Impact of the COVID-19 pandemic on the cost of chronic diseases treatment and care at public hospitals in Wallaga zones, Oromia Regional State, Ethiopia: a hospital-based, cross-sectional study.

OBJECTIVE: Globally, around one-third of the population has at least one long-term health condition that could be affected by the COVID-19 pandemic. Despite the fact that studies have revealed the direct impact of COVID-19 on healthcare provision and utilisation, the impact of the pandemic on the cost of chronic disease treatment and care from a patient perspective was scanty. So, the study aimed to determine the impact of the COVID-19 pandemic on cost of chronic diseases treatment and care at public hospitals in Wallaga zones, Oromia Regional State, Ethiopia, from 1 August to 31 August 2020. METHODS: An institutional-based cross-sectional study design was used, and the sample size for the study (n=642) was determined using a single population mean formula. Data were collected using interviews and analysed using SPSS V.25. Descriptive statistics were performed, and the cost of follow-up care before and after the pandemic was compared using a related-samples Wilcoxon signed-rank test, declaring the level of significance of the median cost difference at p<0.05. RESULTS: A total of 642 patients were included in the study, of whom 605 (94.2%) responded to the interviews. There was a significant median cost difference (n=593, Z=5.05, p=0.001) between the cost of chronic diseases among follow-up patients during the pandemic and the costs incurred by these patients before the pandemic. CONCLUSION: The cost of follow-up care among chronic disease patients during the COVID-19 pandemic was significantly higher compared with before the pandemic era. Therefore, healthcare providers should arrange special fee waiver mechanisms for chronic disease healthcare costs during such types of pandemics and provide the services at proximal health facilities.

Postpartum family planning uptake and its associated factors among postpartum women in Asosa zone, Benishangul Gumuz regional state, Ethiopia: a facility-based cross-sectional study.

BACKGROUND: The first twelve months after a woman has given birth is crucial for the use of contraceptives to prevent unintended pregnancy. Most women, especially in developing countries, do not realize that they are at risk for pregnancy during this period. Due to this, contraceptive use by women is ignored at this time. OBJECTIVE: This study assessed the associated factors of postpartum family planning (PPFP) service uptake in the Asosa zone. METHODS: A facility-based cross-sectional study was conducted among 396 postpartum women in the Asosa zone. An interviewer-administered, structured, and pre-tested questionnaire was used to collect data. Data entry and cleaning were done using Epi Info version 7.0 and analyzed using SPSS version 25 software. Multivariate logistic regression analysis was employed to identify factors associated with postpartum family planning uptake. RESULTS: The majority of the study participants, 384 (97.2%), had heard about at least one method of family planning. Nearly two-thirds of the study participants (64.1%) had resumed sexual intercourse. Only 53.5% of the participants started using PPFP. Injectable forms (54.7%) and implants (26.4%) were the most commonly used methods. More than one-fourth (27.4%) did not use their preferred methods. Family planning use before index pregnancy (AOR = 4.8, 95% CI: 2.65, 8.82), previous use of PPFP (AOR = 2.4, 95% CI: 1.33, 4.38)] and health facility delivery (AOR = 2.8, 95% CI: 1.46, 5.49)] were significantly associated with uptake of postpartum family planning. CONCLUSION AND RECOMMENDATION: Postpartum family planning uptake in the study area was low. Uptake of PPFP was correlated with prior family planning usage and delivery at a healthcare facility. Given these factors, we recommend all study area stakeholders to promote family planning use among women of reproductive age and to encourage deliveries at healthcare facilities. Designing a method to reach women who give birth at home for a variety of reasons is also advisable. Unavailability of different forms of FP also made the participants not use the preferred option. Therefore, we recommend the stakeholders in the study area to avail variety of FP methods.

Barriers and determinants of postpartum family planning uptake among postpartum women in Western Ethiopia: a facility-based cross-sectional study.

BACKGROUND: Despite Ethiopia's efforts to avail postpartum family planning (PPFP) services, the unmet need for family planning among postpartum women remains high. Therefore, this study is aimed to assess barriers and determinants of postpartum family-planning uptake among women visiting Maternal, Neonatal, and Child Health (MNCH) services in public health facilities of western Ethiopia. METHODS: A facility-based cross-sectional study design with a quantitative method was conducted on 989 postpartum women in Western Ethiopia from September 1 to October 30, 2020. Data were collected through face-to-face interviews using pretested structured questionnaires, entered using EPI-INFO version 7.0, and analyzed by SPSS version 25. Descriptive analysis and logistic regressions were performed. The adjusted odds ratio with a 95% confidence interval was used and statistical significance was declared at P-value < 0.05. RESULT: In this study, 56.1% of participants had used PPFP in the last year. The most commonly used method was injectable (51.7%). Family planning use before the index pregnancy (AOR = 2.09;95%CI:1.29,3,41),counselling on PPFP during antenatal care and delivery (AOR = 4.89;95%CI:2.31,10.37),health facility delivery (AOR = 7.61;95%CI:4.36,13.28), skilled birth attendance (AOR = 4.99;95%CI:2.88,8.64),COVID-19 restrictions (AOR = 0.59;95%CI:0.39,0.90) were factors associated with PPFP utilization. Being breastfeeding and amenorrhea were major reasons for not using postpartum family planning. CONCLUSION: Post-partum family planning utilization among study participants was low. Given the associated factors, it is recommended that health facilities should make postpartum family planning one of their top priorities and focus on these factors to improve its utilization.

Hypothermia on admission to a neonatal intensive care unit in Oromia, western Ethiopia: a case-control study.

Objective: Hypothermia is believed to affect more than half of Ethiopian neonates. The goal of this study is to determine risk factors for newborn hypothermia in neonates admitted to public hospitals in the east Wollega zone of western Ethiopia's neonatal intensive care unit. Design: Unmatched case-control study using neonates admitted to the intensive care unit. Setting: Neonatal intensive care units at public hospitals in western Ethiopia. Patients: Neonates admitted to intensive care units. Main outcomes: The cases were all neonates with hypothermia (less than 36.5°C) and the controls were all neonates with a body temperature of greater or equal to 36.5°C when admitted to the neonatal intensive care unit for other reasons. Results: The study involved the participation of 73 cases and 146 controls. The study found that delayed breastfeeding initiation after 1 hour (adjusted OR (AOR)=3.72; 95% CI: 1.39 to 10.00), admission weight less than 2500 g (AOR=3.43; 95% CI: 1.18 to 9.97), cardiopulmonary resuscitation at birth (AOR=3.42; 95% CI: 1.16 to 10.10.08), lack of immediate skin-to-skin contact with their mother (AOR=4.54; 95% CI: 1.75 to 11.81), night-time delivery (AOR=6.63; 95% CI: 2.23 to 19.77) and not wearing a cap (AOR=2.98; 95% CI: 1.09 to 8.15) were all associated with newborn hypothermia. Conclusions: Neonatal hypothermia was associated with obstetric, neonatal and healthcare provider factors. As a result, special consideration should be given to the thermal care of low birthweight neonates and the implementation of warm-chain principles with low-cost thermal protection in Ethiopian public health facilities.

Unintended pregnancy and the factors among currently pregnant married youths in Western Oromia, Ethiopia: A mixed method.

BACKGROUND: Unintended pregnancy is a global concern affecting both developed and developing countries. Some young women who had unintended pregnancies obtain an abortion while others carry their pregnancies to term, incurring the risk of morbidity and mortality higher than those for adult women. Despite the availability of highly effective methods of contraception, different studies in Ethiopia revealed that there is a high level of unintended pregnancy. OBJECTIVE: To assess the magnitude of unintended pregnancy and associated factors among currently pregnant married youths in Kiremu district. METHODS: A community-based cross-sectional study was conducted among currently pregnant married 15-24 years women. Multi-stage stratified sampling technique was used to select 434 study units. Ten kebeles were randomly selected and samples were selected from each of ten kebeles by simple random sampling using kebeles household identification numbers as the sampling frame. Quantitative data was entered with SPSS version 20 and crude and adjusted odds ratio together with their 95%CI were computed and interpreted accordingly. A p-value<0.05 was considered to declare a result as statistically significant in this study. In-depth interviews and transcripts of the recorded discussions were coded and analyzed thematically. The results were finally presented in texts, tables, and graphs. RESULT: Unintended pregnancies among currently pregnant married young women in the study area were 31.1%. Educational status (AOR = 3.195,95%CI = 1.757,5.811),being Gov't employee (AOR = 0.039, 95% CI = 0.002,0.988), ever heard contraceptives(AOR = 0.260, 95%CI = 0.077, 0.876), ever used contraceptives (AOR = 0.348,95%CI = 0.168,0.717),discussion about contraceptives with husband(AOR = 0.027,95%CI = 0.015, 0.050),fear of side effect of contraceptives (AOR = 5.819,95% CI = 1.438,23.422), autonomy on health (AOR = 0.122,95%CI = 0.035,0.431), age at first marriage (AOR = 3.195, 95%CI = 1.757,5.811), age first pregnancy(AOR = 23.660,95%CI = 12.573,44.522), being visited by health care providers (AOR = 0.202,95%CI = 0.073,0.566) and average birth interval (AOR = 3.472,95%CI = 1.392,8.61) were the factors associated with unintended pregnancy. CONCLUSION AND RECOMMENDATION: Significant proportion of women had an unintended pregnancy in the study area. Therefore, emphasis should be given to married youths especially on women empowerment, encouraging partner discussions, and providing appropriate counseling on contraceptive side effects by giving due attention to those marred at younger ages (<18 years).

Predictors of preterm birth in Western Ethiopia: A case control study.

BACKGROUND: Early neonatal death caused by preterm birth contributes the most for perinatal death. The prevalence of preterm birth continues to rise and is a significant public health problem. The exact cause of preterm birth is yet unanswered, as mostly preterm birth happens spontaneously. Predictors of preterm birth in developing countries like Ethiopia were not well investigated, and no study was conducted before this in the study area. OBJECTIVES: To identify predictors of preterm birth in Western Ethiopia, 2017/2018. METHODS: Health facility-based unmatched case-control study was conducted from October 20/2017-march 20/2018 in 4 Hospitals. A total sample size of 358 women was recruited. From this 72 were cases and 286 were controls. Cases were mothers who gave Preterm birth, and controls were mothers who gave birth at term. Ethical clearance was obtained from Wollega University ethical review committee. A pre tested, structured questionnaire was used to collect data. Data entry and analysis was done using Epi Data 3.1 and SPSS version 21, respectively. Logistic regression was done to identify predictors of preterm birth. RESULT: Three hundred fifty-eight women participated in this study of which 72 were cases and 286 were controls; making the overall response rate of 100%. Lack of antenatal care visit [AOR = 3.18, 95% CI 1.37-7.38]),(Having 1-2 antenatal care visit [AOR = 2.27, 95% CI 1.18-4.35]),history of previous preterm)[AOR = 5.19, 95% CI1.29-20.88],Short Interpregnancy Interval [AOR = 4.41.95% CI 2.05-9.47],Having Reproductive tract infections [AOR = 2.54, 95% CI 1.02-6.32] and having Obstetric complications [AOR = 2.48,95% CI 1.31-4.71] were found to be predictors of preterm birth. CONCLUSION AND RECOMMENDATION: Risk factors of preterm delivery are multifactorial and depend on geographical and demographic features of the population studied. Hence results of studies from one area might not be applicable to another area. Antenatal care visits are unique opportunities for early diagnosis and treatment of problems. Therefore, antenatal care should be strengthened, and appropriate counseling should be given at each antenatal care follow up. Maintainning optimum birth interval through family planning, and early identification and treatment of reproductive tract infections are mandatory.

Assessment of access and utilization of adolescent and youth sexual and reproductive health services in western Ethiopia.

BACKGROUND: Despite Ethiopia's enormous effort in youth-friendly service provision, little was investigated about the challenges of accessing sexual and reproductive health services in Western Ethiopia. Thus, this study aimed to assess factors associated with the utilization of adolescent and youth sexual and reproductive health services in this area. METHODS: A community-based cross-sectional quantitative method mixed with the qualitative inquiry was conducted among 771 adolescents and youth aged 15 to 24 years from February 1 to 28, 2020. Data were collected through face-to-face interviews using pretested structured questionaries. Data were entered using EPI-INFO version 7.0 and analyzed by SPSS version 25. Descriptive analysis and logistic regressions were performed. The adjusted odds ratio with a 95% confidence interval was used and statistical significance was declared at P-value < 0.05. The qualitative inquiry was collected through in-depth interviews with service providers, focus group discussions, and observation checklists of service units in the study facilities. Data were analyzed thematically. RESULTS: The mean age of participants was 18.99 years (SD ± 2.49). Two hundred seventeen (28.1%) of participants reported that they have ever heard about adolescents' and youth's reproductive health services. Only 66 (8.6%) have ever visited health facilities for sexual and reproductive health (SRH) services. Factors associated with the utilization of sexual and reproductive health service were age from 15 to 19 years (AOR = 0.36; 95%CI: 0.17, 0.76), history of having sexual intercourse(AOR = 5.34;95%CI: 2.53, 11.23), ever heard about sexual reproductive health service (AOR = 11.33; 95%CI: 5.59, 22.96), and visited a health facility for other health services (AOR = 5.12; 95%CI:1.72,15.24). CONCLUSION: Sexual and reproductive health service utilization among adolescents and youth was found to be low. The factors associated with adolescents and youth sexual and reproductive health services utilization were age, history of ever having sexual intercourse, ever heard about SRH services, and visit the health facility for other services. Therefore, it is better if the concerned bodies work on improving awareness of adolescents and youth towards SRH services and integrating these services into other routine services.

BACKGROUND: Ethiopia is showing its enormous effort to improve the utilization of sexual and reproductive health services by adolescents and youths. But different factors are affecting it. This paper explains how many adolescents and youths are using sexual and reproductive health services and the factors affecting their utilization. METHODS: We interviewed 771 adolescents and youths aged 15 to 24 years in western Ethiopia. We asked them about the awareness and utilization of adolescents' and youths' sexual reproductive health services and the factors affecting their utilization. RESULTS: seven hundred seventy-one adolescents and youths were interviewed. Two hundred seventeen (28.1%) and 66 (8.6%) of them heard about and utilized adolescents' and youths' reproductive health services respectively. Those adolescents and youths who heard about sexual and reproductive health service practiced sexual intercourse and visited a health facility for other health services used sexual and reproductive health service more frequently. CONCLUSION: Adolescents and youths who were using Sexual and reproductive health services were not many. Therefore, it better if the concerned bodies work on improving awareness and utilization of adolescents' and youths' sexual and reproductive health services.

Knowledge and Attitude Towards Antimicrobial Resistance of Graduating Health Science Students of Wollega University.

BACKGROUND: Antimicrobial resistance is a worldwide concern due to the inappropriate and irrational use of antibiotics. Thus, this study was aimed at determining the knowledge and attitude of graduating health science students of Wollega University towards antimicrobial resistance. METHODS: An institution-based cross-sectional study design was employed from June to July 2019. Epi-data version 3.1 was used to receive data and exported to SPSS version 25 for further analysis. Both bivariable and multivariable logistic regression analysis were done to find factors associated with attitudes of students towards antibiotic consumption and resistance at a 95% confidence level. The strength of association was measured with the odds ratio. Variables with a p-value of <0.05 at multivariable analysis were considered to be a significant variable. Finally, texts and simple frequency tables were used to present the findings. RESULTS: Out of 249, 232 students were included in this survey yielding a response rate of 93.6%. Hundred fifty-eight (68.1%) of them had adequate knowledge about antibiotic identification, role, side effects, and resistance. Students with a family member who works in health and related professions had a lower probability of stopping antibiotics when they feel better (AOR = 0.50, 95% CI: 0.28-0.90) and using leftover antibiotics (AOR = 0.51, 95% CI: 0.28-0.92) compared to their counterparts. CONCLUSION: Students' knowledge on antibiotic identification, role, side effects, and resistance was suboptimal, and the attitude of students towards antibiotic consumption was unfavorable. Respondents having a family member in a health-related field showed a good attitude. Respondents with three years of study also had a good attitude, female gender showed good attitude, and urban residence were independent predictors of attitude toward antibiotic consumption. Training on antimicrobial resistance should be arranged for graduating class nursing and medical students, as they are the future prescribers.

Predictors of self-management practices among diabetic patients attending hospitals in western Oromia, Ethiopia.

BACKGROUND: Diabetes Mellitus recognized as one of the emerging public health problems in developing countries. Self-monitoring needs to be individualized and should assist people with diabetes. This study aimed to assess the predictors of self-management practices among diabetic patients attending hospitals in western Oromia, Ethiopia. METHODS: A facility-based cross-sectional study was conducted from November 2017 to February 2018 in hospitals located in western Oromia, Ethiopia. An interview was made with a total of 400 diabetic patients attending the diabetes center and admitted to ward in the study hospitals. The data were entered into Epi Info software version 3.5.4. Data analysis was made using a statistical package for the social sciences (SPSS) version 20. Odds ratio (OR) was used to show the association. The statistical significance was considered at P<0.05, and potential confounding variables were controlled using logistic regression. The analyzed data were presented in texts and tables. RESULTS: From a total of 398 interviewed patients, 129 (32.4%) practiced diabetes self-management. About 63.6% of the study participants' self-management practice was good. Most 103 (79.84%) of those who practiced self-management were presented with one of diabetes mellitus-related complications. Logistic regression analysis results showed that merchants were about six times higher in self-management practice [AOR of 5.945 (1.177-30.027 at 95% CI)] and those having family support in diabetes practiced self-management 2.87 times than others [AOR of 2.835 (1.386-5.801 at 95% CI)]. CONCLUSIONS: Compared to the findings of previous studies, diabetes self-management practices of the participants was good. The study participants regular physical activity, food intake, medication adherence, and foot self-examination were moderate. Two variables, being a merchant and having family support were found to be the predictors of self-management practices. Predictors of self-management should be considered to boost self-management practice.

Factors Affecting Choice of Childbirth Place among Childbearing Age Women in Western Ethiopia: A Community-Based Cross-Sectional Study.

BACKGROUND: Access to proper medical attention and hygienic conditions during delivery can reduce the risk of complications and infections that may lead to serious illness or death or for the mother, baby, or both. In Ethiopia, the high maternal mortality rate with delivery by unskilled birth attendants shows low utilization of maternal health services. OBJECTIVE: This study was aimed at assessing factors determining the choice of childbirth place among women of childbearing age in Jimma Arjo District. METHOD: A cross-sectional design was conducted in Jimma Arjo District, East Wollega Zone, Ethiopia, from March 20 to April 20, 2018. Multistage sampling technique was used to select a total sample of 506 participants. Data were collected using structured questionnaires to interview women of childbearing age with two trained data collectors. Data was entered into Epi Info and exported to SPSS software version 20 for analysis. Data was checked for its completeness, cleaned, entered, and analyzed accordingly. Bivariate and multivariable data analyses were used to examine factors affecting choice of childbirth place. RESULTS: A total of 506 women participated in this study, giving a response rate of 97.8%. The study investigated that home delivery was found to be 200 (39.5%)in the study area. Factors found to be statistically associated with choice of institutional delivery at p < 0.05 were history of obstetric difficulties (AOR = 6, 95%CI = (2.08, 17.60)), woman educational status (AOR = 4.4, 95%CI = (1.47, 13.42)), husband educational status (AOR = 4, 95%CI = (1.43, 11.60)), two or more ANC visits (AOR = 4, 95%CI = (1.95, 8.52)), and accessibility to vehicle transportation (AOR = 2.8, 95%CI = (1.23, 6.46)). CONCLUSION: Preferring health facility as the birthplace in this study seems relatively better compared to other studies. It is shown that both mothers and their husbands attending secondary and greater educational level, history of obstetric difficulties, two or more ANC visits, and physical accessibility to health care facility have influenced mothers to prefer a health institution as the childbirth place. Therefore, any programs aimed at increasing the choice of institutional delivery should work on increasing ANC attendance and transportation facilities in the study area.

Factors affecting demand for modern contraceptives among currently married reproductive age women in rural Kebeles of Nunu Kumba district, Oromia, Ethiopia.

BACKGROUND: Family planning plays a key role in improving the health of the mother and the child. Yet there are still significant levels of demand for family planning that are unmet and these can lead to unintended pregnancy. So, women's demand for contraceptive utilization to limit, space, or delay the number of family size can be increased by integrating family planning service at each service delivery points. OBJECTIVE: The main aim of this study was to assess the demand for modern contraceptive and associated factors among currently married women of the reproductive age group in rural kebeles of Nunu Kumba District, 2015. METHODS: A community-based cross-sectional study design was conducted from January 15-30, 2015 among 584 systematically selected currently married women of reproductive age in six rural kebeles of Nunu Kumba District. A pre-tested and interviewer-administered questionnaire was used to collect the data. Data were analyzed using SPSS version 20. Descriptive statistics were done to summarize the data. A multivariate logistic regressions analysis method was employed and odds ratio with 95% confidence interval was used to control for possible confounders. P-value < 0.05 was used to declare a significant association. RESULTS: The total demand for modern methods of contraceptive was 450 (77.1%) of which 325 (55.7%) of them were current user and 125 (21.4%) of them were had unmet need for modern contraceptive methods. Being in the younger age group (15-24 and 25-34 years [AOR = 0.196; 95% CI: 0.055, 0.692] and [AOR = 0.179, 95% CI: 0.043, 0.745] respectively, husband having no intention for more children [AOR = 4.124, 95% CI: 1.891, 8.996], number of children alive [AOR = 2.617, 95% CI: 1.056, 6.486], and couples ever not discussed on family planning [AOR = 0.340, 95% CI: 0.187, 0.619] were factors associated with demand for modern methods of contraception. CONCLUSION: The total demand for modern methods of contraceptive was high in the study area except for long-acting and permanent methods with high unmet need for spacing than for limiting. Therefore, any program aimed at promoting family planning at the district level should look for ways and means of increasing demand for long-acting and permanent family planning methods and encouraging husband involvement to increase its utilization.

Coverage assessment survey following trachoma mass drug administration (MDA) in six districts of Oromia, Western Ethiopia, 2017.

BACKGROUND: Trachoma is a contagious infection of the eye by specific strains of the bacteria Chlamydia trachomatis. It is the leading cause of blindness worldwide. Mass drug administration (MDA) with azithromycin is a cornerstone of World Health Organization (WHO)'s global effort to eliminate trachoma by 2020. This coverage survey was aimed to assess trachoma post-mass drug administration (MDA) coverage among six selected districts of East Wollega, Horo Guduru Wollega, and West Shewa zones in2017. METHODS: A community based cross-sectional coverage survey was conducted. The sample size was calculated automatically using Coverage Survey Builder (CSB) tool in microsoft excel. Thirty segments were selected per each selected districts of the three zones. A separate Results Entry Form for each district surveyed was completed, saved and uploaded directly into the online Coverage Survey Analysis Tool to estimate the surveycoverage and the program reach along with the corresponding 95% confidence limits and design effects. EPI-INFO 7.0 and SPSS version 20 was used for further analysis of survey data. RESULT: A total of 1,747 households were surveyed, out of which 10,700 individuals were interviewed. Most respondents (95.1%) stated that they heard about trachoma MDA and most of them replied that they got the information from health workers. Program reach ranged between 89.5% in Jimma Geneti district and 94.8% in Dirre Hinchini district. The most common mentioned reasons for not having taken azithromycin included not knowing about the campaign, fear of side effects and being absent during the MDA campaign. CONCLUSION: In this survey, four of the six districts met the target threshold (i.e. 80%) for effective coverage; Ambo rural and Jimma Geneti did not meet the target threshold.Therefore, programmatic improvements should be made for the future campaign to reach the expected thresholds while the campaign in four of the six districts should be encouraged.

Medication Adherence and Associated Factors among Chronic Heart Failure Clients on Follow Up Oromia Region, West Ethiopia.

BACKGROUND: Chronic heart failure is a complex clinical syndrome with typical symptoms that can occur at rest or on effort. It requires patients to manage their lifestyle with their disease and when to notify their healthcare provider. The study was aimed to identify medication adherence and associated factors among chronic heart failure clients on follow up Oromia region, West Ethiopia, 2017. METHODS: Institutional based cross-sectional study design was employed, after selecting three hospitals by lottery method and allocating respondents to the three hospitals proportionally. A total of 424 patients were admitted to the medical ward and/or chronic follow up of Nekemte referral, Gimbi, and Shambu hospitals. The data was collected using a structured questionnaire. The data was entered into Epi-data version 3.1, cleared, explored, and then exported to SPSS windows version 24.0 for further analysis. Variable having a p-value less than 0.05 in the bivariate analysis was a candidate for multivariable analysis and the effect of confounding variables was observed. Variables having a p-value less than 0.05 in the multivariable analysis were assumed significant. RESULTS: A total of 424 respondents were included in the final analysis giving a 95.3% response rate. The result indicated that more than half of the study participants have adhered to prescribed medication. Respondents with good medication adherence were more likely to adhere to good self-care behavior [AOR (95% CI of OR) = 3.5(2.044, 5.96)]. Respondents whose limited fluid intake was one or half-liter per day were more likely to adhere to the medication [AOR (95% CI of OR) = 2.5(1.43, 4.49)]. It was also found that those patients who avoided spices, sauces and others in food are more likely to adhere to the medication [AOR (95% CI of OR) = 2.2 (1.152, 4.039)]. CONCLUSION AND RECOMMENDATION: Even if more than half of the study respondents have good medication and self-care adherence, still it needs great attention in health education over their visit. Health institutions are strongly recommended to give health education for clients and researchers to use advanced study design for measuring medication adherence and self-care behaviors.

Delivery Site Preferences and Associated Factors among Married Women of Child Bearing Age in Bench Maji Zone, Ethiopia.

BACKGROUND: Efforts to reduce maternal mortality and morbidity must address societal and cultural factors that affect women's health and their access to services. There was no research conducted previously on delivery site preferences and associated factors among married women of child bearing age in the study area. The aim of this study was to assess the delivery site preferences and associated factors among women of child bearing age in Bench Maji Zone, Southwest Ethiopia. METHODS: A community based cross sectional quantitative study design supplemented by qualitative data was conducted from April 20 to May 20, 2013. Simple random sampling to select kebeles and systematic random sampling to contact eligible woman were used. Data was collected using structured questionnaire. Data was analyzed by using SPSS version 16. Logistic regressions analysis was employed to identify potential predictor variables. Odds ratio with 95% confidence interval was used to assess the association of variables. P-value less than 5% was used to declare significant association. RESULTS: Three hundred five (61.9%) of the mothers gave birth at home. Three Hundred ninety six (78.7%) of them had Ante natal care. The preference of facility delivery was 412(88.3%). Age of women, mothers' educational level, and place of delivery of the last baby, perception of mothers about pregnancy and health care workers significantly affected delivery site preference. CONCLUSION: Most of the women attended Ante natal care. However, only some had actually delivered at health facilities to their last pregnancy. Community members should get health education to reduce misconceptions on delivering in health facility.