Data quality and associated factors in the health management information system at health centers in Shashogo district, Hadiya zone, southern Ethiopia, 2021.

BACKGROUND: Poor quality routine data contributes to poor decision-making, inefficient resource allocation, loss of confidence in the health system, and may threaten the validity of impact evaluations. For several reasons in most developing countries, the routine health information systems in those countries are described as ineffective. Hence, the aim of this study is to determine the quality of data and associated factors in the routine health management information system in health centers of Shashogo district, Hadiya Zone. METHODS: A facility-based cross-sectional study was conducted from June 1, 2021, to July 1, 2021, and 300 participants were involved in the study through simple random sampling. The data was collected with a self-administered questionnaire by trained data collectors. After checking its completeness, the data was entered into EPI data version 3.1 and exported to SPSS version 25 for statistical analysis. Finally, variables with p < 0.05 during multivariable analysis were considered significant variables. RESULT: A total of 300(100%) participant were included in the interview and HMIS data quality was 83% in Shashogo district health centers. The data quality in terms of accuracy, completeness, and timeliness was 79%, 86%, and 84%, respectively. Conducting supportive supervision [AOR 3.5 (1.4, 8.9)], checking accuracy [AOR 1.3 (1.5, 3.5)], filling registrations [AOR 2.7 (1.44, 7.7)], and confidence level [AOR 1.9 (1.55, 3.35)] were all rated positively found to be factors associated with data quality. CONCLUSION: The overall level of data quality in Shashogo district health centers was found to be below the national expectation level. All dimensions of data quality in the district were below 90% in data accuracy, content completeness, and timeliness of data. Conducting supportive supervision, checking accuracy, filling registrations and confidence level were found to be factors associated with data quality. Hence, all stakeholders should give all necessary support to improve data quality in routine health information systems to truly attain the goal of providing good quality data for the decision-making process by considering the identified factors.

Access to institutional delivery services and its associated factors among mothers in Jimma Zone, Southwest Ethiopia: a cross-sectional study.

BACKGROUND: Poor access to institutional delivery services has been known as a significant contributory factor to adverse maternal as well as newborn outcomes. Previous studies measured access in terms of utilization while it has different dimensions (geographic accessibility, availability, affordability, and acceptability) that requires to be measured separately. Therefore, this study was conducted to assess the four dimensions of access and factors associated with each of these dimensions. METHODS: Community-based cross-sectional study design was used, employing both quantitative and qualitative methods. A simple random sampling technique was used to select 605 mothers who had given birth in the last 6 months preceding the study. Multi-variable binary logistic regression was used to select factors associated with the four dimensions of access by using AOR with 95% CI. Ethical approval was secured from Jimma University Institutional Review Board. RESULTS: Five hundred and ninety-three mothers involved in this study, resulting in a response rate of 98%. Four hundred five (68%), 273(46%), 279(47%), and 273(46%) had geographic, perceived availability, affordability, and acceptability access to institutional delivery services, respectively. Antenatal care [AOR = 3.74(1.56, 8.98)], occupation of mother [AOR = 5.10(1.63, 15.88)], and residence [AOR = 1.93(1.13, 3.29)] were independently associated with geographic accessibility. Household graduation [AOR = 1.46(1.03, 2.06)], residence [AOR = 1.74(1.17, 2.59)], and ANC [AOR = 3.80(1.38, 10.50)] were independently associated with perceived availability. Moreover, wealth quintile [AOR = 11.60(6.02, 22.35)], ANC [AOR = 3.48(1.36, 9.61)], and occupation of husband [AOR = 3.63(1.51, 8.74)] were independently associated with affordability. Lastly, mother's education [AOR = 2.69(1.42, 5.09)], residence [AOR = 2.60(1.66, 4.08)], and household graduation [AOR = 3.12(2.16, 4.50)] were independently associated with acceptability of institutional delivery services. CONCLUSIONS: Moderate proportions of mothers have geographic accessibility to institutional delivery services, but access to the other three dimensions was low. ANC visits of 4 or above, occupation of husband, urban residence, graduation of mother's household as a model family, higher wealth quintiles, and maternal educational level significantly affect access to institutional delivery services. Thus, it was recommended that concerned bodies should give due attention to ANC services, female education, training of model families, and enhancement of household wealth through job creation opportunities to increase access to institutional delivery services.

Willingness to Join and Pay for Community-Based Health Insurance Among Rural Households of Selected Districts of Jimma Zone, Southwest Ethiopia.

BACKGROUND: Globally, millions of people suffer and die because they do not have the money to pay for health care. A voluntary health insurance scheme is a prepayment mechanism to overcome the financial hardship of poor households. There is a high demand to determine the enrolment rate and ability to pay before scale-up of the scheme by the government to be sure of its feasibility and sustainability. OBJECTIVE: To determine willingness to join and pay for a community-based health insurance scheme and associated factors among rural households of selected districts in Jimma Zone, 2018. METHODS: A community-based cross-sectional study design was employed in selected districts of Jimma Zone, Ethiopia. Multistage simple random sampling was used to select 422 households. Data were collected using a semi-structured interviewer-administered questionnaire. A double bounded contingent valuation method was applied to elicit households' willingness to pay for the scheme. Data were entered into Epi-Data 3.1 and analyzed with SPSS V.23. A binary logistic regression model was fitted to determine the presence of statistically significant associations between the dependent and independent variables at p-value <0.05 and AOR values with 95% CI. RESULTS: Of 422 sampled respondents, 389 participated in this study with a response rate of 92%. Of these, 305 (78%) were willing to join and 274 (90%) of them were willing to pay. The average amount of money the households were willing to pay per household per annum was 228 ETB (8.27 USD), with a range of 100-500 ETB. The older age groups, poor households, and experience of local risk-sharing schemes were found to be determinants for willingness to join the community-based health insurance. Similarly, having a large family size, and low economic and education status of households were significant predictors of willingness to pay for this scheme. CONCLUSION: A high proportion of households were willing to join and pay for the CBHI scheme. The average amount of money they were willing to pay for the scheme was very slightly lower than what is planned by the government. Thus, the government of Ethiopia should strengthen efforts to scale up this scheme in the rural areas of the country specifically to districts not yet enrolled, to reduce direct out-of-pocket payment at service delivery points. This will also contribute to guaranteeing dwellers of rural areas access to quality health services without facing financial hardship, to achieve universal health coverage for all by the end of 2035.

Magnitude of disrespectful and abusive care among women during facility-based childbirth in Shambu town, Horro Guduru Wollega zone, Ethiopia.

BACKGROUND: Disrespectful care during childbirth causes suffering and discourages women from seeking facility-based care. It is one of the silent causes of maternal mortality and morbidity worldwide, but not yet well recorded especially in developing countries. The aim of this study was to measure the magnitude of disrespect and abusive behaviors of health professionals during childbirth and associated factors. METHOD: Community based cross-sectional study design was employed among 321 women who gave birth in public health facilities of Shambu town, Ethiopia, between January 01 and December 31, 2018. Simple random sampling was used to select the study participants. Data were collected using a semi-structured interviewer administered questionnaire. Prevalence of disrespect and abuse was measured by using seven categories of disrespect and abuse with their respective verification criteria. The data were entered into Epi-data 3.1 and then transported to SPSS version 23.0. Logistic regression models were fitted to determine the presence of statistically significant associations between the dependent and independent variables at p-value <0.05 and AOR values with 95% confidence interval. RESULTS: Out of 321 sampled respondents, 316 participated in this study with response rate of 98.4%. The overall prevalence of disrespect and abuse was 78.2% (95% CI: 73.5-83.2). The most common forms disrespect and abuse encountered by the mothers were: unconsented care (86.1%), non-dignified care (37.3%), lack of privacy (33.9%), physical abuse (21.5%) and neglectful care (13.3%). Mother's occupational status, increasing number of antenatal care visits and giving birth in a hospital setting were significantly associated with disrespect and abuse during facility-based childbirth. CONCLUSION: Though government interventions are in place, excessive levels of disrespect and abusive practices during facility-based childbirth persisted to be important problems in the study area. To address the unnecessary suffering, health policy makers and program designers should develop strategies to enhance respectful maternity care approaches. Health managers and health professionals should do their best to provide high quality, client-centered care in health facilities so that women are not discouraged from using them. We also recommend knowledge exchange with development partners to determine which practices will be adaptable and helpful to address the problem of mistreatment of women in health care facilities.