Willingness to work in rural areas and associated factors among graduating health students at the University of Gondar, northwest Ethiopia, 2021.

BACKGROUND: Many of the rural areas in developing countries are still in need access to quality healthcare services. To ensure the fair distribution of a high-quality health workforce and the availability of health services, there is a need to assess the background barriers that explain why healthcare providers are not interested to work in rural areas, thereby setting strategies to achieve universal health coverage. Therefore, this study is aimed to assess the willingness to work in rural areas and associated factors among health students at the University of Gondar. METHODS: An institution-based cross-sectional study was conducted at the University of Gondar from August 15 to 25, 2021. A total of 422 study participants were selected using a stratified random sampling technique. A pretested self-administered questionnaire was employed to collect the data. Data were entered into EPI DATA 4.6 and exported to SPSS 25 for further analysis. Multivariable logistic regression analysis was performed to identify factors associated with students' willingness to work in rural areas. The level of significance was decided based on the 95% confidence interval at a p-value of ≤ 0.05. RESULTS: In this study, it was found that health students' willingness to work in rural areas was 78.4% (95% CI: 74.3, 82.4). Being male (AOR = 2.15; 95% CI: 1.17, 3.94), having intention to continue with their profession (AOR = 2.5; 95% CI: 1.28, 4.86), having a favorable attitude towards working in rural areas (AOR = 7.32; 95% CI: 5.71, 18.65), and having a mother with no formal education (AOR = 2.23; 95% CI: 1.02, 4.85) and completed primary education (AOR = 2.69; 95% CI: 1.1, 6.61) were significantly associated with willingness to work in rural areas. CONCLUSION: The willingness of students to work in rural areas was optimal. This calls for concerned bodies to create a conducive environment for male and female students to engage in rural areas without hesitation. It is also important to ensure that students are willing to work in the rural areas voluntarily, instead of working in rural areas due to a lack of employment.

Lifetime adverse pregnancy outcomes and associated factors among antenatal care booked women in Central Gondar zone and Gondar city administration, Northwest Ethiopia.

Background: In developing countries, adverse pregnancy outcomes are major public health issues. It is one of the leading causes of neonatal morbidity and mortality worldwide. Despite the fact that ending prenatal mortality and morbidity is one of the third Sustainable Development Goals (SDG), the burden of the problem continues to be a huge concern in developing countries, including Ethiopia. Hence, this study aimed to determine the prevalence and associated factors of lifetime adverse pregnancy outcomes among antenatal care (ANC) booked women in Northwest Ethiopia. Methods: An institutional-based cross-sectional study design was conducted in Northwest Ethiopia, between March 2021 and June 2021. A multi-stage stratified random sampling technique was employed to recruit participants. An interviewer-administered and checklist questionnaire were used to collect the data. The data were entered into Epi-data version 4.6 software and exported to Stata version 16 for analysis. The binary logistic regression model was fitted to identify an association between associated factors and the outcome variable. Variables with a p-value of < 0.05 in the multivariable logistic regression model were declared as statistically significant. Results: In this study, the lifetime prevalence of adverse pregnancy outcome among study participants was 14.53% (95%CI: 11.61, 18.04). Road access to the health facilities (AOR = 2.62; 95% CI: 1.14, 6.02) and husband-supported pregnancy (AOR = 2.63; 95 CI: 1.46, 4.72) were significantly associated with adverse pregnancy outcomes. Conclusions: More than one in 10 reproductive age women had adverse pregnancy outcome throughout their life. Road access to health facilities and husband-supported pregnancy were statistically significant factors for adverse events in pregnancy. Therefore, it is better to give more attention to expanding infrastructure like road accessibility and increasing husband-supported pregnancy to reduce adverse pregnancy outcomes.

Married women's decision-making autonomy in the household and maternal and neonatal healthcare utilization and associated factors in Debretabor, northwest Ethiopia.

BACKGROUND: Women's decision-making autonomy is very crucial for the improvement of women empowerment, and maternal, neonatal, and child healthcare utilization. As time immemorial, Ethiopian culture is largely gender stratified, and the position of women is subordinate to men in various household and health-seeking decision-making matters. However, there is a dearth of empirical evidence on women's decision-making autonomy, especially in the household and on maternal and newborn healthcare utilization. Therefore, this study assessed married women's decision-making autonomy in the household and on maternal and neonatal healthcare utilization and associated factors in Debretabor, Northwest Ethiopia. METHODS: A community-based cross-sectional study was conducted from October 1st to 30th, 2019. A two-stage sampling technique was used to select 730 married women. Data were collected using a structured, pretested, and interviewer-administered questionnaire. Data were entered into EPI INFO 7 and analyzed by SPSS version 23. Multivariable logistic regression model was fitted to identify factors associated with women's decision-making autonomy in the household and maternal and neonatal healthcare utilization. The adjusted odds ratio with its 95% confidence interval was computed to determine the level of significance at a p-value of ≤ 0.05. RESULTS: A total of 730 married women were included in the analysis. Thus, three-fourths (75.1%) of women had higher decision-making autonomy on their health, neonatal health, and other socio-economic aspects. Besides, the proportion of four and above antenatal visits, delivery at a health facility, postnatal checkup, knowledge of neonatal danger signs, and appropriate health-seeking practices for sick newborns among autonomous women were 52.1%, 56.1%, 71.4%, 32%, and 80% respectively. Age greater than 35 years old (AOR = 2.08; 95% CI: 1.19, 3.62), monthly income of > 5000 ETB (AOR = 3.1; 95% CI: 1.36, 7.07), husband involvement (AOR = 2.36; 95% CI: 1.55, 3.43), and adequate knowledge of neonatal danger signs (AOR = 2.11; 95% CI: 1.4, 3.2) were factors independently associated with women's decision-making autonomy on maternal and neonatal healthcare utilization and other socio-economic affairs. CONCLUSION: Our findings show that women's decision-making autonomy in the household and maternal and neonatal healthcare utilization was optimal. Increasing household income level, promotion of husband's involvement starting from the prenatal period, and increasing women's knowledge of maternal and neonatal danger signs will have a great role in the improvement of women's decision-making autonomy.