Predictors of Maternal Near Miss in Public Hospitals of West Shoa Zone, Central Ethiopia: A Case-Control Study.

Background: Maternal mortality reduction remains a priority to ensure healthy lives and promote wellbeing for mothers and newborns in the new sustainable development goals agenda. There is no evidence-based study done regarding maternal complications and near-miss in the study area. Objectives: This study assessed the predictors of maternal near-miss in public hospitals of West Shoa Zone, Central Ethiopia, 2020. Methods: An unmatched case-control study was conducted among 664 (166 cases and 498 controls) women who gave birth in public institutions in the West Shewa zone. Structured questionnaires and checklists were used to collect the data. Bivariate, multivariable logistic regression, and adjusted odds ratios were used to describe the strength and directions of association. Results: The odds of maternal near-miss were higher among mothers with increased maternal age [Adjusted odds ratio (AOR) = 1.065, 95%CI: (1.015-1.117)], who could not read and write (AOR = 3.06, 95%CI: 1.314-7.135), had primary (AOR = 3.49, 95%CI: 1.518-8.044), and secondary (AOR = 3.213, 95%CI: 1.418-7.282), had no antenatal care (ANC) follow-up (AOR = 2.25, 95%CI: 1.100-4.607), mothers who had a first delay of more than 6 h [AOR = 2.38, 95%CI: (1.517-3.735)] and the distance from health facility of > 60 min [AOR = 4.021, 95%CI: (1.817-8.896)]. Conclusion: In this study, delay in decision making and reaching the health facility, lower educational status, not having ANC follow-up, and increased maternal age were significantly associated with maternal near misses. Therefore, the Ethiopian federal ministry of health and other stakeholders should work on increasing ANC coverage, awareness creation, and strong means of transportation to tackle the complications of a maternal near miss.

Completion of the continuum of maternity care and associated factors among women who gave birth in the last 6 months in Chelia district, West Shoa zone, Ethiopia: A community-based cross-sectional study.

Background: The continuum of maternity care is a continuity of care that a woman receives during pregnancy, childbirth, and the postpartum period from skilled providers in a comprehensive and integrated manner. Despite existing evidence regarding maternal healthcare services discretely, the continuum of maternity care and its associated factors are not well-known in Ethiopia. Objective: This study assessed the completion of the maternity continuum of care and associated factors among women who gave birth 6 months prior to the study in the Chelia district. Methods: A community-based cross-sectional study with a stratified random sampling technique was conducted among 428 mothers at 10 randomly selected kebeles. Pretested and structured questionnaires were used to collect data. Bi-variable and multivariable logistic regression analyzes were performed to identify associated factors. Adjusted odds ratio with its 95% confidence interval was used to determine the degree of association, and statistical significance was declared at a p-value of <0.05. Results: In this study, 92 (21.5%) mothers completed the continuum of maternity care. Secondary and above education of mothers (AOR = 4.20, 95% CI:1.26-13.97), ≤30 min spent on walking by foot (AOR = 4.00, 95% CI: 1.67-9.58), using an ambulance to reach health facility (AOR = 3.68, 95% CI: 1.23-11.06), para ≥5 mothers (AOR = 0.21, 95% CI: 0.05-0.90), planned pregnancy (AOR = 3.29, 95% CI: 1.02-10.57), attending pregnant women's conference (AOR = 13.96, 95% CI: 6.22-31.30), early antenatal care booking (AOR = 3.30, 95% CI: 1.54-7.05), accompanied by partners (AOR = 3.64, 95% CI: 1.76-7.53), and informed to return for postnatal care (AOR = 3.57, 95% CI: 1.47-8.70) were the factors identified. Conclusion: In this study, completion of the maternity continuum of care was low. Therefore, appropriate strategic interventions that retain women in the continuum of maternity care by targeting those factors were recommended to increase the uptake of the continuum of maternity care.

Assessment of Knowledge, Attitude, and Practice of Skilled Assistance Seeking Maternal Healthcare Services and Associated Factors among Women in West Shoa Zone, Oromia Region, Ethiopia.

BACKGROUND: This study aimed to assess women's knowledge, attitude, and practice towards skilled assistance seeking maternal healthcare services in West Shoa Zone, Oromia Region, Ethiopia. METHODS: Cross-sectional survey design was conducted from 1 February to 23 March 2018 in West Shoa Zone, Oromia, Ethiopia. A simple random sampling technique was used to select the participants. The data were collected using a pretested and structured questionnaire. Data were entered using EpiData version 3.1, and descriptive analysis and bivariate and multivariate logistic regression analyses were carried out using SPSS version 20 statistical software package. RESULTS: The study revealed that the knowledge, attitude, and practice towards skilled maternal health services were found such that 473.3 (72.4%) of the study participants had good knowledge, 180.7 (27.6%) had poor knowledge, and 400 (61.3%) had positive attitude, 254 (38.84%) had negative attitude, 460.3 (70.4%) had good practice, and 193.7 (29.6%) had poor practice towards skilled maternal health services. Factors that had a significant association with antenatal care utilization were planned pregnancy (AOR = 8.2, 95% CI = 3.39-19.78-0.87) and access to transport (AOR = 3.1, 95% CI = 1.46-6.61). Attending ANC at least once (AOR = 3.1, 95% CI = 1.13-8.41), women's education (AOR = 3.0, 95% CI = 1.18-7.84), and unplanned pregnancy (AOR = 0.3, 95% CI = 0.21-0.75) were factors associated with skilled delivery service utilization. Attending ANC at least once (AOR = 2.1, 95% CI = 1.1-4.2), birth complications (AOR = 2.2, 95% CI = 1.35-3.66), unplanned pregnancies (AOR = 0.3, 95% CI = 0.22-0.68), and awareness about skilled obstetric care (AOR = 3.7, 95% CI = 1.68-12.79) were factors associated with postnatal care utilization. CONCLUSIONS: This study found that the knowledge, attitude, and practice of skilled maternal health services among the study participants are low, showing less than three-quarters of the total sample size. Therefore, this study implied that interventions are required to improve women's knowledge, attitude, and practice of skilled maternal health services in the study area. Furthermore, women's education is significantly associated with skilled delivery service utilization. Accordingly, this study recommends that improving equity among the marginalized population is needed to increase maternal health service coverage.

Maternal health care services utilization amidstCOVID-19 pandemic in West Shoa zone, central Ethiopia.

The novel coronavirus (COVID-19) is an infectious disease caused by a newly discovered coronavirus. Despite strong efforts that have been taking place to control the pandemic globally, the virus is on the rise in many countries. Hence, this study assessed the maternal health care services utilization amidst the COVID-19 pandemic in West Shoa zone, Central Ethiopia. A community-based cross-sectional study was conducted among 844 pregnant women or those who gave birth in the last 6 months before the study. A multi-stage sampling technique was used to select the study participants. The data were collected through face-to-face interviews using a semi-structured questionnaire. Logistic regressions were performed to identify the presence of significant associations, and an adjusted odds ratio with 95%CI was employed for the strength and directions of association between the independent and outcome variables. A P-value of <0.05 was used to declare statistical significance. The prevalence of maternal health service utilization during the COVID-19 pandemic was 64.8%. The odds of maternal health service utilization was higher among mothers who had primary (AOR = 2.16, 95%CI: 1.29-3.60), secondary (AOR = 1.97, 95%CI: 1.13-3.44), and college and above education (AOR = 2.89, 95%CI: 1.34-6.22) than those who could not read and write. Besides, mothers who did travel 30-60 minutes (AOR = 0.37, 95%CI: 0.23-0.59) and 60-90minutes (AOR = 0.10, 95%CI: 0.05-0.19) to reach the health facility had a lower odds of maternal health service utilization than those who did travel <30 minutes. Moreover, mothers who earn 1000-2000 (AOR = 3.10, 95%CI: 1.73-5.55) and > 2000 birrs (AOR = 2.66 95%CI: 1.52-4.64) had higher odds of maternal health service utilization than those who earn <500 birrs. Similarly, the odds of utilizing maternal health service were higher among mothers who did not fear COVID-19 infection (AOR = 2.79, 95%CI: 1.85-4.20), who had not had to request permission from husband to visit the health facility (AOR = 7.24, 95%CI: 2.65-19.75), who had practicedCOVID-19 prevention measure (AOR = 5.82, 95%CI: 3.87-8.75), and used face mask (AOR = 2.06, 95% CI: 1.28-3.31) than their counterpart. Empowering mothers and creating awareness on COVID-19 preventionis recommended to improve maternal health service utilization during the COVID-19 pandemic.

Adherence to Option B+ Care for the Prevention of Mother-to-Child Transmission Among Pregnant Women in Ethiopia.

PURPOSE: Even if progressive efforts were made in Ethiopia, half of new HIV infections result from mother-to-child transmission. Limited studies assessed the level and factors of adherence that differ among different populations across the country. So, this study aimed to investigate the level and predictors of adherence to the prevention of mother-to-child transmission (PMTCT) Option B+ care among pregnant women in central Ethiopia. METHODS: A facility-based cross-sectional study design was conducted to interview 347 HIV positive pregnant women. Using a multistage sampling technique, participants were recruited from twelve health facilities based on probability proportional to the number of clients. The collected data on socio-demographics, healthcare delivery, clinical and individual factors were entered into EpiInfo v7.2.2.6, and further analysis was done using SPSS v23 software. Adherence was measured based on client self-report either as adherent and non-adherent. Bivariate and multivariate logistic regressions were undertaken to see the association between variables. Statistically significant variables were declared using an adjusted odds ratio with a 95% confidence interval. RESULTS: The overall adherence to option B+ was 80.2% (95% CI: 76.3-84.5%). Time of ART initiation (AOR=3.23; 95% CI: 1.09-6.59), fear of stigma for taking ARV (AOR=5.06; 95% CI: 1.79-10.26), ANC appointment (AOR=4.62; 95% CI: 1.48-6.42), male partner support (AOR=2.23; 95% CI: 1.11-4.50), and counseling (AOR=5.36: 95% CI: 1.00-8.58) were the associated factors with level of adherence. CONCLUSION: The overall adherence level to Option B+ care in this study was inadequate to suppress the viral load during pregnancy. The result revealed that keeping adherence to ARVs during pregnancy is still challenging. So, all concerned bodies need to give attention to minimize the barriers from the client, environment, and health system perspectives.