Glycemic Control and Associated Factors Among Children and Adolescents with Type 1 Diabetes Mellitus, Southwest Ethiopia.

Purpose: Type 1 diabetes mellitus is the most common endocrine disorder among children and adolescents worldwide. Glycemic control is the ultimate goal of management of diabetes. Poor glycemic control is shown to be associated with complications of diabetes. Only a few studies have addressed the problem in Ethiopia, and this study aimed to determine the level of glycemic control and factors associated among children and adolescents with type 1 diabetes mellitus on follow up. Methods: Institution based cross sectional study design was conducted on a total of 158 children and adolescents with type 1 diabetes on follow up at Jimma Medical Center from July to October 2022. Data were collected using structured questionnaire and entered into Epi Data 3.1 then exported to SPSS for analysis. Glycemic control was assessed based on glycosylated hemoglobin (HbA1c) level. Descriptive and inferential statistics were employed, and a p-value <0.05 was considered to declare statistical significance. Results: The mean glycosylated hemoglobin of the participants was 9.67 ± 2.28%. Of the total study participants, 121 (76.6%) had poor glycemic control. In multivariable logistic regression, guardian or father as a primary caregiver [guardian (AOR=4.45, 95%, p=0.045), father (AOR=6.02, 95%, p=0.023)], minimal involvement of caregiver in insulin injection (AOR=5.39, 95%, p=0.002), poor blood glucose monitoring adherence (AOR=4.42, 95%, p=0.026), faced problems at health facility (AOR=4.42, 95%, p=0.018) and being admitted to hospital in the past 6 months (AOR=7.94, 95%, p=0.004) were the variables significantly associated with poor glycemic control. Conclusion: Majority of children and adolescents with diabetes had poor glycemic control. Whereas, primary caregiver other than mother, minimal involvement of caregiver in insulin injection, and poor adherence to glucose monitoring were among the contributing factors for poor glycemic control. Therefore, adherence counseling and the participation of caregivers in diabetes management is recommended.

Prevalence of domestic violence in a time of catastrophic disease outbreaks including COVID-19 pandemic: a systematic review protocol.

BACKGROUND: Domestic violence is a public health issue that has a long-term and irreversible effect on the victims. There are vulnerable groups like children, women, and elders. The problem becomes worse for these populations in the time of catastrophic events including disease pandemics. However, few attempts have been made to systematically review the prevalence and pattern of domestic violence during these times all over the world. METHODS: An initial search of PubMed will be followed by CINAHL, Scopus, Google Scholar, Embase, and ProQuest Health. The titles and abstracts of studies will be reviewed, and full-text articles will be selected if the inclusion criteria are met. Studies that meet the eligibility criteria will then be assessed by two independent reviewers. Full-text articles will be selected if the inclusion criteria are met. A standardized critical appraisal checklist for studies reporting prevalence data will be used to assess the methodological quality, and a standardized data extraction tool will be used. The results from the included studies will be analysed using the JBI SUMARI software. DISCUSSION: This systematic review will provide solid evidence on the magnitude of domestic violence of any forms during catastrophic disease outbreaks including the current pandemic, COVID-19. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020192255 .

The Relation Between Organizational Justice and Counter-Productive Work Behavior Among Health Care Professionals in Jimma Zone Public Health Institutions.

Background: Counterproductive behavior costs organizations and their members which will ultimately affect work-related outcomes and organizational success. Organizational justice has the potential to affect the level of counter productive behavior. However, there is a paucity of studies to show the link between counterproductive behavior and organizational justice dimensions in the Ethiopian health care system context. Therefore, the purpose of this research was to look into the link between organizational justice, and counterproductive work behavior among health care professionals. Methods: The 395 study participants were chosen using a facility-based cross-sectional study methodology. A proportionate stratified systematic random sampling technique was deployed to select study participants from health facilities. Data was gathered using a structured self-report questionnaire by CWB Scale that was developed by Spector and Fox (2005) with Cronbach's alpha of an average of (0.84-0.87). Data was obtained, cleaned, and entered by Epidata3.1. Finally, for descriptive and inferential statistical analysis, the data was exported to SPSS version 23.0. Results: According to the findings, 159 (40.3%) of the study participants engaged in counterproductive job activities. Organizational justice was assumed to be fair by about half of the respondents, 202 (52.2%). Distributive Justice (=-0.141, p.05) was found to be a significant and negative predictor of counterproductive work behavior in the regression analysis. Age (ß=-0.014, p< 0.05), the average number of hours worked every week (ß=-0.009, p< 0.05), and experience (ß=0.016, p< 0.05) were found to be significant predictors of the counterproductive work behaviors. Conclusion and Recommendation: This study indicated that distributive justice show significant contribution in reduction of counterproductive work behaviour.As a result, improving organizational justice can aid to reduce counterproductive work behavior which in turn increases the facility's productivity.

Current practices and evaluation of barriers and facilitators to surgical site infection prevention measures in Jimma, Ethiopia.

Objective: Surgical site infections (SSIs) greatly burden healthcare systems around the world, particularly in low- and middle-income countries. We sought to employ the Systems Engineering Initiative for Patient Safety (SEIPS) model to better characterize SSI prevention practices and factors affecting adherence to prevention guidelines at Jimma University Medical Center (JUMC). Design: Our cross-sectional study consisted of semistructured interviews designed to elicit perceptions of and barriers and facilitators to SSI prevention among surgical staff and observations of current preoperative, perioperative, and postoperative SSI prevention practices in surgical cases. Interviews were recorded, manually transcribed, and thematically coded within the SEIPS framework. Trained observers recorded compliance with the World Health Organization's SSI prevention recommendations. Setting: A tertiary-care hospital in Jimma, Ethiopia. Participants: Surgical nurses, surgeons, and anesthetists at JUMC. Results: Within 16 individual and group interviews, participants cited multiple barriers to SSI prevention including shortages of water and antiseptic materials, lack of clear SSI guidelines and training, minimal Infection Prevention Control (IPC) interaction with surgical staff, and poor SSI tracking. Observations from nineteen surgical cases revealed high compliance with antibiotic prophylaxis (94.7%), hand scrubbing (100%), sterile gloves and instrument use (100%), incision site sterilization (100%), and use of surgical safety checklist (94.7%) but lower compliance with preoperative bathing (26.3%), MRSA screening (0%), and pre- and postoperative glucose (0%, 10.5%) and temperature (57.9%, 47.3%) monitoring. Conclusions: Utilizing the SEIPS model helped identify institution-specific barriers and facilitators that can inform targeted interventions to increase compliance with currently underperformed SSI prevention practices at JUMC.

Utilizing the SEIPS model to guide hand hygiene interventions at a tertiary hospital in Ethiopia.

We aimed to apply the Systems Engineering Initiative for Patient Safety (SEIPS) model to increase effectiveness and sustainability of the World Health Organization's (WHOs) hand hygiene (HH) guidelines within healthcare systems. Our cross-sectional, mixed-methods study took place at Jimma University Medical Center (JUMC), a tertiary care hospital in Jimma, Ethiopia, between November 2018 and August 2020 and consisted of three phases: baseline assessment, intervention, and follow-up assessment. We conducted questionnaires addressing HH knowledge and attitudes, interviews to identify HH barriers and facilitators within the SEIPS framework, and observations at the WHO's 5 moments of HH amongst healthcare workers (HCWs) at JUMC. We then implemented HH interventions based on WHO guidelines and results from our baseline assessment. Follow-up HH observations were conducted months later during the Covid-19 pandemic. 250 HCWs completed questionnaires with an average knowledge score of 61.4% and attitude scores indicating agreement that HH promotes patient safety. Interview participants cited multiple barriers to HH including shortages and location of HH materials, inadequate training, minimal Infection Prevention Control team presence, and high workload. We found an overall baseline HH compliance rate of 9.4% and a follow-up compliance rate of 72.1%. Drastically higher follow-up compared to baseline compliance rates were likely impacted by our HH interventions and Covid-19. HCWs showed motivation for patient safety despite low HH knowledge. Utilizing the SEIPS model helped identify institution-specific barriers that informed targeted interventions beyond WHO guidelines aimed at increasing effectiveness and sustainability of HH efforts.

Quality of Family Planning Services and Associated Factors in Jimma Town Public Hospitals, Southwest Ethiopia.

BACKGROUND: The quality of care is greatly compromised specially in resource limited settings that influence the uptake and continuation of use of family planning services. However, there is paucity of studies in Jimma Town public hospitals. Thus this study aimed to assess the quality of family planning services and associated factors in Jimma Town public hospitals, Southwest Ethiopia. METHODS: A facility-based cross-sectional study design using both qualitative and quantitative methods was employed from March 25 to April 25, 2018. A total of 278 female family planning users (15-49 years old) in Jimma Town public hospitals were included in the study.The sample was calculated using single population proportion formula and consecutive sampling methods was used. Descriptive statistics and multiple logistic regressions were used for analysisis. RESULTS: The mean waiting time of the client before getting service and mean consultation duration were23.5 and 12.5 minutes respectively participant who were unable to read and write were 64% less likely to be satisfied than those who were completed primary and secondary or preparatory schooling (AOR=0.363:CI:0.160,0.822), and clients who were waited for < 30 2minutes at waiting area were 2.7 times more likely to be satisfied than those who waited ≥ 30 minutes (AOR=2.769:CI:1.300,5.898). CONCLUSIONS: In this study, the satisfaction of clients in family planning service was low. Waiting time and received information on what to do in cases of problems and educational level of clients were significant predictors of client satisfaction.