Assessment of Quality of Health Care in Jimma Zone, Southwest Ethiopia

BACKGROUND: Quality of care is an important aspect of health care delivery system that is given a priority. Quality is a multidimensional concept that has been defined in various ways. Variation in quality of care between different health care facilities is thought to reflect differences in efficiency and other organizational factors. There was no adequate study related to quality of health care in Jimma zone. Therefore, the objective of this study was to assess quality of health care in Jimma zone.METHODS: A cross sectional quantitative study design was employed to assess the quality of care with respect to structure, care process and customer satisfaction involving 640 patients and 96 care providers in Jimma zone, southwest Ethiopia. Data were collected using an interview questionnaire and observation checklist devised by the investigators.RESULTS: The study showed that, on average, the studied institutions fulfilled 153(70.4%) of the health human power need. They also fulfilled 86(62.8%) of major equipment requirement against the national standard. The composite average satisfaction level of patients was 89.1% and that of the care providers was 86.7%. Nevertheless, the respect given to patients by care providers was rated as poor. A significant proportion, 39(48.2%) of the care providers were assessed as low performance.CONCLUSIONS: Majority of study subjects rated the overall quality of care as “good”. However the observation revealed that the human aspect of care was “poor”. In addition, the health institutions were facing shortage of human and material resources. Thus it was recommended that the responsible bodies at the 3 levels should take actions for improving institutional capacity and performance of care providers in order to improve quality of care.KEY WORDS: Quality of care, Jimma Zone, Southwest, Ethiopi

Unexpected and dangerous situations cropped during field research data collection for public health research: an experience sharing

AUTHOR AFFILIATION: Morankar Sudhakar Narayan, Health, Behavior and Society, Jimma University, Ethiopia, [email protected]: Researcher has conducted 50 large/small scales research in India and Ethiopia and experienced unexpected dangerous situations during field research despite taking care of ethical rules and regulations. Few dangerous situations are explained here (to be expanded during presentation). Experience: 1. Female respondents' husbands planned to rape female data collectors in remote thick jungle of dacoit area in India due to certain questions in the family planning survey interview. 2. Male researchers were physically beaten by community due to misunderstanding between languages. 3. Field researcher’s vehicle was surrounded by community members with rifles, guns and didn’t allow to collect data detaining more than 4 hours due to not informing to village head in advance and entering village suddenly. 4. Community became angry after 2 days friendly field data collection in the village and surrounded the vehicle of field researchers with sticks, rifles, guns due to dacoits robbed the village during previous night considering field researchers as messengers to dacoits. 5. On the way to rural area for data collection before stopping researcher’s vehicle in one village by villagers having sticks, sharp weapons, stones in hands who was in attacking mood pelted small stone on the vehicle to stop it in Ethiopia. Ethnic riots were suddenly erupted in the area without the knowledge of researchers. There was ethical clearance from the government, district administration and police were informed detailed program of our research. But such situation nobody expected. If this incidence would have occurred what is the ethical solution for it

Contribution of Jimma University to Provide Scintific Information and Research Culture in Ethiopia

Background: Ethiopian Journal of Health Sciences is published by Jimma University since July 1990 to provide scientific and technological information on health and related fields for informed planning and decision-making and to enable researchers share their scientific work, observations and experiences. This study does the content analysis of EJHS regarding its contribution publishing the type of articles, discipline of the study, cultural area (urban/rural), and region of the study, research conducted by (University/college), topics of research and other variables. Methods: Broad categories as variable of each article of all the volumes available in Jimma University were entered in the software SPSS 11.0. Interpretation was based on the simple frequency analysis. Results: A total 209 articles in 15 volumes until January 2005 were analyzed. The journal is regularly published in January and July every year (87%). Emphasis was on original articles (70%) published an average by 2 authors holding Bachelor (55%) and Master (35%) degree. Medical sciences were the dominating discipline publishing 50% articles followed by social and behavioral sciences (22%). Majority research was conducted in urban (82%) by Jimma (82%) university in Oromiya (76%) region. Major topics studied were on communicable diseases (22%), environmental health (11%), demography/family planning (10%), nutrition (9%), pharmacy & drug testing (8%) using quantitative methods (86%). Conclusion: Ethiopian Journal of Health Sciences served its primary purpose providing scientific and technological information regularly. Research community needs to conduct research in rural areas with emphasis on social and behavioral sciences using qualitative methods.Ethiop. J Health Sci. Vol. 16, No. 2 July 200

Assessment of Production and Distribution of Printed Information Education Communication (IEC) Materials in Ethiopia and Utilization in the Case of Jimma Zone, Oromiya National Regional State: A Cross Sectional Study

BACKGROUND: Health promotion and health education activities rely on a variety of well designed and effective printed Information Education Communication materials to help ensure success. However, in Ethiopia, there is no well established evidence that shows the extent to which printed Information Education Communication materials are produced distributed, utilized and the existing needs and gaps. Therefore, the objective of this study was to assess the process of printed Information Education Communication materials production, distribution and utilization and to identify current Information Education Communication needs and gaps.METHODS: Cross sectional study combining quantitative and qualitative approaches was conducted at Federal, Regional (Oromiya), zonal (Jimma) and facility levels. Fourteen health centers within Jimma Zone were randomly selected and 303 health workers working in these health centers were included in the study. Purposive sampling technique was used to identify respondents for in-depth interview. The quantitative data were analyzed by SPSS for windows version 16.0.RESULTS: The materials designed both by the Health Education Extension Center and Oromiya Regional Health Bureau were not fully culture sensitive. Information Education Communication materials inventories had not been practiced, particularly at zonal and health center levels. Furthermore, at zonal and health center level, there were no safe storage places. Chronic shortage of Information Education Communication materials was reported consistently. Only 206 (68.0%) of the participants had ever used printed Information Education Communication material. 146 (48.2%) and 29 (9.6%) of the participants were rated the IEC material they have seen as very good in terms of understablity and the extent to which it takes the local context into account, respectively. Participants who were nurse and laboratory technologist were 0.35 and 0.23 times less likely to use IEC materials than environmental Health experts [AOR=0.35, 95% CI: 0.14-0.85] and [AOR=0.23, 95%CI: 0.07-0.79], respectively. Graduates of private colleges were 10 times more likely to report utilization of IEC materials than graduates of government institutions [AOR=10.46, 95% CI: 3.47-31.50]. CONCLUSION: This study revealed that design, production, distribution and utilization of printed Information Education Communication materials were not in line with the underlying principles of Information Education Communication material development. Thus, all concerned institutions and individuals should work towards to improvement.KEY WORDS: Production and distribution, utilization of printed IEC material

Effectiveness of a positive deviance approach to improve mother’s nutritional knowledge, attitude, self-efficacy, and child’s nutritional status in Maji District, West Omo Zone, South West region, Ethiopia: a cluster randomized control trial

BackgroundAchieving appropriate feeding for infants and young children continues to be a struggle. These impediments are not only due to limited food availability but also inadequate knowledge, unfavorable attitudes, and low self-efficacy. A positive deviant approach (PDA) addressing positive and possible solutions inherent in a community focusing on problems is applied in Africa and particularly to Ethiopia. Therefore, this trial is aimed at evaluating the effectiveness of PDA in improving mothers’ nutritional knowledge, attitudes, self-efficacy, and children’s nutritional status.MethodThis was a cluster randomized control trial in which 516 mothers were randomly assigned to either an intervention or control group after collecting baseline data. The trial participants in the intervention cluster received a positive deviant intervention for 6 months, whereas those in the control group received only the usual care. Trained positive deviant mothers (PDM) delivered the intervention. A pretested, structured, interviewer-administered questionnaire was used for data collection. Generalized estimating equation regression analysis adjusted for baseline covariates and clustering was used to test the intervention effect.ResultThe results showed that PDA improved breastfeeding outcomes in the intervention groups compared to their counterparts. A mean difference (MD) of breastfeeding (BF) knowledge (MD = 6.47; 95% CI: 6.45–6.49), BF attitude (MD = 12.68; 95% CI: 11.96–13.40), and BF self-efficacy (MD = 3.13; 95% CI: 3.05–3.21) was observed favoring the intervention. The intervention group showed better improvement in complementary feeding (CF) knowledge, attitude, and self-efficacy among mothers compared to the control group. A mean difference in CF knowledge (MD = 4.53, 95% CI: 4.31–4.75), CF attitude (MD = 9.14, 95% CI: 8.52–9.75), and CF self-efficacy (MD = 11.64, 95% CI: 11.16–12.12) were observed favoring the intervention. At the end of the 6-month follow-up, children in the intervention group showed a lower prevalence of underweight (18.23%) (95% CI: 4.55, 22.54%; p = 0.004) compared with the control group.ConclusionPDA was effective in improving mothers’ nutritional knowledge, attitude, and self-efficacy and reducing children’s underweight in the intervention area.Clinical trial registration:ClinicalTrials.gov, identifier PACTR202108880303760

Coverage of child health services in rural districts of Ethiopia with the health services extension program

Improving access to health care services has been advocated widely since the Declaration of Alma-Ata. Despite the efforts to realize this in Ethiopia, it is only in the year 2003 that the intention to take the package of essential health services to the kebele level (smallest administrative unit) was realized through the introduction of the Health Services Extension Program (HSEP). The objective of this study was to explore whether introduction of HSEP has improved the coverage of child health services in the rural areas of Jimma Zone. A cross sectional study was conducted in three randomly selected districts of Jimma Zone, Southwest Ethiopia. The data collection was undertaken during the months of May, June and July, 2009. A structured questionnaire was used to interview female heads of sampled households from nine kebeles randomly selected in three Woredas (districts). Data were collected on the socio-demographic characteristics, use of health posts, child vaccination and childhood diarrhea. Checklists were used for record review. Data obtained were analysed using statistical package for social sciences (SPSS) V14. Only 64.0% of the kebeles had functional health posts, although another 32.0% of the kebeles in the zone had health posts under construction. However, most (93.7%) of the kebeles in the zone already had two health extension workers (HEWs) assigned. Vaccination coverage as measured by DPT3 was 67.9%, and 10% of the under-two year old children included in this survey had diarrhoea during the past two weeks. Of the 34 (51.5%) mothers who sought help during diarrhoeal attacks, 12 (35.3%) of them went to the health post. The first places of treatment seeking were health centres and health posts, with equal proportion for both (43.5%). Treatment was sought within a day or two after commencement of diarrhoea for 70.6% of the children. Thirty nine (69.7%) of the 56 children who were given recommended fluids received oral rehydration solution (ORS) or homemade solution. In addition to continuing efforts to improve coverage, there is a need to ensure that activities are linked with follow up of vaccination, early treatment seeking and proper home management of diarrhoea

Factors associated with maternity waiting home use among women in Jimma Zone, Ethiopia : a multilevel cross-sectional analysis

Maternity waiting homes (MWHs) are temporary residential spaces located within or close to health facilities, offering skilled obstetrical care. Data used in this analysis were collected from three districts in Jimma Zone in the southern part of Ethiopia. The survey targeted 3840 women. Qualitative research from this study setting and other areas in Ethiopia highlight the pivotal role of husbands and family support in enabling women’s use of MWHs. Findings have implications for achieving equity in access to maternal healthcare, as poorer women with little social support in the form of companions accompanying them for health facility visits, are among the more vulnerable groups

Capture it on video: Implementing a novel knowledge translation strategy as part of the Safe Motherhood Project, Jimma Zone, Ethiopia

This short report addresses videography as a novel knowledge translation tool in maternal, newborn and child health (MNCH) research, detailing the experiences of the Safe Motherhood Research Project in Ethiopia. The Safe Motherhood Research Project (2015-2020) studied the implementation and scale up of MNCH interventions in rural communities of Jimma Zone, Ethiopia. In 2018, a videography component was integrated into the project, including three major activities: producing a video documentary; delivering capacity building workshops for university students and staff; and donating video equipment to the Jimma University Institute of Health. These activities have increased the exposure of the research project to a broader audience and enabled university students and staff to undertake new videography projects. Challenges, lessons learned, and future opportunities are detailed in the hopes that other research teams can adopt videography to increase the exposure and impact of their research.   Ce court rapport aborde la vidéographie comme un nouvel outil d'application des connaissances dans la recherche sur la santé des mères et des enfants (SME), détaillant les expériences du Safe Motherhood Research Project en Éthiopie. Le projet de recherche (2015-2020) a étudié la mise en oeuvre et l'intensification des interventions de SME dans les communautés rurales de la zone de Jimma, en Éthiopie. En 2018, un élément vidéographie a été intégré au projet, comprenant trois activités majeures : la production d'un documentaire vidéo; organiser des ateliers de renforcement des capacités pour les étudiants et le personnel universitaires ; et en faisant don d'équipement vidéo à institut de la santé à l'Université Jimma. Ces activités ont accru l'exposition du projet de recherche à un public plus large et ont permis aux étudiants et au personnel universitaire d'entreprendre de nouveaux projets de vidéographie. Les défis, les leçons apprises et les opportunités futures sont détaillés dans l'espoir que d'autres équipes de recherche puissent utiliser la vidéographie pour augmenter la visibilité et l'impact de leur recherch