Impact of the COVID-19 pandemic on the cost of chronic diseases treatment and care at public hospitals in Wallaga zones, Oromia Regional State, Ethiopia: a hospital-based, cross-sectional study.

OBJECTIVE: Globally, around one-third of the population has at least one long-term health condition that could be affected by the COVID-19 pandemic. Despite the fact that studies have revealed the direct impact of COVID-19 on healthcare provision and utilisation, the impact of the pandemic on the cost of chronic disease treatment and care from a patient perspective was scanty. So, the study aimed to determine the impact of the COVID-19 pandemic on cost of chronic diseases treatment and care at public hospitals in Wallaga zones, Oromia Regional State, Ethiopia, from 1 August to 31 August 2020. METHODS: An institutional-based cross-sectional study design was used, and the sample size for the study (n=642) was determined using a single population mean formula. Data were collected using interviews and analysed using SPSS V.25. Descriptive statistics were performed, and the cost of follow-up care before and after the pandemic was compared using a related-samples Wilcoxon signed-rank test, declaring the level of significance of the median cost difference at p<0.05. RESULTS: A total of 642 patients were included in the study, of whom 605 (94.2%) responded to the interviews. There was a significant median cost difference (n=593, Z=5.05, p=0.001) between the cost of chronic diseases among follow-up patients during the pandemic and the costs incurred by these patients before the pandemic. CONCLUSION: The cost of follow-up care among chronic disease patients during the COVID-19 pandemic was significantly higher compared with before the pandemic era. Therefore, healthcare providers should arrange special fee waiver mechanisms for chronic disease healthcare costs during such types of pandemics and provide the services at proximal health facilities.

Survival status and predictors of mortality among adult Stroke patients admitted to Jimma University Medical Center, South west Ethiopia: A retrospective Cohort study.

Background: Stroke is the leading cause of cardiovascular disease death in sub-Saharan Africa and the second leading cause of mortality worldwide. In 2016, 6.23% of all fatalities in Ethiopia were stroke-related. Objective: To assess survival status and predictors of mortality among adult stroke patients admitted to Jimma University Medical Center from April 1/2017 to March 31/2022. Methods: A retrospective cohort study was conducted on 480 adult stroke patients selected by simple random sampling from patients admitted to the Jimma University Medical Center Stroke Unit from April 1, 2017 to March 31, 2022. Data were extracted from May to June 2022 and entered Epi-data v.3.1 and analyzed by R v.4.2. The Kaplan-Meier curve with Log rank test was used to estimate survival time and to compare survival experience between categories of explanatory variables. The Cox regression model was computed to identify predictors of survival status in stroke patients. Then the 95% CI of the hazard ratio was set with corresponding p-value < 0.05 to declare statistical significance. Results: During 4350 person-days of follow-up; 88 (18.33%) patients died; resulting in an incidence mortality of 20.23 per 1000 person-days, with a median survival time of 38 days. Glasgow coma score <8 on admission (AHR = 7.71; 95% CI: 3.78, 15.69), dyslipidemia (AHR = 3.96; 95% CI: 2.04, 7.69), aspiration pneumonia (AHR 2.30; 95% CI: 1.23-4.26), and increased intracranial pressure (AHR = 4.27; 95% CI: 2.33, 7.81), were the independent predictors of the time until death. Conclusion: The incidence of stroke mortality was higher at the seven and fourteen days. Glasgow Coma Scale, increased intracranial pressure, dyslipidemia, and aspiration pneumonia were independent predictors of mortality.

Essential newborn care practices and associated factors among home delivered mothers in Guto Gida District, East Wollega zone.

BACKGROUND: Essential Newborn Care is a set of strategic and cost-effective interventions planned to improve the health of newborns through the care they receive from birth up to 28 days. In the current study area, little is known about the prevalence of essential newborn care practices and its associated factors. This study was aimed to assess the prevalence of essential newborn care practice and its associated factors among home-delivered mothers in Guto Gida district, western Ethiopia. METHODS: A community-based cross-sectional study was conducted in Guto Gida district from September 5 to 15, 2020. Data were collected by interviewing 601 systematically selected home-delivered women. Descriptive statistics were employed to describe frequency and percent. Binary logistic regression analysis was employed to identify candidate variables for the final model. Variables with p-value less than 0.25 at bivariate logistic regression were considered as the candidate variable and entered into multivariable logistic regression model. Finally, multivariable logistic regression was employed to identify associated factors at p-value less than 0.05, and the strength of association was described by adjusted odds ratios with 95% CI. RESULTS: The study shows that the level of essential newborn care practices was 168 (28%) (23.9-31.4). In this study, women in the first wealth quantile (AOR [95% CI] = 0.64 [0.34-0.97]), women who had one live birth (AOR [95% CI] = 0.51 [0.22-0.87]), women who lost their neonate before the study period (AOR [95% CI] = 0.11 [0.05-0.22]) were less likely to practice essential newborn care. Women who were advised on essential newborn care practice during a home visit by health extension workers (AOR [95% CI] = 3.45[1.56-7.26]), women who attended antenatal care during their current pregnancy (AOR [95% CI] = 1.79 (1.21-3.36]), and women who were attended at their birth by health extension workers (AOR [95% CI] = 3.29 [2.13-5.94]) were more likely to practice essential newborn care. CONCLUSIONS: In this study, the prevalence of essential newborn care practice was low (28%), as compared with the World Health Organization recommendation that it should be 100%. The wealth quantile, number of live births, home visits by health extension workers, antenatal care, birth attendant, and neonatal death were independent predictors of essential newborn care practices.

Antiretroviral Treatment Adherence Level and Associated Factors Among Adult HIV-Positive Patients on Both HIV/AIDS Care Models: Comparative Study in Selected Hospitals of Western Ethiopia, 2019.

BACKGROUND: Many studies investigating antiretroviral treatment (ART) adherence found the majority of patients had suboptimal adherence for a variety of different reasons. The study aimed to compare the ART adherence level and associated factors among adult human immune deficiency virus (HIV) positive patients on both care models in selected hospitals. METHODS: An institution-based comparative cross-sectional study was conducted among 463 HIV positive patients on ART. The study samples were selected using systematic random sampling, and pretested semi-structured interviewer administered questionnaire was used to collect data. Binary and multivariable logistic regression analyses were used to see the association between outcome and predictors using odds ratio with a 95% confidence interval to estimate the strength of the association. RESULTS: The study had a response rate of 445 (96.1%). Of the study participants, 325 (73%) and 120 (27%) were from the routine and appointment spacing models, respectively. Patients on the appointment spacing model had higher levels of optimum adherence (87.5% vs 74.27%, respectively; p = 0.006). Patients' satisfaction with health service delivery (OR = 0.31, 95%: CI 0.11-0.84), antiretroviral drug dosage taken per day (OR = 3, 95%: CI 1.16-8.1), disclosure of HIV status (OR = 0.30, 95%: CI 0.09-0.93), distance from patient residency to health facility (OR = 0.11, 95%: CI 0.03-0.34), the memory aids used (OR = 0.02, 95%: CI 0.01-0.05), and type of HIV/AIDS care model (OR= 0.24, 95%: CI 0.1-0.6) were factors significantly associated with ART adherence level. CONCLUSION: ART patients on the appointment spacing model had higher optimum ART adherence levels than those on the routine schedule due to factors like satisfaction status, disclosure status, type of memory aid used, type of ART care model used, and distance from the care facility. Therefore, promoting adherence enablers and alleviating barriers of ART adherence will improve ART adherence levels.

Evaluation of quality and use of health management information system in primary health care units of east Wollega zone, Oromia regional state, Ethiopia.

BACKGROUND: Health care practice relies on evidence-based decisions and needs the use of quality health care data. Health management information system (HMIS) is among the core elements of health system building blocks. In our study setting, there is a lack of adequate information on the quality of health information data. This study aimed at exploring the quality of health management information system data in terms of timeliness, completeness, and accuracy. The specific objectives were to evaluate the quality and use of the health management information system in Primary health care units of East Wollega zone, Ethiopia. METHODS: A cross-sectional study was conducted from April to June 2016 on 316 health professionals/health information technicians. The sample was obtained by simple random sampling technique. Qualitative data were obtained from 16 purposefully selected key informants by Focus group discussion (FGD). We observed 50 selected health facilities using an observation checklist. We analyzed quantitative data by SPSS version 20 using descriptive and logistic regression analysis techniques. we applied a thematic analysis approach to analyze qualitative data. RESULTS: Timeliness of report, registration completeness, report completeness, and data accuracy level of the selected facilities were 70, 78.2, 86, and 48%, respectively. All results are below the expected national standards. Commonly reported reasons for the poor practice of data quality were; poor support of management, lack of accountability for the false report, poor supportive supervision, and lack of separate and responsible unit for health information management. CONCLUSION: The Health information management system is poorly coordinated at the primary health units. Accountability should be assured through continuous in-service training, supportive supervision, and concrete feedbacks. Electronic management of health information should be available in primary health care units.