the association between homebirth preference and independent variables were carried out. The level of statistical significance was declared at a p-value < 0.05. Result In this study, in Arba Minch demographic health surveillance site, the prevalence of preference of pregnant women to give birth at their home was 24% [95%CI: (19.9%-28.2%)] The factors significantly associated with the preference of home birth were husband involvement in decision making [AOR: 0.14 (0.05–0.38)], no access of road for transportation [AOR: 2.4 (1.2–5.18)], not heard about the benefit of institutional birth [AOR: 5.3 (2.3–12.2)], poor knowledge about danger signs [AOR: 3 (1.16–7.6)], negative attitude toward services [AOR: 3.1 (1.19–8.02)], and high fear to give birth at institution [AOR: 5.12 (2.4–10.91)]. Conclusions In Arba Minch demographic health surveillance site, the prevalence of preference of pregnant women to give birth at their home was 24%. Husband involvement in decision making, no access of road for transportation, not heard about the benefit of institutional birth, poor knowledge about danger signs, negative attitude toward services, and high fear to give birth at health institutions were factors significantly associated with the preference of home birth.
Background Fecundity is a physiological ability to have children. The inability to get the desired child which was commonly caused by the prolonged time to conceive due to unwanted non-conception period increased from time to time. As a result, many couples are developing psychological, social, and economic problems and unstable life. However, information on fecundity status is limited in Ethiopia context. Therefore, this study aimed to assess the proportion of sub-fecundity and associated factors in Ethiopia context. Methods A health institution based cross-sectional study was conducted in Arba Minch health facilities from March 25 to April 25, 2020. By using a systematic sampling method, 539 mothers were selected for the study. Structured questionnaire was used for data collection. A binary logistic regression model was used to identify factors associated with the sub-fecundity. Variables with p-value <0.25 in the bi-variable logistic regression analysis were interred and checked for association in a multivariable logistic regression model. The level of statistical significance was declared at p-value <0.05. Result The proportion of sub-fecundity was 17.8% with 95%CI (14.8%-21.3%). Mothers’ age ≥ 30 (AOR = 2.54, 95%CI; 1.18–5.48), partners’ age ≥ 35 (AOR = 2.20, 95%CI; 1.01–4.75), coffee consumption of ≥ 4 cups/day (AOR = 2.93, 95%CI; 1.14–7.53), menses irregularity (AOR = 3.79 95%CI; 2.01–7.14) and coital frequency of 1day/week (AOR = 3.65, 95%CI; 1.47–9.05) were significantly associated with the sub-fecundity. Conclusion This study found that a substantial proportion of mothers were sub-fecund. Factors that contributed to the sub-fecundity were pre-pregnancy; mothers’ age, partners’ age, coffee drinking of ≥ 4 cups/day, coital frequency of 1day/week, and menses irregularity. Thus, efforts to prevent sub-fecundity should focus on awareness creation as to plan to conceive at early age, reducing coffee consumption, increasing days of coital frequency per week, and investigating and treating mothers with irregular menses.
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