Determinants of Health Care Providers' Attitudes Toward Safe Abortion Care in Ethiopia: A Systematic Review and Meta-Analysis.

Background: Unsafe abortion is a serious reproductive health problem in developing countries including Ethiopia. The attitude of healthcare providers toward abortion is one of contributing factors to unsafe abortion. This study aimed to determine the pooled effect of healthcare workers' attitudes toward safe abortion care and its determinants factors in Ethiopia. Methods: Search engines such as Scopus, CINAHL, EMBASE, PubMed, Web of Science, and CAB Abstracts were used to find published studies where as Google and Google Scholar were used to find unpublished research. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. The analysis was performed using STATA 14 and the random-effects model was used to calculate the odds ratios of medical professionals' attitudes regarding safe abortion services. Study heterogeneity was assessed by using I2 and P-values. To evaluate the stability of pooled values to outliers and publication bias, respectively, sensitivity analysis and funnel plot were also performed. Results: A total of 15 published and unpublished articles with a sample size of 4060 were incorporated in this Review. The overall pooled prevalence of this study was 56% (95% CI: 45-67). Sex of participants (AOR: 2.37; 95% CI: 1.57, 3.58), having training (AOR: 2.86; 95% CI: 1.58, 5.17), Professional type (AOR: 1.55; 95% CI: 1.04, 4.46), and knowledge of abortion law (AOR:2.26; 95% CI: 1.14, 4.46) were the determinants factors that significantly associated with health care workers' attitude toward safe abortion care. Sensitivity analysis shows that the pooled odds ratios were consistently stable throughout all meta-analyses, and the funnel plot shows no evidence of publication bias. Conclusion: Half of health care providers sampled among the pooled studies have favorable attitudes toward abortion services in Ethiopia; which could hamper women's access to safe abortion care. Sex, training, type of profession, and knowing abortion law were determinants of health care workers' attitudes toward safe abortion services. Stakeholders should emphasize improving the attitude of healthcare workers toward safe abortion care which has a vital role in reducing maternal mortality. Moreover, working on modifiable factors like training, assigning personnel whose professions align with the service, and updating care providers about abortion law is also the essential key point to improve their intentions to deliver the services.

Diarrheal disease and associated factors among children aged 6 to 59 months in Oda Bultum District, Eastern Ethiopia: a community-based cross-sectional study.

BACKGROUND: Diarrhea is a serious health problem in children under the age of five that is both preventable and treatable. In low-income countries like Ethiopia, children under the age five years frequently experience diarrhea. However, the burden and associated factors of these diarrheal diseases are understudied in Eastern Ethiopia, Thus, this study aimed to determine the factors associated with the prevalence of diarrheal diseases in Eastern Ethiopia from September 1-30, 2022. METHODS: A cross-sectional study was conducted on the total of 602 children aged 6 to 59 months in Oda Bultum district in eastern Ethiopia. A multistage sampling method was used. Three kebeles were selected from nine kebeles by the lottery method. Data was entered into Epi data 4.0.2 and exported to SPSS version 21 for analysis. Descriptive analysis was used for frequency, mean, and standard deviations. In addition, bivariable, and multivariable Poisson regression model was used to identify predictors of diarrhea along with a 95% confidence interval. Finally, statistical significance was declared at a p-value of 0.05. RESULT: A total of 602 children were included in this study. The prevalence of diarrhea 7.4% (47/602), 95% CI; 5.5-9.7%) among the children. Factors such as being unvaccinated for any vaccine (AOR = 10.82, 95%CI; 4.58-25.48) and born from a mother who had medium level of empowerment (AOR = 0.34, 95%CI; 0.11-0.88) in the household had statistically significant association with diarrhea among the children compared to their counterparts. CONCLUSION: The study found that nearly one out of thirteen children aged 6 to 59 months had any form of diarrheal diseases in Oda Bultum District, Eastern Ethiopia. In addition, the study revealed that children who were vaccinated for their age developed diarrhea less likely compared to those who did not receive any form of vaccine for their age. Moreover, children with mothers who had a medium level of empowerment were less likely to get diarrhea than children with mothers who had a low level of empowerment.

Prevalence and adverse outcomes of twin pregnancy in Eastern Africa: a systematic review and meta-analysis.

INTRODUCTION: Multiple pregnancies are much more common today than they were in the past. Twin pregnancies occur in about 4% of pregnancies in Africa. Adverse pregnancy outcome was more common in twin pregnancy than in singleton pregnancy. There is no pooled evidence on the burden and adverse pregnancy outcome of twin pregnancy in eastern Africa. Thus, this systematic review and meta-analysis were conducted to assess the prevalence and adverse pregnancy outcomes of twin pregnancies. METHODS: This systematic review and meta-analysis covers published and unpublished studies searched from different databases (PubMed, CINAHL (EBSCO), EMBASE, DOAJ, Web of Sciences, MEDLINE, Cochrane Library, SCOPUS, Google Scholar, and Google search). Finally, 34 studies were included in this systematic review and meta-analysis. JBI checklist was used to assess the quality of included papers. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. Data synthesis and statistical analysis were conducted using STATA Version 14 software. Heterogeneity and publication bias were assessed. A forest plot was used to present the pooled prevalence using the random effect model. RESULTS: The prevalence of twin pregnancy in eastern Africa was 3% [95% CI: 2, 3]. The adverse pregnancy outcomes like neonatal intensive care unit admission (78%), low birth weight (44%), low APGAR score (33%), prematurity (32%), stillbirth (30%), neonatal mortality (12%) and maternal complications like hypertensive disorder of pregnancy (25%), postpartum hemorrhage (7%), Cesarean section (37%), premature rupture of membrane (12%) and maternal mortality are more common among twin pregnancy than singleton pregnancy. CONCLUSION: One in every 33 children born a twin in east Africa; admission to neonatal intensive care unit, low birth weight, low APGAR score, prematurity, stillbirth, neonatal mortality and maternal complications are its associated adverse birth outcomes. Since twin pregnancy is a high-risk pregnancy, special care is needed during pregnancy, labor and delivery to reduce adverse pregnancy outcomes.

Patterns of basic pneumococcal conjugated vaccine coverage in Ethiopia from 2015 to 2018; further analysis of Ethiopian DHS (2016-2019).

Background: Geographic variation is crucial in spotting performance gaps in immunization programs, including the Pneumococcal Conjugated Vaccine (PCV). This will help speed up targeted vaccination and disease elimination programs in resource-limited countries. Thus, this study aimed to investigate the geographic variation and determinants of PCV vaccination coverage among children aged under five years old in Ethiopia. Methods: This analysis was carried out based on the 2016 and 2019 nationally representative Ethiopia Demographic and Health Survey (EDHS). We included two surveys of 10,640 children aged 12-23 months. The spatial analysis also covered 645 and 305 clusters with geographical information for both 2016 and 2019, respectively. We explored the spatial distribution, global spatial autocorrelation, spatial interpolation, and Stats Can windows of children with PCV-3 vaccination. P-values were generated using 999 Monte Carlo simulations to identify statistically significant clusters. To understand the coverage of PCV-3 in all areas of the country, we employed the ordinary Kriging interpolation method to estimate the coverage in unsampled areas. We also used hierarchical multivariate logistic regression to identify the factors associated with the utilization of the PCV vaccine (full vaccination). Results: Except for Addis Ababa, children in all regions have lower odds of receiving all three PCV vaccines compared to the Tigray region. Residence, sex of a child, mother's literacy status, household wealth index, and place of delivery were significant factors associated with receiving the third dose of PCV. Spatial analysis also showed the Somali and Afar regions had the lowest coverage, while the Addis Ababa and Tigray regions had higher coverage in both surveys. Conclusion: Even though the coverage of the full PCV vaccine improved from 2016 to 2019, variation was observed among regions and between rural and urban areas. The wealth index and educational status of mothers were the most important determinants of PCV vaccine utilization. Hence, the mass campaign might boost coverage in nomadic and semi-nomadic regions and rural areas. Similarly, programs that narrow the gap due to low socioeconomic differences should be formulated and implemented to increase uptake and general coverage.

The burdens, associated factors, and reasons for traditional uvulectomy in Ethiopia: A systematic review and meta-analysis.

INTRODUCTION: Traditional uvulectomy is a harmful procedure in which the entire or a portion of the uvula is removed by traditional practitioners. It causes complications like septicemia, transmission of infectious diseases, anemia, excessive bleeding, infection, tetanus, meningitis, and death. A summary of national data was lacking, thus, the study aimed to determine the pooled national burden and determinants of traditional uvulectomy in Ethiopia. METHODS: Studies were retrieved from PubMed, EMBASE, CINHAL (EBSCO), Google Scholar, Web of Sciences, MEDLINE, Cochrane Library, SCOPUS, and Google databases. Finally, 19 studies were included. The methodological quality of the included studies was assessed using the JBI checklist. Data synthesis and statistical analysis were conducted using STATA Version 17 software. Heterogeneity and publication bias were assessed. Forest plots were used to present the pooled and summarized with random-effects meta-analysis models. RESULTS: Totally 19 articles with 23,559 study participants were included in this systematic review and meta-analysis. The overall pooled prevalence of uvulectomy in Ethiopia was 44 % (95 % CI: 31%-57 %). The highest prevalence was observed among studies conducted in the Tigray region (63 % (95 % CI: 34%-94 %), between the year 2011-2014 (58 % (95 % CI: 29%-87 %)) and, community setting (57 % (95 % CI: 36%-78 %). Mothers' educational status (AOR: 1.66, 95 % CI: 1.31-2.01) and residence (AOR: 1.70, 95 % CI: 1.16-2.23) were found to be significantly associated with traditional uvulectomy in Ethiopia. Frequently cited reasons for traditional uvulectomy were to prevent swelling, pus, and rupture of the uvula, for better care, prevention of sore throats and coughs, religion, and culture. CONCLUSION: The pooled result revealed that almost half of children are still subjected to traditional uvulectomy in Ethiopia. There is a need to intensify awareness creation campaigns against the practice by giving special attention to rural residents and uneducated ones.

Predictor of anemia among pregnant women attending antenatal clinics at Hiwot Fana Comprehensive Specialized Hospital, Eastern Ethiopia: a case-control study.

BACKGROUND: Anemia during pregnancy is a public health problem and is related to negative birth outcomes, especially in developing countries. The main aim of this study was to assess predictors of anemia among pregnant women attending antenatal clinics at Hiwot Fana Comprehensive Specialized University Hospital, Eastern Ethiopia. METHODS: Unmatched case-control study design was employed among 352 individuals. A face-to-face interview was used to gather data, and each pregnant woman's antenatal care follow-up record cards were reviewed in addition to the interview. EpiData version 3.1 and IBM SPSS version 26 was used for data entry and analysis, respectively. Bivariable and multivariable analyses were conducted to identify predictors of anemia, a p-value of <0.05 was considered a statistically significant association. RESULT: The common determinants for anemia in pregnant mothers were: rural residency (AOR = 2.25, 95% CI: 1.14-4.8), no formal education (AOR = 4.4, 95% CI: 1.94-9.9), inter-pregnancy interval (AOR = 2.7, 95% CI: 1.24-5.8), and mid-upper arm circumference (AOR = 5.0, 95% CI: 2.0-12.7). CONCLUSION: In this study, the identified determinant factors for anemia were: rural residency, maternal educational status, inter-pregnancy-interval, and mid-upper arm circumference. Therefore, providing health education and promotion for pregnant women regarding anemia by focusing on rural residents and counseling to lengthen their birth spacing is an important task. Moreover, counseling on taking iron supplementation as suggested and consuming a diet rich in iron during antenatal care will be recommended.

Utilization of continuous professional development among health professionals in East Ethiopia: a multi-health facility-based cross-sectional study.

BACKGROUND: Healthcare workers must maintain their knowledge, attitude, and skills regarding the most recent technology and competencies to deliver quality health care. The Ministry of Health, Ethiopia developed guidelines and directives for the utilization of continuous professional development programs. However, there is limited evidence on utilization and barriers to utilization in the study area. Therefore, this study aimed to assess the utilization and barriers to the utilization of continuous professional development among health professionals working in health facilities in eastern Ethiopia. METHODS: A health facility-based cross-sectional quantitative study was conducted among 731 healthcare professionals from September 01, 2022, and October 30, 2022. A multistage sampling technique was utilized. A simple random sampling technique selected health facilities and study participants. A self-administered questionnaire developed from national continuous professional development guidelines was disseminated to healthcare professionals working in the selected forty health centers and four hospitals. STATA statistical package version 14 was used for data analysis. A descriptive summary was used to summarize the variables. A logistic regression model was used to assess the association between independent variables and the outcome variable. Adjusted odds ratios along with 95% CIs were estimated to assess the strength of the association, and a p-value < 0.05 was used to declare the level of statistical significance in the analysis. RESULTS: Continuous professional development utilization was determined for 731 healthcare professionals, of whom 241 (32.97%) [(95% CI: (29.55, 36.38)] had utilized continuous professional development. Lack of continuous professional development knowledge AOR 0.23 [(95% CI: 0.14, 0.37)], being female AOR 0.58 [(95% CI: 0.39, 0.86)], lack of internet access AOR 0.62 [(95% CI: 0.43, 0.89)], greater than 20 km distance from main road AOR 0.58 [(95% CI: 0.37, 0.91)], not heard importance of continuous educational units AOR 0.45 [(95% CI: 0.31, 0.65)], and poor perceived need of continuous professional development AOR 0.61 [(95% CI: 0.38, 0.97)], had a negative statistically significant association with the utilization of continuous professional development. CONCLUSION: The utilization of continuous professional development in the study area was low. Health sectors and stakeholders working on continuous professional development programs are required to focus on developing strategies for knowledge creation, female health workers, and access to the internet, remote areas, information on the importance of continuous educational units, and the variety of needs of professionals for continuous professional development implementation.

Insecticide-treated net utilization and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis.

Background: Malaria is a major public health problem in many developing countries, particularly in sub-Saharan Africa. The pregnant woman, fetus, and newborn infant are all at risk from malaria during pregnancy. Hence, insecticide-treated bed net (ITN) use is the most effective and advisable method for preventing malaria during pregnancy. Studies on the prevalence of ITN utilization among pregnant women in Ethiopia are inconsistently reported and highly varied. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of ITN utilization and associated factors among pregnant women in Ethiopia. Methods: A comprehensive search of databases such as PubMed, CINAHL, Web of Science, SCOPUS, Science Direct, Google, and Google Scholar was performed to find studies conducted in Ethiopia. All original observational studies that reported the prevalence of ITN utilization were identified and screened. The Newcastle-Ottawa scale tool was used to assess the quality of the studies. Data were extracted in Microsoft Excel 2010 format and analyzed using STATA Version 14. A random-effect meta-analysis model was utilized to estimate the pooled prevalence of ITN utilization. The statistical heterogeneity was checked using the I2 test and subgroup analysis. The publication bias was assessed using funnel plots and Egger's regression test. The size of the pooled effect of the factors influencing the use of ITNs was estimated using an odds ratio (OR) with a 95% confidence interval (CI), and a P-value <0.05 was considered statistically significant. Results: Twenty-nine cross-sectional studies with 13,957 study participants were included in this meta-analysis. The overall pooled prevalence of ITN utilization among pregnant women in Ethiopia was 51% (95% CI: 43-60). A statistically significant heterogeneity was observed across studies (I2 = 99.09%; P < 0.001). Being literate [OR = 2.93 (95% CI: 2.14-4.01)], rural residence [OR = 1.76 (95% CI: 1.37-2.26)], and having knowledge of ITN [OR = 4.13 (95% CI: 1.57-10.81)] were factors significantly associated with ITN utilization among pregnant women. Conclusion: The utilization of ITNs among pregnant women was substantially lower than the national target, alarmingly highlighting the need for urgent and effective interventions. Maternal education status, place of residence, and knowledge of ITNs were independent predictors of ITN utilization. Health policymakers and programmers should design and implement the most effective strategies to scale up the utilization of ITNs by pregnant women and reduce malaria-related morbidity during pregnancy. Systematic Review Registration: CRD42022304432.

Active management of the third stage of labor and associated factors among maternity care providers in public health facilities in Eastern Ethiopia: a multi-center study.

INTRODUCTION: The third stage of labor is the shortest, most critical, and hazardous stage as it is linked with postpartum hemorrhage, the leading cause of maternal mortality and morbidity. Postpartum hemorrhage can be prevented by 60% with active management of the third stage of labor (AMTSL). Few studies have been conducted in different parts of Ethiopia showing rates of AMTSL ranging from 16.7% to 43.3%. Limited information, however, exists about its practice in our study area. Thus, we aimed to assess the practice of AMTSL and associated factors among maternity care providers in public health facilities in eastern Ethiopia. METHODS: An institution-based cross-sectional study design was used among 270 maternity care providers in public health facilities in eastern Ethiopia. They were recruited using cluster sampling techniques in their health facilities from July 15-October 30/2021. Pretested self-administered questionnaires and an observational checklist were used to collect data. Descriptive, binary, and multivariable logistic regression analyses were performed. Adjusted odds ratios with 95% confidence intervals were used for statistically significant associations. RESULTS: Good practice of AMTSL occurred in 40.3% (95% CI: 34.5%-46.1%) of births. Being trained (aOR 3.02; 95% CI 1.60-5.70); presence of birth assistance (aOR 2.9; 95% CI 1.42-6.04); having the highest educational level (aOR 4.21; 95% CI 1.08-16.40); and having good knowledge (aOR 3.00; 95% CI 1.45-6.20) were factors statistically associated with maternity care providers' good practice of AMTSL. CONCLUSION: Active management of the third stage of labor was practiced with low rates in the study area. Therefore, we suggest that the stakeholders could enhance the presence of birth assistance during all births and provide education to attain higher educational levels and continuously update the maternity care providers' level of knowledge through comprehensive and on-the-job training to increase the good practice of the third stage of labor.

Prevalence and Patterns of Neonatal Birth Trauma in Ethiopia: Systematic Review and Meta-Analysis.

Introduction. Neonatal death is still alarming in low-income countries including Ethiopia, accounts 30 death per 1000 alive births. Birth trauma is the second most common contributing factors for the death. Nevertheless, there is no aggregate evidence on the prevalence and patterns of neonatal birth trauma in Ethiopia. Therefore, this study aimed to assess the pooled prevalence and patterns of neonatal birth trauma in Ethiopia. Methods. Searching databases including PubMed, MEDLINE, Popline, SCOPUS, Web of Science, EMBASE, CINHAL (EBSCO), Google, Google Scholar, and lists of references were used to search literatures in Ethiopia. STATA version 14 was used for analysis, and the odds ratios of the outcome variable were determined using the random-effects model. Heterogeneity among the studies was assessed by computing values for I2 and P-values. Also, sensitivity analysis and funnel plot were done to assess the stability of pooled values to outliers and publication bias. Results. A total of 6 studies with a sample size of 3663 were included in this study. The overall prevalence of neonatal birth trauma was 15% (95% CI: 13-16). Subgaleal hemorrhage (39%), cephalohematoma (27%), and caput succedaneum (24%) were the most common neonatal birth trauma in Ethiopia. Meta-analyses and sensitivity analyses showed the stability of the pooled odds ratios, and the funnel plots did not show publication bias. Conclusion. This systematic review and meta-analysis revealed a high prevalence of neonatal birth trauma in Ethiopia. Moreover, most of the neonatal birth injuries were severe and life-threatening that need medical attention to safe the neonates and its life long complications.

Trend, prevalence and predictors of successful vaginal birth after caesarean section in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Vaginal birth after caesarean section (VBAC) is an alternative to a caesarean section (CS) in the absence of repeat or new indications for primary CS. There is a knowledge gap regarding the trend and successful VBAC in Ethiopia. Therefore this systematic review and meta-analysis aimed to assess the trend, pooled prevalence of successful VBAC and its predictors in Ethiopia. METHODS: Electronic databases (SCOPUS, CINAHL, Embase, PubMed and Web of Science), Google Scholar and lists of references were used to search works of literature in Ethiopia. Stata version 14 was used for analysis and the odds ratios of the outcome variable were determined using the random effects model. Heterogeneity among the studies was assessed by computing values for I2 and p-values. Also, sensitivity analyses and funnel plots were done to assess the stability of pooled values to outliers and publication bias, respectively. RESULTS: A total of 12 studies with a sample size of 2080 were included in this study. The overall success rate of VBAC was 52% (95% confidence interval 42 to 65). Cervical dilatation ≥4 cm at admission, having a prior successful vaginal delivery and VBAC were the predictors of successful VBAC. CONCLUSIONS: Meta-analyses and sensitivity analyses showed the stability of the pooled odds ratios and the funnel plots did not show publication bias. The pooled prevalence of successful VBAC was relatively low compared with existing evidence. However, the rate was increasing over the last 3 decades, which implies it needs more strengthening and focus to decrease maternal morbidity and mortality by CS complications. Promoting VBAC by emphasizing factors favourable for its success during counselling mothers who previously delivered by CS to enhance the prevalence of VBAC.

Vitamin A deficiency among pregnant women in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Vitamin A deficiency (VAD) during pregnancy is a public health challenge in low-income countries. There are inconsistent findings that can affect policy in planning appropriate intervention. This systematic review and meta-analysis were conducted to summarize the evidence in order to identify existing gaps and propose strategies to reduce VAD during pregnancy in Ethiopia. METHODS: This study included published and unpublished observational studies searched from different databases (PubMed, CINHAL [EBSCO], Embase, Google Scholar, Directory of Open Access Journals, Web of Sciences, MEDLINE, Cochrane Library, Scopus, Google Search and MedNar). Statistical analysis was conducted using Stata version 14 software. Heterogeneity and publication bias were assessed. Forest plots were used to present the pooled prevalence using the random effects model. RESULTS: A total of 37 618 pregnant women from 15 studies were included. The overall pooled prevalence of VAD was 29% (95% confidence interval 21 to 36) with I2=99.67% and p<0.001. Socio-economic and sociodemographic factors were identified as affecting vitamin A deficiencies among pregnant women. CONCLUSIONS: Nearly one-third of pregnant women in Ethiopia had VAD. Strengthening intervention modalities that aimed to increase the uptake of vitamin A-rich foods can avert VAD among pregnant women in Ethiopia.

Prevalence of child marriage and associated factors among reproductive age women in Harari regional state, eastern Ethiopia, 2022: a community-based study.

INTRODUCTION: Child marriage is a union before the age of 18 and a violation of human right. Around 21% of young women in the world married before reaching the age of 18. Every year, 10 million girls under the age of 18 are married. Child marriage causes lifetime suffering, and its abolition was one component of the Sustainable Development Goal to achieve gender equality and empower women and girls. However; abolition of child marriage by 2030 will not happen because its prevalence in the community has remained stable. OBJECTIVE: To assess the prevalence of child marriage and its associated factors among reproductive-age women from March 7 to April 5, 2022 in Harari Regional State, eastern Ethiopia. METHODS: Community-based cross-sectional study was conducted from March 7 to April 5, 2022 among the reproductive age group in the Harari Region state, Eastern Ethiopia. A systematic random sampling technique was used to find study participants. Data were obtained by face-to-face interview using a pre-tested structured questionnaire, input into EpiData version 3.1 and analyzed using Stata version 16. The proportion with 95% confidence interval (CI) and the summery measure were used to report the prevalence. A multivariable logistic regression analysis model was used to examine associated factors, and the results were provided as an adjusted odds ratio (AOR) with a 95% confidence interval. RESULT: In this study 986 were responded to the interview, making response rate of 99.6%. The median age of study participants was 22 years. The prevalence of child marriage was 33.7% [95% CI: 30.8-36.7] in this study. Being a Muslim (AOR = 2.30, 95% CI = 1.26, 4.19), diploma or higher level of education (AOR = 0.26, 95%CI = .10, 0.70), rural residence (AOR = 5.39, 95% CI = 3.71, 7.82), a marriage arranged by others (AOR = 2.68, 95% CI = 1.49, 4.82) and not knowing legal age of marriage (AOR = 4.49, 95% CI = 2.57, 7.85) were significantly associated with child marriage. CONCLUSION: According to this report, nearly one out of every three women engages in child marriage. The practice was more common among those with lower educational attainment, those who lived in rural areas, people who were unaware of the legal age of marriage, and those whose engagement was decided by others. Focusing on strategies that allow for intervention in these factors is beneficial in ending child marriage, which has a direct and indirect impact on women's health and educational achievement.

COVID-19 vaccine acceptance and associated factors among adult clients at public hospitals in eastern Ethiopia using the health belief model: multicentre cross-sectional study.

OBJECTIVE: Immunization is still one of the best ways to reduce viral-related morbidity and mortality . Therefore, this study aimed to assess COVID-19 vaccine acceptance and associated factors among adult clients at public hospitals in Eastern Ethiopia. METHOD: A multicentred facility-based cross-sectional study design was utilised. The systematic random sampling technique was used to select 420 study participants. The characteristics of individuals were described using descriptive statistical analysis such as frequency, median and IQR. Mean was used for health belief model components. The association was assessed using bivariate and multivariable logistic regression and described by the OR along with a 95% CI. Finally, a p-value<0.05 in the adjusted analysis was used to declare a significant association. OUTCOME MEASURE: COVID-19 vaccine acceptance and associated factors. RESULT: A total of 412 adult clients were interviewed, with a response rate of 98.1%. Of the total study participants, 225 (54.6%; 95% CI: 50.0% to -59.7%) were willing to accept the COVID-19 vaccine. Age≥46 (adjusted OR, AOR=3.64, 95% CI: 1.35- to 9.86), college and above level of education (AOR=2.50, 95% CI: 1.30- to 4.81), having health insurance (AOR=1.79, 95% CI: 1.11- to 2.87) and experiencing chronic disease (AOR=1.96, 95% CI: 1.02- to 3.77) were predictor variables. Also, components of the health belief model were significantly associated with COVID-19 vaccine acceptance. CONCLUSION: COVID-19 vaccine acceptance among the adult population was low compared to other study. Factors associated with COVID-19 vaccine acceptance were age, college and above level of education, having a chronic disease, having health insurance, perceived susceptibility, perceived severity, perceived benefit and perceived barrier.Improving awareness about COVID-19 among all sections of the population is crucial to improving vaccine acceptability.

Utilization of pharmacological labour analgesia: a survey of obstetric care providers in eastern Ethiopia.

BACKGROUND: Despite a crucial role played by obstetric care providers (OCPs) in providing pain relief methods during labour, the evidence suggests that there is a large number of women in Ethiopia who did not have access to pain relief methods. Moreover, to the best of the investigators' knowledge, evidence is scarce regarding the utilization of pharmacological labour pain management methods in the study area. Thus this study was carried out to determine the practice of pharmacological labour pain management methods among OCPs in Harari regional state health facilities in Ethiopia. METHODS: A facility-based cross-sectional study was conducted from 20 May to 10 June 2021 in Harari regional state health facilities. All (n=464) OCPs in Harari regional state health facilities were included in the study. Data were collected using a structured questionnaire adapted from previous studies. The data were entered into Epi-data version 3.1 statistical software. Statistical analysis was carried out using SPSS for Windows version 22. Bivariate and multivariate logistic regression analyses were employed to determine the association between independent variables and the outcome variable. A p-value <0.05 was used to establish statistical significance. RESULTS: In this study, 464 OCPs participated. The overall utilization of pharmacological labour pain relief methods was 50.9% (95% confidence interval [CI] 45.8 to 55.8). The main barriers to labouring mothers receiving pain relief include high patient flow (54.4%), the limited number of staff (51.9%) and a lack of knowledge and skill (32.9%). Being female (adjusted odds ratio [AOR] 2.07 [95% CI 1.31 to 3.26]), not having training (AOR 1.60 [95% CI 1.02 to 2.53]) and having an unfavourable attitude (AOR 9.1 [95% CI 5.34 to 15.35]) were the predictors of utilization of pharmacological labour pain management methods. CONCLUSIONS: The study revealed that half of the OCPs utilized the pharmacological labour pain management method. In general, this study identified that variables like sex, training and the attitude of OCPs were factors associated with the utilization of pharmacological labour pain management methods. The health facilities should provide training to enhance the skill of OCPs and equip themselves with sufficient analgesic drugs.

Use of tranexamic acid in decreasing blood loss during and after delivery among women in Africa: a systematic review and meta-analysis.

BACKGROUND: Africa is a developing continent with a high maternal mortality rate. It is beneficial to implement interventions that alleviate the problem. As a result, this systematic review and meta-analysis was carried out to summarize evidence that will assist concerned bodies in proposing strategies to reduce maternal mortality due to post-partum hemorrhage. METHODS: This systematic review and meta-analysis includes randomized control trials (RCT) studies searched from various databases (PubMed, Web of Sciences, SCOPUS, African Journal Online, Clinical trials, and African indexes Medics). Data synthesis and statistical analysis were conducted using a combination of review manager 5.3 and STATA Version 14 software. The effect measure utilized was the standardized mean difference for estimated mean blood loss and mean hemoglobin level. RESULTS: This systematic review and meta-analysis includes a total of 3308 women. The pooled standardized mean difference showed that tranexamic acid statistical significantly reduced the estimated amount of blood loss after vaginal delivery (standardized mean difference with 95% CI - 0.93 [- 1.45, - 0.41]) and during and after cesarean delivery (standardized mean difference with 95% CI - 1.93 [- 2.40, - 1.47]). CONCLUSION: Tranexamic acid has been found to be a good choice for reducing blood loss during and after delivery in Africa regardless of the mode of delivery. Tranexamic acid had no effect on hemoglobin levels before and after delivery. To reduce maternal mortality due to post-partum hemorrhage, it is critical to implement and strengthen interventions aimed at increasing tranexamic acid uptake in Africa.

Acceptance of COVID-19 vaccine and associated factors among health care workers at public hospitals in Eastern Ethiopia using the health belief model.

Introduction: Acceptance of COVID-19 vaccination among Health Care Workers is mandatory to lessen and curve the spread of transmission of COVID-19. Even though the Health Belief Model is one of the most widely used models for understanding vaccination behavior against COVID-19 disease, COVID-19 vaccine acceptance among Health Care Workers in Ethiopia was not adequately explored by using the Health Belief Model domains. Purpose: This study aimed to assess COVID-19 vaccine acceptance and associated factors among Health care workers in eastern, Ethiopia. Methods: Institutional-based cross-sectional study design was used among 417 health care workers selected by a systematic random sampling method from June 1- 30/2021. The data were collected by face-to-face interviews using semi-structured questionnaires and analyzed using STATA version 14 statistical software. Multivariable binary logistic regression analysis with a 95% confidence interval was carried out to identify factors associated with willingness to COVID-19 vaccine acceptance and a statistical significance was declared at a P-value < 0.05. Results: The willingness of health care workers to accept the COVID-19 vaccine was 35.6%. Age 30-39 (AOR = 4.16;95% CI: 2.51, 6.88), age ≥ 40 years (AOR = 3.29;95% CI: 1.47, 7.39), good attitude (AOR = 1.97; 95% CI: 1.00, 3.55), perceived susceptibility (AOR = 1.93; 95% CI: 1.12, 3.32), and perceived severity (AOR = 1.78; 95% CI: 1.03, 3.10) were factors significantly associated with Health Care Workers acceptance of COVID-19 vaccine. Conclusion: The willingness to accept the COVID-19 vaccine among HCWs was low. Factors significantly associated with the willingness to accept the COVID-19 vaccine were age, good attitude, perceived susceptibility, and perceived severity of the disease. The low willingness of Health Care Workers to accept the COVID-19 vaccine was alarming and it needs more emphasis from the government in collaboration with other stakeholders to provide reliable information to avert misconceptions and rumors about the vaccine to improve the vaccine status of Health Care Workers to protect the communities.

COVID-19 vaccine acceptance among pregnant women attending antenatal care in public hospitals in eastern Ethiopia: A multi-center facility-based cross-sectional study.

Objectives: The Ethiopian government had planned to vaccinate the total population and started to deliver the COVID-19 vaccine but, there is limited evidence about vaccine acceptance among pregnant women. Thus, this study aimed to assess COVID-19 vaccine acceptance and associated factors among pregnant women attending an antenatal care unit clinic in Eastern Ethiopia. Study design: A facility-based cross-sectional study. Methods: A study was conducted from June 01 to 30/2021 among systematically selected pregnant women. Data were collected using a pre-tested structured questionnaire, which was adapted from previous studies, through a face-to-face interview. Predictors were assessed using a multivariable logistic regression model and reported using an adjusted odds ratio with 95% CI. Statistical significance was declared at p-value less than 0.05. Results: In this study, data from 645 pregnant women were used in the analysis. Overall, 62.2% of pregnant women were willing to be vaccinated if the vaccine is approved by the relevant authority. Fear of side effects (62.04%), a lack of information (54.29%), and uncertainty about the vaccine's safety and efficacy (25%) were the most common reasons for refusal to take the COVID-19 vaccine. The odds of unwillingness to accept the COVID-19 vaccine among pregnant women were increased significantly among mothers who were able to read and write [AOR = 2.9, 95% CI: (1.16, 7.23)], attain 9-12 grade level [AOR = 4.2, 95% CI: (2.1, 8.5)], lack information [AOR = 2.2, 95% CI: (1.41, 3.57)], and having a history of chronic diseases [AOR = 2.52, 95% CI: (1.34, 4.7)]. Conclusion: Less than two-thirds of pregnant women were willing to accept the COVID-19 vaccine. Extensive public health information dissemination aimed at women with lower educational backgrounds and a history of chronic disease could be critical.

Postabortion Family Planning and Associated Factors Among Women Attending Abortion Service in Dire Dawa Town Health Facilities, Eastern Ethiopia.

Background: Postabortion family planning is a part of comprehensive package of postabortion care. However, it did not receive due attention to break the cycle of repeated abortion, unintended pregnancies, and abortion-related maternal morbidity and mortality. Therefore, this study aimed to determine the utilization of postabortion family planning and associated factors among women attending abortion service in Dire Dawa health facilities, Eastern Ethiopia. Methods: A facility-based cross-sectional study design was employed among 483 clients who sought abortion service in Dire Dawa from 15 May to 30 June 2020. A structured interviewer-administered questionnaire was used for data collection. The collected data were entered into EpiData version 3.2 and exported to SPSS version 22 for analysis. The multivariate logistic regression models were fitted to identify factors associated with utilization of postabortion family planning. Adjusted odds ratios (AORs) along with 95% CI were estimated to measure the strength of the association and statistical association was declared statistical at a p-value < 0.05. Results: More than three-fourths (77.8%) [95% CI: (73.4-81.6%)] of respondents were utilized postabortion family planning methods. Respondents with age 15-24 years [AOR: 5.59, (95% CI: (1.5, 19.7)], attended postsecondary [AOR: 7.6, (95% CI: (2.7, 21.2)], single marital status [AOR: 11.1, (95% CI: (4.6, 26.5)], a monthly income 500-1,000 birr [AOR: 7.9, (95% CI: (3.2, 19.4)], parity ≥ 5 [AOR: 0.41, (95% CI: (0.18, 0.92)], desire of current pregnancy [AOR: 4.2, (95% CI: (1.9, 9.3)], and ever used family planning [AOR: 4.4, (95% CI: (2.2, 8.9)] were major factors significantly associated with postabortion family planning utilization. Conclusion: In this study, more than three-fourths of respondents utilize postabortion family planning. Most of the factors associated with postabortion family planning were modifiable. Therefore, policymakers and health planners need to integrate with comprehensive abortion care to improve the utilization of postabortion family planning.

Magnitude of episiotomy practice and associated factors among women who gave birth at Hiwot Fana Specialized University Hospital, Eastern Ethiopia.

Background: Episiotomy is an intentional surgical incision made on the perineum with the aim of enlarging the introits during the second stage of labor or just before delivery of the baby. It sometimes also interferes with the mother's comfort during the postpartum period and has associated complications especially when it is done without indication. However, there is limited information regarding episiotomy practice in the study area. Objective: This study aimed to determine the magnitude of episiotomy practice and associated factors among women who gave birth at the Hiwot Fana Specialized University Hospital, Eastern Ethiopia, 2021. Methods: A facility-based cross-sectional study was conducted among 408 systematically selected mothers who gave birth at the Hiwot Fana Specialized University Hospital, from 1 January to 30 December 2021. Datas were collected from delivery medical records using a pretested checklist. The extracted data were checked, coded, and entered into the Epi-data version 3.1 and exported to the STATA version 16 software for analysis. Binary logistic regression was fitted to identify factors associated with episiotomy practice. P-values < 0.05 were considered to declare the presence of statistical significance. Results: The overall prevalence of episiotomy practice was found to be 43.4 % (95% CI: 38.7, 48.9), and mediolateral was the most commonly practiced episiotomy type (41.4%). Parity [AOR: 6.2; 95% CI (3.8-17.6)], 1st min Apgar score [AOR: 1.6; 95% CI (1.04-2.67)], presence of maternal medical disease [AOR: 3.3; 95% CI (1.09-6.9)], and induced labor [AOR: 1.6; 95%CI (1.12, 4.13)] were significantly associated with the episiotomy practice. Conclusion: The prevalence of episiotomy practice in the study area was high. Parity, presence of maternal medical disease, induction of labor, and 1st min APGAR score were significant factors associated with episiotomy practice. Considering the presence of appropriate indications or preventing unjustifiable indications, can help to reduce the current high practice rates.