Level of institutional delivery service utilization and associated factors among women who gave birth in the past 12 months, Ga'an libah district, Marodijeh region, Somaliland: a community-based cross-sectional study.

BACKGROUND: Institutional delivery has been considered one of the important strategies to improve maternal and child health and significantly reduce birth-related complications. However, it is still low in developing countries though there are some improvements. even among the community who has access to the health institutions weather health center and hospital including Somaliland. Hence, the aim of this study was to assess the level of institutional delivery service utilization and associated factors among women who gave birth in the last 12 months in Ga'an libah district, Marodijeh region, Somaliland. METHODS: The community-based cross-sectional study was conducted among women who gave birth in the last 12 months from September to December 2022. A simple random sampling technique was employed to select study participants from a total of sample population. Data was collected using semi-structural administered questionnaire through interviewing women. Data was collected with online mobile data collection (Kobo collect). SPSS version 25.0 was used for data management, entering and analysis. Bivariate and multivariable logistic regression models were fitted to determine the presence of a statistically significant association between independent variables and the outcome variable with p-value < 0.05. RESULT: Level of Institutional delivery services utilization in Ga'an libah district was 53.9% [95% Cl 48.2-59.6] gave birth at health institutions. Women who can read and write local were (AOR 2.18, 95% CI 1.08-4.56, p<0.01), Women with their husband can be capable to read and write are [(AOR = 6.95, 95% Cl 2.82-21.58, p<0.002]). Additionally, ability to cost transportation for referral [AOR 5.21, 95% Cl 2.44-11.13, p<0.001]. not good services available [AOR 0.07, 95%Cl 0.01-0.10, p<0.02]. lack of maternal health and child knowledge [AOR 0.034, 95% Cl 0.02-0.57, p<0.01]. were observed associated with level of institutional deliver services utilization. CONCLUSION: The institutional delivery service utilization was relatively high compared to national demographic health services in the study area. A large proportion of women gave both at home without a skilled attendant. Therefore, this finding has important policy implications since changes in the cost of the health service and perceived quality would mean changes in client satisfaction as well as their choice, as well emphasize to expectant women can receive medical advice and ambulance for referrals.

Implementation Evaluation of HIV/AIDS Voluntary Counseling and Testing (VCT) Service at Public Health Facilities of Akaki Kality Sub-City, Addis Ababa, Ethiopia.

Background: Voluntary Counseling and Testing (VCT) is widely acknowledged globally as an effective method for preventing and treating HIV/AIDS. It allows people to understand their HIV status, make informed choices about getting tested for it, evaluate their personal risk of contracting HIV, and create plans to reduce that risk. The study aimed to evaluate the process of VCT services in public health facilities of Akaki Kality sub-city, Addis Ababa, Ethiopia. Methods and Materials: A case study evaluation design with a mixed method was employed from May 12 to June 12, 2021. A total of 244 clients were interviewed during the study period. Furthermore, 12 direct observations, a review of documents from the past six months to the study period, and 12 key informant interviews were conducted. Quantitative data were entered into Epi data 4.6 and exported to SPSS version 25 for analysis. Univariate analysis was done and presented in tables and texts. Qualitative data were transcribed, translated, coded, and analyzed using thematic analysis. The overall service implementation process was measured on the basis of pre-determined judgmental criteria. Results: The overall level of VCT service implementation was 83.84%, to which the availability of resources (84.8%), compliance of service providers with the national guidelines (85.38%), and client satisfaction (76.93%) contributed. One facility had stock-outs of test kits in the last three months, and all VCT counseling and testing rooms lacked audio-visual privacy. Supportive supervision, the use of IEC materials during counseling, linking all HIV-positive clients to treatment and care services, and sending complete reports were practiced in a way that needs some improvement. Conclusion: Overall, the service implementation was deemed satisfactory, but further action is required to improve resource availability, ensure provider compliance with national guidelines, and enhance the status of the service. In addition, the Woreda Health Office and Addis Abeba Health Bureau should regularly supervise and provide feedback.

Quality of integrated community case management services at public health posts, Southwest Ethiopia.

PURPOSE: The purpose of this study is to assess the quality of an integrated community case management service (ICCM) and associated factors at health posts in Ethiopia. DESIGN AND METHODS: Institution-based cross-sectional study design was conducted in the health posts of Jimma zone. Data were collected using a structured questionnaire and in-depth interviews. Binary logistic regression was used to identify independent predictors of client satisfaction on services and the qualitative data were presented by triangulating with quantitative findings. RESULTS: This study indicated that 80%, 65% and 55% of health extension workers (HEW) correctly assessed cases, classified cases and prescribed drugs of ICCM cases respectively. Some caregivers (40.2%) knew about danger signs which they heard from HEWs (81.9%). More than one-fourth (29.01%) of caregivers reported that their children were exposed to illness like diarrhea (39.1%) in the last two weeks. HEWs have demonstrated to a large number of caregivers (66%) how to give medications. Being a housewife [AOR = 0.17(0.05,0.56)], having a farmer husband[AOR = 3.77(1.09,12.98)] and having a government employed husband [AOR = 5.32(1.03,27.48)] were significantly associated with ICCM services. CONCLUSIONS: More than half of health extension workers correctly assessed, classified and prescribed drugs for ICCM cases. Some caregivers knew about danger signs which the majority of them heard from health extension workers. Being a housewife and paternal occupation were significantly associated with clients' satisfaction in ICCM services. PRACTICE IMPLICATIONS: Findings of this study can be used to guide the development of programs to improve integrated community case management service in Ethiopia by informing policymakers and other stakeholders about challenges of ICCM services.