Women In Public Health Facilities Research Articles

Prevalence of Multi Drug Resistant Coagulase Negative Staphylococci among some Pregnant Women Attending Antenatal Clinic in Yola, Nigeria

Study’s Novelty/Excerpt This study presents findings on the prevalence and characterization of coagulase-negative staphylococci (CoNS) among pregnant women in public health facilities in Yola, revealing a significant prevalence rate of 26.97%. The research highlights the high susceptibility of CoNS to certain antibiotics and the alarming presence of multi-drug resistant and extended spectrum beta-lactamase (ESBL) producing strains. This underscores the necessity for routine screening of pregnant women for CoNS to prevent potential gestational complications, providing crucial data for public health interventions and antibiotic stewardship programs. Full Abstract Coagulase negative staphylococci have been reported to be a frequent agent of uncomplicated UTI in young sexually active women which can also lead to symptomatic infection, low birth weight (LBW) babies and preterm delivery. This study was undertaken to determine the prevalence and characterize coagulase negative staphylococci among pregnant women in public health facilities in Yola. A total of 250 urine samples were collected from pregnant women attending antenatal clinic at Specialist Hospital and Boshang Clinic and Maternity both in Yola. The samples were cultured on cysteine lactose electrolyte deficient medium and isolates characterized using phenotypic methods. The prevalence of coagulase negative staphylococci from this study was 26.97%, Staphylococcus aureus 16.29% and Escherichia coli 36.51%. The frequency of CoNS was highest among age group of 36-40 years and least among 16-20 years (12.5%). CONS isolated from this study demonstrated high susceptibility to pefloxacin, ciprofloxacin, erythromycin, ceftriaxone and streptomycin. Some isolates showed high resistance to ampiclox, cefuroxime and amoxicillin. About 83% of the isolates had multiple antibiotic resistant indexes greater than 0.2 with about 25% of the antibiotic resistance being plasmid mediated. Furthermore, phenotypic screening using the double disk synergy test showed that 20 (40%) of the isolates were extended spectrum beta lactamase (ESBL) producing. This study revealed the presence of multi-drug resistant and ESBL producing coagulase negative staphylococci among pregnant women in the study area. There is therefore the need for pregnant women to be screened for coagulase negative staphylococci to avoid complications during gestation period.

“We restrict certain things”: a cross-sectional study of health provider adherence to WHO’s recommendation for intrapartum oral intake of fluid and food in Greater Accra, Ghana

BackgroundSince 2018, WHO recommends oral fluid and food intake for low-risk women during labor to enhance positive childbirth experience and respect for women’s preferences. This study investigated the current practices related to intrapartum oral intake among maternity care providers and women in public health facilities in Greater Accra, Ghana, and explored barriers and opportunities for adherence to the WHO guidance.MethodsWe used a mixed-method design at five public health facilities in Greater Accra, Ghana, which included structured interviews with 11 facility-level quality improvement staff and 12 maternity care providers; a knowledge, attitudes, and practices survey with the same providers; and a client survey with 56 inpatient postpartum women. We conducted descriptive and inferential statistics, including z-tests to assess independent and dependent variables, and inductive thematic analyses.ResultsProvider adherence to the WHO recommendation varied, with many imposing restrictions on oral intake during labor. Concerns included potential complications like Mendelson’s syndrome, consequently framing oral intake decisions as clinical and leading providers to limit women’s involvement in their care decisions. Within our sample, 54% and 43% women reported their provider counseled them on oral fluid and food intake respectively, while 41% and 34% reported their provider asked them their preference for drinking and eating respectively. Ultimately, 73% drank fluids and 19% ate food during their labor. Counseling significantly correlated with women’s intake practices (p < 0.01) and providers’ inquiry to women’s preferences for drinking and eating (p < 0.001) during labor.ConclusionAdherence to evidence-based practices for intrapartum oral intake among low-risk women was inconsistence. Maternity care providers play a vital role in involving women in their care decisions and respecting women’s preferences. Strengthening national-level labor care guidelines and provider quality improvement approaches like in-service training, supportive supervision, and job aides to include the WHO recommendation will help providers adhere to the guidance and contribute to promoting a positive childbirth experience for women.

Barriers to access of maternal health commodities among pregnant women in public health facilities in Ubungo Municipal Council, Tanzania.

Access to maternal health commodities improves maternal outcome and reduce maternal deaths. Tanzania has put in place the fee exemption policy for mothers to access maternal health commodities for free, however, the implementation of user fee exemption has been challenging. Therefore, this study explored the barriers to access of maternal health commodities among pregnant women in public health facilities at Ubungo Municipal Council, Tanzania. This was a descriptive qualitative study conducted from January to February 2023. Both focus group discussions and key informant interviews were conducted. These involved 72 pregnant women and 40 health care providers respectively. A purposive sampling technique was used to selected facilities and study participants. Thematic analysis was used to analysis data. Findings from this study indicated that fear of stigma and discrimination, decision-making autonomy, additional costs and stock out of health commodities were the main barriers to accessing maternal health commodities. Furthermore, both pregnant women and health care providers reported that shortage of health commodities and the inadequacy of service providers, which led to long waiting times, also hinder access to health commodities. Improving health commodities availability, and increasing the number of service providers are important factors to consider to improve access to maternal health commodities. In addition, factors such as fear of stigma and discrimination should also be addressed to improve maternal health.

Uptake of cervical cancer screening and associated factors among human immune virus positive women attending antiretroviral therapy clinic in public health facilities, Northeast Ethiopia, 2022: A cross-sectional study.

Although cervical cancer is the most prevalent cancer in women and has a high morbidity, mortality, and low quality of life burden among human immune virus-positive women, there is little evidence of it in northeastern Ethiopia. Sought to determine the magnitude and associated factors of cervical cancer screening among human immune virus-positive women in public health facilities in northeastern Ethiopia. A multicentered, institution-based cross-sectional study with 401 participants using the systematic random sampling technique was employed. The data was gathered through personal interviews and chart reviews. The predictors were established via multivariate logistic regression analysis. The magnitude of cervical cancer screening was 19.2% (15.7%-22.9%). Multiparity, bad obstetric history, hearing about cervical cancer, recommendations from medical professionals, duration of antiretroviral therapy >10 years, a family record of cervical cancer, and knowing cervical cancer were revealed to be predictors of testing for cervical cancer. The magnitude of cervical cancer screening was 19.2% (15.7%-22.9%). Multiparity, bad obstetric history, hearing about cervical cancer, recommendations from medical professionals, duration of antiretroviral therapy >10 years, a family record of cervical cancer, and knowing cervical cancer were revealed to be predictors of testing for cervical cancer.

High seroprevalence of syphilis infection among pregnant women in Public Health facilities in Shashemene town, southern Ethiopia

BackgroundSyphilis infection is a major public health problem in developing countries including Ethiopia. Thus, this study aimed to assess the seroprevalence of syphilis and associated factors among pregnant women attending Antenatal Care (ANC) in Public health facilities in Shashemene town, southern Ethiopia. MethodAn institutional-based cross-sectional study design was conducted among 230 pregnant women from the 27th of August to the 30th of September 2018. Data were collected using a structured interviewer-administered questionnaire. Data were entered into Epi-Info 7 and analyzed with SPSS Version 21. A multivariate logistic regression model was used to investigate factors associated with syphilis infection. A p-value of <0.05 was considered statistically significant. ResultThe overall prevalence of syphilis infection was 22(9.6%)(95% CI, [6.1, 14.1%]). Pregnant mothers who had multiple sexual partners (AOR = 5.12, 95% CI 1.51, 17.44), abnormal vaginal discharge (AOR = 18.13 95%CI 3.66, 88.42), previous history of abortion (AOR = 5.6, 95%CI 2.03, 15.36) and previous history of stillbirth (AOR = 9.98, 95% CI: 2.85, 34.92) were among factors associated with syphilis infection. ConclusionAccording to this study, the magnitude of syphilis infection among pregnant mothers attending ANC was high. Pregnant mothers who had multiple sexual partners, previous history of abortion, previous history of stillbirth, and abnormal vaginal discharge were significantly associated with syphilis infection. Thus, health providers should provide comprehensive health education about syphilis transmission, signs and symptoms, and the methods of prevention as well as create awareness about the adverse outcome of getting syphilis infection.

Assessment of Iron-Folate Adherence and Associated Factors Among Pregnant Women in Public Health Facilities of Durame Town, Southern Ethiopia.

Iron deficiency anemia during pregnancy is a significant public health problem in low- and middle-income countries. The World Health Organization recommended a daily oral dose of iron and folic acid supplements throughout pregnancy. Poor adherence to iron and folic acid supplementation arises in pregnant women associated with serious adverse health outcomes. This study aimed to assess iron-folate adherence and associated factors among pregnant women in public health facilities of Durame town, Southern Ethiopia, in 2022. An institution-based cross-sectional study was conducted from March 1-30, 2022. A structured interviewer-administered questionnaire was used to interview a total sample size of 317 participants. Logistic regression analysis was computed, and variables with a p-value of less than 0.25 in the bivariate logistic regression analysis were selected for multivariable logistic regression analysis. Finally, significance was declared at p < .05 with 95%CI. The findings of this study showed that adherence to iron-folate among pregnant women was 180 (60%) (95%CI: 54-65.7). The odds of iron-folate adherence among women who had not had anemia in their current pregnancy were 63% (AOR = 0.37, 95%CI: 0.14-0.99) less likely to have adherence, and the odds of iron-folate adherence among women who had not heard about the disease anemia were 58% (AOR = 0.42, 95%CI: 0.22-0.81) less likely to have adherence. Iron-folate adherence in Durame public health facilities was better compared to other studies even if it was not high enough to prevent anemia and folate deficiency. Women who had not had anemia in their current pregnancy and women who had not heard about the disease anemia were significantly associated with adherence to iron-folate. Thus, healthcare providers should provide health education on the enhancement of adherence to iron-folate utilization and the means how to prevent iron-folate deficiency during their clients' pregnancy.

Knowledge, attitude and practice towards cervical cancer screening among women living with human immunodeficiency virus: Implication for prevention strategy uptake.

To explore the knowledge, attitude and practices of cervical cancer screening among HIV-infected women in public health facilities in Lusaka, Zambia. Cross-sectional study. The study was conducted from 1st January 2020 to 28th February 2020. We used a structured questionnaire for data collection. The Structural Equation Modelling (SEM) was used to analyse relationships among latent variables (knowledge, attitude and practice). The overall knowledge, attitude, and practice scores of cervical cancer screening among women living with HIV were 6.86/11 (62.4%), 6.41/7 (91.6%) and 2.92/8 (36.5%), respectively. Overall, knowledge was positively and significantly associated with attitude (r=.53, p < .001) and practice (r=.38, p < 0.001). Additionally, attitude and practice were significantly associated (r=0.29, p < .001). Our findings support the reinforcement of current public health interventional programmes to improve the knowledge about cervical cancer and screening uptake.

Early discontinuation of Implanon and associated factors among women in public health facilities of the Hawassa administration, south Ethiopia

Background/Aims Despite improving availability and use of the contraceptive Implanon, early discontinuation is a public health concern. A significant proportion of women discontinue using Implanon before it is due to be removed, which poses a health concern and may lead to contraceptive failure. Only 8% of married women in Ethiopia use contraceptive implants. There is a paucity of information on factors associated with early discontinuation of Implanon. This study's aims were to assess early discontinuation of Implanon and associated factors among women using public health facilities of Hawassa, south Ethiopia. Methods An institution-based cross-sectional study was conducted in six randomly selected public health facilities in Hawassa. All women using Implanon who visited the selected institutions during the data collection period were invited to participate in the study. Data were collected through face-to-face interviews using a pretested questionnaire. A multivariate logistic regression model was used to identify predictors of early Implanon removal. Results Of the 250 study participants, 54.0% discontinued using Implanon early. A woman having primary level education (adjusted odds ratio=2.332, P=0.048), lack of counselling about the possible benefits of Implanon (adjusted odds ratio=2.496, P=0.019), side effects (adjusted odds ratio=2.092, P=0.002) and the desire to be pregnant in the near future (adjusted odds ratio=2.222, P&lt;0.0001) were associated with early discontinuation. Conclusions Over half of women using Implanon discontinued early, which was related to lower education, a lack of counselling, side effects of the implant and the desire to become pregnant. Pre-insertion counselling for women should include information on the possible side effects and benefits of Implanon, to decrease the proportion of women who discontinue its use early.

Determinants of Intrauterine Contraceptive Device Discontinuation Among Women Using Family Planning, in Southwest Ethiopia: Unmatched Case-Control Study.

BackgroundAlthough the intrauterine contraceptive device is an effective, reliable, safe, and recommended contraceptive method, it is still underutilized and has a high discontinuation rate in Ethiopia. The study aims to assess determinants of the discontinuation of IUCDs among women using family planning in Ilu Aba Bor Zone.MethodsA facility-based unmatched case–control study was conducted from September to October, 2021 among 168 (56 cases and 112 controls) IUCD-user women in public health facilities in south-west Ethiopia. Pretested, structured and interviewer administered questionnaires were used for data collection. The data were coded, cleaned and entered to Epi-data version 3.1 and exported to SPSS version 23 for advanced analysis. A binary logistic regression was used to estimate the degree of association between the outcome variable and independent variables. Finally, variables with a p-value less than 0.05 at 95% confidence interval were declared as statistically significant with outcome variable.ResultsA total of 168 (163) respondents participated in the study, with a response rate of 97%. The mean (+SD) age of the respondents was 31.36 ± 5.916. Regarding the educational status of respondents about 36 (64.3%) of cases and 90 (84.1%) of controls have formal education, and about 42 (75%) of cases’ husbands and 97 (90.65%) of controls’ husbands have formal education, respectively. Experiencing side effects (AOR = 2.36; 95% CI: 1.01, 5.55), lack of follow up (AOR = 4.069; 95% CI: l.30, 12.69), and planning for next pregnancy (AOR 4.14; 95% CI: 1.58, 10.88) were found to be the main determinants of intrauterine device discontinuation.ConclusionThe findings of the study showed that lack of follow-up after insertion of the IUCD, experiencing side effects, and having a plan for the next pregnancy were found to be the main determinants of intrauterine device discontinuation. Hence, arranging recommended regular follow-up and treating side effects are very important to sustain intrauterine device utilization.

Iron Deficiency And Associated Factors Among Pregnant Women’s Attending Antenatal Care In Butajira General Hospital, South Ethiopia 2020

Background: Iron deficiency during pregnancy is major nutritional problem in worldwide in both developing and developed country because it increases iron requirement during pregnancy and it is the most common cause of anemia this nutritional problem directly and indirectly has effect on many women during lack sufficient iron store that lead to anemia and also reduce iron store in the new born. However, there is limited evidence on iron deficiency and its associated factors among pregnant women in low-income countries like Ethiopia including the study area. Objectives: To assess the magnitude of iron deficiency and its associated factors among pregnant women in public health facilities of Butajira town, Guragey Zone, southern Ethiopia, 2020. Methods: Hospital based cross-sectional study was conducted on 407 pregnant women in Butajira general hospital of Butajira town, Gurage Zone, SNNPR region from April 10 to 30, Pretested and structured questionnaire was used to collect the data, MUAC was done, venous blood was collected to determine serum ferritin level Clinical related data was collected from patient medical record by using structured checklist. Data was analyzed by SPSS version 20 software. Bivariable and multivariable logistics regression analysis was done. Adjust odds ratio with 95% CI was estimated to measure the strength of association. Level of statistical significance was declared at p-value &lt; 0.05. Result: The magnitude of iron deficient was 48.9%, data was collected 407 pregnant women of which 199(48.9%). Dietary diversity [AOR: 4.06, 95% CI: (2.08,7.95)], Habit of drinking coffee and tea before 30 min [AOR=8.39, 95% CI: (4.62,15.22)], MUAC [AOR=8.87, 95% CI: (5.12,15.37)] were significantly associated with iron deficiency. Conclusion: Data was collected 407 pregnant women of which 199(48.9%) were iron deficient, 208(5.1%) were normal. The magnitude iron deficiency was found to be major public health problem in the study area. These results suggest screening and supplementation of at-risk pregnancies may be evaluated as a preventive strategy. Early diagnosis and treatment of iron deficiency is recommended for those pregnant women’s having inadequate dietary diversity and low MUAC will be very important for prevention and control of iron deficient

Magnitude and associated factors of early Implanon discontinuation among rural women in public health facilities of central Ethiopia: a community-based cross-sectional study

BackgroundAdvocating for and promoting contraception use is critical in reducing mother and child morbidity and mortality. Early Implanon discontinuation may result in unwanted pregnancies and induced abortions. Although there has been research in Ethiopia on long-acting reversible contraceptives, there has been none on early Implanon removal among rural women who have used and removed it. Hence, this study aimed to investigate the magnitude of Implanon discontinuation and related characteristics among women who had the Implanon removed in central Ethiopian public health facilities.MethodsA community-based cross-sectional study was conducted among all women of the reproductive age group who had removed Implanon after using it. A simple random sampling technique was used to select 373 women after proportional allocation to each health facility. Data were collected using a pretested semi-structured interviewer-administered questionnaire adapted from previous studies. Data were entered using EpiInfo and exported to SPSS version 21 for analysis. A binary logistic regression model was used to determine the association between the outcome variable and independent variables. A p-value less than 0.25 was used as a cutoff point to select candidate variables for the final model. Then, a p value less than 0.05, AOR, and a 95% confidence level were used to declare statistical significance.ResultA total of 360 participants responded to the questionnaires, making a response rate of 96.5%. In this study, the early discontinuation rate was 42% (95% CI 36.9–47.7). No formal education (AOR = 0.53 [95% CI 0.3–0.94], having medium monthly income (AOR = 3.02 [95% CI 1.38–6.6]), inadequate pre-insertion counseling (AOR = 0.55 [95% CI 0.31–0.98]), lack of appointment for follow up (AOR = 0.16 [95% CI 0.05–0.54]), didn`t satisfy with service provided (AOR = 0.067 [95% CI 0.015–0.29] and developed side effect (AOR) = 4.45 [95% CI 2.37–8.36] were significantly associated with Implanon discontinuation.ConclusionThe discontinuation rate of Implanon among those who removed it after using it in this study was high. Lack of formal education, having a medium-income, inadequate pre-insertion counseling, lack of appointments for the follow-up, poor satisfaction, and problems with side effects were the factors associated with early discontinuation rate. Hence, quality family planning service provision is essential to reduce the discontinuation rate.

Immediate Postnatal Care Satisfaction and Associated Factors Among Postnatal Women in Public Health Facilities at Debre Markos Town, Northwest Ethiopia, 2021.

BackgroundImmediate postnatal care (PNC) satisfaction is considered as the desired outcome of the health care system and determines the use of subsequent health care services. There is a paucity of evidence on the level of immediate PNC satisfaction in the study setting. Therefore, the aim of this study was to assess the level of immediate PNC satisfaction and associated factors among women who gave birth in Debre Markos town public health institutions, northwest Ethiopia.MethodsAn institution-based cross-sectional study was conducted from January 1 to February 28, 2021, and a systematic sampling technique was used to select the postnatal women. An interviewer-administered pretested structured tool was used. The level of immediate PNC satisfaction was measured by Jipi’s postnatal satisfaction with the nursing care questionnaire (JPSNQ). The collected data were entered into EpiData version 4.6.0 and exported to SPSS version 23 for management and analysis. Both bivariable and multivariable binary logistic regression analysis were applied. Adjusted odds ratios (AORs) with corresponding 95% confidence intervals (CIs) were calculated and statistical significance was declared at P-value <0.05.ResultsA total of 389 postnatal mothers participated in this study with a response rate of 98.73%. Immediate PNC satisfaction was 60.90% (95%CI: 56.50–65.60). Postnatal women having multiparity (AOR=7.31, 95%CI: 4.40–12.17), four and more antenatal care (ANC) visits (AOR=1.90, 95%CI: 1.08–3.36), satisfied by delivery care (AOR=2.05, 95%CI: 1.24–3.40), received friendly care (AOR=7.72, 95%CI: 2.42–13.52) and having companion (AOR=2.48, 95%CI: 1.37–4.50) had higher likelihood of immediate PNC satisfaction.ConclusionWomen’s satisfaction with immediate PNC was higher than the national achievements of targets for the client satisfaction. Therefore, health-care providers should encourage frequent ANC visits, friendly care, and companionship to increase the level of immediate PNC satisfaction.

Factors associated with reporting good maternal health-related knowledge among rural mothers of Yemen.

Increasing women's knowledge about maternal health is an important step towards empowering them and making them aware of their rights and health status, allowing them to seek appropriate health care. In Yemen, the ongoing conflict has hampered the delivery of health information to women in public health facilities. This study examined rural women's knowledge of, and attitude towards, maternal and child health in Yemen and identified the factors associated with good maternal health knowledge. The study was conducted between August and November 2018. A sample of 400 women aged 15-49 years who had delivered in the 6 months prior to the survey were systematically selected from selected public health facilities in Abyan and Lahj. Women were interviewed using a structured questionnaire to gather data on their demographic and economic characteristics, obstetric history and responses to health knowledge and attitude questions. Women's knowledge level was assessed as poor or good using the mean score as a cut-off. Chi-squared test and multiple logistic regression analysis were used to identify statistically significant factors associated with good maternal health knowledge. The percentage of women who had good knowledge was 44.8% (95% CI: 39.8-49.8). Women's attitude towards maternal health was negative in the areas of early ANC attendance, managing dietary regime and weight during pregnancy, facility delivery, PNC visits, cord care and mother and child health management. Women with primary education, whose husbands had received no formal education, who had their first ANC visit from the second trimester of pregnancy and who had fewer than four ANC visits were more likely to have poor health knowledge. Conversely, those with higher household income and only one child were more likely to have good maternal health knowledge. Overall, women's knowledge on maternal and child health care in rural areas of Yemen was low. Strategies are needed to increase rural women's knowledge on maternal and child health in this conflict-affected setting.

Cervical cancer screening \u201csee and treat approach\u201d: real-life uptake after invitation and associated factors at health facilities in Gondar, Northwest Ethiopia

BackgroundAlthough cervical cancer is a preventable disease, screening coverage in Ethiopia is far below the target. There is limited evidence on uptake among the general population in Ethiopia. Thus, this study was conducted to assess uptake and associated factors with the cervical cancer screening “see and treat approach” among eligible women in public health facilities in Gondar town, Northwest Ethiopia.MethodA facility-based, cross-sectional study was conducted. The total sample size was 493. A consecutive sampling method was applied. Participants were informed about and invited to cervical cancer screening using visual inspection with acetic acid. Crude and adjusted odds ratios were calculated to determine statistical association with socio-demographic variables. Multivariable logistic regression was used to determine factors of cervical cancer screening uptake.ResultOut of 464 women advised for screening, 76 (16.4, 95% CI [13, 19.8%]) attended the screening. Primary education and above (AOR = 5.3, 95% CI [2.20, 13.0]), knowledge about the disease (AOR = 8.4, 95% CI [3.33, 21.21]), perceived susceptibility (AOR = 6.5, 95% CI [2.72, 15.51]), fewer perceived barriers (AOR = 6.4, 95% CI [2.30, 17.80]), cues to action (AOR = 4.6, 95% CI [1.86, 11.32]), perceived self-efficacy (AOR = 5, 95% CI [2.14, 11.73]), and previous recommendation for screening (AOR = 2.7, 95% CI [1.15, 6.51]) were significantly associated with screening uptake.ConclusionThe actual uptake of screening offered in this study was high relative to only 3% national screening coverage. There is a need to implement active invitation for screening with special focus on less-educated women. Repeated invitation may facilitate future screening uptake.

Level of adherence to option B plus PMTCT and associated factors among HIV positive pregnant and lactating women in public health facilities of Hawassa city, Southern Ethiopia.

BackgroundAdherence to antiretroviral therapy is very essential to achieve a great outcome of drugs via suppressing viral load, preventing multidrug resistance, and reducing mother to a child transmission rate of the Human Immune Virus.ObjectiveThis study aimed to assess the level of adherence to option B plus PMTCT and associated factors among HIV Positive pregnant and lactating women in public health facilities of Hawassa city, Southern Ethiopia, 2020 G.C.MethodsInstitution-based cross-sectional study was done on 254 HIV-positive pregnant and lactating women attending the prevention of mother-to-child transmission (PMTCT) follow-up. Participants were selected by simple random sampling. Data collected through a structured interviewer-administered questionnaire were cleaned and entered into Epi-data 3.1 and exported to SPSS 20 for statistical analysis. Descriptive analysis was done. Bivariable and multivariable logistic regressions were done to measure the strength of association between independent and dependent variables using the odds ratio and 95% of confidence interval. A p-value <0.05 was taken as statistically significant.ResultThe overall adherence level to option B+ was 224 (88.2%). Respondents in age group of ≤ 25 [AOR = 0.12, 95% CI (0.03, 0.42)], with no formal education [AOR = 0.12, 95% CI (0.03, 0.51)], experienced drug side effects [AOR = 0.11, 95% CI (0.04, 0.32)], have good knowledge of PMTCT [AOR = 3.6, 95% CI (1.16, 11.3)], and get support from partner/family [AOR = 4.5, 95% CI (1.62, 12.4)] were identified associated factors with adherence level.ConclusionThe level of adherence to option B plus PMTCT was 88.2% which is suboptimal. Ages, educational level, knowledge on PMTCT, getting support from partner/family, and drug side effect were significantly associated with adherence. Therefore, educating and counseling on the service of PMTCT to improve their knowledge and encouraging partner/family involvement in care are mandatory to achieve the standard adherence level.

The Use of Herbal Remedies Among Breastfeeding Mothers: A Cross-Sectional Study Among Women Visiting Public Health Facilities in Kingston and St. Andrew, Jamaica

BACKGROUNDThe use of herbal remedies is increasing among Jamaican women especially during pregnancy and breastfeeding even though there is no sufficient evidence on the safety of herbal remedies used during breastfeeding. The aim of this study was to determine the prevalence, commonly used herbal remedies and factors contributing to the use of herbal remedies among breastfeeding women. This research was guided by the Health Belief Model.METHODSA quantitative cross-sectional study was conducted using a structured and validated questionnaire. A consecutive sampling was used to achieve a sample size of 240 breastfeeding mothers across three Health Centers. Ethical considerations were followed. Data was analyzed using SPSS version 22.0.RESULTSThere was a 100% response rate with 56% of respondents who used herbal remedies while breastfeeding. Additionally, 43% chose garlic as their preferred herbal remedy while 16% used fever grass and 18% preferred ginger as their commonly used herb. The analysis revealed that 58% of the respondents used herbal remedies as supplements. It was also found that 13% used herbs to increase their breast milk supply while 12.9% used herbal remedies to treat illnesses. In addition, 10% used herbal remedies to prevent illness and 7% used herbal remedies for other reasons.CONCLUSIONThe use of herbal remedies is prevalent among breastfeeding women in public health facilities in Jamaica. Although few respondents use herbal remedies to promote lactation, most women use herbs for various reasons other than to increase their breast milk supply.

Level of Good Adherence on Option B+ PMTCT and Associated Factors Among HIV Positive Pregnant and Lactating Mothers in Public Health Facilities of Ilu Abba Bor and Buno Bedele Zones, Oromia Regional State, Southwestern Ethiopia, 2018.

BackgroundPMTCT programs help safe delivery practices and recommended infant feeding, as well as providing ART for infants exposed to HIV after birth for prevention and effective treatment. PMTCT service helps to reduce about 1.4 million HIV infections among children between 2010 and 2018. This study aimed to assess the good adherence level and associated factors of option B+ PMTCT among HIV-positive pregnant and lactating women in public health facilities of Ilu Abba Bor and Buno Bedele zones, Oromia regional state, Southwestern Ethiopia 2018.MethodologyInstitutional-based cross-sectional study design was implemented to investigate the level of good adherence to option B+ PMTCT and possible predictors. A simple random sampling technique was used to interview a total of 180 mothers using the interviewer-guided questionnaire for data collection. Data were entered into EpiData version 3.1 and analyzed by SPSS version 23.0 statistical software. Descriptive statistics and logistic regression were computed to identify and see the relative effect of predictors on the outcome variable.ResultsIn this study, 146 (81.1%) of the study participants had good adherence to PMTCT option B+. Women who received social and financial support from friends, family members, and partners had good adherence to PMTCT option B+ than their counterparts. Similarly, women who disclosed their HIV status to others had good adherence than those who did not expose their status to their friends and parents.Conclusion and RecommendationThis study identified the overall level of PMTCT option B+ adherence level in the study area to be good compared to the national and some other findings. Providing support and encouraging a woman for disclosing their HV status for partners and families are very important to increase the adherence level of option B+.

Mistreatment of women in public health facilities of Ethiopia

BackgroundRecent evidence suggests that mistreatment of women during childbirth is a global challenge facing health care systems. This study seeks to explore the prevalence of mistreatment of women in public health facilities of Ethiopia, and identify associated factors.MethodsA two-stage cross sectional sampling design was used to select institutions and women. The study was conducted in hospitals and health centers across four Ethiopian regions. Quantitative data were collected from postpartum women. Mistreatment was measured using four domains: (1) physical abuse, (2) verbal abuse, (3) failure to meet professional standards of care, and (4) poor rapport between women and providers. Percentages of mistreatment and odds ratios for the association between its presence and institutional and socio demographic characteristics of women were calculated using bivariate and multivariable logistic regression modeling.ResultsA total of 379 women were interviewed, of whom 281 (74%) reported any mistreatment. Physical and verbal abuse were reported by 7 (2%) and 31 (8%) women interviewed respectively. Failure to meet professional standards of care and poor rapport between women and providers were reported by 111 (29%) and 274 (72%) women interviewed respectively.Multivariable logistic regression analysis revealed that the odds of reporting mistreatment were higher among women with four or more previous births (aOR = 3.36 95%CI 1.22,9.23, p = 0.019) compared to women with no previous childbirth, Muslim women (aOR = 3.30 95%CI 1.4,7.77, p = 0.006) and women interviewed in facilities with less than 17 births per MNH staff in a month (aOR = 3.63 95%CI 1.9,6.93, p < 0.001). However, the odds of reporting mistreatment were lower among women aged 35 and older (aOR = 0.22 95%CI 0.06, 0.73, p = 0.014) and among women interviewed between 8 and 42 days after childbirth (aOR = 0.37 95%CI 0.15, 0.9, p = 0.028).ConclusionMistreatment during childbirth in Ethiopia is commonly reported. Health workers need to consider provision of individualized care for women and monitor their experiences in order to adjust quality of their services.

Assessment of women\u2019s satisfaction with family planning service at public health facilities in Northwest Region of Ethiopia: a cross sectional study

BackgroundEthiopia is a Sub Saharan African country with an estimated contraceptive prevalence rate of 36% and 22% unmet need for family planning service among married women. Client satisfaction influences the use of Family Planning and other reproductive health services. There is limited information on satisfaction with family planning service among Family planning users particularly in the northern part of Ethiopia. Hence, this study aimed to provide information on client satisfaction and its determinant among women in Public Health facilities of Northwestern Ethiopia.MethodsA Facility based cross-sectional study was conducted from March 1, 2017, to March 30, 2017. An exit interview using structured pretested questionnaire was conducted on randomly selected 490 women attending family planning service in Bahir Dar city, Public Health facilities of Northwest, Ethiopia. The data was cleaned, coded and entered into Epi info™ 7 statistical software and then exported and analyzed using SPSS Version 20 statistical software. A multivariable binary logistic regression model was fitted to identify factors associated with Client satisfaction. Adjusted Odds Ratio (AOR) with the corresponding 95% Confidence Interval (CI) was calculated to show the strength of association.ResultsA total of 490 family planning service users were approached for an interview and making a response rate of 99.8%. The overall client satisfaction with the family planning services was found to be 66.1%. Clients who were merchants were more likely to be satisfied with the family planning service than government employees [AOR = 2.5, P-value = 0.007). In addition, house wife’s more likely to be satisfied with the family planning service than government employees AOR = 2.4, P-value = 0.007). Daily laborers were also found to be more likely to be satisfied with the FP service as compared with governmental employees AOR = 3.9, P-value = 0.007). New Family Planning user clients were more likely to be satisfied with the family planning service than repeat users [AOR = 2.3, P-value = 0.004).Family planning service waiting time also affects client satisfaction, in which those having awaiting time of less than half an hour’s (AOR = 9.7, (P-value =001), One to half an hour (AOR = 6.4, (P-value =001), One hour to two hours (AOR = 4.6, (P-value =001) were more likely to be satisfied with the family planning service delivered at the facility than those who had waited for more than two hours. In addition, those whose privacy was maintained during counseling were more likely to be satisfied with the family planning service delivered than whose privacy was not maintained (AOR = 3.2, P-Value = < 0.001). Those having convenient service hour were more likely to be satisfied with the family planning service delivered than those who don’t have convenient service hour (AOR = 2.4, p-value = 0.002).ConclusionThe finding of this study concludes that nearly two -third of the clients were satisfied with the family planning service delivered at Public Health facilities of Northwest of Ethiopia. New family planning service users, waiting time for the service, Maintaining privacy during counseling, having convenient service hour and occupational status of the clients were the predictors for client satisfaction with family planning service delivered at Public Health facilities in Bahir Dar city.

Correlates of hepatitis B awareness and disease-specific knowledge among pregnant women in Northern and Central Uganda: a cross-sectional study

IntroductionCountries in sub-Saharan Africa with a high hepatitis B burden also have limited resources to identify underlying drivers of disease among key at-risk populations. To improve prioritization and strengthen prevention of mother to child transmission of HBV, it is imperative to understand disease awareness, knowledge and related factors among pregnant women.ObjectivesThis study assessed HBV disease awareness, knowledge and related factors among pregnant women in public health facilities in two regions with diverse HBV disease epidemiology.MethodsFrom October 2016 through December 2017, a random sample of 455 pregnant women attending antenatal clinics were surveyed to assess HBV awareness, knowledge and associated factors. Participants responded to an 18-item questionnaire with themes on HBV awareness, knowledge of disease signs and symptoms, transmission, prevention and misconceptions about the disease. Results were analysed in STATA (version 14.0).ResultsOf 455 participants enrolled, about two thirds reported having heard about HBV disease. By region, nearly half (47%) of participants from the central region, compared to only 16% from the north, reported that they had never heard of HBV. Region of residence had a moderating effect on the education- HBV awareness relationship. Only 162/455 (36%) of participants had adequate HBV knowledge. More than half 256/455 (56%) and 242/455 (53%) were not knowledgeable about horizontal and mother to child HBV transmission, respectively. About two thirds 298/455 (66%) and 281/455 (62%) believed HBV was spread via sharing of utensils and mosquito bites respectively. In multiple regression analysis, residing in the north, (PR=1.91(1.53 -2.38), p < 0.001) compared to central region and having a secondary education (PR=1.87(1.37 -2.55), p < 0.001) compared to primary were statistically significantly related to being knowledgeable about HBV.ConclusionWe demonstrated marked regional differences in HBV disease awareness and knowledge in this high HBV prevalence setting. However, most pregnant women displayed unacceptably low HBV knowledge and a significant proportion still hold misconceptions about HBV. Interventions to improve HBV prevention through antenatal education will need to be tailored to existing differences in comprehensive HBV knowledge.