Barriers to Medication Adherence Among Patients with Non-Communicable Disease in North Wollo Zone Public Hospitals: Socio-Ecologic Perspective, 2023.

Background: The practice of taking medication as directed by a healthcare provider is known as medication adherence. Therefore, the application of a socio-ecological model to this study identifies multilevel factors on barriers of medication adherence on chronic non-communicable disease and provides information to develop scientific health communication interventional strategies to improve medication adherence. Objective: This study aimed to explore barriers of medication adherence on non-communicable disease prevention and care among patients in North Wollo Zone public hospitals, northeast Ethiopia. Methods: A phenomenological study design was carried out between February 5 and February 30, 2023. The study participants were chosen using a heterogeneous purposive sampling technique. In-depth interviews and targeted focus groups were used to gather data. The focus group discussions and in-depth interviews were captured on audio, accurately transcribed, and translated into English. Atlas TI-7 was utilized to do the thematic analysis. Results: Four main themes, intrapersonal, interpersonal, community level, and health care related, as well as seven subthemes, financial problems, lack of family support, poor communication with healthcare providers, effects of social ceremonies, remote healthcare facility, and drug scarcity, were identified by this study. In this study participants reported that lack of knowledge about the disease and drugs were the main barrier for medication adherence. The study revealed that financial problems for medication and transportation cost were the main factor for medication adherence for non-communicable disease patients. Conclusion: This study explored that lack of knowledge, financial problem, lack of family support, poor communication with healthcare providers, social ceremony effects, remote healthcare facility, and scarcity of drugs were barriers of medication adherence among non-communicable disease patients. In order to reduce morbidity and mortality from non-communicable diseases, it is advised that all relevant bodies look for ways to reduce medication adherence barriers for patients at every level of influence.

Preference of cesarean delivery and its associated factors among pregnant women attending ante natal care at public health facilities of Debrebrehan City, Ethiopia: Cross-sectional study.

BACKGROUND: A Caesarean section is a surgical procedure used to prevent or treat life-threatening maternal or fetal complications. Women's delivery preferences have become a global issue of interest to many researchers and clinicians, especially given the ever-increasing rate of cesarean sections. There is limited data on the preference for cesarean delivery and its associated factors for Ethiopian women, particularly in the study area. The aim of the study is to assess the preference for cesarean delivery and its associated factors among pregnant women attending antenatal care at public health facilities in Debre Berhan, Ethiopia, in 2023. METHODS: An institution-based cross-sectional study design was done from May 5-20, 2023, among 512 participants, and a multi-stage sampling technique was used. The data were collected by using interviewer-administered semi-structured questionnaires. The data were entered by Epi Data version 4.6 and then transferred to SPSS version 25 for analysis. With logistic regression, those variables with a p-value <0.25 in the bivariate analysis were candidates for multivariate logistic regression, and variables with a p-value <0.05 were considered statistically significant. RESULT: The preference for a cesarean section was 26%, with a CI of 22.3% to 29.9%. Pregnant mothers who were not satisfied with their previous intrapartum care (AOR; 6.3 CI = (3.5-11), P = 0.01), had no knowledge about cesarean delivery (AOR; 2.9; 95% CI = 1.6-5.3), P = 0.01), had a previous history of spontaneous abortion (AOR; 3.1; 95% CI = (1.5-6.3), P = 0.001), lived in an urban area (AOR; 1.9; 95% CI = (1.0-3.5), P = 0.038), and had a current pregnancy-related problem (AOR; 4.8; 95% CI = 1.9-10), P = 0.001) were significantly associated with the preference for cesarean delivery. CONCLUSION: In this study, the preference for cesarean delivery was high as compared to the World Health Organization recommendation. Pregnant mothers who were not satisfied with their previous intrapartum care, had no knowledge about cesarean delivery, had a previous history of spontaneous abortion, had an urban residence, and had a current pregnancy-related problem were significantly associated with a preference for caesarean delivery. Clinicians who are working in the delivery room should improve their service provision by using patient-centered care to increase patient satisfaction.

Lived Experience of People with Type 1 Diabetes in North East Ethiopia; Psycho-Social and Economical Perspective, a Phenomenological Study.

Objective: To explore lived experience of people with type 1 diabetes in North East Ethiopia; psycho-social and economical perspective. Methods: A descriptive phenomenological study was conducted to explore the lived experience of people with type 1 diabetes in North East Ethiopia; psycho-social and economical perspective from March 02 to March 25, 2020. A heterogeneous purposive sample method was used to choose the participants. The lead investigator used an in-depth interview to collect data, using an audio recorder and an interview guide. The data were analysed using the thematic analysis method. Atlas. ti software version 7 was used to facilitate the data analysis process. Results: A total of 13 participants were enrolled in this study. The participants age range were 14 to 70 years and their duration of diabetes since diagnosis were from 8 months to 16 years. The three interconnected themes that emerged from the analysis are: (1) psychological experience with two sub-themes (psychological problems due to diabetes including fear and coping strategies for psychological problems), (2) social experience, which has five categories (influence on intimate relationships, influence on social participation, disclosure status, social isolation and stigma, social support, and influence on education); and (3) economic experience. Conclusion: Fear was one of the psychological experiences felt by people with type 1 diabetes. Although type 1 diabetes is a biomedical problem, it is also accompanied by other psychological and socio-economic issues, that require a holistic approach to address it. So, health professionals should strengthen health information dissemination programs.

Maternity waiting Home-use and associated factors among mothers in northwest Ethiopia, The application of the integrated behavioral model

Maternal mortality in Ethiopia is the highest in the world (412/100,000). Health facility delivery is the cornerstone in reducing maternal mortality. However, health facility delivery is low in Ethiopia, due to poor access and ill-equipped health facilities. Maternity waiting home(MWH)is one of the comprehensive packages of essential obstetric services, enabling women to access well-equipped health facilities. However, there are limited studies on maternal waiting home use in Ethiopia. This study aimedto use the integrated behavioral model, toassess maternal waiting home use and associated factors among mothers in the East Bellessa district, northwest Ethiopia.Method:A community-based cross-sectional study was conducted fromthe1-27 of March 2020. The multistage sampling technique was used to select a total of 624 mothers. Data was collected usingthe face-to-face interview technique. The reliability and validity of the itemswere checked using exploratory factor analysis. Multivariable logistic regressions wereconducted toidentify the factors associated with maternal waiting home use. Findings with a p-value <0.05 with a 95% confidence interval were considered statistically significant in the final model.Result.Overall, 20.5% (95% CI=17.3-23.7) of mothers used maternity waiting homes for the index of childbirth. Husband educational status (AOR=3.78, CI =1.44-9.93), the knowledge on maternitywaiting homes(AOR=3.97, CI=2.27-6.95), between 2 and 3antenatal care follow ups(AOR=0.14 CI=0.06-0.31), experiential attitude (AOR=2.37, CI=1.64-3.44), descriptive norms(AOR=0.66, CI=0.47-0.94), perceived behavioral control (AOR=1.07, CI=1.02-1.13) and behavioral intention (AOR=1.37, CI=1.1-1.71) were associated with maternity waiting home use.Conclusion:Maternity waiting home utilization was low. Husband's education status, antenatal care follow-up, knowledge on maternal waiting homes, experiential attitude, descriptive norms, perceived behavioral control and behavioralintention were positively significantly associated with MWH utilization. Therefore, strengthening the use antenatal care services, husbands'education, and developing a positive attitude towards MWH may improve the use of maternity waitinghomesamong women. [Ethiop. J. Health Dev. 2022; 36(2):000-000]Keyword:Maternity waiting home, mothers,integrated behavioral model, Ethiopia