Delay in reaching health facilities for emergency obstetric care and associated factors among postpartum mothers at Bale zones, Ethiopia. A cross-sectional study

Maternal mortality occurs in developing nations as a result of inadequate health care, delayed medical attention and the inability to access medical facilities. The three-delay model was employed to determine the causes of maternal death. There was limited data on maternal delay in reaching health facilities for emergency obstetric care services in the study area. Therefore, the aim of this study was to assess the prevalence of delay in reaching health facilities for emergency obstetric care and associated factors among postpartum mothers at Bale and east Bale zones. An institutional-based cross-sectional study was conducted among 407 postnatal women from April 6 to May 6, 2022. A systematic sampling technique was used to select study participants. The data were collected electronically using an Open Data Kit and exported to SPSS window version 25 for cleaning and analysis. Both bivariable and multivariable analysis was done by using a binary logistic regression model to identify factors associated with delay in traveling for emergency obstetric care services. Statistical significance was declared at P-value < 0.05. In this study, the prevalence of delay in reaching health facilities during emergency obstetric care was 38.1% (95%CI: 33.3, 43). The following factors showed significant association with delay in reaching health facilities during emergency obstetric care: Average monthly income (AOR = 1.87; 95% CI: 1.12, 3.14), distance (AOR = 4.35; 95% CI: 2.65, 7.14), a referral from other health facilities (AOR = 1.77; 95% CI: 1.01, 3.11) and delay one (AOR = 2.9; 95% CI: 1.7, 4.93). This study showed that the prevalence of delay in reaching health facilities for emergency obstetric care services in the study area was high. Promoting road accessibility and transport mechanisms and strengthening referral mechanisms shall be emphasized.

Parental Satisfaction towards Care Given at Neonatal Intensive Care Unit and Associated Factors in Comprehensive and Referral Hospitals of Southern Ethiopia

Background

Patient satisfaction is an important aspect of the quality of care in the inpatient setting. In neonatal intensive care units, parents' satisfaction and their experiences are fundamental to assessing clinical practice and improving the quality of care delivered to infants. Hence then, it reduces infant mortality rates globally. In Ethiopia, few studies address the level of parental satisfaction towards care given at neonatal intensive care unit and no single study was done in the study area. Therefore, this study is aimed at assessing parental satisfaction towards care given at neonatal intensive care unit and associated factors in comprehensive and referral hospitals of southern Ethiopia.

Methods

An institutional-based cross-sectional study was conducted among 401 parents who visited neonatal intensive care from March 28 to April 28, 2022. The data were assorted via a structured interviewer-administered questionnaire using ODK collect version and exported to SPSS window version 25 for further cleaning and analysis. Bivariate and multivariate logistic regressions were used to identify factors associated with parental satisfaction with care given at the neonatal intensive care unit. The adjusted odds ratio with 95% CI was used to show the strength of the association, and a P value < 0.05 was used to declare the cutoff point to determine the level of significance.

Results

In this study, 63% (95% CI: 58%, 68%) of the parents were satisfied with the care given at the neonatal intensive care unit. Factors associated with parental satisfaction towards care given at neonatal intensive care unit were parents with no formal education (AOR: 0.15; 95% CI: 0.07-0.31), availability of necessary information using direction indicator (AOR: 3.14; 95% CI: 1.85-5.31), and availability of enough chairs in waiting area (AOR: 3.26; 95% CI: 1.81-5.87).

Conclusion

Nearly two-thirds of the parents were satisfied with the care given at the neonatal intensive care unit. The availability of enough chairs in the waiting area and the creation of direction indicators are key issues to improve parental satisfaction towards their neonatal care.

Prevalence and associated risk factors for failed obstetric fistula repair in East African countries: A systematic review and meta-analysis

Objective

Obstetric fistula repair failure is a combination of unsuccessful fistula closure and/or incontinence following a successful closure. There is an inconsistent finding on the failure of obstetric fistula repair in East Africa. Therefore, this systematic review and meta-analysis aimed to determine the pooled prevalence of failed obstetric fistula repair and its associated factors among women who have undergone fistula repair in East Africa.

Methods

This systematic review and meta-analysis were written following the PRISMA guideline protocol. A web-based electronic search of PubMed, Google Scholar, and HINARI was performed to find primary studies. Additional articles were searched by cross-referencing references. A random-effects model was used to estimate the pooled prevalence of failed obstetric fistula repair. The heterogeneity of studies was weighed using I2 test statistics. Publication bias was assessed by Eggers and funnel plot test.

Results

The 16 studies that met the inclusion criteria for this systematic review and meta-analysis of failed obstetric fistula repair were included. Nonetheless, one study was used for factor analysis but not in pooled prevalence analysis. The pooled prevalence of obstetric fistula repair failure in East Africa was 26.89% (95% confidence interval: 21.71, 32.07). Labor duration > 48 h (Pooled odds ratio = 2.46; 95% confidence interval 1.58, 3.82), fistula size >3 cm (Pooled odds ratio = 3.92; 95% confidence interval 2.19, 7.05), previous fistula repair (Pooled odds ratio = 3.20; 95% confidence interval 1.94, 5.29), Goh Type 4 fistulas (Pooled odds ratio = 6.07; 95% confidence interval 2.50, 14.75), completely destructed urethra (Pooled odds ratio = 3.35; 95% confidence interval 1.69, 6.65), and severe vaginal scaring (Pooled odds ratio = 3.89; 95% confidence interval 1.99, 7.62) were significantly associated with obstetric fistula repair failure.

Conclusions

One in four women with obstetric fistula repair experienced repair failure. To fight the problem The Ministry of Health in every part of the country, in collaboration with obstetric care providers, shall intervene on factors affecting obstetric fistula repair failure to reduce or prevent the failure of obstetric fistula repair.

Delay in receiving emergency obstetric care and associated factors among mothers who gave birth in public hospitals of Bale and East Bale zones, Oromia region, South East Ethiopia: Facility based cross-sectional study

Introduction

Delays in timely seeking care, failure to reach health institutions and receiving ineffective health care cause maternal mortality in developing countries. The three maternal delay was used to identify contributing factors to maternal death. There was limited data on the maternal delay in receiving emergency obstetric care services in the study area. Therefore, the aim of this study was to assess the magnitude of delay in receiving emergency obstetric care and associated factors among postnatal mothers in the Bale and east Bale zones.

Methods

A facility-based cross-sectional study was conducted among 407 postnatal women from April 6 to May 6, 2022. A systematic random sampling technique was used to select study participants. The data were collected electronically using an Open Data Kit and exported to SPSS window version 25 for cleaning and analysis. Both bivariate and multivariable analyses were done by using a binary logistic regression model to identify factors associated with delay in receiving emergency obstetric care services. Statistical significance was declared at P-value < 0.05.

Results

In this study, the magnitude of delay in receiving institutional delivery service utilization was 34.6% with [95% CI (30.0_39.5)]. Delay one was found to be statistically associated with maternal delay in receiving institutional delivery services (AOR = 2.07; 95% CI: 1.21, 3.53). Mothers with low monthly income had shown higher odds of delay (AOR = 1.79; 95% CI: 1.03, 3.10). Moreover, the delay in receiving emergency obstetric care was 89% less likely among mothers who had not been referred multiple times than among those who had been referred many times (AOR = 0.10; 95% CI: 0.06, 0.18).

Conclusion

This study showed that the magnitude of the delay in receiving the utilization of emergency obstetric care services in the study area was high. Factors such as delay one, average monthly income and multiple referrals of mothers were found significant factors for delay in receiving care. Therefore, it is important to reduce delay in receiving institutional delivery by working on promoting road accessibility, transport mechanisms and building health education on key danger signs.