Evidence-based intrapartum care practice and associated factors among obstetric care providers working in hospitals of the four Wollega Zones, Oromia, Ethiopia.

BACKGROUND: Even though Evidence-Based Practice (EBP) is a key component of quality of Intrapartum care and links to improved health care outcomes, consistent application of EBP in patient care remains a challenge for health care providers. In the study area, there are no previous studies conducted on evidence-based Intrapartum care practice among obstetric care providers. Therefore, this study was aimed to assess the magnitude of evidence based intra-partum care practice and its associated factors among obstetric care providers working in hospitals of Wollega zones, Oromia Region, West Ethiopia, 2022. METHOD: An institution-based cross-sectional study using quantitative method was conducted from January to April/2022 in 11 hospitals of the four Wollega zones. All obstetric care providers (278) who were practicing intrapartum care in the selected hospitals were included. The data was collected using structured self-administered questionnaire and observational checklist. Data was entered via Epi-Data version 3.1 and analyzed by SPSS version 25 statistical software. To see the association between the independent variables and evidence based Intrapartum care practice, multivariable logistic regression analysis was done. The statistical significance of association was declared at p-value ≤ 0.05. Tables, figures and charts were also used in descriptive statistics. RESULT: The overall magnitude of evidence-based Intrapartum care practice was found to be 63.7% [95% CI (59.7, 67.7)]. There was a statistically significant association between evidence-based Intrapartum care practice and having good knowledge about Intrapartum care practice [AOR = 2.95; 95% CI (1.52,5.73)], positive attitude towards Intrapartum care practice [AOR = 3.13; 95% CI (1.59,6.16)], availability of updated Intrapartum care guideline [AOR = 2.88; 95% CI (1.46,5.70)], number of obstetric care providers per a shift (≥5 care providers) [AOR = 2.31; 95% CI (1.01,5.29)], number of deliveries within a day (<10 deliveries) [AOR = 4.61; 95% CI (2.28,9.31)], educational level (MSc and above) [AOR = 5.75; 95% CI (2.23,14.84)] at p-value ≤ 0.05. CONCLUSION: Our study revealed that, magnitude of evidence-based Intrapartum care practice was found to be low according to the WHO recommendation. These findings indicate that additional attention and monitoring is required to implement current Intrapartum care practices with the WHO guidelines.

Nursing students' perception towards educational environment in governmental Universities of Southwest Ethiopia: A qualitative study.

BACKGROUND: Educational environment refers to the diverse physical facilities, the clinical settings where students learn, the design and delivery of the curriculum, and involve the skills, and attitudes of the teachers. Due to various undesirable aspects of the educational environment, students often do not attain the expected professional standard of nursing care. There is limited evidence on students' perception of their educational environment in Ethiopia, particularly in the study area. Thus, this study aimed to assess nursing students' perceptions of their educational environment in government Universities of Southwest Ethiopia. METHODS: An institution-based qualitative case study was employed. Eight participants were interviewed from government Universities of southwest Ethiopia. Face to face in-depth interview was used to generate data. The interviews were conducted for forty-five minutes to one hour using an open-ended semi-structured guiding questionnaire. All interviews were recorded, transcribed, translated, and analyzed using a conventional content analysis approach; finally, themes were derived and presented with narration. RESULTS: The analysis of this study yields four themes categorized as curriculum, instructors', organizations', and students. The result of the study revealed that there were poor institutions students support systems, inadequate skills and knowledge in certain instructors, inadequate instructional materials and teaching aids, scarce facilities in students' practical areas, accommodation, and transportation. CONCLUSION: Improvement of nursing students' educational environment was recognized as a strong attention-seeking area. The majority of the key informants stated that the educational environment is not suitable for the teaching-learning process. Thus, to create a conducive educational environment, the Minister of education, Universities, instructors, and other concerned bodies should design and implement strategies targeted at the aforementioned problems.

The morbidity burden from emergency conditions in Jimma city, Southwest Ethiopia.

BACKGROUND: Sub-Saharan Africa shares a disproportionately large ratio of the global acute disease burden, however epidemiological data specific to the burden of emergency conditions are lacking. This study aimed to determine the morbidity burden of emergency conditions in Jimma city, Southwest Ethiopia. METHODS: A cross-sectional study was conducted using emergency case registries of three years from 2014 to 2017, at Jimma Medical Center and Shenen Gibe Hospital. 39,537 emergency visits were included in the study. The data were exported to SPSS V.23.0 for statistical analysis, descriptive analysis was used to summarize demographic characteristics, causes of visit, and morbidity rates. Findings were integrated with population-based health demographic reports quantifying the morbidity burden. Outcome measures were overall number of emergency visits and morbidity rates for the population groups. RESULTS: From a total of 39,537 visits, those between 15 and 29 years of age accounted for 42.1% (n = 16615), and 50.6% (n = 20004) were females. Communicable, Maternal, Neonatal and Nutritional (CMNNs) conditions accounted for 57.2%(n = 22597), followed by injuries (22.9%, n = 9055). Top five conditions were non-specific trauma (2.3%, n = 4861), complicated labor (8.4%, n = 3320), lower respiratory infections (8.1%, n = 3213), acute febrile illness (6.6%, n = 2600), and neonatal infections (3.7%, n = 1444). CONCLUSION: The burden of acute conditions presented to public hospitals in Jimma city is high. Traumatic injuries, obstetric emergencies, lower respiratory infections, and neonatal emergencies were the most frequent causes of acute visits. An appropriate emergency care system that addresses this high burden of acute emergencies should be established in the study area.

Perinatal Outcomes and Associated Factors among women with hypertensive Disorders of Pregnancy Delivered in Jimma Zone Hospitals, Southwest Ethiopia.

Background: Hypertensive disorders of pregnancy are multisystem diseases that increase the risk of adverse perinatal outcomes worldwide. It Led to early and late serious health consequence on the baby, with a significant proportion occurring in low-income countries. Hence the objective of this study was to determine perinatal outcomes and associated factors among women with hypertensive disorders of pregnancy delivered in Jimma zone hospitals. Method: A Facility based cross-sectional study design was employed from March to May 2020 on 211 hypertensive women delivered in the four randomly selected hospitals. The data were collected by reviewing medical record and face to face interview using consecutive sampling technique. Binary and multivariable logistic regression was performed to identify association. Result: Ninety-one (43.1%) of fetuses developed unfavorable perinatal outcome. Inability to read and write (AOR=2.5; 95% CI:1.03-6.17), being primipara (AOR=4.6; 95% CI:1.6-13.2) and multi-para (AOR=3.1; 95% CI:1.09-9.17), Lack of antenatal care visit (AOR=4.2; 95% CI:1.2-15.01), having preeclampsia (AOR=4.2; 95% CI:1.1-16.6) and eclampsia (AOR=5.8; 95% CI:1.2-26.2) and late provision of drug (AOR=3.9;95% CI:1.9-7.9) were independent factors. Conclusion: Pregnancy complicated with hypertensive disorders was associated with increased unfavorable perinatal outcomes. Preeclampsia and eclampsia, inability to read and write, primipara and multipara, lack of antenatal care and late provision of drug were factors associated with unfavorable perinatal outcomes.