Delay in reaching health facilities and its associated factors among mothers giving birth in South Gondar zone hospitals, Northwest Ethiopia, 2020: A facility-based cross-sectional study.

Background: Delays in reaching health facilities are one of three models identified as major contributors to maternal mortality and morbidity in developing countries, including Ethiopia. However, little is known about the prevalence and associated factors of delays in reaching healthcare facilities in Ethiopia, particularly in rural areas. Objective: The aim of this study was to assess the prevalence of delays in reaching health facilities and associated factors among mothers who gave birth in South Gondar zone hospitals, Northwest Ethiopia, 2020. Methods: A cross-sectional study design was used from 28 November to 25 December 2020, with 417 mothers who had recently given birth participating in the study, selected through a simple random sampling technique. Data were collected using a face-to-face interview with pretested structured questionnaires. The EpiData software (version 3.1) was used to record collected data and then exported to SPSS (version 23) for statistical analysis. Bivariable and multivariable analyses were conducted, and the odds ratio with 95% CI was used to identify factors associated with delays in reaching health facilities. The statistical significance was declared at p < .05. Results: The prevalence of delay in reaching health facilities among mothers who gave birth in South Gondar zone hospitals were 50.6%. Mothers who had no antenatal care (ANC) visits [adjusted odd ratio (AOR) = 3.16, 95% CI = 1.52, 6.56], an unplanned pregnancy (AOR = 1.78, 95% CI = 1.16, 2.72), and a distance from home to a health facility greater than 5 km (AOR = 1.69, 95% CI = 1.08, 2.65) were positively associated with delays in reaching health facilities. Conclusions: The prevalence of delays in reaching health facilities was higher in the study area. Women's empowerment through health education about ANC follow-up, choice of family planning methods, and creating accessibility to health facilities are essential measures to minimize delays in reaching health facilities.

Knowledge and attitude of women towards maternity waiting homes and associated factors among women who gave birth in the last twelve months in Dega Damot district, northwest Ethiopia.

Background: Maternal waiting homes have been identified as one strategy to reduce maternal and perinatal mortality by bringing women living in hard-to-reach areas closer to a health facility that provides emergency obstetric care. Even if utilization of maternal waiting homes is repeatedly assessed, there is a scarcity of evidence in Ethiopia regarding women's knowledge and attitude towards maternal waiting homes. Objective: This study aimed to assess women's knowledge and attitude towards maternity waiting homes and associated factors among women who gave birth in the last twelve months in northwest Ethiopia. Methods: A community-based cross-sectional study was conducted from January 1st to February 30th, 2021. A total of 872 participants were selected by using a stratified cluster sampling technique. Data were collected by face-to-face interviews using a structured, pretested, and interviewer-administered questionnaire. Data were entered into EPI data version 4.6 and analysis was done through SPSS version 25. The multivariable logistic regression model was fitted and the level of significance was declared at a p-value of ≤0.05. Result: Women's adequate knowledge and positive attitude towards maternal waiting homes were 67.3% (95% CI: 64-70) and 73% (95% CI: 70-76), respectively. Had antenatal care visit, the shortest distance to reach the nearby health facility, had history of maternal waiting homes utilization, always involved in health care decision, and sometimes involved in health care decisions were significantly associated with women's knowledge regarding maternal waiting homes. Moreover, secondary and above educational level of women, short distance to reach the nearby health facility and had antenatal care visit were significantly associated with women's attitude towards maternity waiting homes. Conclusion: About two-third of women had adequate knowledge and nearly three-fourth of women had a positive attitude towards maternity waiting homes. It is better to improve the accessibility and utilization of maternal health services Furthermore, it is better to promote women's decision making power and create motivation to have better academic achievement of women.

Consistent Condom Utilization and its Associated Factors among Sexually Active Female Anti-Retro Viral Treatment Users in Finoteselam District Hospital, Northwest Ethiopia, 2018.

Consistent condom utilization is the key strategy to prevent new HIV strain transmissions among ART users. There are limited evidences on consistent condom utilization among women who are on ART in Ethiopia. Methods: A cross-sectional study design was conducted among sexually active female ART users from June to August, 2018. Data were collected using a systematic random sampling data collection method. The multivariable logistic regression model was used to identify the predictors for the outcome Results: study indicated that 137(34.2%) women reported that they were using condom for the last three months, of whom 81 (59.1% (n = 137)) used condoms consistently. Respondents` age group from 21-30 (AOR = 4.381, 95%CI = 1.05, 18.331), Counseling about condom utilization (ARO = 9.442, 95% CI = 4.387, 20.32) and husbands` educational status "diploma and above" (AOR = 3.65, 95% CI = 1.007, 13.227) were significantly associated with condom utilization.

Delays during emergency obstetric care and their determinants among mothers who gave birth in South Gondar zone hospitals, Ethiopia. A cross-sectional study design.

BACKGROUND: The majority of maternal deaths occur during delivery and the immediate postnatal period as a result of delays in seeking care, failure to reach health institutions, and receiving inappropriate health care. In developing countries, delayed access to timely healthcare contributes to high maternal mortality and morbidity. OBJECTIVE: This study aimed to assess the delays during emergency obstetric care and associated factors with delays during emergency obstetric care. METHOD: A cross-sectional study design was conducted. We chose five hospitals at random in the South Gondar zone, Ethiopia. Face-to-face Interviews were conducted with 459 participants using a systematic sampling technique. For this analysis, bi-variable and multivariable logistic regression models were used. The Adjusted Odds Ratio was used to determine the statistical association with delays during emergency obstetric care at p-value <0.05 with a 95% confidence interval. RESULTS: The proportion of delays during emergency obstetric care were found to be 59.7% in this study. The respondents' mean age was 27.23 years old, with a standard error of 5.67. Pregnant mothers living in the rural areas (AOR: 4.1, 95%, CI: 2.36 to 6.25), no ANC visit (AOR: 1.8, 95% CI: 1.32 to 3.18), uneducated women (AOR: 4.6, 95% CI: 2.45 to 8.59) and referral to a higher level of care (AOR: 2.7, 95% CI: 1.60 to 4.44), were all significantly associated with delay. CONCLUSION: Delay during emergency obstetric care was found to be 59.7 percent. Rural residency, absence of ANC visit, uneducated mothers, and referred mothers from one level to the next level of care were factors that contributed to delays in emergency obstetric care in the study area.

Students' Assessment on the Patient Safety Education: The Case of College of Medicine and Health Sciences, University of Gondar.

BACKGROUND: It is well-known that clinical practice could never be free from medical errors. Respectively, in the case of a large number of students with a huge diversity of disciplines, the breach of patients' safety is not uncommon. Thus, this study aimed to assess students' evaluation of patients' safety education in their curriculum. MATERIALS AND METHODS: A cross-sectional study was conducted among 338 students at the University of Gondar. A descriptive analysis was done by using Stata version 13 software and data were presented in tables and text. RESULTS: As stated by 33.40% of medical interns and 51.10% of nursing students, patients' safety education was given as a chapter of a course. On the contrary, 48.20% of midwifery and 32.10% of health officer students stated that it was given as a small portion in a chapter in their curriculum. Almost 60% of students of all professional categories self-reported that their average level of knowledge on the patients' safety rested between "fair" and "poor." Likewise, more than half of students of all professional categories had a "neutral" to "disagree" level of attitude for attitude items. Concerning teaching methods, most students preferred real-life examples and problem-based learning approaches as helpful in patients' safety education. CONCLUSIONS: Patients' safety education has been given less emphasis. Students also self-reported that their average level of knowledge was low. Real-life examples and problem-based learning approaches were preferred learning methods among most of the students.

Risk of Selected Fetal Adverse Pregnancy Outcomes at Advanced Maternal Age: A Retrospective Cohort Study in Debre Markos Referral Hospital, Northwest Ethiopia.

INTRODUCTION: Pregnancy at an advanced maternal age is defined as pregnancy at 35 years or older. Today, women postpone pregnancy due to different socioeconomic and personal reasons. However, there was limited evidence on fetal adverse outcomes' association with pregnancy at an advanced maternal age in Ethiopia and particularly in the study area. This study was aimed at assessing the effect of pregnancy at an advanced age on selected neonatal adverse pregnancy outcomes in Debre Markos Referral Hospital, Ethiopia, 2019. METHODS: Institution-based retrospective cohort study was conducted on 303 exposed (35 years and older) and 604 nonexposed (20-34 years old) immediate postpartum women who delivered at Debre Markos Referral Hospital after 28 weeks of gestation. All exposed women who fulfilled the inclusion criteria were sampled, and systematic random sampling was employed for those in the nonexposed group. The data were collected from 1st of July to 30th of December, 2019, by face-to-face interview and extraction from maternal chart using a structured questionnaire and data extraction checklist, respectively. Binary logistic regression (bivariate and multivariable) model was fitted, and wealth index was analyzed by principal component analysis. Adjusted relative risk with respect to 95% confidence interval was employed for the strength and directions of association between advanced maternal age and selected adverse pregnancy outcomes, respectively. P-value of <0.05 was used to declare statistical significance. RESULTS: The incidence of adverse neonatal outcomes including stillbirth, preterm birth, and low birth weight in the advanced maternal age group was 13.2%, 19.8%, and 16.5%, respectively. The incidence of stillbirth, preterm birth, and low birth weight in the nonexposed group was 3.1%, 8.4%, and 12.4%, respectively. The advanced maternal age group had three times the risk of stillbirth compared with the nonexposed group (ARR = 3.14 95% CI (1.30-7.00)). The advanced maternal age group had 2.66 times the risk of delivering preterm fetus (ARR = 2.66 95% CI (1.81-3.77)) compared with the younger counterparts. Low birth weight was not significantly associated with pregnancy at an advanced maternal age. CONCLUSION: Fetal adverse outcomes including stillbirth and preterm birth were significantly associated with pregnancy at an advanced maternal age.

Uterine rupture among mothers admitted for obstetrics care and associated factors in referral hospitals of Amhara regional state, institution-based cross-sectional study, Northern Ethiopia, 2013-2017.

BACKGROUND: Maternal morbidity and mortality have been one of the most challenging health problems that concern the globe over the years. Uterine rupture is one of the peripartum complications, which cause nearly about one out of thirteen maternal deaths. This study aimed to assess the prevalence and associated factors of uterine rupture among obstetric case in referral hospitals of Amhara Regional State, Northern Ethiopia. METHODS: Institution based cross sectional study was conducted from Dec 5-2017-Jan 5-2018 on uterine rupture. During the study randomly selected 750 charts were included by using simple random sampling method. Data were checked, coded and entered into Epi info version 7.2 and then exported to SPSS Version 20 for Analysis. Binary Logistic regression was used to identify the predictors of uterine rupture and 95% Confidence Interval of odds ratio at p-value less than 0.05 was taken as a significance level. RESULT: The overall prevalence of uterine rupture was 16.68% (95% CI: 14%, 19.2%). Distance from health facility >10km (Adjusted Odds Ratio (AOR) = 2.44; 95%CI:1.13,5.28), parity between II and IV (AOR = 7.26;95% (3.06,17.22)) and ≥V (AOR = 12.55;95% CI 3.64,43.20), laboring for >24hours(AO = 3.44; 95% CI:1.49,7.92), with referral paper(AOR = 2.94;95%CI:1.28,6.55) diagnosed with obstructed labor (AOR = 4.88;95%CI: 2.22,10.70), precipitated labor (AOR = 3.59;95%CI:1.10,11.77), destructive delivery (AOR = 5.18;95%: 1.22,20.08), No partograph (AOR = 5.21; 95% CI: 2.72,9.97), CPD(AOR = 4.08;95%CI:1.99,8.33), morbidly adherent placenta (AOR = 9.00;95%:2.46,27.11), gestational diabetic militias (AOR = 5.78; 95%CI:1. 12,20 .00 ), history of myomectomy(AOR = 5.00;95%CI:1.33,18.73), induction and augmentation of labor (AOR = 2.34;95%:1.15,4.72) obstetric procedure (AOR = 2.54;95%: 1.09,5.91), previous caesarian deliveries 4.90 (2.13,11.26) were found to be significantly associated with uterine rupture. CONCLUSION: This finding showed that the prevalence of uterine rupture is higher. A more vigilant approach to prevent prolonged and obstructed labor, use of partograph, quick referral to a well-equipped center and prevention of other obstetrics complications need to be focused on.