Utilization of pharmacological labour analgesia: a survey of obstetric care providers in eastern Ethiopia.

BACKGROUND: Despite a crucial role played by obstetric care providers (OCPs) in providing pain relief methods during labour, the evidence suggests that there is a large number of women in Ethiopia who did not have access to pain relief methods. Moreover, to the best of the investigators' knowledge, evidence is scarce regarding the utilization of pharmacological labour pain management methods in the study area. Thus this study was carried out to determine the practice of pharmacological labour pain management methods among OCPs in Harari regional state health facilities in Ethiopia. METHODS: A facility-based cross-sectional study was conducted from 20 May to 10 June 2021 in Harari regional state health facilities. All (n=464) OCPs in Harari regional state health facilities were included in the study. Data were collected using a structured questionnaire adapted from previous studies. The data were entered into Epi-data version 3.1 statistical software. Statistical analysis was carried out using SPSS for Windows version 22. Bivariate and multivariate logistic regression analyses were employed to determine the association between independent variables and the outcome variable. A p-value <0.05 was used to establish statistical significance. RESULTS: In this study, 464 OCPs participated. The overall utilization of pharmacological labour pain relief methods was 50.9% (95% confidence interval [CI] 45.8 to 55.8). The main barriers to labouring mothers receiving pain relief include high patient flow (54.4%), the limited number of staff (51.9%) and a lack of knowledge and skill (32.9%). Being female (adjusted odds ratio [AOR] 2.07 [95% CI 1.31 to 3.26]), not having training (AOR 1.60 [95% CI 1.02 to 2.53]) and having an unfavourable attitude (AOR 9.1 [95% CI 5.34 to 15.35]) were the predictors of utilization of pharmacological labour pain management methods. CONCLUSIONS: The study revealed that half of the OCPs utilized the pharmacological labour pain management method. In general, this study identified that variables like sex, training and the attitude of OCPs were factors associated with the utilization of pharmacological labour pain management methods. The health facilities should provide training to enhance the skill of OCPs and equip themselves with sufficient analgesic drugs.

Magnitude of Cesarean Section Delivery and Its Associated Factors Among Mothers Who Gave Birth at Public Hospitals in Northern Ethiopia: Institution-Based Cross-Sectional Study.

BACKGROUND: Cesarean section is one of the most common surgeries around the world performed whenever abnormal conditions complicate labour and vaginal delivery, threatening the life or health of the mother or the baby. Although the cesarean section is a safe operation, when it is performed without medical need, it puts mothers and their babies at risk of short- and long-term health problems. However, the factors are not persistent and there is limited information concerning the levels of cesarean section delivery and its associated factors in public hospitals of North Wollo Zone. Therefore, this study aimed to assess the magnitude of cesarean section and associated factors in hospitals of North Wollo Zone, Northern Ethiopia. METHODS AND MATERIALS: An institution-based cross-sectional study design was employed among 433 mothers who gave birth in public hospitals of North Wollo Zone, Northern Ethiopia, from March 01 to 30, 2019. A systematic random sampling method was used to select the study participants. A structured questionnaire was used to collect data. Bivariable and multivariable analyses were carried out to identify independent predictors of cesarean section. RESULTS: The magnitude of cesarean section delivery was 30.9% (95% CI, 26.8-35.3). Being urban resident (AOR=4.04, 95% CI: 2.19-7.45), malpresentation (AOR=2.56, 95% CI: 1.29-5.05), having a previous cesarean section (AOR=9.11, 95% CI: 3.77-22.01) and antepartum haemorrhage (AOR=8.65, 95% CI: 3.82-19.56) were statistically and positively associated with cesarean section delivery. CONCLUSION: The magnitude of cesarean section delivery among mothers who gave birth at North Wollo Zone public hospitals was high. Residence, antepartum haemorrhage, having a previous cesarean section, and malpresentation were factors associated with cesarean section. Therefore, health education and giving a clear picture regarding the risks and benefits of cesarean section as well as avoiding unjustified cesarean section delivery should be encouraged.

Unintended Pregnancy and Associated Factors among Pregnant Women Attending Antenatal Care at Bako Tibe District Public Health Facility, Oromia Region, Ethiopia.

BACKGROUND: A pregnancy is described unintended if it is either unwanted or mistimed. The former occurs when no child or no more children are desired, and the latter is when the conception occurs earlier than the desired time, but wanted later. Unwanted pregnancy causes a serious health, economic, and social problem to the woman and her family. In the study area, there is limited data on unintended pregnancy. Therefore, this study fills this gap by studying the magnitude of unintended pregnancy and its associated factors among pregnant women attending antenatal care in the study area. METHODS: A facility-based cross-sectional study was done from 1 March to 1 April 2019, among 612 randomly selected pregnant women attending antenatal care at Bako Tibe district public health facility. The data were collected via interview using a structured and pretested questionnaire. They were entered into EpiData Version 3.1 and SPSS Version 23 for cleaning and analyses. The variables, which were significant at P ≤ 0.2 in the bivariate logistic regression, were included in the multivariable analysis. The direction and strength of statistical association were measured by an odds ratio with 95% CI. A variable with a P value < 0.05 was considered a significantly associated factor with the outcome one. RESULTS: In this study, the prevalence of unintended pregnancy was 33.3%, at 95% CI (29.8, 37.3). The factors that had significant association with unintended pregnancy were family size ≥ 6 (AOR = 8.0, 95% CI: 1.38-46.66), women who did not communicate about family planning with their husbands (AOR = 2.8, 95% CI: 1.50-5.20), and parity ≥ 5 (AOR = 3.0, 95% CI: 1.34-6.8). CONCLUSION: About one-third of the pregnant women reported that their pregnancy was unintended. Parity, family size, and lack of spousal communication showed a significant association with the problem. To decrease the current level of unintended pregnancy in the area, the Bako Tibe District Health Bureau and the health workers should work harder to scale up spousal communication on family planning.