Challenges of pre-hospital emergency care at Addis Ababa Fire and Disaster Risk Management Commission, Addis Ababa, Ethiopia: a qualitative study.

BACKGROUND: A challenge to pre-hospital emergency care is any barrier or obstacle that impedes quality pre-hospital care or impacts community pre-hospital utilization. The Addis Ababa Fire and Disaster Risk Management Commission (AAFDRMC) provides pre-hospital emergency services in Addis Ababa, Ethiopia. These services operate under a government-funded organization that delivers free emergency services, including out-of-hospital medical care and transportation to the most appropriate health facility. This study aimed to assess the challenges of pre-hospital emergency care at the Addis Ababa Fire and Disaster Risk Management Commission in Addis Ababa, Ethiopia. METHODS: A qualitative descriptive study was conducted from November 20 to December 4, 2022. Data were collected through in-depth, semi-structured interviews with 21 experienced individuals in the field of pre-hospital emergency care, who were selected using purposeful sampling. A thematic analysis method was used to analyze the data. RESULTS: This study includes twenty-one participants working at the Addis Ababa Fire and Disaster Risk Management Commission. Three major themes emerged. The themes that arose were the participants' perspectives on the challenges of pre-hospital emergency care in Addis Ababa, Ethiopia. CONCLUSION AND RECOMMENDATION: The Fire and Disaster Risk Management Commission faces numerous challenges in providing quality pre-hospital emergency care in Addis Ababa. Respondents stated that infrastructure, communication, and resources were the main causes of pre-hospital emergency care challenges. There has to be more focus on emergency management in light of infrastructure reform, planning, staff training, and education, recruiting additional professional power, improving communication, and making pre-hospital emergency care an independent organization in the city.

Knowledge, Attitude, and Associated Factors towards Prehospital Care among Emergency Health Care Providers Working in Selected Prehospital Care Centers in Addis Ababa, Ethiopia: A Cross-Sectional Study.

BACKGROUND: Patients' health outcomes can suffer as a result of poor knowledge and unfavorable attitude towards prehospital emergency care. The purpose of this study was to assess emergency health care providers' (EHCPs') knowledge, attitude, and associated factors towards prehospital care in selected prehospital Emergency Medical Service institutions in Addis Abeba, Ethiopia. METHODS: An institutional-based cross-sectional study design was conducted among EHCPs working in the three selected prehospital emergency medical care centers in Addis Ababa. Data were collected using a standard self-administered questionnaire, cleaned, coded, and entered into EPI Data Version 6, and then exported to SPSS Version 26 for further analysis. The generated data were compiled using frequency tables, charts, and percentages. Logistic regression analysis was used to see the association between independent and dependent variables. RESULTS: One hundred thirty-five (135) study participants were included in this study, with a response rate of 95.7%. The mean age of the respondents was 29.2 years (SD = 4.86). Almost three-quarters of the respondents (71.1%) were aged between 26 and 35 years. Of the total participants, 58.5% and 62.2% of EHCPs had good knowledge and a favorable attitude towards prehospital care, respectively. The study revealed that profession (AOR = 3.2; 95% CI, 1.03 - 7.65), educational status (AOR = 1.17; 95% CI, 1.08 - 4.93), and having training (AOR = 2.25; 95% CI, 1.33 - 4.52) were significantly associated with the knowledge of EHCPs. This finding also revealed that the respondent's knowledge (AOR = 1.36; 95% CI, 1.05 - 2.32) and having training (AOR = 3.2; 95% CI, 1.24 - 7.83) were significantly associated with EHCPs' attitudes towards prehospital care. CONCLUSIONS: The knowledge and attitude of EHCPs regarding prehospital care were found to be good and favorable as compared to previous studies. In-service training regarding emergency health conditions and the time needed to care for the patient is important for quality prehospital emergency medical care.

The magnitude of mortality and its determinants in Ethiopian adult intensive care units: A systematic review and meta-analysis.

Introduction: Despite mortality in intensive care units being a global burden, it is higher in low-resource countries, including Ethiopia. A sufficient number of evidence is not yet established regarding mortality in the intensive care unit and its determinants. This study intended to determine the prevalence of ICU mortality and its determinants in Ethiopia. Methods: PubMed, Google Scholar, The Cochrane Library, HINARI, and African Journals Online (AJOL) databases were systematically explored for potentially eligible studies on mortality prevalence and determinants reported by studies done in Ethiopia. Using a Microsoft Excel spreadsheet, two reviewers independently screen, select, review, and extract data for further analysis using STATA/MP version 17. A meta-analysis using a random-effects model was performed to calculate the pooled prevalence and odds ratio with a 95% confidence interval. In addition, using study region and sample size, subgroup analysis was also performed. Results: 9799 potential articles were found after removing duplicates and screening for eligibility, 14 were reviewed. Ethiopia's pooled national prevalence of adult intensive care unit mortality was 39.70% (95% CI: 33.66, 45.74). Mechanical ventilation, length of staying more than two weeks, GCS below 9, and acute respiratory distress syndrome were major predictors of mortality in intensive care units of Ethiopia. Conclusion: Mortality in adult ICU is high in Ethiopia. We strongly recommend that all health care professionals and other stakeholders should act to decrease the high mortality among critically ill patients in Ethiopia.

Knowledge, attitude, and practice towards burn first aid and its associated factors among caregivers attending burn units in Addis Ababa, Ethiopia. A cross-sectional study.

Background: Burn injuries are thought to be preventable but are still a prevalent global health problem, especially in low- and middle-income countries. It continues to remain a leading cause of morbidity and mortality in Ethiopia. Proper knowledge about burn first aid minimizes the overall impact of the injury. Purpose: This study aimed to assess the knowledge, attitude, and practice toward burn first aid and its associated factors among caregivers attending burn units in Addis Ababa, Ethiopia, 2021/22. Methods: A hospital-based cross-sectional study was conducted among caregivers of burn patients attending Yekatit 12 hospital medical college and Addis Ababa Burn Emergency and Trauma (AaBET) hospital burn units. A total of 305 caregivers were recruited by a simple random sampling method from both hospitals. Data was collected using a standard interviewer-administrated questionnaire, cleaned, coded, and entered into EPI data version 6, and then exported to SPSS version 26 for further analysis. The generated data were compiled by frequency tables, charts, and graphs. A logistic regression model was used to measure the association between independent versus outcome variables, considering the AOR, 95% CI, and p < 0.05 as significant for all the independent variables. Result: A total of 305 participants responded to this study. Among these, the majority, 185(60.7%) of caregivers were females, while 120(39.3%) were Males. The main source of knowledge for those who had previous information on a burn and its first aid treatment were families, friends, colleagues, and guardians. A significant portion of 246(80.7%) respondents did not take any form of burn first aid training. The study indicates that 202(66.2%) and 195(63.9%) of the study participants have poor knowledge and practice, respectively, despite the majority. 225(73.8%) of responders have a favorable attitude regarding burn first aid. Conclusion and recommendation: This study showed an explicit knowledge and practice gap among caregivers towards burn first aid even though the majorities have a favorable attitude. Developing an effective nationwide burn prevention program and early burn first aid treatment in Ethiopia and promoting a consistent guideline for burn first aid.