Time to first optimal glycemic control and its predictors among adult type 2 diabetes patients in Amhara Regional State comprehensive specialized hospitals, Northwest Ethiopia.

BACKGROUND: Inadequate glycemic management in type 2 diabetes Mellitus patients is a serious public health issue and a key risk factor for progression as well as diabetes-related complications. The main therapeutic goal of preventing organ damage and other problems caused by diabetes is glycemic control. Knowing when to modify glycemic control in type 2 diabetes Mellitus is crucial for avoiding complications and early drug intensifications. METHODS: An institutional based retrospective follow-up study was undertaken among 514 eligible adult diabetes patients in Amhara region Comprehensive Specialized Hospitals, Northwest Ethiopia, from January 2017 to January 2022. Simple random sampling technique was used to select study participants. The Kaplan Meier curve was used to assess the survival status of categorical variables, and the log-rank test was used to compare them. The cox proportional hazard model was fitted to identify the predictors of time to first optimal glycemic control. Variables with a p-value < 0.05 were considered to be statistically significance at 95% confidence interval. RESULTS: A total of 514 patient records (227 males and 287 females) were reviewed in this study. The median time to first optimal glycemic control among the study population was 8.4 months IQR (7.6-9.7). The predictors that affect the time to first optimal glycemic control were age group ((AHR = 0.63, 95% CI = 0.463, 0.859 for 50-59 years), (AHR = 0.638, 95% CI = 0.471, 0.865 for 60-69 years), and (AHR = 0.480, 95% CI = 0.298, 0.774 for > = 70 years)), diabetes neuropathy (AHR = 0.629, 95% CI = 0.441,0.900), hypertension (AHR = 0.667, 95% CI = 0.524, 0.848), dyslipidemia (AHR = 0.561, 95% CI = 0.410, 0.768), and cardiovascular disease (AHR = 0.681, 95% CI = 0.494, 0.938). CONCLUSION: The median time to initial optimal glycemic control in type 2 diabetes Mellitus patients in this study was short. Age between 50 and 59 years and 60-69, diabetes neuropathy, hypertension, dyslipidemia, and cardiovascular disease were predictor's of time to first glycemic control. Therefore, health care providers should pay extra attention for patients who are aged and who have complications or co-morbidities.

Intention to leave and associated factors among health professionals working at public hospitals in East Gojjam zone, Northwest Ethiopia, cross-sectional study.

BACKGROUND: The most important element of health systems for meeting the population's healthcare demands is the workforce. The main issue facing the health industry, particularly in emerging nations, has been their shortage and turnover. Thus, the purpose of this study was to assess the intention of leaving and related variables among medical professionals employed at East Gojjam zone public health hospitals. METHODS: An institution based cross-sectional study was conducted among 561 randomly selected health professionals working at public hospitals in East Gojjam Zone from 04 March 2019 to 30 March 2019. Self-administered structured questionnaire was used for data collection. Both bi-variable and multivariable logistic regression analysis were fitted. Variables having P-value less than 0.2 during bi-variable regressional analysis were entered in to multivariable logistic regression analysis and Adjusted Odds Ratio (AOR) with 95% confidence interval (CI) was used to declare the associated factors with intention to leave. RESULTS: Overall, 61.3% (95% CI: 57.2, 65.4) of health professionals were intended to leave their working organizations. Dissatisfaction with work nature (AOR: 3.01; 95% CI: 2.05, 4.43), work environment (AOR: 1.83, 95% CI: 1.25, 2.68), Remuneration (AOR: 1.89; 95% CI: 1.29, 2.76), having low normative commitment (AOR: 0.55; 95% CI: 0.38, 0.81) and being unmarried (AOR: 1.78; 95% CI: 1.23, 2.58) were satistically significant factors with intention to leave their working organizations. CONCLUSIONS: The health professionals' intention to leave their working organizations was high, three-fifth of the health professionals had intention to leave their organization which might result great service quality compromization and decrease the responsiveness of the health institutions in the study area. Dissatisfaction with remuneration, working environment, work nature, low normative commitment and being unmarried were factors associated with health professional's intention to leave their working organizations. Therefore, hospital administrators, supervisors, and Healthcare policymakers need to emphasize on retention of health workers at their working organization by taking into account the above significant variables. Such as, through creating an attractive working environment and designing better benefit mechanisms.