Validation and Assessment of a Tool to Measure Psychosocial Readiness to Use Modern Contraceptives among Women in Tigray, Ethiopia.

Social norms, beliefs, and attitudes around modern contraception (MC) use can influence the decision to take up a method, but susceptibility to these factors varies between individuals. The effect of psychosocial readiness to use MC at the individual level is not established for women in Ethiopia. Data from 349 women were used for validity and reliability testing of a 12-item MC psychosocial readiness scale. A rating-scale Rasch model tested for unidimensionality, rating scale functioning, and construct and content validity. Multiple linear regression assessed the effect of respondent characteristics on MC psychosocial readiness scores. The psychometric properties of the univariate MC psychosocial readiness scale were satisfactory after the stepwise removal of two items. Prior MC use, socioeconomic status, geographic zone, and education were significantly associated with increased endorsement of MC psychosocial readiness. The 10-item scale measures the extent of endorsement of MC psychosocial readiness for childbearing women in Tigray, Ethiopia. Further research should qualitatively explore the identified influence of education on MC psychosocial readiness.

Correction to: Risk factors of premature rupture of membranes in public hospitals at Mekele city, Tigray, a case control study.

Following publication of the original article [1], we have been notified that the name of one author was spelled incorrectly as Kidanemariam Berhe, when the correct spelling is Kidanemaryam Berhe.

Mothers/caregivers healthcare seeking behavior towards childhood illness in selected health centers in Addis Ababa, Ethiopia: a facility-based cross-sectional study.

BACKGROUND: Seeking healthcare in children is unique since parents decide upon the type and frequency of healthcare services accessed. Mothers/caregivers lower healthcare seeking behavior is one of the major reason for increased morbidity and mortality from childhood illness in developing countries. Hence, this study aimed to assess healthcare seeking behavior of mothers/caregivers towards childhood illnesses in selected health centers of Addis Ababa, Ethiopia. METHODS: A facility-based cross-sectional survey was conducted on 422 sampled mothers/caregivers of children age 0-59 months, from April 18 to May 11, 2016. Ten health centers were selected using simple random sampling technique and proportionate number of participants were included from each health centers. A pre-tested, semi-structured questionnaire was used to collect data. Data were analyzed using SPSS version 20.0. Descriptive statistics was used to summarize socio-demographic characteristics and multivariable logistic regression was employed to identify factors associated with of healthcare seeking behavior. RESULT: In case of illnesses, 26.5% of mothers/caregivers sought healthcare for their children. Among the common childhood illnesses, acute respiratory tract infection and diarrhea accounted for 47.6 and 31%, respectively. Mothers/caregivers healthcare seeking behavior towards common childhood illnesses were influenced by child's age (AOR = 1.78, 95% CI:1.02, 3.13), education of mothers/caregivers (AOR = 4.24, 95% CI:1.32, 13.63), family size (AOR = 3.83, 95% CI:1.06, 13.78), perception of severity of illnesses (AOR = 2.00, 95% CI:1.05, 3.84), previous experience of similar illnesses (AOR = 3.67, 95% CI:1.36, 9.86) and previous history of under-five child death (AOR = 13.31, 95% CI:5.13, 34.53). CONCLUSIONS: The common under-five childhood illnesses were acute respiratory tract infection and diarrhea. The study also revealed that there was a delay in seeking healthcare and this was significantly associated with age of the child; mothers/caregivers level of education; family size; perception of illness severity; previous experience of similar illnesses and under-five child death.

Correction to: Risk factors of premature rupture of membranes in public hospitals at Mekele city, Tigray, a case control study.

Following publication of the original article [1], the author reported that his name was misspelled. The original article has been corrected.Incorrect name: Gidiom GebrehetCorrect name: Gdiom Gebreheat.

Risk factors of premature rupture of membranes in public hospitals at Mekele city, Tigray, a case control study.

BACKGROUND: The incidence of premature rupture of membranes ranges from about 5% to 10% of all deliveries. A woman with premature rupture of membranes is at risk of intra-amniotic infection, postpartum infection, endometritis, and death. A neonate born from premature rupture of membranes mother is at high risk of respiratory distress syndrome, sepsis, intraventricular hemorrhage and death. Little is known regarding the risk factors in Ethiopia. Therefore, this study was conducted to identify risk factors of premature rupture of membranes among pregnant women admitted to public hospitals in Mekelle city, Tigray, Ethiopia. METHODS: Hospital based unmatched case control study design was implemented on 240 samples (160 controls and 80 cases) from pregnant mothers admitted to public hospitals in Mekelle city from February - April/2016. Data was collected by interviewer administered Structured questionnaire and checklist. Binary logistic regression model was used to see the association between dependent and independent variables and multivariable logistic regression was used to identify the independent predictors of premature rupture of membranes. RESULTS: A total of 160 controls and 80 cases were enrolled in the study. Multivariable logistic regression showed that history of abortion [AOR 3.06 (CI: 1.39, 6.71)], history of PROM [AOR 4.45 (CI: 1.87, 10.6)], history of caesarean section [AOR 3.15(CI: 1.05, 9.46)] and abnormal vaginal discharge in the index pregnancy [AOR 3.31(CI: 1.67, 6.56)] were positively associated with premature rupture of membranes. CONCLUSIONS: Past obstetric history and risks in the index pregnancy have an association with premature rupture of membranes. The finding of the study suggests early identification and treatment of genitourinary infection.

Undernutrition among HIV positive women in Humera hospital, Tigray, Ethiopia, 2013: antiretroviral therapy alone is not enough, cross sectional study.

BACKGROUND: In Ethiopia, undernutrition among women on antiretroviral therapy has been a major challenge to achieve the full impact of intervention. Twenty seven percent and 17% of reproductive age Ethiopian women are chronically malnourished and anemic, respectively. Most studies to examine risk factors have been limited to the general population and ART-naive HIV-positive women, making it difficult to generalize findings to ART-treated HIV-positive women. The objectives of this study were thus to assess nutritional status and associated factors among adult women (≥ 20 years) on antiretroviral therapy. METHODS: From August to September we conducted an Institution based cross-sectional survey among 276 women on antiretroviral therapy in Humera Hospital, Tigray, Ethiopia. Data was collected using structured and standard face to face interview, anthropometric measurements, BD FACS (CD4 count machine) and Sysmex-21 (hemoglobin analyzer). Logistic regression was done using SPSS version 16 to identify factors that are associated with nutritional status. RESULTS: The prevalence of under nutrition (Body mass index < 18.5 kg/m(2)) Was 42.3% (95% CI: 37.4% - 47.3%). Severe, moderate and mild under nutrition was detected on 12%, 10% and 20.3% respondents, respectively. The prevalence of wasting (percentage body weight loss >5%) was 75% (95% CI: 70.4% - 79.2%). Severe wasting was accounted for 26.9% of respondents.In the multivariate analysis, Household food insecurity [AOR = 1.85; 95%CI 1.16, 2.86], inadequate dietary diversity [AOR = 1.19; 95%CI 1.08, 1.75], anemia [AOR = 1.67; 95%CI 1.05, 2.65] and absence of nutritional support [AOR = 0.34 95%CI 0.22, 0.54) were found to be independent predictors of under-nutrition. CONCLUSION: HIV/AIDS is associated with an increased burden of undernutrition even among ART treated women in Humera Hospital, Tigray, Ethiopia. In addition to ART among HIV positive women interventions to ameliorate poor nutritional status may be necessary in this and similar settings. Such interventions aimed at improving household food security, dietary diversity, micronutrient supplementation, proper use of therapeutic food, as well as treating oral candidiasis.

Risk Factors for Hepatitis B Virus Infection in North Ethiopia: A Case-Control Study.

Background: Hepatitis B virus infection (HBV) is an important clinical and public health problem that contributes to liver-related public health morbidity and mortality. Although childhood vaccination was introduced in 1980, hospital admissions, morbidity and mortality rates from HBV infection increased in Ethiopia. Risk factors for HBV infection and associated complications generally vary from case to case. No epidemiological studies have identified the risk factors for HBV infection in northern Ethiopia. Therefore, this study aimed to identify risk factors for HBV infection in specialist and teaching hospitals in Ayder. Methods: From March 2019 to May 2019, an unmatched hospital-based case-control study has been carried out on a total of 213 patients [71 cases and 142 controls] in northern Ethiopia. Cases were selected sequentially and two consecutive controls were selected for each case by a simple random method. The data were collected using pretested questionnaires structured by the interviewer as part of a face-to-face interview. Data were entered in Epi Data version 3.1, exported and analyzed with SPSS version 22. Binary and multivariable logistic regression analyses were used. Statistical significance was given as P <0.05. Results: Multivariate logistic regression analysis revealed that patients with familial exposure to hepatitis (AOR 3.7, 95% CI: 1.5-9.01), prior traditional medical procedure (AOR 1.2, 95% CI: 1.08-3.4), any history of dental procedures (AOR 3.8, 95% CI: 1.8-9.01) were associated risk factors to hepatitis B virus infection, and awareness of sexually transmitted hepatitis B virus infection (AOR 0.084, 95% CI: 0.01-0.6) is less likely to be infected with hepatitis B virus infection. Conclusion: This study (findings) demonstrated that contact with a case of hepatitis in the family, history of dentist visits, prior traditional medical procedure, and lack of awareness of its transmission through sexual contact have been identified as independent risk factors for the development of hepatitis B virus infection.

Factors Affecting Satisfaction With Inpatient Services Among Adult Patients Admitted to Arba Minch General Hospital, Southern Ethiopia: A Mixed Method Study.

Previous studies on patient satisfaction in Ethiopia focused on satisfaction with nursing care and outpatient services. Therefore, this study aimed to assess factors affecting satisfaction with inpatient services among adult patients admitted to Arba Minch General Hospital, Southern Ethiopia. A mixed method cross-sectional study was conducted among randomly selected 462 admitted adult patients from March 7 to April 28, 2020. A standardized structured questionnaire and semi-structured interview guide were used to collect data. A total of 8 in-depth interviews were conducted to collect the qualitative data. SPSS version 20 was used to analyze the data, and a P-value <.05 in the multivariable logistic regression was used to declare the statistical significance of the predictor variables. The qualitative data was analyzed thematically. In this study, 43.7% of patients were satisfied with the inpatient services they received. Urban residences (AOR 95% CI 1.67 [1.00, 2.80]), educational status (AOR 95% CI 3.41 [1.21, 9.64]), treatment outcome (AOR 95% CI 2.28 [1.65, 4.32]), use of meal service (AOR 95% CI 0.51 [0.30, 0.85]), and duration of hospital stay (AOR 95% CI 1.98 [1.18, 2.06]) were the predictors of satisfaction with inpatient services. Compared to previous studies, the level of satisfaction with inpatient services was relatively low.

Survival and predictors of mortality among preterm neonates in Northern Ethiopia: A retrospective follow-up study.

Background: In the year 2015, more than one-third of neonatal deaths caused by prematurity was recorded worldwide. Despite different kinds of efforts taken at the global and local levels to reduce neonatal mortality, it remains high with low reduction rates, especially in low- and middle-income countries like sub-Saharan Africa and South Asia. Therefore, this study aims to assess the survival status and predictors of mortality among preterm neonates. Methods: A retrospective follow-up study was conducted on randomly selected 561 preterm neonates. Data were extracted from patient records using a pretested checklist. Data entry and analysis were done using Epi-Data Version 4.4.2.1 and Stata version 14, respectively. The Cox proportional hazard regression model was fitted to identify the predictors of mortality. A hazard ratio with a 95% confidence interval (CI) was estimated and p-values < 0.05 were considered statistically significant. Result: The proportion of preterm neonatal deaths was 32.1% (180) with an incidence of 36.6 (95% CI: 31.6-42.4) per 1,000 person days. The mean survival time was 18.7 (95% CI: 17.7-19.9) days. Significant predictors for time to death of preterm neonates were respiratory distress syndrome [adjusted hazard ratio (AHR): 2.04; 95% CI: 1.48-2.82], perinatal asphyxia (AHR: 2.13; 95% CI: 1.32-3.47), kangaroo mother care (AHR: 0.14; 95% CI: 0.08-0.24), and gestational age (AHR: 0.85; 95% CI: 0.80-0.90). Conclusion: Preterm neonatal death is still a major public health concern. Respiratory distress syndrome, perinatal asphyxia, kangaroo mother care, and gestational age were independent significant predictors for time to death, as found in this study. Hence, priority must be given to neonates with the above illnesses and strengthen the management and care of preterm neonates.

Inpatient Care Service Experience Among Adult Patients Admitted to Arba Minch General Hospital, Southern Ethiopia: Institution-Based Qualitative Study.

Acknowledging patients' experience with the care delivered in healthcare settings is crucial in ensuring the quality of healthcare service delivery. In Ethiopia, qualitative evidence of patients' experience with inpatient care services is limited. This study aimed to explore the experience of inpatient care service among adult patients admitted to Arba Minch General hospital, Southern Ethiopia from April 05-28, 2020. An institution-based qualitative approach was carried out among adult patients discharged from the study hospital. Thirty-one in-depth interviews using a semi-structured interview guide were conducted and audio-recorded data were transcribed verbatim and translated into English. Data were coded, sorted, and themes were developed manually based on the thematic analysis. This study showed that kindness, respecting appointments, and treatment outcomes were the positive experiences highlighted by study participants. Participants reported a lack of drinking water, unpleasant toilet hygiene, lack of bedsheets, and absence of drugs as negative experiences. Therefore, the hospital administration should work on improving the problems mentioned by the participants of this study.

Knowledge about obstetric danger signs and associated factors among mothers in Tsegedie district, Tigray region, Ethiopia 2013: community based cross-sectional study.

BACKGROUND: In many developing countries including Ethiopia, maternal morbidity and mortality still pose a substantial burden and thus progress towards the fifth Millennium Development Goal (MDG) remains slow. Raising awareness of women about the danger signs of pregnancy and childbirth is the first essential step in accepting appropriate and timely referral to obstetric care. However, in Ethiopia little is known about the knowledge level of mothers about obstetric danger signs. The objective of this study was to assess the status of knowledge of danger signs of pregnancy and childbirth among mothers who gave birth in the past two years prior to the survey in Tsegedie district, Tigray regional state, Ethiopia. METHODS: A Community based cross-sectional study was conducted from November 20, 2012 to June 30, 2013 on a randomly selected sample of 485 women who had at least one delivery in the past two years. Multistage sampling technique was employed to select the study participants. A pre-tested structured questionnaire was used to collect quantitative data. Focus group discussion and in-depth interviews were utilized to supplement the Quantitative data. Bivariate and multivariate data analysis was performed using SPSS version 17.0 software. RESULT: Four hundred eighty five mothers participated in the study making a response rate of 100%. Vaginal bleeding was the most commonly mentioned danger signs of pregnancy (49.1%) and childbirth (52.8%). Two hundred eighty five (58.8%) and 299 (61.6%) of respondents mentioned at least two danger signs of pregnancy and childbirth respectively. One hundred seventy (35.1%) and 154 (31.8%) of respondents didn't know any danger signs of pregnancy and childbirth respectively. Educational status of the mother, place of delivery and having functional radio were found to be independent predictors of knowledge of women about the danger signs of pregnancy and childbirth. CONCLUSION: Educational status of the mother, place of delivery and having functional radio were independently associated with knowledge of women about obstetric danger signs. Thus, provision of information, education and communication targeting women, family and the general community on danger signs of pregnancy and childbirth and associated factors was recommended.

Determinants of institutional childbirth service utilisation among women of childbearing age in urban and rural areas of Tsegedie district, Ethiopia.

BACKGROUND: despite receiving greater attention, optimal maternal health remains a challenge in developing countries such as Ethiopia. Evidence from various studies shows that skilled attendance during childbirth is among the key strategies to reduce maternal mortality. However, in Ethiopia, the use of institutional childbirth services is very low. In Ethiopia, studies dealing with factors affecting women׳s use of institutional childbirth services are scarce and generally focus on urban settings. As such, this study aimed to explore the determinants of institutional childbirth service utilisation among urban and rural women who gave birth in the previous two years in Tsegedie district, Ethiopia. METHODS: a community-based cross-sectional study was performed from 20 November 2012 to 30 June 2013 on 485 mothers. The participants were selected systematically using a multistage sampling technique. A pre-tested structured questionnaire, administered by an interviewer, was used to collect quantitative data. Focus group discussions and in-depth interviews were used to triangulate the evidence from the quantitative study. Bivariate and multivariate data analysis was performed using Statistical Package for the Social Sciences Version 17.0. FINDING: this study found that 31.5% of the respondents used institutional childbirth services. The main reason for home birth was close attention from family (47%). Women׳s educational status [adjusted odds ratio (AOR) 5.3, 95% confidence interval (CI) 1.59-17.87], time taken to reach the nearest health facility (AOR 3.3, 95% CI 1.15-9.52), ultimate decision maker regarding the place of childbirth (AOR 3.7, 95% CI 1.08-12.63) and receipt of maternal and child health care information (AOR 9.4, 95% CI 2.4-36.38) were significantly associated with the use of institutional childbirth services. CONCLUSION: the proportion of births attended in health facilities was low in the study district. Women׳s educational status, distance to the nearest health facility, women׳s decision-making power and receipt of maternal and child health care information were important predictors of institutional childbirth service utilisation. This implies that women still lack physical and effective access to maternal health care services. Thus, improving community awareness about skilled providers and institutional childbirth, targeting women who prefer to give birth at home, is encouraged. Safe motherhood education using communication networks in rural and urban communities is crucial. Furthermore, it is recommended that essential obstetric care facilities (health centres) should be established within a reasonable distance of homes, women should be empowered and community midwives should be deployed.

Utilization of Modern Contraceptives among HIV Positive Reproductive Age Women in Tigray, Ethiopia: A Cross Sectional Study.

Background. HIV infected women in sub-Saharan Africa are at substantial risk of unintended pregnancy and sexually transmitted infections. In developing countries including Ethiopia counseling and provision of modern contraceptives of choice to HIV infected women including those on antiretroviral therapy (ART) is an important strategy to prevent unintended pregnancies and sexually transmitted infections. Little is known about the existing practices and utilization of modern contraceptives among HIV positive reproductive age women attending ART units. Objective. The aim of this study was to assess utilization of modern contraceptives and associated factors among HIV positive reproductive age women attending ART units in zonal hospitals of Tigray region, North Ethiopia. Method. Institution based cross-sectional study was conducted by interviewing 364 HIV positive reproductive age women in all zonal hospitals of Tigray region using systematic sampling technique. Structured and pretested questionnaire was used to obtain information from the respondents. Descriptive, bivariate, and multivariate methods were used to analyze utilization of modern contraceptives and the factors associated with it. Result. Three hundred sixty-four subjects participated with a response rate of 99.2%. The mean age of the respondents was 31.9 ± 6.5 (SD) years. About 46% of participants utilized modern contraceptives, 59.9% out of them used dual method. However, a significant proportion of the respondents (46%) reported that they wished to have a desire for children. Being secondary education and higher (AOR: 2.85; 95% CI: 1.17-6.95) and currently on HAART (AOR: 3.23; 95% CI: 1.49-7.01) they were more likely to utilize modern contraceptive. But those women who were ≥25 years old, house wives, single, divorced, or widowed were less likely to utilize modern contraceptive. Conclusion. Results of this study revealed that the number of respondents who were ever heard of modern contraceptives was high. However, modern contraceptive utilization was still low. Additional efforts are needed to promote modern contraceptive utilization in general and dual method use in particular among HIV positive reproductive age women.