Pregnant women's perception of midwifery-led continuity care model in Ethiopia: a qualitative study.

BACKGROUND: A Midwifery-led continuity care (MLCC) model is the provision of care by a known midwife (caseload model) or a team of midwives (team midwifery model) for women throughout the antenatal, intrapartum, and postnatal period. Evidence shows that a MLCC model becomes the first choice for women and improves maternal and neonatal health outcomes. Despite this, little is known about pregnant women's perception of the MLCC model in Ethiopia. Therefore, this study aimed to explore pregnant women's perception and experience of a MLCC model in Ethiopia. METHODS: A qualitative study was conducted in Gurage zone public hospital, Southwest Ethiopia, from May 1st to 15th, 2022. Three focused group discussions and eight in-depth interviews were conducted among pregnant women who were selected using a purposive sampling method. Data were first transcribed and then translated from Amharic (local language) to English. Finally, the thematic analysis technique using open code software was used for analysis. RESULTS: Thematic analysis revealed that women want a continuity of care model. Four themes emerged. Three were specific to women's improved care. That is, (1) improved continuum of care, (2) improved woman-centred care, and (3) improved satisfaction of care. Theme four (4), barrier to implementation, was concerned with possible barriers to implementation of the model. CONCLUSION: The finding of this study shows that pregnant women had positive experiences and showed a willingness to receive midwifery-led continuity care. Woman-centred care, improved satisfaction of care, and continuum of care were identified as the main themes. Therefore, it is reasonable to adopt and implement midwifery-led continuity care for low-risk pregnant women in Ethiopia.

Stunting and Underweight, but not Wasting are Associated with Delay in Child Development in Southwest Ethiopia.

BACKGROUND: Stimulating care during childhood is the foundation for optimal health, learning, productivity, and social well-being throughout the life course. In addition, malnutrition is a major public health concern affecting up to half of children under-five years in Ethiopia. However, evidence on the causal contribution of malnutrition to delay in child development is poorly understood in Ethiopia. OBJECTIVE: To identify the relationship between different forms of malnutrition and delay in child development among children in Southwest Ethiopia. METHODS: A community-based survey was conducted among 507 randomly selected mother-child pairs in the Guraghe Zone, Southwest Ethiopia. A pretested tool and validated anthropometric measurements were used. Anthropometric indices (WFH, WFA, and HFA) were calculated in Anthros software. The data were summarized in mean, median, standard deviation, tables and charts. Bivariable and multivariable binary logistic regression (stepwise backward regression) models were fitted with nutritional status (wasting, stunting and underweight) and other potential factors associated with delay in child developmental. Adjusted odds ratios with 95% confidence intervals and p-values were reported. RESULTS: A total of 507 mother-child (12-59 months) pairs were included in the survey (97% response rate). The mean ASQ-3 score was 150 (± 23.4), with a minimum and maximum score of 45 and 270, respectively. A total of 149 (29.4%; 95% CI: 25.4-33.4) children had developmental delays, where 17.2%, 16.8%, 13.4%, 10.8%, and 10.1% had delays in gross motor, communication, problem-solving, personal-social, and fine motor skills, respectively. Children of working mothers (AOR=2.9; 1.8, 4.8), preterm births (AOR=3.2; 1.4, 7.0), early initiation of complementary feeding (AOR=2.5; 1.37, 4.6), stunting (AOR=3.0; 1.9, 4.7), underweight (AOR= 2.3; 1.1, 4.7) and low dietary diversity score (AOR=3.1; 1.3, 7.5), were predictors of developmental delay. CONCLUSION: Child development delay is a public health concern and it is strongly associated with stunting, underweight, undiversified dietary consumption, and suboptimal infant and young child feeding practices.

Preterm Premature Ruptures of Membrane and Factors Associated among Pregnant Women Admitted in Wolkite Comprehensive Specialized Hospital, Gurage Zone, Southern Ethiopia.

INTRODUCTION: Preterm premature rupture of membrane is the rupture of membrane before 37 weeks of gestational age. It complicates approximately 3 percent of pregnancies and leads to one-third of preterm births. It increases the risk of prematurity and leads to several other perinatal and neonatal complications, including the risk of fetal death. Although the prevalence and associated factors of preterm premature rupture of the membrane were well studied in high-income countries, there is a scarcity of evidence in Ethiopia, particularly in the study area. METHOD: A hospital-based cross-sectional study design was conducted from 1st June to 30th June 2021 in Wolkite comprehensive specialized hospital. One hundred ninety nine (199) pregnant women were included as study subjects using a systematic random sampling technique. Data were collected using a structured interviewer-administered questionnaire. It carried out descriptive statistical analysis and statistical tests like the odds ratio. Both bivariate and multivariate logistic regression analyses were conducted. Statistically, significant tests were declared at a level of p value < 0.05. RESULT: The magnitude of preterm premature rupture membrane is 6.6%. Having gestational diabetes mellitus (AOR = 5.99 (95% CI: 1.01, 32.97) and previous history of abortion (AOR = 5.31 (95% CI: 1.06, 26.69) were found to be significantly associated with preterm premature rupture of membrane. CONCLUSION: Having gestational diabetes mellitus and having a previous history of abortion were significantly associated with preterm premature rupture of membrane.

Utilization of Family Planning Methods and Associated Factors Among Reproductive-Age Women with Disability in Arba Minch Town, Southern Ethiopia.

INTRODUCTION: Globally in 2019, there were 1.9 billion reproductive-age women. Around 922 million of them were using either modern or traditional methods of family planning. Women with disabilities comprise 10% of worldwide women and three-quarters of them reside in low- and middle-income countries. OBJECTIVE: The purpose of this study was designed to assess the magnitude and associated factors for family planning methods use among reproductive-age women with disabilities in Arba Minch town, southern Ethiopia. PATIENTS AND METHODS: A community-based cross-sectional study was conducted among 418 reproductive-age women with disabilities. Data were collected with eight women who had completed grade 12 and two of them were proficient in sign language. The data were entered into Epi-info™ version-7 software and exported into SPSS version 20 for analysis. A statistically significant variable in the final model was declared by adjusted odds ratio (AOR), 95% confidence interval (CI) and p-value <0.05. RESULTS: The magnitude of family planning utilization among reproductive-age women with disabilities was 33.7%. Factors significantly associated with family planning use were being employed (AOR: 2.2, CI: 1.77-4.15), having positive attitudes (AOR: 2.3, 95% CI: 1.21-3.87) and marital status (AOR: 3.9, 95% CI: 2.31-6.63). CONCLUSION: The magnitude of family planning use among reproductive women with disabilities was low. Attitude, marital status, and being employed were significantly associated factors with family planning use. Therefore, the governmental and non-governmental organizations should work to change their attitude and creating job opportunities.