Client perspective assessment of women's satisfaction towards labour and delivery care service in public health facilities at Arba Minch town and the surrounding district, Gamo Gofa zone, south Ethiopia.

BACKGROUND: A woman's satisfaction with labour and delivery care service has a good effect on her health and subsequent utilization of the services. Thus knowledge about women's satisfaction on labour and delivery care used to enhances the services utilization. The objective of this study was to assess the satisfaction of women's towards labour and delivery care service and identify factors associated it at public health facilities in Arba Minch town and the surrounding district, Gamo Gofa zone, southern Ethiopia. METHODS: Facility based cross sectional study was conducted among women who gave birth at public health facility. A total 256 women who gave birth during the study period were included in the study. Data was collected using a structured questionnaire. Satisfaction level was measured using a 5 point-Likert scale questions. Data were entered using Epi data version 3.5.1 and analyzed using SPSS 20.0 statistical software. Factor analysis was employed for Likert scale questions to extract factor represented each of the scale which facilitate treatment of variable as continuous for further analysis. Bi-variate and multivariable logistic regression analysis was employed to identify association between women's satisfaction and predicator variables. Statistical significance was declared at P value <0.05 on final model. The strength of association was interpreted using the adjusted odds ratio and 95% CI. RESULT: This study revealed that 90.2% of women who gave birth in public health facilities were satisfied with labour and delivery care. Factors associated with women's satisfaction with labour and delivery care services include: not attending formal education [AOR = 8.00, 95% CI = (1.52, 12.27)] attending antenatal care four times and more [AOR = 5.00, 95% CI = (1.76, 14.20)] waiting below 15 minutes to be seen by health professional [AOR = 3.37, 95% CI = (1.14, 9.97)] and not paying for drugs and supplies [AOR = 6.19, 95% CI = (1.34, 18.59)]. CONCLUSION: Although majority of women were satisfied with the labour and delivery service they got, their level of satisfaction was influenced by educational status, number of ANC visits, waiting time, and payment for drug and supplies. Thus, public health intervention working on improving delivery care should consider these factors.

Intimate partner physical violence among women in Shimelba refugee camp, northern Ethiopia.

BACKGROUND: Domestic violence has unwanted effects on the physical and psychological well-being of women, which have been recognized globally as an important public health problem. Violence perpetrated by intimate partner is one form of domestic violence, a serious human rights abuse and a public health issue, among refugees owing to its substantial consequences for women's physical, mental and reproductive health problems. Because the incidents are under-reported, the true scale of the problem is unknown and unexamined among refugee women in Ethiopia. Thus, this study aim to assess the magnitude of intimate partner physical violence and associated factors among women in Shimelba refugee camp, Northern Ethiopia. METHODS: A community-based cross-sectional study was conducted among a sample of 422 refugee women from March to April 2011. A simple random sampling method was used to select the study subjects from seven zones of the refugee camp. Census was done to identify all households with women having an intimate partner. A pre-tested interviewer guided structured questionnaire was used for data collection. Data were entered, cleaned and analyzed using SPSS software version 16.0. Descriptive, bivariate and multivariate logistic regression analyses were done where applicable. A p-value less than 0.05 with 95% CI were set and used as a cut-off point to examine the statistical association between the explanatory and outcome variables. RESULTS: The prevalence of physical violence in the last 12 months and lifetime were 107(25.5%) and 131(31.0%) respectively. The commonest forms of physical violence reported included slapping 101(61.6%) and throwing objects 32(19.5%). Significant risk factors associated with experiencing physical violence were being a farmer (AOR = 3.0[95%CI: 1.7, 5.5]), knowing women in neighborhood whose husband to beat them (AOR = 1.87[95%CI: 1.0, 3.5]), being a Muslim (AOR = 2.4 [95%C.I: 1.107, 5.5]), and having a drunkard partner (AOR = 2.1[95%C.I:1.0, 4.5]). CONCLUSIONS: Intimate partner physical violence was found to be high and a serious problem among women in Shimelba refugee camp. Multifaceted interventions such as male counseling, increasing awareness on the consequences of intimate partner violence and the effect of substance use like alcohol will help to reduce intimate partner violence.

Antenatal care services utilization and factors associated in Jimma Town (south west Ethiopia).

BACKGROUND: Antenatal care is potentially one of the most effective health intervention for preventing maternal morbidity and mortality particularly in places where the general health status of women is poor. OBJECTIVE: to assess antenatal care service utilization and factors associated with antenatal care non attendance. METHODS: A community based cross-sectional study was conducted among pregnant women from January 26 to February 06, 2006 in Jimma Town, Jimma zonal administration south west Ethiopia. Structured interviewer administered questionnaire was used for data collection. The data collected on study variables were tabulated in frequency tables and significance of association between variables was tested using chi2--test of significance. RESULT: A total of 360 pregnant women were enrolled in the study. The study, revealed that about 76.7% of the women have attended antenatal care and 23.3% have not attended at all. Literacy status, income, Gravidity, Religion and occupation showed statistically significant association (P < 0.05) with utilization of antenatal care. But marital status, Ethnicity and parity showed no statistically significant association (P > 0.05) with antenatal care utilization. The study showed that about 42.8% of the attendants have made their first antenatal visit in the 3rd trimester of pregnancy. Out of the total only 6.5% the studied women had the recommended four visits. Women in the age group 15-24 are more likely to attend ANC 2.75 times larger than that of women in the age group 25-34 (OR = 2.74, 95% CI: 1.37, 4.38). Similarly others (students and farmers) are about four times likely to attend ANC than House wife's (OR = 4.06. 95% CI: 1.50, 11.40). CONCLUSION: Even if there was high antenatal care utilization the pattern of follow up was in appropriate in most cases as the majority of pregnant women started using the service around 7-9 months with decreasing number in the 1st and 2nd trimester of pregnancy. Effective behavior change communication is needed to bring about proper antenatal care services utilization. Improving the quality of the service delivery and effective monitoring at, evaluation is critically important for improving the utilization of antenatal care services.

Analysis of birth weight in Metu Karl hospital: South West Ethiopia.

BACKGROUND: Birth weight is a sensitive indicator for predicting the chances of both infant survival and healthy child growth and development. Low birth weight continues to remain a major public health problem related to poverty, social factors such as lower status of women, malnutrition, lack of anti-natal care, etc., in Ethiopia in contrast to what is observed in many developing countries. The objective of this study was to determine birth weight distribution and its association with some risk factors among newborns delivered in Metu Karl hospital Metu town (South-West Ethiopia) from February 2003 - February 2005. METHODS: A cross sectional retrospective study was conducted in the month of April 2005. Information collected includes variables such as: birth weight of neonates, maternal residence, maternal age, maternal occupational status, marital status, parity, history of antenatal care follow up, sex of the new born and season of delivery. Data was collected from the registration book and cards of the study subjects using preformed data collection format. The collected information was analyzed by SPSS computer statistical package at Jimma University. RESULT: A total of 1832 singleton live births were included in the study. The over all prevalence of Low Birth Weight (LBW) was 8.6% and the overall mean birth weight was 3147gms where as for males and females it was 3265gm and 3007gms respectively. Sex of the newborn, antenatal care follow up and obstetric illness during the last pregnancy was significantly related to birth weight. CONCLUSION: Based on the results improving antenatal care, maternal and child health and family planning services, health education especially for reproductive age groups and appropriate record keeping systems were recommended.

Knowledge, attitude and practice of home-based care for HIV/AIDS patients by their family/ caregivers at Jimma Town.

BACKGROUND: About 1.5 million people are currently living with HIV/AIDS in Ethiopia-one of the largest HIV infected populations in the world. The current prevalence rate of infection is estimated at 4.4% nationally. Hospital bed occupancy rate due to AIDS has reached over 50% in urban hospitals creating a severe burden to the health service system in the country, or else US $3.4 million is needed in order to increase their bed capacity. Here arises the need to look for a better way of caring for people living with HIV/AIDS. Home care would thus offer the only feasible option for this need as it can mobilize the considerable reservoir of caring and sympathy that exists within a community beyond that of cost cutting. The study was conducted to determine the knowledge, attitude and practice of family/caregivers regarding home-based care for people living with HIV/AIDS. METHODS: This was a cross-sectional community-based study conducted among 274 family/caregivers who were giving care for people living with HIV/AIDS in urban setting of Jimma town from June - August 2005. A structured and pre-tested questionnaire was used to collect data on socio-demographic characteristics, knowledge and attitude towards home based care practice. Data collection was done by interviewing family/caregivers at their respective houses and analyzed using SPSS for windows version 11.0. RESULTS: Over three fourth of the studied subjects (91.6%) were knowledgeable about home based care and 88.7% showed favorable attitude. Ninety two point eight percent agreed that home is a better place for the care of PLWHA than hospital. Single caregivers were about four times more likely to be knowledgeable about home care as compared to their counterparts (OR = 3.98 (95% CI: 0.50, 88.08), but the finding was not statistically significant (p > 0.05). Neighbors and friends were two times more likely to have favorable attitude towards HBC as compared to family members, OR = 1.96 (95% CI: 0.74, 5.21) but, the finding is not statistically significant (p > 0.05). CONCLUSION: The study highlighted that the majority of family members/caregivers have good knowledge and favorable attitude towards HBC and over half favored this care. Therefore, appropriate use of the above promising findings and experience of innovative approaches of HBC from other countries is recommended for further, more organized and effective home-based care practice.

Patterns of accidents among children visiting Jimma University Hospital, south west of Ethiopia.

BACKGROUND: Accidents are now becoming the leading causes of morbidity and mortality after the first year of life; hence the need to analyze the pattern in prospective manner will help plan preventive measures as well as indicate the magnitude of the problem. OBJECTIVE: To assess the pattern of childhood accidents among children under 15 years of age. METHODS: A cross-sectional analysis was undertaken in and out patient service settings of Jimma University specialized hospital, from July 2003 to June 2004. The information was collected using structured and pre-tested questionnaire, on factors related to socio-demographic and economic variables as well as on the nature and type of accident and analysed by SPSS Version 12.0. RESULTS: Of the total 452 cases of accidents 79 (17.5%), 271 (60.0%) and 102(22.6%) of the subjects were within age group of 0-4, 5-9, and 10-14 years, respectively. The predominant observed accidents among all age groups were laceration wounds, 304 (67.3%) and soft tissues contusions, 111 (24.6%). Traumatic injury other than car accident accounted for 82.38%, burn 15.0%, poisoning 1.3% and car accident 1.3%. Burn was common among children 5 - 9 years. There was statitically significant association between age and type of accident and nature of injury (p <0.05). Two hudred eight one of the accident occurred at home (62.2%), followed by school (14.8%), high way (16.8%) and in sport fields (6.2%). One hundred twenty four (27.4%), 76(16.8%) and 252(55.8%) ended with complete recovery, recovery with major and minor sequelae respectively. CONCLUSION: The study, has tried to indicate that accidents are becoming a public health problem in the area which needs designing a local as well as a national strategy on child accident prevention, conrol and management.

A two year retrospective review of reasons for pediatric admission to Chiro Hospital, Eastern Ethiopia.

BACKGROUND: The health and well being of children is of a major importance. Even though much activity and effort is directed towards promoting children's health there is scarcity of information on child health morbidity in this country. The objective of this study was to review pediatric admission and discharge records of Chiro Hospital, East Ethiopia. METHOD: A two-year retrospective record analysis of pediatric ward admission and discharge of Chiro hospital during September 2000 - August 2002 was conducted A record book of pediatric ward of the Hospital was reviewed using pre-tested format. The main diagnosis, cause of admission and death, personal characteristics and length of stay was included in the analysis. Data were analyzed by SPSS version 11. computer statistical software. RESULT: Nine hundred and sixty three pediatric patients were admitted to the hospital within the two years Period. Most common diagnosis leading to pediatric admission were diseases of respiratory system 215 (22.9%) and infective and parasitic diseases (22.9%). The three most common infections: pneumonia 368 (39.2%), malaria 140 (14.9%) and tuberculosis 103 (10.9) were more common among male than female children, but no statistical difference was observed between the ten common infectious diseases and sex of the children (P>0.5). More death was observed in males 50 (5.3%) than females 32 (3.4%). Twenty-eight (34.2%) of the deaths occurred within 48 hours and (39.0%) died after 72 hours of admission. CONCLUSION: The review showed that communicable diseases were the most common causes of admissions (61.3%) and the patterns of morbidity and mortality reflects those of developing countries that call for extensive preventive measures. In view of the limited duration of the study, further review taking five or ten year duration is recommended for planning and strengthen maternal and child health services.