Inequity in uptake of maternal health care services in developing countries: a systematic review and meta-analysis.

Background: Maternal health service uptake remains an important predictor of maternal outcomes including maternal mortality. This systematic review and meta-analysis aimed to summarize the available evidence on the uptake of maternal health care services in developing countries and to assess the impact of place of residence, education status, and wealth index on the uptake of these services. Methods: We examined the databases MEDLINE, Web of Science, Global Index Medicus, and Scopus until June 14, 2022. Cross-sectional studies done between 2015 and 2022 were considered. Mothers of reproductive age and all states of health were included in the study. Independently, two authors determined the eligibility of studies, extracted data, evaluated the risk of bias, and ranked the evidence's degree of certainty. To combine the data, we performed a random-effects meta-analysis. The PROSPERO registration ID is CRD42022304094. Results: We included 51 studies. Mothers living in urban areas were three times more likely to receive antenatal care (OR 2.95; 95% CI 2.23 to 3.89; 15 studies; 340,390 participants) than rural mothers. Compared with no education, those with primary education were twice as likely to utilize antenatal care (OR 2.36; 95% CI 1.80 to 3.09; 9 studies; 154,398 participants) and those with secondary and higher education were six and fourteen times more likely to utilize antenatal care, respectively. Mothers in the second wealth index were twice as likely as mothers in the lowest wealth index to utilize antenatal care (OR 1.62; 95% CI 1.36 to 1.91; 10 studies; 224,530 participants) and antenatal care utilization increased further among mothers in the higher wealth index. We observed similar relative inequalities in skilled delivery care and postnatal care utilization based on the pace of residence, education, and wealth index. Conclusion: In developing countries, the problem of inequity in utilizing maternal health care services persists and needs considerable attention.

Hospital Readiness and Perceived Health Professional Challenges to Prevent Pandemics in Gedeo Zone, Ethiopia: A Mixed-Method Study.

Background: Pandemics pose serious threats to health, society, and economy worldwide. Ethiopia has been affected by the COVID-19 pandemic, which has caused millions of deaths and disrupted essential health services. The readiness of health systems and the challenges that health professionals face in delivering pandemic-related services are crucial for preventing and controlling pandemics. However, these aspects have not been adequately assessed in low-income countries like Ethiopia, where poor prevention techniques and challenging work conditions can increase the transmission of diseases and overwhelm the weak healthcare system. This study aimed to assess hospital readiness and health professional challenges to prevent pandemics in Ethiopia. Methods: A mixed-methods study design was used to collect data from 24 health professionals and four public hospitals using interviews and a checklist which explored the challenges and barriers of health professionals in preventing pandemics and assessed the hospital readiness. Data were analyzed thematically with open code software and descriptively with SPSS software. Results: The study revealed the alarming gaps in the hospitals' readiness and the health professionals' capacity to prevent and control pandemics. Most of the hospitals had insufficient preparedness in terms of administrative activities, infection prevention and control (IPC) activities, emergency room preparedness, outpatient services, and logistics and supplies. The health professionals faced multiple challenges, such as lack of resources, training, personal protection, psychological support, and workload. The most critical challenges were the lack of personal protective equipment (PPE) and training, which compromised their safety and effectiveness. Conclusion: The study underscored the need to enhance the hospitals' readiness and the health professionals' capacity to prevent and control pandemics and health professionals faced various challenges in preventing and controlling pandemics. These challenges include lack of resources, training, psychological support, and lifestyle changes which may compromise their quality of care, safety, and well-being.

Novel Coronavirus (COVID-19)-Associated Guillain-Barre' Syndrome: Case Report.

Though the novel corona virus (COVID-19) mostly affects the respiratory system, it can also result in several neurological complications. One of these is Guillain-Barré Syndrome (GBS) and which is rare and only reported from some parts of the world during this pandemic. Guillain-Barré syndrome (GBS) is an immune-mediated polyradiculoneuropathy. Patients can present with limb or cranial-nerves weakness, loss of deep tendon reflexes, sensory and dysautonomic symptoms. The main pathophysiology for the clinical presentation is demyelination and/or axonal damage to peripheral nerves or roots. Neurological manifestations are more commonly associated with severe COVID-19 infection. Here, we present a case of Guillain-Barré syndrome associated with COVID-19 in Ethiopia.

Adherence to prenatal iron-folic acid supplementation and associated factors among pregnant women attending antenatal care services in Dilla town, South Ethiopia.

Background: During pregnancy, due to the physiological and hormonal change, the requirement of iron-folic acid is enhanced. Therefore, the occurrence of iron/folic acid deficiency is relatively high and it is responsible for 95% of anemia during pregnancy. Objectives: The aim of this study was to assess adherence to prenatal iron-folic acid supplementation (IFAS) and associated factors among pregnant women attending antenatal care services at public health facilities of Dilla town. Methods: Facility-based cross-sectional study design was employed selecting 403 pregnant women attending antenatal care services in three public health institutions of Dilla town. The women were included in the study by simple random sampling. Data were collected by interview and document review. Then it was entered into EPI Data version 3.1 and exported to SPSS version 20 for analysis. Bivariate and multivariate binary logistic regression techniques were used to identify independent predictors. A p-value <0.05 was taken as indication of statistical significance. Results: From the total of planned 403 pregnant women, 396 participated in the study, with a response rate of 98.2%. Of these, 172 (43.4%) pregnant women were adhered to IFAS. The study also revealed that history of previous anemia (adjusted odds ratio (AOR) = 1.87; 95% confidence interval (CI): (1.01-3.47); p = 0.04), frequency of antenatal care center (ANC) visits (AOR = 2.51; 95% CI: (1.17-5.37); p = 0.01), knowledge of IFA supplement (AOR = 2.28; 95% CI: (1.36-3.82); p = 0.002), and knowledge of anemia (AOR = 2.30; 95% CI: (1.40-3.77); p = 0.001) were independent predictors of adherence to IFAS. Conclusion: The finding of this study showed that less than half of the pregnant women were adhered to IFAS. History of previous anemia, frequency of ANC visits, knowledge of IFA supplement, and knowledge of anemia were the factors associated with adherence to IFA supplement.

Assessment of Anti-TB Drug Nonadherence and Associated Factors among TB Patients Attending TB Clinics in Arba Minch Governmental Health Institutions, Southern Ethiopia.

BACKGROUND: Tuberculosis (TB) is an infectious disease caused by the bacillus Mycobacterium tuberculosis. Nonadherence to anti-TB treatment may result in the emergence of multidrug-resistant TB, prolonged infectiousness, and poor tuberculosis treatment outcomes. Ethiopia is one of the seven countries that reported lower rates of treatment success (84%). This study assessed anti-TB drug nonadherence and associated factors among TB patients in Arba Minch governmental health institutions. METHODS: An institution based cross-sectional study design was conducted from April 15 to May 30, 2017. A systematic sampling technique was employed to select the study subjects. Data was collected using a semistructured questionnaire with Morisky Medication Adherence Scale-8 (MMAS-8) and was entered, cleaned, and analyzed in SPSS version 20. RESULTS: The study included 271 TB patients with a response rate of 96.4%; 58.3% were males and 64.9% were Gamo by ethnicity. The overall nonadherence was 67 (24.7%) (CI = 20.0-30.4). Nonadherence was high if the patients experienced side effects (AOR = 13.332; 95% CI = 2.282-77.905), were far from the health facility (AOR = 21.830; 95% CI = 0.054-77.500), and experienced prolonged waiting time to get medical services (AOR = 14.260; 95% CI = 2.135-95.241). CONCLUSIONS: The proportion of TB patients that did not adhere to anti-TB drugs was high in Arba Minch governmental health institutions.

Knowledge, Attitude, and Practice of Complementary and Alternative Medicine Among Residents of Wayu Town, Western Ethiopia.

Complementary and alternative medicine covers a wide variety of therapies and practices, which vary from country to country and region to region. The study was conducted to assess the knowledge, attitude, and practice of complementary and alternative medicine among the residents of Wayu town, Western Ethiopia. A descriptive cross-sectional study was carried out on 302 residents. A systematic sampling was used to select households. Data were entered in SPSS (version 20; IBM Corp) and descriptive statistics was carried out. Of 302 participants, 51.65% have a good knowledge, 78.6% were aware of complementary and alternative medicine, and 74.22% used it in the past 2 years. A total of 23.83% believe that complementary and alternative medicine is more effective than modern medicine and 28.8% preferred complementary and alternative medicine to modern medicine. This study revealed that in Wayu town, there is relatively high public interest in complementary and alternative medicine practices and a significant number has a good knowledge but generally the attitude toward complementary and alternative medicine is relatively low.