Intervention fidelity and its determinants of focused antenatal care package implementation, in south Wollo zone, Northeast Ethiopia

Abstract Background Focused antenatal care is directed at sustaining maternal health and improving fetal wellbeing to ensure birth of a healthy neonate. Failure to implement focused antenatal care can result in inability to reduce maternal and perinatal morbidity and mortality in low income countries. Due to evidence-practice gaps, however, thousands of maternal, fetal and neonatal lives are still lost every day, mostly from preventable causes. This study aimed to assess focused antenatal care package’s intervention fidelity and its determinant factors in South Wollo Zone, Northeast Ethiopia. Methods A cross-sectional study design was employed and a total of 898 women who gave birth in the last 6 months prior to data collection were included. Also 16 health extension workers, working in ten selected health posts, were included. Interviews and self-administered questionnaires were used to collect data from mothers and health extension workers. Ten [10] health posts were audited to assess availability and functionality of drugs and supplies to provide focused antenatal care. Mothers were asked whether or not the required level of care was provided. Health extension workers were provided with self-administered questionnaires to assess socio-demographic characteristics, reception of training, facilitation strategies for the implementation of focused antenatal care and ability to classify danger signs. Multilevel linear regression analysis was performed to identify individual and organizational level’s factors influencing focused antenatal care package intervention fidelity. Results Overall weighted average focused antenatal care package intervention fidelity (implemented as intended/planned) was 49.8% (95% CI: 47.7–51.8), which means the average number of focused antenatal care package interventions women received is 49.8%. Health extension workers implemented 55.1% and skilled providers (nurses, midwives, health officers or medical doctors) 44.9% of focused antenatal care package interventions. Overall antenatal care coverage, irrespective of frequency (at least one visit), was 752/898 women (83.7%; 95% CI: 81.3–86.1); 263/752 women (35.0%; 95% CI: 31.6–38.4) received at least four antenatal visits and only 46/752 women (6.1%; 95% CI: 4.4–7.8) received all recommended components of focused antenatal care. Previous pregnancy-related problems, paternal education and implementation of facilitation strategies were found to be significant factors enhancing focused antenatal care package intervention fidelity. Conclusion Focused antenatal care package intervention fidelity in the study area was low; this may imply that the current level of maternal, perinatal and neonatal mortality might be partly due to the low level of focused antenatal care intervention fidelity. Improving implementation of facilitation strategies is highly required to contribute to the reduction of those mortalities.

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Intervention fidelity and its determinants of focused antenatal care package implementation, in South Wollo Zone, Northeast Ethiopia.

10.21203/rs.3.rs-22069/v5 ◽

2021 ◽

Author(s):

Asressie Molla Tessema ◽

Abebaw Gebeyehu ◽

Solomon Mekonnen ◽

Kassahun Alemu ◽

Zemene Tigabu

Keyword(s):

Antenatal Care ◽

Low Income ◽

Linear Regression Analysis ◽

Weighted Average ◽

Low Income Countries ◽

Intervention Fidelity ◽

Health Extension Workers ◽

Northeast Ethiopia ◽

Focused Antenatal Care ◽

Care Package

Abstract Background: Focused antenatal care activities are directed at sustaining maternal health and improving fetal wellbeing to ensure birth of a live healthy neonate. Failure to implement focused antenatal care can result in inability to reduce maternal and perinatal morbidity and mortality in low income countries. Due to evidence-practice gaps, however, thousands of maternal, fetal and neonatal lives are still lost every day, mostly from preventable causes. This study aimed to assess focused antenatal care package’s intervention fidelity and its determinant factors in South Wollo Zone, Northeast Ethiopia. Methods: A cross-sectional study design was employed and a total of 898 women who gave birth in the last six months prior to data collection were included. Also 16 health extension workers, working in ten selected health posts, were included. Interviews and self-administered questionnaires were used to collect data from mothers and health extension workers. Ten (10) Health posts were audited to assess availability and functionality of drugs and supplies to provide focused antenatal care. Mothers were asked whether or not the required level of care was provided. Health extension workers were provided with self-administered questionnaires to assess socio-demographic characteristics, reception of training, facilitation strategies for the implementation of focused antenatal care and ability to classify danger signs. Multilevel linear regression analysis was performed to identify individual and organizational level’s factors influencing focused antenatal care package intervention fidelity. Results: Overall weighted average focused antenatal care package intervention fidelity (implemented as intended/planned) was 49.8% (95% CI: 47.7 – 51.8), which means the average number of focused antenatal care package interventions a mother received is 49.8%. Health extension workers implemented 55.1% and skilled providers (nurses, midwives, health officers or medical doctors) 44.9% of focused antenatal care package intervention. Overall antenatal care coverage, irrespective of frequency (at least one visit), was 752 women (83.7%; 95% CI: 81.3–86.1); 263 women (35.0%; 95% CI: 31.6 – 38.4) received at least four antenatal visits and 46 women (6.1%; 95% CI: 4.4 - 7.8) received all recommended components of focused antenatal care. Previous pregnancy-related problems, paternal education and implementation of facilitation strategies were found to be significant factors enhancing focused antenatal care package intervention fidelity.Conclusion: Focused antenatal care package intervention fidelity in the study area was low; this may imply that the current level of maternal, perinatal and neonatal mortality might be partly due to the low level of focused antenatal care intervention fidelity. Improving implementation of facilitation strategies is highly required to contribute to the reduction of those mortalities.

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Intervention fidelity and its determinants of focused antenatal care package implementation, in South Wollo, Northeast Ethiopia.

10.21203/rs.3.rs-22069/v6 ◽

2021 ◽

Author(s):

Asressie Molla Tessema ◽

Abebaw Gebeyehu ◽

Solomon Mekonnen ◽

Kassahun Alemu ◽

Zemene Tigabu

Keyword(s):

Antenatal Care ◽

Low Income ◽

Linear Regression Analysis ◽

Weighted Average ◽

Low Income Countries ◽

Intervention Fidelity ◽

Health Extension Workers ◽

Northeast Ethiopia ◽

Focused Antenatal Care ◽

Care Package

Abstract Background: Focused antenatal care is directed at sustaining maternal health and improving fetal wellbeing to ensure birth of a healthy neonate. Failure to implement focused antenatal care can result in inability to reduce maternal and perinatal morbidity and mortality in low income countries. Due to evidence-practice gaps, however, thousands of maternal, fetal and neonatal lives are still lost every day, mostly from preventable causes. This study aimed to assess focused antenatal care package’s intervention fidelity and its determinant factors in South Wollo Zone, Northeast Ethiopia. Methods: A cross-sectional study design was employed and a total of 898 women who gave birth in the last six months prior to data collection were included. Also 16 health extension workers, working in ten selected health posts, were included. Interviews and self-administered questionnaires were used to collect data from mothers and health extension workers. Ten (10) health posts were audited to assess availability and functionality of drugs and supplies to provide focused antenatal care. Mothers were asked whether or not the required level of care was provided. Health extension workers were provided with self-administered questionnaires to assess socio-demographic characteristics, reception of training, facilitation strategies for the implementation of focused antenatal care and ability to classify danger signs. Multilevel linear regression analysis was performed to identify individual and organizational level’s factors influencing focused antenatal care package intervention fidelity. Results: Overall weighted average focused antenatal care package intervention fidelity (implemented as intended/planned) was 49.8% (95% CI: 47.7 – 51.8), which means the average number of focused antenatal care package interventions women received is 49.8%. Health extension workers implemented 55.1% and skilled providers (nurses, midwives, health officers or medical doctors) 44.9% of focused antenatal care package interventions. Overall antenatal care coverage, irrespective of frequency (at least one visit), was 752/898 women (83.7%; 95% CI: 81.3–86.1); 263/752 women (35.0%; 95% CI: 31.6 – 38.4) received at least four antenatal visits and only 46/752 women (6.1%; 95% CI: 4.4 - 7.8) received all recommended components of focused antenatal care. Previous pregnancy-related problems, paternal education and implementation of facilitation strategies were found to be significant factors enhancing focused antenatal care package intervention fidelity.Conclusion: Focused antenatal care package intervention fidelity in the study area was low; this may imply that the current level of maternal, perinatal and neonatal mortality might be partly due to the low level of focused antenatal care intervention fidelity. Improving implementation of facilitation strategies is highly required to contribute to the reduction of those mortalities.

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Intervention fidelity and its determinants of focused antenatal care package implementation, in South Wollo Zone, Northeast Ethiopia.

10.21203/rs.3.rs-22069/v3 ◽

2020 ◽

Author(s):

Asressie Molla Tessema ◽

Abebaw Gebeyehu ◽

Solomon Mekonnen ◽

Kassahun Alemu ◽

Zemene Tigabu

Keyword(s):

Antenatal Care ◽

Neonatal Mortality ◽

Linear Regression Analysis ◽

Weighted Average ◽

Intervention Fidelity ◽

Mortality Reduction ◽

Health Extension Workers ◽

Northeast Ethiopia ◽

Focused Antenatal Care ◽

Care Package

Abstract Background: Home and community-based implementation of focused antenatal care intervention packages have significantly reduced neonatal mortality particularly in resource constrained settings. However, due to evidence-practice gaps, thousands of neonates are still losing their lives every day mostly from preventable causes. This study aimed to assess focused antenatal care package intervention fidelity and its determinant factors in South Wollo Zone, Northeast Ethiopia. Methods: A cross-sectional study design was employed and a total of 898 women who gave birth in the last six months prior to data collection were included. Also 16 health extension workers working in health posts and 10 health posts for facility audits were included. Interviews and self-administered questionnaires were used to collect data from mothers and health extension workers. Facility audits were used to assess availability and functionality of drugs and supplies in the health posts to provide focused antenatal care. Mothers were asked whether or not the required level of care was provided. Health extension workers were provided self-administered questionnaires to assess socio-demographic characteristics, reception of training, facilitation strategies and ability to classify danger signs. Multilevel linear regression analysis was performed to identify individual and organizational levels factors influencing focused antenatal care package intervention fidelity. Results: Overall weighted average focused antenatal care package intervention fidelity (implemented as intended/planned) was 49.8% (95% CI: 47.7 – 51.8); of which 55.1% was implemented by health extension workers and 44.9% by skilled providers (nurses, midwives, health officers or medical doctors). Overall antenatal care coverage, irrespective of frequency, was 83.7% (95% CI: 81.3–86.1); 35.0% (95% CI: of 31.6 – 38.4) of them received at least four antenatal visits and 46 (6.1%, 95% CI: 4.4 - 7.8) received all recommended components of focused antenatal care. Previous pregnancy-related medical problems, paternal education, and implementation of supportive/facilitation strategies were found to be significant factors enhancing focused antenatal care package intervention fidelity.Conclusion: Focused antenatal care package intervention fidelity in the study area was low; this may imply that stagnation of neonatal mortality reduction might be partly due to the low level of focused antenatal care fidelity. Improving implementation of facilitation strategies is highly required to contribute in neonatal mortality reduction.

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Intervention fidelity and its determinants of focused antenatal care package implementation, in South Wollo Zone, Northeast Ethiopia.

10.21203/rs.3.rs-22069/v2 ◽

2020 ◽

Author(s):

Asressie Molla Tessema ◽

Abebaw Gebeyehu ◽

Solomon Mekonnen ◽

Kassahun Alemu ◽

Zemene Tigabu

Keyword(s):

Antenatal Care ◽

Neonatal Mortality ◽

Linear Regression Analysis ◽

Weighted Average ◽

Intervention Fidelity ◽

Mortality Reduction ◽

Health Extension Workers ◽

Northeast Ethiopia ◽

Focused Antenatal Care ◽

Care Package

Abstract Background: Studies show home and community-based implementation of intervention packages have significantly reduced neonatal mortality particularly in resource constrained settings. However, due to evidence-practice gap, thousands of neonates are still losing their lives every day mostly from preventable causes. This study aimed to assess focused antenatal care package intervention fidelity and its determinant factors in South Wollo Zone, Northeast Ethiopia. Methods: A cross-sectional study design was employed and a total of 898 mothers who gave birth in the last six months prior to data collection were included. Also sixteen health extension workers who were working in the health posts (n=10) selected for facility audits were included. Interview and self-administered questionnaires were used to collect data from mothers and health extension workers, respectively. Facility audits were used to assess the availability and functionality of required drugs and supplies for the health posts. Mothers were asked whether or not the required level of care were provided to them. Health extension workers were provided self-administered questionnaires to assess socio-demographic characteristics, reception of trainings, facilitation strategies and ability to classify danger signs. A multilevel linear regression analysis was performed to identify the individual and organizational levels factors influencing focused antenatal care package intervention fidelity. Results: The overall weighted average focused antenatal care package intervention fidelity was 49.78% (95% CI: 47.73 – 51.83). Of these, 62.02% (95% CI: 59.71 – 64.32) was provided by health extension workers and 56.57% (95% CI: 53.94 – 59.19) by skilled providers (nurses, midwifes, health officers or medical doctors). The overall antenatal care coverage was 83.7% (95% CI: 81.28 – 86.12); 34.97% (95% CI: of 31.56 – 38.39) of them received at least four antenatal visits and 6.12% (95% CI: 4.40-7.83) received all the recommended components of focused antenatal care. Previous pregnancy-related medical problems, paternal education, and implementation of supportive/facilitation strategy were found to be significant facilitators of focused antenatal care package intervention fidelity.Conclusion: Focused antenatal care package intervention fidelity in the study area was low, which may contribute to the stagnation of neonatal mortality reduction. Improving the implementation of facilitation strategies is highly required to produce a positive result in neonatal mortality reduction.

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Intervention fidelity and its determinants of focused antenatal care package implementation, in South Wollo, Northeast Ethiopia.

10.21203/rs.3.rs-22069/v4 ◽

2020 ◽

Author(s):

Asressie Molla Tessema ◽

Abebaw Gebeyehu ◽

Solomon Mekonnen ◽

Kassahun Alemu ◽

Zemene Tigabu

Keyword(s):

Antenatal Care ◽

Perinatal Death ◽

Linear Regression Analysis ◽

Weighted Average ◽

Intervention Fidelity ◽

Health Extension Workers ◽

Cross Sectional ◽

Northeast Ethiopia ◽

Focused Antenatal Care ◽

Care Package

Abstract Background: Rendering focused antenatal care activities are directed at sustaining the maternal health and improving the fetal wellbeing to ensure the delivery of a live healthy neonate. Failure to implement focused antenatal care package can results in inability to reduce maternal and neonatal morbidity and mortality, perinatal death and stillbirth in developing countries. However, due to evidence-practice gaps, thousands of maternal, fetal and neonatal lives are still losing every day mostly from preventable causes. This study aimed to assess focused antenatal care package intervention fidelity and its determinant factors in South Wollo Zone, Northeast Ethiopia. Methods: A cross-sectional study design was employed and a total of 898 women who gave birth in the last six months prior to data collection were included. Also 16 health extension workers, working in the selected 10 health posts for facility audits, were included. Interviews and self-administered questionnaires were used to collect data from mothers and health extension workers. Facilities (Health posts) were audited to assess availability and functionality of drugs and supplies in the health posts to provide focused antenatal care. Mothers were asked whether or not the required level of care was provided. Health extension workers were provided self-administered questionnaires to assess socio-demographic characteristics, reception of training, facilitation strategies and ability to classify danger signs. Multilevel linear regression analysis was performed to identify individual and organizational levels factors influencing focused antenatal care package intervention fidelity. Results: Overall weighted average focused antenatal care package intervention fidelity (implemented as intended/planned) was 49.8% (0.498) (95% CI: 47.7 – 51.8); which means the average amount of focused antenatal care package intervention a mother received is 49.8% (0.498). Of which 55.1% was implemented by health extension workers and 44.9% by skilled providers (nurses, midwives, health officers or medical doctors). Overall antenatal care coverage, irrespective of frequency (at least one visit), was 752 women (83.7%; 95% CI: 81.3–86.1); 263 women (35.0%; 95% CI: of 31.6 – 38.4) of them received at least four antenatal visits and 46 women (6.1%, 95% CI: 4.4 - 7.8) received all recommended components of focused antenatal care. Previous pregnancy-related problems, paternal education, and implementation of supportive/facilitation strategies were found to be significant factors enhancing focused antenatal care package intervention fidelity.Conclusion: Focused antenatal care package intervention fidelity in the study area was low; this may imply that the current level of maternal, perinatal, neonatal mortality and stillbirth might be partly due to the low level of focused antenatal care fidelity. Improving implementation of facilitation strategies is highly required to contribute to the reduction of those mortalities.

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Intervention fidelity and its determinants of focused antenatal care package implementation, in South Wollo, Northeast Ethiopia

10.21203/rs.3.rs-17928/v1 ◽

2020 ◽

Author(s):

Asressie Molla Tessema ◽

Abebaw Gebeyehu ◽

Solomon Mekonnen ◽

Kassahun Alemu ◽

Zemene Tigabu

Keyword(s):

Antenatal Care ◽

Neonatal Mortality ◽

Weighted Average ◽

Organizational Level ◽

Antenatal Visit ◽

Intervention Fidelity ◽

Health Extension Workers ◽

Paternal Education ◽

Focused Antenatal Care ◽

Care Package

Abstract Background: Evidences show that intervention packages at home-community setting are found to reduce neonatal mortality significantly. But millions of neonates are still dying by preventable causes with the implementation of these effective interventions. This might be due to evidence-practice gap. Therefore, this study aimed at assessing the intervention fidelity and factors influencing focused antenatal care package. Methods:Cross-sectional study design was employed in this study. In the selected kebeles’, a total of 898 mothers who gave birth within six months before data collection, ten health posts with their health extension workers were employed. Interview-administered, self-administered and facility audit checklist were used for collecting data from all mothers, health extension workers and health posts respectively. Mothers were asked whether or not the required level of care were provided to them. Health extension workers & health posts were assessed for the competency and organizational drivers. Multilevel linear regression model were used to identify the possible moderating factors at individual and organizational level for intervention fidelity. Result: The overall weighted average focused antenatal care package intervention fidelity was 49.78% (95% CI: 47.73 – 51.83). The weighted average focused antenatal care package intervention fidelity by health extension workers was 62.02% (95% CI: 59.71 – 64.32) and skilled providers were 56.57% (95% CI: 53.94 – 59.19). The overall antenatal care coverage were 83.7% (95% CI: 81.28 – 86.12) with 34.97% (95% CI: of 31.56 – 38.39) of mothers received at least four antenatal visit and 6.12% (95% CI: 4.40-7.83) of them received all the recommended components of focused antenatal care. Previous maternal problem, paternal education and implementation of supportive/facilitation strategy were significant facilitators for focused antenatal care package intervention fidelity.Conclusion: In this study, focused antenatal care package intervention fidelity was low. This implies that the stagnation of neonatal mortality reduction might be partly due to the low focused antenatal care packages intervention fidelity. Paternal education and implementation of supportive/facilitation strategies were statistically significant facilitators of focused antenatal care intervention package fidelity. Therefore, improvement of implementation of facilitation strategy is recommended.

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Intervention fidelity and its determinants of focused antenatal care package implementation, in South Wollo, Northeast Ethiopia.

10.21203/rs.3.rs-22069/v1 ◽

2020 ◽

Author(s):

Asressie Molla Tessema ◽

Abebaw Gebeyehu ◽

Solomon Mekonnen ◽

Kassahun Alemu ◽

Zemene Tigabu

Keyword(s):

Antenatal Care ◽

Neonatal Mortality ◽

Weighted Average ◽

Organizational Level ◽

Antenatal Visit ◽

Intervention Fidelity ◽

Health Extension Workers ◽

Paternal Education ◽

Focused Antenatal Care ◽

Care Package

Abstract Introduction Evidences show that intervention packages at home-community setting are found to reduce neonatal mortality significantly. But millions of neonates are still dying by preventable causes with the implementation of these effective interventions. This might be due to evidence-practice gap. Therefore, this study aimed at assessing the intervention fidelity and factors influencing focused antenatal care package. Methods Cross-sectional study design was employed in this study. In the selected kebeles’, a total of 898 mothers who gave birth within six months before data collection, ten health posts with their health extension workers were employed. Interview-administered, self-administered and facility audit checklist were used for collecting data from all mothers, health extension workers and health posts respectively. Mothers were asked whether or not the required level of care were provided to them. Health extension workers & health posts were assessed for the competency and organizational drivers. Multilevel linear regression model were used to identify the possible moderating factors at individual and organizational level for intervention fidelity. Result The overall weighted average focused antenatal care package intervention fidelity was 49.78% (95% CI: 47.73 – 51.83). The weighted average focused antenatal care package intervention fidelity by health extension workers was 62.02% (95% CI: 59.71 – 64.32) and skilled providers were 56.57% (95% CI: 53.94 – 59.19). The overall antenatal care coverage were 83.7% (95% CI: 81.28 – 86.12) with 34.97% (95% CI: of 31.56 – 38.39) of mothers received at least four antenatal visit and 6.12% (95% CI: 4.40-7.83) of them received all the recommended components of focused antenatal care. Previous maternal problem, paternal education and implementation of supportive/facilitation strategy were significant facilitators for focused antenatal care package intervention fidelity. Conclusion In this study, focused antenatal care package intervention fidelity was low. This implies that the stagnation of neonatal mortality reduction might be partly due to the low focused antenatal care packages intervention fidelity. Paternal education and implementation of supportive/facilitation strategies were statistically significant facilitators of focused antenatal care intervention package fidelity. Therefore, improvement of implementation of facilitation strategy is recommended.

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Reducing the distance to walk: establishing a remote maternity facility in Runga, Hoima District, Uganda

African Journal of Midwifery and Women s Health ◽

10.12968/ajmw.2019.0012 ◽

2020 ◽

Vol 14 (2) ◽

pp. 1-8

Author(s):

Rhiannon Grindle ◽

Sofia Giannopoulou ◽

Harriet Jacobs ◽

Jerome Barongo ◽

Alexandra Elspeth Cairns

Keyword(s):

Antenatal Care ◽

Maternal Mortality ◽

Health Facility ◽

Low Income ◽

Local Level ◽

Substantial Reduction ◽

Care Quality ◽

Low Income Countries ◽

Health Seeking ◽

Birth Attendance

Despite a substantial reduction in global maternal mortality, rates in low-income countries remain unacceptably high. Multiple contributing factors exist, grouped into three delays: health-seeking behaviour; accessibility of care; quality of care. In the Hoima District, rates of health facility delivery and skilled birth attendance remain low and maternal mortality exceeds the national average. Establishing the Midwives At Maternity Azur Clinic (February 2017) has addressed these issues at a local level. Health education and antenatal care are provided at the clinic, encouraging women to seek timely, appropriate intrapartum care. Access from surrounding villages is facilitated by a waiting home and weekly transport for antenatal care, alongside transport to a health facility with a staffed operating theatre, when required. It is run by a resident midwife, with regular training updates, and is stocked with the necessary resources for quality healthcare. Since its advent, village leaders report all-cause burials have reduced from one a day to one a week.

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Counseling at all contacts for postpartum contraceptive use: can paper-based tools help community health workers improve continuity of care? A qualitative study from Ethiopia

Gates Open Research ◽

10.12688/gatesopenres.13071.1 ◽

2019 ◽

Vol 3 ◽

pp. 1652 ◽

Cited By ~ 1

Author(s):

Muluneh Yigzaw Mossie ◽

Anne Pfitzer ◽

Yousra Yusuf ◽

China Wondimu ◽

Eva Bazant ◽

...

Keyword(s):

Decision Making ◽

Health System ◽

Community Health ◽

Low Income ◽

Health Workers ◽

Continuum Of Care ◽

Low Income Countries ◽

Health Extension Workers ◽

Pregnancy Risk ◽

The Continuum

Background: Globally, there has been a resurgence of interest in postpartum family planning (PPFP) to advance reproductive health outcomes. Few programs have systematically utilized all contacts a woman and her baby have with the health system, from pregnancy through the first year postpartum, to promote PPFP. Nested into a larger study covering two districts, this study assessed the use, acceptability, and feasibility of tools for tracking women’s decision-making and use of PPFP in the community health system in Oromia region, Ethiopia. Community-level tracking tools included a modified Integrated Maternal and Child Health (IMCH) card with new PPFP content, and a newly developed tool for pregnant and postpartum women for use by Women Development Armies (WDAs). Proper completion of the tools was monitored during supervision visits. Methods: In-depth interviews and focus group discussions were conducted with health officials, health extension workers, and volunteers. A total of 34 audio-files were transcribed and translated into English, double-coded using MAXQDA, and analyzed using a thematic approach. Results: The results describe how HEWs used the modified IMCH card to track women’s decision making through the continuum of care, to assess pregnancy risk and to strengthen client-provider interaction. Supervision data demonstrated how well HEWs completed the modified IMCH card. The WDA tool was intended to promote PPFP and encourage multiple contacts with facilities from pregnancy to extended postpartum period. HEWs have reservations about the engagement of WDAs and their use of the WDA tool. Conclusions: To conclude, the IMCH card improves counseling practices through the continuum of care and is acceptable and feasible to apply. Some elements have been incorporated into a revised national tool and can serve as example for other low-income countries with similar community health systems. Further study is warranted to determine how to engage WDAs in promoting PPFP.

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A Ten Years Retrospective Study of Hysterectomy in Goba Referral Hospital, Bale Zone, South East Ethiopia, Magnitude Indications and Outcomes

10.21203/rs.3.rs-77029/v1 ◽

2020 ◽

Author(s):

Aklilu Getachew ◽

Takele Mengistu ◽

Yaregal Asres

Keyword(s):

Retrospective Study ◽

Antenatal Care ◽

Low Income ◽

Uterine Rupture ◽

Female Genital Tract ◽

Referral Hospital ◽

Low Income Countries ◽

Categorical Variables ◽

P Value

Abstract Background: Hysterectomy is one of the major surgeries performed in clinical practice for commonly encountered diseases of the female genital tract worldwide. Even if Hysterectomy is widely performed surgery in both developed and low income countries little is known about is epidemiology in rural part of develop countries. Especially in developing countries like Ethiopia representative reliable statistics are rarely available on this important aspect of women’s health mainly on its prevalence, indication and outcome. So the aim of this study was to assess the magnitude indication and outcome of hysterectomy in Goba Referral Hospital from January 1, 2008 to January1, 2018. Methods: institutional based retrospective study was conducted in Goba Referral Hospital. Self-administered structured checklists were used to collect the data. The data were entered into Epi data version 3.1 and analyzed by SPSS version 20. Continuous and categorical variables were summarized by tables, graph and descriptive statistics. Logistic regression was used to determine association between predictors and Hysterectomy prevalence. P-value <0.05 was -considered as statistically significant. Results: a total of 200 hysterectomies were done for obstetrics and gynecology indications, of which the commonest, 47% (n=94), indication was uterine rupture. From the total of 116 women, who had no antenatal care follow up, 40% (n=47) had uterine rupture. This study also indicated that, most of uterine rupture cases 80% (n=76) were living far away from the hospital (> 50km from the hospital) 94.6% (n-89) were multiparous. This study has also indicated that from the total of 20 discharged dead, 90% (n=18)) were came from a distance of >100km far from the hospital and 95% (n=19) were those who didn’t attend antenatal care. Conclusions: the higher rate of uterine rupture was seen in those who were multi Para, far from Hospitals and those who have no ANC follow up. Large scale study for the identification of determinant factors for evidence based intervention will be very important.

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