Work autonomy and its associated factors among health professionals in public hospitals of North East Ethiopia.

A low level of work autonomy is the bottleneck for the health service delivery and the quality of the service. Although work autonomy is the pillar of organizational commitment and a means of employee retention mechanism, information about the magnitude of work autonomy among health professionals is limited in Ethiopia. Therefore, this study aimed to assess work autonomy and its predictors among health professionals working in public hospitals of Northeast Ethiopia. Institution-based cross-sectional study was conducted from March 24 to April 24, 2021, among health professionals using a stratified sampling technique. Variables with a p-value of < 0.25 in bivariable analysis were included in the multivariable analysis and variables with a p-value of < 0.05 in multivariable analysis were regarded as significantly associated factors. The overall good work autonomy in public hospitals (Dessie and Boru Meda Hospital) of North East Ethiopia was 54.5% (95% CI 54.48-54.53). Satisfaction with organizational policy and strategy (AOR 2.34, 95% CI 1.29-4.25), satisfaction with supervisor support (AOR 7.20, 95% CI 3.97-13.07), good health service delivery planning practice (AOR 1.88, 95%CI: 1.13-3.13), being married (AOR 4.26, 95%CI: 2.06-8.82) being pharmacy professionals (AOR 0.44, 95% CI 0.19-0.98), and being anesthesia and radiology professionals (AOR 4.66, 95% CI 1.65-13.19) were significantly associated with work autonomy of health professionals. More than half of the health professionals working in public hospitals in Northeast Ethiopia are autonomous in their work. Satisfaction with organizational policy and strategy, satisfaction with supervisor support, having good health service delivery planning practice, being married, and type of profession were significantly associated factors in public hospitals. Thus, strengthening strategies aimed at shaping poor health service delivery planning practices and dissatisfaction of employees concerning supervisor support and organizational policy might have a substantial contribution to improving the work autonomy of health professionals.

Time management practice and associated factors among health professionals working in public and private hospitals in Dessie City, Northeast Ethiopia: a comparative cross-sectional study.

Background: Time management is a widely ignored concern in all types of organizations, including the healthcare system, despite its crucial role in the achievement of personal and organizational goals. Therefore, determining the practice of time management and its associated factors among health professionals is of paramount importance. Objective: We aimed to assess time management practice and associated factors among health professionals working in public and private hospitals in Dessie City, Northeast Ethiopia. Methods: A comparative cross-sectional study was conducted from 24 March to 24 April 24 2021 among 660 health professionals (220 from private hospitals and 440 from public hospitals), who were randomly selected using a stratified sampling technique. A self-administered questionnaire was used to collect data. A multivariable binary logistic regression model was run separately for public and private hospitals. A p-value of < 0.05 and a 95% confidence interval were reported to be statistically significant. Results: A total of 615 participants responded to the survey, which resulted in a response rate of 93.2%. The magnitude of good time management practice among health professionals in both public and private hospitals was reported to be 57.1% (95% CI: 53.5-60.8%). However, the magnitude differed between public [50.1% (95% CI:45.5-54.7%)] and private hospitals [70.9% (95% CI: 63.5-76.7%)]. Living with families (AOR: 5.39, 95% CI: 1.84-15.77), satisfaction with compensation and benefits (AOR: 7.83, 95% CI: 1.97-31.16), satisfaction with work autonomy (AOR: 7.10, 95% CI: 1.94-25.95), and having a good plan (AOR: 3.42, 95% CI: 1.15-10.13) were statistically significant predictors of time management practice in private hospitals. Satisfaction with an organizational policy and strategy (AOR: 2.34, 95% CI: 1.25-4.36), performance appraisal (AOR: 1.95, 95% CI: 1.13-3.36), work autonomy (AOR: 1.92, 95% CI: 1.12-3.27), and the good approach of employees toward time (AOR: 2.12, 95% CI: 1.26-3.58) were statistically significant predictors of time management practice in public hospitals. Conclusion: The magnitude of a good time management practice in public and private hospitals in the study area was low. The practice was observed to be higher in private hospitals than in public hospitals. The study revealed that the magnitude and associated factors of time management practice vary between hospitals, indicating the need for targeted intervention.

Does previous circumcision and wealth index influence women's attitude to discontinue the practice of female genital mutilation and cutting (FGM/C) in Ethiopia?

INTRODUCTION: understanding women's attitudes towards female genital mutilation is an important step towards eliminating this practice. We used the 2016 Ethiopia Demographic and Health Survey (EDHS) data set to examine the relationship between wealth index, and previous history of circumcision on women's opinions whether female genital mutilation (FGM) should be continued or stopped in Ethiopia. METHODS: Data from 6984 women aged 15-49 years were extracted from the 2016 Ethiopia EDHS data set. Multivariable logistic regression analysis was performed to analyse the data. RESULT: In this study, women with a higher level of education and wealth index were more likely to support the cessation of FGM. However, circumcised women (AOR: 0.22; 95% CI: 0.15-0.32), women from the Afar region (AOR: 0.34; 95% CI: 0.22-0.50), Somali region (AOR: 0.42; 95% CI: 0.27-0.65), and Dire Dawa region (AOR: 0.51; 95% CI: 0.32-0.83) were less likely to support discontinuation of FGM. CONCLUSION: The present study revealed that wealth index, education level, history of circumcision, and regional variation are associated with women's attitude towards discontinuation of the practice of FGM in Ethiopia. Empowering women in terms of socioeconomic status and education can change attitudes and might help prevent female genital mutilation in the future. Furthermore, interventions targeting FGM practices should focus on regional variance in order to have a meaningful impact on reducing this harmful cultural practice in Ethiopia.

Uptake of premarital HIV testing and associated factors among women who had autonomous versus non autonomous marriage in Ethiopia: A nationwide study.

BACKGROUND: Premarital HIV testing offers an opportunity where prospective couples can know their HIV status before marriage to prevent both heterosexual and vertical transmission of HIV. Therefore, this study aimed to determine whether there is any significant difference in the prevalence of premarital HIV testing among women who had autonomous versus non-autonomous marriage, and to investigate the factors associated with premarital HIV testing among women who had autonomous versus non-autonomous marriage in Ethiopia. METHODS: Data were extracted from 2016 Ethiopia Demographic and Health Survey dataset and analyzed by using SPSS version 20. Frequencies and weighted percentage of the variables, and second-order Rao-Scott statistic were computed. Multivariable logistic regression analysis was used to identify factors between the two groups. An adjusted odds ratio with 95% confidence interval was considered to state statistically significant associations. RESULT: From 9602 included sample, 4,043 (42.1%) of the women had autonomous marriage, and 5,559(57.9%) of the women had non-autonomous marriage. The prevalence of premarital HIV testing in Ethiopia among women who had autonomous marriage was 30.5% (95% CI: 27.7-33.4%) compared to 20.6% (95% CI: 18.5-22.8) among women who had a non-autonomous marriage. No differences in associated factors were found between women who had autonomous versus non autonomous marriage to uptake HIV testing. In both groups, residence in rural area, education attainment (primary, secondary, higher), media access, being rich and richest, knowing the places for HIV testing, chewing chat, and drinking alcohol were significantly predicts premarital HIV testing. CONCLUSION: The study indicated that 10% more women in autonomous marriage tested for HIV relative to non-autonomous women whilst being an urban resident, educated, having access to media, household wealth and knowledge of testing facilities significantly predict HIV testing among women in Ethiopia. The paper recommends the Ethiopian government shall expand access to education among women while improving their access to media to enhance their socioeconomic wellbeing and health. Furthermore, it is better to inspire women to undergo autonomous marriage by fostering education in the community to enhance premarital HIV testing.

The effect of unemployment and post-natal care on the exclusive breast-feeding practice of women in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Promoting exclusive breastfeeding (EBF) is a major child survival strategy in developing countries like Ethiopia. Studies in EBF are found in a fragmented and inconclusive way in Ethiopia. Therefore, the aim of this study was to examine evidences on the effect of post natal care counseling and maternal employment status on exclusive breastfeeding practice of women in Ethiopia. METHODS: A systematic literature search was conducted from PubMed (contains MEDLINE), CINAHL (EBSCO), Global Health, Food Science and Technology Abstracts (FSTA) (EBSCO) and Grey literature sources such as Google and Google scholar. All primary studies on the effects of employment status and/or post-natal care utilization on EBF practices of women in Ethiopia were included. Data analyses were performed using STATA software. Forest plot, I2 test and the Cochrane Q statistics were used to detect heterogeneity among studies. Heterogeneity was considered significant when the I2 value was ≥ 50%, with p-value < 0.05. Publication bias was checked by looking the asymmetry of funnel and confirmed by Egger's regression test at a 5% significant level. The pooled odds ratio (POR) with 95% confidence interval (CI) was used to report the measures of associations. RESULT: A total of 622 studies were identified in the initial search of which 42 articles were included this systematic review and meta-analysis. A meta-analysis of 24 studies indicated that maternal employment status was significantly associated (POR = 0.51, 95% CI 0.16, 0.86) EBF practice in that employed mother were less likely to practice to practice EBF. Post-natal care service utilization significantly increases (POR = 1.76, 95% CI 1.32, 2.34) the EBF practice in Ethiopia and it was computed using 25 eligible articles. Besides, the pooled estimates of EBF practice was found to be 62.58% (95% CI 56.98, 68.19, I2 = 96.4%, p < 0.001). CONCLUSION: This review found that post-natal care service utilization and maternal employment status has a significant effect on EBF practice. The findings from this review may be used to inform for better supportive and promotive strategies for EBF practice in Ethiopia.

Promotion of EBF in developing countries including Ethiopia is very crucial strategy to improve the survival of children. Despite this, several factors prohibit women from practicing EBF of which post-natal care service utilization and employment status are the main determinants. The previous studies in Ethiopia are inconsistent and inconclusive to policy makers. Thus, this systematic review and meta-analysis underpinned the effects post-natal care service and maternal employment status on the EBF practice of women in Ethiopia. The findings of this study will be vital to forward recommendations on the duration of maternal leave and design promotion strategies of post-natal care, the most unaddressed maternal health care service in Ethiopia. The original studies were retrieved systematically from reputable databases and grey literature sources. The data were extracted using standardized data extraction sheet. Analyses were performed using STATA software. Fixed and random effect models were utilized to compute pooled estimates. Heterogeneities were computed and the sources of heterogeneities were explained. In the current study, the pooled prevalence of EBF was 62.6%. Likewise, post-natal care service utilization and employment status were found to have significant association with the EBF practice. Unemployed women had a better EBF practice as compared to the employed ones. This could be due to the fact that most employed women in Ethiopia are governmental employees where the maximum duration of maternal leave is four months after birth. This is before the due date of commencement of complementary feeding. Post-natal care should also be promoted to improve the EBF practice.

Prevalence of depression and associated factors among HIV/AIDS patients attending antiretroviral therapy clinic at Dessie referral hospital, South Wollo, Ethiopia.

INTRODUCTION: Depression is one of the common mental health disorders and predicted to be the second cause of the global health burden by the year 2020. Depression in HIV patients may lead to poor engagement to their HIV care which may finally result in poor treatment outcomes. Therefore, the aim of this study was to assess the prevalence of depression and associated factors among HIV/AIDS patients on ART at Dessie referral hospital. METHODS: An institution based cross-sectional study was conducted among 395 HIV positive adult patients on antiretroviral treatment from November to January 2019. The study participants were selected by using the systematic random sampling technique among patients who visited the antiretroviral (ART) clinic in the hospital and standardized Patients Health Questionnaire (PHQ-9) was used to measure depression. Descriptive statistics like percentage, median with interquartile range (IQR) was computed and presented in the form of text and table. Binary logistic regression model was fitted to identify factors associated with depression. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to identify factors associated with depression. RESULT: The prevalence of depression was found to be 20% with (95% CI 16.2, 23.8). Age group of 25-34 years (AOR = 6.58, 95% CI 1.11, 38.9), widowed marital status (AOR = 7.05, 95% CI 2.32, 21.38), perceived stigma (AOR = 2.43, 95% CI 1.13, 5.21)], had opportunistic infections [AOR = 4.96, 95% CI (1.05, 23.34)], HIV non-disclosed HIV status (AOR = 6.34, 95% CI 1.34-29.65), poor and fair drug adherence (AOR = 7.1, 95% CI 2.06, 24.44), CD4 count ≤ 200 (AOR = 5.38, 95% CI 2.37-12.23) were factors significantly associated with depression. CONCLUSION: The magnitude of depression was relatively lower than the pooled estimates for Ethiopia. Perceived stigma, younger age, widowed, being symptomatic, fair and poor adherence, recent opportunistic infection, low CD4 count, and HIV status not disclosed were positively associated with depression. This finding suggests the integration of mental health care with antiretroviral therapy and the special emphasis ought to be given for those at higher risk of depression.