Introduction Low birth weight (LBW) is one of the major predictors of perinatal survival, infant ... more Introduction Low birth weight (LBW) is one of the major predictors of perinatal survival, infant morbidity, and mortality, as well as the risk of developmental disabilities and illnesses in future lives. The effect of the nutritional status of pregnant women on birth outcomes is becoming a common research agenda, but evidence on the level of low birth weight (LBW) and its association with prenatal iron status in Ethiopia, particularly among rural residents, is limited. Thus, this study aimed to assess the prevalence, predictors of LBW, and its association with maternal iron status using serum ferritin concentration in Haramaya district, eastern Ethiopia, 2021. Methods A community-based prospective cohort study design was conducted. Of a total of 427 eligible pregnant women followed until birth, 412 (96.48%) were included in the final analysis. Iron status was determined using serum ferritin (SF) concentration from venous blood collected aseptically from the ante-cubital veins analyz...
Health workforces across all levels of the healthcare system are the main modulators in the effec... more Health workforces across all levels of the healthcare system are the main modulators in the effective implementation of disease surveillance system. However, their level of integrated disease surveillance response (IDSR) practice and determinant factors was hardly investigated in Ethiopia. This study determined the level of IDSR practice and associated factors among health professionals in the west Hararghe zone, eastern Oromia, Ethiopia. Methodology: A multicenter facility-based cross-sectional study design was conducted between December 20, 2021, and January 10, 2022, among 297 systematically selected health professionals. Trained data collectors collected data using structured pretested selfadministered questionnaires. The level of IDSR practice was assessed using six questions where each acceptable practice was given "1" and unacceptable "0", with a total score of 0 to 6. Hence, a score above or equal to the median was categorized as good practice. Epi-data and STATA were used for data entry and analysis. A binary logistic regression analysis model with an adjusted odds ratio was used to determine the effects of independent variables on the outcome variable.
Background: Despite rapid growth in the information technology (IT), adoption rate of electronic ... more Background: Despite rapid growth in the information technology (IT), adoption rate of electronic medical records (EMR) in health care setting is lagging behind in Ethiopia. EMRs have long been considered as essential elements in improving healthcare quality and safety, enhance service performance, reduce adverse events for patients, and support clinical decision support system. However, utilization of EMR among healthcare providers still remains low and there has been little progress toward harnessing the bene ts of EMR particularly in developing countries. Objective: This study, therefore, is aimed at exploring EMR use and its determinants among health care providers. Methods: Quantitative cross-sectional study was conducted on 402 health professionals working at public health facilities supplemented with an exploratory qualitative study in Dire Dawa, Ethiopia. Descriptive statistics and logistic regression analysis were used to explore determinant factors of EMR use while qualitative data were thematically analyzed. Results: Overall, about a quarter (26.6%) of health professionals were using electronic medical record. Work experience of 6 years or less (AOR=2.23; 95% CI: [1.15-4.31]), discussion on EMR (AOR=14.47; 95% CI: [5.58-37.57]), presence of EMR manual (AOR=3.10 95%CI: [1.28-7.38]), and positive attitude towards EMR system (AOR=11.15; 95%CI: [4.90-25.36]) and service quality (AOR=8.02; 95% CI: [4.09-15.72]) were independent determinants of EMR use. Conclusion: The analysis carried out indicates that EMR use by health professionals in the study area is very low. Therefore, there is a need to leverage through continuous technical support and commitment to enhance EMR use which has the potential to improve health service performance.
Background Cesarean section (CS) is often complicated by surgical site infection (SSI) that may h... more Background Cesarean section (CS) is often complicated by surgical site infection (SSI) that may happen to a woman within 30 days after the operation. This study was conducted to estimate the prevalence of SSI and identify the factors associated with SSI. Methods A hospital-based analytic cross-sectional study was conducted based on the review of medical records of 1069 women who underwent CS in two public hospitals in Harar city. The post-CS SSI is defined when it occurred within 30 days after the CS procedure. Factors associated with SSI were identified using a multivariable binary logistic regression analysis. The analysis outputs are presented using an adjusted odds ratio (aOR) with a corresponding 95% confidence interval (CI). All statistical tests are defined as statistically significant at P-values<0.05.
<b>Background</b>: HIV infection among children accounts 30 % of the total new infect... more <b>Background</b>: HIV infection among children accounts 30 % of the total new infection in Ethiopia. To reduce pediatric HIV infection, antiretroviral drugs are provided to all HIV positive pregnant and lactating mothers since 2013. The effectiveness of such program is determined by mother's adherence to the regimen, which is indirectly influenced by socio-demographic and behavioral factors. Therefore this study aimed at assessing the level and determinatesof option B+ Aantiretroviral Therapy (ART) adherence among pregnant and lactating women attending public hospitals in Harar and Dire Dawa, Ethiopia, 2016. <b>Method</b>: A facility based cross sectional study was conducted on 359 pregnant and lactating women attending ART clinics at four public health facilities in Harar and Dire Dawa cities, Eastern Ethiopia. Data were collected using pretested, semi structured questionnaire and analyzed using SPSS version 16. Adequate adherence for ART was determined if women took 25 pills and above per month. In crude analysis, variables with p value less than 0.25 were kept in the final adjusted analysis. Variables with p value less than 0.05 in final analysis were considered significantly associated with the outcome variable. <b>Result</b>: About 50 (16.4%) of participants were pregnant and the remaining were lactating women. Antenatal care (ANC) attendance during pregnancy was reported by 246 (80.9%) respondents. Good attitude on prevention of mother to child transmission was reported by 189(62.2%). Adequate adherence was achieved by 251(82.6%) of study participants. Women from urban (AOR= 4.1, 1.7-9.7), having ANC follow up (AOR= 3.8, 1.3-11.3), obtained husband support (AOR=2.7, 1.05-6.8), obtained ART counseling (AOR=2.5, 1-6.3), having good attitude to PMTCT (AOR=2.4, 1-5.7) were significantly associated with adequate adherence to option B+ ART adherence. <b>Conclusion</b>: A fifth of study participants don't have adequate adherence. Factors affecting adherence can be modified with adequate and proper counseling [...]
Background: Acute malnutrition is a major global public health problem, particularly in low and m... more Background: Acute malnutrition is a major global public health problem, particularly in low and middle-income countries. A targeted supplementary feeding program is an approach recommended to address moderate acute malnutrition in food insecure settings. Preventing and treating moderate acute malnutrition requires identifying factors shown to affect the treatment outcome and duration of stay on treatment. This study aimed to determine the treatment outcome and predictors of recovery time from moderate acute malnutrition among children 6-59 months of age in Darolebu district, Eastern Ethiopia. Methods: A retrospective cohort study design was conducted on 540 children with moderate acute malnutrition. A Kaplan-Meier survival analysis was used to estimate the recovery time. Cox proportional hazard regression model was used to determine the association between the independent and the outcome variables. The proportional hazard assumption of the model was checked graphically and statistically. Any violation of the proportional hazard assumption of the model was also considered and adjusted in the analysis. Finally, a variable with a P-value <0.05 in the multivariate cox regression model was considered statistically significant. Results: The overall recovery rate was 73% (95% CI 69.4-76.4%) with the median time to recovery of 16 weeks. Being between the ages of 24 and 59 months (AHR = 1.24, 95% CI: 1.01-1.54), having a mid-upper arm circumference (MUAC) at admission between 11.5 and 11.9 cm (AHR = 1.27, 95% CI: 1.34-2.61), walking for an hour or less to receive services (AHR = 1.2, 95% CI: 1.02-1.89), using ready-to-use supplementary food (AHR= 1.8, 95%CI: 1.38-2.39) were significant predictors of recovery time. Conclusion: The recovery rate was slightly below the accepted minimum international standard, suggesting that further work is needed to improve the treatment outcomes and mortality and morbidity associated with moderate acute malnutrition.
Background: Sexual and reproductive health (SRH) is referring to physical and emotional wellbeing... more Background: Sexual and reproductive health (SRH) is referring to physical and emotional wellbeing and includes the ability to be free from unwanted pregnancy, unsafe abortion, sexually transmitted infections including HIV/AIDS, and all forms of sexual violence and coercion. SRH is the main services packages that prevent and reduce adolescent reproductive health risks and problems. While the government of Ethiopia has undertaken several measures to improve SRH services, there was limited data on utilization among adolescents and associated factors. Objective: To assess utilization of SRH services and associated factors among adolescents attending secondary schools in Haramaya District, Eastern Ethiopia. Methods: A school-based cross-sectional study was conducted among adolescent students aged 15-19 years. A total of 692 adolescents were selected using a multi-stage sampling from two randomly selected secondary schools, each from rural and urban settings, in Haramaya district where 642 provided complete data and included in the analysis. A structured, pretested, and self-administered questionnaire was used to collect data. Data entry was conducted using Epi Data version 3.1 and exported to STATA version 16 for analysis. Bivariable and multivariable binary logistic regression were used to identify factors associated with school adolescents' utilization of SRH. Statistically significant associations are declared at P-value < 0.05. Result: A total of 642 completed the survey questionnaire, constituting a response rate of 92.7% (642/692). Male adolescents accounted 63.7% and the mean age of respondents was 17.71 years. Among those who completed the survey, 23.5% (95% CI: 20-26.8) utilized SRH services. Adolescents who were exposed to SRH information (adjusted odds ratio (AOR) = 2.11, 95% CI: 1.22-3.6), aware of SRH service providing facility (AOR = 1.83, 95% CI: 1.12-3.0) and SRH service components (AOR = 2.76, 95%, CI: 1.53-4.97), and distance from SRH facilities (AOR = 2.28, 95%, CI: 1.13-4.62) were significantly associated with the utilization of SRH services. Conclusion: Nearly one-in-four secondary school adolescents (23.5%) utilized SRH services. Targeted promotion of SRH providing facilities and SRH service components aimed at awareness creation could improve adolescents' utilization of SRH services. Improved SRH services utilization among adolescents who were far from SRH services providing facilities needs further investigation.
Adolescents at secondary schools are susceptible to engaging in risky sexual behavior (RSB) due t... more Adolescents at secondary schools are susceptible to engaging in risky sexual behavior (RSB) due to their teenage stage and the new environment they face. Limited researches in district towns have evaluated the RSB among adolescents with various findings. This study aimed to assess the RSB and associated factors among sexually experienced secondary school students. School-based cross-sectional study was conducted in Guduru district from March 4-8, 2019. A total of 1236 secondary school students were undergoing a survey. The data were collected using a pretested anonymously self-administered questionnaire and students who reported having ever had sex were evaluated for RSB. From all participants, 352 (29.8%) had ever started sexual intercourse from which 240 (68.2%) students were involved in RSB.
Background : The opinions of users about the health care services and the degree of their satisfa... more Background : The opinions of users about the health care services and the degree of their satisfaction may indicate the efficiency of the services. Objective : To assess consumer satisfaction of outpatient health care services. Methods : A cross-sectional survey was conducted at Jimma hospital from November to February 1999. Data were collected by health-workers using pre-tested, structured questionnaire. Results : A total of 385 outpatients, females, were interviewed at exit of hospital. The majority, 140 (36.4%) of the users were within the age group of 30-39 years. About 56% of the females visited the hospital for children's health care while 87.2% of the males visited for own health care. Overall, 57.1% of interviewee believed that the service they received was either good or very good. Satisfaction with health care was found to have a direct relationship with increase in age but has an inverse relation with increase in educational level of respondents. It has a significant association with length of waiting and consultation time, type of investigations performed and securing prescribed medications from hospital pharmacy (P Conclusion : Based on the findings of the study, efficient health service management to improve drug supply and quality of service are recommended. (Ethiopian Journal of Health Development, 2001, 15(3): 179-184)
Introduction Despite the increasingly wider availability of contraceptives and the high levels of... more Introduction Despite the increasingly wider availability of contraceptives and the high levels of unmet need for family planning in rural Ethiopia, contraceptive utilization among young married women is low. Studies on associated factors in Ethiopia so far have been focused on individual factors with little emphasis on socio-cultural factors. This study aimed to assess the association between contraceptive utilization and socio-cultural factors among young married women in Eastern Ethiopia.
Purpose: Addressing the contraceptive needs of young married women is critical to improve their h... more Purpose: Addressing the contraceptive needs of young married women is critical to improve their health and well-being. In patriarchal societies, young married women are under intense pressure to demonstrate their fecundity. Therefore, research that specifically address the needs for contraception of young married women have been generally given less emphasis in Ethiopia. This study assessed the extent of unmet needs for contraception and its associated factors among young married women in Eastern Ethiopia. Methods: A community-based cross-sectional study was conducted among young married women (14-24 years of age) in Eastern Ethiopia. Data were collected using a structured questionnaire. The prevalence ratio (PR) with 95% confidence intervals (CIs) was calculated, and factors associated with unmet needs for contraception were identified using log-binomial regression statistical model. Results: Among 2933 young women interviewed, the unmet need for contraception was 1014 (34.6%; 95% CI, 32.9%-36.4%). The prevalence of unmet needs for contraception decreased with increased young women's household decision-making autonomy score (APR= 0. 76; CI=0.62-0.94). Exposure to family planning (FP) information during the last 12 months (APR= 1.24; CI=1.1-1.42), age 18 or more years (APR=1.25; CI=1.04-1.5), multiparty (APR= 1. 9; CI=1.7-2.1) and desire to have 5 children or lesser than 5 children (APR= 1. 2; CI=1.06-1.32) were associated with higher prevalence of unmet needs for contraception. Conclusion: One-third of married young women had unmet needs for contraception. More efforts to empower women to make decisions that affect their own life and providing appropriate family planning information are necessary to reduce the burden of unmet needs among young married women in rural settings in Ethiopia.
Research for their courageous attention and unreserved support in the production of modules sugge... more Research for their courageous attention and unreserved support in the production of modules suggested by the initiative.
BMC International Health and Human Rights, Dec 1, 2015
Background: To attain a successful treatment outcome, Antiretroviral Therapy (ART) treatment for ... more Background: To attain a successful treatment outcome, Antiretroviral Therapy (ART) treatment for people living with HIV requires more than 95 % adherence level. The adherence level varies depending on different population contexts. Thus, the objective of this study was to investigate ART adherence level among HIV positive patients attending their clinical care in public health facilities in Harar and Dire Dawa, Eastern Ethiopia. Methods: We conducted a cross-sectional study among 626 ART attendees. Data were collected using a structured questionnaire with a face-to-face interview. ART adherence was considered when taking all antiretroviral treatment in a correctly prescribed doses at a right time (no dose missed or delayed for greater than or equal to 90 min) in the week prior to the study. Multivariable logistic analysis was applied to examine the association between the dependent and independent variables. Statistical significance was set at p-value <0.05. Results: The level of ART adherence was 85 %. Adherence was more likely among patients of 35-44 years (AOR = 2.39; 95 % CI = 1.15-5.01), had monthly income of 501.00-999.00 Ethiopian Birr (ETB) (AOR = 6.73; 95 % CI = 2.71-16.75), no history of opportunistic infection (AOR = 2.81; 95 % CI = 1.47-5.36), and had good family support (AOR = 2.61; 95 % CI = 1.45-4.72). However, those who did not disclose their sero-status (AOR = 0.45; 95 % CI = 0.21-0.97) and did experience depression (AOR = 0.36; 95 % CI = 0.21-0.61) were less likely adherent than their counter parts. Conclusions: The level of ART adherence was sub-optimal. Concerted and collaborative efforts through effective and efficient interventions are needed in view of the identified factors in order to improve the adherence level.
Objective: To identify the determinants of term premature rupture of membrane in Southern Ethiopi... more Objective: To identify the determinants of term premature rupture of membrane in Southern Ethiopia public hospitals, 2017. Results: Seventy-five cases and 223 controls women were enrolled for the study. Two hundred eighty-four (95.3%) participants were admitted at the gestational age of above 40, and the rest, 14 (4.7%), were admitted at 37-40 weeks of gestation. The current study identified wealth index and inter-birth interval as preventive predictors, but smoking and hypertension during pregnancy were identified as positive determinants of premature rupture of membrane. This finding is supported by multiple logistic regression analysis result of wealth index (AOR: 0.102, 95% CI [0.033, 0.315]), inter-birth interval (AOR: 0.251, 95% CI [0.129, 0 0.488]), smoking (AOR: 17.053, 95% CI [2.145, 135.6]), and hypertension (AOR: 8.92, 95% CI (1.91, 41.605]). The association between PROM and its determinants indicated that evidence-based interventions should be needed and designed to have very high wealth index, and optimal interbirth interval, and prevent smoking and hypertension during pregnancy to decrease PROM occurrence in the study settings. Hence, we recommended that integration of prevention mechanism of modifiable determinants to the obstetrics health care system will reduce premature ruptures of a membrane.
Introduction Although undernutrition in pregnancy has continued to get global attention as pregna... more Introduction Although undernutrition in pregnancy has continued to get global attention as pregnancy is considered a critical period in the life cycle owed to increase the metabolic and physiological demands, evidence is scarce on undernutrition and associated factors among pregnant women in eastern Ethiopia. Therefore, this study assessed the undernutrition and associated factors among pregnant women in Haramaya district, Eastern Ethiopia. Methods A community-based cross-sectional study was conducted among randomly selected pregnant women in Haramaya district, eastern Ethiopia. Data were collected through face-toface interviews, anthropometric measurement, and hemoglobin analysis by trained research assistants. An adjusted Prevalence ratio (aPR), and a 95% confidence interval (CI), were used to report associations. Poisson regression analysis model with a robust variance estimate identified variables associated with undernutrition. Data were double entered using Epi-data 3.1 and cleaned, coded, checked for missing and outliers, and analyzed using Stata 14 (College Station, Texas 77845 USA. Finally, the p-value <0.05 was the cutoff point for the significant association. Results A total of 448 pregnant women with a mean age of 25.68 (± 5.16) were included in the study. The prevalence of undernutrition among pregnant women was 47.9% (95% CI: 43%-53%). From the analysis, the undernutrition was more likely higher among respondents who had five or more family members (
Introduction: Low birth weight (LBW) is one of the major predictors of perinatal survival, infant... more Introduction: Low birth weight (LBW) is one of the major predictors of perinatal survival, infant morbidity, and mortality, as well as the risk of developmental disabilities and illnesses in future lives. The effect of the nutritional status of pregnant women on birth outcomes is becoming a common research agenda, but evidence on the level of low birth weight (LBW) and its association with prenatal iron status in Ethiopia, particularly among rural residents, is limited. Thus, this study aimed to assess the prevalence, predictors of LBW, and its association with maternal iron status using serum ferritin concentration in Haramaya district, eastern Ethiopia, 2021. Methods: A community-based prospective cohort study design was conducted. Of a total of 427 eligible pregnant women followed until birth, 412 (96.48%) were included in the final analysis. Iron status was determined using serum ferritin (SF) concentration from venous blood collected aseptically from the ante-cubital veins analyzed on a fully automated Cobas e411 (German, Japan Cobas 4000 analyzer series) immunoassay analyzer. Iron deficiency(ID) and iron deficiency anemia (IDA) were classified as having SF less than 15 μg/L and SF less than 15 μg/L and Hb level of < 11.0 g/dl during the first or third trimester or < 10.5 g/dl during the second trimester as well, respectively. Birthweight was measured within 72 h of birth and < 2500 g was considered LBW. Birthweight was measured within 72 h of birth and < 2500 g was considered as LBW. A Poisson regression model with robust variance estimation was used to investigate the factors associated with LBW and the association between maternal iron status and LBW. An adjusted prevalence ratio with a 95% confidence interval was reported to show an association using a p-value < 0.05. Results: About 20.2% (95% CI: 16%-24%) of neonates were born with LBW. The prevalence of LBW was 5.04 (95% CI = 2.78-9.14) times higher among women who were iron deficient during pregnancy compared to those who were normal. The neonates of women who were iron deficient during pregnancy had lower birth weight (aPR=5.04; 95% CI = 2.78-9.14) than the neonates of women who were normal. Prevalence of LBW was higher among mothers who were undernourished (MUAC < 23cm) (aPR = 1.92; 95% CI= 1.33-2.27), stunted (height <145cm) (aPR=1.54; 95% CI=1.04-2.27) and among female neonates (aPR=3.70; 95% CI= 2.28-6.00). However, women who were supplemented with iron and folic acid (IFAS) during pregnancy had a 45% decreased chance of delivering low birth weight (aPR= 0.55; 95% CI=0.36-0.84).
Newborn care refers to the care that is provided to the baby from birth to one-month-old by a car... more Newborn care refers to the care that is provided to the baby from birth to one-month-old by a caregiver or by the mothers including thermal care, hygienic care, cord care, eye care, breastfeeding, immunization, and identification of newborn danger signs. According to Ethiopian Demographic and Health Survey (EDHS) 2016, the neonatal mortality rate was 29 deaths per 1000 live births, and the postneonatal mortality rate was 19 deaths per 1000 live births with neonates contributing 48 deaths per 1000 of the infant mortality. Neonatal mortality accounts for approximately two-thirds of all infant mortality worldwide. Objective. The objective of this study was to assess newborn care practice and associated factors among mothers with babies of one-month-old in Hossana town, Southern Nations, Nationalities, and Peoples' Region, Ethiopia, 2018. Methods. A community-based crosssectional study was conducted among randomly selected 422 mothers with babies of one-month-old in Hossana town, southwest Ethiopia. The data were entered to EpiData 3.1 and exported to Statistical Package for the Social Sciences (SPSS) version 22. Bivariate and multivariate analyses were applied, and frequencies and odds ratios were calculated to determine the prevalence and associated factors, respectively. Results. In this study, 31% of participants had good newborn care practice based on three composite variables such as 84% who have done early breastfeeding initiation, 32.9% who have done safe cord care, and 30.6% who have done thermal care. Educational status of the mother's, primary (AOR = 2:80, 95% CI: 1.027-7.637), secondary (AOR = 2:596, 95% CI: 0.921-7.316), and college and above (AOR = 3:63, 95% CI: 1.056-12.492); mothers who practiced handwashing (hygiene) before touching a newborn (AOR = 2:552, 95% CI: 1.092-5.963); and mothers who had good knowledge on newborn care practice (AOR = 15:638, 95% CI: 3.599-67.943) were significantly associated with newborn care practice. Conclusion and Recommendation. The present study indicated that the level of comprehensive newborn care practice was unsatisfactory; all responsible bodies were giving attention and intervene on the predictors to improve newborn care practice and provide health education regarding newborn care practice. Education level, health education (counseling) on hygiene, and knowledge of mother on newborn care practice were independent predictors of newborn care practice.
Background Pelvic floor disorders (PFDs), include urinary incontinence, overactive bladder, anal ... more Background Pelvic floor disorders (PFDs), include urinary incontinence, overactive bladder, anal incontinence, and pelvic organ prolapse negatively affect physical, psychosocial, and economic wellbeing of women. In developing countries, less than a quarter of women with PFDs seek health care for their problem. Health care seeking for PFDs, and its associated factors, is little known in Ethiopia. This study aimed to assess health care seeking for PFDs, associated factors, and deterrents for seeking care. Methods From a community based cross sectional study conducted form August 10 to September 4, 2016 to assess pelvic floor disorders, seven hundred four participants with PFDs drawn for health care seeking behavior analysis. Data were collected through interviewed administered questionnaire. Poisson regression model with robust variance was used to investigate the association of the independent variable with health care seeking behaviors. The results are reported in crude and adjusted prevalence ratio with 95% confidence intervals. Result Two hundred twenty five (32%; CI: 26.8–35.5) women sought care for their PFDs. Majority 160 (71%) of them seek care from government health facilities. Middle wealth index Adjusted Prevalence Ratio (APR) = 1.4, CI: 1.1, 1.8), autonomous decision making on own health (APR = 1.3, CI: 1.1, 1.7), and sever impact of PFDs on quality of life (APR = 1.4, CI:1.1, 1.9) were identified as associated factors for health care seeking. Conclusion A large number of women with pelvic floor disorder did not seek health care: this calls for urgent and tailored intervention to enhance health care seeking behaviors of women with PFD.
Background: Despite the significant benefits of digital health technologies (ITs), developing cou... more Background: Despite the significant benefits of digital health technologies (ITs), developing countries are lagging behind their developed counterparts in the adoption of electronic medical records (EMRs) in a healthcare setting. EMRs have long been considered essential elements in improving the quality of healthcare. However, the rate of utilization of EMRs among healthcare providers still remains low, particularly in developing countries. Objective: This study aimed at exploring EMR use and its determinants among healthcare providers at public health facilities in Dire Dawa, eastern Ethiopia. Methods: A quantitative cross-sectional study was conducted among 402 health professionals working at public health facilities supplemented with an exploratory qualitative study in Dire Dawa, Ethiopia. Descriptive summary statistics and binary and multivariable logistic regression analysis were used to explore the determinant factors of EMR use, while qualitative data were thematically analyzed. Results: Overall, about a quarter (26.6%) of health professionals were using electronic medical records. A work experience of 6 years or less [adjusted odds ratio (AOR) = 2.23; 95% confidence interval (CI): [1.15-4.31]], a discussion on EMR (AOR = 14.47; 95% CI: [5.58-7.57]), the presence of an EMR manual (AOR = 3.10; 95% CI: [1.28-7.38]), and a positive attitude toward the EMR system (AOR = 11.15; 95% CI: [4.90-25.36]) and service quality (AOR = 8.02; 95% CI: [4.09-15.72]) were independent determinants of EMR use. Poor collaboration among stakeholders and dependence on the software programs of NGOs were the main challenges cited by key informants. Conclusion: The findings of this study indicate that EMR use by health professionals in the study area is very low. Several organizational, technical, and behavioral factors were identified for this low utilization. Therefore, there is a need to leverage EMRs through continuous technical support and
Peer Review History: PLOS recognizes the benefits of transparency in the peer review process; the... more Peer Review History: PLOS recognizes the benefits of transparency in the peer review process; therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. The editorial history of this article is available here:
Introduction Low birth weight (LBW) is one of the major predictors of perinatal survival, infant ... more Introduction Low birth weight (LBW) is one of the major predictors of perinatal survival, infant morbidity, and mortality, as well as the risk of developmental disabilities and illnesses in future lives. The effect of the nutritional status of pregnant women on birth outcomes is becoming a common research agenda, but evidence on the level of low birth weight (LBW) and its association with prenatal iron status in Ethiopia, particularly among rural residents, is limited. Thus, this study aimed to assess the prevalence, predictors of LBW, and its association with maternal iron status using serum ferritin concentration in Haramaya district, eastern Ethiopia, 2021. Methods A community-based prospective cohort study design was conducted. Of a total of 427 eligible pregnant women followed until birth, 412 (96.48%) were included in the final analysis. Iron status was determined using serum ferritin (SF) concentration from venous blood collected aseptically from the ante-cubital veins analyz...
Health workforces across all levels of the healthcare system are the main modulators in the effec... more Health workforces across all levels of the healthcare system are the main modulators in the effective implementation of disease surveillance system. However, their level of integrated disease surveillance response (IDSR) practice and determinant factors was hardly investigated in Ethiopia. This study determined the level of IDSR practice and associated factors among health professionals in the west Hararghe zone, eastern Oromia, Ethiopia. Methodology: A multicenter facility-based cross-sectional study design was conducted between December 20, 2021, and January 10, 2022, among 297 systematically selected health professionals. Trained data collectors collected data using structured pretested selfadministered questionnaires. The level of IDSR practice was assessed using six questions where each acceptable practice was given "1" and unacceptable "0", with a total score of 0 to 6. Hence, a score above or equal to the median was categorized as good practice. Epi-data and STATA were used for data entry and analysis. A binary logistic regression analysis model with an adjusted odds ratio was used to determine the effects of independent variables on the outcome variable.
Background: Despite rapid growth in the information technology (IT), adoption rate of electronic ... more Background: Despite rapid growth in the information technology (IT), adoption rate of electronic medical records (EMR) in health care setting is lagging behind in Ethiopia. EMRs have long been considered as essential elements in improving healthcare quality and safety, enhance service performance, reduce adverse events for patients, and support clinical decision support system. However, utilization of EMR among healthcare providers still remains low and there has been little progress toward harnessing the bene ts of EMR particularly in developing countries. Objective: This study, therefore, is aimed at exploring EMR use and its determinants among health care providers. Methods: Quantitative cross-sectional study was conducted on 402 health professionals working at public health facilities supplemented with an exploratory qualitative study in Dire Dawa, Ethiopia. Descriptive statistics and logistic regression analysis were used to explore determinant factors of EMR use while qualitative data were thematically analyzed. Results: Overall, about a quarter (26.6%) of health professionals were using electronic medical record. Work experience of 6 years or less (AOR=2.23; 95% CI: [1.15-4.31]), discussion on EMR (AOR=14.47; 95% CI: [5.58-37.57]), presence of EMR manual (AOR=3.10 95%CI: [1.28-7.38]), and positive attitude towards EMR system (AOR=11.15; 95%CI: [4.90-25.36]) and service quality (AOR=8.02; 95% CI: [4.09-15.72]) were independent determinants of EMR use. Conclusion: The analysis carried out indicates that EMR use by health professionals in the study area is very low. Therefore, there is a need to leverage through continuous technical support and commitment to enhance EMR use which has the potential to improve health service performance.
Background Cesarean section (CS) is often complicated by surgical site infection (SSI) that may h... more Background Cesarean section (CS) is often complicated by surgical site infection (SSI) that may happen to a woman within 30 days after the operation. This study was conducted to estimate the prevalence of SSI and identify the factors associated with SSI. Methods A hospital-based analytic cross-sectional study was conducted based on the review of medical records of 1069 women who underwent CS in two public hospitals in Harar city. The post-CS SSI is defined when it occurred within 30 days after the CS procedure. Factors associated with SSI were identified using a multivariable binary logistic regression analysis. The analysis outputs are presented using an adjusted odds ratio (aOR) with a corresponding 95% confidence interval (CI). All statistical tests are defined as statistically significant at P-values<0.05.
<b>Background</b>: HIV infection among children accounts 30 % of the total new infect... more <b>Background</b>: HIV infection among children accounts 30 % of the total new infection in Ethiopia. To reduce pediatric HIV infection, antiretroviral drugs are provided to all HIV positive pregnant and lactating mothers since 2013. The effectiveness of such program is determined by mother's adherence to the regimen, which is indirectly influenced by socio-demographic and behavioral factors. Therefore this study aimed at assessing the level and determinatesof option B+ Aantiretroviral Therapy (ART) adherence among pregnant and lactating women attending public hospitals in Harar and Dire Dawa, Ethiopia, 2016. <b>Method</b>: A facility based cross sectional study was conducted on 359 pregnant and lactating women attending ART clinics at four public health facilities in Harar and Dire Dawa cities, Eastern Ethiopia. Data were collected using pretested, semi structured questionnaire and analyzed using SPSS version 16. Adequate adherence for ART was determined if women took 25 pills and above per month. In crude analysis, variables with p value less than 0.25 were kept in the final adjusted analysis. Variables with p value less than 0.05 in final analysis were considered significantly associated with the outcome variable. <b>Result</b>: About 50 (16.4%) of participants were pregnant and the remaining were lactating women. Antenatal care (ANC) attendance during pregnancy was reported by 246 (80.9%) respondents. Good attitude on prevention of mother to child transmission was reported by 189(62.2%). Adequate adherence was achieved by 251(82.6%) of study participants. Women from urban (AOR= 4.1, 1.7-9.7), having ANC follow up (AOR= 3.8, 1.3-11.3), obtained husband support (AOR=2.7, 1.05-6.8), obtained ART counseling (AOR=2.5, 1-6.3), having good attitude to PMTCT (AOR=2.4, 1-5.7) were significantly associated with adequate adherence to option B+ ART adherence. <b>Conclusion</b>: A fifth of study participants don't have adequate adherence. Factors affecting adherence can be modified with adequate and proper counseling [...]
Background: Acute malnutrition is a major global public health problem, particularly in low and m... more Background: Acute malnutrition is a major global public health problem, particularly in low and middle-income countries. A targeted supplementary feeding program is an approach recommended to address moderate acute malnutrition in food insecure settings. Preventing and treating moderate acute malnutrition requires identifying factors shown to affect the treatment outcome and duration of stay on treatment. This study aimed to determine the treatment outcome and predictors of recovery time from moderate acute malnutrition among children 6-59 months of age in Darolebu district, Eastern Ethiopia. Methods: A retrospective cohort study design was conducted on 540 children with moderate acute malnutrition. A Kaplan-Meier survival analysis was used to estimate the recovery time. Cox proportional hazard regression model was used to determine the association between the independent and the outcome variables. The proportional hazard assumption of the model was checked graphically and statistically. Any violation of the proportional hazard assumption of the model was also considered and adjusted in the analysis. Finally, a variable with a P-value <0.05 in the multivariate cox regression model was considered statistically significant. Results: The overall recovery rate was 73% (95% CI 69.4-76.4%) with the median time to recovery of 16 weeks. Being between the ages of 24 and 59 months (AHR = 1.24, 95% CI: 1.01-1.54), having a mid-upper arm circumference (MUAC) at admission between 11.5 and 11.9 cm (AHR = 1.27, 95% CI: 1.34-2.61), walking for an hour or less to receive services (AHR = 1.2, 95% CI: 1.02-1.89), using ready-to-use supplementary food (AHR= 1.8, 95%CI: 1.38-2.39) were significant predictors of recovery time. Conclusion: The recovery rate was slightly below the accepted minimum international standard, suggesting that further work is needed to improve the treatment outcomes and mortality and morbidity associated with moderate acute malnutrition.
Background: Sexual and reproductive health (SRH) is referring to physical and emotional wellbeing... more Background: Sexual and reproductive health (SRH) is referring to physical and emotional wellbeing and includes the ability to be free from unwanted pregnancy, unsafe abortion, sexually transmitted infections including HIV/AIDS, and all forms of sexual violence and coercion. SRH is the main services packages that prevent and reduce adolescent reproductive health risks and problems. While the government of Ethiopia has undertaken several measures to improve SRH services, there was limited data on utilization among adolescents and associated factors. Objective: To assess utilization of SRH services and associated factors among adolescents attending secondary schools in Haramaya District, Eastern Ethiopia. Methods: A school-based cross-sectional study was conducted among adolescent students aged 15-19 years. A total of 692 adolescents were selected using a multi-stage sampling from two randomly selected secondary schools, each from rural and urban settings, in Haramaya district where 642 provided complete data and included in the analysis. A structured, pretested, and self-administered questionnaire was used to collect data. Data entry was conducted using Epi Data version 3.1 and exported to STATA version 16 for analysis. Bivariable and multivariable binary logistic regression were used to identify factors associated with school adolescents' utilization of SRH. Statistically significant associations are declared at P-value < 0.05. Result: A total of 642 completed the survey questionnaire, constituting a response rate of 92.7% (642/692). Male adolescents accounted 63.7% and the mean age of respondents was 17.71 years. Among those who completed the survey, 23.5% (95% CI: 20-26.8) utilized SRH services. Adolescents who were exposed to SRH information (adjusted odds ratio (AOR) = 2.11, 95% CI: 1.22-3.6), aware of SRH service providing facility (AOR = 1.83, 95% CI: 1.12-3.0) and SRH service components (AOR = 2.76, 95%, CI: 1.53-4.97), and distance from SRH facilities (AOR = 2.28, 95%, CI: 1.13-4.62) were significantly associated with the utilization of SRH services. Conclusion: Nearly one-in-four secondary school adolescents (23.5%) utilized SRH services. Targeted promotion of SRH providing facilities and SRH service components aimed at awareness creation could improve adolescents' utilization of SRH services. Improved SRH services utilization among adolescents who were far from SRH services providing facilities needs further investigation.
Adolescents at secondary schools are susceptible to engaging in risky sexual behavior (RSB) due t... more Adolescents at secondary schools are susceptible to engaging in risky sexual behavior (RSB) due to their teenage stage and the new environment they face. Limited researches in district towns have evaluated the RSB among adolescents with various findings. This study aimed to assess the RSB and associated factors among sexually experienced secondary school students. School-based cross-sectional study was conducted in Guduru district from March 4-8, 2019. A total of 1236 secondary school students were undergoing a survey. The data were collected using a pretested anonymously self-administered questionnaire and students who reported having ever had sex were evaluated for RSB. From all participants, 352 (29.8%) had ever started sexual intercourse from which 240 (68.2%) students were involved in RSB.
Background : The opinions of users about the health care services and the degree of their satisfa... more Background : The opinions of users about the health care services and the degree of their satisfaction may indicate the efficiency of the services. Objective : To assess consumer satisfaction of outpatient health care services. Methods : A cross-sectional survey was conducted at Jimma hospital from November to February 1999. Data were collected by health-workers using pre-tested, structured questionnaire. Results : A total of 385 outpatients, females, were interviewed at exit of hospital. The majority, 140 (36.4%) of the users were within the age group of 30-39 years. About 56% of the females visited the hospital for children's health care while 87.2% of the males visited for own health care. Overall, 57.1% of interviewee believed that the service they received was either good or very good. Satisfaction with health care was found to have a direct relationship with increase in age but has an inverse relation with increase in educational level of respondents. It has a significant association with length of waiting and consultation time, type of investigations performed and securing prescribed medications from hospital pharmacy (P Conclusion : Based on the findings of the study, efficient health service management to improve drug supply and quality of service are recommended. (Ethiopian Journal of Health Development, 2001, 15(3): 179-184)
Introduction Despite the increasingly wider availability of contraceptives and the high levels of... more Introduction Despite the increasingly wider availability of contraceptives and the high levels of unmet need for family planning in rural Ethiopia, contraceptive utilization among young married women is low. Studies on associated factors in Ethiopia so far have been focused on individual factors with little emphasis on socio-cultural factors. This study aimed to assess the association between contraceptive utilization and socio-cultural factors among young married women in Eastern Ethiopia.
Purpose: Addressing the contraceptive needs of young married women is critical to improve their h... more Purpose: Addressing the contraceptive needs of young married women is critical to improve their health and well-being. In patriarchal societies, young married women are under intense pressure to demonstrate their fecundity. Therefore, research that specifically address the needs for contraception of young married women have been generally given less emphasis in Ethiopia. This study assessed the extent of unmet needs for contraception and its associated factors among young married women in Eastern Ethiopia. Methods: A community-based cross-sectional study was conducted among young married women (14-24 years of age) in Eastern Ethiopia. Data were collected using a structured questionnaire. The prevalence ratio (PR) with 95% confidence intervals (CIs) was calculated, and factors associated with unmet needs for contraception were identified using log-binomial regression statistical model. Results: Among 2933 young women interviewed, the unmet need for contraception was 1014 (34.6%; 95% CI, 32.9%-36.4%). The prevalence of unmet needs for contraception decreased with increased young women's household decision-making autonomy score (APR= 0. 76; CI=0.62-0.94). Exposure to family planning (FP) information during the last 12 months (APR= 1.24; CI=1.1-1.42), age 18 or more years (APR=1.25; CI=1.04-1.5), multiparty (APR= 1. 9; CI=1.7-2.1) and desire to have 5 children or lesser than 5 children (APR= 1. 2; CI=1.06-1.32) were associated with higher prevalence of unmet needs for contraception. Conclusion: One-third of married young women had unmet needs for contraception. More efforts to empower women to make decisions that affect their own life and providing appropriate family planning information are necessary to reduce the burden of unmet needs among young married women in rural settings in Ethiopia.
Research for their courageous attention and unreserved support in the production of modules sugge... more Research for their courageous attention and unreserved support in the production of modules suggested by the initiative.
BMC International Health and Human Rights, Dec 1, 2015
Background: To attain a successful treatment outcome, Antiretroviral Therapy (ART) treatment for ... more Background: To attain a successful treatment outcome, Antiretroviral Therapy (ART) treatment for people living with HIV requires more than 95 % adherence level. The adherence level varies depending on different population contexts. Thus, the objective of this study was to investigate ART adherence level among HIV positive patients attending their clinical care in public health facilities in Harar and Dire Dawa, Eastern Ethiopia. Methods: We conducted a cross-sectional study among 626 ART attendees. Data were collected using a structured questionnaire with a face-to-face interview. ART adherence was considered when taking all antiretroviral treatment in a correctly prescribed doses at a right time (no dose missed or delayed for greater than or equal to 90 min) in the week prior to the study. Multivariable logistic analysis was applied to examine the association between the dependent and independent variables. Statistical significance was set at p-value <0.05. Results: The level of ART adherence was 85 %. Adherence was more likely among patients of 35-44 years (AOR = 2.39; 95 % CI = 1.15-5.01), had monthly income of 501.00-999.00 Ethiopian Birr (ETB) (AOR = 6.73; 95 % CI = 2.71-16.75), no history of opportunistic infection (AOR = 2.81; 95 % CI = 1.47-5.36), and had good family support (AOR = 2.61; 95 % CI = 1.45-4.72). However, those who did not disclose their sero-status (AOR = 0.45; 95 % CI = 0.21-0.97) and did experience depression (AOR = 0.36; 95 % CI = 0.21-0.61) were less likely adherent than their counter parts. Conclusions: The level of ART adherence was sub-optimal. Concerted and collaborative efforts through effective and efficient interventions are needed in view of the identified factors in order to improve the adherence level.
Objective: To identify the determinants of term premature rupture of membrane in Southern Ethiopi... more Objective: To identify the determinants of term premature rupture of membrane in Southern Ethiopia public hospitals, 2017. Results: Seventy-five cases and 223 controls women were enrolled for the study. Two hundred eighty-four (95.3%) participants were admitted at the gestational age of above 40, and the rest, 14 (4.7%), were admitted at 37-40 weeks of gestation. The current study identified wealth index and inter-birth interval as preventive predictors, but smoking and hypertension during pregnancy were identified as positive determinants of premature rupture of membrane. This finding is supported by multiple logistic regression analysis result of wealth index (AOR: 0.102, 95% CI [0.033, 0.315]), inter-birth interval (AOR: 0.251, 95% CI [0.129, 0 0.488]), smoking (AOR: 17.053, 95% CI [2.145, 135.6]), and hypertension (AOR: 8.92, 95% CI (1.91, 41.605]). The association between PROM and its determinants indicated that evidence-based interventions should be needed and designed to have very high wealth index, and optimal interbirth interval, and prevent smoking and hypertension during pregnancy to decrease PROM occurrence in the study settings. Hence, we recommended that integration of prevention mechanism of modifiable determinants to the obstetrics health care system will reduce premature ruptures of a membrane.
Introduction Although undernutrition in pregnancy has continued to get global attention as pregna... more Introduction Although undernutrition in pregnancy has continued to get global attention as pregnancy is considered a critical period in the life cycle owed to increase the metabolic and physiological demands, evidence is scarce on undernutrition and associated factors among pregnant women in eastern Ethiopia. Therefore, this study assessed the undernutrition and associated factors among pregnant women in Haramaya district, Eastern Ethiopia. Methods A community-based cross-sectional study was conducted among randomly selected pregnant women in Haramaya district, eastern Ethiopia. Data were collected through face-toface interviews, anthropometric measurement, and hemoglobin analysis by trained research assistants. An adjusted Prevalence ratio (aPR), and a 95% confidence interval (CI), were used to report associations. Poisson regression analysis model with a robust variance estimate identified variables associated with undernutrition. Data were double entered using Epi-data 3.1 and cleaned, coded, checked for missing and outliers, and analyzed using Stata 14 (College Station, Texas 77845 USA. Finally, the p-value <0.05 was the cutoff point for the significant association. Results A total of 448 pregnant women with a mean age of 25.68 (± 5.16) were included in the study. The prevalence of undernutrition among pregnant women was 47.9% (95% CI: 43%-53%). From the analysis, the undernutrition was more likely higher among respondents who had five or more family members (
Introduction: Low birth weight (LBW) is one of the major predictors of perinatal survival, infant... more Introduction: Low birth weight (LBW) is one of the major predictors of perinatal survival, infant morbidity, and mortality, as well as the risk of developmental disabilities and illnesses in future lives. The effect of the nutritional status of pregnant women on birth outcomes is becoming a common research agenda, but evidence on the level of low birth weight (LBW) and its association with prenatal iron status in Ethiopia, particularly among rural residents, is limited. Thus, this study aimed to assess the prevalence, predictors of LBW, and its association with maternal iron status using serum ferritin concentration in Haramaya district, eastern Ethiopia, 2021. Methods: A community-based prospective cohort study design was conducted. Of a total of 427 eligible pregnant women followed until birth, 412 (96.48%) were included in the final analysis. Iron status was determined using serum ferritin (SF) concentration from venous blood collected aseptically from the ante-cubital veins analyzed on a fully automated Cobas e411 (German, Japan Cobas 4000 analyzer series) immunoassay analyzer. Iron deficiency(ID) and iron deficiency anemia (IDA) were classified as having SF less than 15 μg/L and SF less than 15 μg/L and Hb level of < 11.0 g/dl during the first or third trimester or < 10.5 g/dl during the second trimester as well, respectively. Birthweight was measured within 72 h of birth and < 2500 g was considered LBW. Birthweight was measured within 72 h of birth and < 2500 g was considered as LBW. A Poisson regression model with robust variance estimation was used to investigate the factors associated with LBW and the association between maternal iron status and LBW. An adjusted prevalence ratio with a 95% confidence interval was reported to show an association using a p-value < 0.05. Results: About 20.2% (95% CI: 16%-24%) of neonates were born with LBW. The prevalence of LBW was 5.04 (95% CI = 2.78-9.14) times higher among women who were iron deficient during pregnancy compared to those who were normal. The neonates of women who were iron deficient during pregnancy had lower birth weight (aPR=5.04; 95% CI = 2.78-9.14) than the neonates of women who were normal. Prevalence of LBW was higher among mothers who were undernourished (MUAC < 23cm) (aPR = 1.92; 95% CI= 1.33-2.27), stunted (height <145cm) (aPR=1.54; 95% CI=1.04-2.27) and among female neonates (aPR=3.70; 95% CI= 2.28-6.00). However, women who were supplemented with iron and folic acid (IFAS) during pregnancy had a 45% decreased chance of delivering low birth weight (aPR= 0.55; 95% CI=0.36-0.84).
Newborn care refers to the care that is provided to the baby from birth to one-month-old by a car... more Newborn care refers to the care that is provided to the baby from birth to one-month-old by a caregiver or by the mothers including thermal care, hygienic care, cord care, eye care, breastfeeding, immunization, and identification of newborn danger signs. According to Ethiopian Demographic and Health Survey (EDHS) 2016, the neonatal mortality rate was 29 deaths per 1000 live births, and the postneonatal mortality rate was 19 deaths per 1000 live births with neonates contributing 48 deaths per 1000 of the infant mortality. Neonatal mortality accounts for approximately two-thirds of all infant mortality worldwide. Objective. The objective of this study was to assess newborn care practice and associated factors among mothers with babies of one-month-old in Hossana town, Southern Nations, Nationalities, and Peoples' Region, Ethiopia, 2018. Methods. A community-based crosssectional study was conducted among randomly selected 422 mothers with babies of one-month-old in Hossana town, southwest Ethiopia. The data were entered to EpiData 3.1 and exported to Statistical Package for the Social Sciences (SPSS) version 22. Bivariate and multivariate analyses were applied, and frequencies and odds ratios were calculated to determine the prevalence and associated factors, respectively. Results. In this study, 31% of participants had good newborn care practice based on three composite variables such as 84% who have done early breastfeeding initiation, 32.9% who have done safe cord care, and 30.6% who have done thermal care. Educational status of the mother's, primary (AOR = 2:80, 95% CI: 1.027-7.637), secondary (AOR = 2:596, 95% CI: 0.921-7.316), and college and above (AOR = 3:63, 95% CI: 1.056-12.492); mothers who practiced handwashing (hygiene) before touching a newborn (AOR = 2:552, 95% CI: 1.092-5.963); and mothers who had good knowledge on newborn care practice (AOR = 15:638, 95% CI: 3.599-67.943) were significantly associated with newborn care practice. Conclusion and Recommendation. The present study indicated that the level of comprehensive newborn care practice was unsatisfactory; all responsible bodies were giving attention and intervene on the predictors to improve newborn care practice and provide health education regarding newborn care practice. Education level, health education (counseling) on hygiene, and knowledge of mother on newborn care practice were independent predictors of newborn care practice.
Background Pelvic floor disorders (PFDs), include urinary incontinence, overactive bladder, anal ... more Background Pelvic floor disorders (PFDs), include urinary incontinence, overactive bladder, anal incontinence, and pelvic organ prolapse negatively affect physical, psychosocial, and economic wellbeing of women. In developing countries, less than a quarter of women with PFDs seek health care for their problem. Health care seeking for PFDs, and its associated factors, is little known in Ethiopia. This study aimed to assess health care seeking for PFDs, associated factors, and deterrents for seeking care. Methods From a community based cross sectional study conducted form August 10 to September 4, 2016 to assess pelvic floor disorders, seven hundred four participants with PFDs drawn for health care seeking behavior analysis. Data were collected through interviewed administered questionnaire. Poisson regression model with robust variance was used to investigate the association of the independent variable with health care seeking behaviors. The results are reported in crude and adjusted prevalence ratio with 95% confidence intervals. Result Two hundred twenty five (32%; CI: 26.8–35.5) women sought care for their PFDs. Majority 160 (71%) of them seek care from government health facilities. Middle wealth index Adjusted Prevalence Ratio (APR) = 1.4, CI: 1.1, 1.8), autonomous decision making on own health (APR = 1.3, CI: 1.1, 1.7), and sever impact of PFDs on quality of life (APR = 1.4, CI:1.1, 1.9) were identified as associated factors for health care seeking. Conclusion A large number of women with pelvic floor disorder did not seek health care: this calls for urgent and tailored intervention to enhance health care seeking behaviors of women with PFD.
Background: Despite the significant benefits of digital health technologies (ITs), developing cou... more Background: Despite the significant benefits of digital health technologies (ITs), developing countries are lagging behind their developed counterparts in the adoption of electronic medical records (EMRs) in a healthcare setting. EMRs have long been considered essential elements in improving the quality of healthcare. However, the rate of utilization of EMRs among healthcare providers still remains low, particularly in developing countries. Objective: This study aimed at exploring EMR use and its determinants among healthcare providers at public health facilities in Dire Dawa, eastern Ethiopia. Methods: A quantitative cross-sectional study was conducted among 402 health professionals working at public health facilities supplemented with an exploratory qualitative study in Dire Dawa, Ethiopia. Descriptive summary statistics and binary and multivariable logistic regression analysis were used to explore the determinant factors of EMR use, while qualitative data were thematically analyzed. Results: Overall, about a quarter (26.6%) of health professionals were using electronic medical records. A work experience of 6 years or less [adjusted odds ratio (AOR) = 2.23; 95% confidence interval (CI): [1.15-4.31]], a discussion on EMR (AOR = 14.47; 95% CI: [5.58-7.57]), the presence of an EMR manual (AOR = 3.10; 95% CI: [1.28-7.38]), and a positive attitude toward the EMR system (AOR = 11.15; 95% CI: [4.90-25.36]) and service quality (AOR = 8.02; 95% CI: [4.09-15.72]) were independent determinants of EMR use. Poor collaboration among stakeholders and dependence on the software programs of NGOs were the main challenges cited by key informants. Conclusion: The findings of this study indicate that EMR use by health professionals in the study area is very low. Several organizational, technical, and behavioral factors were identified for this low utilization. Therefore, there is a need to leverage EMRs through continuous technical support and
Peer Review History: PLOS recognizes the benefits of transparency in the peer review process; the... more Peer Review History: PLOS recognizes the benefits of transparency in the peer review process; therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. The editorial history of this article is available here:
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