Incidence of mortality and its predictors among patients with head injury admitted to adult intensive care unit at AaBET and ALERT hospitals, Addis Ababa, Ethiopia.

Background: Traumatic head injury, referred to as the "silent epidemic", remains a growing public health concern and the leading cause of mortality in young adults, with a disproportionate burden of disability and death occurring in low-income and middle-income countries, including Ethiopia. However, estimates of the traumatic brain injury burden from low and middle-income countries are scarce. The aim of this study was to assess outcome and its associated factors among patients with head injury admitted to the Adult Intensive care unit at AaBET and ALERT hospitals, Addis Ababa, Ethiopia. Methods: Institution-based retrospective cohort study was conducted at AaBET and ALERT hospitals from February 01, 2019 to January 30, 2020. All head injury patients' records were reviewed. A structured checklist was used to collect data. Binary logistic regression analysis was used to identify factors associated with death among head injury patients. Result: Out of 205 patients, 178 (86.8%) improved, while 27 (13.2%) died. Road traffic accident was the most common cause of head injury (Adjusted odds ratio (AOR) = 46.3%). Patients with pulse rate admission (AOR = 1.49), NA + level (3.48), type of head injury (AOR = 3.67), mechanical ventilation (AOR = 4.70) were significant predictors of death among patients with head injuries. Conclusion: The incidence of death among head injury patients was 13.2% (27). Road traffic accident was the leading cause of head injury. Pulse rate, plasma sodium level, penetrating head injury, being on a mechanical ventilator were predictors of death among traumatic head injury (THI) patients treated for head injuries. Prevention of road traffic accidents and continuous awareness creation about the consequences of a road traffic accident is recommended.

Making pregnancy safer initiative--program impact in selected pilot areas.

OBJECTIVE: This paper highlights program evaluation carried out on Making Pregnancy Safer Program interventions implemented by FHD in partnership with WHO, UNICEF, UNFPA, SIDA Sweden, the World bank and European Commission to increase availability of Emergency Obstetric Care Services in four pilot regions. METHOD: A participatory evaluation design was employed that included FMoH, RHB and other key partners. The qualitative approach examined client and community perception, provider's perspectives and program manager's views at different levels with regard to service provision, quality of care, service utilization and the impact of the MPS strategy. The quantitative aspect assessed met and unmet needs, service utilization and quality of service. RESULTS: Evaluation shown positive trend in process indicators of maternal health service utilization. Staff who received training in Emergency Obstetric Care are better off in both skill and knowledge acquisition. Majority of facilities had basic resources and functions for Emergency Obstetrics care. However, infrastructure deficiencies such as absence of waiting area, lack of privacy for clients, lack of toilets and water, shortage of life saving drugs, lack of context specific IEC materials were observed. At the community level, the main reason for dissatisfaction with health facility services was poor service provider attitude. CONCLUSION: MPS established a strong foundation to build stronger, better quality of emergency obstetrics and neonatal care that are used by those who needed it. It is time to consolidate and sustain improvements and vigorously support Regional Health Bureaus to ensure quality emergency obstetrics and neonatal care can be made available for all pregnant women, and progress toward the Millennium Development Goals can be achieved.