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Use of herbal medicine during pregnancy and associated factors among pregnant women with access to public healthcare in west Shewa zone, Central Ethiopia: sequential mixed-method study

Por: Bekele · G. G. · Woldeyes · B. S. · Taye · G. M. · Kebede · E. M. · Gebremichael · D. Y.
Objective

This study was aimed at assessing the prevalence of herbal drug use among pregnant women with access to modern medicine and associated factors in public health facilities in the west Shewa zone, Oromia regional state, Ethiopia.

Design

A sequential mixed-method study approach was carried out among pregnant women and other stakeholders.

Setting

This study was conducted at public health facilities, including 3 public hospitals and 20 health centres, in the west Shewa zone of Ethiopia.

Participants

A systematically selected sample of 411 pregnant women was participated in the quantitative study. For the qualitative method, focus group discussions and in-depth interviews were conducted among pregnant women attending antenatal care and key informants using an interview guide until data saturation was achieved.

Primary outcome

For outcome variables, the respondents were asked if they used any herbal medicine during their current pregnancy. It was then recorded as 0=no and 1=yes.

Results

The prevalence of herbal medicines was found to be 19.7%. The most commonly used herbal medicines were Zingiber officinale, Ocimum gratissimum, Eucalyptus globules, Allium sativum and Rutacha lepensis. Herbal medicine use during pregnancy was significantly associated with older maternal age (adjusted OR (AOR) 2.4, 95% CI 1.2 to 5.1), urban residence (AOR 2.3, 95% CI 1.3 to 3.7) and second trimester of pregnancy (AOR 2.3, 95% CI 1.3 to 4.5).

Conclusions

In this study, one in five pregnant women uses herbal medicine, which is relatively low. Sociodemographic factors and the duration of pregnancy affected the utilisation of herbal drugs during pregnancy. The most common herbals used by pregnant women were intended to treat minor disorders of pregnancy and medical disorders such as hypertension.

Evaluating the performance of a novel anthropometric index: weight adjusted for waist-to-height ratio (W-WHR) - for predicting cardiometabolic risk among adults in Addis Ababa

Por: Gebremedhin · S. · Bekele · T.
Objective

Various anthropometric indices had been proposed to predict cardiometabolic risk, yet few were validated in the African population. We evaluated the diagnostic accuracy of a novel anthropometric index—weight adjusted for waist-to-height ratio (W-WHR)—as a predictor of cardiometabolic risk among adults 18–64 years in Addis Ababa, Ethiopia; and compared its performance with other indices commonly used in the literature.

Design

Cross-sectional study.

Setting

Community-based study in Addis Ababa, Ethiopia.

Participants

Randomly selected adults (n=600) completed serum lipid, blood pressure, blood glucose and anthropometric measurements.

Primary and secondary outcome measures

The primary outcomes of interest were dyslipidaemia, hypertension and hyperglycaemia. Having at least one of the three outcomes was considered as a secondary outcome. Receiver-operating characteristic curve (ROC) used to measure the diagnostic accuracy of W-WHR and another 13 indices for predicting the primary and secondary outcomes. Optimal thresholds were determined using Youden’s index.

Results

W-WHR demonstrated an acceptable diagnostic accuracy (area under the curve (AUC), 95% CI) for correctly classifying dyslipidaemia (0.80, 0.76 to 0.84), hypertension (0.74, 0.70 to 0.78), hyperglycaemia (0.76, 0.70 to 0.82) and the secondary outcome of interest (0.79, 0.75 to 0.83). Depending on the outcomes, thresholds between 32.6 and 36.7 concurrently maximised sensitivity and specificity of the index. ROC analysis indicated, W-WHR (AUC=0.80), abdominal volume index (AVI) (AUC=0.78) and waist circumference (WC) (AUC=0.78) for dyslipidaemia; W-WHR (AUC=0.74) and WC (AUC=0.74) for hypertension; and waist-to-height ratio (AUC=0.80) and body roundness index (AUC=0.80) for hyperglycaemia, had the highest diagnostic accuracy. Likewise, W-WHR (AUC=0.79), AVI (AUC=0.78) and WC (AUC=0.78) had better performance for the secondary outcome. Most indices have better utility among younger than older adults, and per cent body fat had the highest diagnostic accuracy among women (AUC 0.74–0.83).

Conclusion

W-WHR is a useful index for predicting cardiometabolic risk, especially among young adults.

Immediate postnatal care guidelines implementation and associated factors among healthcare providers in East Shewa zone public health facilities, Oromia, Ethiopia, 2022: a multicentre cross-sectional study

Por: Bune · A. G. · Girmaye · E. · Lemma · D. · Bekele · G. G.
Objectives

Immediate postnatal care is a critical intervention to reduce maternal and neonatal morbidity and mortality; however, many women and newborns receive inadequate postnatal care timely and effectively during the first 24 hours following childbirth. Therefore, this study aimed to assess the immediate postnatal care guidelines implementation and its associated factors among healthcare providers in the East Shewa zone public health facilities, Oromia, Ethiopia.

Design

Facility-based cross-sectional study was conducted from 13 September 2022 to 28 October 2022.

Setting

The study was conducted in 6 hospitals and 19 health centres in the East Shewa zone.

Participants

All healthcare providers who work in the maternity ward of the East Shewa zone public health facilities were the source population while all healthcare providers who work in the maternity ward of the randomly selected East Shewa zone public health facilities were the study population. Healthcare providers who were assigned to the delivery and postnatal ward during data collection were included in the study. Healthcare providers, who are not on duty for annual, maternity, sick and study leave, were excluded from the study.

Measures

A structured self-administered questionnaire and observational checklist were used for data collection. The questionnaires were pretested and data were collected by the Kobo toolbox software. Data were analysed by using the SPSS V.25. Binary logistic regression (bivariate and multivariable) analyses were done to identify significantly associated variables, and finally, an adjusted OR (AOR) at a 95% CI was used to declare significant variables depending on a p

Result

The study revealed that 196 healthcare providers with a response rate of 97.03% were included in this study. The overall proportion of healthcare providers who have a good implementation of immediate postnatal care guidelines was 44.4% (95% CI 37.3% to 51.6%). Providers who received basic emergency obstetrics and newborn care training (AOR 3.72, 95% CI 1.7 to 8.1), working in a tertiary-level hospital (AOR 3.85, 95% CI 1.3 to 11.2), and who had maternal and newborn care guidelines in their facility (AOR 3.2, 95% CI 1.5 to 6.6) were significantly associated factors with good implementation of immediate postnatal care guidelines.

Conclusions

Implementation of the immediate postnatal care guideline by healthcare providers in the maternity ward was found low as less than half of healthcare providers have good implementation. Receiving basic emergency obstetrics and newborn care training, having maternal and newborn care guidelines in their facility, and working in a tertiary-level hospital were significantly associated factors with good implementation of immediate postnatal care guidelines.

Factors associated with uptake of human papillomavirus vaccination among adolescent girls in Mettu town, southwest Ethiopia: a school-based cross-sectional study

Por: Dawud · A. · Kera · A. M. · Bekele · D. · Hiko · D. · Zewdie · A.
Objective

This study was designed to assess the level of uptake of human papillomavirus (HPV) vaccination and its associated factors among school-age adolescent girls.

Design

School-based cross-sectional study.

Setting

High schools in Mettu town, southwest Ethiopia, from 5 February to 10 March 2022.

Participants

Data were collected using a pretested and structured questionnaire through face-to-face interviews with 667 adolescent girls selected via multistage random sampling. Data were entered into EpiData V.3.1 and exported to SPSS V.26 for analysis. Simple binary logistic regression was done, and variables with a p value less than 0.25 were entered into a multivariable logistic regression model; variables with a p value

Results

About half (48.6%) of adolescent girls aged 14–18 years had received the HPV vaccine. Being in the 16–18 years age group (adjusted OR 2.7, 95% CI 1.50 to 4.80), having good knowledge (2.14, 95% CI 1.29 to 3.52), having a positive attitude (5.86, 95% CI 3.51 to 9.76), and getting encouragement from healthcare workers (3.04, 95% CI 1.36 to 6.79), teachers (2.14, 95% CI 1.05 to 4.34) and parents (2.39, 95% CI 1.02 to 5.64) were significantly associated with vaccine uptake.

Conclusion

The uptake of HPV vaccination was low. Having good knowledge and positive attitude as well as encouragement from parents, healthcare workers and teachers were identified as factors associated with HPV vaccine uptake. Improving knowledge about HPV and involving teachers and parents in the immunisation campaign might help promote HPV vaccine uptake.

Magnitude of disrespectful and abusive care among women during facility-based childbirth in Shambu town, Horro Guduru Wollega zone, Ethiopia

Disrespectful care during childbirth causes suffering and discourages women from seeking facility-based care. It is one of the silent causes of maternal mortality and morbidity worldwide, but not yet well recorded especially in developing countries. The aim of this study was to measure the magnitude of disrespect and abusive behaviors of health professionals during childbirth and associated factors.
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