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Community-based newborn care utilisation and associated factors in Geze Gofa rural district, South Ethiopia: a community-based cross-sectional study.

ABSTRACT: OBJECTIVE:The community-based newborn care (CBNC) is a newborn care package along the maternal and newborn health continuum of care that has been implemented at the community level in Ethiopia. The utilisation which might be affected by several factors has not been well assessed. Thus, this study aimed to examine the utilisation of CBNC and associated factors among women who delivered recently in Geze Gofa rural district, south Ethiopia. DESIGN:Cross-sectional study. SETTING:Community-based. PARTICIPANTS:Three-hundred seventy-one women who had their newborns recently were randomly selected. Then, they were interviewed at their places using an interviewer-administered structured questionnaire. METHODS:A binary logistic regression analysis was done. In the multivariable logistic regression analysis, a p value of <0.05?and adjusted OR (AOR) with 95% CI were used to identify factors statistically associated with CBNC utilisation. OUTCOMES:CBNC utilisation. RESULTS:The findings showed that the overall utilisation of CBNC by women who delivered recently with their newborns was 37.5% (95% CI: 32.6 to 42.6). Factors associated with the utilisation of CBNC included women who attended elementary school (AOR: 1.76, 95%?CI: 1.01 to 3.07), college and above (AOR: 3.71, 95%?CI: 1.12 to 12.24), farmer women (AOR: 0.35, 95%?CI: 0.16 to 0.79), women in the lowest (AOR: 3.76, 95%?CI: 1.65 to 8.54) and middle quantile of wealth status (AOR: 1.96, 95%?CI: 1.01 to 3.76), and those whose preference was visiting hospital only when they faced any signs of danger (AOR: 0.29, 95%?CI: 0.11 to 0.78). CONCLUSION:The use of the CBNC programme in the study area was surprisingly low. To increase utilisation and potentially improve the outcomes of these neonates, we need to increase awareness at community levels, make convenient arrangements and increase the availability of services at nearby health facilities that are essential to improve the uptake of CBNC in the rural district.

SUBMITTER: Gebremedhin T

PROVIDER: S-EPMC7443266 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Community-based newborn care utilisation and associated factors in Geze Gofa rural district, South Ethiopia: a community-based cross-sectional study.

Gebremedhin Tsegaye T Atnafu Asmamaw A Atnafu Asmamaw A Dellie Endalkachew E

BMJ open 20200820 8

<h4>Objective</h4>The community-based newborn care (CBNC) is a newborn care package along the maternal and newborn health continuum of care that has been implemented at the community level in Ethiopia. The utilisation which might be affected by several factors has not been well assessed. Thus, this study aimed to examine the utilisation of CBNC and associated factors among women who delivered recently in Geze Gofa rural district, south Ethiopia.<h4>Design</h4>Cross-sectional study.<h4>Setting</h ...[more]

PMID: 32819995

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Project description:BACKGROUND:The Community-Based Newborn Care (CBNC) program is a comprehensive strategy designed to improve the health of newborns during pregnancy, childbirth, and the postnatal period through health extension workers at community levels, although the implementation has not been evaluated yet. Therefore, this study aimed to evaluate the process of the CBNC program implementation in Geze Gofa district, south Ethiopia. METHODS:A case study evaluation design with a mixed method was employed from May 1 to 31, 2017. A total of 321 mothers who gave birth from September 01, 2016 to February 29, 2017, were interviewed. Similarly, 27 direct observations, six-month document reviews, and 14 key informant interviews were conducted. The quantitative data were entered into Epi-Data version 3.1 and exported to SPSS version 20 for analysis. In the multivariable logistic regression analysis, variables with <?0.05 p-values and Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were used to declare factors associated with maternal satisfaction. The qualitative data were transcribed, translated, coded, and analyzed using thematic analysis. The overall process of program implementation was measured based on pre-determined judgmental criteria. RESULTS:The overall level of the implementation process of the CBNC program was 72.7%, to which maternal satisfaction, availability of resources, and healthcare providers' compliance with the national guideline contributed 75.0, 81.0, and 68.0%, respectively. Essential drugs and medical equipment, like vitamin K, chlorohexidine ointment, neonatal resuscitation bags, and masks used in the program were out of stock. Very severe diseases were not treated according to the national guidelines, and the identification of neonatal sepsis cases was poor. Trading occupation (AOR: 0.16, 95% CI: 0.03-0.97) and low wealth status (AOR: 3.11, 95% CI: 1.16-8.36) were factors associated with maternal satisfaction. CONCLUSION:The process of CBNC program implementation was relatively good, although the compliance of healthcare providers with the national guideline and maternal satisfaction with the services was low. Some essential drugs and medical equipment were out of stock. Merchant and low wealth status affected maternal satisfaction. Therefore, healthcare offices should provide crucial medicines and equipment for better program implementation and improve the wealth status of mothers to enhance maternal satisfaction.

Project description:BACKGROUND:Maternal and neonatal mortality remain a significant problem across much of the developing world, especially in sub-Saharan Africa countries. In Ethiopia, most maternal and neonatal deaths occur during the postpartum period; this is a critical time for monitoring the health of women and newborns, but the most neglected period for care. In rural communities of Ethiopia, the utilization of postnatal care service is very low and evidence on which factors contribute to the non-utilization of postnatal care (PNC) is insufficient. Consequently, this study was designed to identify the determinants of postnatal service non-utilization among women who gave birth in Demba Gofa rural district, Southern Ethiopia. METHODS:A community-based unmatched case-control study was conducted among 186 cases (postnatal care non-utilizers) and 186 controls (postnatal care utilizers) in Demba Gofa rural district from March 1 to April 10, 2019. A previously tested interviewer-administered structured questionnaire was used for data collection. Binary logistic regression analysis was performed. In the final multivariable logistic regression analysis model, a p-value of less than 0.05 and an Adjusted Odd Ratio (AOR) with a 95% confidence interval (CI) was used to determine variables for postnatal care non-utilization. RESULTS:In this study, women who delivered recently were incorporated within 186 cases and 186 controls. Not knowing the availability of PNC services (AOR: 4.33, 95% CI: 1.71-10.99), having a home delivery (AOR: 7.06, 95% CI: 3.71-13.44), ANC non-attendance (AOR: 6.14, 95% CI: 3.01-12.50), unable to make an independent decision (AOR: 9.31, 95% CI: 3.29-26.35), and not participating in the Women's Development Army (WDA) (AOR: 5.09, 95% CI: 2.73-9.53) comprised the determinants which were assessed for non-utilization of postnatal care services. CONCLUSIONS:Encouraging institutional delivery along with integrated health education about postnatal care and postnatal danger signs, empowering women to execute independent decisions, accessing PNC services and strengthening participation in the Model Families will likely improve postnatal care service utilization in the district of Ethiopia.

Project description:ObjectiveThis study aimed to analyse the prevalence and factors associated with continuum of maternal healthcare services among women who gave birth in Siyadebirena Wayu district, Central Ethiopia.DesignCommunity-based cross-sectional study.SettingAt eight Kebeles in Central Ethiopia.ParticipantsThe study was done on 614 women aged 15-49 years using interviewer-administered structured questionnaire. Following proportional allocation of the sample, we used simple random sampling technique to select study participants.MethodsBinary logistic regression model was fitted to identify the factors associated with the outcome. Variables with p<0.2 in the bivariable analysis were the candidates for multivariable analysis. A p<0.05 and adjusted OR (AOR) with 95% CI were taken to declare the factors and the strengths of association with continuum of maternal healthcare utilisation.OutcomeContinuum of maternal healthcare utilisation.ResultsOnly 16.1% (95% CI 13.3% to 19.0%) of the women had used a complete continuum of maternal health services. Variables, such as contraceptive use (AOR 4.95; 95% CI 1.61 to 15.20), autonomy (AOR 4.45; 95% CI 1.69 to 11.60), urban residence (AOR 3.91; 95% CI 1.06 to 14.39), educated women (AOR 5.36; 95% CI 1.15 to 25.06), took less than 30 min to reach a health facility (AOR 3.17; 95% CI 1.38 to 7.25), use public transportation (AOR 2.48; 95% CI 1.12 to 5.52) and good knowledge (AOR 9.88; 95% CI 3.89 to 25.0) were positively associated with continuum of maternal healthcare. In the contrary, women who had third child birth order (AOR 0.22; 95% CI 0.06 to 0.8) was negatively associated.ConclusionsOverall, the level of the continuum of maternal healthcare services utilisation was low compared with the national and global targets. Therefore, programme planners and implementer had better conduct health education to enhance the awareness of women about continuum of maternal healthcare services. Healthcare sector policy-makers and managers shall also scale up healthcare facilities to improve access to maternal healthcare services.

Project description:ObjectiveThis study aimed to assess the use of institutional delivery services and associated factors among Delgi District mothers of childbearing age.DesignA community-based cross-sectional study design.SettingAt five Kebeles in Delgi District, Northwest Ethiopia.ParticipantsThe study was performed on 403 childbearing age mothers using a structured questionnaire and a face-to-face interview. We used a systematic random sampling method to select the study participants.MethodsThe data were analysed using descriptive analysis, binary logistic regression analysis, and multivariable logistic regression analysis.OutcomeInstitutional delivery service utilisation.ResultsIn the present study, 75.9% (95% CI: 71.7% to 80.1%) of respondents used health facilities for their last delivery. After adjusting for covariates, diploma holders (adjusted odds ratio (AOR)=5.63; 95% CI: 3.77 to 8.39), maternal age at 23-27 years (AOR=6.47; 95% CI: 2.74 to 15.32), divorced women (AOR=0.30; 95% CI: 0.12 to 0.75), husband's primary education (AOR=0.38; 95% CI: 0.18 to 0.82), the distance required above 10 km to reach the health facility (AOR=0.17; 95% CI: 0.04 to 0.72) and the time required above 4 hours to reach the health facility (AOR=0.30; 95% CI: 0.12 to 0.73) were significantly associated with institutional delivery service utilisation.ConclusionsThe majority of respondents utilised institutional delivery services in this study. High-level maternal education, younger maternal age, divorce marital status, low-level husband education, long distances to reach a health facility and prolonged time to reach a health facility were all independently linked to the use of institutional delivery services. One of the foundations for increasing institutional delivery service use is improving mother-waiting centres for delivery services, infrastructure and transportation services and awareness about institutional delivery services. Providing counselling services for mothers during antenatal care visits or house-to-house health education on institutional delivery services for rural residents will improve institutional delivery service use even more.

Project description:IntroductionImmunization is a cost-effective intervention that prevented more than 5 million deaths worldwide from 2010 to 2015. Despite increased vaccination coverage over the past four decades in many African countries, including Ethiopia, universal coverage has not yet been reached. Only 39% of children aged 12-23 months received full vaccinations in Ethiopia, according to the 2016 Ethiopian Demographic Health Survey. This study aimed to evaluate immunization coverage and identify individual and community factors that explain incomplete vaccination coverage among children aged 6-36 months in the Wonago district of southern Ethiopia.MethodsWe conducted a community-based, cross-sectional study in three randomly selected kebeles in the Wonago district from June to July 2017. Our nested sample of 1,116 children aged 6-36 months included 923 child-mother pairs (level 1) within kebeles (level 2). We conducted multilevel regression analysis using STATA software.ResultsAmong participants, 85.0% of children aged 12-36 months received at least one vaccine, and 52.4% had complete immunization coverage. After controlling for several individual and community variables, we identified six significant predictor variables for complete immunization: Older mothers' age (AOR = 1.05, 95% CI: 1.00-1.09), higher utilization of antenatal care (AOR = 1.36, 95% CI: 1.14-1.62), one or more tetanus-toxoid vaccination during pregnancy (AOR = 2.64, 95% CI: 1.43-4.86), mothers knowing the age at which to complete child's vaccinations (AOR = 2.00, 95% CI: 1.25-3.20), being a female (AOR = 0.64, 95% CI: 0.43-0.95), and child receiving vitamin A supplementation within the last 6 months (AOR = 2.79, 95% CI: 1.59-4.90). We observed a clustering effect at the individual and community levels with an intra-cluster correlation coefficient of 48.1%.ConclusionsWe found low immunization coverage among children in the Wonago district of southern Ethiopia, with significant differences across communities. Promoting maternal health care and community service could enhance immunization coverage.

Project description:BackgroundPodoconiosis, affects lower limb, is an entirely preventable non-communicable tropical disease common in low income countries. Globally it is estimated that there are 4 million peoples with podoconiosis and nationally it is estimated that there are 1.56 million cases of podoconiosis. Even though nationwide mapping has been conducted including the current district under investigation, there are no studies conducted to identify factors associated with podoconiosis in the district. Hence, this study was aimed to determine the prevalence of podoconiosis and associated factors in the west Shewa of Dano district community.MethodA community based cross sectional study was conducted from March 1 to 26, 2018. Seven kebeles out of the total of twenty-three kebeles found in the district were selected randomly. The total sample size was allocated by probability proportional to size to each kebele based on the number of households they had. Then, systematic random sampling was employed to select 652 study participants from the seven kebeles. Data was collected using interviewer administered structured questionnaire and observation. In addition, a blood sample was collected from the study subjects who had leg swelling for ruling out lymphedema due to lymphatic filarasis by using Immunochromatographic test card. Podoconiosis case was defined as bilateral but asymmetric swelling which develop first in the foot often confined to the lower leg and negative result for immune-chromatographic test (ICT card). The prevalence of podoconiosis was determined and multiple logistic regression model was fitted using SPSS version 23 to identify factors associated with podoconiosis.ResultThe prevalence of podoconiosis in Dano district was found to be 6.3% (95%CI: 5.8, 6.8). Age at first shoe wearing (AOR = 1.08,95% CI = 1.06-1.11), washing practice of feet by water only (AOR = 3.68, 95% CI = 1.47-9.24) and not wearing shoe daily (AOR = 9.32, 95% CI = 4.27-20.4) were found to be significantly associated with increased odds of podoconiosis.ConclusionThis study revealed that there was significant burden of podoconiosis in the study area. Age at first shoe wearing, washing practice and frequency of shoe wearing were associated with the development of podoconiosis disease. Modalities to enhance the shoe wearing behaviour of the communities should be planned by high level decision makers working in the area of Health. Moreover, collaboration between local government and non-government stakeholders, and integration with existing programs addressing foot hygiene which involves washing feet with soap and water needs to be addressed.

Project description:BackgroundA Community-Based Essential Newborn Care is a national initiative that incorporates a newborn care program into the continuum of maternal and child health care through enhancing community participation to reduce child morbidity and mortality and encourage healthy growth and development. This study aimed at assessing the level of Community-Based Essential Newborn Care service uptake and its associated factors among rural women in the Guraghe zone, Southern Ethiopia, 2020.MethodsA community-based cross-sectional study was conducted in the rural districts of Southern Ethiopia, from 1 to 31 May 2020. A multistage sampling technique was applied. Using a systematic random sampling technique, a total of 818 respondents were selected. The data collected by a pretested structured questionnaire were entered into EpiData 3.1 and exported to the Statistical Package for Social Sciences (Version 23) for analysis. To identify significant predictors of Community-Based Essential Newborn Care utilization, a multivariable logistic regression analysis was fitted. Adjusted odds ratios with 95% confidence intervals were used to estimate the strength of associations, and statistical significance was declared at a p value <0.05.ResultsOne-third, 269 (33.1%) (95% confidence interval = 30.0-36.2), of women and their newborns got the entire packages of the Community-Based Essential Newborn Care program. Desire on the last pregnancy (adjusted odds ratio = 2.66, 95% confidence interval = 1.56-4.51), birth preparedness and complication readiness plan (adjusted odds ratio = 4.82, 95% confidence interval = 3.26-7.12), timing of the postpartum visit (adjusted odds ratio = 3,56, 95% confidence interval = 2.00-6.34), attending monthly pregnant women conference (adjusted odds ratio = 3.01, 95% confidence interval = 1.99-4.57), and being a certified model household (adjusted odds ratio = 1.88, 95% confidence interval = 1.24-2.85) were identified as key predictors of Community-Based Essential Newborn Care utilization.ConclusionThe uptake of the full Community-Based Essential Newborn Care packages in the study area was low. Health care providers at the health institution and community level should give due emphasis to improve contraceptive service delivery. Besides, health extension workers at the community level should work on providing immediate postpartum visits, creating model households, and strengthening pregnant women conferences.

Dataset Information

Community-based newborn care utilisation and associated factors in Geze Gofa rural district, South Ethiopia: a community-based cross-sectional study.

Publications

Community-based newborn care utilisation and associated factors in Geze Gofa rural district, South Ethiopia: a community-based cross-sectional study.

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