Person-centered Maternity Care Among Mothers Who Gave Birth in South Wollo Zone Public Hospitals, Northeastern Ethiopia: A Mixed-method Study.

Background: Globally, less attention has been given to the abuse and disrespect observed during maternity care. Person-centered maternity care is providing care that is respectful and responsive to individual women's preferences and needs and that their values guide all clinical decisions during childbirth. In Ethiopia, person-centered health care is one of the factors that increase client satisfaction and health service utilization. Therefore, we aimed to determine the level of person-centered maternity care among mothers who gave birth in health facilities of South Wollo Zone public hospitals, Northeastern, Ethiopia, 2019 using a mixed-method study. Methods: An institution-based cross-sectional study was conducted using both qualitative and quantitative data collection methods. Three hundred sixty-nine study participants were selected for the quantitative study using simple random sampling. Twelve study participants were selected for the qualitative study using purposive sampling. The quantitative data was coded and entered into Epi data 4.4 version and the analysis was carried out using Statistical Package for Social Sciences version 23. Descriptive statics was presented using tables and figures. Thematic analysis was used for qualitative data and presented with the quantitative result through triangulation. Result: The Percentage mean score of the person-centered maternity care scale of the respondents was 64% of the total expected score. Whereas, the percentage means score sub-scales were 81.9%, for dignity and respect, 56.4% for communication and autonomy and 61.6% for supportive care. Most mothers who participated in an in-depth interview reported that there is not enough bed, delivery coach and bedpan in government hospitals. Conclusion and recommendations: Person-centered maternity care in health facilities of South Wollo Zone public hospitals is low. Therefore, responsible health sectors should work to improve the quality of care through effective communication between clients and providers and a supportive environment is crucial to succeeding in increasing the uptake of high-quality facility-based births.

Simulated Patient-Based Communication Skills Training for Undergraduate Medical Students at a University in Ethiopia.

BACKGROUND: Educational strategies following interactive methods of teaching enhance communication skill acquisition of medical students. However, which method of interactivity results in the most compelling communication skill improvement is the prime question yet unanswered. MATERIALS AND METHODS: In this study, experimental study design was employed among pre-clerkship II medical students of Jimma University, in the 2017/18 academic year. Accordingly, study participants were grouped in to two arms randomly. Arm 1 students were trained using simulated patients in a skill development lab and arm 2 students were trained using case-based role-plays. Both forms of training lasted for 20 hours and focused on 7 important communication skill dimensions key to patient care tasks, as adapted from the Kalamazoo II Report. An objective structured clinical examination (OSCE) form of assessment with a standardized checklist was utilized to investigate communication skill acquisition. RESULTS: In this study a total of 60 medical students was assessed for communication skills via 12 SP-based OSCE stations. This study discerned that, out of the total students, 21 (35.0%) were found to be poor at listening effectively. Similarly, 19 (31.7%), 18 (30.0%) and 16 (26.7%) were rated as poor at demonstrating caring and respectful behaviors, building and maintaining a therapeutic relationship and making informed judgments based on client data and preferences, respectively. Furthermore, the modalities of communication skill training are associated with key communication skill competencies except for eliciting information with effective questioning skills and counseling and educating patients. Thus, the SP-based training approach was found to be significantly associated with communication skill acquisition as compared to the case-based role-play approach, with AOR 21.696 at a p-value of <0.001. CONCLUSION: In this study, it was concluded that an SP-based communication skill training approach is superior to a case-based role-play approach.

Technical efficiency of public health centers in three districts in Ethiopia: two-stage data envelopment analysis.

OBJECTIVE: The aim of the study was to measure technical and scale efficiency of public health centers in three districts of Jimma zone, Ethiopia. A two-stage data envelopment analysis was used. First, we estimated technical and scale efficiency of the health centers. In the second stage, institutional and environmental factors were against technical efficiency of the health centers to identify factors associated to efficiency of the health centers. RESULTS: Eight out of the 16 health centers in the study were found to be technically efficient, with an average score of 90% (standard deviation = 17%). This indicates that on average they could have reduce their utilization of all inputs by about 10% without reducing output. On the other hand, 8 out of 16 health centers were found to be scale efficient, with an average scale efficiency score of 94% (standard deviation = 9%). The inefficient health centers had an average scale score of 89%; implying there is potential for increasing total outputs by about 11% using the existing capacity/size. Catchment population and number of clinical staff were found to be directly associated with efficiency, while the number of nonclinical staff was found to be inversely associated with efficiency.

Utilization Status of Electronic Information Sources (EIS) for HIV/AIDS Care and Treatment in Specialized Teaching Hospitals of Ethiopia, 2016.

BACKGROUND: According to the World Health Organization, the use of Electronic Information Sources (EIS) in healthcare is not merely about application of technology, but it is also a foundation to provide higher quality clinical care. This study was aimed to assess Utilization Status of EIS for HIV/AIDS Care and Treatment in specialized teaching hospitals of Ethiopia, 2016. MATERIALS AND METHODS: A facility based cross-sectional study design was used. The study populations were 352 healthcare professionals selected by using simple random sampling technique from three randomly selected specialized teaching hospitals of Ethiopia. Quantitative and qualitative data were collected and analyzed by fitting multivariate logistic regression model and thematically by bringing similar themes together respectively. RESULTS: This study revealed that only 33.2% of the health professionals used EIS as supporting tool in their clinical practice including HIV/AIDS care and treatment. The main reasons for not using EIS were having no training 285(89.9%), followed by preferring print resources 20(6.3 %). Furthermore, there was statistically significant association between use of EIS and perceived electronic information retrieval skills AOR = 3.271, CI (1.942, 4.051), perceived quality of electronic information content retrieved AOR= 2.069, CI (1.051, 3.925) and limited access to computer and internet connection AOR = 5.072, CI (1.834, 5.931). CONCLUSIONS: In this study, only one-third of health professionals used EIS as supporting tool in their clinical practice. Hence, hospital boards should devise strategies to improve utilization of EIS.

Willingness to join and pay for the newly proposed social health insurance among teachers in Wolaita Sodo Town, South Ethiopia.

BACKGROUND: Cost-sharing between beneficiaries and governments is critical to achieve universal health care coverage. To address this, Ethiopia is currently introducing Social Health Insurance. However, there has been limited evidence on willingness to join the newly proposed insurance scheme in the country. The purpose of this study is to assess willingness to join and pay for the scheme among teachers in Wolaita Sodo Town government educational institutions, South Ethiopia. METHODS: A cross-sectional study was conducted from February 5 to March 10, 2012 on 335 teachers. Stratified simple random sampling technique was used and data were collected using structured interviewer administered questionnaire. Binary and multiple logistic regressions were used to estimate the crude and adjusted odds ratios for willingness to pay. RESULTS: Three hundred twenty-eight teachers participated in the study with response rate of 98%. About 55% of the teachers had never heard of any type of health insurance scheme. However, 74.4% of them were willing to pay for the suggested insurance scheme. About 47% of those who were willing to pay agreed to contribute greater than or equal to 4% of their monthly salaries. Willingness to pay was more likely among those who had heard about health insurance, had previous history of inability to pay for medical bills and achieved higher educational status. CONCLUSION: The majority of the teachers were willing to join social health insurance; however, adequate awareness creation and discussion should be made with all employees at various levels for the successful implementation of the scheme.