Determinants of Health Care Providers' Attitudes Toward Safe Abortion Care in Ethiopia: A Systematic Review and Meta-Analysis.

Background: Unsafe abortion is a serious reproductive health problem in developing countries including Ethiopia. The attitude of healthcare providers toward abortion is one of contributing factors to unsafe abortion. This study aimed to determine the pooled effect of healthcare workers' attitudes toward safe abortion care and its determinants factors in Ethiopia. Methods: Search engines such as Scopus, CINAHL, EMBASE, PubMed, Web of Science, and CAB Abstracts were used to find published studies where as Google and Google Scholar were used to find unpublished research. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. The analysis was performed using STATA 14 and the random-effects model was used to calculate the odds ratios of medical professionals' attitudes regarding safe abortion services. Study heterogeneity was assessed by using I2 and P-values. To evaluate the stability of pooled values to outliers and publication bias, respectively, sensitivity analysis and funnel plot were also performed. Results: A total of 15 published and unpublished articles with a sample size of 4060 were incorporated in this Review. The overall pooled prevalence of this study was 56% (95% CI: 45-67). Sex of participants (AOR: 2.37; 95% CI: 1.57, 3.58), having training (AOR: 2.86; 95% CI: 1.58, 5.17), Professional type (AOR: 1.55; 95% CI: 1.04, 4.46), and knowledge of abortion law (AOR:2.26; 95% CI: 1.14, 4.46) were the determinants factors that significantly associated with health care workers' attitude toward safe abortion care. Sensitivity analysis shows that the pooled odds ratios were consistently stable throughout all meta-analyses, and the funnel plot shows no evidence of publication bias. Conclusion: Half of health care providers sampled among the pooled studies have favorable attitudes toward abortion services in Ethiopia; which could hamper women's access to safe abortion care. Sex, training, type of profession, and knowing abortion law were determinants of health care workers' attitudes toward safe abortion services. Stakeholders should emphasize improving the attitude of healthcare workers toward safe abortion care which has a vital role in reducing maternal mortality. Moreover, working on modifiable factors like training, assigning personnel whose professions align with the service, and updating care providers about abortion law is also the essential key point to improve their intentions to deliver the services.

Prevalence and adverse outcomes of twin pregnancy in Eastern Africa: a systematic review and meta-analysis.

INTRODUCTION: Multiple pregnancies are much more common today than they were in the past. Twin pregnancies occur in about 4% of pregnancies in Africa. Adverse pregnancy outcome was more common in twin pregnancy than in singleton pregnancy. There is no pooled evidence on the burden and adverse pregnancy outcome of twin pregnancy in eastern Africa. Thus, this systematic review and meta-analysis were conducted to assess the prevalence and adverse pregnancy outcomes of twin pregnancies. METHODS: This systematic review and meta-analysis covers published and unpublished studies searched from different databases (PubMed, CINAHL (EBSCO), EMBASE, DOAJ, Web of Sciences, MEDLINE, Cochrane Library, SCOPUS, Google Scholar, and Google search). Finally, 34 studies were included in this systematic review and meta-analysis. JBI checklist was used to assess the quality of included papers. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. Data synthesis and statistical analysis were conducted using STATA Version 14 software. Heterogeneity and publication bias were assessed. A forest plot was used to present the pooled prevalence using the random effect model. RESULTS: The prevalence of twin pregnancy in eastern Africa was 3% [95% CI: 2, 3]. The adverse pregnancy outcomes like neonatal intensive care unit admission (78%), low birth weight (44%), low APGAR score (33%), prematurity (32%), stillbirth (30%), neonatal mortality (12%) and maternal complications like hypertensive disorder of pregnancy (25%), postpartum hemorrhage (7%), Cesarean section (37%), premature rupture of membrane (12%) and maternal mortality are more common among twin pregnancy than singleton pregnancy. CONCLUSION: One in every 33 children born a twin in east Africa; admission to neonatal intensive care unit, low birth weight, low APGAR score, prematurity, stillbirth, neonatal mortality and maternal complications are its associated adverse birth outcomes. Since twin pregnancy is a high-risk pregnancy, special care is needed during pregnancy, labor and delivery to reduce adverse pregnancy outcomes.

Utilization of preconception care and associated factors among pregnant mothers in Fiche Town, Central Ethiopia: a community-based cross-sectional study 2021.

Introduction: Preconception care is an important preventive intervention for adverse pregnancy outcomes. It is recognized as a strategy to optimize women's health and pregnancy outcomes in Western countries. However, preconception care is underutilized in sub-Saharan Africa, like Ethiopia, where maternal mortality is high. Evidence is scarce in the study area about the prevalence and factors associated with preconception care utilization. Therefore this study aimed to assess the proportion of preconception care utilization and associated factors among pregnant mothers in Fiche town, central Ethiopia, 2021. Method: A community-based cross-sectional study was done from May 10 to June 25, 2021. A systematic random sample technique was used to choose 393 pregnant women for the study. A structured, pre-tested, interviewer-administered questionnaire was used to collect data. The data were entered into Epi Data version 3.1 and then exported into SPSS version 25 for analysis. A Bivariable and multivariable logistic regression analysis was used to check for the association. Odds ratio along with 95% was used to describe the association. Finally, a significant association was declared at a p-value less than 0.05. Results: 388 respondents participated in this study, making the response rate 98.7%. Of total study participants only 84 (21.6%; 95% CI, 18, 25.8) utilized preconception care. The study found that diploma or higher level of education (AOR = 3.47, 95% CI: 1.27, 9.53), psychological and financial support from a partner (AOR = 3.86, 95% CI: 2.1, 7.10), joint discussion and plan with a partner (AOR = 3.32, 95% CI: 1.55, 7.13), history of chronic disease (AOR = 3.47, 95% CI: 1.67, 7.25), and good knowledge about preconception care (AOR = 2.42, 95% CI: 1.34, 4.38) were significantly associated with preconception care utilization. Conclusions: Overall, less than a quarter of the pregnant mothers utilized preconception care, indicating that awareness is very low. Pregnant mothers who have a higher educational level, have good communication and support from their partners, have chronic health problems, and have good knowledge about preconception care were more likely to utilize the service. Preconception care is a better opportunity to intervene and maintain the mother in the continuum of care.

Prevalence and determinants of maternal near miss in Ethiopia: a systematic review and meta-analysis, 2015-2023.

BACKGROUND: One of the most challenging problems in developing countries including Ethiopia is improving maternal health. About 303,000 mothers die globally, and one in every 180 is at risk from maternal causes. Developing regions account for 99% of maternal deaths. Maternal near miss (MNM) resulted in long-term consequences. A systematic review and meta-analysis was performed to assess the prevalence and predictors of maternal near miss in Ethiopia from January 2015 to March 2023. METHODS: A systematic review and meta-analysis cover both published and unpublished studies from different databases (PubMed, CINHAL, Scopus, Science Direct, and the Cochrane Library) to search for published studies whilst searches for unpublished studies were conducted using Google Scholar and Google searches. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. Duplicated studies were removed using Endnote X8. The paper quality was also assessed based on the JBI checklist. Finally, 21 studies were included in the study. Data synthesis and statistical analysis were conducted using STATA Version 17 software. Forest plots were used to present the pooled prevalence using the random effect model. Heterogeneity and publication bias was evaluated using Cochran's Q test, (Q) and I squared test (I2). Subgroup analysis based on study region and year of publication was performed. RESULT: From a total of 705 obtained studies, twenty-one studies involving 701,997 pregnant or postpartum mothers were included in the final analysis. The national pooled prevalence of MNM in Ethiopia was 140/1000 [95% CI: 80, 190]. Lack of formal education [AOR = 2.10, 95% CI: 1.09, 3.10], Lack of antenatal care [AOR = 2.18, 95% CI: 1.33, 3.03], history of cesarean section [AOR = 4.07, 95% CI: 2.91, 5.24], anemia [AOR = 4.86, 95% CI: 3.24, 6.47], and having chronic medical disorder [AOR = 2.41, 95% CI: 1.53, 3.29] were among the predictors of maternal near misses from the pooled estimate. CONCLUSION: The national prevalence of maternal near miss was still substantial. Antenatal care is found to be protective against maternal near miss. Emphasizing antenatal care to prevent anemia and modifying other chronic medical conditions is recommended as prevention strategies. Avoiding primary cesarean section is recommended unless a clear indication is present. Finally, the country should place more emphasis on strategies for reducing MNM and its consequences, with the hope of improving women's health.

Nearly One-Fourth of Eastern Ethiopian Adolescents are Current Psychoactive Substance Users: A School-Based Cross-Sectional Study.

Introduction: Psychoactive substance use is a growing health problem in both developing and developed countries. Despite adolescents being at high risk of practicing risky behaviors including substance use, there is no adequate information on the problem in the Harari Region, in the Eastern part of Ethiopia. Hence, the present study aimed to identify the burden of current substance use in high school adolescent students of Harari Region, Ethiopia, from 10th April to 10th May 2022. Methods: A school-based cross-sectional study was employed on a total of 1498 randomly selected adolescent students. Poisson regression was used for the assessment of substance use over the last three months among adolescent students. The substance use burden was reported by IRR (incidence rate ratio) at a 95% Confidence interval. The final model fitness was checked using Akaike information criterion (AIC) and Bayesian information criterion (BIC) reports. The variables that had less than 0.05 P-value were declared to be statistically significant. Results: The overall psychoactive substance use was 373 (24.9%, 95% Confidence Interval (CI); 22.8-27.1%). The substances included khat (21.6%, 95% CI; 18.6-23.6%), alcohol drinking (1.8%; 95% CI; 1.3-2.6%), and smoking (1.2%, 95% CI; 0.75-1.9%). Being male (IRR (Incidence Rate ratio) = 1.21, 95% CI; 1.11-1.38), availability of the substance (IRR (Incidence Rate ratio) = 2.02, 95%; 1.53-2.66), having substance user friends (IRR=1.60: 95% CI: 1.30-2.01), and being at a younger age (IRR = 1.21; 95% CI: 1.02-1.44) increased the psychoactive substance use rate in the adolescents. Conclusion and Recommendation: One out of four adolescents was a current psychoactive substance user. Being male, substance availability, having substance-user friends, and being at younger age increased the psychoactive substance use rate in school adolescents in Eastern Ethiopia. The intervention that involves the schools' community, students' families, and executive bodies should be strengthened to overcome the substance use-related burdens among high school adolescent students.

Suicidal ideation, attempt and associated factor among secondary school students in Harari regional state, Eastern Ethiopia. A multi-center cross-sectional study.

Background: Suicide is a major public health issue across the globe. It is the second leading cause of death in adolescents. Even though the rate of suicide has increased, no study has been conducted to investigate the determinants of suicide in the study area. Therefore, this study aimed to assess the magnitude of suicidal ideation, suicide attempts, and its associated factors among secondary school students in the Harari regional state of Eastern Ethiopia. Methods: An institutional-based cross-sectional study was conducted among randomly selected 1,666 secondary school students. A structured-self-administered questionnaire was used for data collection. The WHO Composite International Diagnostic Interview (CIDI) was used to assess suicidal ideation and suicide attempts. The Depression Anxiety and Stress Scale (DASS) was also used to assess depression, anxiety, and stress. Data were entered into EpiData version 3.1 and exported to Stata version 14.0 for the analysis. A logistic regression analysis was performed to determine the association between the outcome and independent variables and the statistical significance was declared at a p-value of < 0.05. Result: The overall magnitude of suicidal ideation and attempts was 13.82% at 95% confidence interval (CI): 12.16-15.66 and 7.61% at 95% CI: 6.37-9.07, respectively. Suicidal ideations and suicide attempts were significantly associated with undergoing depressive symptoms (adjusted odds ratio [AOR]: 1.54; 95% CI: 1.08-2.19 and AOR: 2.37; 95% CI: 1.46-3.86, respectively), experiencing anxiety symptoms (AOR: 1.80; 95% CI: 1.25-2.59 and AOR: 1.89; 95% CI: 2.14-10.65, respectively), being exposed to sexual violence (AOR: 3.36; 95% CI: 1.65-6.84), and having a family history of suicidal attempts (AOR: 2.12; 95% CI: 1.21-3.69 and AOR: 4.74; 95% CI: 2.14-10.65, respectively), whereas living in a rural residence (AOR: 1.65 95%, CI: 1.08-2.55) was significantly associated only with suicide attempts. Conclusion and recommendations: Nearly one in six secondary school students had both suicidal ideation and attempted to take their own life. Suicide is one of the psychiatric emergencies that need immediate action. Therefore, the concerned body from either a governmental or a non-governmental organization should work in setting strategies to minimize sexual violence as well as depressive and anxiety symptoms.

Predictors of surgical site infection among women following cesarean delivery in eastern Ethiopia: a prospective cohort study.

Despite the availability of prophylactic antibiotics prior to skin incisions, surgical site infection (SSI) following cesarean section (CS) remains an unresolved health issue. As a result, this study aimed to assess the incidence and predictors of SSI after a CS. Methods: The authors conducted a prospective cohort study in eastern Ethiopia. The women were serially enrolled until the desired sample size was reached. A structured questionnaire was used to collect data. Women were followed at the hospital during their weekly visits. Culture-based microbiological methods were used to identify causal agents. A binary logistic regression model was used to identify the predictors of SSI after CS. Results: Among serially enrolled women, 336 were followed for 30 days. The incidence of SSI was 7.74% (95% CI: 7.68-7.80). Rupture of the membrane before operation [adjusted odds ratio (AOR)=3.75, 95% CI: 1.85-16.6], labor duration greater than 24 h (AOR=4.04, 95% CI: 1.52-10.79), and postoperative hemoglobin less than 11 g/dl (AOR=3.42, 95% CI: 1.32-8.87) were all significantly associated with SSI. The most common isolated pathogen was Staphylococcus aureus, followed by Escherichia coli. Conclusions: Nearly one-tenth of the women developed SSIs. Factors such as rupture of the membrane before the operation, absence of antenatal care, labor duration greater than 24 h, a midline skin incision, and postoperative hemoglobin less than 11 g/dl were the predictors of SSI. To reduce the incidence of SSI, policymakers should consider the importance of high-quality antenatal care, shorten the duration of labor, and maintain women's hemodynamics in future SSI prevention bundles.

Survival Status and Predictors of Mortality Among Women with Uterine Rupture at Public Hospitals of Eastern Ethiopia. Semi-Parametric Survival Analysis.

Background: Uterine rupture is the most dangerous complication of labor and contributes to high maternal mortality. Despite efforts to improve basic and comprehensive emergency obstetric treatment, women continue to suffer from disastrous maternal outcomes. Purpose: This study aimed to assess the survival status and predictors of mortality among women with uterine rupture at public hospitals in the Harari Region, Eastern Ethiopia. Patients and Methods: We conducted a retrospective cohort study among women with uterine rupture in public hospitals in Eastern Ethiopia. All women with uterine rupture were followed for 11 years retrospectively. Statistical analysis was conducted with STATA version 14.2. Kaplan-Meier curves together with a Log rank test were used to estimate the survival time and show the presence of differences among groups. Cox Proportion Hazard (CPH) model was used to determine the association between independent variables and survival status. Results: There were 57,006 deliveries in the study period. We found that 10.5% (95% CI: 6.8-15.7) of women with uterine rupture have died. The median recovery and death time for women with uterine rupture were 8 and 3 days with interquartile range (IQR) of 7-11 days and 2-5 days, respectively. Antenatal care follow-up (AHR: 4.2, 95% CI: 1.8-9.79), education status (AHR: 0.11; 95% CI: 0.02-0.85), visiting health center (AHR: 4.89; 95% CI: 1.05-22.88), and admission time (AHR: 4.4; 95% CI: 1.89-10.18) were the predictors of survival status of women with uterine rupture. Conclusion: One out of ten study participants died due to uterine rupture. Factors including not having ANC follow-up, visiting health centers for treatment, and being admitted during the night time were predictors. Thus, a great emphasis has to be given to the prevention of uterine rupture and the linkage within health institutions has to be smooth to improve the survival of patients with uterine rupture with the help of different professionals, health institutions, health bureaus, and policymakers.

Knee Pain After Retrograde Intramedullary Nailing with Surgical Implant Generation Network of Femur Shaft Fractures at Public Hospitals in Bahir Dar City, Ethiopia: Analysis of 6-Months Follow-Up Results.

Background: The incidence of femur fractures in young and elderly people has increased, particularly in countries with limited resources like Ethiopia. Intra-medullary nailing (IM) has been an effective and cost-effective method of treating long bone shaft fractures, but it can lead to complications such as knee pain. Purpose: This study aimed to evaluate knee pain and its associated factors following retrograde intramedullary nailing for femur fractures. Patients and Methods: The study followed 110 patients diagnosed with femur fractures and treated with retrograde SIGN Standard Nail or Fin Nail from January 2020 to December 2022 at two hospitals in Ethiopia. The patients were followed up for at least 6 months, and data were collected from medical charts, patient interviews, and phone calls to patients who did not attend the follow-up appointment. Binary logistic regression analysis was used to identify factors associated with knee pain. Results: The study showed that 40 patients reported knee pain at 6-months follow-up, making a prevalence of 36.4%. Factors significantly associated with knee pain were a time of injury to nailing (AOR=4.23, 95% CI: 1.28-13.92), use of a screw to the medial cortex (AOR=9.30, 95% CI: 2.90-12.74), and fracture site (AOR= 2.67, 95% CI: 14.01-7.03). Specifically, the longer the time from injury to nailing, the higher the risk of knee pain. The use of a longer screw to the medial cortex and a fracture site were also positively associated with knee pain. Conclusion: This study concludes that although retrograde intramedullary nail fixation is an effective method for femur fractures, it often results in knee pain. Approximately 4 of 10 patients suffered from knee pain in this study. Avoiding delayed surgical management and minimizing the use of prominent metalwork may reduce knee pain.

Reproductive health service utilization and associated factors among secondary school students in Harari regional state, eastern Ethiopia, 2022: a multicenter study.

INTRODUCTION: Reproductive health encompasses all conditions relating to the reproductive system and goes beyond simply being free from disease or infirmity. Several socioeconomic and socio-cultural factors affect reproductive health service utilization. OBJECTIVES: To assess reproductive health service utilization and its associated factors among government secondary school students in Harari regional state, Eastern Ethiopia 2022. METHODS: A school-based cross-sectional study design was conducted among 1275 secondary school students in six randomly selected secondary schools in Harari Regional state, in eastern Ethiopia. The study participants were chosen using a simple random sampling method. Data was gathered using self-administered questionnaires, entered into Epi Data version 3.1, and exported to SPSS version 25 for cleaning and analysis. Descriptive statistics, bivariable, and multivariable logistic regression analyses were carried out to compute the frequency of each independent variable and the magnitude of the outcome variables, then to identify factors associated with the outcome variable, respectively. To declare a significant association, an adjusted odd ratio (AOR) with a 95% confidence interval and a p-value of 0.05 were used. RESULTS: Our finding indicated that 25.3% (95% CI:22.9, 27.7) of the secondary school students utilized reproductive health services. Being in grade 11-12 (AOR = 1.67, 95% CI: 1.18, 2.38), having a history of sexually transmitted infection (AOR = 6.11, 95% CI: 2.20, 16.99), presence of a health facility nearby (AOR = 1.49, 95% CI: 1.12, 1.99), discuss voluntary counseling and testing with family (AOR = 2.73, 95% CI: 1.90, 3.94), and discussing about contraceptive with friends (AOR = 1.22, 95% CI: 0.91, 1.65) were the elements that had a strong correlation with reproductive health service utilization. CONCLUSION: In this study, only one-fourth of secondary school students utilized RH service during the past year. The student's educational level, having a history of STI, the presence of a health facility nearby, and discussing RH service with family/friends were the factors significantly associated with reproductive service utilization among secondary school students.

Blood donation practice and its predictors among undergraduate college students in Harari Regional State, Eastern Ethiopia.

Objectives: The main objective of this study was to assess blood donation practice and its associated factors among undergraduate college students in Harari Region, Eastern Ethiopia. Methods: An institutional-based cross-sectional study was employed among 518 college students selected by using a simple random sampling technique. Data was collected using pretested structured self-administered questionnaire. The collected data was entered into Epi-data 3.41 and exported to Statistical Package for Social Science version 22 for analysis. Bivariate and multivariable logistic regressions were utilized to identify factors associated with blood donation practice. p-Values of 0.05 or less was used to declare statistical significance. Results: In this study, the overall blood donation practice was 35.7% (95% confidence interval: 31.6, 39.8). Students studying health sciences were more likely than non-health sciences students (53.5%) to donate blood. Having positive knowledge about blood donation (adjusted odds ratio = 4.17; 95% confidence interval: 2.50, 6.92), being male (adjusted odds ratio = 0.57; 95% confidence interval: 0.38, 0.87), being student of midwifery department (adjusted odds ratio = 2.16; 95% confidence interval: 1.07, 4.36) and nursing department (adjusted odds ratio = 2.42; 95% confidence interval: 1.18, 4.98) were significantly associated with blood donation practice. Conclusion: Practice of blood donation among college students in the study is relatively low. Knowledge about blood donation, male sex and being a nursing and midwifery student were independently associated with blood donation practice. Therefore, the Regional Health Bureau and Blood Bank in collaboration with college administrators should design and implement appropriate strategies to improve blood donation practice.

Use of tranexamic acid in decreasing blood loss during and after delivery among women in Africa: a systematic review and meta-analysis.

BACKGROUND: Africa is a developing continent with a high maternal mortality rate. It is beneficial to implement interventions that alleviate the problem. As a result, this systematic review and meta-analysis was carried out to summarize evidence that will assist concerned bodies in proposing strategies to reduce maternal mortality due to post-partum hemorrhage. METHODS: This systematic review and meta-analysis includes randomized control trials (RCT) studies searched from various databases (PubMed, Web of Sciences, SCOPUS, African Journal Online, Clinical trials, and African indexes Medics). Data synthesis and statistical analysis were conducted using a combination of review manager 5.3 and STATA Version 14 software. The effect measure utilized was the standardized mean difference for estimated mean blood loss and mean hemoglobin level. RESULTS: This systematic review and meta-analysis includes a total of 3308 women. The pooled standardized mean difference showed that tranexamic acid statistical significantly reduced the estimated amount of blood loss after vaginal delivery (standardized mean difference with 95% CI - 0.93 [- 1.45, - 0.41]) and during and after cesarean delivery (standardized mean difference with 95% CI - 1.93 [- 2.40, - 1.47]). CONCLUSION: Tranexamic acid has been found to be a good choice for reducing blood loss during and after delivery in Africa regardless of the mode of delivery. Tranexamic acid had no effect on hemoglobin levels before and after delivery. To reduce maternal mortality due to post-partum hemorrhage, it is critical to implement and strengthen interventions aimed at increasing tranexamic acid uptake in Africa.

Follow-up conditions of care and associated factors among adult hypertensive patients during COVID-19 at West Arsi public health facilities, Southeastern Ethiopia: A multi-center cross-sectional study.

Background: Coronavirus disease (COVID-19) is a viral-borne infection caused by the SARS-CoV-2 virus. Aside from the morbidity and mortality effects, it leaves the majority of hypertensive patients untreated and vulnerable to uncontrolled hypertension. Objective: The purpose of this study was to assess follow-up conditions of care and its associated factors among adult hypertensive patients during COVID-19 in public health facilities of West Arsi, Southeastern Ethiopia. Methods: A health facility-based retrospective cross-sectional study was conducted among 423 adult hypertensive patients in the West Arsi public health facilities from July 5 to August 6, 2021. A systematic random sampling technique was used to recruit the study participants. A pretested structured face-to-face interviewer and medical records were used to collect sociodemographic variables, basic clinical features, and follow-up data. The follow-up conditions of care were assessed using 12 items with "yes or no" questions. Then, based on the mean value of the items, the follow-up conditions of care were dichotomized into good and poor. As a result, the follow-up condition was good if the score was greater or equal to the mean, and poor unless otherwise. To investigate parameters related with follow-up conditions of care, bivariable and multivariable logistic regression analyses were used. A 95% confidence interval and a p-value of 0.05 were used to indicate a significant association. Results: The rate of poor follow-up conditions of care during COVID-19 was 29% (95% confidence interval: 24.9-33.4%), according to this study. Age ≥ 60 years (AOR = 3.55; 95% CI: 2.09-6.03), transportation problem (AOR = 2.43; 95% CI: 1.28-4.61), fear of COVID-19 (AOR = 3.34; 95% CI: 1.59-7.01), co-morbidity (AOR = 1.93; 95% CI: 1.14-3.26) and physical distancing (AOR = 2.43; 95% CI: 1.44-4.12) were significantly associated with poor follow-up conditions of care. Conclusions: In our study, 29% of the participants had poor follow-up care conditions. When compared to WHO recommendations, the findings of this study may explain poor follow-up care conditions. To enhance patients' follow-up treatment, evidence-based target interventions should be designed and executed, taking into account individuals at high risks, such as those over the age of 60 and those with comorbidities, and identifying additional risk factors.

Perception of Caring Behaviors and Associated Factors Among Nurses Working in Harar Hospitals, Eastern Ethiopia.

Introduction: Perception of caring behavior is very necessary to enhance human life, and the provision of health care, and is considered a basic key in the provision of healthcare facilities. Even though all nursing interventions are verified through nurse caring behaviors, poor perception of caring behaviors reduces the well-being of the patients. Objective: The objective of this study was to assess the perception of caring behaviors and associated factors among nurses working in Harar Hospitals, Eastern Ethiopia. Methods: An institutional-based cross-sectional study was conducted among 465 randomly selected nurses. Data were collected by using a pretested and structured self-administered questionnaire. Descriptive statistics including frequency table, mean, standard deviation, and percentage were employed. Binary logistic regression analysis was used to identify factors associated with the good perception of caring behaviors. Variables with a p-value of < .05 were considered statistically significant. Results: This study revealed that the proportion of nurses who had a good perception of caring behaviors was found to be 63.4% (95% CI: 58.5-68.2%). High-level education (AOR = 2.98, 95% CI: 1.28-4.34), low workload (AOR = 1.22, 95% CI: 1.16-3.05), satisfied with a job (AOR = 1.92, 95% CI: 1.42-4.01), good relation with coworkers (AOR = 4.56, 95% CI: 2.15-9.67) were significantly associated with a good perception of caring behaviors. Conclusions: This study reported that the proportion of nurses who had a good perception of caring behaviors was 63.4%. Educational level, workload, job satisfaction, and joint participation in the decision-making process were factors significantly associated with good perceptions of nurses caring behavior. Therefore, nurses caring behavior is enhanced by increasing educational levels, creating a conducive working environment, and making nursing active in the decision-making process to improve the perception of nurses toward nurses caring behavior.

Level of implementation of district health information system 2 at public health facilities in Eastern Ethiopia.

Objective: The major aim of this study was to assess the level of District health information system 2 (DHIS 2) implementation in the public health facilities (HFs) in Dire Dawa City Administration. Methods: This study was employed both quantitative (cross-sectional) and qualitative (phenomenological) study designs. All public HFs found in Dire Dawa City Administration and health workers were participated in the study. Quantitative data were collected using a pre-tested, structured, self-administered questionnaire. The collected data were entered into Epi-Data and analyzed using STATA version 14 software. A descriptive summary was computed using proportion and frequencies. Qualitative data were collected from in-depth interview with key informants (KIs), and the results were then analyzed thematically. Results: The overall implementation level of DHIS 2 was 80%, which shows good implementation. The main difficulties encountered in implementing DHIS 2 were a lack of power backup (64.3%), unreliable internet connectivity (43%), and a lack of training (34.6%). According to an in-depth interview with a 32-year-old professional, "…there is offline and online DHIS 2 software for data collection and reporting that is an opportunity for the health center, but there is a challenge of interruption of electricity lost unsaved data and hinder data to enter and view for making a decision…." Conclusion: The level of DHIS 2 implementation in this study was good compared to other studies in Ethiopia. However, more than half of the HFs require infrastructure maintenance and support.

Pelvic organ prolapse and associated factors among women admitted to gynecology ward at the Hiwot Fana Comprehensive Specialized Hospital, Harar, eastern Ethiopia.

Objectives: The major aim of this study was to assess the magnitude of pelvic organ prolapse and its associated factors among patients admitted to the gynecology ward at Hiwot Fana Specialized University Hospital, eastern Ethiopia. Methods: A retrospective review of records was undertaken at Hiwot Fana Specialized University Hospital. We used a simple random sampling technique to pick 387 gynecology ward-admitted patient records from 30 December 2020 to 10 January 2021. Data were extracted from maternal medical charts using a pretested checklist. The extracted data were entered into EpiData version 3.1 and then exported into SPSS version 25 for analysis. Binary logistic regression was carried out to observe a significant correlation between independent and pelvic organ prolapse. An adjusted odds ratio and 95% confidence interval was used to report the result. A p-value of less than 0.05 was used to declare statistical significance. Results: Among 387 responded women, 39 (10.1%; 95% confidence interval = 8.3-15.6) of them had at least one stage of pelvic organ prolapse. Multiparty (adjusted odds ratio = 1.88, 95% confidence interval = 1.41-10.60), grand multiparty (adjusted odds ratio = 2.63, 95% confidence interval = 1.53-12.90), older maternal age (adjusted odds ratio = 2.29, 95% confidence interval = 1.220-7.52), lifting a heavy object (adjusted odds ratio = 4.61, 95% confidence interval = 2.31-15.83), and having chronic cough (adjusted odds ratio = 2.39, 95% confidence interval = 1.10-5.19) were significantly associated with pelvic organ prolapse. Conclusion: Among women admitted to the hospital because of gynecological morbidity, one in ten of them had pelvic organ prolapse. Multiparty, advanced maternal age, having a chronic cough, and lifting heavy objects were identified to be risk factors for pelvic organ prolapse. Tailored primary prevention would enhance the well-being of reproductive-age women.

Attitudes toward safe abortion care and its associated factors among health care providers working in public health facilities in eastern Ethiopia.

Objectives: The main aim of this study was to assess health care providers' attitudes toward safe abortion services and its associated factors in public health facilities of Harar city, Eastern Ethiopia. Methods: Facility-based cross-sectional study was conducted among 411 health care providers who were working at public health facilities in Harari regional state, in eastern Ethiopia. A simple random sampling technique was used to select study participants. Data were collected using self-administered questionnaires, and collected data were entered into EpiData version 4.6 and then exported to SPSS version 26 for cleaning and analysis. Descriptive statistics, bivariable, and multivariable logistic regression analysis were carried out to compute the prevalence of the outcome variables and to identify factors associated with the outcome variable, respectively. Adjusted odds ratio at 95% confidence interval and p-value < 0.05 was used to declare a significant association. Results: More than half (58.4%, 95% confidence interval: 53.8-63.2) of the health care providers had a favorable attitude toward safe abortion care. Being male (adjusted odds ratio = 2.90; 95% confidence interval: 1.80-4.65), ever trained on safe abortion (adjusted odds ratio = 2.55; 95% confidence interval: 1.39-4.66), familiarity with the current abortion law of Ethiopia (adjusted odds ratio = 2.38; 95% confidence interval: 1.40-4.05), preference of unrestricted abortion law (adjusted odds ratio = 1.86; 95% confidence interval: 1.15-3.02), and being medical doctors or health officers (adjusted odds ratio = 1.90; 95% confidence interval: 1.06-3.41) were the factors significantly associated with health care providers' favorable attitude toward safe abortion care. Conclusion: Approximately three in five of the health care providers working at public health facilities had a favorable attitude toward safe abortion care in eastern Ethiopia. We suggest giving pre-service or in-service training on safe abortion care and supporting health care providers to be familiar with the country's abortion laws are crucial to improve health care providers' attitudes toward safe abortion service in Ethiopia.

Uncontrolled hypertension and associated factors among adult hypertensive patients on follow-up at public hospitals, Eastern Ethiopia: A multicenter study.

Objective: The aim of this study was to assess the magnitude of uncontrolled hypertension and associated factors among adult hypertensive patients on follow-up at public hospitals in Eastern Ethiopia. Methods: A hospital-based cross-sectional study was conducted among 415 hypertensive patients in Eastern Ethiopia from June 15 to July 15, 2021. A systematic random sampling technique was used to select the study participants. Data were collected through face-to-face interviews and reviewing patients' charts. Bivariable and multivariable logistic regression analyses were performed to identify factors associated with uncontrolled hypertension. Results: This study revealed that magnitude of uncontrolled hypertension was 48% (95% confidence interval = 43.1%-52.8%). Being male (adjusted odds ratio = 2.05, 95% confidence interval = 1.29-3.26), age ⩾55 years (adjusted odds ratio = 3.16, 95% confidence interval = 1.96-5.08), non-adherence to medication (adjusted odds ratio = 1.83, 95% confidence interval = 1.14-2.94), low diet quality (adjusted odds ratio = 4.04, 95% confidence interval = 2.44-8.44), physically inactive (adjusted odds ratio = 3.20, 95% confidence interval = 1.84-5.56), and having comorbidity (adjusted odds ratio = 3.04, 95% confidence interval = 1.90-4.85) were significantly associated with uncontrolled hypertension. Conclusions: In our sample of hypertensive patients on follow-up at public hospitals in Eastern Ethiopia, half had uncontrolled hypertension. Older age, male sex, non-adherence to antihypertensive medication, low diet quality, physically inactive, and having comorbidity were found to be predictors of uncontrolled hypertension. Therefore, sustained health education on self-care practices with special emphasis on older, males, and patients with comorbid conditions.