Dataset Information

Healthcare providers' perspectives on use of the national guideline for family planning services in Amhara Region, Ethiopia: a qualitative study.

ABSTRACT:

Objective

To explore healthcare providers' views on barriers to and facilitators of use of the national family planning (FP) guideline for FP services in Amhara Region, Ethiopia.

Design

Qualitative study.

Setting

Nine health facilities including two hospitals, five health centres and two health posts in Amhara Region, Northwest Ethiopia.

Participants

Twenty-one healthcare providers working in the provision of FP services in Amhara Region.

Primary and secondary outcome measures

Semistructured interviews were conducted to understand healthcare providers' views on barriers to and facilitators of the FP guideline use in the selected FP services.

Results

While the healthcare providers' views point to a few facilitators that promote use of the guideline, more barriers were identified. The barriers included: lack of knowledge about the guideline's existence, purpose and quality, healthcare providers' personal religious beliefs, reliance on prior knowledge and tradition rather than protocols and guidelines, lack of availability or insufficient access to the guideline and inadequate training on how to use the guideline. Facilitators for the guideline use were ready access to the guideline, convenience and ease of implementation and incentives.

Conclusions

While development of the guideline is an important initiative by the Ethiopian government for improving quality of care in FP services, continued use of this resource by all healthcare providers requires planning to promote facilitating factors and address barriers to use of the FP guideline. Training that includes a discussion about healthcare providers' beliefs and traditional practices as well as other factors that reduce guideline use and increasing the sufficient number of guideline copies available at the local level, as well as translation of the guideline into local language are important to support provision of quality care in FP services.

SUBMITTER: Tessema GA

PROVIDER: S-EPMC6398659 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Healthcare providers' perspectives on use of the national guideline for family planning services in Amhara Region, Ethiopia: a qualitative study.

Tessema Gizachew Assefa GA Gomersall Judith Streak JS Laurence Caroline O CO Mahmood Mohammad Afzal MA

BMJ open 20190220 2

<h4>Objective</h4>To explore healthcare providers' views on barriers to and facilitators of use of the national family planning (FP) guideline for FP services in Amhara Region, Ethiopia.<h4>Design</h4>Qualitative study.<h4>Setting</h4>Nine health facilities including two hospitals, five health centres and two health posts in Amhara Region, Northwest Ethiopia.<h4>Participants</h4>Twenty-one healthcare providers working in the provision of FP services in Amhara Region.<h4>Primary and secondary out ...[more]

PMID: 30787080

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Project description:BackgroundLiteratures revealed that healthcare-associated infections are still a great concern in many developing countries including in Ethiopia. Despite the development of detailed guidelines for infection control, they remain as a critical challenge for the public health sectors and the knowledge of standard precautions among healthcare workers in many developing countries is low and not properly applied. Hence, the present study tried to determine the level of knowledge about standard precautions among healthcare workers of Amhara region, Ethiopia.MethodsInstitutional based cross-sectional study was conducted on a randomly selected public hospitals of Amhara region, Northwest Ethiopia from March 01-April 01/2017. A multistage sampling strategy was utilized to select 795 sampled healthcare workers. Data were collected using pretested self-administered questionnaire. The collected data entered using EpiData Version 3.1 statistical software and analyzed using SPSS version 20 statistical package. After using binary logistic regression, multivariable logistic regression analysis used to form the model. Variables which had statistically significant association with the outcome variable (P < 0.05) were identified as significant in the multivariable logistic regression analysis.ResultsAlmost half (49.2%) of the study participants were female healthcare workers. Three-fourth (74.3%) of the healthcare workers involved in the current study had good knowledge towards standard precautions. Good knowledge towards standard precautions refers to scoring correct responses to > 60% of knowledge items from the survey. Year of service (AOR: 0.27, 95% CI: 0.16 to 0.44), educational status (AOR: 1.7, 95% CI: 1.13 to 2.56) were among the predictor variables. In addition, physicians were 6.97 times more likely to be knowledgeable (AOR: 6.97, 95% CI 2.42 to 20.12) than laboratory technician/technology counterparts. Study participants working in medical, Gyn/obs, pediatrics wards, and OPD were about 2.23, 4.27, 2.81 and 2.52 times more likely to be knowledgeable than study participants working in surgical ward.ConclusionsOverall, the majority of healthcare workers had good knowledge of standard precautions. But variation in knowledge was detected across healthcare workers by hospital type and ward/units. This may help to design a solution by prioritizing the problem.

Project description:IntroductionPostpartum 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.MethodsA 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.ResultsA 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).ConclusionOur 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.

Project description:Healthcare providers (HCPs) are at an increased risk of getting COVID-19 as a result of their front-line works. Health behaviors of HCPs can influence prevention and control actions implemented in response to the pandemic. Hence, this study aimed to assess the knowledge, attitude, and practice (KAP) and factors associated with prevention practice towards COVID-19 among healthcare providers in Amhara region, northern Ethiopia. A multicenter cross-sectional study was conducted among 422 HCPs in selected public health facilities of Amhara region, between 20th September and 20th October 2020. Data related to HCP’s KAP and socio-demographic characteristics were collected using a pre-tested self-administered questionnaire. Bloom’s cut-off ≥ 80%, ≥90%, and ≥75% was used to determine adequate knowledge, positive attitude, and good prevention practice, respectively. Data were analyzed using SPSSS version 25.0. A multivariable logistic regression analysis was performed to identify factors significantly associated with COVID-19 prevention practice. Statistical significance was determined at a p-value of < 0.05 and the presence of association was described using odds ratio (OR) with their 95% confidence interval (CI). Overall, 368 (89.8%), 387 (94.4%), and 326 (79.5%) HCPs had adequate knowledge, positive attitude, and good prevention practice towards COVID-19, respectively. Factors significantly associated with good COVID-19 prevention practice were being a Nurse in profession (AOR = 2.13, 95% CI = 1.13–3.99), having < 5 years of working experience (AOR = 0.46, 95% CI = 0.24–0.86), using social media (AOR = 6.20, 95% CI = 2.33–16.51) and television and or radio (AOR = 4.03, 95% CI = 1.56–10.38) as sources of COVID-19 information. HCPs had adequate knowledge, positive attitude and good prevention practice towards COVID-19. Being a Nurse, having < 5 years of working experiences, using social media and television and or radio were factors associated with good prevention practice. Thus, developing HCP’s professional carrier through training opportunities, sharing experiences and using verified information sources are crucial to better improve COVID-19 prevention practice.

Project description:Background Nutrition during pregnancy has lifelong impacts on the mother and fetus. In Ethiopia, nearly a third of pregnant women experience undernutrition. When designing nutrition interventions during pregnancy, it is important to understand existing dietary perspectives and practices in local communities. Objectives To explore the processes that shape dietary perspectives and practices during pregnancy in rural West Gojjam and South Gondar Zones of the Amhara region in Ethiopia. Methods From October to November 2018, we conducted 40 in-depth interviews with pregnant women (n = 16), family members (n = 12), and healthcare providers (n = 12) using a semistructured interview guide. Interviews were conducted in Amharic, transcribed in Amharic, and translated into English. We used a thematic analysis approach to organize data per the predefined topic areas and identify emerging themes, as well as barriers and enablers to healthy nutrition during pregnancy. Results Pregnant women and their family members recognized the benefits of a diversified diet to promote the health of the mother and the fetus. However, participants reported low dietary diversity because of limited access to nutritious foods and particular perspectives on food restrictions during pregnancy. The common practice of religious fasting also limited pregnant women’s dietary intake. Women reported restricting their food intake in later pregnancy because of loss of appetite, as well as concerns about having a large infant, which might complicate delivery. Intake of locally made alcoholic drinks (Tella) was reported among pregnant women because participants thought it had low levels of alcohol that would not harm the fetus. Conclusions Although participants understood the importance of a healthy and diverse diet in pregnancy, we identified several barriers and perspectives regarding nutrition during pregnancy. Low income and lack of access to diverse foods, particularly in certain seasons, religious fasting, intentional food restrictions to limit the size of the infant, and alcohol use were commonly reported. Locally appropriate counseling and interventions should be developed, with an emphasis on increasing access to and consumption of diverse foods. Curr Dev Nutr 2023;x:xx.

Project description:BackgroundHealth care workers (HCWs) are at an increased risk of acquiring tuberculosis (TB) compared to the general population, because of the frequent face to face contact or potential exposure to TB through shared air or space with infectious patient(s), regardless of economic setting and local TB incidence. Information on the burden of active TB disease among HCWs will help guide control measures, can be utilized to evaluate the effectiveness of TB infection prevention programs in the health care setting, and guide necessary actions. However, data on TB among HCW in Ethiopia is limited. Therefore, this study aimed to determine the prevalence of active TB disease among healthcare workers and support staff in healthcare settings in the Amhara region of Ethiopia.MethodsA cross-sectional study design was used to recruit a total of 580 randomly selected study participants in the Amhara region. Data were collected over four months in selected hospitals and health centers. Implementation of TB prevention and control measures was evaluated using a standardized checklist. The main outcome indicator was active TB as measured by a laboratory diagnosis using GeneXpert technology.ResultsA total of 580 study participants were enrolled. The mean age was 31.3 (±7.8 standard deviation) years, with about two-thirds (65.3%) aged between 18-24 years. A total of 9 (1.6%) MTB cases were detected, 4 (1.4%) in HCWs and 5 (1.7%) in support staff, which did not significantly differ (P = 0.50). About 90% of the participants had not received TB infection prevention and control training ever. More than half (54%) of the study participants worked in poorly ventilated rooms. Triage of coughing patients was not practiced in 32% of the studied facilities (health centers and hospitals).ConclusionsThe magnitude of TB among healthcare workers and support staff in healthcare settings was higher than in the general population (140 per 100000 population). The status of implementation of tuberculosis prevention and control measures indicated missed opportunities. Hence, strict implementation of developed infection control plans of TB in healthcare settings needs to be improved.

Project description:OBJECTIVES:The objective of this study was to explore the access to, and perceived utility of, various simulation modalities by in-service healthcare providers in a resource-scarce setting. SETTING:Paediatric training workshops at a national paediatric conference in Nigeria. PARTICIPANTS:All 200 healthcare workers who attended the workshop sessions were eligible to participate. A total of 161 surveys were completed (response rate 81%). PRIMARY AND SECONDARY OUTCOME MEASURES:A paper-based 25-item cross-sectional survey on simulation-based training (SBT) was administered to a convenience sample of healthcare workers from secondary and tertiary healthcare facilities. RESULTS:Respondents were mostly 31-40 years of age (79, 49%) and women (127, 79%). Consultant physicians (26, 16%) and nurses (56, 35%) were in both general (98, 61%) and subspecialty (56, 35%) practice. Most had 5-10 years of experience (62, 37%) in a tertiary care setting (72, 43%). Exposure to SBT varied by profession with physicians more likely to be exposed to manikin-based (29, 30% physicians vs 12, 19% nurses, p<0.001) or online training (7, 7% physician vs 3, 5% nurses, p<0.05). Despite perceived barriers to SBT, respondents thought that SBT should be expanded for continuing education (84, 88% physician vs 39, 63% nurses, p<0.001), teaching (73, 76% physicians vs 16, 26% nurses, p<0.001) and research (65, 68% physicians vs 14, 23% nurses, p<0.001). If facilities were available, nearly all respondents (92, 98% physicians; 52, 96% nurses) would recommend the use of online simulation for their centre. CONCLUSIONS:The access of healthcare workers to SBT is limited in resource-scarce settings. While acknowledging the challenges, respondents identified many areas in which SBT may be useful, including skills acquisition, skills practice and communication training. Healthcare workers were open to the use of online SBT and expressed the need to expand SBT beyond the current scope for health professional training in Nigeria.

Project description:BackgroundCoronavirus (CoV) is a novel respiratory virus that can cause severe acute respiratory syndrome (SARS). It affects millions of people in the world and thousands of people in Ethiopia. In responding to this, digital health technologies help to reduce COVID-19 outbreaks by sharing accurate and timely COVID-19 related information. Additionally, digital solutions are used for remote consulting during the pandemic, in creating COVID-19 related awareness, for distribution of the vaccine, and so on. Therefore, this study aimed to assess digital health literacy to share COVID-19 related information and associated factors among healthcare providers who worked at COVID-19 treatment centers in the Amhara region, Northwest Ethiopia.MethodAn institutional-based cross-sectional survey was conducted from April 4 to May 4, 2021. The study included 476 healthcare providers who worked at COVID-19 treatment centers in the Amhara region. A pretested, structured self-administered questionnaire was used to collect data. EpiData 4.6 and SPSS version 26 were used for data entry and analysis respectively. Bi-variable and Multivariable logistic regression analysis was used to identify factors associated with the dependent variable. A P-value of less than 0.05 was used to declare statistical significance.ResultA total of 456 respondents were participated in the study, with 95.8% response rate. Digital health literacy to share COVID-19 related information found to be 50.4% (95% CI: 46-55). Educational status [AOR = 4.37, 95% CI(2.08-9.17)], training [AOR = 3.00, 95% CI (1.80-5.00)], attitude [AOR = 1.99, 95% CI(1.18-3.36)], perceived usefulness [AOR = 2.01, 95% CI(1.22-3.32)], perceived ease of use [AOR = 2.00, 95% CI(1.25-3.21)] and smartphone access [AOR = 5.21, 95% CI(2.34-9.62)] were significantly associated with digital health literacy to sharing of COVID-19 related information at P-value less than 0.05.ConclusionThis finding indicated that approximately half of the respondents had digital health literacy to share COVID-19 related information which was inadequate. Improving respondents' educational status, computer training, smartphone access, perceived usefulness, perceived ease of use, and attitude was necessary to measure digital health literacy to sharing of COVID-19 related information.

Project description:BackgroundMental health conditions are among the health issues associated with homelessness, and providing mental healthcare to people experiencing homelessness is challenging. Despite the pressing issue of homelessness in Addis Ababa, Ethiopia, there is scant research on how service providers address women's mental health and psychosocial needs. Therefore, we explored service providers' and programme coordinators' perceptions and experiences regarding mental healthcare and psychosocial services delivery to women experiencing street homelessness in the city.MethodsWe conducted a descriptive qualitative study with selected healthcare and social support providers and programme coordinators. The study involved 34 participants from governmental and non-governmental organisations in Addis Ababa, Ethiopia. Data were analysed using an inductive thematic approach.ResultsFour themes were derived from the analysis. The first of these was "divergent intentions and actions". While service providers and programme coordinators showed empathy and compassion, they also objectified and blamed people for their own homelessness. They also expressed opposing views on mental health stigma and compassion for these people. The second theme addressed "problem-solution incompatibility", which focused on the daily challenges of women experiencing homelessness and the types of services participants prioritised. Service providers and programme coordinators proposed non-comprehensive support despite the situation's complexity. The participants did not emphasise the significance of gender-sensitive and trauma-informed care for women experiencing street homelessness in the third theme, "the lack of gendered and trauma-informed care despite an acknowledgement that women face unique challenges". The fourth theme, "mismatched resources," indicated structural and systemic barriers to providing services to homeless women.ConclusionsConflicting attitudes and practices exist at the individual, organisational, and systemic levels, making it challenging to provide mental healthcare and psychosocial services to women experiencing homelessness. An integrated, gender-sensitive, and trauma-informed approach is necessary to assist women experiencing homelessness.

Project description:BACKGROUND:Preventing unintended pregnancies among HIV positive women is one component of HIV prevention strategies. However, programs to prevent mother-to-child transmission (PMTCT) of HIV started in antenatal care. The objective of this study was to examine the status of family planning integration to HIV care from client and facility perspectives and identify factors associated with current family planning use. METHODS:A facility-based cross-sectional study was conducted from December 2017 to April 2018. Data were coded and double entered into EPI Info version 3.5.4 and exported to STATA version 14 for analysis. Bi-variable and multivariable logistic regression analyses were conducted to assess the association of variables with the current family planning use. RESULTS:A total of 518 HIV-positive women were included in the study. Among HIV-positive women, 35.3% had an unmet need for family planning, and 21.4% responded that their pregnancies were unwanted. About two-thirds (68.1%) of women were using a modern family planning method at the time of the study. Among women who were currently using family planning, 88.8% got the service from a family planning clinic in the same facility, and only 1.1% got the service from the HIV care unit. Women who were not knowledgeable on PMTCT (AOR 0.47, 95% CI?=?0.24-0.90), divorced or separated women (AOR 0.19, 95% CI?=?0.10-0.37) and women in the age group of 25-34?years (AOR 0.42, 95% CI?=?0.20-0.88) and 35-49?years (AOR 0.41, 95% CI?=?0.17-0.99) were less likely to use modern family planning methods compared with those women who were knowledgeable, married and women in the age group of 15-24?years. Besides, women with higher income (AOR 2.12, 95% CI?=?1.26-3.57) were more likely to use modern family planning methods compared with women with lower incomes. CONCLUSION:This study indicated that there is a high unmet need for family planning among HIV-positive women and low family planning services integration in the PMTCT/ART clinics. Efforts should be strengthened to tackle the factors which hinder the use of modern family planning and improve family planning service integration.

Dataset Information

Healthcare providers' perspectives on use of the national guideline for family planning services in Amhara Region, Ethiopia: a qualitative study.

Objective

Design

Setting

Participants

Primary and secondary outcome measures

Results

Conclusions

Publications

Healthcare providers' perspectives on use of the national guideline for family planning services in Amhara Region, Ethiopia: a qualitative study.

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