Predictors of labor pain management among pregnant women in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: Labor pain is the nastiest conceivable pain women are involved in during labor and delivery. In this way, the end of labor pain is frequently outlined by myths and equivocalness. Hence, giving a compelling absence of pain in labor remained a challenge specifically in developing countries including Ethiopia. OBJECTIVES: This systematic review and meta-analysis aimed to explore the pooled prevalence of labor analgesia and associated factors to pregnant women in Ethiopia. DESIGN: A systematic review and meta-analysis were utilized in agreement with the Preferred Reporting Items for Systematic Reviews. DATA SOURCES: PubMed/Medline, SCOPUS, EMBASE, Web of Science, Google Scholars, and the Cochrane Library and supplemented it with manual were deliberately looked at until January 1-30, 2024. METHODS: Two authors independently extricated all principal information utilizing standardized data extraction designs, and the analysis was done utilizing STATA version 17. Heterogeneity over the studies was evaluated utilizing I2 measurement. The funnel plot and Egger's weighted regression tests were utilized to assess subjective and objective publication biases respectively. Also, the pooled effect of labor pain management and the associations were evaluated utilizing a random-effects model. RESULTS: The general pooled prevalence of labor analgesia in the present study was 23.3% with a (95% confidence interval (CI): 13.5, 33.1). Maternal age (odds ratio (OR): 1.91; 95% CI: 1.11, 2.77), parity of the mother (OR: 0.28; 95% CI: 0.06, 0.63), history of pregnancy misfortune (OR: 0.12; 95% CI: 0.11, 0.36), length of labor (OR: 2.09; 95% CI: 1.06, 3.13), and awareness about labor analgesia (OR: 1.91; 95% CI: 0.34, 3.49) were significantly related with labor analgesia among pregnant women in Ethiopia. CONCLUSIONS: The generally pooled prevalence of labor analgesia among pregnant women in Ethiopia was low. Maternal age, parity of the mother, history of pregnancy loss, length of labor, and awareness of labor analgesia were factors influencing labor analgesia among pregnant women in Ethiopia. This finding proposes exceptional consideration to make laboring mothers free of pain by scaling up the strategies and utilizing labor pain administration in a way that universally recognized standards are met. REGISTRATION NUMBER: PROSPERO CRD: 42024525636.

Determinants and willingness to practice obstetric analgesia among women attending antenatal clinic at Dr. Bogalech Gebre Memorial General Hospital Central Ethiopia: a cross-sectional study.

BACKGROUND: Labor pain is uniquely experienced and described by the woman giving birth, and it is often considered one of the most excruciating experiences for many women. This study aimed to evaluate factors associated with the willingness to receive labor analgesia among women attending the antenatal clinic at Dr. Bogalech Gebre Memorial General Hospital Central Ethiopia in 2022. METHODS: An institution-based, cross-sectional study was conducted from January to March 2022. Data were collected using semi-structured questionnaires by a convenience sampling technique. Data was entered in EpiData 4.2 and exported to SPSS version 20 for analysis. Both Bivariable and multivariable logistic regressions were conducted to determine factors associated with pregnant women's willingness to choose labor analgesia. Crude odds ratio (COR) and adjusted odds ratio (AOR) were computed to assess the association between variables. RESULTS: A total of 398 pregnant women have participated in the study with a response rate of 94%. Nearly 30%, (29.4%) of the pregnant women had a willingness to practice labor pain management. Being a housewife (AOR: 8.35, 95% CI: 2.07, 33.63). Women who live in urban (AOR: 2.60, 95% CI: 1.29, 5.29). Having had awareness about labor analgesia (AOR: 1.70, 95% CI: 1.00, 2.60) and the short duration of labor time (AOR: 1.84, 95% CI: 1.15, 2.96) were statistically significant with a willingness to practice labor analgesia. CONCLUSION: We conclude that the willingness of pregnant mothers' toward obstetric analgesia practice was low in the study area. Being a housewife, urban residence, awareness about labor analgesia, and short duration of labor were statistically significant with the willingness of the mothers to practice labor analgesia. To increase willingness to use labor analgesia, authorities should prioritize delivering health education on pain management choices to address concerns and promote effective methods and practices.

Parental Satisfaction towards Care Given at Neonatal Intensive Care Unit and Associated Factors in Comprehensive and Referral Hospitals of Southern Ethiopia.

Background: Patient satisfaction is an important aspect of the quality of care in the inpatient setting. In neonatal intensive care units, parents' satisfaction and their experiences are fundamental to assessing clinical practice and improving the quality of care delivered to infants. Hence then, it reduces infant mortality rates globally. In Ethiopia, few studies address the level of parental satisfaction towards care given at neonatal intensive care unit and no single study was done in the study area. Therefore, this study is aimed at assessing parental satisfaction towards care given at neonatal intensive care unit and associated factors in comprehensive and referral hospitals of southern Ethiopia. Methods: An institutional-based cross-sectional study was conducted among 401 parents who visited neonatal intensive care from March 28 to April 28, 2022. The data were assorted via a structured interviewer-administered questionnaire using ODK collect version and exported to SPSS window version 25 for further cleaning and analysis. Bivariate and multivariate logistic regressions were used to identify factors associated with parental satisfaction with care given at the neonatal intensive care unit. The adjusted odds ratio with 95% CI was used to show the strength of the association, and a P value < 0.05 was used to declare the cutoff point to determine the level of significance. Results: In this study, 63% (95% CI: 58%, 68%) of the parents were satisfied with the care given at the neonatal intensive care unit. Factors associated with parental satisfaction towards care given at neonatal intensive care unit were parents with no formal education (AOR: 0.15; 95% CI: 0.07-0.31), availability of necessary information using direction indicator (AOR: 3.14; 95% CI: 1.85-5.31), and availability of enough chairs in waiting area (AOR: 3.26; 95% CI: 1.81-5.87). Conclusion: Nearly two-thirds of the parents were satisfied with the care given at the neonatal intensive care unit. The availability of enough chairs in the waiting area and the creation of direction indicators are key issues to improve parental satisfaction towards their neonatal care.

Prevalence and factors associated with malnutrition among school adolescents of Durame Town, Kambeta Tembaro Zone, Ethiopia.

Introduction: malnutrition is a major public health issue affecting adolescents globally and developing countries in particular. Adolescent period is very sensitive to malnutrition. Adolescent malnutrition can be affected by different factors. The objective of this study was to assess prevalence and associated factors of adolescent malnutrition among high school students. Methods: an institutional-based cross-sectional study was carried out among school adolescents in Durame town high schools. Of the 498 selected school adolescents, 455 (91.4 %) were included in this study. Data were entered into Epi data and exported to World Health Organization (WHO) Anthroplus and Statistical package for the social sciences (SPSS). Odds ratio at 95% confidence interval (CI) was calculated to check for the existence and strength of association between variables. P-value less than 0.05 was used to declare significance of association. Results: the prevalence of stunting, thinness and overweight among adolescents was 26 (5.7%), 11(2.4 %) and 42 (9.2%), respectively. Residing in rural (AOR=5.31, 95% CI: 1.03-27.27) and utilize community based nutrition (AOR=0.26, 95% CI: 0.07-0.98) were associated with thinness. Male (AOR=3.55, 95% CI: 1.62-7.81) and having cattle (AOR=2.78, 95% CI: 1.393, 5.565) were associated with overweight. Conclusion: around two in twenty-five adolescents are stunted. About one in twenty-five adolescents are thin. More than two in twenty-five adolescents are overweight. Sex of adolescents, having cattle were associated with overweight of adolescent. Rural residence and utilizing community based nutrition were associated with thinness. Minister of Health and other health offices should implement nutrition education to school adolescents by giving emphasis on place of residence and for both male and female adolescents.

Utilization of Nonpneumatic Antishock Garment and Associated Factors among Obstetric Care Providers in Public Hospitals of Sidama Region, Hawassa, Ethiopia, 2022.

Background: Nonpneumatic antishock garment is one of the newly emerging technology advances that reduce blood loss which is caused by obstetric hemorrhage and help women survive during delays to get definitive care. Over 80% of maternal mortality due to hemorrhagic shock may have been prevented if a nonpneumatic antishock garment had been utilized by an obstetric care provider. However, to the current knowledge, the utilization of nonpneumatic antishock garments is low and even no single study was conducted in the study area. Hence, we found that it is necessary to assess the magnitude and factors affecting the utilization of antishock garments among obstetric care providers in public hospitals of the Sidama region, Ethiopia, 2022. Methods: A facility-based cross-sectional study design was employed among 403 obstetric care providers from June 15 to July 15, 2022. A two-stage sampling technique was applied; the data was collected by 5 trained BSc midwives using pretested and structured self-administered questionnaires. Data was entered into EpiData Manager version 4.6 and exported to Statistical Package for Social Sciences (SPSS) version 26 software. Bivariate and multivariable logistic regression analyses were used. Results: A total of 394 (97.8%) health professionals participated in this study. Overall, 30.71% (95% CI: 26.4%, 35%) of the obstetric care providers had utilized nonpneumatic antishock garments for the management of postpartum hemorrhage. Training on the antishock garment (AOR = 4.183, 95% CI: 2.167, 8.075, p < 0.00), tertiary hospital (AOR = 0.355, 95% CI: 0.132, 0.952, p < 0.04), having protocol in the facility (AOR = 2.758, 95% CI: 1.269, 5.996), availability of NASG in the facility (AOR = 4.6, 95% CI: 1.603, 13.24), good knowledge (AOR = 2.506, 95% CI: 1.26, 4.984), and positive attitude (AOR = 2.381, 95% CI: 1.189, 4.766) were significantly associated factors. Conclusion and Recommendation. We found that less than one-third of the study participants have used the antishock garment in the management of postpartum hemorrhage in the current study. In addition to enhancing in-service and ongoing professional development training, it is preferable to insure the availability and accessibility of antishock in the facilities in order to close the knowledge and attitude gap among obstetric care providers.

Prevalence of male participation in modern contraceptive use among married men in Durame Town Southern Ethiopia: a community based cross sectional study, 2021.

Introduction: failure to involve men in the family planning programs in a male-controlled society as Ethiopia, has serious consequences even if women are interested to use contraception their husbands oppose them. Therefore, pointing men for contraceptive methods interventions may meaningfully increase contraceptive acceptance by the provision of information, education and communication. Thus, this study assessed prevalence of men participation in family planning utilization in Durame Town, Southern Ethiopia, 2021. Methods: a community based cross-sectional study was employed. Systematic random sampling technique was used to select study subjects. Data was collected using pretested structured interviewer administered questionnaire. Descriptive analysis was done to describe the study population. Bi-variable and multi-variable logistic regression analyses were done to identify factors associated with participation of men in family planning. Results: from 382 currently married men who were interviewed, 366 were responded to the questionnaires making the response rate of 96%. The mean age of the participants was 34 (± 6.1) years. Majority of the participants were Kembata 311 (85%) by ethnicity and Protestant 257 (70.2%) by religion. Regarding respondent's occupation about 153 (41.8%) were merchants and more than half of respondents´ monthly income was >2500 Ethiopian birr. The prevalence of male participation in family planning was 255 (69.7%). Men's participation in family planning was significantly associated with educational, number of currently living children, source of information, knowledge and attitude of the respondents. Conclusion: strategies and programs aimed at increasing contraceptive prevalence should appropriately address the involvement of males and integrating them use the contraceptive methods.

Unprotected sexual practices and associated factors among adult people living with HIV on antiretroviral therapy in public hospitals of Kembata Tembaro Zone, Southern Ethiopia.

INTRODUCTION: Antiretroviral therapy (ART) significantly increases the life expectancy of HIV positive people by improving quality of life as well as enabling them to resume sexual activity. A growing number of people living with HIV became a source of exposure to sexually transmitted infections, including other strains of HIV that place others at risk unless they consistently use condoms. This study assessed the magnitude of unprotected sexual practices and associated factors among adult people living with HIV on ART in public hospitals of the Kembata Tembaro Zone, Southern Ethiopia. METHODS: a facility-based cross-sectional study was conducted among adult people living with HIV on ART in public hospitals of the zone from March 1-30, 2016. Data were collected by a pretested and structured questionnaire. Binary logistic regression was used to investigate variables, independently associated with the outcome variable. The adjusted odds ratio with 95% CI used to show the strength of the association and a P-value < 0.05 was used to declare the cut-off point in determining the level of significance. RESULTS: the study revealed that 40.9% of respondents practiced unprotected sexual intercourse. On multivariate logistic regression analyses, being females, having more than one sexual partner, mean monthly income of <530 Ethiopian birrs/ month, those who had a seropositive partner, a partner of unknown serostatus, and respondents who had insufficient knowledge of HIV transmission and prevention were statically significant with the outcome variable. CONCLUSION: the scarcity of knowledge on HIV transmission, negative attitude towards condom use, non-disclosure status and having more than one sexual partnership increased likelihood of have unprotected sex among the respondents.

Knowledge, Attitude, and Practices Towards Tuberculosis Among Clients Visiting Tepi General Hospital Outpatient Departments, 2019.

BACKGROUND: Tuberculosis, which is an infectious disease, is one of the leading causes of morbidity and mortality in developing countries. Ethiopia is facing high tuberculosis burdens. Even if it is preventable and curable, individuals' KAP towards the disease is one of the bottlenecks in decreasing the disease burdens. TGH, located in the Sheka zone, is one of the remote areas and the KAP towards TB is unknown. Therefore, the current study was undertaken in TGH to assess the KAP towards TB. MATERIALS AND METHODS: A cross-sectional study was conducted among 415 randomly selected participants. A structured questionnaire was used to collect the data by a face-to-face interview from May 23 to June 23/2019. Data were entered into Epidata 3.1 and exported to SPSS version 21 for descriptive analysis. RESULTS: A total of 345 (83%) respondents have heard about TB, while 76 (18%) respondents said persistence productive cough as symptoms of tuberculosis. Only 9.9% of participants mentioned bacteria as the cause of the diseases and 170 (41%) considered that the transmission is via air droplets. The majority (70%) of participants responded that its transmission is not preventable and overall 236 (56.9%) had high overall knowledge about TB. Thirty percent of the respondents considered that TB is serious to the area while 29% considered TB is not very serious for them. Fifty-three percent of the participants were having a favorable attitude towards tuberculosis. The majority (85%) did not cover their mouth while coughing, while 79.5% did not screen for tuberculosis and 82% of participants have not received any health education about TB. Overall, 44.6% practiced TB prevention. CONCLUSION: The majority of the study participants had high overall knowledge and positive attitude towards tuberculosis prevention, which are not seen in the practice of tuberculosis. Effective educational programs should be implemented to overcome the problem.

Perceptions of obstetric analgesia: a qualitative study among midwives attending normal vaginal deliveries in Durame Hospital, Southern Ethiopia.

BACKGROUND: Labor pain is distressing and produces undue side effects to both woman and fetus. In low-income countries like Ethiopia, addressing pain relief is often neglected. Professionals attending labor may not have awareness of obstetric analgesia. Besides this, there is a lack of published research on perceptions of obstetric analgesia among health professionals in Ethiopia. The aim of this study was to explore perceptions of obstetric analgesia among midwives attending normal vaginal deliveries in Durame Hospital. METHODS: The study adopted an exploratory descriptive qualitative approach in Durame General Hospital, Kembata Tembaro Zone, Southern Ethiopia from March 1 to April 2, 2017. Fifteen midwives were purposely selected and participated in in-depth interviews. Data from interviews were transcribed, translated to English, coded, and categorized into themes. Data analysis was initiated alongside data collection using a thematic approach. Written informed consent was obtained from all study participants. RESULTS: Scarcity of knowledge, negative attitudes, lack of trained personnel, and absence of protocols were impediments to using labor analgesia for midwives to relieve labor pain. CONCLUSION: This study suggests that perceptions and practices of midwives with regard to labor analgesia needs special attention to address labor pain by scaling up forms and practice of labor analgesia in such a way that internationally accepted standards are met.

Utilization of obstetric analgesia in labor pain management and associated factors among obstetric caregivers in public health facilities of Kembata Tembaro Zone, Southern Ethiopia.

BACKGROUND: Nowadays, obstetric analgesia is provided routinely in most developed countries. However, in developing countries, labor pain management is not a well-established service. The poor utilization of labor analgesia in low-income countries including Ethiopia results in laboring mothers in unmeasured suffering, let alone analgesia. The aim of this study was to assess utilization of obstetric analgesia in labor pain management and associated factors among obstetric caregivers in public health facilities of KTZ, Kembata Tembaro zone, Southern Ethiopia. MATERIALS AND METHODS: A facility-based cross-sectional study design was conducted among all obstetric caregivers at KTZ in public health facilities from March to April 2017. Data were collected by a pretested, self-administered, and structured questionnaire. A convenient sampling technique was used and descriptive analysis was done to characterize the study population. Bivariate and multivariate logistic regressions were used to identify factors associated with utilization of labor analgesia. The adjusted odds ratio with 95% CI was used to show the strength of the association and a P-value <0.05 was used to declare the cutoff point in determining the level of significance. RESULTS: Three hundred forty respondents participated in the study with a response rate of 93%. The prevalence of labor analgesia use by the respondents was 37.9%. On multivariable logistic regression analyses, inadequate knowledge, positive attitude, and unavailability of labor analgesia drugs were significant independent predictors of obstetric analgesia utilization. CONCLUSION: Proportion of analgesia utilization was low; inadequate knowledge, positive attitude, and unavailability of analgesia drugs in the facilities were significantly associated with obstetrics analgesia utilization. Health institutions and health personnel should work on provision of training for those obstetric care providers, and necessary drugs should be available in each facility.