Postpartum intrauterine contraceptive device use and its associated factors in Ethiopia: systematic review and meta-analysis.

BACKGROUND: The intrauterine contraceptive device, a type of long-acting reversible contraception, is one of the most effective and safe contraceptive methods. In Ethiopia, intrauterine contraceptive device is little known and practised to delay pregnancy. Therefore, this study aimed to assess post-partum intrauterine contraceptive device utilisation and its associated factors among women in Ethiopia. METHOD: In the current meta-analysis, variables were searched from different electronic database systems, including PubMed, Google Scholar, EMBASE, HINAR, Scopus, Web of Sciences, and Grey literature. Data were extracted using a standardised data collection measurement tool. The data were also analysed by using STATA 16 statistical software. I2 tests assessed heterogeneity between the studies. A random-effect model was used to forecast the pooled utilisation of postpartum intrauterine contraceptive device. RESULTS: Twelve full-article studies were included. The pooled prevalence of post-partum intrauterine contraceptive device among women in Ethiopia was 21.63%. Occupation (OR = 4.44, 95% CI, 2.24-8.81), educational level of college and above (OR = 5.93, 95% CI, 2.55-13.8), antenatal care (OR = 2.09, 95% CI, 1.4-3.12), age (OR = 4.8, 95% CI, 2.3-10.04), good knowledge (OR = 4.16, 95% CI, 1.65-10.49), counseling (OR = 3.05, 95%CI, 1.41-6.63), husband support (OR = 11.48, 95% CI, 6.05-21.79) and awareness about IUCD (OR = 3.86, 95% CI, 1.46-10.2) were positively associated with utilization of postpartum intrauterine contraception device. CONCLUSIONS: Utilisation of post-partum intrauterine contraceptive device was significantly low. Scaling up women's educational status and ANC use has paramount importance in increasing post-partum IUD use, which further improves maternal and child health in general. This finding may be useful in both reproductive health promotion at an individual level and policy-making regarding this issue.

Family planning (FP) is widely recognised as a life-saving and health-improving intervention for women and children. An IUCD is a small, "T-shaped" intrauterine contraceptive device inserted into a woman's uterus. It is also referred to as an IUD, a loop, or a coil. Post-partum IUCD is an intrauterine contraceptive device inserted during the post-partum period. Although several primary studies have been conducted in various regions of Ethiopia, there is no nationally representative evidence on the PPIUCD utilisation and the pooled effects of its determinants in Ethiopia. In this review, some of the factors associated with the post-partum intrauterine contraceptive device were pooled quantitatively, and some were not because of inconsistent classification (grouping) of the exposures concerning the outcome (post-partum intrauterine contraceptive device).This systematic review and meta-analysis used the following electronic database; PubMed, Google Scholar, EMBASE, HINAR, Scopus, Web of Sciences, and Grey literature to search the primary articles. A total of 12 primary studies assessing the utilisation of postpartum intrauterine contraceptive device (PPIUCD) were included based on study eligibility criteria.And also, in this study we found that the pooled prevalence of post-partum intrauterine contraceptive device among women in Ethiopia was 21.63%. Occupation, educational status, good knowledge, husband support, age, counselling, antenatal care follow-up, and awareness about IUCD were factors that affect the use of post-partum intrauterine contraceptive devices.This systematic review and meta-analysis report that utilisation of post-partum intrauterine contraceptive device was significantly low. Therefore, scaling up women's educational status, and ANC use has paramount importance in increasing post-partum IUD use, which further improves maternal and child health in general. Beside this health professional also should be give health education and promotion about the importance of PPIUCD.

The Effects of Prophylactic Intravenous Lignocaine vs Vecuronium on Succinylcholine-Induced Fasciculation and Postoperative Myalgia in Patients Undergoing Elective Surgery at Debre Markos Comprehensive Specialized Hospital, Ethiopia, 2022: Prospective Cohort Study.

Background: The incidence and severity of succinylcholine-induced fasciculation and postoperative myalgia have been shown to decrease when vecuronium bromide or preservative-free 2% plain lignocaine hydrochloride is administered before induction. The aim of this study is to examine the effectiveness of defasciculation dosages of vecuronium bromide and 2% preservative-free plain lignocaine hydrochloride in decreasing succinylcholine-induced fasciculation and postoperative myalgia in patients undergoing elective surgery. Methods: A total of 110 participants were included in a prospective observational cohort study that was located in an institution. Patients were randomly assigned to (Group L) and (Group V) based on the prophylactic measures they received from the responsible anesthetist utilizing preservative-free 2% plain lignocaine and defasciculation dose of vecuronium bromide, respectively. We recorded, socio-demographic variables, fasciculation, postoperative myalgia, total number of analgesics administered following surgery in 48hrs, and kind of procedure. The descriptive data were compiled using descriptive statistics. Categorical and continuous data were evaluated, respectively, using chi-square statistics and the independent sample t-test. To compare the prevalence of fasciculation and myalgia across the various groups, the Fischer exact test was performed. A 0.05 p-value was deemed statistically significant. Results: This study found that the incidence of fasciculation in the groups receiving the defasciculation doses of vecuronium bromide and preservative-free 2% plain lignocaine hydrochloride was 14.6% and 20% (p-value 0.007), respectively. The rate of mild-to-moderate postoperative myalgia in the vecuronium bromide group was 23.7%, 30.9%, and 16.4% in the first, 24th, and 48th hours, respectively (p-value 0.001), as opposed to 0%, 37.3%, and 9.1%, respectively (p-value 0.008) in the group receiving preservative-free 2% plain lignocaine hydrochloride. Conclusion: Pretreatment with 2% plain lignocaine that is preservative-free is more efficient than vecuronium bromide at reducing the frequency and intensity of postoperative succinylcholine-induced myalgia, whereas defasciculation dose of vecuronium was more effective prevention of succinylcholine-induced fasciculation.

Survey on knowledge, attitude and practice of labor analgesia among health care providers at Debre Markos Comprehensive Specialized Hospital, Ethiopia 2021. A cross-sectional study.

BACKGROUND: Childbirth is among the most painful experiences a woman has during their childbearing years. Despite improvement in the development of standards for pain assessment and treatment, labor pain is mostly ignored especially in low and middle-income countries. OBJECTIVES: To assess the knowledge, attitude, and practice of labor analgesia among health care providers at Debre-Markos comprehensive specialized hospital, Ethiopia,. METHODS: After ethical approval was obtained from the ethical review board, institutional-based cross-sectional study was conducted in June 2021, written consent was taken from each health care provider (HCP) before data collection, and structured self-administered questionnaires were used. The collected data were coded and analyzed using SPSS version 22. Descriptive statistics were computed to determine frequencies and percentages finally data were presented using texts, tables, and graphs.The study is registered with a research unique identifying number of 7407 found with the link address https://www.researchregistry.com/browse-the registry#home/?view_2_search = 7407&view_2_page = 1 and reported in line with STROCSS 2021. RESULTS: A total of 112 health care providers have participated with 70.5%, 29.5% being males and females respectively. This study was found that most gynecologists/obstetricians, 75% of general practitioners, and more than half (57.1%) of integrated emergency surgery and obstetrics (IESO) have good knowledge about labor analgesia, while the majority (58.3%) of midwives found to have poor knowledge. Although 75% of general practitioners and 71.4% of IESO have a good attitude towards obstetric and labor pain management, only 55.6% of midwives and 51.2% of graduating medical students were found to have a good attitude. Among health care providers (HCP), 60.3% of graduating medical students, 75% of general practitioners, 74.1% of IESO, and most of the seniors were found to have good practice of labor analgesia. CONCLUSION: There is a wide gap among health care providers in knowledge, attitude, and practice of labor analgesia. Training health care providers about safe, efficient, and affordable labor analgesia is crucial to improving health care.

Preparedness level and associated factors of health professionals regarding COVID-19.

OBJECTIVE: To assess the level of preparedness of health professionals working in South Gondar Zone public hospital, Debre Tabor Comprehensive specialized Hospital for coronavirus. METHODS: An institutional-based cross-sectional survey was conducted with a self-administered questionnaire from April 20 to May 20. Descriptive statistics, chi-square test, bivariable, and multivariable logistic analysis were done. Bivariable and multivariable regression was held to determine significant predictors for preparedness. For all statistical analyses, a p value ⩽ 0.05 was considered as significant. RESULTS: From a total health professionals, 301 health professionals with a response rate of 86% participated in the study. Among these, 206 were males while 95 participants were females with a mean age of 29.71 ± 5.84 years. To determine the preparedness level, we use the mean preparedness score of the respondents. Around 64.1% of health professionals were well prepared. Among 20 respondents who had a chronic illness, 80% of them think their illness is risky for the pandemic. The majority of the respondents (229/76.1%) responded as they were working without protective equipment. From the multivariable analysis male sex (adjusted odds ratio = 2.07, 95% confidence interval = 1.193-3.590), family living with them (adjusted odds ratio = 4.507, 95% confidence interval = 1.863-10.90), and involvement of other previous outbreak (adjusted odds ratio = 2.245, 95% confidence interval = 1.176-4.286) were the predictors for good preparedness. CONCLUSION: Most of the health professionals were well prepared. Being male, living within a family, and involvement of other outbreaks leads to good preparation. Governmental bodies and hospital managers have to help health professionals to be prepared enough to combat the pandemic.

Acceptance of COVID-19 vaccine and associated factors among health professionals working in Hospitals of South Gondar Zone, Northwest Ethiopia.

BACKGROUND: Health-care professions are among the highly exposed group of population affected by COVID-19 pandemic and identified as the target population to get vaccination against the spread of the infection. However, vaccine reluctance is still high, which may negatively affect the efforts to prevent the spread of the infection. Hence, this study was aimed to assess acceptance of COVID-19 vaccine and associated factors among health professionals working in Hospitals of South Gondar Zone, Northwest Ethiopia. METHODS: Institutional-based cross-sectional study was performed among 422 health professionals working in Hospitals of South Gondar Zone, Northwest Ethiopia, from March 1 to 30, 2021. Study participants were selected through simple random sampling techniques. Data were collected through a self-administered questionnaire. Multivariable logistic regression analysis was performed to identified factors associated with acceptance of COVID-19 vaccine with a p-value < 0.05 at 95% CI considered as statistically significant. RESULT: Overall, 45.3% of health professionals accepted COVID-19 vaccine. Age (AOR: 2.55; 95% CI: 1.32-4.92), being male (AOR: 1.729; 95% CI: 1.32-2.34), had higher risk of COVID-19 (AOR: 1.74, 95% CI: 1.00-3.02), and positive attitude (AOR: 3.26, 95% CI: 2.14-4.96) were found to be statistically significant with the acceptance of COVID-19 vaccine. CONCLUSION: The acceptance of COVID-19 vaccine among health professionals was significantly low. Participant's age, sex, high risk of COVID-19, and attitude toward COVID-19 vaccine were significantly associated with vaccine acceptance. Therefore, the government with respective stakeholders should emphasize addressing the concern of the health professionals and increase attitudes regarding COVID-19 vaccine to scale up vaccine acceptance.