Correction: Assessing the dynamic impacts of non-pharmaceutical and pharmaceutical intervention measures on the containment results against COVID-19 in Ethiopia.

[This corrects the article DOI: 10.1371/journal.pone.0271231.].

Work-related stress and associated factors among garment workers in Bole Lemi Industrial Park of Addis Ababa, Ethiopia: a multi-center institution-based cross-sectional study.

BACKGROUND: Work-related stress (WRS) is a growing problem around the world that affects the health and well-being of employees. However, evidence of work-related stress in Ethiopia, particularly among garment industry employees, is scarce. This study aimed to assess the prevalence and associated factors of work-related stress among garment workers in the Bole Lemi industrial park in Addis Ababa, Ethiopia. METHODS: A multi-center institutional-based cross-sectional study was conducted from February 01 to March 31, 2021. A total of 605 study participants were selected using a stratified random sampling technique. A pre-tested, interviewer-administered standardized questionnaire was used to collect data. The logistic regression model was employed to identify determinant factors for work-related stress, and statistical significance was declared at a p-value < 0.05. RESULTS: The magnitude of work-related stress in garment workers was 44.1% (95% CI: 40.0, 48.0). Being within the age group of 25 - 34 years (AOR = 0.57, 95% CI: 0.36, 0.90) and receiving induction training (AOR = 0.35, CI: 0.20, 0.62) were protective factors with stress. Whereas lack of family support (AOR = 2.72, CI: 1.60, 4.64), lack of job satisfaction (AOR = 4.26, CI: 2.77, 6.57), and khat chewing (AOR = 3.14, CI: 1.35, 7.32) were positively associated with work-related stress. CONCLUSION: Work-related stress is prevalent among garment workers in the study setting. Being between the ages of 25-34 years and receiving induction training were protective factors against stress, while a lack of family support, a lack of job satisfaction, and khat chewing practices were positively associated with work-related stress. Therefore, improving family support and job satisfaction, providing induction training during employment, and providing psychological support for substance users to bring about changes are mandatory in Bole Lemi Industrial Park, Ethiopia.

Assessing the dynamic impacts of non-pharmaceutical and pharmaceutical intervention measures on the containment results against COVID-19 in Ethiopia.

The rapid spread of COVID-19 in Ethiopia was attributed to joint effects of multiple factors such as low adherence to face mask-wearing, failure to comply with social distancing measures, many people attending religious worship activities and holiday events, extensive protests, country election rallies during the pandemic, and the war between the federal government and Tigray Region. This study built a system dynamics model to capture COVID-19 characteristics, major social events, stringencies of containment measures, and vaccination dynamics. This system dynamics model served as a framework for understanding the issues and gaps in the containment measures against COVID-19 in the past period (16 scenarios) and the spread dynamics of the infectious disease over the next year under a combination of different interventions (264 scenarios). In the counterfactual analysis, we found that keeping high mask-wearing adherence since the outbreak of COVID-19 in Ethiopia could have significantly reduced the infection under the condition of low vaccination level or unavailability of the vaccine supply. Reducing or canceling major social events could achieve a better outcome than imposing constraints on people's routine life activities. The trend analysis found that increasing mask-wearing adherence and enforcing more stringent social distancing were two major measures that can significantly reduce possible infections. Higher mask-wearing adherence had more significant impacts than enforcing social distancing measures in our settings. As the vaccination rate increases, reduced efficacy could cause more infections than shortened immunological periods. Offsetting effects of multiple interventions (strengthening one or more interventions while loosening others) could be applied when the levels or stringencies of one or more interventions need to be adjusted for catering to particular needs (e.g., less stringent social distancing measures to reboot the economy or cushion insufficient resources in some areas).

Mothers experience on neonatal danger signs and associated factors in northwest Ethiopia: a community based cross-sectional study.

Introduction: even though there is a significant decline in neonatal mortality globally, it remained unacceptably high in Ethiopia. The estimated experience of neonatal danger signs affects the outcome more than the perceived knowledge. The main aim of this study was to estimate the experience of mothers on neonatal danger signs and its associated factors in Northwest Ethiopia. Methods: a community-based cross-sectional study was conducted from April 6-16, 2019. All the women who have delivered live birth in the past six months in three districts of Northwest Ethiopia were the source populations. A total of 2424 mothers were selected using two-stage stratified cluster random sampling technique. A pretested and semi-structured interviewer-administered questionnaire was used to collect data from eligible mothers. A multivariable logistic regression model was used to identify independent factors that affected mother´s experiences about neonatal danger signs at a p-value of 5%. Results: in this study, 2335 (96.3%) mothers completed the interview and 1509 (64.6%) of them have mentioned at least one danger sign. However, only 160 (11.0%) mothers have experienced danger signs in their babies. Of these, about 54 (49.1%) mothers have noticed within 24 hours of delivery and 37 (33.6%) have noticed after 48 hours of delivery. Fifty (45.5%) mothers have noticed the danger signs at home after birth, and 48 (43.6%) have noticed during birth. The frequently reported danger signs were; baby feels hot 106 (66.3%), fast breathing 67(41.9%), and difficulty of breathing 61(38.1%). Mothers who are living in urban, AOR=1.8(95%CI: 1.04,3.0), having multiple pregnancy, AOR=9.8 (95%CI: 2.3,42.0), absence of obstetric danger signs or complication, AOR=0.4 (95%CI: 0.2,0.6), post-term gestational age, AOR=6.5 (95%CI: 2.1,19.5), preterm gestational age, AOR=3.3 (95%CI: 0.8,13.4), assessment by hospital staff during delivery, AOR=2.1 (95% CI: 1.01,4.3), and poor mothers knowledge on neonatal danger signs, AOR=0.7 (95% CI: 0.5,0.9) were the predictors of mothers experience on neonatal danger signs. Conclusion: even though the knowledge of mothers on neonatal danger signs is high, the practice or experience in using their knowledge is very low. We recommend an implementation study to be conducted to bridge this "know-do" gap.

Perceived quality of essential newborn care implementation among health facility deliveries in North Gondar Zone, Northwest Ethiopia: a cross-sectional study.

BACKGROUND: Quality of essential newborn care is defined as the extent of health care services to improve the health of newborns. However, studies are scarce regarding the quality of newborn care implementation. Therefore, this study aimed to measure the magnitude and factors associated with essential newborn care implementation perceived quality among health facility deliveries in Northwest Ethiopia. METHODS: A facility-based cross-sectional study design was employed to collect data from 370 randomly selected deliveries in 11 health facilities from November 2018 to March 2019. Essential newborn care implementation perceived quality was assessed in two domains (delivery and process) from clients' perspectives. A pre-tested interviewer-administered structured questionnaire was adopted from different kinds of literature and guidelines. The research data were collected by trained midwives and nurses. A binary logistic regression model was used to identify associated factors with newborn care implementation perceived quality. Odds ratio with 95% CI was computed to assess the strength and significant level of the association at p-value < 0.05. RESULTS: About 338 mothers completed the interview with a response rate of 97.1%. The mean age of the study participants was 26.4 (SD = 5.7) with a range of 12 and 45 years. Most mothers, 84.3%, have attended antenatal care. The overall implementation perceived quality of essential newborn care was found to be 66.3%. The implementation perceived quality of cord care, breast-feeding and thermal care was 75.4, 72.2 and 66.3% respectively. Newborn immunization and vitamin K administration had the lowest implementation perceived quality i.e. 22.4 and 24.3% respectively. Friendly care during delivery (AOR = 5.1, 95% CI: 2.4, 11.0), partograph use (AOR = 3.0, 95% CI: 1.1, 8.6), child immunization service readiness (AOR = 2.9, 95% CI: 1.5, 5.7), BEmEONC service readiness (AOR = 2.1, 95% CI: 1.2, 3.9) and facing no neonatal illness at all (AOR = 4.2, 95% CI: 1.6, 10.9) were significantly associated with good essential newborn care implementation qualities. CONCLUSIONS: The perceived quality of essential newborn care implementation was low in the study area. This is associated with poor readiness on BEmEONC and child immunization services, unfriendly care and not using partograph during delivery. Hence, availing the BEmEONC and the child immunization service inputs, continuous training and motivation of healthcare workers for friendly care are vital for improving essential newborn care implementation perceived quality.

Essential newborn care is a set of practices provided by healthcare workers and mothers to every newborn during delivery. Studies are scarce regarding the quality of newborn care implementation. Therefore, this study aimed to measure the magnitude and factors associated with essential newborn care implementation perceived quality among health facility deliveries in Northwest Ethiopia.A facility-based cross-sectional study design was employed to collect data from 370 randomly selected deliveries in 11 health facilities. A pre-tested interviewer-administered structured questionnaire was adopted from different kinds of literature and guidelines. A binary logistic regression model was fitted to assess the strength and significant level of the association at p-value < 0.05.The overall implementation perceived quality of essential newborn care was found to be 66.3%. The implementation perceived quality of cord care, breast-feeding and thermal care was 75.4, 72.2 and 66.3% respectively. Newborn immunization and vitamin K administration had the lowest implementation perceived quality i.e. 22.4 and 24.3% respectively. Friendly care during delivery (AOR = 5.1, 95% CI: 2.4, 11.0), partograph uses (AOR = 3.0, 95% CI: 1.1, 8.6), child immunization service readiness (AOR = 2.9, 95% CI: 1.5, 5.7), BEmEONC service readiness (AOR = 2.1, 95% CI: 1.2, 3.9) and facing no neonatal illness at all (AOR = 4.2, 95% CI: 1.6, 10.9) were significantly associated with good essential newborn care implementation qualities.The perceived quality of essential newborn care implementation was low in the study area. This is associated with poor readiness on BEmEONC and child immunization services, unfriendly care and not using partograph during delivery. Hence, availing the BEmEONC and child immunization service inputs, continuous training and motivation of healthcare workers for friendly care are vital for improving essential newborn care implementation perceived quality.

Essential Newborn Care Service Readiness and Barriers in Northwest Ethiopia: A Descriptive Survey and Qualitative Study.

BACKGROUND: Despite the efforts put forth in improving neonatal survival, there is still a high rate of neonatal morbidity and mortality in northwest Ethiopia. Therefore, this study aimed to determine the essential newborn care service readiness scores and explore the health facility-related barriers in North Gondar Zone, Northwest Ethiopia. METHODS: A cross-sectional survey of 16 health facilities (14 health centers and two hospitals) and twelve in-depth interviews were included in the study in three randomly selected districts of North Gondar Zone. A pretested health facility inventory questionnaire customized from the World Health Organization (WHO) service readiness assessment tool was used for a facility audit. Basic emergency and essential obstetric and newborn care (BEmONC), and child immunization service readiness scores were determined using unweighted averages according to the WHO guideline. Descriptive statistics were done for the quantitative data, and thematic content analysis was employed using NVivo 12 software for the qualitative data. RESULTS: All the surveyed health facilities had no specialist medical doctors, and 50% (8/16) of them had no inpatient beds. The overall BEmONC service readiness score was 62.7% (10/16) (95% CI: 34.8, 83.8) and only one facility had all the tracer items. Trained staff and guidelines had a 27.5% (4/16) readiness score, followed by 71.9% (12/16) readiness score for equipment, and 88.6% (14/16) readiness score for medicine and commodities. The overall child immunization service readiness score was 90.3% (15/16) (95% CI: 51.4, 94.7) and eleven facilities (68.8%) had all the tracer items. The immunization service readiness score was higher; 84.4% (14/16) for trained staff and guidelines, 92.8% (15/16) for equipment, and 93.8% (15/16) for medicines and commodities. Unavailability of equipment, shortage of supplies, and lack of respectful and compassionate healthcare practices were the key facility-related barriers compromising essential newborn care service readiness. CONCLUSIONS FOR PRACTICE: The survey revealed that the essential newborn care service readiness score of the health facilities was low, and it calls for improving BEmONC service readiness in particular. Provision of timely training for newly recruited staff, fulfilling essential equipment, and steady supply is imperative.

Determinants of Health Facility Delivery in Northwest Ethiopia: A Community-Based Case-Control Study.

BACKGROUND: Although Ethiopia has developed many strategies to promote health facility delivery, more than half of the women gave birth at home contributing to high maternal and neonatal mortality. Therefore, this study aimed to identify the determinants of health facility delivery in Northwest Ethiopia. METHODS: A community-based unmatched case-control study was conducted in selected districts in Northwest Ethiopia. The sample included 885 infant mothers (295 cases and 590 controls) from April 6-16, 2019. Data were collected using a pretested interviewer-administered structured questionnaire. A multivariable logistic regression model was used to identify predictors, and STATA 14 statistical software was used to analyze the data. RESULTS: The mean maternal age was 26.4 years (SD±6.7) for cases and 28.1 years (SD±6.8) for controls. The overall good newborn care qualities were 95.8% (206) for cases and 40.8% (262) for controls. Attending a formal education (AOR=2.1 (95% CI: 1.5, 2.9)), having first pregnancy from 18 to 25 (AOR=1.5 (95% CI: 1.1, 2.1)), living within 1 km distance from the nearest health center (AOR=2.5 (95% CI: 1.5, 4.0)), having ANC visits (AOR=3.9 (95% CI: 2.4, 6.5)), having a mobile (AOR=1.7 (95% CI: 1.3, 2.4)) were the determinants of health facility delivery. CONCLUSION: Maternal education, not having pregnancy at early age, accessing health facilities to the nearby residents, attending antenatal care, and having a mobile were the determinants of health facility delivery. Therefore, strengthening education and health-seeking behavior of the mothers using a locally contextualized strategy is essential. Reaching mothers who are still far from health facility also deserves needs due attention.

Prevalence of common symptoms of neonatal illness in Northwest Ethiopia: A repeated measure cross-sectional study.

BACKGROUND: The neonatal period is the most vulnerable stage of life. In Ethiopia, neonatal illness is common and the reduction in neonatal mortality is not as significant as for under-five mortality. OBJECTIVES: To determine the prevalence and factors associated with neonatal illness symptoms reported by mothers delivering in health facilities in Northwest Ethiopia. METHODS: A repeated measure cross-sectional study design was employed to collect data from 358 randomly selected deliveries in 11 health facilities from November 2018 to March 2019. A pretested and interviewer-administered structured questionnaire adapted from the literature was employed to record neonatal outcomes (illnesses and/or deaths) at birth, 24 hours, 7th, 14th and 28th day from birth. Cleaned data was exported to STATA version 14 software for analysis. Multilevel analysis was used to identify individual and facility-level characteristics associated with neonatal illness symptoms. RESULTS: The prevalence of neonatal illness symptoms was 27.8% (95% CI; 23.2, 32.8) of the 338 babies born alive and the neonatal mortality rate was 41/1000 live births (14/338). The most common symptoms or conditions of neonatal illness reported by mothers' in the study area were possible serious bacterial infections (95.8%, 90/94), localized bacterial infections (43.6%, 41/94), low birth weight (23.4%, 22/94), diarrhea (18.1%, 17/94), prematurity (14.9%, 14/94), and jaundice (7.5%, 7/94). Among the babies who died, neonates who had possible serious bacterial infections, low birth weight, localized bacterial infections, and prematurity took the highest proportions with 100% (14/14), 64.3% (9/14), 50% (7/14), and 42.9% (6/14), respectively. Having a maximum of 3 children (AOR = 1.96; 95% CI = 1.1-3.6), having twins or triplets during pregnancy (AOR = 2.43; 95% CI = 1.1-6.1), and lack of antenatal counseling (AOR = 1.83; 95% CI = 1.1-3.3) were among the maternal factors associated with neonatal illness. Having low birth length (AOR = 7.93; 95% CI = 3.6-17.3), and having a poor breastfeeding quality (AOR = 2.37; 95% CI = 1.4-4.0) were found to be the neonatal factors associated with neonatal illness. CONCLUSIONS: This study indicated a high prevalence of neonatal illness symptoms in Northwest Ethiopia. Therefore, early detection, referral and better management of symptoms or conditions with a high mortality, like sepsis and low birth weight are compulsory to save the lives of many neonates. Strengthening the health extension programme to improve antenatal care service utilization and breastfeeding quality of neonates among postpartum women is crucial.