Interventions to improve the quality of maternal care in Ethiopia: a scoping review.

Introduction: Quality improvement interventions have been part of the national agenda aimed at reducing maternal and neonatal morbidities and mortality. Despite different interventions, neonatal mortality and morbidity rates remain steady. This review aimed to map and synthesize the evidence of maternal and newborn quality improvement interventions in Ethiopia. Methods: A scoping review was reported based on the reporting items for systematic reviews and meta-analysis extensions for the scoping review checklist. Data extraction, collation, and organization were based on the Joanna Briggs Institute manual of the evidence synthesis framework for a scoping review. The maternal and neonatal care standards from the World Health Organization and the Donabedian quality of health framework were used to summarize the findings. Results: Nineteen articles were included in this scoping review. The review found that the studies were conducted across various regions of Ethiopia, with the majority published after 2013. The reviewed studies mainly focused on three maternal care quality interventions: mobile and electronic health (eHealth), quality improvement standards, and human resource mobilization. Moreover, the reviewed studies explored various approaches to quality improvement, such as providing training to healthcare workers, health extension workers, traditional birth attendants, the community health development army, and mothers and supplying resources needed for maternal and newborn care. Conclusion: In conclusion, quality improvement strategies encompass community involvement, health education, mHealth, data-driven approaches, and health system strengthening. Future research should focus on the impact of physical environment, culture, sustainability, cost-effectiveness, and long-term effects of interventions. Healthcare providers' knowledge, skills, attitudes, satisfaction, and adherence to guidelines should also be considered.

Health Professionals' knowledge and practice on basic life support and its predicting factors in Ethiopia: Systematic review and meta-analysis.

BACKGROUND: Basic Life Support (BLS) is a sequence of care provided to patients who are experiencing respiratory arrest, cardiac arrest, or airway obstruction. Its main purpose is to maintain the airway, breathing, and circulation through CPR. This review aimed to estimate the pooled prevalence of Health Professionals' knowledge and practice on basic life support in Ethiopia. METHOD: Eligible primary studies were accessed from international database (PubMed, Google Scholar, Hinari databases) and grey literatures found in online repositories. The required data were extracted from those studies and exported to Stata 17 for analysis. A weighted inverse-variance random-effects model and Der Simonian-Laird estimation method were used to compute the overall pooled prevalence of Health Professional's knowledge, practice of basic life support and its predictors. Variations across the included studies were checked using forest plot, funnel plot, I2 statistics, and Egger's test. RESULT: A total of 5,258 Health Professionals were included from 11 studies. The pooled prevalence of knowledge and practice outcomes on basic life support in Ethiopia were 47.6 (95% CI: 29.899, 65.300, I2: 99.21%) and 44.42 (95% CI: 16.42, 72.41, I2: 99.69) respectively. Educational status of the Professional's was significantly associated with knowledge outcome. Those who had degree and above were 1.9 times (AOR: 1.90 (1.24, 2.56)) more likely knowledgeable on basic life support than under degree. CONCLUSION: The overall pooled estimates of Health Professionals knowledge and practice on basic life support was considerably low. The educational status of the Health Professionals was significantly associated with knowledge outcome. The Health Professionals and responsible stakeholders should focus on the basic life support at Health Institutions. The professionals should advance their knowledge and skill on basic life support for the patients.

Non-Adherence to Anti-Retroviral Therapy Among Adult People Living with HIV in Ethiopia: Systematic Review and Meta-Analysis.

Human immunodeficiency virus remains a global public health problem. Despite efforts to determine the prevalence of non-adherence to ART and its predictors in Ethiopia, various primary studies presented inconsistent findings. Therefore, this review aimed to determine the pooled prevalence of non-adherence to ART and identify its predictors. We have searched PubMed, Google Scholar and Web of Science databases extensively for all available studies. A weighted inverse-variance random-effects model was used to compute the overall non-adherence to ART. The pooled prevalence of non-adherence to ART was 20.68% (95% CI: 17.74, 23.61); I2 = 98.40%; p < 0.001). Educational level of primary school and lower [AOR = 3.5, 95%CI: 1.7, 7.4], taking co-medications [AOR = 0.45, 95%CI: 0.35, 0.59], not using memory aids [AOR = 0.30, 95%CI: 0.13, 0.71], depression [AOR = 2.0, 95%CI: 1.05, 3.79], comorbidity [AOR = 2.12, 95%CI: 1.16, 3.09), under-nutrition [AOR = 2.02, 95%CI: 1.20, 3.43], not believing on ART can control HIV [AOR = 2.31, 95%CI: 1.92, 2.77], lack of access to health facilities [AOR = 3.86, 95%CI: 1.10, 13.51] and taking ART pills uncomfortably while others looking [AOR = 5.21, 95%CI: 2.56, 10.53] were significantly associated with non-adherence to anti-retroviral therapy. The overall pooled prevalence of non-adherence to ART was considerably high in Ethiopia. Educational status, taking co-medications, not using memory aids, depression, comorbidity, under nutrition, not believing on anti-retroviral therapy controls HIV, lack of access to health facilities and taking ART pills uncomfortably were independent predictors of non-adherence to ART in Ethiopia. Therefore, healthcare providers, adherence counselors and supporters should detect non-adherence behaviors and patients' difficulties with ART early, and provide intensive counseling to promote adherence.

Level of Postnatal Checkup in Ethiopia - Implications for Child Health Services.

Background: High neonatal mortality rates continue to be a major public health issue in Ethiopia. Despite different maternal and neonatal care interventions, neonatal mortality in Ethiopia is at a steady state. This could be due to the low utilization of neonatal checkups. Thus, nationally assessing the level and predictors of postnatal checkups could provide important information for further improving neonatal healthcare services. Materials and Methods: A secondary data analysis of the 2016 Ethiopia Demographic and Health Survey (EDHS) was performed on 7,586 women who had live births in the 2 years before the survey. All variables with a p-value of ≤0.25 in the bivariable analysis were entered into the final model for multivariable analysis, and the level of statistical significance was declared at a P-value of <0.05. Results: According to the national survey, only 8.3% [95% CI: 8.19, 8.41] of neonates received postnatal checkups. About two-thirds of women, 62.8% had antenatal care visits, 67.9%, gave birth at home, and 95.7% were unaware of neonatal danger signs. Distance from health care institutions [AOR = 1.42; 95% CI: 1.06, 1.89], giving birth in a healthcare facility [AOR = 1.55; 95% CI: 1.12, 2.15], antenatal care visit [AOR = 3.0; 95% CI: 1.99, 4.53], and neonatal danger signs awareness [AOR = 3.06; 95% CI: 2.09, 4.5] were all associated with postnatal care visits. Conclusion: The number of neonates who had a postnatal checkup was low. Increasing antenatal care visit utilization, improving institutional delivery, raising awareness about neonatal danger signs, increasing access to health care facilities, and implementing home-based neonatal care visits by healthcare providers could all help to improve postnatal checkups.

Youth-friendly sexual and reproductive health services utilization and its determinants in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: In most developing countries, meeting young people's sexual and reproductive health (SRH) needs remains a problem. Despite policy initiatives and strategic measures aimed at increasing youth utilization of sexual and reproductive health services in Ethiopia, its utilization remains very low. Therefore, this study aimed to assess Ethiopia's youth-friendly sexual and reproductive health services' utilisation and determinants. METHODS: Scopus, Medline, Google Scholar, and CINAHL databases were searched for articles published until March 2021. The pooled prevalence and effect size of youth-friendly sexual and reproductive health service use and associated factors were estimated using a weighted DerSimonian-laird random effect model. The I2 statistics were used to determine the degree of heterogeneity. The funnel plot and Egger's regression test were used to examine publication bias. Subgroup analyses were performed to reduce underlying heterogeneity. RESULTS: One thousand one hundred and ninety-one articles were generated from various databases, and a final 26 articles were included in the review, including 16246 participants. Ethiopia's pooled prevalence of youth-friendly sexual and reproductive health service utilization was 42.73 % (95% CI: 35.38-50.09). The findings of this study showed that grade level 11-12, grade level 9-10, close to home sexual and reproductive health services, male sex, and discussion of sexual and reproductive health service with family, friends, and groups, ever experience sexual activity were associated with utilization of youth-friendly sexual and reproductive health services. Maternal educational status secondary school and above, age 15-19 years, age 20-24 years, having ever experienced reproductive problems, living with a partner, living alone, knowing about sexual and reproductive health, having a convenient working hour for youth-friendly service, and participation in a school clubs were also associated with the utilization of youth-friendly sexual and reproductive health services. CONCLUSION: We found several determinant factors for adolescent and youth utilization of sexual and reproductive health services. The review highlights the importance of improving service usage through youth education and promotion and the scaling up and institutionalizing of youth-friendly services through extensive capacity building.

Knowledge and Attitude Towards the Current Pandemic Corona Virus Disease and Associated Factors Among Pregnant Women Attending Antenatal Care in Debre Tabor General Hospital Northwest Ethiopia: An Institutional-Based Cross-Sectional Study.

PURPOSE: The current emerging respiratory disease known as the novel Coronavirus 2019 (COVID-19) is now an international concern and a pandemic with non-availability of treatment. Due to altered physiology, weakened mechanical and immunological features pregnant mothers constitute a particularly suspectable segment of population in any infection pandemic. The goal of this study was to assess level of knowledge and attitude towards COVID-19 and determinants among pregnant mothers attending antenatal care (ANC) in Debre Tabor General Hospital Northwest Ethiopia. PATIENT AND METHODS: An institutional-based cross-sectional study was performed from June 05 to 26, 2020. A total of 403 pregnant mothers participated and were selected by systematic random sampling. Data were collected via face-to-face interviewer-administered questionnaire. Data were entered using Epi-Data version 4.2 and analyzed by SPSS version 23. Bivariable and multivariable logistic regression analysis was performed and p-value <0.05 at 95% CI was considered as statistically significant. RESULTS: Overall, 52.1% and 52.6% of participants had a good level of knowledge and positive attitude towardCOVID-19, respectively. Level of knowledge was significantly associated with participants' age (15-24 years) (AOR: 4.58; 95% CI: 1.721-12.201), educational status (AOR:7.78; 95% CI: 2.31-15.65) occupation (AOR:2.26; 95% CI: 1.23-4.15), and condition of pregnancy (AOR:4.55; 95% CI: 1.84-11.25). Whereas age (25-34 years) (AOR:2.61; 95% CI: 1.23-5.55), participants husband completed secondary education (AOR=2.75, 95% CI: 1.13-6.70) and college and above (AOR:3.77; 95% CI: 1.1.62-8.76), wanted pregnancy (AOR:2.70; 95% CI: 1.22-5.97) and knowledge (AOR:1.65; 95% CI: 1.06-2.572) were the significant predictors for attitude. CONCLUSION: Findings show that almost half of the participants had a good level of knowledge and positive attitude towards COVID-19. Age, educational status, occupational status, condition of current pregnancy was positively associated with women level of awareness of COVID-19. Additional research is needed to see the impact of COVID-19 on pregnancy and feto-maternal effect.