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.

Utilization of sexual and reproductive health services among construction worker women in southern Ethiopia.

BACKGROUND: In Ethiopia, the utilization of sexual and reproductive health services (SRH) is alarmingly inadequate, leading to higher rates of maternal and newborn mortality. Disparities in accessing sexual and reproductive health (SRH) services exist among different population groups, with construction worker women at a higher risk of experiencing such issues. We investigated the utilization of sexual and reproductive health services and associated factors among construction worker women in Southern Ethiopia. METHOD: We conducted a cross-sectional study among construction worker women (15-49) in Southern Ethiopia from July 1st to July 30th, 2021. The participants were selected randomly using venue-day-time sampling (VDTS). The data were collected by a pretested structured questionnaire using an open data kit (ODK) and exported to Statistical Package for Social Sciences (SPSS) version 25 for analysis. Binary logistic regression analysis was conducted to identify factors associated with sexual and reproductive health service utilization. An adjusted odds ratio with 95% CI was used and statistical significance was declared at p-value < 0.05. RESULTS: The study revealed that 54.4% of women of reproductive age had used at least one sexual and reproductive health service in the past year. About 66.7% of women experienced sexual harassment at work, with sex discrimination (86.9%) and sexist hostility (57.9%) being the most common. Aged over 20 years, married women, living with husbands, friends, and boyfriends, within 30 min of health facilities, and having a favorable attitude were significantly associated with SRH service utilization. CONCLUSION: Nearly half of construction workers in southern Ethiopia are not using sexual and reproductive health services, indicating a concerning lack of access to such services. Over two-thirds of women experience sexual harassment in construction site. Therefore, to ensure universal access to SRH services, it is essential to design a new approach including outreach programs specifically tailored to reach such vulnerable groups.

The sexual and reproductive healthcare challenges when dealing with female migrants and refugees in low and middle-income countries (a qualitative evidence synthesis).

BACKGROUND: Migrants and refugees face unprecedented inequalities in accessing sexual and reproductive health (SRH) in developed and developing countries. Most attention has focused on the rich world perspective, while there are huge numbers of migrants and refugees moving towards less developed countries. This article synthesizes the barriers to proper SRH care from low and middle-income countries perspective. METHODS: We performed a systematic review of articles containing primary source qualitative and quantitative studies with thick qualitative descriptions. Articles from various databases, including PubMed, Science Direct, HINARI, and Google Scholar, published between 2012 and 2022 were included. Because the context differed, we excluded articles dealing with migrants and refugees from low- and middle-income countries living in high-income countries. To select articles, a preferred reporting item for systematic reviews and meta-analyses (PRISMA) was used. The articles' quality was assessed using the standard QASP checklist. We used a socio-ecological model to investigate barriers at various levels, and thematic analysis was used to identify the strongest themes at each level of the model. This synthesis is registered under PROSPERO number CRD42022341460. RESULTS: We selected fifteen articles from a total of 985 for the final analysis. The results show that despite the diversity of the participants' homes and countries of origin, their experiences using SRH services were quite similar. Most female migrants and refugees claimed to have encountered discrimination from service providers, and linguistic and cultural obstacles played a significant role in their experiences. In nations lacking universal healthcare coverage, the cost of care was a barrier to the use of SRH services. Other main obstacles to using SRH services were a lack of knowledge about these programs, worries about privacy, inadequate communication, stigma in the community, and gender-related power imbalances. CONCLUSION: To enhance the use of SRH by female migrants and refugees, it is vital to provide person-centered care and involve husbands, parents, in-laws, and communities in SRH coproduction. Training on cultural competency, compassion, and respect must be provided to healthcare personnel. Increasing financial access for migrant and refugee healthcare is crucial, as is meeting their basic requirements.

Client satisfaction with antiretroviral treatment services in South Ethiopian public health facilities: an institution-based cross-sectional survey.

BACKGROUND: HIV/AIDS remains the leading cause of morbidity and mortality worldwide. Moreover, sub-Saharan countries, including Ethiopia, are highly affected by HIV/AIDS pandemic. Ethiopia's government has been working on a comprehensive HIV care and treatment programme, including antiretroviral therapy. However, evaluating client satisfaction with antiretroviral treatment services is not well studied. OBJECTIVES: This study aimed to assess client satisfaction and associated factors with antiretroviral treatment services provided at public health facilities of Wolaita zone, South Ethiopia. METHODS: A facility-based cross-sectional study involved 605 randomly selected clients using ART services from six public health facilities in Southern Ethiopia. A multivariate regression model was used to see an association between independent variables and the outcome variable. The odds ratio with 95% CI was computed to determine the presence and strength of the association. RESULTS: Four hundred twenty-eight (70.7%) clients were satisfied with an overall antiretroviral treatment service, which included significant variations ranging from 21.1% to 90.0% among health facilities. Sex [AOR = 1.91; 95% CI = 1.10-3.29], employment [AOR = 13.04; 95% CI = 4.34-39.22], clients' perception of the availability of prescribed laboratory services [AOR = 2.56; 95% CI = 1.42-4.63], availability of prescribed drugs [AOR = 6.26; 95% CI = 3.40-11.52] and cleanliness of toilet in the facility [AOR = 2.83; 95% CI = 1.56-5.14] were factors associated with client satisfaction with antiretroviral treatment services. CONCLUSION: The overall client satisfaction with antiretroviral treatment service was lower than the national target of 85%, with a marked difference among facilities. Sex, occupational status, availability of comprehensive laboratory services, standard drugs, and cleanliness toilets in the facility were factors associated with client satisfaction with antiretroviral treatment services. Sex-sensitive services needed to address and sustained availability of laboratory services and medicine recommended.

Delay in seeking treatment and associated factors among women with pelvic organ prolapse in Wolaita zone, Southern Ethiopia: Hospital based mixed method study.

BACKGROUND: Despite increasing efforts to improve access to diagnosis and treatment services, women with pelvic organ prolapse tend to stay at home for years before getting treatment. A large number of women, particularly in rural areas do not get early diagnosis and treatment, and they come with an advanced stage; but the reason for this appears unclear. Thus, this study aimed to determine the proportion and associated factors of delay in seeking treatment among women with pelvic organ prolapse (POP) in the Wolaita zone, Southern Ethiopia. METHODS: A hospital-based cross-sectional study mixed with qualitative method was conducted in the Wolaita zone, Southern Ethiopia, from September to October 2021. A total of 422 women with pelvic organ prolapse were selected by systematic random sampling for quantitative data. The women recruited for in-depth interviews were purposefully selected until data saturation reaches via phenomenological study design. The quantitative data were collected by interviewer-administered questionnaire and reviewing clients' medical records via an open data kit and then exported to and analyzed with a statistical package for social science version 25. The associated variables were determined by conducting a logistic regression model and are presented with the crude odds ratio (COR) and adjusted odds ratio (AOR) with their respective 95% confidence intervals (95%CI). All statistical tests were conducted at a 5% level of significance. The interview was first transcribed, coded, and categories and themes were generated by applying thematic analysis. RESULTS: The study showed that 82.0% (95% CI: [74.8-89.3%]) of women with POP delayed seeking treatment. The delay to seek treatment was associated with a lack of support (AOR = 4.9; 95% CI [1.8-13.2]), low-income (AOR = 6.4; 95% CI [2.2-19.2]), fear of disclosure (AOR = 5.0; 95% CI [1.3-19.2]) and fear of social stigma (AOR = 4.6; 95% CI [1.5-14.2]). The reasons for the delay were feeling shameful to disclose, fear of stigma and cultural and spiritual beliefs. CONCLUSIONS: More than three-fourths of women with POP delayed seeking treatment, and improving support, improving the economy, raising awareness, and involving influential people in interventions are all necessary to avert it.

Perceived HIV Stigma and Associated Factors Among Adult ART Patients in Wolaita Zone, Southern Ethiopia.

Objective: This study aimed to assess perceived HIV stigma and associated factors among adult ART patients in Wolaita Zone, Southern Ethiopia. Methods: A facility-based cross-sectional study was conducted among 638 participants selected using a multistage sampling technique from July 10 to September 2020. A 12-item short version of the HIV stigma scale was used to measure HIV-related stigma. Data were collected by the interview method using a pre-tested questionnaire. Binary and multivariable logistic regression analyses were performed to identify the factors associated with the outcome variable. The strength and direction of the association were measured using the adjusted odds ratio (AOR) with a 95% confidence interval (CI). Statistical significance was declared at P-value <0.05. Results: In this study, 57.8% (95% CI = 54.1%-61.9%) of people under HIV care perceived high stigma and 450 (70.5%) disclosed their HIV status. Widowed marital status (AOR = 2.984; 95% CI = 1.728-5.155), primary education (AOR = 3.36; 95% CI = 2.072-5.42), undisclosed HIV status (AOR = 1.657; 95% CI = 1.121-2.451), poor social support (AOR: 2.05; 95% CI = 1.195-3.433), and being member of an HIV support group (AOR: 0.396; 95% CI = 0.249-0.630) were significantly associated with perceived stigma. Conclusion: The perceived stigma is high among adult ART patients in the study setting. Widowed marital status, primary education, undisclosed HIV status, membership to the social support network NEP+ and poor social support were predictors of perceived HIV stigma. Thus, ART patients should be given more psychosocial support to minimize their perceived public HIV-related stigma.

Full vaccination coverage and associated factors among children aged 12 to 23 months in remote rural area of Demba Gofa District, Southern Ethiopia.

Background: Full vaccination refers to the administration of vaccines/antigens recommended for children in the first year of life. However, little is known about full vaccination in remote, rural Ethiopia. This study aimed to measure full vaccination coverage and associated factors among children aged 12 to 23 months in Demba Gofa District, Southern Ethiopia. Methods: A community-based cross-sectional study was conducted in April and May 2019 using a multistage sampling technique to select 677 mothers with children 12-23 months of age. Data was collected using a pre-tested structured questionnaire, and data were edited, coded, entered, and cleaned using Epi Info v3.1 and analyzed using SPSS v20. Bivariate and multivariable logistic regression was used to understand associations between dependent and independent variables. Results: Three-hundred and nine children (47.0%) were fully vaccinated, 274 (41.7%) were partially vaccinated, and 74 (11.3%) were not vaccinated at all. Children were more likely to be vaccinated if decisions were made jointly with husbands (AOR = 1.88, 95% CI [1.06-3.34]), were made by mothers (AOR = 4.03, 95% CI [1.66-9.78]), followed postnatal care (AOR = 5.02, 95% CI [2.28-11.05]), if the child's age for completing vaccination was known (AOR = 2.54, 95% CI [1.04-6.23]), and if vaccinations did not make the child sick (AOR = 0.32, 95% CI [0.16-0.64]). Conclusion: Full vaccination coverage was less than average in the study district and far below the governmental target (90%) necessary for sustained control of vaccine-preventable diseases. Interventions targeted towards maternal healthcare decision-making, postnatal care, knowledge on vaccination timing, and importance should be prioritized to improve full vaccination coverage. A continuous supply of vaccination cards needs to be ensured to improve vaccination conditions.

Institutional Delivery Service Utilization among Women from Rural Districts of Wolaita and Dawro Zones, Southern Ethiopia; a Community Based Cross-Sectional Study.

INTRODUCTION: The highest number of maternal deaths occur during labour, delivery and the first day after delivery highlighting the critical need for good quality care during this period. Therefore, for the strategies of institutional delivery to be effective, it is essential to understand the factors that influence individual and household factors to utilize skilled birth attendance and institutions for delivery. This study was aimed to assess factors affecting the utilization of institutional delivery service of women in rural districts of Wolaita and Dawro Zones. METHODS: A community based cross-sectional study was done among mothers who gave birth within the past one year preceding the survey in Wolaita and Dawro Zones, from February 01 -April 30, 2015 by using a three stage sampling technique. Initially, 6 districts were selected randomly from the total of 17 eligible districts. Then, 2 kebele from each district was selected randomly cumulating a total of 12 clusters. Finally, study participants were selected from each cluster by using systematic sampling technique. Accordingly, 957 mothers were included in the survey. Data was collected by using a pretested interviewer administered structured questionnaire. The questionnaire was prepared by including socio-demographic variables and variables of maternal health service utilization factors. Data was entered using Epi-data version 1.4.4.0 and exported to SPSS version 20 for analysis. Bivariate and multiple logistic regressions were applied to identify candidate and predictor variables respectively. RESULT: Only 38% of study participants delivered the index child at health facility. Husband's educational status, wealth index, average distance from nearest health facility, wanted pregnancy, agreement to follow post-natal care, problem faced during delivery, birth order, preference of health professional for ante-natal care and maternity care were predictors of institutional delivery. CONCLUSION: The use of institutional delivery service is low in the study community. Eventhough antenatal care service is high; nearly two in every three mothers delivered their index child out of health facility. Improving socio-economic status of mothers as well as availing modern health facilities to the nearest locality will have a good impact to improve institutional delivery service utilization. Similarly, education is also a tool to improve awareness of mothers and their husbands for the improvement of health care service utilization.