Adverse Perinatal and Maternal Outcomes and Associated Factors among Women with Antepartum Hemorrhage in Jimma University Medical Center, Southwest Ethiopia, 2020.

Background: Globally, antepartum hemorrhage is the main cause of perinatal and maternal morbidity and mortality during pregnancy and childbearing. Objective: To assess adverse perinatal and maternal outcomes and associated factors among women with antepartum hemorrhage in Jimma University Medical Center, Southwest Ethiopia, 2020. Methods: Prospective cross-section study was conducted, and data were collected through face to face interview among pregnant women admitted with antepartum hemorrhage. Patient condition was observed and followed up, and patient card was reviewed. Data were coded, checked, entered into EPI version 4.6, and exported to SPSS version 26.0 for analysis. Multivariate logistic regression analysis was made to determine independent factors associated with adverse outcomes. Result: A total of 377 pregnant women were included, and nearly half (192 (50.9%)) of women experienced adverse maternal outcome and 113 (30%) women experienced adverse perinatal outcome. The status of vital sign, address, parity, antenatal care, duration of bleeding before arrival, gestational age, prematurity, and amount of vaginal bleeding were factors significantly associated with adverse maternal and perinatal outcome at p value <0.05. Conclusion: Vital sign derangement, vaginal bleeding for ≥12 hrs, gestation age before 37 weeks, rural address, prim parity, amount of vaginal bleeding, and prematurity baby has predicted high rate of adverse perinatal and maternal outcomes. Recommendation. Jimma Hospital should give patient-centered service and strengthen counseling on danger sign of pregnancy to alert women early health care seeking and immediate resuscitation, and appropriate management should be given for women admitted with APH to minimize of adverse perinatal and maternal outcomes.

A Quantitative Study on Stigma and Statistically Correlated Factors Among Women Living with Genital Fistula in Oromia Region, Ethiopia. Identification of Urgent Corrective Strategies.

BACKGROUND: Two-to-three million women worldwide live with a genital fistula, with Asian and sub-Saharan African countries including Ethiopia accounting for the greatest percentage. Genital fistula is a devastating health problem due to the stigma associated with constant incontinence and bad-odor. Thus, this study aimed to determine the magnitude of the stigma towards women living with genital fistula in Oromia region, Ethiopia, and to highlight the factors associated with it, identifying potential strategies for corrective interventions. METHODS: This quantitative study was conducted among 422 women living with genital fistula in five fistula treatment centers of Oromia region using a cross-sectional study design from August 30, 2019 to February 28, 2020. Data were collected by face-to-face interview using a structured questionnaire, entered into Epi-data version 4.2, and analyzed by SPSS version 23. Bivariate and multivariable logistic regression analysis was done. P-value <0.05 was used to ascertain statistical significance with an adjusted odds ratio at 95% confidence interval (CI). The results were presented by text and tables. RESULTS: The response rate for this study was 100%. The magnitude of perceived high stigma related to genital fistula was 178 (42.2%). The factors associated with it were the respondents' father's educational level of being able to write and read compared to unknown fathers' educational level (AOR=0.09; 95% CI=0.03-0.34), and duration of living with a genital fistula of less than 2 years compared to living with a genital fistula for 5 years or more (AOR=0.52; 95% CI=0.31-0.86). CONCLUSION: The perceived level of stigma among women living with a genital fistula in Oromia region was significantly high. To reduce the perceived level of stigma and therefore to prevent the severe negative consequences of it, fathers, but also mothers, husbands, family members, and all the persons close to women living with genital fistulas should provide care and psychological support and all the necessary means to strongly encourage them to seek health care quickly, and to make them feel that they are beloved, and that there is hope for a healthy life in their near future.

Achievement of Clinical Learning Outcomes and Associated Factors Among Midwifery and Nursing Undergraduate Students of Jimma University, Ethiopia.

BACKGROUND: Effective achievement of clinical learning outcomes indicates the success of the clinically oriented educational program including midwifery and nursing. In contrast, studies reported poor achievement of clinical competence in different health sciences programs in the country. Thus, this study aimed to determine the status of achievement of clinical learning outcomes and associated factors among midwifery and nursing students of Jimma University, Ethiopia. METHODS: Institution-based cross-sectional study was conducted from March 25 to 30, 2021 among 147 midwifery and nursing students of Jimma University selected by simple random sampling technique. Data were collected by a semi-structured, pre-tested, self-administered questionnaire, entered into EpiData version 4.2, and analyzed by SPSS version 23. Bivariate and multivariable logistic regression analyses were done to test the association. The odds ratio at 95% confidence interval (CI) and P-value < 0.05 was used to ascertain statistical significance. RESULTS: Only 65 (44.2%) participants achieved their clinical learning outcomes. Being a third year student (AOR 3.38; 95% CI = 1.5, 7.5) at p-value = 0.003, having good practice of COVID-19 preventive measures (AOR 2.25; 95% CI = 1.01, 5) at p-value = 0.047, perceived high students load in clinical teaching site (AOR 4.9; 95% CI = 1.6, 14.7) at p-value = 0.005, and students motivation to their clinical learning (AOR 3.1; 95% CI = 1.4, 6.63) at p-value = 0.004 were factors positively associated with achievement of clinical learning outcomes. CONCLUSION: Less than half of midwifery and nursing students of Jimma University had achieved their clinical learning outcomes. Therefore, the students, clinical teachers, and all concerned bodies should struggle their best to enhance good practice of COVID-19 preventive measures, students motivation to their clinical learning, and facilitate clinical learning in clinical teaching site with high students load for better achievement of clinical learning outcomes.

Effective Clinical Teaching Practice and Associated Factors Among Midwifery Educators in Public Universities of Ethiopia: Institution-Based Cross-Sectional Study.

BACKGROUND: Although effective clinical teaching realistically improves learners to be competent, in Ethiopia only 31.6% of midwifery graduates have passed the national proficiency standard for graduation. Likewise, research evidence is lacking on effective clinical teaching practice of midwifery educators in Ethiopia. OBJECTIVE: This study aimed to assess effective clinical teaching practice and associated factors among midwifery educators in public universities of Ethiopia. METHODS: Institution-based cross-sectional study was conducted in April 2019 on 424 midwifery educators selected by simple random sampling technique. Data were collected through email by using a semi-structured, pretested, self-administered questionnaire, entered into Epi-data version 4.2, and analyzed by SPSS version 23. Bivariate and multivariable logistic regression analyses were done to test the association. The odds ratio at 95% confidence interval (CI) and P-value <0.05 were used to ascertain statistical significance. RESULTS: Only 178 (47.3%) of participants had effective clinical teaching practice. Clinical teaching experience (AOR= 4.72; 95% CI=1.97, 11.29), training on higher diploma in teaching profession (AOR=2.78; 95% CI=1.61, 4.82), clinical teaching workshop (AOR=4; 95% CI=1.98, 8.05), students per clinical unit (AOR= 3.71; 95% CI= 1.66, 8.26), giving objectives of clinical learning for students (AOR= 4.74; 95% CI=2.43, 9.25), using performance-based assessment tool (AOR =1.82; 95% CI=1.04, 3.16) and having good interest in clinical teaching (AOR=8.63; 95% CI=2.91, 25.56) were factors positively associated with effective clinical teaching practice. CONCLUSION: Less than half of midwifery educators of Ethiopian Public Universities had effective clinical teaching practice. The educators' clinical teaching experience, training, and adherence to clinical teaching standards were identified to affect effective clinical teaching positively. Therefore, educators should adhere to the standards for effective clinical teaching and receive training on effective teaching.

COVID-19's Negative Impacts on Clinical Learning and Proposed Compensation Mechanisms Among Undergraduate Midwifery and Nursing Students of Jimma University.

BACKGROUND: Even though lockdown measures contributed to reducing the rate of COVID-19 transmission, it resulted in great distraction in clinical learning. Thus, the aim of this study was to assess COVID-19's negative impacts on clinical learning, and proposed compensation mechanisms among midwifery and nursing undergraduate students of Jimma University, southwest Ethiopia. METHODS: This study was conducted among 147 midwifery and nursing students of Jimma University in March 2021 using cross-sectional study design. The respondents were selected by simple random sampling method. Data were collected by using a self-administered questionnaire and analyzed descriptively by SPSS v.23. The results were presented in tables, and narrated. RESULTS: Three fifths (88 (59.9%)) of the study participants perceived high negative impacts of COVID-19 on their recent clinical learning. The proposed compensation mechanisms to be implemented before and during the next clinical practice include: using teacher-facilitated skill demonstration laboratory, case scenarios, clinical teaching videos, and clinical conferences. Students' effort to understand the objectives of their clinical learning and using multi-media to achieve it was another proposed compensation mechanism. Also, providing pre-placement training and in-service training with priority for students graduating during COVID-19 pandemic were proposed compensation mechanisms. CONCLUSION: COVID-19's negative impacts on clinical learning were great among the participants of this study. The proposed compensation mechanisms should be applied by all concerned bodies with great emphasis to end the long-term negative impact of the pandemic, thereby ensuring the production of competent midwives and nurses.

Prevalence and Factors Associated with Depression among HIV/AIDS-Infected Patients Attending ART Clinic at Jimma University Medical Center, Jimma, Southwest Ethiopia.

BACKGROUND: HIV is a chronic life-threatening illness and, like other similar chronic and stigmatizing illnesses, can be stressful to manage. Depression is a common mental health problem that deteriorates the quality of life of people with HIV/AIDS and found to be a strong predictor for noncompliance to antiretroviral therapy treatment. Therefore, epidemiological evidence on the factors associated with depression among patients with HIV/AIDS can contribute towards effective and efficient preventive health care strategies for this population. OBJECTIVES: To assess the prevalence and factors associated with depression among HIV/AIDS-infected patients attending ART clinic at Jimma University Medical Center, Jimma, Southwest Ethiopia, in 2018. METHODS: This study followed an institution-based cross-sectional quantitative study design. A simple random sampling method yielded 303 participants who were interviewed from April to May 2018, using a pretested questionnaire, followed by their card review. The SPSS version 23 was used for bivariate analysis which was used to find out the significance of association. Variables that showed association in bivariate analysis at p value < 0.25 were entered to multivariable logistic regressions to control for confounders, and the significance of association was determined by 95% confidence interval and p value < 0.05. RESULTS: The point prevalence of depression was 94 (31%). Variables like sex (AOR = 0.510 (95%CI = 0.264-0.986)), marital status (AOR = 3.610 (95%CI = 1.649-7.901)), opportunistic infection (AOR = 3.122 (95%CI = 1.700-5.733)), and medication adherence (AOR = 0.470 (95%CI = 0.266-0.831)) were significantly associated with depression. Conclusion and Recommendation. From the findings of this study, it is possible to conclude that depression was highly prevalent among people living with HIV/ADS. Sex, marital status, opportunistic infection, and medication adherence were found to be associated with depression and need attention from the health professional working in the ART clinic.