Maternal satisfaction on delivery service and associated factors among mothers delivered at Arba Minch town governmental health facilities, South Ethiopia: A cross-sectional study.

Objective: To assess maternal satisfaction with delivery service and associated factors among mothers delivered at Arba Minch town governmental health facilities, South Ethiopia, 2022. Methods: A facility-based cross-sectional design study was conducted from 1 April to 30 June 2022. The total sample size was 320. A systematic random sampling technique was used to select mothers. Data were entered using Epi-data Version 3.1 and exported to SPSS Version 25 for analysis. Multicollinearity was considered using a variance inflation factor. The goodness of fit test was done using the Hosmer-Lemeshow model. Binary logistic regression was done, and variables with a p-value of <0.25 in the bivariable analysis were taken into the multivariable analysis. Statistically significant was declared at a p-value of <0.05 with an adjusted odds ratio and 95% confidence interval. Result: The maternal satisfaction with delivery service was 75.0% (95% CI: 70.3%-79.4%). Being urban residence (AOR: 4.15, 95% CI: 1.87-9.19), absence of anemia during pregnancy (AOR: 2.38, 95% CI: 1.07-5.29), absence of antepartum hemorrhage (AOR: 2.96, 95% CI: 1.35-6.50), induction to onset labor (AOR: 0.08, 95% CI: 0.02-0.39), female sex of the newborn (AOR: 0.33, 95% CI: 0.15-0.72), absence of fetal distress during labor (AOR: 5.01, 95% CI: 1.69-14.86), absence of intrauterine meconium release (AOR: 2.77, 95% CI: 1.02-7.63), and presence of privacy measures during examination (AOR: 3.11, 95% CI: 1.37-7.04) were associated with maternal satisfaction. Conclusion and recommendation: About 8 in 10 mothers are satisfied with the delivery service. Residence, anemia during pregnancy, antepartum hemorrhage, the onset of labor, sex of the newborn, fetal distress during labor, intrauterine meconium release, and privacy measures during examination are associated with maternal satisfaction with delivery services. Therefore, preventing anemia during pregnancy and antepartum hemorrhage, minimizing induction of labor, preventing fetal distress and intrauterine meconium release during labor, and taking privacy measures during examination might enhance maternal satisfaction with delivery services.

Financial risk of emergency abdominal surgery: a cross sectional study from Ethiopia.

BACKGROUND: The Lancet Commission on Global Surgery suggested six indicators every country should use to measure their surgical systems. One of these indicators, catastrophic expenditure (CE), is defined as money paid for service which amounts to more than 10% of the patient's total annual expenditure, or more than 40% of annual non-food household expenditure. Ethiopian Ministry of Health has set a target of 100% protection from CE by 2030. However, so far there is lack of studies that assess financial risk of surgery. METHODS: Using a cross sectional study design, financial risk assessment was carried out on 142 patients from Yekatit 12 and Zewditu Memorial hospitals in Addis Ababa, Ethiopia from May 15 to September 15, 2021. RESULTS: Appendectomy (69.0%), emergency laparotomy (26.1%) and cholecystectomy (4.9%) resulted in mean direct medical expenditures of 111.7USD, 200.70USD and 224.60USD, respectively. Medications and imaging accounted for 60.8 and 13.9% of total treatment cost. By applying the two definitions of catastrophic expenditure, 67.6 and 62.7% of patients sustained CE, respectively Overall rates of CE across procedures were 67.3 and 59.1% for appendectomy, 70.2 and 70.2% for laparotomy, 57.0 and 71.2% for cholecystectomy. Thirty-five (24.6%) patients had some form of insurance, with Community Based Health Insurance being the most common form (57%). Insured patients were less likely to sustain CE with both definitions (AOR 0.09, p = 0.002 and AOR 0.10, p = 0.006 respectively). CONCLUSION AND RECOMMENDATIONS: Substantial proportion of patients undergoing emergency abdominal surgery sustain CE in Addis Ababa. Medications and imaging take major share of total cost mainly because patients have to acquire them from private set ups. Policy makers should work on availing medications and imaging in public hospitals as well as expand insurance and other forms of surgical care financing to protect patients from CE.

Early Outcome of Laparotomy Wounds in Pediatric Patients in TASH, Addis Ababa, Ethiopia: A Six-Months Prospective Study.

BACKGROUND: Surgical Site Infection (SSI) and wound dehiscence are two early complications of laparotomy causing significant morbidity and mortality. This study was conducted to determine the prevalence and risk factors of SSI and wound dehiscence in pediatric surgical patients. METHODS: We performed a prospective observational study of all pediatric surgical patients who underwent laparotomy at Tikur Anbessa Specialized Hospital, Ethiopia, from December 2017 to May 2018. Data collected included demographics, operative indication, nutritional status, prophylactic antibiotics administration, and duration of operation. Primary outcome was SSI; secondary outcomes were hospital stay and other postoperative complications, including wound dehiscence and mortality. Data were analyzed using SPSS, Version 23. Fisher's exact and Chi-squared tests used to report outcomes. Multivariable logistic regression was used to identify variables associated with SSI, wound dehiscence and other outcomes. RESULTS: Of 114 patients, median age was 46 months [range: 1day-13 years]; 77(67.5 %) were males. Overall SSI rate was 21.05%. Nine (7.9%) developed wound dehiscence while 3(2.6%) had abdominal contents evisceration. Overall mortality rate was 2.6%. In multivariate analysis, prophylactic antibiotics administration (AOR=13.05, (p=0.006)), duration of procedure (AOR=8.62, (p=0.012)) and wound class (AOR=16.63, (p=0.034)) were independent risk factors for SSI while SSI was an independent predictor of prolonged hospital stay, >1 week (AOR=4.7, p=.003,) and of wound dehiscence (AOR=33. 96, p=0.003). Age (p=0.004) and malnutrition (p<0.001) were significantly associated with wound dehiscence. CONCLUSION: SSI and wound dehiscence are common in this setting. Wound contamination, antibiotics administration >1 hour before surgery and operative time >2 hours are independent predictors of SSI.