Active management of the third stage of labor and associated factors among maternity care providers in public health facilities in Eastern Ethiopia: a multi-center study.

INTRODUCTION: The third stage of labor is the shortest, most critical, and hazardous stage as it is linked with postpartum hemorrhage, the leading cause of maternal mortality and morbidity. Postpartum hemorrhage can be prevented by 60% with active management of the third stage of labor (AMTSL). Few studies have been conducted in different parts of Ethiopia showing rates of AMTSL ranging from 16.7% to 43.3%. Limited information, however, exists about its practice in our study area. Thus, we aimed to assess the practice of AMTSL and associated factors among maternity care providers in public health facilities in eastern Ethiopia. METHODS: An institution-based cross-sectional study design was used among 270 maternity care providers in public health facilities in eastern Ethiopia. They were recruited using cluster sampling techniques in their health facilities from July 15-October 30/2021. Pretested self-administered questionnaires and an observational checklist were used to collect data. Descriptive, binary, and multivariable logistic regression analyses were performed. Adjusted odds ratios with 95% confidence intervals were used for statistically significant associations. RESULTS: Good practice of AMTSL occurred in 40.3% (95% CI: 34.5%-46.1%) of births. Being trained (aOR 3.02; 95% CI 1.60-5.70); presence of birth assistance (aOR 2.9; 95% CI 1.42-6.04); having the highest educational level (aOR 4.21; 95% CI 1.08-16.40); and having good knowledge (aOR 3.00; 95% CI 1.45-6.20) were factors statistically associated with maternity care providers' good practice of AMTSL. CONCLUSION: Active management of the third stage of labor was practiced with low rates in the study area. Therefore, we suggest that the stakeholders could enhance the presence of birth assistance during all births and provide education to attain higher educational levels and continuously update the maternity care providers' level of knowledge through comprehensive and on-the-job training to increase the good practice of the third stage of labor.

Level of antiretroviral therapy adherence and associated factors during COVID-19 pandemic era in public hospitals of Jigjiga City eastern Ethiopia: a cross-sectional study.

Background: Coronavirus-19 disease is more severe in patients on antiretroviral therapy (ART). Low-income countries, such as those in Sub-Saharan Africa, are particularly vulnerable to the virus' spread. However, there is little information on antiretroviral therapy (ART) use in Ethiopia during the pandemic, particularly in the study area. Therefore, this study aimed to assess the level of antiretroviral treatment adherence and associated factors during the COVID-19 pandemic era in public hospitals in Jigjiga City, Somalia, and Eastern Ethiopia. Methods: An institution-based cross-sectional study was conducted among 382 randomly selected HIV patients on antiretroviral therapy (ART) follow-up in public hospitals in Jigjiga City from March 1-30, 2022. The data was collected through face-to-face interviews and a review of the patient's record. To explore the relationship between variables, both bivariate and multivariable logistic regression analyses were performed. The adjusted odds ratio (AOR) was utilized, along with a 95% confidence interval, to assess the strength and direction of the association. Statistical significance was considered at p < 0.05. Results: The antiretroviral therapy (ART) adherence rate of HIV patients was 76.9% (95% CI, 71.9-82). Disclosing HIV status to sexual partners [AOR = 2.3, (95% CI (1.22-4.19)], having communication with health care providers' [AOR = 3.2, (95% CI (1.57-6.53)], having no history of current substance use [AOR = 2.6, (95% CI (1.45-4.63)], and patients who did not fear COVID-19 infection [AOR = 5.8 (95% CI (11-10.98)] were significantly associated with antiretroviral therapy (ART) adherence. Conclusion: In this study, the level of antiretroviral therapy (ART) adherence was poor in comparison to the expected level. Patients' adherence status was favorably related to disclosing their status to families and having contact with their healthcare providers, whereas worrying about COVID-19 pandemic infection and current substance use was adversely associated.