Complication experience during pregnancy and place of delivery among pregnant women: a cross-sectional study.

BACKGROUND: Unlike other causes such as abortion, obstetric complications like hemorrhage, and hypertensive disorders of pregnancy, which are difficult to resolve for women who give birth out of health facilities are persisted or increased to be the cause of maternal mortality in Ethiopia. Direct obstetric complications resulted in the crude direct obstetric case fatality rate in this country. This study aimed to assess the relationship between Complication Experience during Pregnancy and Place of Delivery among Pregnant Women. METHOD: A community-based cross-sectional study was conducted to assess the baseline information as a part of a randomized control trial study. The sample size that was calculated for the cohort study with the assumptions to detect an increase in a minimum acceptable diet from 11 to 31%, with 95% CIs and 80% power, an intra-cluster correlation coefficient of 0·2 for a cluster size of 10 was used for this study. Statistical analysis was done using SPSS version 22. RESULT: The prevalence of self-reported pregnancy-related complications and home delivery were 79(15.9%, CI; 12.7-19.1) and 46.90% (95%CI; 42.5-51.1) respectively. Women who did not face vaginal bleeding were five times AOR 5.28(95% CI: 1.79-15.56) more like to give birth at home than those who faced this problem. Women who did not face severe headache were nearly three AOR 2.45(95%CI:1.01-5.97) times more like to give birth at home. CONCLUSION: This study concluded that home delivery was high among the study participants whereas pregnancy-related complications such as vaginal bleeding and severe headache were identified as protective factors for facility delivery. Hence, the researchers recommended the incorporation of "storytelling" into the existing health extension program packages to improve facility delivery which shall be applied after the approval of its effectiveness by further research.

Health-related quality of life among patients with chronic diseases during COVID-19 pandemic: a cross-sectional study.

Introduction: in the last two years, COVID-19 has largely changed the rhythm of human life and overwhelmed the healthcare systems globally. Patients with pre-existing chronic diseases have worse outcomes during the COVID-19 pandemic. Methods: an institution-based cross-sectional study was conducted from April 1-30, 2021. Data were collected using an interviewer-administered questionnaire and data extraction checklist. A systematic random sampling technique was used to select a total of 400 study participants. Data were entered into EPI data version 3.5.3 and exported to Statistical Package for the Social Science (SPSS) version 23.0 for analysis. Multivariable logistic regression was used and variables with a p-value < 0.05 were considered statistically significant. Results: three hundred and ten (77.5%) of the respondents had a poor overall health-related quality of life (HRQOL) during the COVID-19 pandemic. Younger age (AOR=0.10.95% CI: 0.04-0.27), no formal education (AOR=5.03, 95% CI: 1.92-13.22), shorter treatment duration(AOR=0.11, 95% CI: 0.04-0.29), presence of respiratory symptoms (AOR=9.69, 95% CI: 2.93-32.09) and missed health-care appointment during COVID-19 (AOR=3.68, 95%CI: 1.82-7.43) were significantly associated with health-related quality of life (HRQOL). Conclusion: most of the respondents had a poor overall health-related quality of life during the COVID-19 pandemic. Consideration of the influence of outbreaks on the continuity of care for a patient and focusing on contributing factors should be an essential concern of the healthcare system. The objective is to assess health-related quality and factors associated with health-related quality of life among patients with chronic diseases during the COVID-19 pandemic.

Impact of COVID-19 on Health Seeking Behavior of Patients with Chronic Disease at Public Hospitals in Jimma Zone, South West Ethiopia.

Background: COVID-19 is a global pandemic with unprecedented medical, economic and social consequences affecting nations across the world. This epidemic arises while chronic diseases are continued to be a public health concern. Though evidence is generated on its impact on the health care system, little is known about the Impact of COVID -19 on the care-seeking behavior of chronic patients. Objective: To assess the Impact of COVID-19 on healthcare-seeking behavior of patients with chronic diseases attending follow-up at public hospitals in Jimma zone, South West Ethiopia. Methods: Facility-based cross-sectional study design was employed. The sample was calculated using the single population proportion formula. Hospitals were selected by using simple random sampling. Then, the final calculated sample size for the study was proportionally allocated to each selected hospital. Data were collected from 400 participants through face-to-face interviews and card reviews. Data were entered into Epi-Data version 3.1 and then exported to SPSS version 23 for analysis. Binary and multivariable logistic regression analyses with 95% CI for odds ratio (OR) were used to identify significant factors. Results: Of the total respondents 156 (39.0%) of them had poor health-seeking behavior. Contact history with COVID -19 patient (AOR = 2.8; 95% CI = 1.1-7.0), perceived moderate depression (AOR = 2.3; 95% CI = 1.2-4.2), perceived extreme depression (AOR = 4.3; 95% CI = 1.8-10.5), shortage of medication (AOR = 2.4; 95% CI = 1.0-6.2) increases the odds of poor health-seeking behavior. In addition, the odds of poor health-seeking in patients with no formal education were higher compared to patients with higher educational status (AOR = 2.7; 95% CI = 1.0-9.0). Conclusion: COVID -19 outbreaks affected the health-seeking behavior of patients with chronic diseases. The impact was found to be more significant among patients who had a contact history with COVID -19 patients. Moreover, perceived depression, shortage of medication, and low educational status were significant predictors of poor health-seeking behavior. Therefore, working on the barriers to the health-seeking behavior of chronic patients may reduce the effect of COVID-19.

Delay in Reaching Institutional Delivery Service Utilization among Mothers Attending Jimma Medical Center, Ethiopia.

Background: Maternal delay in the utilization of delivery services is one of the contributing factors for high maternal mortality in developing countries. However, it is preventable by timely arrival for obstetric care. The difference between life and death in obstetrics might be a matter of timely arrival and management. The objective of this study was to assess factors associated with maternal delay in reaching institutional delivery service utilization among mothers attending Jimma Medical Center. Method: Facility-based cross-sectional study design was employed. The sample size was determined by a single population proportion formula and entered into epi data version 3.1, then exported to SPSS version 23. The data was presented using texts and tables. Binary and multivariable logistic regression analysis with 95% CI for odds ratio (OR) was used to assess the factors. Result: The prevalence of maternal delay in reaching institutional delivery service utilization was 163(40.2%). Low husbands' educational levels were significantly associated with delay in reaching: illiterate (AOR=4.22, 95% CI: 1.10-16.19), primary (AOR=3.88, 95% CI: 1.24-12.1). Mothers who live in rural areas have been delayed 2 times more than mothers who live in urban areas (AOR=2.22, 95% CI: 1.044-4.73). Likewise, mothers who live a long distance from health facilities are 13 times more likely to delay than mothers who live ≤ 10 kilometers (AOR= 12.89,95%CI:6.66-24.94). Conclusion: Delay in reaching institutional delivery service was high. Factors such as husband's education, distance of health facility, and living area were significant factors with delay in reaching.

Delay in Seeking Institutional Delivery Service Utilization and Associated Factors Among Mothers Attending Jimma Medical Center, Jimma, Ethiopia.

BACKGROUND: Pregnancy and childbirth-related complications are unpredictable; however, it is preventable by timely care-seeking to obstetric care service. OBJECTIVE: To assess delay in seeking institutional delivery service utilization and associated factors among mothers attending Jimma medical center, Southwest Ethiopia. METHODS: Facility-based cross-sectional study design was employed. The sample size was determined by a single population proportion formula. Data were collected from 405 mothers by face-to-face interview and entered using epi-data version 3.1, then exported to SPSS version 23 for analysis. Binary and multivariable logistic regression analysis with 95% CI for odds ratio (OR) was used to identify significant factors. RESULTS: The prevalence of delay in seeking institutional delivery service utilization was 189 (46.7%). Husbands' educational status was found to be significantly associated with a maternal delay in seeking care, (AOR= 4.9; 95% CI=2.1-11.3). Unemployed mothers and mothers with a low income had shown higher odds of delay (AOR= 6.0; 95% CI=1.7-21.2), (AOR=2.1; 95% CI=1.2-3.7) respectively. Similarly, mothers who live >10 kilometers from health facility delayed about 2times, (AOR=1.8; 95% CI= 1.0-3.2). Moreover, the likelihood of mothers with no antenatal care follow-up was found to have higher delay than mothers who have antenatal care follow-up (AOR =2.8; 95% CI =1.1-6.7). CONCLUSION: Delay in seeking institutional delivery service was high. Factors such as the husband's educational status, distance from the health facility, income, Antenatal care follow-up, and occupation of the mother were found significant factors of delay in seeking care. Therefore, it is important to reduce delay in seeking care for institutional delivery service utilization by working on barriers, plus empowering women, promoting antenatal care, and education.