College of Medicine and Health Science

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UTILIZATION OF ELECTRONIC COMMUNITY HEALTH INFORMATION SYSTEM (eCHIS) AND ASSOCIATED FACTORS AMONG HEALTH EXTENSION WORKERS IN SIDAMA REGION, ETHIOPIA
(hawassa universty, 2023-05) KIDEST FEKADU
Background: Effective community health management information systems (C-HMIS) are important in low-resource countries that rely heavily on community-based health care providers [3]. Electronic community health information systems (eCHIS) have been increasingly developed and deployed to quantify and support services delivered by community health workers. However, there is no evidence of the level of utilization of electronic community health information systems. Objective: The main aim of this study is to assess the level of electronic community health information system (eCHIS) and associated factors among health extension workers in the Sidama region, Ethiopia, in 2023. Methods: This study employed quantitative (cross-sectional) studies complemented by qualitative (Phenomenology) study designs. All health posts found in the Sidama region and health extension workers have been included in the study. Quantitative data has been collected using a pre-tested, structured, self-administered questionnaire whereas qualitative data has been collected from in-depth interviews with key informants (KIs). The collected quantitative data has been entered into Epi-Data Version 3.1 and is being analyzed using SPSS version 25 software. A descriptive summary has been computed using proportions and frequencies. Multi Variable Logistic Regression analysis has been computed to identify the factors associated with eCHIS use and Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) has been reported. On the other hand, the qualitative data has been analyzed thematically and the results had being presented in narration. Work plan and Budget: The study has been conducted from January October 2022 to May 2023 and a total of 131,540.2 Birr has been required to carry out this study.
DETEMINANTS OF SURGICAL SITE INFECTION FOLLOWING CESAREAN DELIVERIES IN HAWASSA UNIVERSITY COMPREHENSIVE SPECIALIZED HOSPITAL, HAWASSA, ETHIOPIA : UNMATCHED CASE –CONTROL STUDY
(hawassa universty, 2023-05) SISAY DEJENE
Background - Globally the incidence of infection following Cesearn delivery was significantly higher in lower-income countries including Ethiopia. Even though surgical site infection is among the leading causes of maternal mortality and morbidity, only a few studies have been conducted on the determinants of surgical site infection following cesarean deliveries. Objective – This study aimed to identify the determinants of surgical site infection following cesarean deliveries in Hawassa University Comprehensive Specialized Hospital Hawassa, Ethiopia. Methods – A hospital-based unmatched case-control study was conducted from September 2019- to September 2022 at Hawassa University Comprehensive Specialized Hospital. Data was extracted from April 15 to May 15, 2023. Cases were selected through consecutive sampling, while controls were selected using a systematic random sampling method. A total of 320 participants were included (107 cases and 213 controls). Data were collected by using the Open Data kit (ODK) downloaded and exported to XLS then imported to SPSS version 26. A binary logistic regression model was conducted and a variable with a p-value of < 0.25 was selected as a candidate variable for the final multivariable logistic regression model and a P-value of less than 0.05 was statistically considered as significant predictors. Results: A total of 320 mothers (107 cases and 213 controls) were included in this study. Women with diabetes mellitus were 3.7 times [AOR: 3.71, 95%CI: 1.18–11.66] at higher odds for surgical site infection compared to women who did not have diabetes mellitus. Vaginal examination [AOR= 2.28 (95%CI, 1.15-4.54)], post-operative hematocrit less than 30% [AOR= 4.12(95% CI 1.97-8.61).women in labour during C/S [AOR= 5.16( (95%CI,1.33-20.1)]. more than 5 days duration of hospital stay[AOR=3.42 (95%CI, 1.32-8.89)] were identified factors. Conclusion and Recommendation ; In this study Diabetes mellitus, Number of vaginal examinations, post-operative hematocrit, labor status during C/S and length of hospital stay were the identified as determinants of surgical site infection following cesarean deliveries. Therefore early detection and risk assessment during certain times in order to reduce these determining factors of surgical site infection is important
KANGAROO MOTHER CARE PRACTICE AND ASSOCIATED FACTORS AMONG POSTNATAL MOTHERS IN TERTIARY CARE HOSPITALS, SOUTHERN NATION, NATIONALITIES AND PEOPLES REGION, ETHIOPIA, 2023
(Hawassa University, 2023-06) TAKELE MATHEWOS BEYENE
Background: Kangaroo mother care is early, prolonged, and ongoing skin-to-skin contact between the mother and her child while they are both in the hospital and following their discharge. The country-level practice of kangaroo mother care has been low, and few studies have examined the reasons for this poor practice. Therefore, this study aimed to assess kangaroo mother care practice and associated factors among mothers in tertiary care hospitals in the Southern Nation, Nationalities, and Peoples Region in 2023. Method: An institutional-based cross-sectional study was conducted among 132 mothers from May 1 to June 30, 2023. A single population proportion with an adjusted formula was used to calculate the total sample size. A face-to-face interview with a structured questionnaire and an observant checklist for the practice part was used to collect data. Data was collected through the Kobo toolbox, exported into an Excel sheet, and finally exported into SPSS version 25 for statistical analysis. Bivariate and multivariate logistic regressions with proportion values <0.25 and <0.05 were used, respectively. A Hosmer and Lemeshow model fitness test was checked, and the model was adequate and well-fitted. Result: A total of 130 participants were included in the study, with a response rate of 98.48%, of which 68 (52.3%) had good KMC practice. Type of recent birth [AOR: 6.59 (95% CI: 1.46, 29.67)], spontaneous vaginal mode of delivery [AOR: 8.24 (95% CI: 2.12, 32.01)], mothers who got help from other mothers [AOR: 4.16 (95% CI: 1.02, 16.94)], and mothers who had good knowledge [AOR: 6.54( 95% CI: 1.82, 23.42)] were significantly associated factors with good kangaroo mother care practice among mothers with pre-term and low birth weight babies. Conclusion: More than half of postnatal mothers have good kangaroo mother care practice. Current single birth, spontaneous vaginal delivery, support from other mothers in the unit, and mother’s knowledge about kangaroo mother care, were identified as significantly associated variables. Hence, hospital administration and health care providers should be engaged in encouraging others to share experiences with other mothers in the unit and provide adequate awareness about the overall procedure and benefits of kangaroo mother care.
TREND, AND IMMEDIATE OUTCOMES OF TRANSCATHETER CLOSURE VERSUS SURGICAL LIGATION OF PDA IN CHILDREN WHO UNDERGONE CLOSURE OF PDA AT THE CARDIAC CENTER OF ETHIOPIA FROM 2012 TO 2022: COMPARATIVE CROSS-SECTIONAL STUDY.
(hawassa universty, 2023-10) MOHAMMED NASIR
Background: The Ductus arteriosus is an important fetal structure that helps in reducing right ventricular afterload during fetal life, but the patent ductus arteriosus (PDA) often closes spontaneously after birth. To prevent complications from patent ductus arteriosus, transcatheter closure (TC)and surgical ligation (SL) are management options for PDA that have not spontaneously closed. TC is preferred nowadays in older children and adults and SL in infants. However, the magnitude of the complications and outcomes associated with transcatheter closure (TC) and surgical ligation (SL) of PDA vary across studies. In this study, the trend, and immediate outcomes of TC of PDA versus SL of PDA were compared. Methodology:This study was conducted on children under 18 years ofage who underwent TC and SL of PDA at a cardiac center in Ethiopia (CCE) from January1, 2013, to January1, 2022, by retrospectively reviewingtherecords from February 1, 2022, to June 1, 2022.664 patients who underwent PDA closure, (n=316) in theTCgroup and (n=348) patients in the SL group were included in this study.Trend analysis was performed using theCochrane-Armitage test to test for linear trends. The propensity scoresmultivariable logistic regression model used in the mainanalysis considered the following variables:EchocardiographicPDAsize, age at diagnosis, age at surgery,gender, weight at surgery, height at surgery, and presence of severe pulmonary hypertension. Usingthe inverse probability of treatment weighting (IPTW) by propensity score and after adjusting for baseline variables, the Man U test, chi-square test, and Fisher's exact test were used to compare the complications and outcomes of SL and TC of PDA. Results: There was a linear trend in both transcatheter closure and surgical ligation of PDA. The SC-group patients were younger, lighter, and shorter and more proportion of patients had severe pulmonary hypertensionOverall complications were significantly higher with PDA surgical ligation compared with transcatheter closure ((112 (35.4%vs286 (71.9%)), p-value = 0.001)). Total mechanical ventilationtime, ICU stay, and hospital stay were higher in the surgical ligationgroup with ap-value of 0.001 each. vii | P a g e Conclusion: Transcatheter closure of PDA is a good and safe alternative to surgical ligation of PDA with reduced overall complication and shorter mechanical ventilation time, lower ICU stay, and lower hospital stay.
BEHAVIORAL INTENTION AND ITS ASSOCIATED FACTORS TO USE CERVICAL CANCER SCREENING AMONG WOMEN (30-49) YEARS OLD ATTENDING MATERNAL AND CHILD HEALTH SERVICE IN SHEBEDINO DISTIRICT HEALTH CENTERS, SIDAMA REGIONAL STATE, ETHIOPIA, 2023.
(hawassa universty, 2023-10-10) YOHANNES TEFERA AYANE
Background Cervical cancer is the leading cause of death from cancer in Ethiopian women. Despite numerous interventions, there is a low uptake of cervical cancer screening services. Objective: The aim of this study was to assess the magnitude of behavioral intention and associated factor to use cervical cancer screening services among women who are visiting maternal and child health services in Shebedino district health centers. Method: Institutional based mixed cross-sectional study design used to employ women’s age between 30-49 years old. Systematic random sampling method employed to select participants. Qualitative Data was gathered and analyzed through discussion under major thematic area. linear regressions model was conducted to identify independent predictors of intention on cervical cancer screening among women. Result: Out of 401, 288(71%) of respondents had heard about cervical cancer, however, about 92(23%) of women were knowledgeable about the disease. 120 (29%), 98 (24%), 81 (20.1%), and 42(11%) of the respondents were know the sign & symptoms, risk factors, prevention methods and screening frequency of cervical cancer respectively. The qualitative finding revealed that women did not like to be screened for cervical cancer because they thought that procedure squeeze the cervix and it may result in perforating the uterus that would expose them for infertility. In addition, the qualitative findings supported quantitative results, where the constructs of the theory of planned behavior play an essential role in the improvement of women’s intention. Having knowledge about cervical cancer and past screening practice were positively associated with intention to screen (β = 0.145, CI, 0.001, 0.122), (β = 0.098, CI, 0.093, 1] respectively. Standardized regression coefficient shows; all constructs of the theory were positively and significantly associated with intention to screening. Perceived difficulty or easness (β = 0.297, CI, 0.172, 0.343), perceived social pressure (β = 0.248, CI, 0.131, 0.30) and attitude (β=0.11, CI, 0.018, 0.158).The study showed that magnitude of intention was 198 (44%) of woman had intention to screen for cervical cancers from date of interview. Conclusion: This study showed that women’s intention to screen for cervical cancer was low. Positive attitudes towards cervical cancer screening (CCS), subjective norms, and perceived behavioral control were predictors of women’s intention to screen for cervical cancer. Recommendation: Thus, efforts should be exerted to improve the attitude of women involving influential people, who could improve women’s intention for cervical cancer screening. Moreover; behavioral change communication focuses on the constructs of the theory of planned behavior.
KNOWLEDGE, PRACTICE AND ASSOCIATED FACTORS TOWARDS DISASTER PREPAREDNESS AMONG NURSES WORKING IN THE EMERGENCY DEPARTMENT OF PUBLIC HOSPITALS IN SIDAMA REGION, ETHIOPIA,2023.
(Hawassa University, 2023-11) YUNUKA MARUFA TUNUSHE
Introduction: According to recent researches, nurses in health-care settings who lack sufficient knowledge and practice in disaster preparedness can lose resources, delay treatments, cause patient unhappiness, and have other negative effects. Little is known regarding nurses’ knowledge, practice, and associated factors towards disaster preparedness in Ethiopia, particularly in this study area. Objective: The aim of this study was to assess the knowledge, practice and associated factors toward disaster preparedness among nurses working in emergency department at Public Hospitals in Sidama region, Ethiopia, 2023. Methods: A facility-based cross-sectional study design was conducted among randomly selected 175 nurses working in the emergency department (ED) from June 15 to July 15, 2023. The collected data was entered into Epi Data Version 4.6 and exported to Statistical Package for Social Science (SPSS) Version 25 for analysis. A logistic regression model was used to assess the strength of the association between the dependent and independent variables. Variables with a p-value <0.05 in the multivariable analysis were considered statistically significant. Results: A total of 175 nurses working in emergency departments participated in the study. The mean age of the respondents was 29 ± 4 years. From all study participants, around 95 (53%) and 114 (65%) of nurses working in the ED had poor knowledge levels and insufficient practice towards disaster preparedness respectively.In multivariate logistic regression, being male(AOR=2.6(CI 95%1.19-5.76 p=0.017), receiving training on subject (AOR=6.42, CI 95% 2.2-15.8, P=0.000), and having experience in disaster management(AOR=2.43, CI 95% 1.02 5.62, p=0.043) were factors significantly associated with the good knowledge of participants, while having disaster guideline(AOR=3.96, CI 95% 1.6-9.5, p=0.002, direct personal or professional exposure to disaster events, receiving training(AOR=4.4, CI 95% 1.7-11.8, p=0.003), and having good knowledge (AOR=3.32, CI 95% 1.7-11.8, p=0.01) were significantly associated with sufficient practices. Conclusion and recommendation: The current study revealed that more than half of the study participants have poor knowledge and insufficient practice in disaster preparedness. It’s advisable to hospitals have to have and distribute disaster guideline in emergency departments, and ongoing professional development training for nurses has to be given to improve the knowledge and practice of nurses working in the emergency department.
EVALUATION OF WOUND HEALING ACTIVITIES OF 80% METHANOL EXTRACT OF CLEMATIS HIRSUTA (PER AND GUILL) LEAVES IN MICE.
(Hawassa Universityth, 2023-11) WOYESA ELEMA
Background: Wound healing is one of the most challenging health problems that needs correction and efficient wound management. The leaves of Clematis hirsuta (Perr and Guill) have been used to treat wounds as traditional medicine in different local communities.But no scientific investigation was conducted on the wound healing activities of Clematis hirsuta leaves using an in vivo study model. The aim of this study was to evaluate the wound healing activity of an 80% methanol crude extract of Clematis hirsuta (Perr and Guill) leaves in mice. Methods: The leaves of Clematis hirsuta were crushed, dried, and macerated in 80% methanol. The resulting extract was concentrated, dried, and formulated into ointments at strengths of 5% w/w and 10% w/w. Acute dermal toxicity was evaluated in female mice at a dose of 2000 mg/kg using the 10% w/w extract. Wound healing activities were assessed using excision, burn, and incision wound models, comparing the 5% w/w and 10% w/w extracts, 0.2% w/w nitrofurazone, and a simple ointment. Parameters such as epithelialization period, wound contraction, histopathological analysis, and tensile strength were measured. Statistical analysis was conducted using a one-way ANOVA followed by a Tukey test, and significance was considered at p < 0.05. Results: In mice, a 2000 mg/kg limit test dose of 10% w/w CE was safe. Topical application of 5% w/w CE and 10% w/w CE of Clematis hirsuta leaves possessed potential wound healing activity at (p<0.037) and (p<0.001), respectively, by increasing wound contraction rate in the excision wound model, while at (p<0.04) and (p<0.001) in the burn wound model compared to the negative control. Both 5% w/w CE and 10% w/w CE reduced the epithelialization period and possessed collagen deposit, angiogenesis, and fibroblast proliferation in both excision and burn wound models. In the incision wound model, both 5% w/w CE and 10% w/w CE significantly increased tensile strength (p <0.001) when compared to the negative control. Conclusion: The 80% methanol crude extract of Clematis hirsuta (Perr and Guill) leaves showed significant wound healing activities in mice, validating its traditional use for wound treatment.
MAGNITUDE OF NEONATAL HYPOGLYCEMIA AND ITS ASSOCIATED FACTORS AMONG NEONATES ADMITTED TO NEONATAL INTENSIVE CARE UNIT AT HAWASSA CITY PUBLIC HOSPITALS, ETHIOPIA, 2023.
(Hawassa University, 2023-11) SELAM TADELE MARKOS
Background: Neonatal hypoglycemia is one of the most common metabolic abnormalities seen in newborns. If unrecognized or poorly treated it may result in poor neurologic development, motor deficits, poor intellectual function, seizure disorders, or even death. In Ethiopia, neonatal hypoglycemia is frequently diagnosed and one of the commonest causes of admission to the neonatal intensive care unit. Nevertheless, documented records regarding its magnitude and factors associated with hypoglycemia are scarce in the study area. Objective: To assess the magnitude of neonatal hypoglycemia and its associated factors among neonates admitted to the neonatal intensive care unit at Hawassa City Public Hospitals, Ethiopia. Method: Institution-based cross-sectional study was conducted among 293 neonates admitted in Hawassa City Public Hospitals, Ethiopia from April 20 – June 20, 2023. The study participants were neonates with their mothers. A convenience sampling technique was used to reach the study subjects. A structured pretested questionnaire was adopted from different studies and the data was collected through face-to-face interviews and card review. Ethical clearance was taken from Hawassa University institutional review board and consent was taken from mothers of neonates. Then the collected data were checked, coded, and entered into Epi data version 3.1 and exported to SPSS software version 25 for cleaning and analysis. A Binary logistic regression model was used to determine the association. From bivariate analysis, variables with p-values <0.25 were taken for multivariable analysis. From multivariable analysis, variables with adjusted odds ratio, p-values <0.05 at 95% confidence interval (CI) were declared as factors significantly associated with neonatal hypoglycemia. Result: In this study, from all neonate-mother pair the overall response rate was 92.5%. The magnitude of neonatal hypoglycemia was found 16.6%. Variables significantly associated with the occurrence of neonatal hypoglycemia were: Diabetes mellitus [AOR=9.8, 95%CI (3.08 31.37)], perinatal asphyxia [AOR=2.87, 95%CI (1.07-7.72)], delayed initiation of breastfeeding [AOR=2.63, 95%CI (1.04-6.6)] and hypothermia [AOR=3.8, 95%CI (1.6-9.1)]. Conclusion: the magnitude of neonatal hypoglycemia among neonates was high. Neonates with hypothermia, perinatal asphyxia, and delayed initiation of breastfeeding and maternal history of diabetes mellitus have an increased risk of developing hypoglycemia. Hence, Health care providers who are working on delivery and neonatal care should focus on early identification and management of these identified factors.
MAGNITUDE AND ASSOCIATED FACTORS OF EARLY MORTALITY AMONG DEATHS IN ADULT EMERGENCY DEPARTMENT, AT PUBLIC HOSPITALS, HAWASSA, SIDAMA, ETHIOPIA,2023.
(Hawassa University, 2023-11) GELANE GELETO
Background: early mortality defined as death with 72 hours of emergency department presentation. In low-income countries with limited resources, adult emergency department mortality remains high. The majority (59.8%) of those deaths occur within the first three days of admission to the emergency department in Ethiopia. Previously, only single-center studies at tertiary hospitals were conducted in Ethiopia. Objective: to assess the magnitude and associated factors of early mortality among deaths in adult emergency departments at selected public hospitals in Hawassa, Sidama, Ethiopia, from January 2021 to December 2022. Methods: An institutional-based cross-sectional study design was applied. A systematic random sampling technique was used to select 369 charts of patients who died in adult emergency departments of selected public hospitals in two years. The data was collected using a pre-tested data abstraction tool entered into the Kobo toolbox, then entered into EpiData version 4.6.0 and exported to SPSS version 27 for analysis. By using binary logistic regression Bivariate and multivariate analyses were run. Finally, statistical significance was declared at p-value <0.05, and an adjusted odds ratio with a 95% confidence interval was used to report the strength of the association Result: This study result shows that 50.2% of the participants were between the ages of 25-54 with mean average 40.6 ± 17.5 and 67.7% were male. 288 (78%) died within 72 hours. Lack of prehospital care [(AOR = 4.2; 95% CI: 2.23, 7.87), P = 0.007], road traffic accidents [(AOR = 4.1; 95% CI: 1.403, 12.076), P = 0.013], red triage categories [(AOR = 3.9; 95% CI: 1.6, 9.4), P = 0.003], had lack of investigation[(AOR = 3.4; 95% CI: 1.2, 9.4), comorbid illness [(AOR = 3.2; 95% CI: 1.558, 6.49), P = 0.001] and delayed initial intervention [(AOR = 2.338; 95% CI: 1.259, 4.339), P = 0.007] were significantly associated with early mortality. Conclusion: In this study, a greater early mortality rate was detected. Early morality was increased by a lack of prehospital treatment, road traffic accidents, a red warning score, a lack of investigation, comorbidity, and a delay in the first intervention.
KNOWLEDGE AND PRACTICE TOWARDS BASIC LIFE SUPPORT AMONG NURSES WORKING AT PUBLIC HOSPITALS, IN HAWASSA CITY, SIDAMA, ETHIOPIA, 2023
(Hawassa University, 2023-11) BETELHEM DEMEKE ALEMU
Introduction: Basic Life Support (BLS) is the foundation for saving lives after cardiac arrest, respiratory arrest, and choking in adults, children, and infants. In hospital cardiac arrest situations as well as community emergency calls, nurses are frequently the initial responders; as a result, their proficiency in basic life support is crucial for enhancing patient outcomes. However, little is known about the knowledge and practice of basic life support in Ethiopia. Objective: To assess knowledge, practice, and their associated factors toward basic life support among nurses working at public hospitals in Hawassa City, Sidama, Ethiopia, in 2023. Methodology: An institution-based cross-sectional study was conducted from April 1 to 15, 2023, in Hawassa City public hospitals with a sample size of 410 study participants selected using simple random sampling techniques. Data were collected using a self-administered, structured questionnaire. Logistic regression was applied to control the effects of some variables on the outcome variables, and odd ratios were calculated to determine the strength of the association. Results were interpreted as an association if the p-value was < 0.05 at 95% CI. Descriptions of data were made using tables, percentages, and graphs. Results: A total of 375 participants took part in the study, with a response rate of 91.5%. About one-fourth of 102 (27.2%) [95% CI (22.7–31.7)] and 106 (28.3%) [95% CI (23.7–32.9)] were found to be knowledgeable and have good practices towards basic life support, respectively. Being female, age and work experience were found to be significantly associated with knowledge of BLS. Being male, Nurses’ who had taken training and good knowledge level nurses towards basic life support were found to be significantly associated with practice of BLS. Conclusion: The results of this study showed that nurses working at public hospitals in Hawassa City's overall knowledge and practice of basic life support were poor. Therefore, more work needs to be done to increase nurses’ knowledge and practice in order to reduce avoidable deaths caused by unexpected emergencies such as choking, drowning, or sudden cardiac arrest. Thus, subsequent training and education on basic life support are mandatory to achieve the desired outcome.
PALLIATIVE CARE PRACTICE, PERCEIVED BARRIERS, AND ASSOCIATED FACTORS AMONG NURSES WORKING IN SELECTED PUBLIC HOSPITALS IN HAWASSA CITY, SIDAMA ETHIOPIA
(hawassa universty, 2023-11) BEYENE FELEKE ASHAGRE (BSc)
Background: Palliative care is a comprehensive approach that enhances the quality of life of patients and their families facing problems related to life-threatening illnesses. Since nurses play an active role in managing patients' disease diagnosis and treatment in clinical palliative care practice, identifying their practice level is critical. However, there is a lack of data regarding palliative care practice, barriers, and associated factors among nurses in the study area. Objective: To assess the palliative care practice, perceived barriers, and associated factors among nurses working in selected public hospitals in Hawassa, Sidama, Ethiopia. Methods: An institutional-based cross-sectional study design using quantitative supplemented by qualitative data collection methods was employed among 319 nurses and 8 key informants, respectively, at a selected public hospital in Hawassa City, Sidama, Ethiopia, from March 15 to July 30, 2023.Simple random sampling techniques and purposive sampling techniques were used to collect data. Data were collected using pretested, self-administered questionnaires and an in-depth interview. Epi-Data and Statistical Program for Social Sciences software were used for data entry and analysis. Descriptive, bivariate, and multivariable logistic regression analyses were utilized. A p-value of <0.05 on multivariate logistic regression was declaredfor the associated variable. For qualitative data, thematic analysis was used. Results:The response rate among the 313 nurses who completed the questionnaire was 98%. Around three-fourths,76.6% [95% CI, 72–81] of participants had poor palliative care practices. Type of hospital, age, education level, experiences, and training were significantly associated with overall palliative care practices. This study explored four main themes in qualitative findings: knowledge deficit, negative patient attitudes, spiritual care, and modern medicine clash, issues with healthcare providers, and inadequate hospital facilities. Conclusion and recommendations: Overall, nurses had poor palliative care practices. Type of hospital, age, education level, experiences, and training were factors associated with practice towards palliative care, anda sub-category of themes emerged from a qualitative study. Therefore, it is necessary to provide basic education and continue on-the-job training for nurses to bridge the gap of poor practice.
KNOWLEDGE AND PRACTICE TOWARDS BASIC LIFE SUPPORT AMONG NURSES WORKING AT PUBLIC HOSPITALS, IN HAWASSA CITY, SIDAMA, ETHIOPIA, 2023
(hawassa universty, 2023-11) BETELHEM DEMEKE ALEMU (BSc)
Introduction: Basic Life Support (BLS) is the foundation for saving lives after cardiac arrest, respiratory arrest, and choking in adults, children, and infants. In hospital cardiac arrest situations as well as community emergency calls, nurses are frequently the initial responders; as a result, their proficiency in basic life support is crucial for enhancing patient outcomes. However, little is known about the knowledge and practice of basic life support in Ethiopia. Objective: To assess knowledge, practice, and their associated factors toward basic life support among nurses working at public hospitals in Hawassa City, Sidama, Ethiopia, in 2023. Methodology: An institution-based cross-sectional study was conducted from April 1 to 15, 2023, in Hawassa City public hospitals with a sample size of 410 study participants selected using simple random sampling techniques. Data were collected using a self-administered, structured questionnaire. Logistic regression was applied to control the effects of some variables on the outcome variables, and odd ratios were calculated to determine the strength of the association. Results were interpreted as an association if the p-value was < 0.05 at 95% CI. Descriptions of data were made using tables, percentages, and graphs. Results: A total of 375 participants took part in the study, with a response rate of 91.5%. About one-fourth of 102 (27.2%) [95% CI (22.7–31.7)] and 106 (28.3%) [95% CI (23.7–32.9)] were found to be knowledgeable and have good practices towards basic life support, respectively. Being female, age and work experience were found to be significantly associated with knowledge of BLS. Being male, Nurses’ who had taken training and good knowledge level nurses towards basic life support were found to be significantly associated with practice of BLS. Conclusion: The results of this study showed that nurses working at public hospitals in Hawassa City's overall knowledge and practice of basic life support were poor. Therefore, more work needs to be done to increase nurses’ knowledge and practice in order to reduce avoidable deaths caused by unexpected emergencies such as choking, drowning, or sudden cardiac arrest. Thus, subsequent training and education on basic life support are mandatory to achieve the desired outcome.
MAGNITUDE AND ASSOCIATED FACTORS OF EARLY MORTALITY AMONG DEATHS IN ADULT EMERGENCY DEPARTMENT, AT PUBLIC HOSPITALS, HAWASSA, SIDAMA, ETHIOPIA,2023.
(hawassa universty, 2023-11) GELANE GELETO (BSc)
Background: early mortality defined as death with 72 hours of emergency department presentation. In low-income countries with limited resources, adult emergency department mortality remains high. The majority (59.8%) of those deaths occur within the first three days of admission to the emergency department in Ethiopia. Previously, only single-center studies at tertiary hospitals were conducted in Ethiopia. Objective: to assess the magnitude and associated factors of early mortality among deaths in adult emergency departments at selected public hospitals in Hawassa, Sidama, Ethiopia, from January 2021 to December 2022. Methods: An institutional-based cross-sectional study design was applied. A systematic random sampling technique was used to select 369 charts of patients who died in adult emergency departments of selected public hospitals in two years. The data was collected using a pre-tested data abstraction tool entered into the Kobo toolbox, then entered into EpiData version 4.6.0 and exported to SPSS version 27 for analysis. By using binary logistic regression Bivariate and multivariate analyses were run. Finally, statistical significance was declared at p-value <0.05, and an adjusted odds ratio with a 95% confidence interval was used to report the strength of the association Result: This study result shows that 50.2% of the participants were between the ages of 25-54 with mean average 40.6 ± 17.5 and 67.7% were male. 288 (78%) died within 72 hours. Lack of prehospital care [(AOR = 4.2; 95% CI: 2.23, 7.87), P = 0.007], road traffic accidents [(AOR = 4.1; 95% CI: 1.403, 12.076), P = 0.013], red triage categories [(AOR = 3.9; 95% CI: 1.6, 9.4), P = 0.003], had lack of investigation[(AOR = 3.4; 95% CI: 1.2, 9.4), comorbid illness [(AOR = 3.2; 95% CI: 1.558, 6.49), P = 0.001] and delayed initial intervention [(AOR = 2.338; 95% CI: 1.259, 4.339), P = 0.007] were significantly associated with early mortality. Conclusion: In this study, a greater early mortality rate was detected. Early morality was increased by a lack of prehospital treatment, road traffic accidents, a red warning score, a lack of investigation, comorbidity, and a delay in the first intervention.
ADMISSION OUTCOMES AND ASSOCIATED FACTORS OF ADULTS ADMITTED TO INTENSIVE CARE UNITS OF SELECTED GOVERNMENTAL HOSPITALS IN SIDAMA REGION, ETHIOPIA, 2023
(hawassa universty, 2023-11) BIRHANU MULETA BAYECHA
Background: Intensive care ismultidisciplinary and inter-professional specialty dedicated to the total management of patients with acute life-threatening conditions. Patientsadmitted to the intensive care unit need frequent assessments of their vital signs, invasive hemodynamic monitoring, intravenous drugs and fluid management, ventilatory assistance, and dietary support. The overall goal is to increase the patient chance of survival.In resource-limited settings, mortality is still higher due to various reasons. Objective:To assess admissionoutcomes, andassociated factors of adults admitted to intensive care units of selected governmental hospitals in theSidama region, Ethiopia, 2023. Materials and methods: After obtaining ethical clearance,a cross-sectional study was conducted on 401adult patients admitted to ICUfromMarch 2020 to February 2023. Patient‘s chart was selected by systematic randomsampling; needed information was retrieved by a pretested data abstraction tool and analyzed with SPSS version 26.Furthermore,to support this study ICU director and/or chief nurse were surveyed regarding ICU characteristics.A binary and multivariable logistic regression was conducted to see if variables were associated with outcomes. Results: The emergency department was a common source of admission (65.4%) to the ICUs. Cardiovascular diseases107(27.4%) were common causes of ICU admission.The mortality rate was 39.5%.Patients who were within the 56-65(AOR=3.6, CI,1.130-11.408), and >65 (AOR=4.3,CI,1.125-16.625) age category, mechanically ventilated(AOR=4.3, CI,2.117-8.837), high serum creatinine (AOR=2.4, CI,1.186-4.668), lowsodium(AOR=2.6, CI,1.344-5.188), lowpotassium (AOR=2.1, CI, 1.038-4.097),anemicat admission (AOR= 3.6, CI,1.908-6.636), and supported with a vasopressor (AOR= 6.2, CI, 3.212-12.131)were at higher risk of mortality whereasthose treated in general hospitals (AOR=0.5, CI,0.239 0.950)were at lower risk of mortality. Conclusion and Recommendation: The overall mortality observed in this study was high. ICU to hospital bed ratio should be improved and clinicians should give due attention to patients who had these associated factors of mortality at admission.Overall there is a need to strengthen action to improve critical care services in the region.
PATTERN OF INJURY, OUTCOME AND ASSOCIATED FACTORS AMONG PATIENTS VISITING THE EMERGENCY DEPARTMENT IN SIDAMA REGIONAL GENERAL HOSPITALS, ETHIOPIA; 2023.
(hawassa universty, 2023-11) DREREJE BUCHE
Background: Injury has a significant impact on societal health and well-being, taking the lives of more than 15,000 people daily and more than 4.4 million people annually. Low- and middle income countries have a disproportionately high injury burden, account for almost 90% of injury-related fatalities. Despite government health agencies and hospitals should have a detailed picture of injuries, little is known about injury statistics and outcomes in this region and across the country. Objectives: To assess pattern of injury, outcome, and associated factors of injury outcome Among patients visited selected general hospitals in Sidama regional state, Ethiopia, 2023. Methodology: An institutional-based cross-sectional study was conducted on Sidama Regional General Hospitals from March 10 to June 10, 2023, after three general hospitals were selected by the lottery method out of five general hospitals. The sample size was calculated by using the single population formula, and it became 342. Data was collected using a structured questionnaire adopted from WHO trauma surveillance, and ethical clearance was obtained from Hawassa University's ethical review board. Data was entered into EpiData version 4.1 and analyzed through SPSS version 27. Result: A total of 342 injured patients participated in this study, and unintentional injuries accounted for 225 (65.2%) of the total injuries, and the age group 24-44 years was the most commonly affected, with 137 (40.1%). 35.6% of injury cases were due to road traffic injuries, and 27.19% of the cases were due to interpersonal violence. Out of the total participants, 96.2% were discharged alive, and 3.8% died. The glaucoma scale, severity of injury , time between injury and care, head injury, triage scale, and operated on have associations with mortality. Conclusion and recommendation: Male patients and those aged 25–44 had a higher proportion of injury victims. The primary cause of injury was RTA, followed by interpersonal violence and fall injuries. The glaucoma scale, severity of injury, triage scale, head injury, and those patients who operated were more associated with mortality. More efforts are needed to raise awareness of RTA, improve road safety, and impose severe regulations on pedestrians and drivers.
BREAST CANCER SCREENING PRACTICE AND ASSOCIATED FACTORS AMONG FEMALE NURSES WORKING AT SOUTH OMO ZONE PUBLIC HEALTH FACILITIES, SOUTHERN ETHIOPIA, 2023
(hawassa universty, 2023-11) TADELE DAMENA (BSc)
Background: Globally, breast cancer is one of the most prevalent cancers and the leading cause of mortality for women due to not receiving screening. Therefore, early detection of breast cancer could potentially reduce morbidity and mortality from breast cancer among women. Hence, female nurses play a vital role in promoting breast cancer screening, although there is scarce data regarding the screening practices among female nurses in the research area. Objective: To assess breast cancer screening practice and associated factors among female nurses working at South Omo Zone public health facilities in Southern Ethiopia in 2023. Methods: An institutional-based cross-sectional study was conducted from May 15 to June 15, 2023, among female nurses employed in public health facilities in the South Omo Zone. Simple random sampling was used to select the study participants. Data was collected using a pre tested, structured, and self-administered questionnaire. The collected data were entered and cleaned using Epi Data version 3.1 and exported to SPSS version 22 for analysis. Binary logistic regression analyses were used. Variables with a p-value <0.05 in the multivariable logistic regression analysis were considered statistically significant. Result: In the current study, the prevalence of breast cancer screening practice was 21% (95% CI: 16.0, 26.5) based on recommendations. The mean age of respondents is 33 ±7 SD. Being age ≥40 years (AOR = 0.18; 95% CI: 0.04–0.70), having good knowledge about breast cancer signs and symptoms (AOR =2.94; 95% CI: 1.18–7.35), good knowledge of risk factors (AOR =8.60; 95% CI: 3.72–19.87), high perceived susceptibility (AOR = 2.55; 95% CI: 1.11–5.88), and a high perceived benefit of breast cancer screening (AOR = 2.30; 95% CI: 1.02–5.18) were significantly associated. Conclusion and recommendation: The practice of breast cancer screening among female nurses in the study area was low as compared to previous studies. Being age ≥40 years, knowledge of signs and symptoms, risk factors of breast cancer, susceptibility to breast cancer, and benefits from breast cancer screening were associated with the practice of breast cancer screening. It is better to provide mammography and training to improve breast cancer screening.
KNOWLEDGE, PRACTICE AND ASSOCIATED FACTORS TOWARDS DISASTER PREPARDNESS AMONG NURSES WORKING IN THE EMERGENCY DEPARTMENT OF PUBLIC HOSPITALS IN SIDAMA REGION, ETHIOPIA,2023.
(hawassa universty, 2023-11) YUNUKA MARUFA TUNUSHE
Introduction: According to recent researches, nurses in health-care settings who lack sufficient knowledge and practice in disaster preparedness can lose resources, delay treatments, cause patient unhappiness, and have other negative effects. Little is known regarding nurses’ knowledge, practice, and associated factors towards disaster preparedness in Ethiopia, particularly in this study area. Objective: The aim of this study was to assess the knowledge, practice and associated factors toward disaster preparedness among nurses working in emergency department at Public Hospitals in Sidama region, Ethiopia, 2023. Methods: A facility-based cross-sectional study design was conducted among randomly selected 175 nurses working in the emergency department (ED) from June 15 to July 15, 2023. The collected data was entered into Epi Data Version 4.6 and exported to Statistical Package for Social Science (SPSS) Version 25 for analysis. A logistic regression model was used to assess the strength of the association between the dependent and independent variables. Variables with a p-value <0.05 in the multivariable analysis were considered statistically significant. Results: A total of 175 nurses working in emergency departments participated in the study. The mean age of the respondents was 29 ± 4 years. From all study participants, around 95 (53%) and 114 (65%) of nurses working in the ED had poor knowledge levels and insufficient practice towards disaster preparedness respectively.In multivariate logistic regression, being male(AOR=2.6(CI 95%1.19-5.76 p=0.017), receiving training on subject (AOR=6.42, CI 95% 2.2-15.8, P=0.000), and having experience in disaster management(AOR=2.43, CI 95% 1.02 5.62, p=0.043) were factors significantly associated with the good knowledge of participants, while having disaster guideline(AOR=3.96, CI 95% 1.6-9.5, p=0.002, direct personal or professional exposure to disaster events, receiving training(AOR=4.4, CI 95% 1.7-11.8, p=0.003), and having good knowledge (AOR=3.32, CI 95% 1.7-11.8, p=0.01) were significantly associated with sufficient practices. Conclusion and recommendation: The current study revealed that more than half of the study participants have poor knowledge and insufficient practice in disaster preparedness. It’s advisable to hospitals have to have and distribute disaster guideline in emergency departments, and ongoing professional development training for nurses has to be given to improve the knowledge and practice of nurses working in the emergency department.
Knowledge and Practice towards Initial Management of Acute Poisoning Among Nurses Working at Emergency Department of Sidama Region Hospitals
(hawassa universty, 2023-11) Tamire Adamu
Introduction: Acute poisoning remains a common medical emergency worldwide. It is an important health problem, which cause both morbidity and mortality globally.Even though acutely poisoned patients have been visited emergency department and got emergency care, so many people died from poisoning worldwide.Emergency department nurses’ knowledge and practice can affect the early management of poisoning. However, limited information is available regarding the level and factors associated with nurses’ knowledge and practice on initial management of acute poisoning. Objective: To assess knowledge, practice and its associated factors of initial management of acute poisoning among nurses at emergency department of hospitals in Sidama Region, Ethiopia. Methods and Materials:Institutional based cross sectional study was conducted at emergency departments at 10 selected Hospitals found in Sidama Region from April to May 2023 on 182 nurses. Structured and self-administered questionnaire was used for data collection. Collected data were entered in to Epi-data version 3.1 and transported to SPSS version 20 for analysis. Bi variate and multivariable logistic regression were performed to identify factors. Statistical significances were set at p-value less than 0.25 and less than 0.05 during bi-variate and multivariable logistic regression respectively. Results:The study was conducted among 182 nurses, with a response rate of 98.4%. From total 99 (54.4%) (Mean =6.6, SD±2.5) and 69 (37.9%) (Mean =6.5, SD±2.3) of nurses had good knowledge and good practice on acute poisoning management respectively.Nurses; 30-39 and ≥40 years old were 93% (AOR=0.066, 95% CI (0.012-0.355)) and 98% (AOR=0.023, 95% CI (0.002-0.247)) less likely knowledgeable compared to nurses 20-29 years old respectively. Trained nurses on acute poisoning management were three times (AOR=3.186, 95% CI (1.553 6.538)to have good knowledgethan those they are not trained. Nurses trained on acute poison management were 5.4 times more likely to have good practice compared with not trained (AOR=5.377, 95% CI (2.595-11.143).
MALE INVOLVEMENT IN POSTPARTUM LONG-ACTING REVERSIBLE CONTRACEPTIVE USE AND ASSOCIATED FACTORS AMONG MARRIED MEN IN SHEBEDINO WOREDA, SIDAMA REGION, SOUTHERN ETHIOPIA, 2023
(hawassa universty, 2023-11) ABDULAH WASSU
Background: Males' participation in long-acting reversible contraceptives during the postpartum period is determinantal to reproductive health outcomes and for achieving national and sustainable development goals. Most research findings on male participation in family planning are concerned with short-acting family planning in Africa, including Ethiopia. Despite this, little is known about male involvement in postpartum long-acting reversible contraceptive use of their wife in Africa, particularly in Ethiopia. Objective: To assess the magnitude of male involvement in postpartum long-acting reversible contraceptive use and association factors among married males in Shebedinno woreda, Sidama regional state, Southern Ethiopia, 2023. Methods: A community-based cross-sectional study was conducted among 633 randomly selected married males from July 30 to August 30, 2023. Data were collected using pretested, questionnaires. Bivariable and multivariable logistic regression analyses were conducted. Multicollinearity and model fitness were examined. The crude and adjusted odds ratios, together with their corresponding 95% confidence intervals, were computed; a P value < 0.05 was considered a level of statistical significance. Result: A total sample size of 623 married men responded to the questionnaires, yielding a response rate of 98.4%. Out of the 623 male participants, 197 (31.6%, 95% CI: 28.6, 36.0) were involved in postpartum long-acting reversible contraceptive usage by their spouses. Men with a secondary school education (AOR = 2.35, 95% CI: 1.12, 4.93) and those with a diploma or higher (AOR = 4.42, 95% CI: 1.80, 10.83), heard information about long-acting reversible contraceptives (AOR = 2.77, 95% CI: 1.07, 7.16), having good knowledge (AOR = 1.84, 95% CI: 1.24, 2.74) and a positive attitude towards the use of long-acting reversible contraceptives postpartum (AOR = 2.18, 95% CI: 1.47, 3.24) all proved to be positively significant factors. Conclusion and recommendations: Overall, male participation in postpartum long-acting reversible contraceptive use of their spouse was relatively low. Therefore promoting male participation in postpartum long-acting reversible contraceptives requires effective community awareness, dissemination of information, education, and communication, and fostering a positive attitude towards these contraceptives.
KNOWLEDGE AND ASSOCIATED FACTORS TOWARDS PREVENTABLE RISK FACTORS OF CONGENITAL ANOMALIES AMONG ANTENATAL CARE ATTENDING MOTHERS AT PUBLIC HEALTH INSTITUTIONS IN HAWASSA CITY, ETHIOPIA
(hawassa universty, 2023-11) DEBISO ERGINO
Background:- Congenital anomalies are problems of structure and function that can develop during intrauterine life and can be detected during pregnancy, at birth, or later in life. The etiology is genetic, environmental, multifactorial, and unknown. Globally 1 in 33 babies is born with a birth defect. More than 90% of birth defects occurred in low and middle-income countries. In Ethiopia, there was limited evidence to assess the knowledge of pregnant mothers despite the increasing prevalence of birth defects of preventable risk factors of congenital anomalies. Objective:- To assess the knowledge and associated factors towards preventable risk factors of congenital anomalies among antenatal care attending mothers at public health institutions in Hawassa City, Ethiopia, 2023. Methodology:- An institutional-based cross-sectional study was conducted among 422 systematically selected pregnant mothers who attended the ANC clinic in Hawassa City public health institutions from July 20-August 20, 2023. A pretested, interviewer-administered questionnaire was used. An open data kit and statistical package for Social Science version 27 were used for data collection and analysis, respectively. To identify associated factors bivariate and multivariable analyses were carried out. Result:- A total of 422 pregnant mothers participated in this study with a response rate of 100%. Of the total participants, 79.4% were urban residents, 45.0% attain secondary school and 73.9% had antenatal care follow-up. Only 5.9% knew that congenital anomalies are acquired by pregnant mothers, 68.2% of them knew that congenital anomalies are genetic, and 11.4% of them knew that it occur due to the sin of families. Overall 58.3% of mothers had good knowledge of preventable risk factors of congenital anomalies. Conclusion:- Comparatively participants had moderate knowledge on overall knowledge about preventable risk factors of congenital anomalies compared to other studies. However, the knowledge was influenced by urban residence; college and above educational attainment, and antenatal care follow-up of the participants. It is advised to address pre-pregnancy and pregnancy health education, with a focus on birth defect prevention.