The Experts below are selected from a list of 119073 Experts worldwide ranked by ideXlab platform
Shumye Admasu - One of the best experts on this subject based on the ideXlab platform.
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providers knowledge on postpartum intrauterine contraceptive device ppiucd service provision in amhara region public Health Facility ethiopia
PLOS ONE, 2019Co-Authors: Yeshiwas Abebaw, Solomon Berhe, Solomon Mekonnen Abebe, Mulat Adefris, Abebaw Gebeyehu, Tadesse Gure, Birtukan Asmare, Masresha Dagnu, Wubetu Alebachew, Shumye AdmasuAbstract:Introduction Postpartum intrauterine contraceptive devices (PP-IUCD) are one type of post-partum family planning method, which can be provided to a post-partum woman starting from the placental delivery time (within 10 minutes), or within the first 48 hours of postpartum period. In most developing countries, delivery time is the primary opportunity for women to access post-partum family planning methods, especially for those living in remote areas. Hence, this study assesses providers' knowledge on postpartum intrauterine contraceptive device service provision. Methods A Facility-based cross-sectional study was conducted in Amhara region Health center and hospitals. Health providers surveyed included obstetricians, gynecologists, general practitioners, emergency surgical officers, Health officers, midwives and nurses from September 18, 2015 to December18, 2016. Simple random sampling was used to select 864 subjects. Data were collected by using a structured self-administered questionnaire and observing the Facility. Multilevel analysis was done to see factors associated with outcome. Results A total of 197 Health facilities and 864 providers are included in the final analysis. Of the total providers 524 (60.6%) were from a Health center. The mean age (±SD) of participants was 27.8 years (±5.4). The number of providers with good knowledge accounted for 253 of those surveyed (29.3%). The proportion of good knowledge among trained PP-IUCD providers was 35.7% (those who scored above average), and 27.9% was untrained about PP-IUCD. A considerable heterogeneity was observed between Health facilities for each indicator of provider's knowledge. Gender differences were observed as the mean knowledge score deference on PP-IUCD by 0.4 points (β = -0.41; -0.72, -0.10) when the participant was female. Having experience of regular counseling of pregnant women increases PP-IUCD knowledge score by 0.97. (β = 0.97; 95% CI: 0.48, 1.47). Where the Health Facility requested clients to purchase the IUCD themselves, the mean knowledge score decreased by 0.47 points compared with free of charge at the Facility level (β = -0.47; 95%CI: -0.87, -0.07). Conclusion Our findings showed that providers' knowledge about postpartum IUCD was low in the Amhara region public Health Facility. The lowest knowledge score was noted among nurses, Health Officers, midwives, and general practice professionals. Factors associated with providers' knowledge on PP-IUCD are the status of Health Facility, female sex, training on PP-IUCD, regular counseling of pregnant women, and unavailability of IUCD service.
Alemayehu Worku - One of the best experts on this subject based on the ideXlab platform.
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distance from Health Facility and mothers perception of quality related to skilled delivery service utilization in northern ethiopia
International Journal of Women's Health, 2017Co-Authors: Girmatsion Fisseha, Alemayehu Worku, Yemane Berhane, Wondwossen TerefeAbstract:BACKGROUND Poor maternal Health service utilization is one of the contributing factors to a high level of maternal and newborn mortality in Ethiopia. The factors associated with utilization of services are believed to differ from one context to another. We assessed the factors associated with skilled delivery service utilization in rural northern Ethiopia. SUBJECTS AND METHODS A community-based survey was conducted among mothers who gave birth in the 12 months preceding the study period, from January to February 2015, in the Tigray region of Ethiopia. Multistage sampling technique was used to select mothers from the identified clusters. Households within a 10 km radius of the Health Facility were taken as a cluster for a community survey. Data were collected using face-to-face interview at the household level. We compared the mothers who reported giving birth to the index child in a Health Facility and those who reported delivering at home, in order to identify the predictors of skilled delivery utilization. Multivariable logistic regression model was used to determine the predictors of skilled delivery service utilization. The results are presented with odds ratio (OR) and 95% confidence interval (CI). RESULTS A total of 1,796 mothers participated in the study, with a 100% response rate. Distance to Health facilities (adjusted odds ratio [AOR] =0.53 [95% CI: 0.39, 0.71]), perception of mothers to the availability of adequate equipment in the delivery service in their catchment area (AOR =1.5 [95% CI: 1.11, 2.13]), experiencing any complication during childbirth, using antenatal care, lower birth order and having an educated partner were the significant predictors of skilled delivery service utilization. CONCLUSION Implementing community-based intervention programs that will address the physical accessibility of delivery services, such as the ambulance service, road issues and waiting rooms, and improving quality maternity service will likely reduce the current problem.
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the effect of Health Facility delivery on neonatal mortality systematic review and meta analysis
BMC Pregnancy and Childbirth, 2013Co-Authors: Gurmesa Tura, Mesganaw Fantahun, Alemayehu WorkuAbstract:Background Though promising progress has been made towards achieving the Millennium Development Goal four through substantial reduction in under-five mortality, the decline in neonatal mortality remains stagnant, mainly in the middle and low-income countries. As an option, Health Facility delivery is assumed to reduce this problem significantly. However, the existing evidences show contradicting conclusions about this fact, particularly in areas where enabling environments are constraint. Thus, this review was conducted with the aim of determining the pooled effect of Health Facility delivery on neonatal mortality.
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the effect of Health Facility delivery on neonatal mortality systematic review and meta analysis
BMC Pregnancy and Childbirth, 2013Co-Authors: Gurmesa Tura, Mesganaw Fantahun, Alemayehu WorkuAbstract:Though promising progress has been made towards achieving the Millennium Development Goal four through substantial reduction in under-five mortality, the decline in neonatal mortality remains stagnant, mainly in the middle and low-income countries. As an option, Health Facility delivery is assumed to reduce this problem significantly. However, the existing evidences show contradicting conclusions about this fact, particularly in areas where enabling environments are constraint. Thus, this review was conducted with the aim of determining the pooled effect of Health Facility delivery on neonatal mortality. The reviewed studies were accessed through electronic web-based search strategy from PUBMED, Cochrane Library and Advanced Google Scholar by using combination key terms. The analysis was done by using STATA-11. I2 test statistic was used to assess heterogeneity. Funnel plot, Begg’s test and Egger’s test were used to check for publication bias. Pooled effect size was determined in the form of relative risk in the random-effects model using DerSimonian and Laird's estimator. A total of 2,216 studies conducted on the review topic were identified. During screening, 37 studies found to be relevant for data abstraction. From these, only 19 studies fulfilled the preset criteria and included in the analysis. In 10 of the 19 studies included in the analysis, Facility delivery had significant association with neonatal mortality; while in 9 studies the association was not significant. Based on the random effects model, the final pooled effect size in the form of relative risk was 0.71 (95% CI: 0.54, 0.87) for Health Facility delivery as compared to home delivery. Health Facility delivery is found to reduce the risk of neonatal mortality by 29% in low and middle income countries. Expansion of Health facilities, fulfilling the enabling environments and promoting their utilization during childbirth are essential in areas where home delivery is a common practice.
Odd Morkve - One of the best experts on this subject based on the ideXlab platform.
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acceptability of community and Health Facility based directly observed treatment of tuberculosis in tanzanian urban setting
Health Policy, 2006Co-Authors: Eliud Wandwalo, Emmanuel A Makundi, Torunn Hasler, Odd MorkveAbstract:Abstract Setting An urban district in Dar es Salaam, Tanzania. Objective To assess the acceptability of community and Health Facility-based direct observation of treatment (DOT) of tuberculosis (TB) patients in Temeke district. Design Both quantitative and qualitative study methodologies were used. Eight focus group discussions were carried out with TB patients, treatment supporters, Health workers and community members. Quantitative study was also carried out among TB patients and treatment supporters. Results A total of 268 patients and 103 treatment supporters were enrolled in the study. The majority of the patients (75%) were satisfied with the DOT options they received. Males were more satisfied with community-based DOT (84%) than females (67%) (OR 4.96, 95% CI 1.38–17.86). The majority (81%) were willing to supervise another TB patient. The results of the qualitative study demonstrated that community-based DOT was preferred because it was found to be convenient, reduced costs, saved time of the patients and reduced workload in Health services. The main challenge of community-based DOT was to ensure effective supervision and monitoring of patients and treatment supporters in the community. Conclusion The results from the quantitative and qualitative studies indicate that both DOT options were acceptable. The study has also identified key challenges and opportunities for effective implementation of community-based DOT interventions that are relevant, sensitive and acceptable to the population. Community-based DOT is a viable option and can complement and strengthen the existing Health Facility-based DOT, especially in countries like Tanzania where the Health system is overwhelmed with increasing number of TB and HIV/AIDS patients.
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cost and cost effectiveness of community based and Health Facility based directly observed treatment of tuberculosis in dar es salaam tanzania
Cost Effectiveness and Resource Allocation, 2005Co-Authors: Eliud Wandwalo, Bjarne Robberstad, Odd MorkveAbstract:Identifying new approaches to tuberculosis treatment that are effective and put less demand to meagre Health resources is important. One such approach is community based direct observed treatment (DOT). The purpose of the study was to determine the cost and cost effectiveness of Health Facility and community based directly observed treatment of tuberculosis in an urban setting in Tanzania. Two alternative strategies were compared: Health Facility based directly observed treatment by Health personnel and community based directly observed treatment by treatment supervisors. Costs were analysed from the perspective of Health services, patients and community in the year 2002 in US $ using standard methods. Treatment outcomes were obtained from a randomised-controlled trial which was conducted alongside the cost study. Smear positive, smear negative and extra-pulmonary TB patients were included. Cost-effectiveness was calculated as the cost per patient successfully treated. The total cost of treating a patient with conventional Health Facility based DOT and community based DOT were $ 145 and $ 94 respectively. Community based DOT reduced cost by 35%. Cost fell by 27% for Health services and 72% for patients. When smear positive and smear negative patients were considered separately, community DOT was associated with 45% and 19% reduction of the costs respectively. Patients used about $ 43 to follow their medication to Health Facility which is equivalent to their monthly income. Indirect costs were as important as direct costs, contributing to about 49% of the total patient's cost. The main reason for reduced cost was fewer number of visits to the TB clinic. Community based DOT was more cost-effective at $ 128 per patient successfully treated compared to $ 203 for a patient successfully treated with Health Facility based DOT. Community based DOT presents an economically attractive option to complement Health Facility based DOT. This is particularly important in settings where TB clinics are working beyond capacity under limited resources.
Yeshiwas Abebaw - One of the best experts on this subject based on the ideXlab platform.
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providers knowledge on postpartum intrauterine contraceptive device ppiucd service provision in amhara region public Health Facility ethiopia
PLOS ONE, 2019Co-Authors: Yeshiwas Abebaw, Solomon Berhe, Solomon Mekonnen Abebe, Mulat Adefris, Abebaw Gebeyehu, Tadesse Gure, Birtukan Asmare, Masresha Dagnu, Wubetu Alebachew, Shumye AdmasuAbstract:Introduction Postpartum intrauterine contraceptive devices (PP-IUCD) are one type of post-partum family planning method, which can be provided to a post-partum woman starting from the placental delivery time (within 10 minutes), or within the first 48 hours of postpartum period. In most developing countries, delivery time is the primary opportunity for women to access post-partum family planning methods, especially for those living in remote areas. Hence, this study assesses providers' knowledge on postpartum intrauterine contraceptive device service provision. Methods A Facility-based cross-sectional study was conducted in Amhara region Health center and hospitals. Health providers surveyed included obstetricians, gynecologists, general practitioners, emergency surgical officers, Health officers, midwives and nurses from September 18, 2015 to December18, 2016. Simple random sampling was used to select 864 subjects. Data were collected by using a structured self-administered questionnaire and observing the Facility. Multilevel analysis was done to see factors associated with outcome. Results A total of 197 Health facilities and 864 providers are included in the final analysis. Of the total providers 524 (60.6%) were from a Health center. The mean age (±SD) of participants was 27.8 years (±5.4). The number of providers with good knowledge accounted for 253 of those surveyed (29.3%). The proportion of good knowledge among trained PP-IUCD providers was 35.7% (those who scored above average), and 27.9% was untrained about PP-IUCD. A considerable heterogeneity was observed between Health facilities for each indicator of provider's knowledge. Gender differences were observed as the mean knowledge score deference on PP-IUCD by 0.4 points (β = -0.41; -0.72, -0.10) when the participant was female. Having experience of regular counseling of pregnant women increases PP-IUCD knowledge score by 0.97. (β = 0.97; 95% CI: 0.48, 1.47). Where the Health Facility requested clients to purchase the IUCD themselves, the mean knowledge score decreased by 0.47 points compared with free of charge at the Facility level (β = -0.47; 95%CI: -0.87, -0.07). Conclusion Our findings showed that providers' knowledge about postpartum IUCD was low in the Amhara region public Health Facility. The lowest knowledge score was noted among nurses, Health Officers, midwives, and general practice professionals. Factors associated with providers' knowledge on PP-IUCD are the status of Health Facility, female sex, training on PP-IUCD, regular counseling of pregnant women, and unavailability of IUCD service.
Claudia Hanson - One of the best experts on this subject based on the ideXlab platform.
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Health system support for childbirth care in southern tanzania results from a Health Facility census
BMC Research Notes, 2013Co-Authors: Claudia Hanson, Carine Ronsmans, Suzanne Penfold, Werner Maokola, Fatuma Manzi, Jenny Jaribu, Godfrey Mbaruku, Hassan MshindaAbstract:Background: Progress towards reaching Millennium Development Goals four (child Health) and five (maternal Health) is lagging behind, particularly in sub-Saharan Africa, despite increasing efforts to scale up high impact interventions. Increasing the proportion of birth attended by a skilled attendant is a main indicator of progress, but not much is known about the quality of childbirth care delivered by these skilled attendants. With a view to reducing maternal mortality through Health systems improvement we describe the care routinely offered in childbirth at dispensaries, Health centres and hospitals in five districts in rural Southern Tanzania. We use data from a Health Facility census assessing 159 facilities in five districts in early 2009. A structural and operational assessment was undertaken based on staff reports using a modular questionnaire assessing staffing, work load, equipment and supplies as well as interventions routinely implemented during childbirth. Results: Health centres and dispensaries attended a median of eight and four deliveries every month respectively. Dispensaries had a median of 2.5 (IQR 2–3) Health workers including auxiliary staff instead of the recommended four clinical officer and certified nurses. Only 28% of first-line facilities (dispensaries and Health centres) reported offering active management in the third stage of labour (AMTSL). Essential childbirth care comprising eight interventions including AMTSL, infection prevention, partograph use including foetal monitoring and newborn care including early breastfeeding, thermal care at birth and prevention of ophthalmia neonatorum was offered by 5% of dispensaries, 38% of Health centres and 50% of hospitals consistently. No first-line Facility had provided all signal functions for emergency obstetric complications in the previous six months. Conclusions: Essential interventions for childbirth care are not routinely implemented in first-line facilities or hospitals. Dispensaries have both low staffing and low caseload which constrains the ability to provide high-quality childbirth care. Improvements in quality of care are essential so that women delivering in Facility receive “skilled attendance” and adequate care for common obstetric complications such as post-partum haemorrhage.
