Abstract Background Patient satisfaction is a critical measure of the quality of healthcare services provided by healthcare facilities. However, very few studies, particularly in Ethiopia, which ...includes the study area, have specifically examined these discrepancies among people who use outpatient care. In this study, satisfaction levels and associated factors were compared between insured and uninsured patients receiving outpatient services at public health institutions in Hadiya Zone, southern Ethiopia. Methods A facility-based comparative cross-sectional study design was employed on 630 patients using multistage and systematic random sampling. Data were collected using a pretested and structured interviewer-administered questionnaire. Results of the analysis were presented in text, tables, and graphs as appropriate. Multivariable logistic regression was used to predict associations between predictors and the outcome variable. Statistical significance was declared at p-value < 0.05. Results Overall, 344(55.48%) patients were satisfied with the service they received, of which 206(65.8%) out of 313 with a 95% CI 60.7–71.2% were insured and 138(44.95%) out of 307 with a 95% CI 39.4–5.1% were uninsured. Among insured patients, factors associated with higher satisfaction included having a family size less than five members AOR = 3.3, 95% CI; 1.5, 7.4, perceived fair waiting time to be seenAOR = 2.35, 95% CI; 1.02, 5.5, perceived short waiting time to be seenAOR = 8.12, 95% CI; 1.6, 41.3, having all ordered laboratory tests available within the facilityAOR = 7.89, 95% CI; 3.5, 17.5, having some ordered laboratory tests within the facilityAOR = 2.97, 95% CI; 1.25, 7.01 having all prescribed medications available within the facilityAOR = 16.11, 95% CI; 6.25, 41.5, having some prescribed medications available within the facilityAOR = 13.11, 95% CI; 4.7, 36.4. Among non-insured patients, factors associated with higher satisfaction included urban residency, a fair and short perceived time to be seen, having ordered laboratory tests within the facility, and having prescribed drugs within the facility. Conclusion This study identified lower overall satisfaction, particularly among uninsured patients. Enrollment in the CBHI program significantly impacted satisfaction, with both groups reporting lower levels compared to enrollment periods. Access to essential services, wait times, and socio-demographic factors identified as associated factors with patient satisfaction regardless of insurance status.
Long-acting and permanent methods (LAPMs) prevent women from having unintended pregnancies. Globally, unintended pregnancies, both mistimed and unwanted, occur every year. In developing countries, ...maternal mortality and unsafe abortions result from unintended pregnancies. This study aimed to assess the unmet need for LAPMs of contraceptives and associated factors among married women of the reproductive age group (15-49 years) in Hosanna Town, Southern Ethiopia, in 2019.
A community-based, cross-sectional study was conducted from March 20 to April 15, 2019. Data were collected on 672 current married women in the reproductive age group (15-49) through face-to-face interviews using a structured questionnaire. Study participants were selected using a multi-stage sampling method. Data were entered into the computer using EpiData version 3.1 and exported to SPSS version 20 for analysis. Bivariate and multiple logistic regressions were performed to identify factors associated with the unmet need for LAPMs. An odds ratio with 95% CI was used to assess the association between the independent and dependent variables.
The unmet need for LAPMs for contraception in Hossana town was 234 (34.8%) (95% CI: 29.8, 39.8). Factors significantly associated with the unmet need for LAPMs of contraception were: women's age 35-49 AOR = 9.01, 95% CI: 4.21, 19.32; education of women AOR = 8.64, 95% CI: 1.65, 45.42; lack of discussion between partners AOR = 4.79, 95% CI: 3.11, 7.39; lack of proper counseling for women AOR = 2.13, 95% CI: 1.41, 3.23; having a daily laborer occupation AOR = 7.08, 95% CI: 2.44, 20.51; and attitude of women toward LAPMs of contraception AOR = 1.62, 95% CI: 1.03, 2.56.
The unmet need for LAPMs was high in the study area. Age of women, discussions with partners, women ever counseled by health professionals, respondents' educational status, husband's educational status, women's attitude toward LAPMs, and respondents' occupational status were contibutes for high unmet need. High unmet need contributes to an unintended pregnancy and risky abortions. Proper counseling of women and women's discussions with their husbands is fundamental areas of intervention.
Anxiety before surgery is one of the most challenging aspects of preoperative care. Preoperative anxiety has a number of postoperative complications. There are only a few studies that report on ...preoperative anxiety in surgical patients in Ethiopia, and their prevalence differs from one study to the next.BackgroundAnxiety before surgery is one of the most challenging aspects of preoperative care. Preoperative anxiety has a number of postoperative complications. There are only a few studies that report on preoperative anxiety in surgical patients in Ethiopia, and their prevalence differs from one study to the next.The aim of this study was to assess the level of preoperative anxiety and associated factors among surgical patients admitted at public hospitals in southern Ethiopia.ObjectiveThe aim of this study was to assess the level of preoperative anxiety and associated factors among surgical patients admitted at public hospitals in southern Ethiopia.From July to August 2022, a facility-based cross-sectional study was conducted among patients admitted to surgical wards at public hospitals. Data collection was conducted using a pretested, structured questionnaire administered by an interviewer. Preoperative anxiety was assessed using the State-Trait Anxiety Inventory scale. The data were coded and entered in Epi Data Version 4.6, then exported to Statistical Package for Social Sciences version 25 for analysis. To describe the study variables, descriptive statistics were used. The associated factors were then identified using bivariate and multivariate logistic regression analyses. Results were declared at a p-value of less than 0.05 based on an adjusted odds ratio with a 95% confidence interval.MethodsFrom July to August 2022, a facility-based cross-sectional study was conducted among patients admitted to surgical wards at public hospitals. Data collection was conducted using a pretested, structured questionnaire administered by an interviewer. Preoperative anxiety was assessed using the State-Trait Anxiety Inventory scale. The data were coded and entered in Epi Data Version 4.6, then exported to Statistical Package for Social Sciences version 25 for analysis. To describe the study variables, descriptive statistics were used. The associated factors were then identified using bivariate and multivariate logistic regression analyses. Results were declared at a p-value of less than 0.05 based on an adjusted odds ratio with a 95% confidence interval.A total of 220 patients were enrolled, with a 99.5% response rate. The observed preoperative anxiety level was 57.5% (95%CI: 54.63-62.35). High preoperative anxiety was associated with no formal educational status (AOR: 3.75; 95%CI = 1.36, 10.39), fear of death (AOR =2.01; 95%CI = 1.09, 3.73), fear of waking up in middle of surgery (AOR =3.42; 95%CI =1.19, 9.77), fear of postoperative pain (AOR = 2.56; 95%CI = 1.15, 5.74).ResultA total of 220 patients were enrolled, with a 99.5% response rate. The observed preoperative anxiety level was 57.5% (95%CI: 54.63-62.35). High preoperative anxiety was associated with no formal educational status (AOR: 3.75; 95%CI = 1.36, 10.39), fear of death (AOR =2.01; 95%CI = 1.09, 3.73), fear of waking up in middle of surgery (AOR =3.42; 95%CI =1.19, 9.77), fear of postoperative pain (AOR = 2.56; 95%CI = 1.15, 5.74).This study found that five out of ten patients scheduled for surgery in public hospitals had high levels of preoperative anxiety. Anxiety levels were associated with factors such as the educational status of respondents, fear of death, fear of waking up in the middle of surgery, and fear of postoperative pain. Preoperative anxiety assessments should be conducted regularly in each hospital, and appropriate anxiety-reducing methods must be implemented.ConclusionThis study found that five out of ten patients scheduled for surgery in public hospitals had high levels of preoperative anxiety. Anxiety levels were associated with factors such as the educational status of respondents, fear of death, fear of waking up in the middle of surgery, and fear of postoperative pain. Preoperative anxiety assessments should be conducted regularly in each hospital, and appropriate anxiety-reducing methods must be implemented.
Background. Healthcare-seeking behavior is referred to as any action taken by individuals who believe they have a health problem or are ill in order to find an appropriate remedy. The aim of this is ...to assess healthcare-seeking behavior on newborn danger signs and associated factors among mothers who gave birth in the last 12 months in the Anlemo district. Methods. A community-based cross-sectional study was conducted in the Anlemo district from June 15th, 2019 to July 16th, 2019. Data were collected from 421 randomly selected mothers through a face-to-face interview. Data were cleaned and entered into Epi-Data version 3.1, and then, exported to SPSS version 22.0 for analysis. Binary logistic regression with p values less than 0.25 was entered into a multivariable logistic regression for analysis. Finally, adjusted odds ratios (AOR) with 95% confidence intervals at a p value of <0.05 were considered as a statistically significant association with the outcome variable. Results. Among mothers whose newborns faced newborn danger signs, 34.5% (95% CI: 28.7, 40.5%) sought medical attention for newborn danger signs. When mothers were faced with neonatal danger signs, the multivariable logistic regression model identified three independent variables that were associated with their healthcare-seeking behavior. Mothers who had a college degree or above were 6.34 times more likely than mothers who could not read or write to seek medical care (AOR = 6.34, 95% CI: 1.23–32.69). Mothers or healthcare seekers who did not travel a long distance (less than 5 kilometers) to acquire healthcare were 2.53 times more likely than mothers who traveled a long distance (AOR = 2.53, 95% CI: 1.05–6.08), which had a significant association with the dependent variable. Conclusions. In this study, the proportion of mothers seeking care for newborn danger signs was low, and the mothers’ education, time to reach the nearest health facility, and place of delivery were factors of statistical significance with the dependent variable.
Human papillomavirus infections are the most prevalent sexually transmitted disease among women worldwide. Cervical cancer is the second-most frequent disease worldwide in terms of incidence and ...mortality, and it is primarily responsible for fatalities in low- to middle-income nations, including Ethiopia.
To assess awareness, acceptance, and associated factors of the human papillomavirus vaccine among parents of daughters in the Hadiya zone, southern Ethiopia.
From November to December 2021, a community-based cross-sectional study was conducted in the Hadiya zone among parents with daughters in the zone. The study respondents were chosen using a two-stage sampling technique from parents with a 9-14-year-old daughter. An interviewer-administered questionnaire was used to collect data. For analysis, the data were entered into Epidata version 3.1 and exported to SPSS version 25. Variables with a
-value less than 0.25 in the bivariate analysis were transferred to multivariable analysis. A logistic regression model was applied to forecast the association between the predictor and outcome variables. Statistical significance was considered at a 0.05
-value.
The study showed that the overall acceptance of parents to vaccinate their daughters with HPV vaccination was 450 (84.9%). Parents of daughters of male sex (AOR: 0.407; 95%CI: 0.221, 0.748), who had only one daughter (AOR: 2.122; 95%CI: 1.221, 3.685), whose daughter(s) attended a government school (AOR: 0.476; 95%CI: 0.263, 0.861), who had poor knowledge (AOR: 0.532; 95%CI: 0.293, 0.969) and who had a negative attitude (AOR: 0.540; 95%CI: 0.299, 0.977) were discovered to have a strong correlation.
This study found that there was a high level of parental acceptance; attitudes and knowledge about the HPV vaccine are significant in determining their intentions to vaccinate their daughter. Authorities in high-risk areas for cervical cancer incidence should plan and implement strategies by providing health information regarding human papillomavirus vaccination with an emphasis on raising community awareness.
Global evaluations of the progress towards the WHO End TB Strategy 2020 interim milestones on mortality (35% reduction) and incidence (20% reduction) have not been age specific. We aimed to assess ...global, regional, and national-level burdens of and trends in tuberculosis and its risk factors across five separate age groups, from 1990 to 2021, and to report on age-specific progress between 2015 and 2020.
We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 (GBD 2021) analytical framework to compute age-specific tuberculosis mortality and incidence estimates for 204 countries and territories (1990–2021 inclusive). We quantified tuberculosis mortality among individuals without HIV co-infection using 22 603 site-years of vital registration data, 1718 site-years of verbal autopsy data, 825 site-years of sample-based vital registration data, 680 site-years of mortality surveillance data, and 9 site-years of minimally invasive tissue sample (MITS) diagnoses data as inputs into the Cause of Death Ensemble modelling platform. Age-specific HIV and tuberculosis deaths were established with a population attributable fraction approach. We analysed all available population-based data sources, including prevalence surveys, annual case notifications, tuberculin surveys, and tuberculosis mortality, in DisMod-MR 2.1 to produce internally consistent age-specific estimates of tuberculosis incidence, prevalence, and mortality. We also estimated age-specific tuberculosis mortality without HIV co-infection that is attributable to the independent and combined effects of three risk factors (smoking, alcohol use, and diabetes). As a secondary analysis, we examined the potential impact of the COVID-19 pandemic on tuberculosis mortality without HIV co-infection by comparing expected tuberculosis deaths, modelled with trends in tuberculosis deaths from 2015 to 2019 in vital registration data, with observed tuberculosis deaths in 2020 and 2021 for countries with available cause-specific mortality data.
We estimated 9·40 million (95% uncertainty interval UI 8·36 to 10·5) tuberculosis incident cases and 1·35 million (1·23 to 1·52) deaths due to tuberculosis in 2021. At the global level, the all-age tuberculosis incidence rate declined by 6·26% (5·27 to 7·25) between 2015 and 2020 (the WHO End TB strategy evaluation period). 15 of 204 countries achieved a 20% decrease in all-age tuberculosis incidence between 2015 and 2020, eight of which were in western sub-Saharan Africa. When stratified by age, global tuberculosis incidence rates decreased by 16·5% (14·8 to 18·4) in children younger than 5 years, 16·2% (14·2 to 17·9) in those aged 5–14 years, 6·29% (5·05 to 7·70) in those aged 15–49 years, 5·72% (4·02 to 7·39) in those aged 50–69 years, and 8·48% (6·74 to 10·4) in those aged 70 years and older, from 2015 to 2020. Global tuberculosis deaths decreased by 11·9% (5·77 to 17·0) from 2015 to 2020. 17 countries attained a 35% reduction in deaths due to tuberculosis between 2015 and 2020, most of which were in eastern Europe (six countries) and central Europe (four countries). There was variable progress by age: a 35·3% (26·7 to 41·7) decrease in tuberculosis deaths in children younger than 5 years, a 29·5% (25·5 to 34·1) decrease in those aged 5–14 years, a 15·2% (10·0 to 20·2) decrease in those aged 15–49 years, a 7·97% (0·472 to 14·1) decrease in those aged 50–69 years, and a 3·29% (–5·56 to 9·07) decrease in those aged 70 years and older. Removing the combined effects of the three attributable risk factors would have reduced the number of all-age tuberculosis deaths from 1·39 million (1·28 to 1·54) to 1·00 million (0·703 to 1·23) in 2020, representing a 36·5% (21·5 to 54·8) reduction in tuberculosis deaths compared to those observed in 2015. 41 countries were included in our analysis of the impact of the COVID-19 pandemic on tuberculosis deaths without HIV co-infection in 2020, and 20 countries were included in the analysis for 2021. In 2020, 50 900 (95% CI 49 700 to 52 400) deaths were expected across all ages, compared to an observed 45 500 deaths, corresponding to 5340 (4070 to 6920) fewer deaths; in 2021, 39 600 (38 300 to 41 100) deaths were expected across all ages compared to an observed 39 000 deaths, corresponding to 657 (–713 to 2180) fewer deaths.
Despite accelerated progress in reducing the global burden of tuberculosis in the past decade, the world did not attain the first interim milestones of the WHO End TB Strategy in 2020. The pace of decline has been unequal with respect to age, with older adults (ie, those aged >50 years) having the slowest progress. As countries refine their national tuberculosis programmes and recalibrate for achieving the 2035 targets, they could consider learning from the strategies of countries that achieved the 2020 milestones, as well as consider targeted interventions to improve outcomes in older age groups.
Bill & Melinda Gates Foundation.
