Survival Status, Length of Stay, and Predictors of Mortality Among Neonates Admitted in the Neonatal Intensive Care Unit of Gurage Zone Public Hospitals.

Background: Many countries need to accelerate their progress to achieve the sustainable development goal target of neonatal death. It is still high in Ethiopia. Thus, this study aimed to assess the mortality predictors and length of hospital stay among Neonates admitted to the Neonatal Intensive Care Unit of Gurage zone public Hospitals. Method: In this study, a facility-based retrospective follow-up study was applied among 375 neonates admitted to the NICU of selected public hospitals in the Gurage zone from June 1, 2019 to June 30, 2021. The researchers used Epi-Data entry 3.1 for the data entry and then exported it to STATA version 14 for analysis. The Kaplan-Meier survival curve and log-rank test were used to estimate and compare the survival time of categorical variables, respectively. Result: The researchers observed about 85 (22.7% with 95%CI: 18.7, 27.2) deaths from the 2305 person-days follow-up. The median survival time was 14 days. The overall incidence density rate was 36.9 per 1000 person-days observed (95%CI: 29.8, 45.6). Perinatal asphyxia (AHR: 2.9[CI: 1.8; 4.8]), cesarean section as a mode of delivery (AHR: 1.1[CI; 1.01; 1.15]), maternal age of greater or equal to 35 years (AHR: 1.1[95% CI: 1.01, 1.15]), and twin pregnancy (AHR: 2.3[95% CI: 1.2, 4.3]) were predictors of neonatal mortality. Conclusion: The survival rate of neonates was higher compared to other studies. So, to reduce the burden of neonatal mortality, health care providers should give special attention to twin pregnancies, neonates delivered via cesarean section, and neonates with a problem of perinatal asphyxia.

Completion of the maternal continuum of care and its association with antenatal care attendance during previous pregnancy among women in rural areas of the Gurage Zone, Southwest Ethiopia: a community-based cross-sectional study.

OBJECTIVE: The maternal continuum of care is a cost-effective intervention to prevent pregnancy and childbirth-related maternal and neonatal mortality and morbidity. This study aimed to investigate the prevalence of completion of the maternal continuum of care and its association with antenatal care (ANC) attendance during previous pregnancy among women in rural kebeles of Gurage Zone, Southwest Ethiopia. DESIGN: A community-based cross-sectional study. SETTING: The study took place in 12 rural kebeles of the Gurage Zone from 1 April 2022 to 12 May 2022. PARTICIPANTS: Randomly selected 497 women who gave birth in the previous 12 months in rural kebeles of the Gurage Zone. OUTCOME: The outcome of this study was the prevalence of completion of the maternal continuum of care. RESULTS: Overall, the prevalence of completion of the maternal continuum of care was 15.5% (95% CI: 12.55% to 18.9%). After adjusting for potential confounders, having ANC attendance during a previous pregnancy (adjusted OR (AOR): 2.01; 95% CI: 1.07 to 3.76) was positively associated with the completion of the maternal continuum of care. In addition, having access to ambulance service as a means of transportation (AOR: 6.01; 95% CI: 3.16 to 11.39) and exposure to mass media (AOR: 2.43; 95% CI: 1.27 to 4.68) were positively associated with completion of the maternal continuum of care. CONCLUSION: The prevalence of completion of the maternity continuum of care was unacceptably low in this study. This result indicates that the women did not receive the maximum possible health benefit from existing maternal healthcare services. The completion of the maternal continuum of care was affected by ANC attendance in a previous pregnancy. Therefore, interventions that can strengthen ANC are crucial in the maternal continuum of the care pathway.

Low back pain and associated factors among obstetrics care providers in public hospitals of Amhara Regional State, Ethiopia: a cross-sectional study.

OBJECTIVES: Although the study of low back pain (LBP) among healthcare workers in Ethiopia is becoming common, it mainly focused on nurses leaving obstetrics care providers aside. The objective of this study was to assess the prevalence and associated factors of LBP among obstetrics care providers in public hospitals in Amhara Regional State, Ethiopia. DESIGN: An institution-based cross-sectional study. SETTINGS: The study settings were nine public hospitals in Amhara Region. PARTICIPANTS: Randomly selected 416 obstetrics care providers working in public hospitals in Amhara Region, Ethiopia. OUTCOMES: The outcomes of this study were the prevalence of LBP in the last 12 months among obstetrics care providers and its associated factors. RESULTS: Overall, the prevalence of LBP was 65.6% (95% CI 61.5% to 70.2%) among obstetrics care providers in the last 12 months.Female gender (AOR 2.33, 95% CI 1.344 to 4.038), not having regular physical exercise habits (AOR 8.26, 95% CI 4.36 to 15.66), job stress (AOR 2.21, 95% CI 1.24 to 3.92), standing longer while doing procedures (AOR 2.04, 95% CI 1.14 to 3.66) and working more than 40 hours a week (AOR 2.20, 95% CI 1.09 to 4.45) were significantly associated with LBP. CONCLUSION: About two-thirds of obstetrics care providers working in public hospitals in the Amhara region reported LBP. The prevalence of LBP was higher among those who did not have regular physical exercise habits, had job stress, stood longer than 1 hour while doing procedures, worked more than 40 hours a week and female obstetrics care providers. Providing resting periods, decreasing the working hours of obstetrics care providers in a week, and counselling on the importance of doing regular physical exercise help to reduce the prevalence of LBP.

Unintended Pregnancy and Associated Factors Among Women Attending Antenatal Care in Public Hospitals During COVID-19 Pandemic, Southwest Ethiopia: A Cross-Sectional Study.

BACKGROUND: COVID-19 pandemic directly or indirectly increases the burden of unintended pregnancy by limiting women's access to family planning and other reproductive health services. COVID-19 results in extra 15 million unintended pregnancies over a year. Almost all previous studies conducted about unintended pregnancy were before COVID-19 pandemic in Ethiopia. Therefore, the purpose of this study was to assess the prevalence and associated factors of unintended pregnancy during the COVID-19 pandemic among women attending antenatal care in public hospitals of southwest Ethiopia. METHODS: This study was cross-sectional and conducted among women attending antenatal care at public hospitals of southwest Ethiopia from June 14 to July 14, 2021. Data were collected using a face-to-face interview. Factors associated with unintended pregnancy were analyzed using binary and multiple logistic regressions with an adjusted odds ratio and 95% confidence interval. Finally, the p-value was used as a graded measure of evidence to quantify the degree of significance. RESULTS: A total of 405 women participated in this study. The overall prevalence of unintended pregnancy was 19.5% (95% CI: 1.44-6.92) among women attending antenatal care during COVID-19 pandemic. Of which, 50.6% were mistimed and 49.4% unwanted. Urban residence (AOR: 3.1 95% CI: 1.44-6.92) and not being primary decision-maker (AOR: 2.85 95CI: 1.18-6.88) had high significance with unintended pregnancy. Not having ANC in a previous pregnancy (AOR: 3.40; 95% CI: 1.02-11.94) and not being exposed to community education about maternal health care (AOR: 2.36; 95% CI: 1.06-5.27) had medium significance with unintended pregnancy. CONCLUSION: One-fifth of women attending antenatal care had unintended pregnancies during the COVID-19 pandemic. Efforts to scale up women's decision-making power on family planning services and access to community education are needed to prevent unintended pregnancy.

Maternal near miss among women admitted in major private hospitals in eastern Ethiopia: a retrospective study.

BACKGROUND: Since maternal mortality is a rare event, maternal near miss has been used as a proxy indicator for measuring maternal health. Maternal near miss (MNM) refers to a woman who nearly died but survived of complications during pregnancy, childbirth or within 42 days of termination of pregnancy. Although study of MNM in Ethiopia is becoming common, it is limited to public facilities leaving private facilities aside. The objective of this study was to assess MNM among women admitted in major private hospitals in eastern Ethiopia. METHODS: An institution based retrospective study was conducted from March 05 to 31, 2020 in two major private hospitals in Harar and Dire Dawa, eastern Ethiopia. The records of all women who were admitted during pregnancy, delivery or within 42 days of termination of pregnancy was reviewed for the presence of MNM criteria as per the sub-Saharan African MNM criteria. Descriptive analysis was done by computing proportion, ratio and means. Factors associated with MNM were assessed using binary logistic regression with adjusted odds ratio (aOR) along with its 95% confidence interval (CI). RESULTS: Of 1214 pregnant or postpartum women receiving care between January 09, 2019 and February 08, 2020, 111 women developed life-threatening conditions: 108 MNM and 3 maternal deaths. In the same period, 1173 live births were registered, resulting in an MNM ratio of 92.1 per 1000 live births. Anemia in the index pregnancy (aOR: 5.03; 95%CI: 3.12-8.13), having chronic hypertension (aOR: 3.13; 95% CI: 1.57-6.26), no antenatal care (aOR: 3.04; 95% CI: 1.58-5.83), being > 35 years old (aOR: 2.29; 95%CI: 1.22-4.29), and previous cesarean section (aOR: 4.48; 95% CI: 2.67-7.53) were significantly associated with MNM. CONCLUSIONS: Close to a tenth of women admitted to major private hospitals in eastern Ethiopia developed MNM. Women with anemia, history of cesarean section, and old age should be prioritized for preventing and managing MNM. Strengthening antenatal care and early screening of chronic conditions including hypertension is essential for preventing MNM.