The effect of catchment based mentorship on quality of maternal and newborn care in primary health care facilities in Tigray Region, Northern Ethiopia: A controlled quasi-experimental study.
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ABSTRACT:
SUBMITTER: Weldearegay HG
PROVIDER: S-EPMC9671353 | biostudies-literature | 2022
REPOSITORIES: biostudies-literature
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The effect of catchment based mentorship on quality of maternal and newborn care in primary health care facilities in Tigray Region, Northern Ethiopia: A controlled quasi-experimental study.
Weldearegay Haftom Gebrehiwot HG Kahsay Alemayehu Bayray AB Godefay Hagos H Petrucka Pammla P Medhanyie Araya Abrha AA
PloS one 20221117 11
<h4>Background</h4>In Ethiopia, quality of maternal and newborn care is poor. This situation has persisted, despite the wide implementation of several capacity building-oriented interventions including clinical mentoring for skilled birth attendants that were anticipated to translate in to high-quality maternal and newborn care on each encounter. The effectiveness of mentoring programs is not yet well documented in the research literature. Therefore, we evaluated the effect of a catchment based ...[more]
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Project description:BackgroundQuality intrapartum and newborn care is considered to be poor in Sub-Saharan Africa. However, studies done in Ethiopia are limited. Therefore, this study was conducted to assess the magnitude and factors associated with quality intrapartum and newborn care in Tigray, Northern Ethiopia.MethodsFacility based survey was conducted from December 2014 to February 2015 in Tigray, Northern Ethiopia. The quality of intrapartum care provided by a total of 106 skilled birth attendants to 216 labouring mothers and newborns were observed during childbirth in the health facilities. Standardized questionnaires and checklist were utilized to collect data. Quality of intrapartum service was measured using standard intrapartum criteria. Thus, good quality service was considered if the mother and newborn scored 75% or more of the intrapartum criteria during childbirth. Binary and multiple logistic regression model was used to determine the factors associated with quality intrapartum and newborn care services.Results29.2% of mothers and 67.6% newborns received good quality care during intrapartum and immediate postpartum periods respectively. However, only 47.2% of mothers and newborns received a friendly care during childbirths. The independent predictors of quality intrapartum and newborn care were the appropriate use of partograph (AOR 3.92; 95% CI 1.78, 8.63), friendly maternal and newborn care services (AOR 7.9; 95% CI 3.59, 17.33), more than two years working experience (AOR 0.31; 95% CI 0.13, 0.73) and using services in different Zones in the study area.ConclusionsThe quality intrapartum care is poor in the study area and it is associated with inappropriate use of partograph, unfriendly care, and experience of health providers. Scaling up obstetric service, continuous training and motivation of service providers and revising the criterion for accreditation of service providers are important.
| S-EPMC6339373 | biostudies-literature
Project description:BackgroundEfforts to expand access to institutional delivery alone without quality of care do not guarantee better survival. However, little evidence documents the quality of childbirth care in Ethiopia, which limits our ability to improve quality. Therefore, this study assessed the quality of and barriers to routine childbirth care signal functions during intra-partum and immediate postpartum period.MethodsA sequential explanatory mixed method study was conducted among 225 skilled birth attendants who attended 876 recently delivered women in primary level facilities. A multi stage sampling procedure was used for the quantitative phase whilst purposive sampling was used for the qualitative phase. The quantitative survey recruitment occurred in July to August 2018 and in April 2019 for the qualitative key informant interview and Focus Group Discussions (FGD). A validated quantitative tool from a previous validated measurement study was used to collect quantitative data, whereas an interview guide, informed by the literature and quantitative findings, was used to collect the qualitative data. Principal component analysis and a series of univariate and multivariate linear regression analysis were used to analyze the quantitative data. For the qualitative data, verbatim review of the data was iteratively followed by content analysis and triangulation with the quantitative results.ResultsThis study showed that one out of five (20.7%, n = 181) mothers received high quality of care in primary level facilities. Primary hospitals (β = 1.27, 95% CI:0.80,1.84, p = 0.001), facilities which had staff rotation policies (β = 2.19, 95% CI:0.01,4.31, p = 0.019), maternal involvement in care decisions (β = 0.92, 95% CI:0.38,1.47, p = 0.001), facilities with maternal and newborn health quality improvement initiatives (β = 1.58, 95% CI:0.26, 3.43, p = 0.001), compassionate respectful maternity care training (β = 0.08, 95% CI: 0.07,0.88, p = 0.021), client flow for delivery (β = 0.19, 95% CI:-0.34, -0.04, p = 0.012), mentorship (β = 0.02, 95% CI:0.01, 0.78, p = 0.049), and providers' satisfaction (β = 0.16, 95% CI:0.03, 0.29, p = 0.013) were predictors of quality of care. This is complemented by qualitative research findings that poor quality of care during delivery and immediate postpartum related to: work related burnout, gap between providers' skill and knowledge, lack of enabling working environment, poor motivation scheme and issues related to retention, poor providers caring behavior, unable translate training into practice, mismatch between number of provider and facility client flow for delivery, and in availability of essential medicine and supplies.ConclusionsThere is poor quality of childbirth care in primary level facilities of Tigray. Primary hospitals, facilities with staff rotation, maternal and newborn health quality improvement initiatives, maternal involvement in care decisions, training on compassionate respectful maternity care, mentorship, and high provider satisfaction were found to have significantly increased quality of care. However, client flow for delivery service is negatively associated with quality of care. Efforts must be made to improve the quality of care through catchment-based mentorship to increase providers' level of adherence to good practices and standards. More attention and thoughtful strategies are required to minimize providers' work-related burnout.
| S-EPMC7292403 | biostudies-literature
Project description:ObjectiveThis study seeks to examine the prevalence of maternal morbidities and deaths in Ayder Comprehensive Specialized Hospital from 1 July 2018 to 30 June 2019.MethodsThis was a cross-sectional study. Total purposive sampling method was employed to collect data prospectively using modified World Health Organization criteria for baseline assessment of maternal near-miss and mortality. Pregnant women or those who are within 42 days postpartum/any form of pregnancy termination that satisfy the inclusion criteria were enrolled.ResultsA total of 691 mothers were recorded as having severe maternal complications. Out of these, 170 women developed severe maternal outcome, ending with 146 maternal near-miss cases and 24 maternal deaths. The maternal near-miss ratio and maternal mortality ratio were 28.5 per 1000 live births and 469.1 per 100,000 live births, respectively. The overall mortality index was 14%. The top underlying causes of severe maternal complications were the infamous triads of preeclampsia (n = 303, 43.8%), obstetric hemorrhage (n = 166, 24.0%) and sepsis (n = 130, 18.8%). About 62.5% of mothers who died were not admitted to intensive care unit.ConclusionThis study found that the infamous triads of preeclampsia, obstetric hemorrhage and sepsis persist as the commonest causes of severe maternal complications in the study area. A significant number of women with severe maternal outcome were not admitted to intensive care unit. It also highlights that the severe maternal complications, severe maternal outcome, maternal near-miss ratio and mortality index in the study area are disproportionately higher than the global average. These staggering numbers call for a system re-thinking at multiple junctures.
| S-EPMC8883400 | biostudies-literature
Project description:Introduction. Neonatal mortality contributes a higher percentage of infant mortality, especially in developing countries including Ethiopia where the rate of institutional delivery is low. In Ethiopia, scientific evidences on the level of community-based essential newborn care practice were scanty and inconclusive. Objectives:The aim of the study was to assess community-based essential newborn care practices and associated factors among women who have infant < 12 months. Methods:A community-based cross-sectional study was employed among 634 randomly selected women who have infant < 12 months from June 23, 2017, to August 29, 2017, at Enderta district. Data was collected by a face-to-face interview through structured questionnaires, and it was coded, entered, and cleaned using EpiData version 3.1. Then, the data was exported to SPSS version 21 for analysis. Odds ratios and p value were computed to know the association between the independent variables with the dependent variable. Finally, a variable at p value were computed to know the association between the independent variables with the dependent variable. Finally, a variable at p value were computed to know the association between the independent variables with the dependent variable. Finally, a variable at. Result:The overall community-based essential newborn care practice was found 40.7%. Educational status (AOR = 6.6, 95% CI, 2.49-11.97), previous ANC follow-up (AOR = 1.7, 95% CI, 1.2-3.80), weight of the child during birth (AOR = 1.3, 95% CI, 1.12-2.98), and place of delivery (AOR = 2.1, 95% CI, 1.50-4.63) were found to be significantly associated with community-based essential newborn care. Even though overall newborn practice was found to be good, the cord care practices were found to be poor that indicated there is a need to rise community awareness.
| S-EPMC6995491 | biostudies-literature
Project description:BackgroundAsthma self-management education empowers patients to manage their condition effectively. However, evidence on its impact in Ethiopia remains limited. This study evaluated the effect of asthma education on asthma control and self-management knowledge among adult asthma patients in Ethiopia.MethodsA quasi-experimental design was employed, with a total of 204 participants, comprising 102 individuals in the intervention group and 102 in the control group at baseline. After accounting for follow-up losses (20.6% in the intervention group and 23.5% in the control group), 81 participants from the intervention group and 78 from the control group were retained six months after the completion of the education (post-intervention). Pre- and post-intervention assessments were conducted using validated questionnaires to measure asthma control levels and self-management knowledge. The intervention group received a structured, small-group asthma education program comprising three sessions over six months. The intervention's effect was analyzed using linear regression models for difference-in-differences and interaction effects, while heterogeneity analysis was performed using a generalized linear model.Results10% of the intervention group and 7.8% of the control group reported prior asthma management education, most of which (60%) was over a decade ago. Asthma control levels significantly improved in the intervention group, with a 19.4% increase compared to 0.6% in the control group. The overall increase in the intervention group was 18.8% higher than in the control group (P = 0.03). Similarly, self-management knowledge improved markedly in the intervention group, with a 24.3% increase compared to 0.7% in the control group. The intervention group demonstrated a 23.6% overall improvement relative to the control group (P = 0.000).Participants in the intervention group were six times more likely to achieve well-controlled asthma and 13 times more likely to exhibit good self-management knowledge compared to the comparison group (p < 0.01). The intervention's impact was consistent across subgroups, with no significant variations by socio-demographic and asthma related factors.ConclusionsAsthma self-management education interventions significantly enhance asthma management knowledge and control levels. This study highlights the need to implement and expand asthma education programs during patient follow-ups to empower patients, to reduce medical costs, unscheduled hospital visits, emergency department visits, and premature mortality.Trial registrationRegistered retrospectively with TRN PACTR202407741896902.
| S-EPMC11910835 | biostudies-literature
Project description:INTRODUCTION:Neural tube defects are the major causes of fetal loss and considerable disabilities in infants. Currently, there is no significant research on the incidence of Neural tube defects in the Tigray region of Ethiopia. OBJECTIVE:To determine the incidence and clinical pattern of the Neural Tube Defects. METHODS:A hospital-based cross-sectional study was conducted from October 2016 to June 2017. All pregnancy outcomes were examined for any externally visible birth defects and neurological integrity by trained midwives under the supervision of senior obstetrics and gynecology and a neurosurgeon. Data were collected using a survey tool to collect maternal and newborn demographic data and a checklist developed to capture newborns with Neural Tube Defects. Data were analyzed using SPSS version 20. The prevalence of NTDs was calculated per 10,000 births. RESULT:Out of the 14,903 births during the study period, a total of 195 infants were born afflicted with Neural Tube Defects. The burden of infants with anencephaly and spina bifida was 66.4 and 64.4 per 10, 000 births, respectively. The overall incidence rate of NTDs in this study was 131 per 10, 000 births of which 23% were liveborn and 77% were stillborn. The highest burden of Neural Tube Defects was observed in Adigrat Hospital from Eastern Zone of Tigray (174 per 10,000 births) and Lemlem Karl Hospital from Southern Zone of Tigray (304 per 10,000 births) compared to Kahsay Abera Hospital from Western Zone (72.8 per 10,000 births) and Sihul Hospital from North Western Zone of Tigray (69.8 per 10,000 births). CONCLUSION AND RECOMMENDATION:Assuming that the non folic acid preventable rate should be 5 per 10,000 births, our prevalence rate is 131 per 10,000 births, and then we have a rate or an epidemic that is 26 times what it should be. This just emphasizes the urgency to implement effective programs to get all women of reproductive age to have adequate folic acid to prevent all of folic acid-preventable spina bifida and anencephaly, which would prevent 96% (125/130) of spina bifida and anencephaly in the Tigray Provence.
| S-EPMC6235279 | biostudies-other
Project description:BackgroundEthiopia federal ministry of health has been working on increasing access to immunization service by deploying solar refrigerators to primary health care facilities. However, there is limited evidence on cold chain and vaccine management status. Therefore, the objective of this study was to assess knowledge of vaccine handlers and status of cold chain and vaccine management and their associated factors in primary health care facilities of Tigray region Northern Ethiopia.MethodsInstitutional based cross-sectional study was conducted in four randomly selected districts of Tigray region, Northern Ethiopia. In each selected district, all primary health care facilities with functional vaccine refrigerators were included in the study. Data were collected using a pre-tested semi-structured questionnaire. The collected data were entered into Epi-data version 3.1 and then exported to Statistical Package for Social Sciences (SPSS) version 21 for analysis. All variables with p-value of < 0.25 in bivariate logistic regression analysis were included in multi-variable model to identify predictors of the dependent variables.ResultsIn this study, fifty Primary Health Care Facilities (PHCFs) were included with a response rate of 94.4%. The overall level of good knowledge of vaccine handlers and good status of cold chain and vaccine management were 48% (95% CI; 30.7%-62%) and 46% (95%CI; 26.1%-61.3%) respectively. Receiving training on cold chain and vaccine management (AOR = 5.18; 95%CI: 1.48-18.18) was significantly associated with knowledge of vaccine handlers. Furthermore, receiving supportive supervision (AOR = 4.58; 95%CI: 1.04-20.17) and good knowledge of vaccine handlers (AOR = 10.97; 95%CI: 2.67-45.07) were significant associated with cold chain and vaccine management.ConclusionsThis study showed that knowledge of vaccine handlers on cold chain and vaccine management was poor. Similarly, the cold chain and vaccine management status was also poor. Therefore, on-site training should be provided to vaccine handlers to increase their knowledge, so as to improve their practices on cold chain and vaccine management. In addition, Programme based supportive supervision is needed to improve cold chain and vaccine management.
| S-EPMC9159613 | biostudies-literature
Project description:Back groundHIV/AIDS remained among the common public health problems in developing country. Despite the extensive delivery of ART and improved coverage of the service access, still, man-made problems like war have negatively influenced the utilization of antiretroviral treatment services. The war in Tigray Region in the northern Ethiopia broke out in November 2020 and thereby has brought about an extreme damage on most of the infrastructure in Tigray, including the health institutions. The purpose of this study is, therefore, to assess and report the trend of HIV service provision across the war affected rural health facilities in Tigray.MethodsThe study was conducted in 33 rural health facilities during the active war in Tigray. A facility based retrospective cross-sectional study design was conducted among health facilities from July 03 to August 05, 2021.ResultA total of 33 health facilities from 25 rural districts were included in the HIV service delivery assessment. A total of 3274 and 3298 HIV patients were seen during pre-war period in September and October 2020, respectively. The number of follow-up patients during the war period in January remained to be only 847(25%) which is significantly reduced with a P value<0.001. A similar trend was observed during the subsequent months until May. The trend of follow-up patients on ART significantly declined from 1940 in September (pre-war) to 331(16.6%) in May (during the war). This study also revealed a 95.5% reduction of laboratory service provision to HIV/AIDS patients during the war in January and with similar trends thereafter (P<0.001).ConclusionThe war has led to a significant decline of HIV service provision in the rural health facilities and most part of the region during the first eight months of active war in Tigray.
| S-EPMC10153695 | biostudies-literature
Project description:BackgroundEthiopia is one of the ten countries with the highest number of neonatal deaths globally, and only 1 in 10 women deliver with a skilled attendant. Promotion of essential newborn care practices is one strategy for improving newborn health outcomes that can be delivered in communities as well as facilities. This article describes newborn care practices reported by recently-delivered women (RDWs) in four regions of Ethiopia.MethodsWe conducted a household survey with two-stage cluster sampling to assess newborn care practices among women who delivered a live baby in the period 1 to 7 months prior to data collection.ResultsThe majority of women made one antenatal care (ANC) visit to a health facility, although less than half made four or more visits and women were most likely to deliver their babies at home. About one-fifth of RDWs in this survey had contact with Health Extension Workers (HEWS) during ANC, but nurse/midwives were the most common providers, and few women had postnatal contact with any health provider. Common beneficial newborn care practices included exclusive breastfeeding (87.6%), wrapping the baby before delivery of the placenta (82.3%), and dry cord care (65.2%). Practices contrary to WHO recommendations that were reported in this population of recent mothers include bathing during the first 24 hours of life (74.7%), application of butter and other substances to the cord (19.9%), and discarding of colostrum milk (44.5%). The results suggest that there are not large differences for most essential newborn care indicators between facility and home deliveries, with the exception of delayed bathing and skin-to-skin care.ConclusionsImproving newborn care and newborn health outcomes in Ethiopia will likely require a multifaceted approach. Given low facility delivery rates, community-based promotion of preventive newborn care practices, which has been effective in other settings, is an important strategy. For this strategy to be successful, the coverage of counseling delivered by HEWs and other community volunteers should be increased.
| S-EPMC4219496 | biostudies-literature
Project description:Properly recorded solar radiation data are very important in providing accurate information on solar radiation intensity and potential for the application of any solar energy technology. Since such type of data is hardly available in most developing countries like Ethiopia, analysis of temporal and spatial variations of solar radiation is essential for exploring the true potential of a specific area. This scientific data article is, therefore, related to the research work entitled "Temporal and Spatial Solar Resource Variation by Analysis of Measured Irradiance in Geba Catchment, North Ethiopia" (https://doi.org/10.1016/j.seta.2021.101110). In this work, we present the solar radiation measurement data collected for five years (from January 2011 to December 2015) from four sites of the Geba catchment (Dera, May Derhu, Hagere Selam, and Mekelle University) located in the Northern part of Ethiopia. Data were measured at ten-minute intervals using Pyranometers mounted on wind masts. The data was used for the analysis of the temporal variation and spatial distribution performed using MS Excel spreadsheet and Inverse Distance Weight (IDW) method of the ArcGIS software, respectively. Accordingly, the data revealed insight on the solar variation and potential of the catchment and is expected to contribute significantly to further decision-making by governmental and non-governmental agencies, investors, consultants, and project developers. It is also expected to help for future research and solar project implementation directions across similar catchments.
| S-EPMC8792435 | biostudies-literature