Mothers' satisfaction with referral hospital delivery service in Amhara Region, Ethiopia

<p>Abstract</p> <p>Background</p> <p>A woman's satisfaction with the delivery service may have immediate and long-term effects on her health and subsequent utilization of the services. Providing satisfying delivery care increases service utilization. The objective of this study is to assess the satisfaction of mothers with referral hospitals' delivery service and identify some possible factors affecting satisfaction in Amhara region of Ethiopia.</p> <p>Methods</p> <p>A hospital-based cross-sectional survey that involved an exit interview was conducted from September to November 2009 in three referral hospitals in Ethiopia. A total of 417 delivering mothers were enrolled in the study. Client satisfaction was measured using a survey instrument adopted from the Donabedian quality assessment framework. We collect data systematically from every other postnatal woman who delivered in the referral hospitals. Multivariate and binary logistic regression was applied to identify the relative effect of each explanatory variable on the outcome (satisfaction).</p> <p>Results</p> <p>The proportion of mothers who were satisfied with delivery care in this study was 61.9%. Women's satisfaction with delivery care was associated with wanted status of the pregnancy, immediate maternal condition after delivery, waiting time to see the health worker, availability of waiting area, care providers' measure taken to assure privacy during examinations, and amount of cost paid for service.</p> <p>Conclusions</p> <p>The overall satisfaction of hospital delivery services in this study is found to be suboptimal. The study strongly suggests that more could be done to assure that services provided are more patient centered.</p

Perceptions and attitude towards violence against women by their spouses: A qualitative study in Northwest Ethiopia.

Introduction: To stop violence against women by their spouses we need to understand how the specific society perceives and views such violence. Then and only then can we institute effective and acceptable strategy to tackle the problem.Objective: To assess community perceptions and attitude towards violence against women by their spouses Methods: We conducted a qualitative study using focus group discussions and in-depth interviews with women,family arbitrators, healthcare workers, psychosocial experts, victims and perpetrator of violence, and law enforcement bodies in Gondar town, Northwest Ethiopia. Data were analyzed thematically using the Open Code Software. Results: The normative expectation that conflicts are inevitable in marriage makes it difficult for society to reject violence. Acts of violence against women represent unacceptable behavior according to existing social and gender norms when there is no justification for the act and the act causes severe harm. There is considerable permissiveness of violent acts when the act is not regarded as wrong, there is socially acceptable premise, and the consequences are deemed mild. Marital rape is not understood well and there is less willingness to condemn it. Conclusions: We conclude that there is insufficient understanding of violence against women in its contemporary use and many people hold a non-disapproving stance regarding violence against women by their spouses calling for a culturally sensitive information, education and communication intervention. [Ethiop. J. Health Dev. 2010(1):39-45

Evaluating the effect of interventions for strengthening non-physician anesthetists' education in Ethiopia: a pre- and post-evaluation study

Background Access to safe surgery has been recognized as an indispensable component of universal health coverage. A competent anesthesia workforce is a prerequisite for safe surgical care. In Ethiopia, non-physician anesthetists are the main anesthesia service providers. The Government of Ethiopia implemented a program intervention to improve the quality of non-physician anesthetists' education, which included faculty development, curricula strengthening, student support, educational resources, improved infrastructure and upgraded regulations. This study aimed to assess changes following the implementation of this program. Methods A pre-and post-evaluation design was employed to evaluate improvement in the quality of non-physician anesthetists' education. A 10-station objective structured clinical examination (OSCE) was administered to graduating class anesthetists of 2016 (n = 104) to assess changes in competence from a baseline study performed in 2013 (n = 122). Moreover, a self-administered questionnaire was used to collect data on students' perceptions of the learning environment. Results The overall competence score of 2016 graduates was significantly higher than the 2013 class (65.7% vs. 61.5%, mean score difference = 4.2, 95% CI = 1.24-7.22, p 0.05 in favor of females), and female students scored better in some stations. Student perceptions of the learning environment improved significantly for almost all items, with the largest percentage point increase in the availability of instructors from 38.5 to 70.2% (OR = 3.76, 95% CI = 2.15-6.55, p < 0.05). Conclusion The results suggest that the quality of non-physician anesthetists' education has improved. Stagnation in competence scores of some stations and student perceptions of the simulated learning environment require specific attention.Research into fetal development and medicin

Polio Outbreak Response in Ethiopia

Background: Ethiopia had been polio-free for almost four years until December 2004. However, between December 2004 and February 2006, 24 children were paralysed as a result of infection with wild poliovirus imported from the neighbouring country of Sudan. In response, the country has attempted to document the impact of various response measures on the containment of wild poliovirus transmission. Objectives: This study aims at systematic and epidemiological assessment of the extent of the outbreak, its determinants, and the lessons learned as well as the implications for future control strategies to interrupt wild poliovirus transmission. Design: A cross-sectional study design with qualitative and quantitative data collection approaches was used to conduct the epidemiologic assessment. Subjects: All confirmed wild poliovirus cases, and reported acute flaccid paralysis cases in close proximity to the confirmed polio cases were the study subjects. Child caretakers and health service providers were interviewed as part of the investigation. Results: Between December 2004 and February 2006, eight children from Tigray Regional State, nine children from Amhara Regional State and seven children from Oromia Regional State were paralysed as a result of infection with wild poliovirus type 1. Genetic sequencing demonstrated two separate importations to Ethiopia. Risk factors that may have facilitated spread of the outbreak within the country included gaps in vaccination coverage and interruption of the cold chain system, gaps in acute flaccid paralysis surveillance performance, high population mobility, poor environmental sanitation, crowded living conditions and unsafe drinking water. In response to the outbreak, Ethiopia conducted detailed outbreak investigations within two days of confirmation of the index cases. Large-scale, house-to-house vaccination campaigns were also implemented. As a result, the three regions interrupted the wild poliovirus transmission within the regions within one year of confirmation of the index case. Conclusion: Outbreak response activities were successful in interrupting the imported wild poliovirus transmission in Tigray, Amhara and Oromia Regional States of Ethiopia within a oneyear period of time. In Ethiopia, programme strategies should be intensified to contain further spread and prevent future importation of wild poliovirus. Large-scale immunisation campaigns should reach every child, including those isolated by geography, poverty and security. East African Medical Journla Vol. 85 (5) 2008: pp. 222-23

A Secure Cloud-based Platform to Host Healthcare Applications

Digital technologies, such as Big Data analytics, artificial intelligence, cloud and high-performance computing are presenting new opportunities to transform healthcare systems, increase connectivity of hospitals and other providers, and therefore potentially and significantly improve patient care. However, such networked computing infrastructures also raise significant cybersecurity risks, especially in the healthcare domain, where protecting sensitive personal information is of paramount importance. Project ASCLEPIOS aims at strengthening the trust of users in cloud-based healthcare services by utilizing trusted execution environment and several modern cryptographic approaches such as attribute based encryption, searchable encryption, functional encryption to build a cloud-based e-health framework that protects users’ privacy, prevents both internal and external attacks, verifies the integrity of medical devices before application, and runs privacy-preserving data analytics on encrypted data. The project investigates modern encryption techniques and their combination in order to provide increased security of e-health applications that are then presented towards end-users utilizing a cloud-based platform. Although some topics such as security and privacy are already investigated through block-chain related technologies, it has been decided that the selected approaches would be more suitable for these particular challenges. In order to prototype its security services, ASCLEPIOS develops and deploys three large-scale healthcare demonstrators, provided by three leading hospitals from Europe. These demonstrators are rooted in the practice-based problems and applications provided by the project’s healthcare partners. The Amsterdam University Centers, University of Amsterdam, plans to improve stroke hyper-acute care through secure information sharing on a cloud computing platform to improve patient management. Additionally, they are also building prediction models to enable earlier discharge of patients from hospitals with lower risk factors. Charité Berlin plans to improve inpatient and outpatient sleep medication by remotely controlling the quality of the collected data and transferring it on-line for further analysis. Finally, the Norwegian Centre for e-health Research, University Hospital of North Norway is developing a system for privacy-preserving monitoring and benchmarking of antibiotics prescription of general practitioners. The common characteristics of these three scenarios are the increased demand for high levels of security in data transfer, storage and privacy preserving analytics on cloud infrastructures. In order deploy, operate and further develop these applications to increase their security with the ASCLEPIOS framework, a cloud computing testbed is being setup. The testbed uses state-of-the-art technologies for cloud application deployment and run-time orchestration in order to ensure the optimized deployment and execution of the demonstrator applications. As the data sources do not require the local execution (albeit in one case data may remain on the data source) of processing, there is no need for fog or edge computing, but the testbed is based on private OpenStack cloud computing infrastructures and utilizes the MiCADO framework which is compatible with different containers such as Docker and Kubernetes. The project started only recently, and currently it is in the early stages of systems design and specification. This presentation will provide a short introduction to the ASCLEPIOS project and its demonstrators and will present early results of the currently ongoing requirements specification and platform design processes

Magnitude and Correlates of Intimate Partner Violence against Women and Its Outcome in Southwest Ethiopia

BACKGROUND: Intimate Partner Violence (IPV) is a major public health problem with serious consequences. This study was conducted to assess the magnitude of IPV in Southwest Ethiopia in predominantly rural community. METHODS: This community based cross-sectional study was conducted in May, 2009 in Southwest Ethiopia using the World Health Organization core questionnaire to measure violence against women. Trained data collectors interviewed 851 ever-married women. Stata version 10.1 software and SPSS version 12.0.1 for windows were used for data analysis. RESULT: In this study the life time prevalence of sexual or physical partner violence, or both was 64.7% (95%CI: 61.4%-67.9%). The lifetime sexual violence [50.1% (95% CI: 46.7%-53.4%)] was considerably more prevalent than physical violence [41.1% (95%:37.8-44.5)]. A sizable proportion [41.5%(95%CI: 38.2%-44.8%)] of women reported physical or sexual violence, or both, in the past year. Men who were controlling were more likely to be violent against their partner. CONCLUSION: Physical and sexual violence is common among ever-married women in Southwest Ethiopia. Interventions targeting controlling men might help in reducing IPV. Further prospective longitudinal studies among ever-married women are important to identify predictors and to study the dynamics of violence over time

Two-Thirds of Smear-Positive Tuberculosis Cases in the Community Were Undiagnosed in Northwest Ethiopia: Population Based Cross-Sectional Study

Background: Tuberculosis (TB) case detection rate remains low in Ethiopia. One of the underlying reasons is the emphasis on passive case finding strategy which may seriously underestimate the burden of the disease. Estimating the prevalence of smear-positive pulmonary TB through active case finding at population level can help assessing the degree to which passive case detection is successful. Methods and findings: This is population based cross-sectional study. The study population was all individuals aged $14 years. Interviews using a uniform questionnaire were done initially to identify individuals with chronic cough ($15 days) and the two sputum (spot and morning) samples were gathered for standard smear microscopy. A total of 23,590 individuals aged $14 years were interviewed and 984 had a chronic cough for$15 days. Of 831 individuals who provided two sputum samples for acid fast bacilli (AFB), 41 had positive smears. A total of 22 smear-positive TB cases detected through passive case finding were on anti-TB treatment. The prevalence of new smear-positive TB was 174 per 100,000 in persons aged $14 years (95$45 years [AOR: 2.26, 95 % CI (1.12–4.59). Conclusions: The study revealed that about two-thirds of patients with active TB remain undiagnosed and thus untreated. This may indicate the need for strengthening case detection at the community level. Furthermore, the high burden of T

Intimate partner violence against women in western Ethiopia: prevalence, patterns, and associated factors

<p>Abstract</p> <p>Background</p> <p>Intimate partner violence against women is the psychological, physical, and sexual abuse directed to spouses. Globally it is the most pervasive yet underestimated human rights violation. This study was aimed at investigating the prevalence, patterns and associated factors of intimate partner violence against women in Western Ethiopia.</p> <p>Methods</p> <p>A cross-sectional, population based household survey was conducted from January to April, 2011 using standard WHO multi-country study questionnaire. A sample of 1540 ever married/cohabited women aged 15-49 years was randomly selected from urban and rural settings of East Wollega Zone, Western Ethiopia. Data were principally analyzed using logistic regression.</p> <p>Results</p> <p>Lifetime and past 12 months prevalence of intimate partner violence against women showed 76.5% (95% CI: 74.4-78.6%) and 72.5% (95% CI: 70.3-74.7%), respectively. The overlap of psychological, physical, and sexual violence was 56.9%. The patterns of the three forms of violence are similar across the time periods. Rural residents (AOR 0.58, 95% CI 0.34-0.98), literates (AOR 0.65, 95% CI 0.48-0.88), female headed households <b>(</b>AOR 0.46, 95% CI 0.27-0.76) were at decreased likelihood to have lifetime intimate partner violence. Yet, older women were nearly four times (AOR 3.36, 95% CI 1.27-8.89) more likely to report the incident. On the other hand, abduction (AOR 3.71, 95% CI 1.01-13.63), polygamy (AOR 3.79, 95% CI 1.64-0.73), spousal alcoholic consumption (AOR 1.98, 95% CI 1.21-3.22), spousal hostility (AOR 3.96, 95% CI 2.52-6.20), and previous witnesses of parental violence (AOR 2.00, 95% CI 1.54-2.56) were factors associated with an increased likelihood of lifetime intimate partner violence against women.</p> <p>Conclusion</p> <p>In their lifetime, three out of four women experienced at least one incident of intimate partner violence. This needs an urgent attention at all levels of societal hierarchy including policymakers, stakeholders and professionals to alleviate the situation.</p