Utilization of preconception care and associated factors among pregnant mothers in Fiche Town, Central Ethiopia: a community-based cross-sectional study 2021.

Introduction: Preconception care is an important preventive intervention for adverse pregnancy outcomes. It is recognized as a strategy to optimize women's health and pregnancy outcomes in Western countries. However, preconception care is underutilized in sub-Saharan Africa, like Ethiopia, where maternal mortality is high. Evidence is scarce in the study area about the prevalence and factors associated with preconception care utilization. Therefore this study aimed to assess the proportion of preconception care utilization and associated factors among pregnant mothers in Fiche town, central Ethiopia, 2021. Method: A community-based cross-sectional study was done from May 10 to June 25, 2021. A systematic random sample technique was used to choose 393 pregnant women for the study. A structured, pre-tested, interviewer-administered questionnaire was used to collect data. The data were entered into Epi Data version 3.1 and then exported into SPSS version 25 for analysis. A Bivariable and multivariable logistic regression analysis was used to check for the association. Odds ratio along with 95% was used to describe the association. Finally, a significant association was declared at a p-value less than 0.05. Results: 388 respondents participated in this study, making the response rate 98.7%. Of total study participants only 84 (21.6%; 95% CI, 18, 25.8) utilized preconception care. The study found that diploma or higher level of education (AOR = 3.47, 95% CI: 1.27, 9.53), psychological and financial support from a partner (AOR = 3.86, 95% CI: 2.1, 7.10), joint discussion and plan with a partner (AOR = 3.32, 95% CI: 1.55, 7.13), history of chronic disease (AOR = 3.47, 95% CI: 1.67, 7.25), and good knowledge about preconception care (AOR = 2.42, 95% CI: 1.34, 4.38) were significantly associated with preconception care utilization. Conclusions: Overall, less than a quarter of the pregnant mothers utilized preconception care, indicating that awareness is very low. Pregnant mothers who have a higher educational level, have good communication and support from their partners, have chronic health problems, and have good knowledge about preconception care were more likely to utilize the service. Preconception care is a better opportunity to intervene and maintain the mother in the continuum of care.

Why intrauterine device (IUD) utilization is low in southwestern Ethiopia. A mixed-method study.

INTRODUCTION: An intrauterine device (IUD) is a highly effective long-acting and reversible contraceptive method widely available around the world. However, only a small proportion of women in developing countries, including Ethiopia, are currently using the method. Therefore, this study aimed to identify why IUD utilization is low in southwestern Ethiopia. MATERIAL AND METHODS: A mixed-method study involving health facilities and communities was conducted. The focus group discussions and key informant interviewees for the qualitative study were selected purposively, whereas 844 women family planning users were selected using systematic random sampling from November 1-30, 2020. Quantitative data was collected using Open Data Kit and analyzed using Stata version 16.0. Multivariable logistic regression analyses were done to identify significant factors influencing IUD use. The qualitative data were tape-recorded, transcribed, and finally, thematic analyses were done. RESULTS: A total of 784 participants were involved in the study yielding a response rate of 92.9%. Among all respondents, only 1.3%, 2.4%, and 30.0% had been using an IUD, preferred an IUD, and had the intention to use an IUD, respectively. The main reported barriers to use an IUD among qualitative participants were fear of side-effects, religious prohibitions of contraception use, husband disapproval, lack of training by health workers, misconceptions, and longer duration of use. IUD information (AOR = 2.19 [CI: 1.56-3.08]), and rich wealth status (AOR = 1.70 [CI: 1.13-2.56]) were associated with the intention to continue or start to use an IUD. CONCLUSIONS: IUD use and information on IUDs in the study area was very low. Information about IUDs, wealth status, and partner disapproval were determinant factors for intention to use an IUD. Thus, a regular awareness creation program using accessible media platforms by the government and stakeholders on IUD use is necessary to provide reliable information to the community and resolve misconceptions. In addition, women's empowerment to balance partner dominance on decision-making of contraception use and health care worker training on long-acting reversible contraceptives (LARCs) to increase access to LARC services are necessary to increase uptake of LARCs in general and of IUDs, in particular in the study regions.

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.

Adherence to Antiretroviral Treatment and Associated Factors among Seropositive People Received Treatment in Jimma Town Public Health Facilities, Ethiopia.

Background: Drug adherence is the most significant in the progression of diseases. Thus, this study aimed to assess adherence and associated factors among seropositive people received treatment. Methods: Facility-based cross-sectional study was conducted in Jimma town public health facility from March to April 2019 on 385 selected participants. Systematic sampling technique was used to select study participants. The data were entered using Epi-data version 4.1 and analyzed by SPSS version 20 software. Variables with p-value of less than 0.25 in binary logistic regression were entered into the multivariable logistic regression to control cofounding A significance level of less than 0.05 was used in the final model to judge statistical significance. Results: The magnitude of adherence to antiretroviral treatment was 69.4%. Food security (AOR = 1.75 (95% CI;(1.01-3.0), substance abuse (AOR = 0.55 (95% CI;(0.32-0.96), Didn't take other medications (AOR = 2.11(95%CI;(1.15-3.87), Good relationship with providers (AOR = 3.35(95%CI;(1.55-7.2), and irregular appointment (AOR = 0.19(95%CI; (0.11-0.34) were significantly associated. Conclusion: The magnitude of adherence to Anti-retroviral therapy was low compare to WHO. Food security, substance abuse, use of other medication, relationship with the health care providers, and irregular appointment were the factors associated. Treatment. Therefore, it is recommended that patients and health care workers enhance Antiretroviral Treatment adherence.

The Relationship Between Organizational Commitment and Organizational Justice Among Health Care Workers in Ethiopian Jimma Zone Public Health Facilities.

BACKGROUND: The healthcare service sector is confronting a global labor shortage. Despite this fact, health care professionals are still highly vulnerable to organizational injustice, which negatively influence organizational commitment, putting an additional burden on the health sector. Thus, this study aimed to investigate the correlation between organizational commitment and organizational justice among health care workers. METHODS: Facility-based cross-sectional study design was conducted among 395 health care professionals in the Jimma zone. Four Hospitals and 10 health centers were involved in the study randomly. The sample was distributed proportionally based on the number of health care workers. To select individuals, a systematic random sampling method was employed. Data were collected through self-report questionnaire using modified Alan and Mayer scale to measure organizational commitment and Niehoff and Moorman scale to measure organizational justice. The validity of the tools was checked using the reliability coefficient alpha and it was >0.7. The collected data were cleaned and entered into EpiData software version 3.1 and exported to SPSS version 20 for analysis. Descriptive and inferential statistics were done. RESULTS: This study revealed that 212 (53.7%) of the respondents scored a low level of organizational commitment. About half of the participants, 202 (52.2%), judged organizational justice were fair. All organizational justice dimensions showed a positive and significant correlation with all organizational commitment dimensions. Thus, the finding revealed that overall organizational commitment and organizational justice had a strong and positive correlation (r = 0.695**, P < 0.01). From the regression analysis distributive justice (B = 0.382, 95% CI: 0.31-0.45), and procedural justice (B = 0.17, 95% CI: 0.06-0.283) were among the factors affecting organizational commitment. CONCLUSION AND RECOMMENDATION: This study showed a strong link between organizational commitment and organizational justice. This suggests that organizational justice has been recognized as a motivator and factor influencing health care workers' organizational commitment. As a result, enhancing organizational justice can help to maintain the commitment of healthcare workers and the facility's capabilities.

Trends and Determinants of Small Birth Weight in Ethiopia: Further Analysis of Ethiopian Demographic and Health Surveys.

BACKGROUND: Globally, Low Birth Weight (LBW) prevalence is estimated to be 14.6%. It is a major cause of neonatal mortality in developing countries including Ethiopia. Despite extensive institution-based studies in Ethiopia, there is no comprehensive study using countrywide data. Thus, this study aimed to investigate trends and determinants of Small Birth Weight (SBW) among under-five children in Ethiopia. METHODS: Under-five children data from 2000, 2005, 2011, and 2016 Ethiopian Demographic and Health Surveys (EDHS) were used. However, only 2787 children were weighed at birth and used for analysis in this study. Descriptive statistics and the logistic regression model were used to determine trends and determinants of SBW respectively. RESULTS: The prevalence of SBW increased from 7.0% (95% CI; 3.1-10.0) to 13.2% (95% CI; 11.4-15.0) between 2000 and 2016. The odds of SBW increased by being a female child (AOR 1.50; 95% CI [1.07-2.09]), mother's with partner occupation of agriculture (AOR 1.54; 95% CI [1.05-2.26]) and mothers who did not know their partner's occupation (AOR 7.35; 95% CI [1.96-27.48]). However, infants born to mothers with primary (AOR 0.43; 95% CI [0.29-0.65]), secondary (AOR 0.30; 95% CI [0.16-0.55]) and higher (AOR 0.55; 95% CI [0.31-0.97]) educational status versus no education and grandmultiparous mothers (OR 0.39; 95% CI [0.19-0.78]) versus primiparous had lower odds of SBW. CONCLUSION: In Ethiopia, during the survey period, there was an increment in prevalence of SBW, and maternal related factors were significant determinants. Therefore, empowering mothers through education and improving the socioeconomic status of the household can be one strategy to reduce SBW.

Quality of integrated community case management services at public health posts, Southwest Ethiopia.

PURPOSE: The purpose of this study is to assess the quality of an integrated community case management service (ICCM) and associated factors at health posts in Ethiopia. DESIGN AND METHODS: Institution-based cross-sectional study design was conducted in the health posts of Jimma zone. Data were collected using a structured questionnaire and in-depth interviews. Binary logistic regression was used to identify independent predictors of client satisfaction on services and the qualitative data were presented by triangulating with quantitative findings. RESULTS: This study indicated that 80%, 65% and 55% of health extension workers (HEW) correctly assessed cases, classified cases and prescribed drugs of ICCM cases respectively. Some caregivers (40.2%) knew about danger signs which they heard from HEWs (81.9%). More than one-fourth (29.01%) of caregivers reported that their children were exposed to illness like diarrhea (39.1%) in the last two weeks. HEWs have demonstrated to a large number of caregivers (66%) how to give medications. Being a housewife [AOR = 0.17(0.05,0.56)], having a farmer husband[AOR = 3.77(1.09,12.98)] and having a government employed husband [AOR = 5.32(1.03,27.48)] were significantly associated with ICCM services. CONCLUSIONS: More than half of health extension workers correctly assessed, classified and prescribed drugs for ICCM cases. Some caregivers knew about danger signs which the majority of them heard from health extension workers. Being a housewife and paternal occupation were significantly associated with clients' satisfaction in ICCM services. PRACTICE IMPLICATIONS: Findings of this study can be used to guide the development of programs to improve integrated community case management service in Ethiopia by informing policymakers and other stakeholders about challenges of ICCM services.

Institutional Delivery Among Young Women in Ethiopia: Further Analysis of Trends and Determinants, from the Four Consecutive Ethiopia Demographic and Health Survey.

PURPOSE: Although young people have a right to sexual and reproductive health, they are facing inadequate access to information and services. The Ethiopian government has started implementing policies and strategies to eliminate inequalities in reproductive health service use. However, there are huge disparities in institutional delivery utilization between different age groups. Therefore, this study aimed to explore trends and factors associated with institutional childbirth among young women in Ethiopia. METHODS: Ethiopian demographic and health survey data (EDHS) from 2000 to 2016 surveys were used. Data on the most recent births to women aged 15-24 years that occurred in the 5 years preceding the survey period were extracted. All the four EDHS data were used to examine trends of institutional delivery, whereas determinants for institutional delivery were analyzed from a 2016 dataset by using multivariable logistic regression analysis. FINDINGS: Between 2000 and 2016, the proportion of institutional delivery among young women increased from 6% (95% CI=3.7-6.5%) to 40.1% (95% CI=30.6-44.3%). The odds of institutional delivery increased for young women who had attended secondary and above education (AOR=2.68; 95% CI=1.559-4.607), started ANC visits early (AOR=1.518; 95% CI=1.095-2.105) and received four or more ANC visits (AOR=1.87; 95% CI=1.370-2.561). However, the odds were lower among young women who had two (AOR=0.31; 95% CI=0.185-0.514), and three or more children (AOR=0.62; 95% CI=0.452-0.849). CONCLUSION: There is an increase in trend of institutional delivery among young women during the 2000 to 2016 EDHS. Having higher educational levels, early ANC booking, and attending four or more ANC visits were positively associated with institutional delivery. Increased number of children is negatively associated with institutional delivery. Strengthening strategies for improving girls' education and addressing their socioeconomic and demographic vulnerabilities, and strengthening strategies being implemented for encouraging early and recommended ANC visits is crucial.

Prevalence of Self-Reported Symptoms of Sexually Transmitted Infection among Establishment-Based Female Sex Workers in Ethiopia.

INTRODUCTION: In spite of the fact that female sex workers being regarded as core transmitters of sexually transmitted infections to the general population, previous studies undertaken around STIs in Ethiopia fail to consider this segment of the population. Hence, the present study investigated the prevalence of self-reported symptoms of STIs and the risk factors among FSWs in Adama Town, Ethiopia. METHOD: A cross-sectional study was conducted from May 01, 2017, to April 30, 2017, in Adama Town. Three hundred ninety female sex workers were selected from 120 licensed drinking establishments by using simple random sampling technique. The interviewer-administered structured tool was used to collect data. Data were entered using EPI data version 3.1 and exported to SPSS version 20 for analysis. Bivariate and multivariable logistic regression analyses were used to identify factors associated with the outcome variable. RESULT: Among the requested 423 female sex workers, 390 willingly responded to the interviewer-administered structured questionnaires making a response rate of 92.2%. One hundred thirty-nine (35.6%, 95% CI (33.8%-37.4%) of the female sex workers reported one or more STI symptoms. Several risk factors were identified including inconsistent condom use with a nonpaying client (AOR = 5.43, 95% CI: 2.73, 10.80), alcohol use before sex (AOR = 2.41, 95% CI: 1.35, 4.30), longer duration of sex work (AOR = 2.27, 95% CI: 1.26, 4.08), and having poor knowledge of STIs (AOR = 2.44, 95% CI: 1.31, 4.54). CONCLUSION: Self-reported symptom of STI among female sex workers in Adama Town is relatively high when compared with previous studies. Hence, health education programs should address the issue of inconsistent condom use with nonpaying clients, alcohol consumption before sex, and knowledge of STIs, with a particular emphasis on those female sex workers who stayed longer in the business.

Factors influencing decision-making power regarding reproductive health and rights among married women in Mettu rural district, south-west, Ethiopia.

BACKGROUND: Women's decision-making power regarding reproductive health and rights (RHR) was the central component to achieve reproductive well-being. Literatures agree that a women having higher domestic decision-making power regarding their health care were more likely to utilize health services. More than 80% of women in Ethiopia reside in rural areas where they considered as the subordinates of their husbands. This would restrict women to fully exercise their RHR. Thus, this study aims to determine the factors influencing the women's decision-making power regarding RHR in Mettu rural district, South West Ethiopia. METHODS: A community based cross-sectional study was done among 415 by using randomly selected married women of reproductive age from March to April 2017. Data was entered by using Epi-data manger 1.4 and analyzed by SPSS version 21. Descriptive and multivariate logistic regression analysis was carried out. RESULT: One hundred sixty-eight (41.5%) of the women had greater decision-making power regarding RHR. Woman's primary education AOR 2.62[95% C. I 1.15, 5.97], secondary (9+) education AOR 3.18[95% C. I 1.16, 8.73] and husband's primary education AOR 4.0[95% C. I 1.53, 10.42], secondary (9+) education AOR 3.95 [95% C. I 1.38, 11.26], being knowledgeable about RHR AOR 3.57 [95% C. I 1.58, 8.09], marriage duration of more than 10 years AOR 2.95 [95% C. I 1.19, 7.26], access to micro-credit enterprises AOR 4.26[95% C. I 2.06, 8.80], having gender equitable attitude AOR 6.38 [95% C. I 2.52, 12.45] and good qualities of spousal relation AOR 2.95 [95% C. I 1.30, 6.64] were positively influencing women's decision-making power regarding RHR. CONCLUSION: More than four in ten rural women had greater decision-making power regarding RHR. External pressures (qualities of spousal relation, gender equitable attitude) and knowledge about RHR were found to influence women's decision-making power. Public health interventions targeting women's RHR should take into account strengthening rural micro-credit enterprises, qualities of spousal relations and priority should be given to women with no formal education of husband or herself and marriage duration of < 5 years.

Factors associated with institutional delivery service utilization in Ethiopia.

BACKGROUND: Most obstetric complications occur unpredictably during the time of delivery, but they can be prevented with proper medical care in the health facilities. Despite the Ethiopian government's efforts to expand health service facilities and promote health institution-based delivery service in the country, an estimated 85% of births still take place at home. OBJECTIVE: The review was conducted with the aim of generating the best evidence on the determinants of institutional delivery service utilization in Ethiopia. METHODS: The reviewed studies were accessed through electronic web-based search strategy from PubMed, HINARI, Mendeley reference manager, Cochrane Library for Systematic Reviews, and Google Scholar. Review Manager V5.3 software was used for meta-analysis. Mantel-Haenszel odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated. Heterogeneity of the study was assessed using I (2) test. RESULTS: People living in urban areas (OR =13.16, CI =1.24, 3.68), with primary and above educational level of the mother and husband (OR =4.95, CI =2.3, 4. 8, and OR =4.43, CI =1.14, 3.36, respectively), who encountered problems during pregnancy (OR =2.83, CI =4.54, 7.39), and living at a distance <5 km from nearby health facility (OR =2.6, CI =3.33, 6.57) showed significant association with institutional delivery service utilization. Women's autonomy was not significantly associated with institutional delivery service utilization. CONCLUSION AND RECOMMENDATION: Distance to health facility and problems during pregnancy were factors positively and significantly associated with institutional delivery service utilization. Promoting couples education beyond primary education regarding the danger signs of pregnancy and benefits of institutional delivery through available communication networks such as health development army and promotion of antenatal care visits and completion of four standard visits by pregnant women were recommended.