Determinants of puerperal sepsis among postpartum women: a case-control study in East Shoa Zone public hospitals, Central Ethiopia.

OBJECTIVE: To identify determinants of puerperal sepsis among postpartum women attending East Shoa Zone public hospitals, Central Ethiopia, 2023. DESIGN AND SETTING: An institutional-based, unmatched case-control study was conducted from 19 June 2023 to 4 September 2023, in East Shoa Zone public hospitals. PARTICIPANTS: 495 postpartum women (100 cases and 395 controls) were selected using systematic sampling techniques. Data were collected through face-to-face interviews and from medical charts using a pretested, structured questionnaire. The AOR with its corresponding 95% CI was used to identify determinant variables. Findings were presented in texts and tables. OUTCOME MEASURES: The medical charts of participants were reviewed to identify those who had developed puerperal sepsis. RESULTS: Anaemia (AOR 6.05; 95% CI 2.57 to 14.26), undernourishment (AOR 4.43; 95% CI 1.96 to 10.01), gestational diabetes mellitus (AOR 3.26; 95% CI 1.22 to 8.74), postpartum haemorrhage (AOR 3.17; 95% CI 1.28 to 7.87), obstructed labour (AOR 2.76; 95% CI 1.17 to 6.52), multiparity (AOR 2.54; 95% CI 1.17 to 5.50), placenta previa (AOR 2.27; 95% CI 1.11 to 4.67) and vaginal examination ≥5 times (AOR 2.19; 95% CI 1.05 to 4.54) were the independent determinants of puerperal sepsis in this study. CONCLUSION: This study found that gestational diabetes mellitus, anaemia, undernourishment, placenta previa, obstructed labour, postpartum haemorrhage and five or more per-vaginal examinations during labour were the determinants of puerperal sepsis. Therefore, it is recommended that obstetric care providers strictly adhere to guidelines on the number of vaginal exams that should be performed throughout labour and that they perform these exams using the appropriate infection-prevention techniques. In addition, they should provide comprehensive health education on nutrition during pregnancy and postnatal periods and the importance of iron supplements.

Maternal satisfaction with intrapartum care and associated factors among mothers who gave birth in public hospitals of the South West Shewa Zone, Ethiopia, 2022.

Background: Maternal satisfaction with intrapartum care is a multidimensional assumption of satisfaction with self and with the physical environment of the delivery ward and quality of care. Maternal satisfaction with intrapartum care affects the selection of birthplace and helps to identify gaps between actual and intended healthcare outcomes. This study aims to assess factors that affect maternal satisfaction with intrapartum care. Objectives: To assess maternal satisfaction with intrapartum care and associated factors among mothers who gave birth in public hospitals in the South-west Shewa Zone, Ethiopia, 2022. Methods: A cross-sectional study approach among 420 mothers was conducted between April 14 and June 14, 2022. Systematic random sampling was used to select mothers for face-to-face interviews every two intervals. Bivariate and multivariable logistic regression analyses were carried out. P-values of <0.25 in association with study variables were transferred to multivariable logistic regression models. An adjusted odds ratio with a 95% confidence interval was computed, and p-values of <0.05 were considered statistically significant in the multivariable model. The results of this study are presented using text, tables, and charts. Results: Data were collected from 420 participants, and 413 mothers completed the interview, giving a response rate of 98.33%. The overall maternal satisfaction with intrapartum care was 245 (59.32%) [95% CI: 55-64]. Mothers who were considered normal during labor and delivery (AOR = 2.57 (95% CI: 1.30-5.07), had a labor duration of 12 h or less (AOR = 1.59 (95% CI: 1.03-2.44), and experienced a waiting time of <15 min (AOR = 2.06 (95% CI: 1.21-3.52) were significantly associated with maternal satisfaction with intrapartum care. Conclusion and Recommendations: More than half of mothers were satisfied with the overall intrapartum care they received. Health facility managers and healthcare providers work together to improve maternal satisfaction with intrapartum care.