Outcomes and factors associated with prolonged stays among patients admitted to adult intensive care unit in a resource-limited setting: a multicenter chart review.

The length of stay in an intensive care unit is used as a benchmark for measuring resource consumption and quality of care and predicts a higher risk of readmission. The study aimed to assess the outcome and factors associated with prolonged intensive care unit stays among those admitted to adult intensive care units of selected public hospitals in Addis Ababa from January 1, 2022, to December 31, 2022. A multicenter retrospective chart review was conducted involving 409 adult patients. Binary logistic regression was used to assess factors associated with a prolonged stay and chi-square tests were used to assess associations and differences in outcomes for prolonged stays. The study, involving 409 of 421 individuals, revealed a predominantly male (55.0%) and the median age of study participants was 38, with an interquartile range (27, 55). Approximately 16.9% experienced prolonged stays, resulting in a 43.5% mortality rate. After adjustments for confounders, there were significant associations with prolonged stays for sedative/hypnotics, readmission, and complications. The study revealed that for every six patients admitted to the intensive care unit, one patient stayed longer, with nearly half experiencing mortality, demanding increased attention. The study emphasized the critical need for improvement in addressing associations between sedative/hypnotics, readmissions, complications, and prolonged stays.

Socio-economic and spatial inequalities in animal sources of iron-rich foods consumption among children 6-23 months old in Ethiopia: A decomposition analysis.

Iron deficiency anaemia is the most common type of anaemia in young children which can lead to long-term health consequences such as reduced immunity, impaired cognitive development, and school performance. As children experience rapid growth, they require a greater supply of iron from iron-rich foods to support their development. In addition to the low consumption of iron-rich foods in low- and lower-middle-income countries, there are also regional and socio-economic disparities. This study aimed to assess contributing factors of wealth-related inequality and geographic variations in animal sources of iron-rich food consumption among children aged 6-23 months in Ethiopia. We used data from the Ethiopian Mini Demographic and Health Surveys (EMDHS) 2019, a national survey conducted using stratified sampling techniques. A total of 1,461 children of age 6-23 months were included in the study. Iron-rich animal sources of food consumption were regarded when parents/caregivers reported that a child took at least one of the four food items identified as iron-rich food: 1) eggs, 2) meat (beef, lamb, goat, or chicken), 3) fresh or dried fish or shellfish, and 4) organs meat such as heart or liver. Concentration indices and curves were used to assess wealth-related inequalities. A Wagstaff decomposition analysis was applied to identify the contributing factors for wealth-related inequality of iron-rich animal source foods consumption. We estimated the elasticity of wealth-related inequality for a percentage change in socioeconomic variables. A spatial analysis was then used to map the significant cluster areas of iron-rich animal source food consumption among children in Ethiopia. The proportion of children who were given iron-rich animal-source foods in Ethiopia is 24.2% (95% CI: 22.1%, 26.5%), with figures ranging from 0.3% in Dire Dawa to 37.8% in the Oromia region. Children in poor households disproportionately consume less iron-rich animal-source foods than those in wealthy households, leading to a pro-rich wealth concentration index (C) = 0.25 (95% CI: 0.12, 0.37). The decomposition model explained approximately 70% of the estimated socio-economic inequality. About 21% of the wealth-related inequalities in iron-rich animal source food consumption in children can be explained by having primary or above education status of women. Mother's antenatal care (ANC) visits (14.6%), living in the large central and metropolitan regions (12%), household wealth index (10%), and being in the older age group (12-23 months) (2.4%) also contribute to the wealth-related inequalities. Regions such as Afar, Eastern parts of Amhara, and Somali were geographic clusters with low iron-rich animal source food consumption. There is a low level of iron-rich animal source food consumption among children, and it is disproportionately concentrated in the rich households (pro-rich distribution) in Ethiopia. Maternal educational status, having ANC visits, children being in the older age group (12-23 months), and living in large central and metropolitan regions were significant contributors to these wealth-related inequalities in iron-rich animal source foods consumption. Certain parts of Ethiopia such as, Afar, Eastern parts of Amhara, and Somali should be considered priority areas for nutritional interventions to increase children's iron-rich animal source foods consumption.

Nurses' competency on electrocardiography interpretation in adult emergency room: Addis Ababa, Ethiopia, 2021. Multicenter cross-sectional study.

AIM: This study aimed to assess the proficiency of nurses in interpreting electrocardiogram within the adult emergency units of Addis Ababa, Ethiopia, during the year 2021. METHODS: This institutional-based descriptive, cross-sectional study involved 175 nurses from five randomly selected hospitals' adult emergency units. Semi-structured, self-administered questionnaires were used for data collection. Data were entered into Epi-Data and analyzed using SPSS version 26. Fisher's exact test identified statistical significance between dependent and independent variables at a p-value < 0.05. RESULTS: Out of 203 respondents, 175 participated actively, yielding a response rate of 86.2%. Among these nurses, 159 (90.9%) were deemed not competent (scoring < 65%), with a mean score of 6.82 ± 3.65 SD. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution was included in this study. CONCLUSION: The overall competency level in electrocardiogram interpretation among nurses is significantly poor. This indicates that most nurses in the emergency units are unable to accurately interpret ECG monitoring, potentially leading to the failure to recognize signs of arrhythmias, electrolyte disturbances, and other cardiac abnormalities. Consequently, this may result in inappropriate patient care and increased mortality rates. Education and training were identified as key factors in enhancing their competency.

Residential and wealth-related disparities of high fertility preferences in Ethiopia: A decomposition analysis.

BACKGROUND: Fertility preference significantly influences contraceptive uptake and impacts population growth, especially in low and middle-income countries. In the previous pieces of literature, variations in fertility preference across residence and wealth categories and its contributors were not assessed in Ethiopia. Therefore, we decomposed high fertility preferences among reproductive-aged women by residence and wealth status in Ethiopia. METHODS: We extracted individual women's record (IR) data from the publicly available 2016 Ethiopian Demographic Health Survey (EDHS) dataset. A total of 13799 women were included in the study. Multivariate decomposition analysis was conducted to identify the factors that contributed to the differences in the percentage of fertility preferences between rural and urban dwellers. Furthermore, we used an Erreygers normalized concentration index and curve to identify the concentration of high fertility preferences across wealth categories. The concentration index was further decomposed to identify the contributing factors for the wealth-related disparities in high fertility preference. Finally, the elasticity of wealth-related disparity for a change in the socioeconomic variable was estimated. RESULTS: The weighted percentage of women with high fertility preference among rural and urban residents was 42.7% and 19%, respectively, reflecting a 23.7 percentage point difference. The variations in fertility preference due to the differences in respondents' characteristics accounted for 40.9%. Being unmarried (8.4%), secondary (14.1%) and higher education (21.9%), having more than four children (18.4%), having media exposure (6.9%), middle (0.4%), richer (0.2%) and richest (0.1%) wealth were the positive and city administration (-30.2%), primary education (-1.3%) were the negative contributing factors for the variations in high fertility preferences due to population composition. Likewise, about 59% of the variations in fertility preference were due to variations in coefficients. City administration (22.4%), primary (7.8%) and secondary (7.4%) education, poorer wealth (0.86%) were the positive and having media exposure (-6.32%) and being unmarried (-5.89%), having more than four children (-2.1%) were the negative factors contributing to the difference in high fertility preferences due to the change in coefficients across residents. On the other hand, there was a pro-poor distribution for high fertility preferences across wealth categories with Erreygers normalized concentration index of ECI = -0.14, SE = 0.012. Having media exposure (17.5%), primary (7.3%), secondary (5.4%), higher (2.4%) education, being unmarried (8%), having more than four children (7.4%), rural residence (3%) and emerging (2.2%) were the positive and city administration (-0.55) was the negative significant contributor to the pro-poor disparity in high fertility preference. CONCLUSION: The variations in high fertility preferences between rural and urban women were mainly attributed to changes in women's behavior. In addition, substantial variations in fertility preference across women's residences were explained by the change in women's population composition. In addition, a pro-poor distribution of high fertility preference was observed among respondents. As such, the pro-poor high fertility preference was elastic for a percent change in socioeconomic variables. The pro-poor high fertility preference was elastic (changeable) for a percent change in each socioeconomic variables. Therefore, women's empowerment through education and access to media will be important in limiting women's desire for more children in Ethiopia. Therefore, policymakers should focus on improving the contributing factors for the residential and wealth-related disparities in high fertility preferences.

Mental illness in children and its determinants in Ethiopia: A systematic review and meta-analysis, 2023.

INTRODUCTION: Young people are at risk of developing mental health disorders. Depression, anxiety, and behavioral problems are among the primary causes of illness and impairment among teenagers. Suicide is the fourth highest cause of mortality in those aged 15 to 29. This study aimed to assess the determinants of mental health among children in Ethiopia. METHODS: Online databases were searched from inception until March 2023. Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 was used in this review. Subgroup analysis, I2 test, funnel plot, and Egger's test were performed. Pooled odds ratios (OR) were calculated. RESULT: Fourteen studies were included in the meta-analysis. The pooled prevalence of mental illnesses among Ethiopian children was 24.68% (95% CI: 19.99%-32.38%). Having previous child abuse history (OR: 5.65; 95% CI: 4.32-7.39), poor socio-economic status (OR: 1.94; 95% CI: 1.24-3.04), urban residence (OR: 1.93; 95% CI:1.39-2.67), and being male (OR: 1.65; 95% CI: 1.15-2.38) were determinants of childhood mental illness in Ethiopia. CONCLUSION: and Recommendations: Mental disorders are highly prevalent in children with a history of child abuse, and a strong legislative body must be established to prosecute child abusers. Interventions that focus on gender equality in education and the creation of a safe environment for poor urban children are suggested.

Determinants and geographic distribution of early newborn care in Ethiopia: evidence from the 2019 Ethiopian Mini Demographic Health Survey.

Early newborn care provided in the first 2 days of life is critical in reducing neonatal morbidity and mortality. This care can be used to monitor and evaluate the content and quality of neonatal postnatal care. This study aimed to identify determinants and geographic distributions of early newborn care uptake in Ethiopia. We used data from the 2019 Ethiopian Mini Demographic and Health Survey (EMDHS). We conducted a multilevel binary logistic regression model and geographic analysis to identify the determinants of receiving early newborn care. A total of 2105 children were included in the study. Of the included children, 39.6% (95% confidence interval (CI) 38%, 42%) received at least two components of early newborn care services in the first 2 days after birth. Greater odds of receiving early newborn care were experienced by infants to mothers with secondary or above education (adjusted odds ratio (AOR) = 1.72; 95% CI 1.44, 2.18), from households with highest wealth quantiles (AOR = 1.47; 95% CI 1.16, 1.79), with at least one antenatal care contact (AOR = 2.73; 95% CI 1.79, 4.16), with birth at health facility (AOR = 25.63; 95% CI 17.02, 38.60), and those births through cesarean section (AOR = 2.64; 95% CI 1.48, 4.71). Substantial geographic variation was observed in the uptake of early newborn care in Ethiopia. Several individual- and community-level factors were associated with newborn postnatal care. Policymakers should prioritise these areas and the enhancement of postnatal healthcare provisions for mothers with low socioeconomic status.

Public Preferences for Digital Health Data Sharing: Discrete Choice Experiment Study in 12 European Countries.

BACKGROUND: With new technologies, health data can be collected in a variety of different clinical, research, and public health contexts, and then can be used for a range of new purposes. Establishing the public's views about digital health data sharing is essential for policy makers to develop effective harmonization initiatives for digital health data governance at the European level. OBJECTIVE: This study investigated public preferences for digital health data sharing. METHODS: A discrete choice experiment survey was administered to a sample of European residents in 12 European countries (Austria, Denmark, France, Germany, Iceland, Ireland, Italy, the Netherlands, Norway, Spain, Sweden, and the United Kingdom) from August 2020 to August 2021. Respondents answered whether hypothetical situations of data sharing were acceptable for them. Each hypothetical scenario was defined by 5 attributes ("data collector," "data user," "reason for data use," "information on data sharing and consent," and "availability of review process"), which had 3 to 4 attribute levels each. A latent class model was run across the whole data set and separately for different European regions (Northern, Central, and Southern Europe). Attribute relative importance was calculated for each latent class's pooled and regional data sets. RESULTS: A total of 5015 completed surveys were analyzed. In general, the most important attribute for respondents was the availability of information and consent during health data sharing. In the latent class model, 4 classes of preference patterns were identified. While respondents in 2 classes strongly expressed their preferences for data sharing with opposing positions, respondents in the other 2 classes preferred not to share their data, but attribute levels of the situation could have had an impact on their preferences. Respondents generally found the following to be the most acceptable: a national authority or academic research project as the data user; being informed and asked to consent; and a review process for data transfer and use, or transfer only. On the other hand, collection of their data by a technological company and data use for commercial communication were the least acceptable. There was preference heterogeneity across Europe and within European regions. CONCLUSIONS: This study showed the importance of transparency in data use and oversight of health-related data sharing for European respondents. Regional and intraregional preference heterogeneity for "data collector," "data user," "reason," "type of consent," and "review" calls for governance solutions that would grant data subjects the ability to control their digital health data being shared within different contexts. These results suggest that the use of data without consent will demand weighty and exceptional reasons. An interactive and dynamic informed consent model combined with oversight mechanisms may be a solution for policy initiatives aiming to harmonize health data use across Europe.

Determinants of hypertensive crisis among hypertensive patients at adult emergency departments of public hospitals in Addis Ababa, Ethiopia, 2021: a case-control study.

BACKGROUND: Hypertension (HTN) is a major global health problem that affects approximately 1.13 billion people worldwide, and 1-2% of this population has hypertensive crisis. Hypertensive crisis is becoming a major health issue in low-income countries. However, few studies have been conducted in developing countries such as Ethiopia. This study aimed to assess the determinants of hypertensive crisis among patients visiting adult emergency departments of public hospitals in Addis Ababa. METHOD: A hospital-based unmatched case-control study was conducted among 85 cases with a hypertensive crisis and 170 controls with hypertension without a hypertensive crisis in the adult emergency departments of public hospitals in Addis Ababa from March 15 to May 15, 2021. Data were collected using a structured questionnaire and analyzed using SPSS version 26. Binary logistic regression and multivariable logistic regression were performed. Finally, a statistically significant level was declared at a p value of less than 0.05. The result was summarized and presented in text, tables, and graph. RESULT: The odds of having hypertensive crisis were 3.6 times (AOR = 3.621) higher among participants with a history of hypertension compared to those without a history of hypertension. There was also 4 times increased risk of hypertensive crisis among participants who presented with diabetes mellitus than participants who presented without it (AOR = 4.179). Similarly, participants who presented with stroke had 7 times higher odds of having hypertensive crisis (AOR = 7.174) than participants without stroke. CONCLUSION: This study demonstrated a statistically significant association between unemployment, diabetes mellitus, stroke, heart failure, history of hypertension, family history of hypertension, and regular follow-up with a hypertensive crisis. The Ethiopian Ministry of Health, Ababa City Administration Health Bureau, and hospitals shall give due attention to the HTN crisis. Health care workers, hospital managers, and other stakeholders shall work towards the early detection and management of HTN-crisis to prevent related morbidity, disability, and mortality.

Time to initiation of antenatal care visit and its predictors among reproductive age women in Ethiopia: Gompertz inverse Gaussian shared frailty model.

Background: Early initiation of antenatal care (ANC) is essential for the early detection of pregnancy-related problems and unfavorable pregnancy outcomes. However, a significant number of mothers do not initiate ANC at the recommended time. Therefore, this study aimed to determine the median time of ANC initiation and its predictors among reproductive-age women in Ethiopia. Methods: We used the Ethiopian Demographic and Health Survey (EDHS) 2016 data set. The proportional hazard assumption was assessed using Schoenfeld residual test and log-log plot. A life table was used to determine the median survival time (time of ANC initiation). The Gompertz inverse Gaussian shared frailty model was the best-fitting model for identifying the predictors for the early initiation of ANC booking. Finally, the adjusted hazard ratio (AHR) with a 95% confidence interval (CI) was used to determine the significance of predictors. Results: A total of 7,501 reproductive-aged women gave recent birth in the last 5 years preceding the survey. Nearly three in five women [61.95% (95% CI: 60.85-63.04%)] booked their first ANC visit with a median time of 4.4 months. Women who attended primary education (AHR = 1.10, 95% CI: 1.01-1.20), secondary and above (AHR = 1.26, 95% CI: 1.11-1.44), media exposure (AHR = 1.07, 95% CI: 1.00-1.16), rich wealthy (AHR = 1.17, 95% CI: 1.06-1.30), grand multiparous (AHR = 0.82, 95% CI: 0.72-0.93), unwanted pregnancy (AHR = 0.88, 95% CI: 0.81-0.96), small periphery region (AHR = 0.58, 95% CI: 0.51-0.67), and rural residence (AHR = 0.86, 95% CI: 0.75-0.99) were significantly associated with first ANC visit. Conclusion: According to this study, a significant number of women missed their first ANC visit. The education status of women, place of residence, region, wealth index, media exposure, unintended pregnancy, and multi-parity were significantly associated with the time of initiation of the first ANC visit. Therefore, policymakers should focus on improving the socioeconomic status (education, media coverage, and wealth) of reproductive-aged women by prioritizing women who live in small periphery regions and rural residences to improve the early initiation of ANC.

A multilevel analysis of factors associated with vitamin A supplementation among children aged 6-35 months in Ethiopia.

Background: Vitamin A deficiency is among the leading preventable causes of childhood morbidity and mortality that might be attributable to the low uptake of vitamin A supplementation (VAS). Factors contributing to its low utilization are not researched at the national level and with the appropriate model. Therefore, this study aimed at identifying the magnitude and the individual- and community-level factors associated with vitamin A supplementation among children aged 6-35 months in Ethiopia. Methods: We have used the Ethiopian mini demographic and health survey data, which was conducted from 21 March to 28 June 2019. A weighted sum of 2,362 mothers having children aged 6-35 was extracted. Considering the hierarchical nature of the data, we fitted the multilevel multivariable logistic regression model. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) was reported and variables with a p-value of < 0.05 were declared to be significantly associated factors. Results: In this study, 43.4% (95% CI: 41.4-45.4%) of children have taken the VAS. Moreover, the 12-23 age of the child (AOR = 2.64; 95% CI: 1.88-3.72), 30-34 age of the mother (AOR = 3.34; 95% CI: 1.21-9.20), middle household wealth status (AOR = 1.75; 95% CI: 1.06-2.90), and four and above antenatal care (AOR = 2.90; 95% CI: 1.90-4.43) are the individual-level factors associated with VAS whereas being from Amhara (AOR = 2.20; 95% CI: 1.29-3.76) and Tigray (AOR = 2.16; 95% CI: 1.17-3.98) regions is a community-level factor significantly associated with the uptake of VAS. Conclusion: Overall, a low proportion of children have taken the VAS in Ethiopia. The higher age of the child and mother, full antenatal care, and improved wealth status positively influence VAS. Moreover, a child from the Tigray or Amhara regions was more likely to get VAS. Therefore, an intervention has to be designed to address the VAS uptake among young mothers, and working to improve the wealth status of the household would be helpful. Moreover, the advocacy of antenatal care and minimizing the regional disparity through encouraging the uptake in the rest of the regions would help increase the national-level uptake of VAS.

Rural job preferences of graduate class medical students in Ethiopia-a discrete choice experiment (DCE).

BACKGROUND: Human resource is one of the health system's building blocks, which ultimately leads to improved health status, equity, and efficiency. However, human resources in the health sector are characterized by high attrition, distributional imbalance, and geographic inequalities in urban and rural settings. METHODS: An discrete choice experiment (DCE) with 16 choice tasks with two blocks containing five attributes (salary, housing, drug and medical equipment, year of experience before study leave, management support, and workload) were conducted. A latent class and mixed logit model were fitted to estimate the rural job preferences and heterogeneity. Furthermore, the relative importance, willingness to accept and marginal choice probabilities were calculated. Finally, the interaction of preference with age and sex was tested. RESULTS: A total of 352 (5632 observations) final-year medical students completed the choice tasks. On average, respondents prefer to work with a higher salary with a superior housing allowance In addition, respondents prefer a health facility with a stock of drug and medical equipment which provide education opportunities after one year of service with supportive management with a normal workload. Young medical students prefer lower service years more than older students. Besides age and service year, we do not find an interaction between age/sex and rural job preference attributes. A three-class latent class model best fits the data. The salary was the most important attribute in classes 1 and 3. Contrary to the other classes, respondents in class 2 do not have a significant preference for salary. Respondents were willing to accept an additional 4271 ETB (104.2 USD), 1998 ETB (48.7 USD), 1896 ETB (46.2 USD), 1869 (45.6 USD), and 1175 ETB (28.7 USD) per month for the inadequate drug and medical supply, mandatory two years of service, heavy workload, unsupportive management, and basic housing, respectively. CONCLUSION: Rural job uptake by medical students was influenced by all the attributes, and there was individual and group-level heterogeneity in preference. Policymakers should account for the job preferences and heterogeneity to incentivize medical graduates to work in rural settings and minimize attrition.

Evaluation of the pediatric antiretroviral therapy service in Gondar city public health facilities-A case study design with mixed methods.

BACKGROUND: The pediatric antiretroviral therapy (ART) service is introduced to save lives, restore mental and physical functions, and improve the quality of life of children living with HIV/AIDS. This evaluation aimed to assess the implementation status of the pediatric ART service provision in Gondar city administration health facilities to promote evidence-based decision-making for program improvement. METHODS: An institutional-based single case-study design with concurrent mixed methods were applied. The service was evaluated by the availability of essential resources, compliance of health providers with the standard guideline, and caregivers' satisfaction dimensions. Document review, key informant interviews, observations, and interviewer-administered exit-interview were conducted. The quantitative data were analyzed in descriptive and analytical, while the qualitative data were transcribed, translated, and thematically analyzed. A logistic regression analysis was performed to identify factors associated with caregivers' satisfaction. RESULTS: The overall implementation of pediatric ART service was 75.32%. The availability, compliance, and satisfaction were 68.96%, 74.44%, and 84.64%, respectively. Trained healthcare professionals, essential ART drugs, registers, and basic laboratory diagnostic equipment were reasonably available. However, the lack of opportunistic infection medications and adequate rooms were significant gaps in service provision. Respondents noted a shortage of drugs and rooms for consultation and service provision. Short travel distance (AOR = 2.87), low viral load (AOR = 3.15), and sex of caregivers (AOR = 4.98) were significantly associated with good satisfaction. CONCLUSIONS: The overall implementation of pediatric ART service is well based on the pre-determined judgment criteria. The health facilities and policymakers are advised to focus on availing medications to treat opportunistic infections and expanding the health facility to have enough space for consultation and service provision. Furthermore, particular emphasis should be given to caregivers who come from long distances and patients with a high viral load to increase caregivers' satisfaction.

Pattern of Orthopedic Injuries Related to Road Traffic Accidents Among Patients Managed at the Emergency Department in Black Lion Hospital, Addis Ababa, Ethiopia, 2021.

Background: Studies showed that each year people lose their life on the road and many people are disabled. The majority of this disability was caused by orthopedic injury related to road traffic accidents. However, in the context of Ethiopia, studies ascribed to orthopedic injuries related to road traffic accidents are limited. The study aimed to assess the pattern of orthopedic injuries related to road traffic accidents among patients managed at the emergency department of Black Lion Hospital. Methods: An institutional-based cross-sectional study was conducted on 354 victims of road traffic accidents with orthopedic injuries who were visiting the Emergency department of Black Lion Hospital. Patient charts were selected by systematic random sampling technique and the data was entered into Epi-data version 4.4.2.2 and exported to the static package for social science window version 26, and descriptive statistics were used for analysis. Results: The study reveals that males were mostly injured persons (71.7%) with the age group of 13-24 were the most injured. Passenger car accounts 36.3% of causes of injury followed by motorbikes (27.4%) and lower limbs were the most common anatomic site of injuries (47.9). Of all injury types, a fracture is the most common one with 71.1%, especially lower limb fracture (42.1%). More than half victims (59.5%) had open wounds, and almost half of the study subjects (51.8%) experience Road traffic accidents while they are crossing or walking along the way. Conclusion: Orthopedic injuries related to road traffic accidents are the main cause of death and disability in many individuals, especially in reproductive age groups. Therefore, policy-makers should be aware of different patterns of orthopedic injuries associated with a victim of road traffic accidents to have an appropriate and sustainable capacity to manage the orthopedic injuries.

Factors contributing to delay intensive care unit admission of critically ill patients from the adult emergency Department in Tikur Anbessa Specialized Hospital.

BACKGROUND: The transfer time for critically ill patients from the emergency department (ED) to the Intensive care unit (ICU) must be minimal; however, some factors prolong the transfer time, which may delay intensive care treatment and adversely affect the patient's outcome. PURPOSE: To identify factors affecting intensive care unit admission of critically ill patients from the emergency department. PATIENTS AND METHODS: A cross-sectional study design was conducted from January 13 to April 12, 2020, at the emergency department of Tikur Anbesa Specialized Hospital. All critically ill patients who need intensive care unit admission during the study period were included in the study. A pretested structured questionnaire was adapted from similar studies. The data were collected by chart review and observation. Then checked data were entered into Epi-data version 4.1 and cleaned data was exported to SPSS Version 25 for analysis. Descriptive statistics, bivariate and multivariate logistic regression were used to analyze the data. RESULT: From the total of 102 critically ill patients who need ICU admission 84.3% of them had prolonged lengths of ED stay. The median length of ED stay was 13.5 h with an IQR of 7-25.5 h. The most common reasons for delayed ICU admission were shortage of ICU beds 56 (65.1%) and delays in radiological examination results 13(15.1%). On multivariate logistic regression p < 0.05 male gender (AOR = 0.175, 95% CI: (0.044, 0.693)) and shortage of ICU bed (AOR = 0.022, 95% CI: (0.002, 0.201)) were found to have a significant association with delayed intensive care unit admission. CONCLUSION: there was a delay in ICU admission of critically ill patients from the ED. Shortage of ICU bed and delay in radiological investigation results were the reasons for the prolonged ED stay.

Outcome evaluation of capacity building and mentorship partnership (CBMP) program on data quality in the public health facilities of Amhara National Regional State, Ethiopia: a quasi-experimental evaluation.

BACKGROUND: Capacity Building and Mentorship Partnership (CBMP) is a flagship program designed by the Ethiopian Ministry of Health in collaboration with six local universities to strengthen the national health information system and facilitate evidence-informed decision making through various initiatives. The program was initiated in 2018. This evaluation was aimed to assess the outcome of CBMP on health data quality in the public health facilities of Amhara National Regional State, Ethiopia. METHODS: A matched comparison group evaluation design with a sequential explanatory mixed-method was used to evaluate the outcome of CBMP on data quality. A total of 23 health facilities from the intervention group and 17 comparison health facilities from a randomly selected district were used for this evaluation. The Organization for Economic Cooperation and Development (OECD) evaluation framework with relevance, effectiveness, and impact dimensions was used to measure the program's outcome using the judgment parameter. The program's average treatment effect on data quality was estimated using propensity score matching (PSM). RESULTS: The overall outcome of CBMP was found to be 90.75 %. The mean data quality in the intervention health facility was 89.06 % [95 %CI: 84.23, 93.88], which has a significant mean difference with the comparison health facilities (66.5 % [95 % CI: 57.9-75]). In addition, the CBMP increases the data quality of pilot facilities by 27.75 % points [95 %CI: 17.94, 37.58] on the nearest neighboring matching. The qualitative data also noted that there was a data quality problem in the health facility and CBMP improved the data quality gap among the intervention health facilities. CONCLUSIONS: The outcome of the CBMP was highly satisfactory. The program effectively increased the data quality in the health facilities. Therefore, the finding of this evaluation can be used by policymakers, program implementers, and funding organizations to scale the program at large to improve the overall health data quality for health outcome improvement.

Utilization of insecticide treated bed net and associated factors among households of Kola Diba town, North Gondar, Amhara region, Ethiopia.

OBJECTIVE: The primary aim of this study was to assess the utilization of an insecticide-treated bed net on the preceding night and associated factors among households of Kola Diba town in 2017. RESULTS: Of the 260 households, 239 (91.9%) (95% CI = 88.5-95%) utilized insecticide-treated bed net on the night preceding the interview. 242 (93.1%) households didn't treat the bed net whereas 18 (6.9%) treat the bed net by chemical regularly. Household structure and knowledge about malaria transmission were found to be associated with insecticide-treated bed net utilization.

Prediction of Low Community Sanitation Coverage Using Environmental and Sociodemographic Factors in Amhara Region, Ethiopia.

This study developed and validated a model for predicting the probability that communities in Amhara Region, Ethiopia, have low sanitation coverage, based on environmental and sociodemographic conditions. Community sanitation coverage was measured between 2011 and 2014 through trachoma control program evaluation surveys. Information on environmental and sociodemographic conditions was obtained from available data sources and linked with community data using a geographic information system. Logistic regression was used to identify predictors of low community sanitation coverage (< 20% versus ≥ 20%). The selected model was geographically and temporally validated. Model-predicted probabilities of low community sanitation coverage were mapped. Among 1,502 communities, 344 (22.90%) had coverage below 20%. The selected model included measures for high topsoil gravel content, an indicator for low-lying land, population density, altitude, and rainfall and had reasonable predictive discrimination (area under the curve = 0.75, 95% confidence interval = 0.72, 0.78). Measures of soil stability were strongly associated with low community sanitation coverage, controlling for community wealth, and other factors. A model using available environmental and sociodemographic data predicted low community sanitation coverage for areas across Amhara Region with fair discrimination. This approach could assist sanitation programs and trachoma control programs, scaling up or in hyperendemic areas, to target vulnerable areas with additional activities or alternate technologies.