Background Despite Ethiopia’s efforts to avail postpartum family planning (PPFP) services, the unmet need for family planning among postpartum women remains high. Therefore, this study is aimed to assess barriers and determinants of postpartum family-planning uptake among women visiting Maternal, Neonatal, and Child Health (MNCH) services in public health facilities of western Ethiopia. Methods A facility-based cross-sectional study design with a quantitative method was conducted on 989 postpartum women in Western Ethiopia from September 1 to October 30, 2020. Data were collected through face-to-face interviews using pretested structured questionnaires, entered using EPI-INFO version 7.0, and analyzed by SPSS version 25. Descriptive analysis and logistic regressions were performed. The adjusted odds ratio with a 95% confidence interval was used and statistical significance was declared at P-value < 0.05. Result In this study, 56.1% of participants had used PPFP in the last year. The most commonly used method was injectable (51.7%). Family planning use before the index pregnancy (AOR = 2.09;95%CI:1.29,3,41),counselling on PPFP during antenatal care and delivery (AOR = 4.89;95%CI:2.31,10.37),health facility delivery (AOR = 7.61;95%CI:4.36,13.28), skilled birth attendance (AOR = 4.99;95%CI:2.88,8.64),COVID-19 restrictions (AOR = 0.59;95%CI:0.39,0.90) were factors associated with PPFP utilization. Being breastfeeding and amenorrhea were major reasons for not using postpartum family planning. Conclusion Post-partum family planning utilization among study participants was low. Given the associated factors, it is recommended that health facilities should make postpartum family planning one of their top priorities and focus on these factors to improve its utilization.
Background Postpartum spontaneous vulvar hematoma is a rare complication of childbirth that can potentially cause maternal death if not managed properly and in a timely manner. Case summary We present the case of maternal near miss secondary to postpartum hemorrhage secondary to vulvar hematoma after home delivery in a 28-year-old para IV mother from rural Ethiopia. The case was surgically managed under spinal analgesia. The mother and her newborn were discharged on the fourth postprocedure day. Conclusion Neglected and inappropriately managed postpartum vulvar hematoma can cause significant maternal morbidity; therefore, timely surgical exploration, ligation of bleeding vessels, and obliteration of dead space can avert severe maternal complications
Objectives: The use of youth sexual and reproductive health (YSRH) services is low in poor nations like Ethiopia. This puts individuals at risk for a variety of sexual and reproductive health issues. Thus, the goal of this study is to evaluate how young people in East Wollega, Western Ethiopia, perceive and use YSRH services. Methods: A community-based cross-sectional quantitative study mixed with a qualitative inquiry was conducted among 771 participants from February 1 to 28, 2020. Data were collected through face-to-face interviews using pretested structured questionnaires adopted from reviewed works of literature on YSRH services. Data were entered using Epi Info version 7.0 and analyzed by SPSS version 20. The qualitative data was collected using interview guides and checklists. These data were analyzed using a thematic framework approach. Results: In this study, 48.2% of teens felt that the YSRH service units’ location within the medical facilities was inconvenient and difficult to access. More than half, 71.3% of participants, concurred that the health providers offer services that are technically sound. The confidentiality of information is disputed by 18% of participants at YSRH service locations. The limited awareness and use of YSRH services was investigated. Because of their fear of embarrassment, lack of privacy, the providers’ attitudes and workload, and the service unit’s awkward location, the adolescents believe they lack the confidence to use YSRH services. Conclusion: Due to low awareness, providers’ attitudes, and characteristics specific to health facilities, such as poorly placed service sites inside such facilities, a lack of services offered there, and a terrible work environment, youth had a negative opinion of YSRH services. Therefore, it is advised that families, local authorities, the medical field, the educational field, and the media all collaborate to alter public opinions of juveniles by utilizing youth-friendly strategies. The authors advise health facilities to respect young people’s privacy, alter health workers’ attitudes, let them use the services, remove obstacles to payment, designate enough health workers for both working and non-working hours, and reorganize the services.
Worldwide, the incidence of cesarean sections has increased. Cesarean scar dehiscence, in which the scar tissue from the prior cesarean section is disrupted and separated, is one of the most significant complications of cesarean deliveries. Spontaneous cesarean scar dehiscence is among rare obstetric events. It carries catastrophic fetal and maternal complications. Timing of occurrence, screening, diagnosis, and obstetrics management in the current and subsequent pregnancies are full of controversies. Here, we present a case of spontaneous cesarean scar dehiscence in a patient who had an inter-pregnancy interval of only 4 months. We present the case of spontaneous cesarean scar dehiscence during pregnancy in a 30-year-old patient from western Ethiopia. She got pregnant after 4 months of previous cesarean delivery. Currently, she presented to the hospital with previous two cesarean scars and a term pregnancy. Intraoperative findings showed separation of the uterine wall which is covered by only fetal membranes. After delivering the fetus and placenta, the uterus was repaired in two layers. The patient had a smooth postoperative course and was discharged on the fifth day with appropriate counseling. During pregnancy, there is a chance of spontaneous cesarean scar dehiscence. Therefore, it is essential to properly assess pregnant mothers who have had a previous cesarean scar. If the cesarean scar dehiscence is diagnosed before the elective cesarean section, the obstetrician should get prepared to prevent potential complications.
Objectives: This study assesses the pattern of semen analysis results in male partners of infertile couples at Gimbie Adventist Hospital, Western Ethiopia, 2021. Methods: A retrospective cross-sectional study on 131 semen samples of male partners of infertile couples was conducted at Gimbie Adventist Hospital from 5 September 2021 to 5 October 2021. All semen samples were processed and analyzed according to methods and standards outlined by the World Health Organization laboratory manual for the examination and processing of human semen 2010. The data were coded and entered into EpiData version 3.1, and then cleaned and exported to Statistical Package for Social Sciences (SPSS for Windows version 25) for analysis. The results were presented in tables, figures, and charts. Results: The age of study participants ranges from 20 to 65 years with a mean age of 30.2 ± 8.1 years. Sperm cell count, morphology, total motility, and vitality below the World Health Organization reference level were found in 48.9%, 27.5%, 43.5%, and 67.2% of the analyzed samples, respectively. Low power of hydrogen and high viscosity were observed in 31.3% and 16.8% of the semen samples, respectively. The majority, 84%, had one or more abnormal semen analysis parameters. Asthenozoospermia (43.5%), necrozoospermia (25.2%), oligozoospermia (24%), azoospermia (24%), and oligoasthenoteratozoospermia (25.2%) were the severe forms of abnormal semen analysis findings detected in this study. The decline in sperm cell morphology and motility were noticed after the age of 31–34 years. Conclusion: In this study, both sperm quantity and quality were more affected when compared to similar studies. Only 16% of analyzed samples had normal semen parameters. Given this finding, identifying risk factors and introducing advanced diagnostic modalities for the workup of male infertility in the study area are highly recommended.
Objectives: Screening for precancerous cervical lesions and providing access to effective treatment can significantly improve the likelihood of survival. To identify associated factors of positive visual inspection of the cervix with acetic acid test for precancerous cervical lesions among women screened for cervical cancer at public health facilities in Woliso Town, Southwest Shoa, Ethiopia. Methods: A facility-based unmatched case–control study was conducted on 86 cases and 172 controls. Cases were women who had a positive result for the visual inspection of the cervix with acetic acid test, and controls were women with a negative result. Data were collected using a pretested structured questionnaire and organized using SPSS version 20. Descriptive analysis and logistic regressions were performed. The adjusted odds ratio with a 95% confidence interval was used, and statistical significance was declared at p-value <0.05. Results: The study found that women aged 40–44 years (adjusted odds ratio = 4.11, 95% confidence interval (1.20–14.50)), greater or equal to five deliveries (adjusted odds ratio = 2.78, 95% confidence interval (1.39–5.56)), age at first birth less than 20 (adjusted odds ratio = 5.45, 95% confidence interval (1.41–21.04), age at first sexual intercourse less than 18 (adjusted odds ratio = 4.73, 95%, confidence interval (1.79–12.48)), ever used condom (adjusted odds ratio = 11.06, 95% confidence interval (3.93–31.14), having a history of sexually transmitted diseases (adjusted odds ratio = 4.05, 95% confidence interval (2.15–7.76), having a history of multiple sexual partners (adjusted odds ratio = 4.81, 95% confidence interval (1.37–16.90)), and being human immunodeficiency virus positive (adjusted odds ratio = 3.85, 95% confidence interval (1.68–8.83)) were associated factors of positive visual inspection with acetic acid test for precancerous cervical lesions. Conclusion: Given the above-associated factors of positive visual inspection with acetic acid test for precancerous cervical lesions, the health facilities should target women with these factors and timely screen them with the application of acetic acid on the cervix.
Objective Intrauterine devices are a widely used method of contraception worldwide. These devices are reliable, cost-effective, long-acting, and reversible. Their placement in the uterus is usually simple and safe. Forgotten IUDs carry some complications and can adversely affect the health of women. Therefore, appropriate counseling during insertion and timely removal is crucial. Case Summary We present the case of retained Lippes loop IUD for 40 years in a 75-year-old postmenopausal patient from Western Ethiopia. The patient presented to the hospital with postmenopausal pelvic pain. Speculum exam showed part of loop at external cervical os. The loop was easily removed with spongy forceps. The patient was discharged with analgesia and doxycycline twice a day for 3 days. Conclusion In the absence of embedment of an IUD into the uterine wall or uterine perforation, spontaneous expulsion of an IUD after prolonged use is possible.
Background: About 47% of under-five deaths occurred in the first month of life. Even though under-five mortality declines globally, death is more concentrated in the first days of life. This provides a clue to focus more on immediate newborn care than ever before. Therefore, this study aimed to assess level of immediate newborn care practice and associated factors among newborns delivered at public health facilities in Debre Markos Town, North West Ethiopia from March 28 to May 27, 2020. Methods: Facility based cross sectional study with quantitative and qualitative methods were used. For the quantitative study a total of 286 mothers with their newborns were included. For the qualitative study 10 key-informants were interviewed. Pre-tested, semi-structured questionnaires and observational checklists were used for the data collection. Collected data were entered into Epi-data version 3.1, and exported to SPSS version 22 for analysis. Binary and multivariable logistic regression were done. Independent variables with a P-value of ≤ 0.25 in bivariable analysis were considered as candidate for multivariable analysis. P-value < 0.05 was used as cut off point for presence of statistical significance in the multi-variable model. Goodness of fit test was checked using Hosmer and Lemeshow test. Results: The level of immediate newborn care practice was 76.9% [(95% CI = (72.0-82.0)].History of ANC follow up(AOR=3.36;95%CI:1.50,7.53), mother’s knowledge on immediate newborn care(AOR=5.29;95%:2.00,14.00), birth-preparedness of the mother(AOR=7.80;95%:3.36,18.06) and availability of drugs, equipment and materials(AOR=6.79;95%CI:3.05,15.12) were found to be independent predictors of the level of immediate newborn care practices.Conclusion: In this study, the level of immediate newborn care practices among newborn neonates was found to be unsatisfactory compared to the national target. So it is important to promote immediate newborn care through adequate supply of essential drugs and equipment, counseling and education on immediate newborn care, promotion of birth preparedness activity and strengthen ANC service for all pregnant women.
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