Quality of option B + prevention of mother-to-child transmission of HIV services in public hospitals of Gamo zone, Southern Ethiopia, mixed approach.

BACKGROUND: Prevention of mother-to-child transmission service is a comprehensive package of services planned to reduce the risk of mother-to-child transmission of HIV. It is very crucial to determine the level of quality of PMTCT services in this study area since other studies in our country omitted several variables in each category of the Donobedian model. Therefore, this study aimed to determine the level of quality of option B + PMTCT of HIV services. METHODS: An institution-based cross-sectional study design with both quantitative and qualitative data collection method was employed. Donabedian's model was used to assess the level of quality of PMTCT service. A total of 422 pregnant women were used to assess the level of satisfaction of clients. An inventory of resources and direct observation was done to assess the quality of the input and output component of the Donobedian model respectively. In addition to satisfaction items, 12 output-related items were also used to assess quality in the output dimension. Finally, those hospitals that scored above 90% in each component of the Donovedian model were categorized as having good quality. Finally, twelve in-depth interviews were conducted to explore barriers to the quality of option B + PMTCT services. The qualitative data were analyzed using the thematic analysis method and finally, it was presented with the quantitative result through triangulation. RESULTS: No hospitals simultaneously met the requirements for good quality in all three dimensions of option B + PMTCT service quality. Only one hospital out of the four hospitals met the requirements for good quality of PMTCT service in the input dimension. Regarding the process and output dimension's quality of PMTCT services, two of the hospitals met the criteria for good quality. One hospital out of the total exhibited poor performance in all three dimensions of service quality for option B + PMTCT services. CONCLUSION: According to this study no hospitals simultaneously met the requirements for good quality in all three dimensions of option B + PMTCT service quality. PMTCT unit performance must be continuously monitored, reviewed, and supervised. To obtain the minimum required resources primary hospitals must be supported.

Exploring experiences of quarantined people during the early phase of COVID-19 outbreak in Southern Nations Nationalities and Peoples' Region of Ethiopia: A qualitative study.

BACKGROUND: Ethiopia enforced extremely rigorous contact tracing and mandatory quarantine for all suspected contact and travelers entering the country for a period of 14-days duration during the early phases of the COVID-19 outbreak. Several studies investigated the experience of quarantined people because of COVID-19 or previous outbreaks. However, quarantine is often perceived differently in different cultures because of its historical association with class, gender, ethnicity, politics, and prejudices. To our knowledge, there is limited literature on quarantine experience in Ethiopia related to either COVID-19 or other infectious diseases. Therefore, this study was aimed to explore quarantine experience of people in Southern Nations Nationalities and Peoples' Region (SNNPR) of Ethiopia during early phase of COVID-19 pandemic. METHODS: The study implemented an exploratory qualitative research design using a phenomenological approach. Face-to-face in-depth interviews were conducted with purposively recruited 29 respondents. Digitally recorded audio files have been listened to several times and verbatim transcriptions were done. The transcribed narratives were examined independently and content analysis was carried out through reading and re-reading the verbatim several times, open coding, grouping, categorizing, and abstracting the final themes. RESULTS: Three broad themes were identified and characterized the experiences of quarantined people due to COVID-19. These themes were a) handling of the suspected person, b) adverse effects of quarantine and c) coping strategies. In addition, quarantine refusals; injustice in quarantine; quarantine errors; psychological distress; physiological changes; social effects; financial losses; personal and social coping strategies were the emerged sub-themes. CONCLUSIONS: This study explored a range of complex experiences of quarantined people because of the COVID-19 outbreak in SNNPR. The quarantined people included in this study were adversely affected psychologically, physiologically, socially, and economically. They also experienced quarantine errors and injustice. There is a need to gather clear justification for close contact before forcing the suspect for mandatory quarantine. In addition, there is a need to develop risk communication strategy to approach suspected contacts for quarantine. Moreover, assessing psychological, physiological, social, and economic impacts of quarantine on the individuals while they are in quarantine and after release could be important. The use of personal and social coping strategies including psychosocial support may lessen the adverse impacts of the quarantine.

Knowledge, Perception and Preparedness Related to COVID-19 among Adult Rural Population in Konso, Southern Ethiopia.

BACKGROUND: According to the world health organization, the COVID-19 outbreak has currently affected millions of people worldwide. Since the start of the pandemic in China, everything countries have thrown at the virus turned unsuccessful. As there is no established vaccine to halt the virus transmission, it might be very difficult for developing countries like Ethiopia even after vaccine development. Thus, focusing on improving knowledge, perception, and preparedness related to the virus might be very vital. METHODS: A community-based cross-sectional survey was conducted using the questionnaire applied in most countries which is suitable to apply in the Konso zone in South Nations Nationalities Region (SNNPR) from April.2020 to July 2020. Data were collected, cleaned, coded, checked, and entered into Epi Info and then exported and analyzed in STATA 15. We fitted a binary logistic regression model. Categorical variables were presented using figure tables, and proportion and for continuous variables, mean and standard deviation were used. The results were also presented using Adjusted Odds Ratio (AOR) with 95% CI. RESULTS: From 636 respondents expected, 615(97%) were participated and possessed the knowledge of 39%, and 64% perception and preparedness each. Measurements related to the policy and interventions like restrictions to movement, self-isolation, wearing a face mask, & the need for more tests was not supported by most participants. CONCLUSION: The poor knowledge, perception, and preparedness were correlated with the unavailability of water and electricity, less education, and informal source of information which could be improved through area appropriate health education interventions.

Covid-19 Community Mitigation Status at Selected Districts of Southwest Ethiopia: A Mixed Design Survey.

BACKGROUND: The spread of covid-19 was alarmingly continued in Ethiopia. This survey assessed the status of community mitigations to fight the pandemic. The ongoing forward effort by local task forces can be assessed to note the achievements. METHODS: A mixed design using quantitative and qualitative triangulations used. Data was collected through interviewer administration using a structured W.H.O tool. The univariate and bivariate analysis employed to analyze descriptive statistics. The logistic regression model was applied to control confounders and determine potent predictors. OBJECTIVE: This study assessed community mitigation status on covid-19 pandemic at four selected districts of southwest Ethiopia: a mixed design survey. RESULTS: From the total of 624 participants interviewed, nearly half reported good mitigations toward fighting the covid-19 epidemic. This study suggested that nearly half (54.2%) of the participants had good knowledge about the newly emerged epidemic symptoms. Three out of five participants had good Knowledge of preventive practices (63.1%). Nearly four out of five (72.6%) participants were knowledgeable about 14 days incubation period. The odds of having good mitigation to prevent covid-19 among the participants who had single marital status were 55% lower than those married union (AOR=0.45, 95% CI: 0.24, 0.86). The odds of having good mitigation to prevent covid-19 among the participants (good knowledge symptoms) were 3.4 times higher than those with poor knowledge (AOR= 3.39, 95% CI: 2.19, 5.23). CONCLUSIONS AND RECOMMENDATIONS: Participants' mitigation status to fight covid-19 was promising. Handwashing with soap and water, disinfecting surfaces, and covering mouth or nose while coughing were mitigated practices by the vast majority. Home staying was the least mitigated practice. Participants' demographic status, knowledge of the epidemic symptoms, and knowledge of preventive measures were potent predictors of mitigations to fight covid-19. HID services should be extended to the rural population through HCWs and task forces.

Intention and Practice on Personal Preventive Measures Against the COVID-19 Pandemic Among Adults with Chronic Conditions in Southern Ethiopia: A Survey Using the Theory of Planned Behavior.

PURPOSE: With prevention being the only and best available intervention, COVID-19 has recently become a global threat, having had and continuing to have enormous health, economic, and societal impacts. Evidence so far has documented a heightened risk of mortality to people with chronic conditions. There is a dearth of evidence regarding chronic disease patients' intention and practice on the preventive measures. This study tried to fill this gap by assessing the intention to practice and practice on personal preventive measures (PPMs) among adults with chronic conditions. MATERIALS AND METHODS: A facility-based cross-sectional study was conducted in Southern Ethiopia among 806 adults with chronic conditions by employing a multistage sampling technique. Data were collected using a pre-tested and structured questionnaire. Statistical analysis was done using IBM SPSS software version 25. Binary logistic regression analysis was done to identify factors associated with intention and practice. Level of statistical significance was declared at a P-value of less than 0.05. RESULTS: The study showed that 52% (95% CI=47.61-54.80) and 76.3% (95% CI=73.36-79.24) of adults with chronic conditions were intending to practice and had ever practiced the personal preventive measures. Participants' subjective norm (SN) (AOR=4.94; 95% CI=3.49-6.96) and perceived behavioral control (PBC) (AOR=4.13; 95% CI=2.69-6.34) were the factors associated with their intention. Good knowledge and a positive attitude were found to be significant factors associated with the participants' actual practice of the PPMs among other independent factors. CONCLUSION: Around half of the participants were intending to practice PPMs, and three-quarters had good practice on the PPMs against COVID-19. Interventions targeted to improve intention and practice on the PPMs need to take into account improving knowledge and attitude, and build positive subjective norms and heighten the confidence to control the preventive behaviors.