Conectar
Our objective was to assess the feasibility of using the routine health information system data source, District Health Information System (DHIS2) to measure the effective coverage of selected health service indicators in Ethiopia and to explore stakeholder perceptions of those measures.
We conducted a mixed-methods study. We mapped the availability of data elements in DHIS2 between July 2022 and June 2023 for five indicators (four or more antenatal care visits (ANC4+), skilled birth attendance, postnatal care, sick child care and child nutrition care). We defined effective coverage cascade steps for each indicator, assessed data quality and analysed data using STATA V.17. Finally, qualitative interviews were conducted with 15 key stakeholders, and the data were analysed thematically for reflections on the DHIS2 output.
The data were captured from all public health facilities of 11 regions and 2 administrative cities in Ethiopia.
There was better availability of data elements for maternal healthcare than for child healthcare. It was possible to estimate the intervention-adjusted coverage of ANC4+ (16% nationally) and the process-quality-adjusted coverage of skilled birth attendance (19% nationally). Postnatal care, sick child care and child nutrition indicators lacked data across multiple cascade steps. The quality of data for effective coverage measurement differed by region. The key informants expressed concerns about the adequacy and appropriateness of DHIS2 data for this analysis. While all acknowledged its potential for decision-making, respondents emphasised the need for standardised methods and data sources to enhance comparability and acceptability of the findings.
The findings underscore the need for system-level improvement of data availability and quality, and adoption of a standardised approach to calculating effective coverage using DHIS2. There was a concern that the findings may not be accepted by policymakers; however, the local level granularity made possible through DHIS2 was appreciated.
by Osman Yimer Mohammed, Kerstin Erlandsson, Tewodros Seyoum, Solomon Hailemeskel, Lemma Derseh, Helena Lindgren
BackgroundWork-related musculoskeletal disorder is a limiting, painful condition that affects the muscular, skeletal, articular, and nervous tissues of the body. The condition is mainly associated with poor working conditions and awkward body positions. Health professionals, including midwives, are among the most affected workforce globally. The condition affects the health of the professionals and the quality of care that professionals are expected to provide. However, there is a scarcity of information on the magnitude of the condition, its effect on midwifery practice, and associated factors. Objectives: This study aimed to assess the magnitude of work-related musculoskeletal disorder, its effect on midwifery practice, and associated factors among midwives in North Shoa Zone, Amhara Regional State, Ethiopia.
MethodAn institution-based cross-sectional study assessed the magnitude of work-related musculoskeletal disorder (WRMSD), the effect on midwifery practice, and associated factors. The Nordic Musculoskeletal Disorder Scale was used to assess the presence of WRMSDs in the nine regional body parts and its effect. A stepwise backward elimination logistic regression model was used, and significant association was declared at a p-value of less than 0.05.
ResultsA total of 473 (252 (53.3%) female and 221 (46.7%) male) midwives participated in this study. Overall, in the last 12 months, 355 (75.05%, 95% CI: 71.15% − 78.95%) midwives were affected by WRMSD, which was seen in any one of the nine regional body parts. About 45% (162) of them reported being unable to perform their daily tasks while they were affected, and 27% (96) of them sought treatment for their condition. The lower back was the most affected axial body part, reported by 300 (63.4%, 95% CI: 59% − 68%) midwives. Working in awkward or uncomfortable positions was significantly associated with the development of WRMSD (AOR: 1.81, 95% CI: 1.15–2.87). Similarly, awkward positions significantly affected the development of area-specific WRMSD in the lower back, upper back, neck, and limbs. Working in the same position for a longer time, seeing clients daily, and moving heavy objects were among the risk factors associated with developing area-specific WRMSD among midwives.
ConclusionThe magnitude of work-related musculoskeletal disorders is high among midwives, and a significant number of them were unable to perform their daily tasks. The lower and upper back are the most commonly affected areas. Working in uncomfortable positions and attending to large clients daily were common risk factors. Therefore, training midwives about safe working positions and reducing the workload is commendable.
This study aimed to assess the psychosocial determinants of psychological distress among people with disabilities in Ethiopia.
A cross-sectional study was conducted at an institution from 01 to 30 May 2021, using a census sampling approach.
A total of 269 individuals aged 18 and older with disabilities were present at the University of Gondar in Ethiopia.
The Kessler psychological distress scale (K10), the multidimensional scale of perceived social support, the actual help-seeking behaviour and the stigma scale for chronic illness-8 were used to assess the dependent and independent variables, respectively. Binary logistic regression analyses were performed; a p value less than 0.05 was considered statistically significant at a 95% CI.
In this study, the prevalence of psychological distress was 34.6% with a 95% CI (29.40 to 40.10). Factors, such as older age (adjusted ß=1.09; 95% CI 1.04 to 1.15), low perceived social support (adjusted OR (AOR)=1.83; 95% CI 1.16 to 2.89), experiencing stigma (AOR=2.50; 95% CI 1.12 to 5.61) and cognition problems (adjusted ß=0.73; 95% CI 0.62 to 0.85), were significantly associated with increased psychological distress. Of the participants with psychological distress, professional help-seeking behaviour was 7.5%.
Psychological distress was notably high among individuals with disabilities, while professional help-seeking remained very low. This underscores the urgent need for targeted mental health interventions to reduce stigma, strengthen social support and improve access to appropriate psychological care.
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