Community-based new born care practice and its associated factors among women who give birth at home in Ethiopia: cross-sectional study.

BACKGROUND: In Ethiopia, perinatal mortality rate was 33 per 1000 pregnancies and 64.4% of this death was occurred within the first 7 days of neonatal life. Moreover, more than 2.1% of new born babies were died within their first seven days of life in Ethiopia. Majority of neonatal deaths are preventable by applying an effective and lifesaving interventions. However, little is known about newborn care practice at the community level. METHODS: A community-based cross-sectional study design was used. Multi-stage sampling techniques were used to get a total of 540 mothers who gave birth at home within the past six months from their kebeles in Ethiopia. Data was collected by using face-to-face interview with structured questionnaires. Then the data was coded, cleaned, and entered into Epidemiological data version 3.1 and exported to statistical package for social science version 23.0 for analyses. Bivariate and multivariable logistic regression model was used to identify statistically significant associations between dependent and independent variables. The odds ratio at 95% confidence interval with P-Value 0.05% was computed. RESULTS: A total of 540 women were participated with a response rate of 98.3%. Only 208 (44%) of the women had good practice towards essential newborn care. Head of households [AOR (95%CI) 2.7417 (1.80-4.25)], type of birth attendant [AOR (95%CI) 3.962 (3.329-7.171)] and bad obstetrical history [AOR (95%CI) 3.151 (2.209-4.969)] were significantly associated with maternal newborn care practice. CONCLUSION: Less than half of the mothers had good newborn care practice. In this study, head of household, type of birth attendant, and bad obstetrical history were significantly associated with maternal newborn care practice. Therefore, Ministry of Women and Woreda women and Child offices needs to promote the socioeconomic empowerment of women to increase the practice of essential newborn care practices.

Asymptomatic Malaria and Helminths Coinfection and Its Association with Anemia among Primary School Children in Gedeo Zone, Southern Ethiopia: A Cross-Sectional Study.

BACKGROUND: Asymptomatic malaria and helminths coinfection occurs mainly in the tropics and subtropics where poverty and sanitary practice favor its high prevalence. In the tropics, where malaria is endemic, helminths also thrive resulting in coinfection. This study aimed to access the prevalence of asymptomatic malaria and helminths coinfection and its contribution for anemia in primary school children of Gedeo Zone, Southern Ethiopia. Methodology. This was a cross-sectional study conducted among 413 primary school children from February to April 2020. Finger-prick blood samples were used to determine asymptomatic malaria and hemoglobin concentrations. Stool samples were collected and processed through formalin-ether concentration techniques to detect the presence of intestinal helminths. Data were double entered into Epi Data version 3.1 software and exported to SPSS version 20 for analysis. Pearson's chi-square and correlation analysis were performed as part of the statistical analyses. RESULT: A total of 413 primary school children aged 6 to 16 years (mean age ± SD: 10.7 ± 2.64years) were enrolled in the study. 159 (38.5%) of school children were infected with at least one of the parasitic diseases. The overall prevalence of asymptomatic malaria and intestinal helminths was 46 (11.1%) and 113 (27.3%) respectively. Asymptomatic malaria and helminths coinfection was 29 (7%). Total of 39.1% of asymptomatic malaria-infected school children were anemic, which is statistically significant (P < 0.05). 15.9% of helminths-infected school children were anemic, not statistically significant (P > 0.05). The prevalence of anemia was 12 (41.3%) among coinfected students, which is statistically significant (P < 0.005). CONCLUSION: Asymptomatic malaria and helminths coinfection affects the health status of considerable number of primary school children in the study area. Therefore, simultaneous combat against the two parasitic infections is crucial to improve health of the school children.

Pulse oximeter with integrated management of childhood illness for diagnosis of severe childhood pneumonia at rural health institutions in Southern Ethiopia: results from a cluster-randomised controlled trial.

OBJECTIVE: To assess whether pulse oximetry improves health workers' performance in diagnosing severe childhood pneumonia at health centres in Southern Ethiopia. DESIGN: Parallel cluster-randomised trial. SETTING: Government primary health centres. PARTICIPANTS: Twenty-four health centres that treat at least one pneumonia case per day in Southern Ethiopia. Children aged between 2 months and 59 months who present at health facilities with cough or difficulty breathing were recruited in the study from September 2018 to April 2019. INTERVENTION ARM: Use of the Integrated Management of Childhood Illness (IMCI) algorithm and pulse oximeter. CONTROL ARM: Use of the IMCI algorithm only. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was the proportion of children diagnosed with severe pneumonia. Secondary outcomes included referred cases of severe pneumonia and treatment failure on day 14 after enrolment. RESULT: Twenty-four health centres were randomised into intervention (928 children) and control arms (876 children). The proportion of children with severe pneumonia was 15.9% (148 of 928 children) in the intervention arm and 3.9% (34 of 876 children) in the control arm. After adjusting for differences in baseline variables children in the intervention arm were more likely to be diagnosed as severe pneumonia cases as compared with those in the control arm (adjusted OR: 5.4, 95% CI 2.0 to 14.3, p=0.001). CONCLUSION: The combined use of IMCI and pulse oximetry in health centres increased the number of diagnosed severe childhood pneumonia. TRIAL REGISTRATION NUMBER: PACTR201807164196402.

Inadequate management of pneumonia among children in South Ethiopia: findings from descriptive study.

BACKGROUND: Health system support is crucial for quality child healthcare. Therefore, this baseline survey, which is part of the community-based management study of severe pneumonia, was conducted to assess the state of health system support of IMNCI and iCCM, and health workers' knowledge in managing childhood pneumonia at health facilities. METHODS: A survey was conducted in 99 government health institutions in South Ethiopia from 07 to 14 January, 2018. A questionnaire for health system support and case scenario for the management of severe pneumonia was adapted from the WHO health facility survey tool. The questionnaire's interview, facility observation, case scenario and retrospective record review were all used as data collection methods. Indicators of health system support in the context of an integrated management of childhood illness were used. Proportions for categorical variables and means for continuous variables were also computed for each indicator. Mean score was analysed for assessing the knowledge of health workers in managing the case scenario. RESULTS: In the study area, only 12 (34%) of health centres and 18 (29%) of health posts received supervision, which included the observation of case management. The mean number of essential oral antibiotics for the home treatment of pneumonia available at the facility was 1.1 (95% CI 0.9 to 1.3), whereas the mean number of pre-referral drugs for the treatment of severe pneumonia was 1.3 (95% CI 1.0 to 1.6). Approximately 47 (48%; 95% CI 37.7 to 57.3) of the surveyed health facilities had materials and equipment to support vaccination services, and 71 (72%; 95% CI 62.8 to 80.6) of them had the vaccines on the day of the survey. Only four (4%; 95% CI 0.3 to 8.3) of the health facilities had all the essential job aids and supplies for providing services for pneumonia. The providers' mean knowledge score for the management of severe childhood pneumonia was 14.9 out of 22 correct answers. CONCLUSION: There is a room to improve the health system support to integrated management of neonatal and childhood illness through supply chain management and knowledge of health workers in the management of severe pneumonia by providing training.