scholarly journals Cesarean delivery rates, hospital readiness and quality of clinical management in Ethiopia: national results from two cross-sectional emergency obstetric and newborn care assessments

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Misrak Getnet Beyene ◽  
Theodros Getachew Zemedu ◽  
Azmach Hadush Gebregiorgis ◽  
Ana Lorena Ruano ◽  
Patricia E. Bailey
Keyword(s):  
Cesarean Delivery ◽  
Clinical Management ◽  
Unmet Need ◽  
Newborn Care ◽  
Public Hospitals ◽  
Cross Sectional ◽  
For Profit ◽  
Robson Classification ◽  
Hospital Readiness

Abstract Background Cesarean delivery (CD) rates have reached epidemic levels in many high and middle income countries while increasingly, low income countries are challenged both by high urban CD rates and high unmet need in rural areas. The managing authority of health care institutions often plays a role in these disparities. This paper shows changes between 2008 and 2016 in Ethiopian CD rates, readiness of hospitals to provide CD and quality of clinical care, while highlighting the role of hospital management authority. Methods This secondary data analysis draws from two national cross-sectional studies to assess emergency obstetric and newborn care. The sample includes 111 hospitals in 2008 and 316 hospitals in 2016, and 275 women whose CD chart was reviewed in 2008 and 568 in 2016. Descriptive statistics are used to describe our primary outcome measures: population- and institutional-based CD rates; hospital readiness to perform CD; quality of clinical management, including the relative size of Robson classification groups. Results The national population CD rate increased from 2008 to 2016 (< 1 to 2.7%) as did all regional rates. Rates in 2016 ranged from 24% in urban settings to less than 1% in several rural regions. The institutional rate was 54% in private for-profit hospitals in 2016, up from 46% in 2008. Hospital readiness to perform CDs increased in public and private for-profit hospitals. Only half of the women whose charts were reviewed received uterotonics after delivery of the baby, but use of prophylactic antibiotics was high. Partograph use increased from 9 to 42% in public hospitals, but was negligible or declined elsewhere. In 2016, 40% of chart reviews from public hospitals were among low-risk nulliparous women (Robson groups 1&2). Conclusions Between 2008 and 2016, government increased the availability of CD services, improved public hospital readiness and some aspects of clinical quality. Strategies tailored to further reduce the high unmet need for CD and what appears to be an increasing number of unnecessary cesareans are discussed. Adherence to best practices and universal coverage of water and electricity will improve the quality of hospital services while the use of the Robson classification system may serve as a useful quality improvement tool.

scholarly journals Use and Quality of Cesarean Delivery in a Low and Middle Income Setting: National Results from Two Emergency Obstetric and Newborn Care Assessments

2020 ◽  
Author(s):  
Misrak Getnet Beyene ◽  
Theodros Getachew Zemedu ◽  
Azmach Hadush Gebregiorgis ◽  
Ana Lorena Ruano ◽  
Patricia E Bailey
Keyword(s):  
Cesarean Delivery ◽  
Low Income ◽  
Unmet Need ◽  
Newborn Care ◽  
Public Hospitals ◽  
Middle Income ◽  
For Profit ◽  
Robson Classification ◽  
Hospital Readiness

Abstract Background: Cesarean delivery (CD) rates have reached epidemic levels in many high and middle income countries while increasingly, low income countries are challenged both by high urban CD rates and high unmet need in rural areas. The managing authority of health care institutions often plays a role in these disparities. This paper shows changes between 2008 and 2016 in CD rates and the capacity of the Ethiopian health system to deliver quality CD services, highlighting the role of the management sector.Methods: We compare results from two national cross-sectional emergency obstetric and newborn care assessments using descriptive statistics. The sample includes 111 hospitals in 2008 and 316 hospitals in 2016, and 275 CD case reviews in 2008 and 568 in 2016. Our primary outcome measures include population- and institutional-based CD rates; hospital readiness to perform CD; quality of clinical management; and the relative size of Robson classification groupsResults: The national population-based rate increased (< 1% to 2.7%) as did all regional rates. Rates ranged from 24% in urban settings to less than 1% in several rural regions. The institutional rate was 54% in the private for-profit sector in 2016, up from 46% in 2008. Hospital readiness to perform CDs increased in public and for-profit hospitals. Only half of the women whose cases were reviewed received uterotonics after delivery of the baby, but use of prophylactic antibiotics was high. Partograph use increased from 9% to 42% in public hospitals, but was negligible or declined elsewhere. In 2016, a third of case reviews from the public sector were among low-risk nulliparous women (Robson group 1).Conclusions: Between 2008 and 2016, government increased the availability of CD services, improved public hospital readiness and some aspects of clinical quality. Strategies tailored to further reduce the high unmet need for CD and what appears to be an increasing number of unnecessary cesareans are discussed. Adherence to best practices and universal coverage of water and electricity will improve the quality of hospital services while the use of the Robson classification system may serve as a useful quality improvement tool.

THE QUALITY OF PUBLIC HOSPITALS IN CAN THO CITY, 2016

2018 ◽  
Vol 8 (6) ◽  
pp. 76-81
Author(s):  
Chu Cao Minh ◽  
Thang Vo Van ◽  
Dat Nguyen Tan ◽  
Hung Vo Thanh
Keyword(s):  
Hospital Medicine ◽  
Secondary Data ◽  
Quality Criterion ◽  
Quality Criteria ◽  
Public Hospitals ◽  
Ministry Of Health ◽  
Cross Sectional ◽  
Significant Difference ◽  
Can Tho City

Background: The criteria set of assessing hospital quality in Vietnam in 2016 was revied from the criteria set in 2013 by the Ministry of Health in order to help hospitals to self-assess towards improvinge quality of hospitals in the international integration context. The study aimed to assess the quality of public hospitals in Can Tho City according to the revised criteria set of the Ministry of Health in 2016 and compare the quality among three hospital ranks (including grade I, grade II, and grade III) via to 5 groups of quality criteria. Methods: A cross-sectional study, using secondary data analysis was applied to assess the service quality of 7 general public hospitals in Can Tho City. Results: The average total score of 7 hospitals is 245 and the average for the criteria of 7 hospitals is 2.99, which is just satisfactory. In the criterion of quality, criterion D and E had the lowest scores compared to the other three groups. There was no statistically significant difference (p = 0.076) among the mean scores for the three hospital categories. Conclusion: The quality of public hospitals in Can Tho city in 2016 only reached moderately good level (2.99). Interventions should be developed to improve the quality of hospitals, with particular emphasis on improving the quality of criteria groups D and E. Key words: Quality, hospital, medicine, health, public, Can Tho

Quality of Life of Healthcare Workers Suffering from Occupational Contact Dermatitis

2021 ◽  
Vol 15 ◽  
Author(s):  
Amira Omrane ◽  
Asma Khedher ◽  
Chayma Harrathi ◽  
Maher Maoua ◽  
Taoufik Khalfallah ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Contact Dermatitis ◽  
Healthcare Workers ◽  
Female Gender ◽  
Public Hospitals ◽  
Healthcare Personnel ◽  
Related Factors ◽  
Cross Sectional ◽  
Occupational Contact Dermatitis

Background: Healthcare workers are at a high risk of developing Occupational Dermatitis (OD). Affected workers often experience severe impairment of their Quality of Life (QoL). This study aimed to assess the skin-related QoL of healthcare workers with OD and to explore its related factors. Methods: A cross-sectional and exhaustive study was conducted among healthcare personnel of four public hospitals in the central region of Tunisia. All the cases of OD declared were included. Skin-related QoL was assessed using the validated Tunisian version of the “Dermatology Life Quality Index” (DLQI). Some related patents were discussed. Results: A total of 37 cases of OD were collected with an annual incidence of 4.2 cases per 10000 workers. The population was predominantly female (73%) and mean aged 44.7±9.4 years. Nurses were the most represented occupational category (38%). Allergic contact dermatitis was the most frequent diagnosis (96%). Use of gloves was the most frequently reported occupational hazard (86%). The most frequently affected sites were hands (97%). The median score of DLQI was five. Multivariate analysis showed an association between the impairment of skin-related QoL and female gender (p = 0.04; OR = 19.3,84), exposure to disinfecting chemicals in the workplace (p = 0.01; OR = 17,306) and the absence of occupational reclassification (p = 0.01; OR = 21,567). Conclusion: About one third of the population had an impaired quality of life. The score impairment was significantly related to female gender, exposure to disinfecting chemicals and the absence of occupational reclassification.

scholarly journals Quality of life and its associated factors among epileptic patients attending public hospitals in North Wollo Zone, Northeast Ethiopia: A cross-sectional study

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247336
Author(s):  
Ayelign Mengesha Kassie ◽  
Biruk Beletew Abate ◽  
Mesfin Wudu Kassaw ◽  
Addisu Getie ◽  
Adam Wondmieneh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Public Hospitals ◽  
Evil Spirit ◽  
Health Related Quality ◽  
Cross Sectional ◽  
Life Score ◽  
Epileptic Patients ◽  
Related Quality ◽  
Health Related

Background Epilepsy is thought to be caused by witchcraft, evil spirit, and God’s punishment for sins in many developing countries. As a result, people with epilepsy and their families usually suffer from stigma, discrimination, depression, and other psychiatric problems. Thus, this study aimed to assess the quality of life and its associated factors among epileptic patients attending public hospitals in North Wollo Zone, Northeast Ethiopia. Methods An institution-based cross-sectional study design was employed in this study. A simple random sampling technique was utilized. Health-related quality of life was measured based on the total score of the Quality of Life in Epilepsy Inventory (QOLIE-31) instrument. Data were entered into Epi-data 3.1 statistical package and exported to SPSS Version 20 for further analysis. Linear regression models were used to assess the relationship between quality of life and the independent variables. Statistically significant values were declared at a P-value of < 0.05. Results A total of 395 patients participated in the study making the response rate 98.5%. The mean age of the participants was 32.39 ±10.71 years. More than half, 199 (50.4%) of epileptic patients had an overall weighted average health related quality of life score of mean and above. Male sex (B = 4.34, 95%CI, 0.41, 8.27, P = 0.03), higher educational status (B = 7.18, 95%CI, 1.39, 13.00, P = 0.015) and age at onset of epilepsy (B = 0.237, 95%CI, 0.02, 0.45, P = 0.035) were associated with increased health related quality of life score. On the other hand, family history of epilepsy (B = -4.78, 95%CI,-9.24,-0.33, P = 0.035), uncontrolled seizure (B = -11.08, 95%CI,-15.11,-7.05, P < 0.001), more than 5 pre-treatment number of seizures (B = -4.86, 95%CI,-8.91,-0.81, P = 0.019), poor drug adherence (B = -11.65, 95%CI,-16.06,-7.23, P < 0.001), having moderate (B = -4.526, 95%CI,-8.59,-0.46, P = 0.029) to sever (B = -12.84, 95%CI,-18.30,-7.37, P < 0.001) anxiety and depression, believing that epilepsy is caused by evil spirit (B = -7.04, 95%CI,-11.46,-2.61, P = 0.002), drinking alcohol (B = -5.42, 95%CI,-10.72,-0.13, P = 0.045), and having other co-morbidities (B = -9.35, 95%CI,-14.35,-4.36, P < 0.001) were significantly negatively associated with the health related quality of life score among epileptic patients. Conclusions Only around half of the epileptic patients have a good health-related quality of life. In addition, multiple variables including family history, uncontrolled seizure, and poor drug adherence were associated with quality of life among epileptic patients. Hence, targeting these variables in epilepsy management is recommended.

scholarly journals Quality of Care Delivered to Tuberculosis Patients among Public Hospitals in Central Northeast Ethiopia

2020 ◽  
Vol 30 (5) ◽  
Author(s):  
Balkew Asegidew Tegegn ◽  
Betregiorgis Zegeye Hailu ◽  
Birhanu Damtew Tsegaye ◽  
Gashaw Garedew Woldeamanuel ◽  
Wassie Negash
Keyword(s):  
Quality Of Service ◽  
Quality Of Care ◽  
Quality Of Healthcare ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Binary Logistic Regression Analysis ◽  
Cross Sectional ◽  
The Mean ◽  
Process Dimension

BACKGROUND: Inappropriate Tuberculosis (TB) diagnosis and treatment contributes to unfavorable health outcome among TB patients. Improving quality of healthcare service helps to avert TB related morbidity. Despite these facts, the level of quality of service is not known in the hospitals. Hence, the present study was conducted to assess the quality of care delivered to TB patients among publichospitals.METHODS: A facility-based cross-sectional study was conducted from March 15 to April 30, 2019 in North Shewa Zone, Amhara region, Ethiopia. All TB patients who had follow-up in the hospitals were included. This resulted in the involvement of 82 TB patients. Data was collected by trained data collectors using facility audit, clinical observation checklists, structured questionnaire and in-depth interview. Data was analyzed using SPSS version 20. Binary logistic regression analysis was done to identify the predictors of patients’ satisfaction.RESULTS: In this study, 82 respondents with a mean age of 36.48 (±13.27) years were participated. The mean quality score for structural dimension was 59.5%, and 53.7% of participants were found to be satisfied in outcome dimension. The mean score for process dimension of quality of service were 67.9%. Having TB symptoms were significantly associated with the level of patientsatisfaction towards TB care [AOR = 0.217, p = 0.015].CONCLUSION:Quality of TB services from structural and outcome dimension were low and higher in process dimension. Thus, careful attention on the quality of services will help to reduce the burden of TB.

scholarly journals Working hours and health in nurses of public hospitals according to gender

2017 ◽  
Vol 51 (0) ◽  
Author(s):  
Juliana da Costa Fernandes ◽  
Luciana Fernandes Portela ◽  
Rosane Härter Griep ◽  
Lúcia Rotenberg
Keyword(s):  
Rio De Janeiro ◽  
Reference Group ◽  
Working Hours ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Cross Sectional ◽  
Long Working Hours ◽  
Self Rated Health ◽  
Janeiro State

ABSTRACT OBJECTIVE To assess the association between weekly working hours and self-rated health of nurses in public hospitals in Rio de Janeiro, State of Rio de Janeiro, Brazil. METHODS A total of 3,229 nurses (82.7% of the eligible group) participated in this cross-sectional study, carried out between April 2010 and December 2011. The collection instrument consisted of a self-administered multidimensional questionnaire. The weekly working hours were calculated from a recall of the daily hours worked over seven consecutive days; this variable was categorized according to tertiles of distribution for men and women. The outcome of interest, self-rated health, was categorized into three levels: good (very good and good), regular, and poor (poor and very poor). The statistical analysis of the data included bivariate and multivariate analyses, having as reference group those with short working hours (first tertile). All the analyses were stratified by gender and elaborated using the program SPSS. RESULTS Among women, the group corresponding to the longest working week (more than 60.5 hours per week) were more likely to report regular self-rated health, compared with those with shorter working hours, after adjusting for confounding factors (OR = 1.30; 95%CI 1.02–1.67). Among men, those with average working hours (49.5–70.5 hours per week) were more than twice as likely to rate their health as regular (OR = 2.17; 95%CI 1.08–4.35) compared to those with shorter working hours (up to 49.5 hours). There was no significant association between long working hours and poor self-rated health. CONCLUSIONS The results point to the urgent need to promote interventions in the organization of work and appreciation of the nursing profession, in order to reduce the number of multiple jobs and thus contribute to mitigate potential effects on the health of workers and the quality of care in hospitals.

scholarly journals Health-related quality of life and associated factors among epileptic patients on treatment follow up at public hospitals of Wollega zones, Ethiopia, 2018

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Muktar Abadiga ◽  
Getu Mosisa ◽  
Tadele Amente ◽  
Adugna Oluma
Keyword(s):  
Quality Of Life ◽  
Associated Factors ◽  
Public Hospitals ◽  
Health Related Quality ◽  
Cross Sectional ◽  
Significance Level ◽  
Epileptic Patients ◽  
Related Quality ◽  
Health Related

Abstract Objective The aim of this study was to assess health-related quality of life and its associated factors among epileptic patients in public hospitals of Wollega zones, Ethiopia. Institutional based cross-sectional study was conducted on 402 epileptic patients, from March 01 to March 30, 2018. Multiple linear regression with backward elimination was used, and all analyses were conducted at the 0.05 significance level. Results The overall mean total score on the WHOQOL-BREF scale was 60.47 with ± 23.07 SD. Monthly income ≤ 500 EB (β = − 12.49, P < 0.001), living alone (β = − 7.11, P = 0.007), adverse drug reaction (β = − 10.86, P < 0.001), comorbidity of anxiety (β = − 12.99, P < 0.001), perceived social stigma (β = − 9.73, P < 0.001) and frequency of seizure once per week (β = − 8.41, P = 0.001) were negatively associated with quality of life of epileptic patients. The mean quality of life of patients living with epilepsy in this study was low. The clinician should early recognize and treat drug side effects, detect and manage comorbidity, and control seizure in order to increase quality of life of epileptic patients.

scholarly journals Evaluation of caesarean section practices according to Robson's 10-group classification at a level two maternity ward in Conakry, Guinea

2019 ◽  
Vol 8 (11) ◽  
pp. 4468
Author(s):  
Daniel W. A. Leno ◽  
Mamoudou E. Bah ◽  
Jerry C. Moumbagna ◽  
Tamba M. Millimouno ◽  
David Lamah ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Medical Center ◽  
Caesarean Section Rate ◽  
Relative Size ◽  
Newborn Care ◽  
Fetal Distress ◽  
Cross Sectional Study ◽  
Maternity Ward ◽  
Cross Sectional ◽  
Robson Classification

Background: The frequency of caesarean sections (CS) increased dramatically in the world over the last twenty years. The objective of this study was to evaluate caesarean section practices based on Robson classification in an urban referral hospital in Conakry, GuineaMethods: We conducted a cross-sectional study of 2,266 birthing records collected at the maternity ward of the Coronthie Communal Medical Center in Conakry, from January 1st to December 31st 2016. We included in the study all women who had a caesarean section and whose medical records were complete. Robson's classification was used to classify women into 10 groups based on maternal and fetal characteristics. The relative size of each group, its gross caesarean section rate as well as its contribution to overall caesarean section rate and the main caesarean section indications were calculated.Results: In 2016, 769 caesarean sections were performed out of 2,266 deliveries, corresponding to a hospital section rate of 33.9%. Groups 5 (11.0%), 1 (4.8%), and 3 (4.3%) of the Robson classification were the most contributors to registered hospital caesarean section rate. The main indications for caesarean section were uterine scar in group 5 and acute fetal distress in groups 1 and 3.Conclusions: The systematic reference to the Robson classification could help to identify and avoid the relative indications of the caesarean section in urban Guinea. Besides, increasing induction of labor and strengthening providers’ capacities in emergency obstetric and newborn care services could contribute to reduce caesarean section rates in Guinea.

scholarly journals Perbedaan Komunikasi Terapeutik Perawat Di Ruang Rawat Inap RS Pemerintah Dan RS Swasta

2017 ◽  
Vol 12 (1) ◽  
pp. 43
Author(s):  
Nova Fitria ◽  
Zahroh Shaluhiyah
Keyword(s):  
Job Satisfaction ◽  
Private Hospital ◽  
Work Motivation ◽  
Work Climate ◽  
Public Hospitals ◽  
Therapeutic Communication ◽  
Cross Sectional ◽  
Private Hospitals ◽  
Government Hospitals

ABSTRAKDengan adanya kesetaraan peran rumah sakit pemerintah dan rumah sakit swasta dalam meningkatkan kualitas layanan kesehatan di Indonesia, maka setiap rumah sakit harus memberikan pelayanan yang baik dan berkualitas. Perawat merupakan bagian dari SDM Rumah Sakit yang memberikan pengaruh cukup besar terhadap kualitas pelayanan. Pelaksanaan asuhan keperawatan yang baik tidak dapat dipisahkan dari peran komunikasi terapeutik yang dilakukan oleh perawat yang juga merupakan salah satu upaya peningkatan pelayanan kepada pasien. Jenis penelitian ini adalah penelitian kuantitatif dengan desain penelitian menggunakan cross-sectional. Hasil penelitian menunjukkan ada perbedaan yang signifikan pada pelaksanaan komunikasi terapeutik perawat di RS Pemerintah dan di RS Swasta, dimana pelaksanaan komunikasi terapeutik perawat di RS swasta lebih baik. Faktor-faktor yang berhubungan secara signifikan dengan pelaksanaan komunikasi terapeutik perawat di RS Pemerintah dan di RS Swasta adalah sama, yaitu variabel kepuasan kerja, motivasi kerja, iklim kerja, dukungan teman kerja dan dukungan kepala ruang. Faktor yang paling dominan berpengaruh terhadap kepatuhan perawat di RS Pemerintah dalam melaksanakan komunikasi terapeutik adalah motivasi kerja (OR 36,866); sedangkan di RS Swasta adalah dukungan kepala ruang (OR 28,598). Perbedaan yang bermakna antara RS Pemerintah dengan RS Swasta nampak pada variabel: umur, masa kerja, sikap, kepuasan kerja, motivasi kerja, iklim kerja, dukungan teman kerja, dukungan kepala ruang, dan pelaksanaan komunikasi terapeutik itu sendiri. Kata Kunci: Pelaksanaan, Komunikasi Terapeutik, RS Pemerintah-RS Swasta Differences Therapeutic Communication Nurse In Inpatient Room Government Hospital And Private Hospital;quality role of government hospitals and private hospitals in improving the quality of health services in Indonesia, causing every hospital should provide a good service and quality. Nurses are part of hospital human resource that considerable influence on the quality of service, and the implementation of good nursing care can not be separated from therapeutic communication. the optimal implementation of therapeutic communication by nurse is one of the efforts to improve services to the patients. The type of this research was quantitative with cross-sectional study. The results showed a significant differences in the implementation of nurses therapeutic communication between public hospitals and private hospitals, where the implementation of nurses therapeutic communication in private hospital are better. Associated factors significantly with the implementation of nurses therapeutic communication in public hospitals and in private hospitals are the same, the variables are job satisfaction, work motivation, work climate, coworkers support and head of ward support. The most dominant factor that affects the compliance of nurses in government hospitals in implementing therapeutic communication is work motivation (OR 36.866), while in private hospitals is head of ward support (OR 28.598). Significant differences between the government hospitals and private hospitals appears on variables: age, period of work, attitude, job satisfaction, work motivation, work climate, coworker support, head of ward support, and the implementation of therapeutic communication itself. Keywords: Implementation, Therapeutic Communication, Government-Private Hospital

Patients’ perspectives of emergency care quality and priorities for care improvement

2017 ◽  
Vol 22 (4) ◽  
pp. 234-245 ◽  
Author(s):  
Lily Yarney ◽  
Roger Ayimbillah Atinga
Keyword(s):  
Emergency Care ◽  
Principal Component ◽  
Care Quality ◽  
Public Hospitals ◽  
Cross Sectional ◽  
Content Type ◽  
Logistic Regression Models ◽  
Central Regions ◽  
Care Improvement

Purpose Studies have examined strategies implemented to strengthen quality of emergency care in healthcare provider institutions in Ghana. But few studies have focused on what determines quality of emergency care from the patient’s perspective. The purpose of this paper is to fill that gap by examining factors salient to gauging quality of emergency care and priority areas for care improvement. Design/methodology/approach Cross-sectional data were collected from patients admitted in emergency units of public hospitals in two regions: Greater Accra and Central Regions. A structured questionnaire designed with inputs from emergency medicine physicians and patients was used to collect data from 381 patients. Principal component analysis (PCA) and logistic regression models were computed to respectively determine salient measures of emergency care quality and their association with patient overall perceived quality of emergency care. Findings Using the PCA, four factors (social and relational care, attentive prehospitalised care, ward quality and privacy and medical supplies) were derived as salient measures of emergency care quality. All the factors derived had statistically significant association with patient overall perception of quality. Originality/value Emergency care quality improvement strategies that incorporate the dimensions identified can produce effective therapeutic outcomes.

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