Factors associated with neonatal near miss among neonates admitted to public hospitals in dire Dawa administration, Eastern Ethiopia: A case-control study.

INTRODUCTION: The neonatal near-miss cases are subject to factors that are major causes of early neonatal deaths. For every death, more newborns suffer a life-threatening complication. Nearly 98% of neonatal death unduly existed in developing countries. Though there were few prior studies in other regions, they failed in identifying the factors of NNM. Besides, there has been no prior study in the study area. Therefore, this study aimed to assess factors associated with neonatal near-miss. METHODS: A case-control study was employed on a total of 252 cases and 756 controls using a systematic random sampling technique. Data were collected using pre-tested and interview administered questionnaires adapted from similar studies and medical records from December 2020 -March 2021. Pragmatic and management criteria definition of neonatal near miss were utilized. Epi-Data version 3.1 and SPSS version 23 were used for data entry and analysis respectively. Bivariable and multivariable analyses were done to identify factors associated with a neonatal near-miss by using COR and AOR with a 95% confidence interval. Finally, the statistical significance was declared at a p-value < 0.05. RESULTS: There were a response rate of 100% for both cases, and controls. Factors that affects neonatal near miss were non-governmental/private employee (AOR, 1.72[95%CI: 1.037, 2.859]), referral in (AOR, 1.51[95%CI: 1.079, 2.108]), multiple birth (AOR, 2.50[95%CI: 1.387, 4.501]), instrumental assisted delivery (AOR, 4.11[95%CI: 1.681, 10.034]), hypertensive during pregnancy (AOR, 3.32[95%CI: 1.987, 5.530]), and male neonates (AOR, 1.71[95%CI: 1.230, 2.373]), paternal education of secondary school (AOR, 0.43[95%CI: 0.210, 0.868]) and college/above (AOR, 0.25[95%CI: 0.109, 0.578]), monthly income (1500-3500 birr) (AOR, 0.29[95%CI: 0.105, 0.809]) and >3500 birr (AOR, 0.34[95%CI: 0.124, 0.906]). CONCLUSION: Maternal occupation, paternal education, income, referral, multiple births, mode of delivery, hypertension during pregnancy, and sex of the neonate have identified factors with neonatal near-miss. Better to create job opportunities, improving education, and income generation. Counseling on multiple birth and hypertension, and minimizing instrumental delivery should be done at the health facility level.

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.

Magnitude of child sexual abuse and its associated factors among high school female students in Dire Dawa, Eastern Ethiopia: a cross-sectional study.

BACKGROUND: Child sexual abuse (CSA) refers to the involvement of a child (< 18 years) in sexual activity that he or she does not fully comprehend, is unable to give informed consent to, or for which the child is not developmentally prepared and cannot give consent, or that violates the laws or social taboos of society. It is a serious public health problem affecting millions of people each year worldwide but the most neglected and least documented form of violence in Ethiopia among school girls. Therefore, this study aimed to assess the magnitude of child sexual abuse and its associated factors among female high school students in the Dire Dawa administration, Eastern Ethiopia. METHODS: An institutional-based cross-sectional study was conducted among female high school students in Dire Dawa administration between March 1 and 23/2021. We employed stratified and multistage sampling techniques to include 794 participants from selected high schools. A pretested self-administered questionnaire was used, and the data were analyzed using the SPSS software version 24. RESULTS: The proportion of students who reported at least one form of sexual abuse was 384 (48.9%) and approximately 19% of the students reported rape from the total respondents. Students who live alone 4.3 times (AOR 4.30; 95% CI 1.81-10.24), those who live with their friends five times (AOR 5.02; 95% CI 2.24-8.04), and those who live with their single parent three times (AOR 3.31; 95% CI 1.23-8.89) more likely to experience sexual abuse than those living with both parents. The odds of experiencing sexual abuse among students of rural residence were 3.2 times higher than their urban counterparts (AOR 3.2; 95% CI 2.02-4.51). Students who didn't drink alcohol were 70% more protective than those who drank alcohol (AOR 0.70; 95% CI 0.28-0.97). Among rape survivors (64, 37.9%) developed unwanted pregnancies, 26.0% of them underwent an abortion, and (39, 26.0%) developed STI as an outcome of sexual abuse. CONCLUSION: This study demonstrated that the magnitude of child sexual abuse among female students in Dire Dawa was high. Lack of discussion about sexual issues with parents, living without both parents, drinking alcohol, and being a rural residence had a significant association with child sexual abuse. Unwanted pregnancy, abortion, and STIs have been reported as reproductive health outcomes of rape. Therefore, policymakers should introduce and strengthen comprehensive sexual and reproductive health education both in school and out of school, in addition to formal education to reduce the magnitude of the problem. Parents should discuss all sexual and reproductive health issues with their children to reduce the magnitude and consequences of child sexual abuse.

Utilization of modern contraceptives and associated factors among street women in Dire Dawa, Eastern Ethiopia: a mixed study.

INTRODUCTION: Unwanted pregnancy and sexually transmitted diseases are the major problems in street women because of the non-utilization of modern contraceptives. To the best of our knowledge, no studies have assessed the utilization of modern contraceptives and associated factors among street women in the study area. Therefore, this study aimed to determine the utilization of modern contraceptives and its associated factors among street women. METHODS: A community-based cross-sectional study using mixed methods was conducted from February 16th to April 10, 2021, among all censuses and 615 reproductive-aged street women. Face-to-face and in-depth interviews were employed to generate quantitative and qualitative data, respectively. Binary logistic regression was used to analyze the association between modern contraceptive utilization and independent variables with statistical significance set at p < 0.05. Qualitative data were analyzed using a thematic approach. RESULTS: Approximately half 279 (50.3%) (95% CI: 46.3%, 54.4%) street women currently used modern contraceptives. Factors significantly associated were women aged 25-34 years [AOR = 5.5, 95% CI: 1.2-24], distance from a nearby health facility within 30 min [AOR = 9.2, 95% CI: 1.6-51], getting advice from health professionals [AOR = 14.3; 95% CI = 5.3-38.4], discussed with their sexual partners about the utilization of modern contraceptives [AOR = 6.2, 95% CI: 2.4-16.5], a history of pregnancy [AOR = 2.7, 95% CI: 1.2-6], the desire to have a child after two years [AOR = 2.2, 95% CI: 1.1-4.7], and women who faced rape in street life [AOR = 5.4; 95% CI = 1.9-15.3]. Fear of side effects, misperceptions, and the desire to have a child are the main identified themes for the key barriers to using modern contraceptives. CONCLUSION: The proportion of street women currently using modern contraceptives was low. Age, distance from the health facility, discussion with health professionals, discussion with sexual partners, history of pregnancy, desire time to have a child in the future, and history of rape were factors significantly associated with the use of modern contraceptives. Most of the participants' reasons for the lack of use of modern contraceptives were fear of its side effects.

Street women are a segment of the population in absolute poverty, which they suffer from the major problems of unwanted pregnancy and sexually transmitted diseases. Besides this issue, its consequences necessitate the use of modern contraceptives. This study aimed to determine the utilization and associated factors, and explore the key barriers to modern contraceptive utilization among street women in Dire Dawa.In this study, a community-based cross-sectional study design was conducted among all censuses and 615 reproductive-aged street women from February 16th to April 10, 2021. Face-to-face and in-depth interviews were employed to generate data for both methods. Data were analyzed using the SPSS software version 25 and a thematic approach for quantitative and qualitative, respectively.The findings of this study showed that the proportion of street women who currently used modern contraceptives was 279 (50.3%). Factors significantly associated were age, distance from the health facility, discussion with health professionals, discussion with sexual partners, history of pregnancy, desire time to have a child, and history of rape. The key barriers to using modern contraceptives are fear of side effects, misperceptions, and the desire to have a child.In conclusion: this study demonstrated that the proportion of street women currently using modern contraceptives was low. Health professionals and health extension workers should give health education that integrates well-organized street women's groups and community health extension workers that may help reduce women's fear of potential side effects. To correct the misperceptions and myths about modern contraceptives too.

Emergency contraceptive utilization and associated factors among college students in Dire Dawa City, Eastern Ethiopia: A cross-sectional study.

INTRODUCTION: Emergency contraception is a contraceptive method that can be used to prevent pregnancy after unprotected sexual intercourse. Higher education students fall under the sexually active age group and form a high-risk group for unintended pregnancy, because of limited utilization of emergency contraception. The aim of this study was to assess emergency contraceptive utilization and associated factors among college students in Dire Dawa City, Eastern Ethiopia. METHODS: An institutional-based cross-sectional study was conducted in May 2019. A total of 286 students using simple random sampling technique were included in the study. Data were collected by using self-administered questionnaires and entered into EpiData (Classic) Entry version 3.1 and analysed using SPSS version 24.0. Binary and multivariable logistic regression analysis were done to determine the association between the outcome and predictor variables. RESULTS: A total of 286 female students participated in the study giving a response rate of 100%. Eighty-six (86) participants had a history of sexual practice, and 60 (69.7%) had ever used emergency contraceptive. Having knowledge about emergency contraceptive (AOR=3.24; 95% CI: 1.32-7.98), age at first sexual intercourse ≥20 years (AOR=4.04; 95% CI: 1.72-9.52), history of previous pregnancy (AOR=3.12; 95% CI: 1.34-7.24) and previous use of regular contraceptives (AOR=5.01; 95% CI: 2.23-11.27) were found to be significant predictors of emergency contraceptive utilization. CONCLUSIONS: This study showed that emergency contraceptive utilization among female college students having unprotected sexual intercourse is still low. Level of knowledge, age at first sexual intercourse, previous use of regular contraceptives and history of pregnancy were major predictors of emergency contraceptive utilization. Therefore, focus on awareness creation activity and delaying sexual activity is recommended.

HIV-positive status disclosure to a sexual partner and associated factors among HIV-positive pregnant women attending antenatal care in Dire Dawa, Ethiopia: A cross-sectional study.

INTRODUCTION: Pregnant women who disclose their HIV-positive status to their sexual partners have played an important role in reducing the risk of HIV/AIDS transmission to the baby during the antepartum, intrapartum, and postnatal periods. Studies are limited in the current study area in a similar arena. Therefore, this study aimed to assess the proportion of HIV-positive status disclosure and its associated factors among pregnant women. METHODS: A facility-based cross-sectional study was conducted among 156 HIV-positive pregnant women in Dire Dawa administrative from March 12th to May 10th, 2020. Data were generated using a pretested structured questionnaire through face-to-face interviews. Binary logistic regression analysis was employed to identify the predictor variables associated with the disclosure of HIV-positive status among pregnant women to their sexual partners. Finally, the adjusted odds ratio with 95% confidence intervals at P-value< 0.05 was considered statistically significant. RESULTS: Of the total, 135 (86.5%) of HIV-positive pregnant women disclosed their HIV status to their sexual partner. Christian followers (both Orthodox and Protestant) [AOR = 8.8, 95% CI: 2.3. 34] more likely to disclose HIV status to their sexual partner than those Muslims. Those participants who started practicing safer sex [AOR = 17.6, 95% CI: 4-77] and those women who had a smooth relationship before the HIV disclosure were [AOR = 14.7, 95% CI: 3-68.6] more likely to disclose HIV status to their sexual partner than their counterparts, respectively. CONCLUSIONS: The proportion of HIV serostatus disclosure by HIV-positive pregnant women attending antenatal care services to their sexual partners was encouraging. However, this does not mean that there is no need for further awareness and intervention. Hence, interventions to boost and support women in safely disclosing their HIV-positive status are needed.

Minimum Dietary Diversity Practice and Associated Factors among Children Aged 6 to 23 Months in Dire Dawa City, Eastern Ethiopia: A Community-Based Cross-Sectional Study.

Objective: Malnutrition because of poor dietary diversity contributing to child morbidity and mortality. Two-thirds of child mortality occurs within the first 2 years. However, there is limited data related to dietary diversity among children aged 6 to 23 months in Ethiopia. Thus, this study aimed to assess dietary diversity and factors among children aged 6 to 23 months in the study setting. Methods: A community-based cross-sectional study conducted on 438 children aged 6 to 23 months in Dire Dawa, 1-30/02/2019. Simple random sampling was used to select study subjects. Data collected using a structured and pretested interview administered questionnaire. Data entered using EpiData 4.2 and analyzed with SPSS Version 22. Multivariable logistic regression was used to examine associated factors. Adjusted odd-ratio with 95% confidence interval (CI) used, and P-value <.05 considered statistically significant. Results: The overall minimum dietary diversity practice was 24.4% (95% CI: 20.3, 28.5). Maternal education [AOR 2.20; 95% CI: 1.08, 4.52], decision-making [AOR = 2.5; 95% CI: 1.19, 5.29], antenatal care [AOR = 2.19; 95% CI: 1.20, 3.99], postnatal care [AOR = 6.4; 95% CI: 2.78, 14.94] and facility delivery [AOR = 2.66; 95% CI: 1.35, 5.25] were maternal factors. Moreover, child's age [AOR = 2.84; 95% CI: 1.39, 5.83], and child's sex [AOR = 2.85; 95% CI: 1.64, 4.94] were infant factors. Conclusion: One-fourth of children practiced minimum dietary diversity. Child's age, birth interval, postnatal care, antenatal care, child's sex, mothers' decision-making, mothers' education, and place of delivery were significant predictors. Therefore, maternal education, empowering women, and improve maternal service utilization are crucial to improving dietary diversity.

Practice of COVID-19 Prevention Measures and Associated Factors Among Residents of Dire Dawa City, Eastern Ethiopia: Community-Based Study.

INTRODUCTION: COVID-19 is a current health concern in the world. People applying the prevention methods of COVID-19 are vital determinants of curbing the spread of the coronavirus. This study aimed to assess the practices and associated factors of the COVID-19 preventive measures among Dire Dawa residents. METHODS: A community-based, cross-sectional mixed method was used. We conducted the study between June 15th and July 15th, 2020. The subjects of the study were selected by using systematic random sampling. We collected data through face-to-face and in-depth interviews. Both bivariate and multiple logistic regression were employed to determine the predictor variables with the practice of COVID-19 prevention measures. Thematic content analysis analyzed qualitative data. RESULTS: The practice of COVID-19 preventive measures was 40.7% (95% CI: 37-44.4%). Being female [AOR= 1.8; 95% CI: 1.17-2.72], married [AOR=2.75; 95% CI: 1.68-4.48], family income >10,000 Ethiopia birr [AOR=7.3; 95% CI: 3.8-13.9], having history of a chronic disease [AOR=3.46 (1.69, 7.08)], not chewing khat [AOR= 2.15; 95% CI: 1.1-4.2], had a good knowledge about COVID-19 [AOR=5.23; 95% CI: 3-9], and had a favorable attitude about COVID-19 [AOR=3.87; 95% CI: 2.4-6.14] were significantly associated with practice of COVID-19 preventive measures. The qualitative result revealed the communities are not willingly practicing prevention measures because of carelessness and ignorant of the consequences of COVID-19, and some communities believed that COVID-19 is not a real pandemic rather government uses it merely to gain political profit. CONCLUSION: The proportion of practice of COVID-19 preventive measures was low. Sex, marital status, income, history of chronic disease, history of khat chewing, knowledge, and attitude about COVID-19 were associated factors with COVID-19 preventive practices. The communities were not practicing the COVID-19 prevention method because of poor knowledge and a negative attitude.

Clinical Practice Competence and its Associated Factors Among Midwifery and Nursing Students at Dire Dawa Health Sciences Colleges, East Ethiopia, 2020.

BACKGROUND: Competence is defined as the ability to perform a task with desirable outcomes. Globally, an estimated 530,000 women and 2 million newborns die each year, because of no access to competent health professionals. But half of those deaths can be prevented with competent health professionals. However, the existing literature shows that most new graduates have a lack of competence in the clinical environment, none of them have assessed whether student or preceptor factors have an association with clinical competence or not. So, this study is crucial to fill data scarcity. OBJECTIVE: To determine the clinical practice competence and associated factors among midwifery and nursing students at Dire Dawa. METHODS: Institutional cross-sectional study was conducted on nursing and midwifery students from February 10/2020 to February 30/2020. Self-administered questionnaires were given to 318 students through a simple random lottery. Multivariate logistic regression analysis was done for variables with a p-value <0.2 in binary logistic regression. The odds ratio was used to measure the degree of association. RESULTS: Only 19.2% are clinically competent. Students who were oriented about assessment methods were 4 times more likely competent [AOR = 4.096 p-value 0.035]. Students who have staff encouragement and have preceptors were 5 times [AOR = 4.900 p-value 0.12] and 11 times [AOR = 11.052 p-value 0.00] more likely competent, respectively. Confident students were 4 times more likely competent [AOR = 4.460, p-value 0.005]. CONCLUSION: The prevalence of clinical competence is very minimal. This is due to assessment methods orientation, staff encouragement, clinical preceptor support and students' confidence. This finding contributes to the federal ministry of health should work closely with teaching institutions, health facilities, and other stakeholders to overcome those gaps.

HIV-positive status disclosure and associated factors among children in public health facilities in Dire Dawa, Eastern Ethiopia: A cross-sectional study.

INTRODUCTION: HIV status disclosure in children is one of acontroversial issue in current health. Over 44,000 children in Ethiopia were living with HIV in the year 2019 with a variable level of disclosure, which ranges from 16.3% to 49%. Therefore, this study aimed to assess HIV-positive status disclosure and associated factors among HIV-infected children. METHODS: A cross-sectional study was conducted in ten public health facilities providing pediatric antiretroviral therapy services. Systematic random sampling was used to select 221 caregivers of children aged 6-15 years. Face-to-face interviews were employed to generate the data. Binary logistic regression was used to analyze the association between HIV-positive status disclosure to children and independent variables with statistical significance set at p-value <0.05. RESULTS: Out of the total, 134 (60.6%) of HIV-infected children knew about their HIV status. The mean age at disclosure was 10.71 years. Children aged older than 10 years [AOR = 22, 95% CI: 5.3-79.2], female children [AOR = 3; 95% CI = 1.2-8.7], children lost their family member by HIV [AOR = 3.5, 95% CI: 1.2-10], caregiver's perception of child did not get stigmatized [AOR = 4, 95% CI: 1.6-11], and children's responsible for anti-retroviral therapy [AOR = 16, 95% CI: 5-50] were significantly associated with HIV positive status disclosure compared to their counterpart respectively. Children who stayed on anti-retroviral for 10-15 years were [AOR = 7; 95% CI: 2-27] more likely to know their HIV positive status compared to those staying on anti-retroviral therapy for <6 years. CONCLUSION: The proportion of disclosure of HIV-positive status among HIV-infected children was low. Factors associated were the age of the child, sex, existence of parent, stigma, ART duration, and responsibility of the child for his/her drugs. HIV care providers should consider these factors while supporting disclosure.

Knowledge of Neonatal Danger Signs and Associated Factors Among Mothers of <6 Months Old Child in Dire Dawa, Ethiopia: A Community Based Cross-Sectional Study.

INTRODUCTION: Neonatal mortality is one of the challenging issues in current global health. Globally, about 2.5 million children die in the first month of life, out of which Sub-Saharan Africa accounts >40% per annual. Currently, the neonatal mortality rate in Ethiopia is 30/1000 live births. In the study area, there was a limitation of data on mothers' knowledge towards neonatal danger signs. Therefore, this study aimed to assess mothers' knowledge of neonatal danger signs and associated factors. PATIENTS AND METHODS: A community-based cross-sectional design study was conducted in Dire Dawa from March 01/2019 to April 30/2019. Data were collected from 699 randomly selected mothers through a face-to-face interview. Bivariate logistic regression with p-value <0.25 was entered into the multivariable logistic regression analysis. Finally, AOR with 95% confidence intervals at P-value <0.05 was considered a significant association with the outcome variable. RESULTS: About 285 (40.8%) (95% CI: 37.3-44.3) of mothers had good knowledge of neonatal danger signs, and 97.1% (95% CI: 94.1, 99.3) of mothers sought medical care at a health facility. Mothers who were governmental employed (AOR = 2.14, 95% CI: 1.17-3.9), whose fathers' educational level is secondary or above (AOR=2.3, 95% CI: 1.18-4.49), four/more antenatal care visit (AOR=4.3, 95% CI: 1.5-12.3), whose baby developed danger signs (AOR=3.5, 95% CI: 2.13-5.73), and those mothers received education on neonatal danger sign (AOR=7, 95% CI: 4.2-11.5), had a significant association with knowledge of neonatal danger signs. CONCLUSION: Maternal knowledge toward neonatal danger signs was low and a high number of mothers sought medical care at a health facility. Mother's occupation, fathers' education, development of neonatal danger signs, frequency of antenatal care visit, and received health education on neonatal danger signs were factors associated with mothers' knowledge towards neonatal danger signs.