RESUMO
Background: Adequate antenatal care is essential for the health of the mother and the development of the fetus. The World Health Organization recommends at least four antenatal care (ANC) visits during pregnancy. In Ethiopia, only 32% of women of childbearing age attend four or more ANC visits. This figure is significantly lower than the average for least developed countries. This study is aimed at calculating the magnitude and identifying the factors associated with optimal antenatal care utilization in the South Gondar Zone, Northwest Ethiopia. Methods: A community-based cross-sectional study was conducted in the South Gondar Zone of Northwest Ethiopia from September 2020 to May 2021. A total of 434 participants were selected using multistage cluster sampling. Data were gathered through face-to-face interviews using a structured questionnaire. A multivariate binary logistic regression model was used to determine the factors associated with the optimal use of antenatal care. Result: The magnitude of optimal antenatal care utilization was 59% (95% CI; 54.20, 63.65). The study showed that mothers who completed their secondary school (AOR = 8.205; 95% CI: 3.406, 19.767), women who completed their tertiary school (AOR = 6.406; 95% CI: 2.229, 18.416), women whose husbands' level of education is secondary school (AOR = 5.967; 95% CI: 2.753, 12.936), those with a planned pregnancy (AOR = 1.912; 95% CI: 1.117, 3.271), those with a wanted pregnancy (AOR = 2.341; 95% CI: 1.366, 4.009), women whose husbands work in the government or nongovernment sector (AOR = 3.736; 95% CI: 2.093, 6.669), those not being exposed to the media (AOR = 0.520; 95% CI: 0.345, 0.783), and rural women (AOR = 0.267; 95% CI: 0.164, 0.435) were significantly associated with optimal ANC utilization. Conclusion: The findings suggest that more emphasis should be placed on education-based programs for women and their husbands that highlight the benefits of a planned pregnancy, desired pregnancy, and maternal health care. Meanwhile, the government and other concerned bodies should focus on expanding road accessibility, health institutions, and ambulance distribution to improve optimal ANC utilization in the area.
RESUMO
Background: Heart rate is a significant modifiable factor in lowering mortality in heart failure patients. The heart rate, often known as the pulse rate, is the number of times the heart beats in a given amount of time. Irregular pulse rate or heart block are all measured using heart rate data. A higher heart rate has been associated with worse clinical outcomes. The main purpose of this study was to identify factors associated with the longitudinal pulse rate of congestive heart failure patients. Methods: Hospital-based retrospective studies were conducted among 249 congestive heart failure patients who were 18 years old or older and who were on treatment follow-up from first February 2016 to thirty-one December 2017 in Felege Hiwot Referral Hospital, Bahir Dar, Ethiopia. Results: Data were explored using descriptive statistics, individual and mean profile plots, and analyzed using linear mixed models. Out of the total 249 patients, 139 (55.8%) were females. The majority 179 (71.9%) of the CHF patients were rural residents. 65 (26.1%) patients had Hypertension, 30 (12.5%) patients had Diabetes Mellitus, 58 (23.3%) patients had Pneumonia. Thus age, LVEF, follow-up time in a month had a negative significant effect whereas NYHA class, male gender, pneumonia had a positive significant effect on the average evaluation of pulse rate of patients. The time interaction effect of NYHA Class (Time* NYHA Class), and LVEF (Time*LVEF) had a significant effect on average pulse rate evolution. Conclusion: The variables age, LVEF, and follow-up time were negatively associated whereas, male gender, NYHA class, and presence of pneumonia were positively associated with the progression change of pulse rate of patients rate of progression of pulse rate decreases over time. Furthermore, health professionals give more attention to patients who are NYHA class IV, had low LVEF, pneumonic patients to reduce pulse rate during the follow-up time.
