Quality of life among women with a diagnosis of pelvic organ prolapse at Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Northwest Ethiopia: an institutional based cross-sectional study.

INTRODUCTION AND HYPOTHESIS: Pelvic organ prolapse is among the most common gynecologic problems worldwide. It greatly influences women's quality of life. However, research regarding the effect of pelvic organ prolapse on quality of life is limited in our study area. METHODS: An institutional-based study design among women with the diagnosis of pelvic organ prolapse at Felege Hiwot Comprehensive Specialized Hospital was employed from May to July 2018. Interviewer-administered questionnaire and Prolapse Quality of Life assessment tool were used to collect data. Gynecologic speculum examination was done to collect objective data. Data were entered into Epi info version 7 and then exported in to SPSS, version 20.0, for analysis. Descriptive statistics and logistic regression were used. All the statistical tests were significant at P < 0.05. RESULTS: The average prolapse quality of life score was 48.35 ± 22.75 SD. The physical limitation (score: 69.83 ± 28.77 SD) and general health perception (score: 67.39 ± 20.26 SD) domains were the most affected life domains. Younger age (AOR = 3.02 [95% CI: 1.22-7.45]), being illiterate (AOR = 3.52 [95% CI: 1.12-11.10]), and having stage IV POP (AOR = 2.84 [95% CI: 1.16-7.00]) were associated with lower quality of life. CONCLUSIONS: The QOL score showed huge variability among the study participants. The physical limitation and general health perception domains were most affected. Being illiterate, being < 35 years old, and having stage IV pelvic organ prolapse were the factors associated with lower quality of life.

Breast self-examination and its associated factors among women who attended anti-retroviral therapy clinic in Bahir Dar city administration, North West Ethiopia.

Objective: Although breast self-examination has been shown to be the least-expensive, less time-consuming, and non-invasive screening method, still there is a gap in practice. Furthermore, the information among more risky population which attends anti-retroviral therapy is too limited. Therefore, the aim of this study is to assess breast self-examination practices and its associated factors among women who attended the anti-retroviral therapy clinic in Bahir Dar city administration, Northwest Ethiopia. Methods: An institution-based cross-sectional study was conducted among 660 women who attended anti-retroviral therapy clinics from March 1 to March 30, 2020. A systematic random sampling technique was used to select study participants. Pre-tested interviewer-administered questionnaires were used to collect data. Data were entered in to EPI data 3.1 and exported to Statistical Package for the Social Sciences version 23.00 software for analysis. A binary logistic regression model was fitted to identify factors associated with self-breast examination. Variables with a p value less than 0.2 in bivariable regression were candidates for multivariable regression. Adjusted odds ratios with a 95% confidence intervals and p values less than 0.05 were used to determine the association between independent and dependent variables. Hosmer-Lemeshow Test was used to determine model fitness. Result: Among 641 study participants, 224 (34.9%) have ever practiced breast self-examination. Women who attended college or above (adjusted odds ratio = 4.04, 95% confidence interval (1.65,9.90)), rich (adjusted odds ratio = 6.64, 95% confidence interval (2.72,16.20)), knowledgeable about signs and symptoms of breast cancer (adjusted odds ratio = 5.13, 95% confidence interval ( 2.55,10.31)), risk factors for breast cancer (adjusted odds ratio = 3.62, 95% confidence interval (1.85,7.07)), positive attitude toward breast self-examination (adjusted odds ratio = 2.76,95% confidence interval (1.41,11.84)), family history of breast cancer (adjusted odds ratio = 3.68,95% confidence interval (1.14,11.84)), and knowledge about breast self-examination technique (adjusted odds ratio = 2.64, 95% confidence interval (1.23,5.66)) had higher odds of breast self-examination practice. Conclusion: The practice of breast self-examination was low. During their regular visits for other issues, education and information dissemination about the benefits and techniques of self-breast examination is recommended.

Respectful maternity care among laboring women in public hospitals of Benishangul Gumuz Region, Ethiopia: A mixed cross-sectional study with direct observations.

OBJECTIVES: Promoting respectful maternity care is a fundamental strategy for enhancing facility birth, which significantly reduces maternal and newborn mortality and morbidity. Despite these effects, disrespect and abusive childbirth care remain a challenge in Ethiopia. Therefore, this study aimed to determine the prevalence of respectful maternity care and its associated factors among laboring women in public hospitals of Benishangul Gumuz region, Ethiopia. METHODS: A facility-based cross-sectional study design was employed, and trained external assessors observed the care provided to 404 laboring women in public hospitals using structured observation checklists. A focus group discussion and two key informant interviews were also conducted. A structured pre-tested questionnaire and a semi-structured guide were used to generate quantitative and qualitative data, respectively. Seven verification criteria were employed, and the mean value and above for each criterion were used to measure respectful maternity care. RESULTS: Of the 404 client-provider interaction observations during childbirth, only 12.6% (n = 51) participants received respectful maternity care. Being from an urban area (adjusted odds ratio = 3.34, 95% confidence interval: 1.39, 8.08), giving childbirth at daytime (adjusted odds ratio = 2.59, 95% confidence interval: 1.26, 5.33), receiving the service from compassionate and respectful care trained provider (adjusted odds ratio = 4.54, 95% confidence interval: 1.63, 12.66), giving childbirth at general hospital (adjusted odds ratio = 3.03, 95% confidence interval: 1.39, 6.65) were positively associated with respectful maternity care. Staff workload, shortage of supply and equipment, partiality in providing timely care, yelling and insulting at clients and birth companions were also barriers to respectful maternity care. CONCLUSION: The observed respectful maternity care practices were low in the study area. Therefore, the findings of this study suggest that addressing respectful maternity care would require increased compassionate and respectful care trained providers, and sustained efforts to improve access to basic equipment and supply for maternity care with an emphasis on primary hospitals. Tailored interventions aimed at improving respectful maternity care should also target rural residents and nighttime parturients.

Early initiations of first antenatal care visit and associated factor among mothers who gave birth in the last six months preceding birth in Bahir Dar Zuria Woreda North West Ethiopia.

BACKGROUND: Timing of Antenatal care booking is one of the basic components of antenatal care services; that helps to early detection, managing, and prevention of problems during the pregnancy and helps the mother to receive full packages of antenatal care services. However, in the world including Ethiopia, significant numbers of pregnant mothers were not booking the follow up on the recommended time. The main aim of this study was to assess the prevalence and factors that associated with the early timing of antenatal care visit in Bahir Dar Zuria District, North West Ethiopia. METHODS: A community-based cross-sectional study was conducted. A total of 410 mothers have participated. Data were collected through the interview from March 1 to 30/2018 using a structured and pre-tested questionnaire. Data were clear, code, and enter into Epi-info version 7.1 and export to SPSS for farther analysis. Both bivariate and multivariate analyses were used. On bivariate analysis p-value, less than 0.2 were used to select the candidate variable for multivariate analysis. P-value and confidence interval were used to measure the level of significance on multivariate analysis and those variables whose P-value < 0.05 were considered as statically significant. RESULTS: The prevalence of early timing of ANC in the study area was 46.8%; with [95% CI 40.5, 51.8]. Distances [AOR 2.47, 95% CI; 1.4, 4.2], Knowledge on the timing of ANC [AOR 2.1; 95% CI; 1.2, 3.7], No under-five children [AOR 2.7; 95% CI; 1.3, 5.8], having one under-five children [AOR 2.2; 95% CI; 1.1, 4.5], and wanted pregnancy [AOR 2.4, 95% CI, 1.3, 4.7] were affects the early timing of ANC. CONCLUSIONS: The prevalence of early timing of ANC was high when compared to the national figure and the Sub-Saharan country. Accessibility of health services, knowledge on the timing of ANC, under-five children, and desire for pregnancy were factors that affect the early timing of ANC.

Perceived risk factors of HIV infection and ART adherence at Zewditu Memorial hospital, Addis Ababa, Ethiopia: A survey of people living with HIV/ AIDS experiences

Introduction: Despite several interventions, HIV/AIDS continued global leading cause of morbidity and mortality, particularly in developing countries including Ethiopia. Aim: This study was aimed at assessing the risks of HIV infection and conditions after ART initiation among people living with HIV/AIDS at Zewditu Hospital, Addis Ababa, Ethiopia. Methods: An ethnographic study was conducted using an in-depth interview through semi structured questionnaire and tape recorder. Using tape recorder, careful probing, verbatim transcription, interviewing up to saturation point and considering disparity are activities to keep data trustworthiness. Data were read carefully and grouped in to themes; risky behaviors, diagnosis and reactions, conditions after ART initiation, and future plan for thematic analysis. Results: Seven people living with HIV/AIDS (three male and four female) were participated. The mean age of respondents was 39.29 ± 6.34 SD. There were three orthodox followers, three divorced, two in marriage and two college graduated. All had serious risky behaviors to HIV infection: four had multiple sexual partners, three were very poor, two with substance abuse, two had blood contact history, and one had unprotected sex with different men. All accepted their diagnosis result, but only four started ART soon. All participants stopped having children or pregnancy since knowing their status and only four disclosed status. All respondents showed health improvement, and four respondents have desire to have marriage and children. Conclusions: Interviewed people were with different serious risky behaviors that will lead them HIV infection. ART service helped them improve their health, weight gain and have future plan on marriage, having children and education. Coordinated community level education, strong counseling, accessing uninterrupted HIV testing and ART services, open partner/family discussion, early HIV diagnosis and treatment, avoiding substance abuse, improving income of people with HIV/AIDS and safe sex practice are crucial to prevent HIV infection and improve ART adherence

Cultural Competence among Maternal Healthcare Providers in Bahir Dar City Administration, Northwest Ethiopia: Cross sectional Study.

BACKGROUND: Cultural competency is now a core requirement for maternal health providers working in multicultural society. However, it has not yet received due attention in Ethiopia. This study aimed to determine the level of cultural competence and its associated factors among maternal health care providers in Bahir Dar City Administration, Northwest Ethiopia. METHODS: Institution based cross-sectional study was carried out using both quantitative and qualitative methods. Maternal health care providers from all health facilities were our study participants. Structured Questionnaire with some modification of Campinha Bacote's tool was used to collect quantitative data from health workers and semi structured guide line was used for qualitative data among women. While quantitative data analysis was done using SPSS, qualitative data was analyzed using open code software. P-value of less than 0.05 was taken to determine statistical significance. Cronbach's alpha was used to test internal reliability and a factor loading of 0.3 or greater was the criterion used to retain items. RESULT: Two hundred seventy four health workers and seven women were involved in the study. The overall competency level was 57.3 % thought vary in different subscales or stages. Of the cultural competent health workers near to three fourth (73.0 %) were in awareness stage which is the earliest stage of competence in which individuals were aware only their own culture but not the world view of their clients. The voices of mothers in the qualitative assessment also showed discordance in cultural competence with their healthcare providers. Female health workers almost six times [AOR,5.5; 2.71, 11.30] more competent than male providers and those who got in-service training related to maternal care provided services more culturally competent than their counter parts with [AOR,3.5; 1.4, 8.64]. Reliability Cronbach's α coefficient value of cultural competence subscales showed 0.672,0 .719, 0.658, 0.714, and 0.631 for cultural awareness, knowledge, skill, encounter and desire, respectively. CONCLUSIONS: The overall competence level of health workers was low and the mean competence level falls in awareness stage in the continuum of culturally incompetent, culturally aware, culturally competent, and culturally proficient indicated that the providers were aware of only their own culture but not the world view of their clients. The voices of mothers also showed that they were dissatisfied for the services they got and the interactions they had with health care providers. Hence, we recommend on job training of health workers and incorporation of cultural components in the curriculum of health workers as it would be the key to provide culturally acceptable services.