Disparities in satisfaction among insured and uninsured adult outpatient department service users in Southern Ethiopia, 2022: a comparative cross-sectional study.

BACKGROUND: Patient satisfaction is a critical measure of the quality of healthcare services provided by healthcare facilities. However, very few studies, particularly in Ethiopia, which includes the study area, have specifically examined these discrepancies among people who use outpatient care. In this study, satisfaction levels and associated factors were compared between insured and uninsured patients receiving outpatient services at public health institutions in Hadiya Zone, southern Ethiopia. METHODS: A facility-based comparative cross-sectional study design was employed on 630 patients using multistage and systematic random sampling. Data were collected using a pretested and structured interviewer-administered questionnaire. Results of the analysis were presented in text, tables, and graphs as appropriate. Multivariable logistic regression was used to predict associations between predictors and the outcome variable. Statistical significance was declared at p-value < 0.05. RESULTS: Overall, 344(55.48%) patients were satisfied with the service they received, of which 206(65.8%) out of 313 with a 95% CI [60.7-71.2%] were insured and 138(44.95%) out of 307 with a 95% CI [39.4-5.1%] were uninsured. Among insured patients, factors associated with higher satisfaction included having a family size less than five members [AOR = 3.3, 95% CI; 1.5, 7.4], perceived fair waiting time to be seen[AOR = 2.35, 95% CI; 1.02, 5.5], perceived short waiting time to be seen[AOR = 8.12, 95% CI; 1.6, 41.3], having all ordered laboratory tests available within the facility[AOR = 7.89, 95% CI; 3.5, 17.5], having some ordered laboratory tests within the facility[AOR = 2.97, 95% CI; 1.25, 7.01] having all prescribed medications available within the facility[AOR = 16.11, 95% CI; 6.25, 41.5], having some prescribed medications available within the facility[AOR = 13.11, 95% CI; 4.7, 36.4]. Among non-insured patients, factors associated with higher satisfaction included urban residency, a fair and short perceived time to be seen, having ordered laboratory tests within the facility, and having prescribed drugs within the facility. CONCLUSION: This study identified lower overall satisfaction, particularly among uninsured patients. Enrollment in the CBHI program significantly impacted satisfaction, with both groups reporting lower levels compared to enrollment periods. Access to essential services, wait times, and socio-demographic factors identified as associated factors with patient satisfaction regardless of insurance status.

Prevention of mother-to-child transmission screening among pregnant women in southern Ethiopia from the perspective of the current WHO recommendation.

Objective: The aim of this study was to assess HIV screening for prevention of mother-to-child transmission service utilization and associated factors among pregnant women in Hadiya zone, Southern Ethiopia. Methods: The study was conducted in a community setting and was cross-sectional with a multistage sampling technique. A total of 613 women were selected randomly from 29 kebeles (the smallest administrative unit next to the district). Data were collected using a standardized interviewer-administered questionnaire. After being coded, reviewed, and entered into Epi-data, the data were exported to SPSS Version 21. Frequencies, percentages, graphs, and means and standard deviations were used to show descriptive data. In bivariate analysis, a p-value of 0.25 was utilized to identify candidate variables for multivariable logistic regression analysis. The statistical significance level was established at 0.05, and the strength of the association was measured using an adjusted odds ratio. Results: A total of 613 pregnant women out of 630 who were eligible, were included in our study. Among them, 276 (45%; 95% CI: 41.1-48.8) were tested for HIV. HIV screening was associated with secondary and higher maternal educational level (AOR = 5.01, 95% CI: (3.08-8.16)), number of antenatal care visits four and higher (AOR = 4.25, 95% CI: 2.41-7.51), distance from health facility (AOR = 1.93, 95% CI: 1.24-3.101), and male partner involvement (AOR = 1.88, 95% CI: 1.31-2.69). Conclusion: Less than half of the pregnant women included in our study had been tested for HIV; which was quite lower than the national requirement that every pregnant woman be tested during a visit. Only those who had a higher level of education, who regularly took antenatal care, who were not far away from the health facility, and whose partner was involved in antenatal care, were more susceptible to being tested. Thus, actions such as female education and increasing accessibility of the service should be prioritized.

Partograph Utilization and Associated Factors among Obstetric Care Providers at Public Health Facilities in Hadiya Zone, Southern Ethiopia.

BACKGROUND: A partograph is a graphic representation of labor which is used by health professionals for monitoring labor progress and fetal and maternal wellbeing. However, its utilization and associated factors have not been studied yet in Hadiya Zone, Southern Ethiopia. Hence, the aim of this study was to determine partograph utilization and associated factors among obstetric care providers at public health facilities in Hadiya Zone, Southern Ethiopia. METHODS: A facility-based cross-sectional study was conducted on 436 health professionals. The study was conducted from March 04 to April 07, 2019. A simple random sampling method was carried out to select 19 health facilities and study participants from selected facilities. Data was collected using a pretested structured questionnaire, entered into EPI-data version 3.1 and exported to Statistical Package for Social Sciences (SPSS) version 20. Descriptive statistics and binary and multivariable logistic regression analyses were done. P values less than 0.05 were used to declare significant association between dependent and independent variables. RESULTS: The overall magnitude of partograph utilization was found to be 54.4%, and finding from data abstraction from a document revealed that out of 18 parameters, only 10 parameters were recorded completely. Type of health facility (hospital as compared to HC) (AOR = 2.96; CI = 1.71, 5.12), received on-the-job training on partograph (AOR = 7.06; CI = 4.3, 11.37), knowledgeable about partograph (AOR = 2.12; CI = 1.3, 3.9), and favorable attitude toward partograph use (AOR = 1.8; CI = 1.12 - 2.97) were significantly associated with partograph use. CONCLUSION: Overall partograph utilization was low, and incomplete recording of required parameters on partograph was observed in this study. Participants who received on-the-job training on partograph, who are working in a hospital, who are knowledgeable about partograph, and who have favorable attitude toward partograph use were factors affecting partograph use positively.

Practice and Associated Factors of Health Professionals towards Citizens' Charter at Jimma University Medical Center.

BACKGROUND: Citizens' Charter is a public promise between citizens and service providing organizations which visibly specifies expectations and standards in the service delivery. Citizens' charter standard has been implemented in Jimma University Medical Center since 2016/17. However, the practice and associated factor of citizens' charter among health professionals have not been studied yet. Hence, the aim of this study was to assess the practice of citizens' charter and associated factors among health professionals. METHODS: Facility based cross-sectional study was conducted on 389 health care providers, selected through stratified sampling, from April 1 to April 26. Data was collected using a pretested structured self-administered questionnaire. Data were entered into EPI-data version 3.1 and exported to Statistical Package for Social Sciences (SPSS) version 20. Descriptive statistics, binary and multivariable logistic regression analysis were done. P-values less than 0.05 were used to declare significant association between dependent and independent variables. In the process of multivariable logistic regression analysis, knowledge and attitude variables were not tested due to low number of respondents to those specific variables' measuring items. Hence, it was difficult to declare as a predictor at bivariate analysis. RESULT: For this study, the response rate was 92%. Out of all, 237(60.9%) professionals were properly practicing citizens' charter standard while 152(39.1%) were not properly practicing it. The factors affecting the practice were job satisfaction [AOR =7.4, 95%CI (4.4, 12.5)], perceived workload [AOR =1.8, 95%CI (1.05, 3.0)] and type of profession [AOR=5.4, 95%CI ((1.98, 14.8)]. CONCLUSION: This study revealed that more than half of the respondents properly practiced citizens' charter. However, few health professionals only knew the existence of citizens' charter. Job satisfaction, perceived workload, and type of profession were the factors affecting the practice of citizens' charter.