Person-centered maternity care during childbirth and associated factors at public hospitals in central Ethiopia.

Objectives: Person-centered maternity care during childbirth is crucial for improving maternal and newborn health outcomes. Therefore, this study was aimed at assessing the determinants of person-centered maternity care in Central Ethiopia. Methods: An institutional-based cross-sectional study was conducted in public hospitals in Central Ethiopia from 30 January to 1 March 2023. A systematic random sampling technique was employed to enroll the study participants. Data were collected through face-to-face interviews using a structured questionnaire. After data collection, it was checked for completeness and consistency, then coded and entered into Epi Data version 4.4.2 and exported to SPSS version 26 for analysis. Both bivariate and multivariable logistic regressions were used to identify associated factors. Results: In this study, a total of 565 participants were involved, resulting in a response rate of 98.77%. The respondents mean score for person-centered maternity care was 60.2, with a 95% CI of (59.1, 62.3). No formal education (ß = -2.00, 95% CI: -4.36, -0.69), fewer than four antenatal contacts (ß = -4.3, 95% CI: -5.46, -2.37), being delivered at night (ß = 2.20, 95% CI: 1.56, 6.45), and complications during delivery (ß = -6.00, 95% CI: -9.2, -0.79) were factors significantly associated with lower person-centered maternity care. Conclusion: This study revealed that person-centered maternity care is low compared with other studies. Consequently, it is imperative to prioritize initiatives aimed at enhancing awareness among healthcare providers regarding the benchmarks and classifications of person-centered maternity care. Moreover, efforts should be directed toward fostering improved communication between care providers and clients, along with the implementation of robust monitoring and accountability mechanisms for healthcare workers to prevent instances of mistreatment during labor and childbirth.

The effects of advanced maternal age on perinatal mortality in Ethiopia: A systematic review and meta-analysis.

Background: Pregnancy in women over the age of 35 years is considered advanced maternal age. The relationship between advanced maternal age and the risk of perinatal mortality is still controversial. As a result, this systematic review and meta-analysis were carried out to clarify the relationship between advanced maternal age and perinatal mortality in Ethiopia. Methods: The following electronic databases were used for this systematic review and meta-analysis: PubMed, Web of Science, Scopus, Science Direct, Google Scholar, HINARI, and African Journals Online up to March 2022. Addis Ababa, Gondor, and Jimma University research repositories were also searched. A random-effects model was used to pool study-specific odds ratios. Results: A total of 18 articles, including a total of 45,541 participants, were included in the meta-analysis. A total of 11 cross-sectional, 2 case-control, and 5 cohort studies were included. The overall pooled estimate indicates that women with advanced maternal age had a 1.58 higher risk of perinatal mortality compared to women in the younger age group (odds ratio = 1.58; 95% Confidence Interval: 1.13-2.03). The subgroup analysis also revealed that there were differences in the effect size as the geographical region differed. The result showed that the odd of perinatal mortality was highest in the Oromia region and lowest in the Southern Nations Nationalities and Peoples' Region. Conclusion: The overall pooled estimate indicates that women with advanced maternal age had a 1.58-fold higher risk of perinatal mortality. Even though this risk could also be increased with other comorbid diseases, it is important for healthcare providers and other concerned stakeholders to be aware of the increased risks associated with advanced maternal age and provide different intervention programs designed to create awareness and provide counseling services to couples who seek to have a child in their later ages about the risks of advanced maternal age pregnancy on perinatal mortality and other adverse pregnancy outcomes.

Concomitant use of medicinal plants and pharmaceutical drugs among pregnant women in southern Ethiopia.

Background: In several African nations, including Ethiopia, improving mother and child health is a top public health concern. Unfortunately, there is a dearth of study on pregnant women in Ethiopia who concomitantly utilize pharmaceutical drugs and medicinal plants. Hence, the objective of this research was to assess the concomitant use of pharmaceutical drugs and medicinal plants among pregnant women in Southern Ethiopia in 2021. Methods: A community-based cross-sectional study was conducted among systematically selected 400 pregnant women in Shashamane town, Southern Ethiopia, from July 1-30/2021. An interviewer-administered structured questionnaire was used to collect data. Binary logistic regression was performed to examine the association between a dependent variable and independent variables. Results: According to this study, among those who self-medicated, 90 (22.5%) reported using at least one pharmaceutical drug, while 180 (45%) reported using at least one medicinal plant. Moreover, 68 (17%) of the participants who had taken drugs while pregnant also used pharmaceutical drugs and medicinal plants concomitantly. Having a medical condition during pregnancy (AOR = 5.6, 95% CI: 2.7-11.6), not having ANC follow up (AOR = 2.9, 95% CI: 1.3-6.2), gestational age (AOR = 4.2, 95% CI: 1.6-10.7), and not having a formal education (AOR = 4.2, 95% CI: 1.3-13.4) were all significantly associated with concomitant use of pharmaceutical drugs and medicinal plants during pregnancy. Conclusion: This study showed that nearly one in five pregnant women used medicinal plants concomitantly with pharmaceutical drugs. Mother's educational status, medical illness during pregnancy, having ANC follow up and gestational period were significantly associated with concomitant use of medicinal plants and pharmaceutical drugs. Therefore, health care providers and concerned stakeholders should consider these factors to minimize the risks associated with drug use during pregnancy on both mother and fetus.

Time to initiate postpartum modern contraceptives among pregnant women in Ambo Town, Central Ethiopia; Cox-proportional hazard regression analysis.

BACKGROUND: Timing of postpartum family planning is crucial for maternal and child wellbeing by preventing unintended and closely spaced pregnancies. However, studies are limited on the time to use modern contraceptives in Ethiopia. Therefore, this study aimed to fill these gaps by assessing the time to initiate postpartum modern contraceptive and identifying its predictors among pregnant women in Ambo town, central Ethiopia. METHODS: An institution based cross-sectional study was conducted among 356 pregnant women in Ambo town, Central Ethiopia. The data were analysed using STATA-16 software. Kaplan-Meier estimates were performed to explain time-to- modern contraceptive use. A Cox-proportional hazard regression analysis was conducted to identify predictors. The adjusted hazard ratio (AHR) with a 95% confidence interval was considered to declare a statistically significant association. RESULTS: This study showed that the median survival time to initiate postpartum modern contraceptives was 6 months. In this study, the risk of modern contraceptive use was 2.13 times higher (AHR = 2.13; 95% CI: 1.02-4.45) among younger women, 1.44 times higher (AHR = 1.44; 95% CI: 1.09-2.66) among women with no desire for more children, and 2.25 times higher (AHR = 2.25; 95% CI: 1.02-4.95) among nulliparous women. However, it is 57% times lower (AHR = 0.57; 95% CI: 0.32-0.94) among pregnant women with current unintended pregnancy. CONCLUSION AND RECOMMENDATION: The median survival time to initiate postpartum modern contraceptive was 6 months. Age of the women, desire for more children, parity and pregnancy status were found to be the significant predictors of time to initiate postpartum modern contraceptive. Therefore health care providers and concerned stakeholders should consider these factors to increase the uptake of the postpartum contraceptive methods.

Essential newborn care practice and associated factors among obstetric care providers of public hospitals in Sidama regional state, Ethiopia.

Introduction: The global neonatal death rate was predicted to be 18 per 1000 live births during the first 28 days of life. Ethiopia continues to have one of the highest neonatal mortality rates in the world. Essentially, over 70% of these deaths may have been averted or prevented if proper essential newborn care had been provided. The purpose of this study was to assess the practice of essential newborn care and associated factors among obstetric care providers in public hospitals in Sidama regional state, Ethiopia. Methods: This study was conducted from 1 to 30 July 2020, using an institutionally based cross-sectional study design. The study comprised 182 obstetric care professionals from six hospitals chosen at random. EpiData (version 3.1) was used to enter data, which was then exported to SPSS (version 20). Descriptive, bivariable, and multivariable logistic regression were used. Statistical significance of the explanatory variables was declared at p values <0.05. Results: The overall prevalence of good practice on essential newborn care was 56.6% (95% confidence interval = 49.4-63.7). Working in the delivery room (adjusted odds ratio = 3.53, 95% confidence interval = 2.04-10.06), having training in essential newborn care (adjusted odds ratio = 3.65, 95% confidence interval = 1.63-8.17), and access to established essential newborn care protocols (adjusted odds ratio = 6.88, 95% confidence interval = 3.10-15.26) were found to be statistically significant factors of essential newborn care practice. Conclusion: The study found that having necessary newborn care standards, being interested in working in the delivery room, and having essential newborn care training are all important factors in implementing essential newborn care practices. Important knowledge gaps were noted in key areas of essential newborn care.