Background: The neonatal period is the most susceptible phase of life. In Ethiopia changes in neonatal mortality are not as significant as changes in post-neonatal and child mortality. The aim of this study was to assess the causes and factors associated with neonatal mortality at Jimma Medical Center. Materials and methods: A cross-sectional study was conducted for 11 days from February 12, 2018 at the Neonatal ICU of Jimma Medical Center. Data were extracted from the medical records of neonates admitted during a three year period from September 07, 2014 to August 31, 2017, using pretested checklists. Bivariate and multivariate logistic regressions were used to determine factors associated with neonatal mortality and P -values <0.05 were considered statistically significant. Results: Of 3,276 neonates admitted during the study period, 412 (13.3%) died, equating to a rate of 30 deaths per 1,000 institutional live births. The majority (249, 60.4%) of deceased neonates had low birth weight, while 230 (55.8%) were premature and 169(41%) had Respiratory Distress Syndrome (RDS). Residency being outside Jimma city (AOR 1.89, 95% CI: 1.43, 2.51) and the length of stay <7Days (AOR 3.93, 95% CI: 2.82, 5.50), low birth weight (AOR 1.54, 95% CI: 1.06, 2.25), prematurity (AOR 2.2, 95% CI: 1.41, 3.42), RDS (AOR 4.15, 95% CI: 2.9, 5.66), perinatal asphyxia (AOR 4.95, 95% CI: 3.6, 7.34), and congenital malformations (AOR 4, 95% CI: 2.55, 2.68) were significantly associated with neonatal mortality. Conclusions: A significant proportion of neonates attending the neonatal ICU died. Parental residency, the length of stay, low birth weight, prematurity, RDS, perinatal asphyxia, and congenital malformations were factors associated with neonatal mortality, which could be avoidable. Therefore, preventive measures such as enhancing the utilization of antenatal care services and, early identification and referral of high risk pregnancy and neonates could reduce the neonatal deaths

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Background: World health organization (WHO) and United Nations for Children's Fund (UNICEF) in the early 1990s developed Integrated Management of Childhood Illness (IMCI), a strategy designed to reduce child mortality and morbidity in developing countries. This study is aimed at assessing factors associated with utilization of IMNCI protocol by nurses West Arsi Zone, Oromia Region, Ethiopia. Methods: An institutional based cross-sectional study was conducted on a total of 185 nurses who were included from health facilities selected using simple random sampling technique. Data was coded, entered and cleaned using Epi-data 3.1 and exported to SPSS version 22 for analysis. Univariate and bivariate analysis was performed. Multivariate analysis was also done to control for possible confounding variables. Results: Data were obtained from 185 nurses, of which 131 (70.8%) were males. More than half 103 (55.7%) of the respondents was aged between 25-29 years. The mean (± SD) age was 26.65 ± (1.7) with the range of 20-43 years and 107 (57.8%) were diploma nurses. The overall IMNCI protocol utilization was 58.7%. In multivariate analysis, the odd of IMNCI utilizations among nurses who had attended IMNCI training were 2.76 times higher compared to nurses who had not attended IMNCI training [AOR=2.76, 95% CI:1.388, 5.51]. Nurses who had practice of always referring chart booklet during every case management process were three times more likely to utilize IMNCI protocols [AOR=2.95, 95% CI: 1.48, 5.89] compared to their counterparts. Conclusions: The proportion of IMNCI utilizations in the selected districts was low and less than the WHO recommendations. Training and frequent referring of chart booklet were found to significantly associate with the utilization of the IMNCI protocols. Therefore the emphasis should be given to the provision of IMNCI training to the nurse by the stakeholders and motivating the nurses to always refer chart booklet, in order to enhance proper utilization of the protocols.

Background: African nations experience a significant proportion of the global burden of death and disability. The provision of prehospital emergency care has been shown to partially reduce excess morbidity and mortality. However, access to prehospital care in Africa is still limited. This study sought to identify barriers to access prehospital care in the city of Jimma, Ethiopia.Methods: This is an interview-based qualitative study of key prehospital stakeholders in Jimma, conducted in February 2018. A purposive sample of individuals from the community and local ambulance organizations was selected for interviews. Interviews were conducted in local languages, translated into English, and then coded for consistent themes. Results: All respondents felt that prehospital care was difficult to access and therefore infrequently utilized. This was due to a combination of a limited number of ambulances, the lack of a toll-free emergency number, the lack of a single organized Emergency Medical Service (EMS) system, inconsistent and limited training of ambulance crews, public mistrust of the existing system, poor road infrastructure, and limited public understanding of the role of prehospital care. Respondents suggested that establishment of a formalized prehospital care system, investment in infrastructure, establishment of a toll-free emergency number, public awareness campaigns, and more widely available emergency medical training, which were feasible solutions to these current barriers to access.Conclusion: Multiple barriers to accessing prehospital care were identified in Jimma. Establishing a formalized, well-resourced prehospital system in parallel with improving community capacity and knowledge building were suggested solutions to improve access. Hence, interventions to improve prehospital emergency care delivery should ideally target these identified barriers and proposed solutions.

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