ABSTRACT
Background: Maternity Waiting Home (MWH) utilization is valuable for enhancing maternal and neonatal health service utilization. Although few studies have been conducted in non-pastoral areas, more evidence is needed from pastoralist communities. Hence, the study aimed to assess the utilization of MWH and its associated factors among women in pastoralist communities in Ethiopia. Methods: A concurrent mixed-method design was conducted from 10 Augustto15 September 2021. The cluster sampling technique was used to select the study participants. Qualitative data was collected through focus group discussions and in-depth interviews. Multivariable logistic regression analysis is used to identify significant factors. Qualitative data were thematically analyzed and triangulated with quantitative findings. Results: Only 13 % (95%CI:10.5-15.6) of women had utilized MWHs. Husbands participation in antenatal care (AOR = 5.54, 95%CI: 2.14-14.35), having caregivers at home (AOR = 2.59, 95%CI: 1.14-4.86), attending pregnant-women conferences (AOR = 5.01, 95%CI: 2.17-11.49), the husband received information about MWH (AOR = 3.6, 95%CI: 1.54-8.49), favorable attitude towards MWH (AOR = 3.15, 95%CI:1.47-6.77), birth during the rainy season (AOR = 0.35, 95%CI: 0.15-0.81) and residing within 10 km of a health center (AOR = 0.15,95%CI:0.04-0.58) were significantly associated with MWH utilization. The main themes that emerged as barriers to MWH utilization were lack of awareness, availability and accessibility of the services, norms and perceptions, lack of decision-making power, family support and women's workload. Conclusion: The study found low utilization of MWHs. Husbands' involvement, having information about MWHs, a favorable attitude, the season of birth, and distance were significantly associated. Lack of transportation access, norms, and limited awareness of MWH were also found to be barriers to service utilization. Health education to raise awareness about the importance of MWHs, enabling transportation access, husbands' involvement, and encouraging women to take an active role in household decision-making are crucial to boosting MWH utilization.
ABSTRACT
BACKGROUND: Birth asphyxia is still one of the primary causes of newborn mortality worldwide. Similarly, the risk of newborn asphyxia in Ethiopia remains unacceptably high. Thus, studies on the incidence and predictors of mortality among newborns admitted with birth asphyxia are crucial to addressing this problem. As a result, the purpose of this study was to assess the incidence and predictors of mortality among neonates admitted with birth asphyxia to the neonatal intensive care units (NICUs) of West Shewa Zone Public Hospitals in Central Ethiopia. METHODS: An institution-based retrospective cohort study was conducted among 760 asphyxiated neonates admitted to the NICUs of West Shewa Zone Public Hospitals between 30 March 2021 and 30 April 2023. The data were collected using CSEntry and analysed bu using Stata V.17. Bivariate and multivariate Cox proportional hazard regression analyses were carried out, and significant predictors were found using a 95% CI and a p<0.05. RESULTS: A total of 760 asphyxiated neonates were followed for a total of 6880 neonatal days. At the end of follow-up, 263 (34.6%) of the neonates died (95% CI 31.3% to 38.1%), which resulted in a mortality incidence of 10.6/100 person-days of observation. Chewing khat (adjusted HR, AHR 2.21; 95% CI 1.13 to 4.31), home delivery (AHR 1.45, 95% CI 1.1 to 1.9), lack of antenatal care follow-up (AHR 1.44, 95% CI 1.08 to 1.89), hypothermia (AHR 1.56, 95% CI 1.12 to 2.17), hypoglycaemia (AHR 2.23, 95% CI 1.91 to 2.25) and obstructed labour (AHR 1.4, 95% CI 1.02 to 1.91) were found to be the significant predictors of neonatal mortality among asphyxiated neonates at a p≤0.05. CONCLUSION AND RECOMMENDATION: The magnitude of neonatal mortality among asphyxiated neonates in the study area was high. Therefore, in order to significantly reduce the risks of birth asphyxia and subsequent newborn death, all interested stakeholders should take these predictors into consideration.
