Utilization of emergency medical service and its associated factors among patients visited public hospitals at Hawassa City, Sidama Region, Ethiopia, 2023.

Background: The burden of emergency medical conditions is borne mostly by poorer nations, with a 6 % increase in deaths of adults and children due to emergency conditions between 1990 and 2015. Emergency medical service is crucial to improve outcomes of those injuries and other time-sensitive illnesses. However, access to emergency medical services in Hawassa City is still limited and its' utilization is influenced by different factors. Methods: A facility-based cross-sectional study was conducted among 422 randomly selected clients who visited the emergency service in public hospitals of Hawassa City. A structured interviewer-administered questionnaire adapted by reviewing previous literature was used. The collected data by using the Kobo toolbox was exported into a statical package for social science software for analysis. Descriptive statistics such as frequency, percentage, mean, and standard deviation were used. A binary logistic regression model at a 95 % confidence interval was used to declare an association between dependent and independent variables using the odds ratio. Results: All 422 participants completed the interview with a response rate of 100 %. The mean age of the study participants was 33.73 years with a 14.67 standard deviation. One quarter (24.9 % (95 % CI: 21.1-29.4)) of the study participants have utilized emergency medical services. Urban residence (AOR = 3.48, 95 % CI: 1.69-7.16), ever utilized ambulance service (AOR = 2.37, 95%CI: 1.21-4.67), having Red Cross Association ambulance number (AOR = 2.64, 95%CI: 1.20-5.83) and awareness on presence of free government ambulance (AOR = 3.74, 95%CI: 1.46-9.59) were the predictors of the outcome variable. Conclusion: utilization of emergency medical services in the study area was relatively low when compared with other studies. urban residence, ever utilization of ambulance service, awareness of the presence of free government ambulances, and having a Red Cross Association ambulance number were predictors of utilization of emergency medical service.

Prevalence of low back pain and associated factors among bank workers at Hawassa city, Northern Zone, Sidama Region, Southern Ethiopia.

BACKGROUND: Lower back pain (LBP) is a public health threat that affects people who frequently experience sedentary working conditions. Few studies reported on low back pain among bank workers in Ethiopia, particularly in the study area. Therefore, this study aimed to determine the magnitude and associated factors of low back pain among bank workers in Hawassa City, Sidama Region, Ethiopia. METHODS: This institutional-based cross-sectional study was conducted from April 20, 2023, to June 30, 2023. A multistage sampling technique was employed to select participants, and data were collected using a structured self-administered questionnaire, entered into Epidata version 4.6, and transferred to SPSS version 25 for further analysis. Bivariate and multivariate logistic regression analyses were performed to identify the independent predictors of lower back pain. RESULTS: Of the 627 total study participants, six hundred seven bank workers participated in the study, with a response rate of 96.8%. The overall magnitude of lower back pain among the study population was 55.2%, with a 95% confidence interval (CI 51.1-59). Based on the multivariate binary logistic regression analysis, being in a manager position (AOR = 3.85; 95% CI = (1.2,12), a level 2 banker (AOR = 3.8; 95% CI = (1.9,8.9), age 30-39 years (AOR = 4; 95% CI = (2,12.4), an age ≥ 40 years (AOR = 5.4; 95% CI= (3.04,16.3), working in sufficient space (AOR = 0.4; 95% CI = (0.3,0.9), and physical activity (AOR = 0.2; 95% CI = (0.1,0.8)) were significantly associated with low back pain. CONCLUSION: The prevalence of low back pain among the bank workers was high in the study area. Being in a managerial position, being a level two banker, being aged 30-39 years, being aged ≥ 40 years, working in sufficient space, and engaging in physical activity were significantly associated. Therefore, it is essential to establish a health screening team, create awareness programs for the benefit of physical activity, provide sufficient working space, and give special attention to elderly and senior bankers and bank managers to reduce the risk of developing low back pain.

Factors affecting need and utilization of palliative care services among Ethiopian women in an oncology department: A hospital-based cross-sectional study.

Background: Palliative care, which aims to alleviate physical and emotional distress from cancer, is underutilized in many African healthcare systems. Therefore, there is a lack of data on the need and utilization of palliative care services among women with breast cancer in Ethiopia. Objectives: The goal of this study was to identify the level of need and utilization of palliative care services and identify associated factors among women in an oncology department of Hawassa comprehensive and specialized hospitals. Design: Hospital-based cross-sectional study. Methods: A total of 121 women age ⩾18 years old with breast cancer participated from 1 August to 30 October 2021. A hospital-based consecutive sampling technique was used. Data regarding the need and utilization of palliative care services were collected via questionnaire and interview, entered using EpiData 4.6.0.6, and analyzed by SPSS version 25. Variables with p < 0.25 were considered for multivariate analysis, and those with p < 0.05 indicate an association with palliative care utilization. Result: Seventy-two (59.5%) had worse utilization of palliative care services, with higher odds in rural areas (adjusted odds ratio = 11.82). Conclusion: The study findings indicated that more than half of the study participants had worse utilization of palliative care services, with rural living being a contributing factor.

Determinants of respectful maternity care among women who gave childbirth in Southern Ethiopia.

BACKGROUND: Having a good provision of respectful maternity care (RMC) to a woman who gives childbirth is a crucial component of maternal health care to result in positive maternal and neonatal outcomes. Disrespect and lack of women-centered care in birth discourage a woman from seeking healthcare during childbirth contributing to poor healthcare-seeking behaviour and dissatisfaction with the maternity service. The current study aimed to assess key determinants of RMC during childbirth at selected public health facilities of the Gofa zone, Southern Ethiopia. METHODS: A cross-sectional study design was conducted from March to April 2021 among 390 women who gave birth in eight randomly selected public health facilities of Gofa zone, Southern Ethiopia. The level of RMC was measured using structured exit interview items. A structured-interviewer-administered questionnaire was used to collect data and then entered into Epi-data version 4.6 and exported to SPSS version 25 for further analysis. Bivariate and multivariate logistic regression analyses were used to identify determinants of RMC among women. RESULTS: A total of 390 women responded to the exit interview making a response rate of 100%. The mean (± SD) age of the 390 women was 27.9 (± 4.85) years. The overall prevalence of women who received RMC was 40.5%, 95% CI (36-45%). Two hundred and ninety-seven (76.2%; n = 297/390) women had antenatal care (ANC) attendance in the index pregnancy. A woman who had planned pregnancy (AOR = 1.72, CI: 1.04, 2.85), planned to deliver in a health facility (AOR = 1.68, CI: 1.00, 2.81), presence of familial support (AOR = 2.04, CI: 1.20, 3.48), and had information about service availability (AOR = 4.44, CI: 2.09, 9.42) were associated with RMC among women. CONCLUSION: The provision of respectful maternity care in the study area was low when compared with local studies. Planned pregnancy, plan to deliver in a health facility, family support, and presence of information about service availability were factors associated with RMC among women. More attention should be given to training and supportive supervision of health care professionals on respectful maternity care and its standards to increase service uptake and make service more women-centred.

Out of sight: chronic kidney diseases among diabetic patients attending care and follow up. Findings from pastoralist health facilities of Southern Ethiopia.

Background: In Ethiopia, the prevalence of chronic kidney disease (CKD) among the adult population ranges to 19.1%. The disease's impact has increased in low-resource settings due to a lack of knowledge about the condition and its risk factors. Diabetes is one of the numerous causes of CKD. Despite this, little was known in Ethiopia, particularly in the study area. This study aimed to identify the determinants of CKD among diabetic patients enrolled in care and follow up at pastoralist health facility of Jinka General Hospital (JGH), Southern Ethiopia, 2023. Methods: An institutional-based cross-sectional study design was conducted among 626 diabetic patients recruited through a systematic random sampling. Data was collected using a structured interviewer-administered questionnaire and entered into Epi data version 7.2 and then exported to the Statistical Package for Social Sciences (SPSS) version 25 for further analysis. Bivariate and multivariate logistic regression analyses were conducted to find eligible variables for the later analysis. Variables with p < 0.25 at bivariate logistic regression were selected for multivariate logistic regression analysis. The variables with p < 0.05 at the multivariate analysis were taken as statically significant in the final model. Results: The prevalence of CKD was 2.7% (95% CI: 1.12-6.01%). Place of residence (AOR: 4.84; 95% CI: 1.51-15.40), presence of hypertension (AOR: 5.69; 95% CI: 1.58-20.51) and family history of CKD (AOR: 6.20; 95% CI: 1.40-15.49) were factors associated with CKD among diabetes patients. Conclusion: The prevalence found in this study was low when compared with the local studies. Provision of health education to diabetic patients on preventative measures such as physical exercise is cost-effective approach. Factors associated with CKD among diabetics can be significantly mitigated by strengthening the existing NCDs prevention packages in the study area particularly and in Ethiopia generally.

Quality of Chronic Disease (Diabetes & Hypertension) Care in Health Care Facilities in High Disease Burden Areas in Sidama Region: Cross-Sectional Study.

Background: Diabetes and hypertension are major synergistic risk factors for microvasculopathy, microangiopathy, and neuropathy problems among patients with chronic disorder. Control of hypertension and diabetes have significant value in delaying these complications. The key for delaying complications in diabetes and hypertension is the quality of care. Objective: This study explored the quality of diabetes-hypertension care in health care facilities with high disease burden in Sidama region. Methodology: An institution-based cross-sectional study was carried out. Patients with diabetes and hypertension were included in the study. In this study, we included 844 patients were included in the study. For data collection, the application software Kobo Collect was utilized. For data analysis, SPSS version 25 was used. Logistic regression was used to identify factors associated with quality of care. To measure quality, we employed patient outcome indicators focusing on long-term complications of the eye, heart, fasting blood pressure, and neuropathic complications. Ethical approval clearance was obtained from Hawassa University, College of Medicine and Health Sciences ethical review board. Results: The mean age of patients was 47.99 ± 15.26 years, with a range of 18-90 years, while men make up 62% of the overall number of respondents. In terms of marital status, 700 (82.9%) were married. Concerning place of residence; 433 (51.3%) were from rural area. The primary diagnosis is diabetes for 419 (49.6%) patients, and nearly 23% of patients have both diabetes and hypertension. In terms of blood pressure, the average systolic pressure was 129.6 mmHg and the average diastolic pressure was 82.6 mmHg. Among the study participants, 391 (46.33%) patients received poor quality of chronic disease care. Patients living alone, patients who have professional work, fasting blood glucose in normal range, patients with higher education, and patients with serum creatinine receive relatively good chronic illness care.

Determinants of unmet physical and psychological supportive care needs among adult cancer patients in Southern Ethiopia.

OBJECTIVE: The main objective of this study was to assess the prevalence of unmet physical and psychological supportive care needs and associated factors among adult patients with cancer in Southern Ethiopia. METHODS: A cross-sectional study was conducted among 321 patients with cancer from 20 June 2022 to 5 August 2022 at Hawassa University Comprehensive Specialized Hospital oncology centre. Simple random sampling technique was used to recruit participants. Data were entered into Epi-Data V.4.6 and were exported to SPSS V.26 for analysis. Logistic regression model was used to describe the association between dependent and independent variables. RESULT: The mean age of the study participants was 45±14.27. The prevalence of unmet physical and psychological supportive care needs was 47.3% and 71.1%, respectively. Rural residence ((adjusted OR, AOR 2.73; 95% CI (1.27 to 5.83)) and late-stage cancer ((AOR 2.95; 95% CI 1.02 to 8.52) were factors significantly associated with unmet physical supportive care need. Coexisting illness was associated with both unmet physical and psychological supportive care needs (AOR 2.73; 95% CI 1.27 to 5.83) and (AOR 2.71; 95% CI 1.16 to 6.33), respectively. CONCLUSION: Nearly half of the study participants had an unmet physical supportive care need while greater than two-thirds had unmet psychological supportive care need. Residence and late-stage cancer were factors significantly associated with physical unmet supportive care need while coexisting illness was associated with both unmet physical and psychological supportive care needs. Hence, supportive care for patients with cancer should be given an emphasis and incorporated into the cancer treatment protocol.

Level of modern health-seeking behavior for common childhood illnesses and its associated factors among mothers of under-five children in southern Ethiopia: A community based study.

Background: Health-seeking behavior is an action taken by an individual who perceives to have a health problem. Many childhood morbidities and mortalities are associated with a low level of a mother's healthcare-seeking behavior. However, there are limited studies about modern health-seeking behavior among mothers of ill under-five children in the study area. Objective: To assess the level of modern health-seeking behavior of mothers/caregivers and associated factors for childhood illness in Hawassa city, Sidama, Ethiopia 2021. Methods: A community-based cross-sectional study was conducted from November 15 to December 15, 2021, in Hawassa City. Eight kebeles were selected by using simple random sampling methods. A total of 366 mothers with children less than five years were included in this study and an interviewer-administered questionnaire was used to collect data. Data entry, cleaning, and analysis were done by using Statistical Package for Social sciences version 24 and logistic regression was used to determine the presence of association, and significance was declared at p-value <0.05. Result: The study found that 70.2% of mothers/caregivers seek modern health care for their child's illnesses. Number of Antenatal care follow up ([AOR(Adjusted Odds Ratio) = 2.106; 95% CI(Confidence Interval) (1.097-4.042)), urban residence ([AOR = 2.688; 95% CI (1.403-5.149)), perceived severity of illness ([AOR2.832; 95% CI1.101-7.290)), four or above birth order (5.501; 95% CI (1.761-17.184)) and symptoms guiding severity of illness ([AOR = 4.664; 95% CI (1.918-11.342)) were associated with modern health-seeking behavior. Conclusion: The overall modern health-seeking behaviors of mothers of under-five children are higher than in previous studies. However, a still significant proportion of mothers do not seek modern health care for their ill children. mothers/caregivers' residence, birth order, number of Antenatal care follow-ups, perceived severity of childhood illness, and perceived guiding symptoms of severity are the significant predictors of mothers' healthcare-seeking behavior.

Informed choice and its associated factors among women received immediate postpartum long-acting reversible contraceptives at public hospitals in Sidama Regional State, Ethiopia, 2022.

INTRODUCTION: It is crucial to ensure the quality of family planning (FP) services through women's informed choice during the provision of long-acting reversible contraceptives. In Ethiopia, previous studies have focused on the quality of family planning services. However, much emphasis was not given to the informed choice of immediate postpartum long-acting reversible contraceptives (LARCs), particularly in the study area. This study determines the mangnitude of informed choice and associated factors among immediate postpartum women who received long-acting reversible contraceptives. METHOD: An institution-based cross-sectional study was conducted from July 1 - August 31, 2022, among 373 immediate postpartum women who received long-acting reversible contraceptives at public hospitals in the Sidama regional state, Ethiopia. Women were selected and interviewed using a systematic random sampling technique and via a structured interviewer-administered questionnaire respectively. Data was collected using Kobo Toolbox software and then exported to the Statistical Package for Social science (SPSS) version 25 for analysis. A logistic regression model was used to identify the predictor variables. RESULTS: The magnitude of informed choice of long-acting reversible contraceptives was 23.5% (95% CI (19.6%-27.7%)). The messages through posters about long-acting reversible contraceptives at the facility (AOR 3.6, 95% CI (1.92-6.79), postpartum family planning counseling during antenatal care (AOR 2.8, 95% CI (1.2-6.4), previous contraceptive use (AOR 3.23, 95% CI (1.12-9.33), and being secondary and higher educated (AOR 2.92, 95%CI (1.27-6.73) and (AOR 5.7, 95% CI (2.267-14.669) respectively were factors significantly associated with informed choice during immediate postpartum family planning service. CONCLUSION AND RECOMMENDATION: In the current study, nearly one-fourth of women were informed about LARCs. Socio-demographic factors, prior use of contraception, exposure to posters that have messages about long-acting reversible contraceptives, and postpartum family planning counselling during antenatal care are factors that affect the woman's ability to make an informed choice. There should be immediate PPFP counselling that focuses on a full range of contraceptive method choices to facilitate postpartum women's ability to make informed choices.

Utilization of palliative care and its associated factors among adult cancer patients in Hawassa University comprehensive specialized hospital oncology center, Hawassa, Ethiopia, 2021: a cross-sectional study.

OBJECTIVE: To assess the utilization of palliative care (PC) and its associated factors among adult cancer patients in Hawassa University Comprehensive Specialized Hospital (HUCSH) oncology center, Hawassa, Ethiopia, 2021. METHODS: An institution-based cross-sectional study was conducted among adult cancer patients. Randomly selected adult cancer patients (≥ 18 years of age) attending their treatment at HUCSH oncology center PC unit were included. Data was collected from June to August, 2021. The aim was to interview 185 patients. A structured questionnaire was used to collect the data. Data entry was done using Epi-Data version 4.6 and bivariate and multivariate logistic regression models were used in SPSS for analysis. RESULTS: Out of 180 study respondents, 66% were aged 50 years or older. Sixty-three percent were characterized to have a better utilization of PC services. Patients aged below 50 years (adjusted odds radio (AOR) = 2.7; 95% CI = 1.13-6.63), with a higher educational status (grade 9 to 12 or college/university graduation (AOR = 1.46; 95% CI = 0.41-5.21, and AOR = 3.23; 95% CI = 0.98-10.61, respectively), with a higher income >5,500 Birr (AOR = 2.7; 95% CI = 0.51-5.76), with and good accessibility of PC services (AOR = 2.99; 95% CI = 1.21-3.28) were significantly associated with better utilization of PC services. CONCLUSION: The current study revealed two thirds of patients had better utilization of PC services. Older patients with low educational status and income and those living in rural areas had worse access to PC services. It is recommended to improve information provision about PC especially for older patients and patients with low education and to improve accessibility for patients in suburban and rural areas.

Determinants of breast self-examination practice among women attending pastoralist health facilities, Southern Ethiopia: a cross-sectional study.

BACKGROUND: Breast cancer remains the most serious public health problem affecting millions of women worldwide. Despite various studies regarding breast self-examination practices conducted among health professionals and students in Ethiopia, limited information was found on women attending health care services in the pastoralist community. This study aimed to identify the determinants of breast self-examination practice (BSE) among women attending pastoralist health facilities in Southern Ethiopia. METHODS: An institutional-based cross-sectional study was conducted among 421 women who were attending family planning services in pastoralist health facilities in South Omo Zone, Southern Ethiopia from January to February 2022 using systematic random sampling to select a woman from each health facility in Jinka town. Data were collected using structured, pretested, and interviewer-administered questionnaires. Descriptive statistics such as proportions, means, and standard deviations were used to describe each relevant variable. Bivariate and multivariate logistic regression analyses were used to identify the determinants of BSE practices among women. RESULT: The mean age of the women was 25.43 ± 6.66 years. Fifty-four percent (n = 173) of the women had heard of BSE from health professionals. Eighty-nine (21.1%) women had undergone BSE. Women who resided in the urban areas (AOR = 6.79, CI: 3.40, 13.56), attained at least primary education and above (AOR = 8.96, CI: 4.14, 19.35), heard about BSE (AOR = 4.07, CI: 2.07, 7.98), and had a family history of breast cancer (AOR = 7.46, CI = 3.27, 17.00) were significantly associated with BSE practice. CONCLUSION AND RECOMMENDATION: Our study showed that women's practice of BSE was lower when compared with the local studies. We recommend health care professionals and others working in the area improve ways of increasing awareness about breast cancer, including its risk, and the need for BSE.

Practice towards Hepatitis B Virus Infection Prevention and Its Associated Factors among Undergraduate Students at Hawassa University College of Medicine and Health Sciences, Hawassa, Sidama, Ethiopia, 2021: Cross-Sectional Study.

Background: Hepatitis B virus infection is a major global health burden accounting for 2.7% of all deaths globally. Being part of the health care system, the risk of exposure to hepatitis B viral infection among medical and health science students is found to be high. In Ethiopia, particularly in this study area, very little is known about the practice of students towards hepatitis B virus infection prevention and its associated factors. Objective: The aim of this study was to assess the practice towards hepatitis B virus infection prevention and its associated factors among undergraduate students at Hawassa University College of Medicine and Health Sciences, Hawassa, Ethiopia, 2021. Methods and Materials: An institution-based cross-sectional study was conducted from May 15 to June 15, 2021, among undergraduate students who had clinical exposure. The 404 sampled participants were recruited using a systematic random sampling technique. Data was collected using a structured self-administered questionnaire. Data was entered into EpiData version 4.6.0 and was exported to SPSS version 25 for analysis. Association between the dependent and independent variables was computed using the bivariate and multivariate logistic regression model. Odds ratio was calculated. Results were interpreted as significant if P value is <0.05 at 95% CI. Result: This study revealed that 277 (69.9%) of the students were in the age group of 20-24 years and 266 (67.2%) were males. Out of 396 participants, about half 199 (50.3%) 95% CI (0.452-553) had a good practice towards hepatitis B virus infection prevention. Only 43.4% of the study participants had been completely vaccinated against hepatitis B virus. Age (20-24 years) (AOR = 2.736), 95% CI (1.130-6.625), and good knowledge (AOR = 1.990), 95% CI (1.207-3.282) were factors significantly associated with the practice towards hepatitis B virus infection prevention. Conclusion and Recommendation. The current study showed that about half of the study participants had good practice towards hepatitis B virus infection prevention but more than half were not completely vaccinated against HBV. Age and knowledge were factors significantly associated. It is recommended to give training for students on hepatitis B virus infection prevention. It is also advisable to screen and vaccinate students before they start their clinical attachments.

Failed induction of labor and associated factors among women delivered in Jigjiga University Sheik Hassan Yabare Referral Hospital: a cross-sectional study.

OBJECTIVE: This study was aimed to assess the magnitude of failed induction of labor and associated factors among mothers delivered in Eastern Ethiopia. METHODS: An institutional-based cross-sectional study was carried out among 364 women who had induction of labor at Jigjiga University, Sheik Hassan Yabare Referral Hospital from 2018 to 2021. A checklist was used to collect the data from the women's chart. To isolate independent predictors related to failed induction of labor, multivariate logistic regression analyses were performed. RESULT: The magnitude of failed induction of labor was 36.8% (95% CI: 31.8, 42.0). Age (AOR = 3.2; CI: 1.78, 5.75), rural residency (AOR = 2.28; CI:1.29, 4.01), para (AOR = 2.76; CI: 1.55, 4.91), gestational age (AOR = 2.65; CI: 1.44, 4.89), multiple pregnancy (AOR = 2.36; CI: 1.01, 5.55), premature rapture of membrane (AOR = 4.88; CI: 2.33, 10.21), pregnancy-induced hypertension (AOR = 5.11; CI: 2.67, 9.79), and bishop score (AOR = 1.95; CI: 1.15, 3.32) were significantly associated with failed induction of labor. CONCLUSION: The magnitude of failed induction of labor was relatively high in the study setting. Failed induction of labor was significantly associated with age, rural residency, primipara, gestational age, multiple pregnancy, premature rapture of membrane, PIH, and bishop score less than six. Prior to initiating the induction of labor, proper pelvis assessment and cervical ripening for bishop score might be considered. Beside to this, adherence to locally available induction protocols and guidelines might also be needed.

Isoniazid Preventive Therapy for Prevention of Tuberculosis among People Living with HIV in Ethiopia: A Systematic Review of Implementation and Impacts.

BACKGROUND: Tuberculosis (TB) is a major cause of morbidity and mortality in people living with HIV (PLWHIV). Isoniazid preventive therapy (IPT) prevents TB in PLWHIV, but estimates of its effects and actual implementation vary across countries. We reviewed studies that examined the impact of IPT on PLHIV and the factors influencing its implementation in Ethiopia. METHODS: We searched PubMed/MEDLINE, Embase, and the Cochrane Central Register of Clinical Controlled Trials from their inception to 1 April 2021 for studies of any design that examined the impact of IPT on PLHIV and the factors influencing its implementation. The protocol was registered in PROSPERO, ID: CRD42021256579. RESULT: Of the initial 546 studies identified, 13 of which enrolled 12,426 participants, 15,640 PLHIV and 62 HIV clinical care providers were included. PLHIV who were on IPT, independently or simultaneously with ART, were less likely to develop TB than those without IPT. IPT interventions had a significant association with improved CD4 count and reduced all-cause mortality. IPT was less effective in people with advanced HIV infection. The major factors influencing IPT implementation and uptake were stock-outs, fear of developing isoniazid-resistant TB, patient's refusal and non-adherence, and improper counseling and low commitment of HIV clinical care providers. CONCLUSION: IPT alone or in combination with ART significantly reduces the incidence of TB and mortality in PLHIV in Ethiopia than those without IPT. More research on safety is needed, especially on women with HIV who receive a combination of IPT and ART. Additionally, studies need to be conducted to investigate the efficacy and safety of the new TPT (3 months combination of isoniazid and rifapentine) in children and people living with HIV.