Obstetric emergencies and adverse maternal-perinatal outcomes in Ethiopia; A systematic review and meta-analysis.

Background: Obstetric emergencies are life-threatening medical problems that develop during pregnancy, labor, or delivery. There are a number of pregnancy-related illnesses and disorders that can endanger both the mother's and the child's health. During active labor and after delivery, obstetrical crises can arise (postpartum). While the vast majority of pregnancies and births proceed without a hitch, all pregnancies are not without risk. Pregnancy can bring joy and excitement, but it can also bring anxiety and concern. Preterm birth, stillbirth, and low birth weight are all adverse pregnancy outcomes, leading causes of infant illness, mortality, and long-term physical and psychological disorders. Purpose: The purpose of this study is to assess the magnitude and association of obstetric emergencies and adverse maternal-perinatal outcomes in Ethiopia. Method: We used four databases to locate the article: PUBMED, HINARI, SCIENCE DIRECT, and Google Scholar. Afterward, a search of the reference lists of the identified studies was done to retrieve additional articles. For this review, the PEO (population, exposure, and outcomes) search strategy was used. Population: women who had obstetric emergencies in Ethiopia. Exposure: predictors of obstetric emergencies. Outcome: Women who had an adverse perinatal outcome. Ethiopian women were the object of interest. The primary outcome was the prevalence of adverse maternal and perinatal outcomes among Ethiopian women. Obstetrical emergencies are life-threatening obstetrical conditions that occur during pregnancy or during or after labor and delivery. The Joanna Briggs Institute quality assessment tool was used to critically appraise the methodological quality of studies. Two authors abstracted the data by study year, study design, sample size, data collection method, and study outcome. Individual studies were synthesized using comprehensive meta-analysis software and STATA version 16. Statistical heterogeneity was checked using the Cochran Q test, and its level was quantified using the I 2 statistics. Summary statistics (pooled effect sizes) in an odd ratio with 95% confidence intervals were calculated. Result: A total of 35 studies were used for determining the pooled prevalence of adverse maternal and perinatal outcomes; twenty-seven were included in determining the odd with 95% CI in the meta-analysis, from which 14 were cross-sectional, nine were unmatched case-control studies, and 14 were conducted in the south nation and nationality Peoples' Region, and eight were from Amhara regional states, including 40,139 women who had an obstetric emergency. The magnitude of adverse maternal and perinatal outcomes following obstetric emergencies in Ethiopia was 15.9 and 37.1%, respectively. The adverse maternal outcome increased by 95% in women having obstetric emergencies (OR 2.29,95% CI 2.43-3.52), and perinatal deaths also increased by 95% in women having obstetric emergencies (OR 3.84,95% CI 3.03-4.65) as compared with normotensive women. Conclusion: This review demonstrated the high prevalence of perinatal mortality among pregnant women with one of the obstetric emergencies in Ethiopia. Adverse maternal and perinatal outcomes following obstetric emergencies such as ICU admission, development of PPH, giving birth via CS, maternal death, NICU admission, LBW, and perinatal death were commonly reported in this study.

Level of knowledge toward essential newborn care practices among postnatal mothers in governmental hospitals of Harar Town, Eastern Ethiopia.

OBJECTIVES: Essential newborn care is a set of comprehensive recommendations designed by the World Health Organization to improve the newborn's health through intervention before conception, during pregnancy, soon after birth, and the postnatal period. Globally 4 million newborns die every year before they reach the age of 1 month. Therefore, this study assessed the level of knowledge and associated factors toward essential newborn care practices among postnatal mothers attending postnatal service in governmental hospital of Harar town, Eastern Ethiopia, 2020. METHODS: Facility-based cross-sectional study was conducted in Harar Town, Jugul, and HiwotFana Specialized University Hospital. Voluntary postnatal mothers who are randomly selected were participated in the study. A total number of 266 women were included in the study. Data were collected through face-to-face interviews. The training was given for data collectors, and data evaluation was done on daily basis. Cleaned data were entered to SPSS version 20, and multiple logistic regression analysis was used for better prediction of determinants and to reduce bias due to confounders. Those variables with a p value less than 0.25 were entered into multiple logistic regression analyses. Associations with p value less than 0.05 were declared as statistically significant. Text, figures, and tables presented the result. RESULT: The overall prevalence of good knowledge was 57.2%. Educational status, average monthly income, antenatal care visit, and parity had significantly associated with outcome variables. CONCLUSION: More than half of mothers had inadequate newborn care knowledge. In addition, educational status, average family monthly income, frequency of antenatal care visit, and parity were independently associated with knowledge on essential newborn care. Therefore, more significant improvement in essential newborn care practices could be attained through policy implications and recommendations. Therefore, we recommend that stakeholders of the health sector have a close follow-up on maternal and newborn care services and maintain a strategy that will incorporate maternal education service on essential newborn care practice.

Assessment of quality antenatal care-linked HIV counseling and testing as an intervention for prevention of mother-to-child transmission of HIV at government health facilities in Harari region, Eastern Ethiopia.

OBJECTIVE: To assess quality of antenatal care-linked to HIV counseling and testing as an intervention for prevention of mother-to-child transmission at government health facilities in Harar Town, Eastern Ethiopia, 2020. METHODS: Institutional-based cross-sectional study was done from 1 February to 30 February 2020 by applying quantitative method conducting in government health facilities in Harar town, Eastern, Ethiopia. A total of 422 participants were recruited from four governmental hospitals in Harar Town. Simple random sampling method was used to select the participants. Data were collected by three nurses selected from prospected hospitals. The collected data were cleaned, checked for quality, coded, and analyzed using "Software package Social Science, version 20" computer program. RESULT: From a total of 422 participants, 348 (82.5%) were satisfied with the counseling room's privacy, and having pre-test and post-test counseling by the same person provided comfort for 357 (98.9%) of clients. Three hundred eighty-nine (92.2%) felt comfortable with the counselors' client handling/respect; 386 (91.5%) were satisfied with technical competence of the counselors. About a quarter (25.4%) of clients had no discussion of prevention of mother-to-child transmission at all, and the majority (68.2%) comprehended that HIV counseling and testing could benefit prevention of mother-to-child transmission. CONCLUSION: Exit interview revealed that the basic topics were covered in most of the pre- and/or post-test sessions, and the majority of those counseled comprehended the information; however, nearly a quarter of the clients did not understand why they were offered HIV counseling and testing particularly during their pregnancy time.