College of Medicine and Health Science

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    QUALITY OF MEDICAL RECORDS IN PUBLIC HOSPITAL OF WOLAYTA ZONE, SOUTH ETHIOPIA: 2023 MIXED STUDY
    (hawassa universty, 2023-11) MUHIDN JEMAL
    Background – Medical record is a multifunctional document that is used to communicate and document critical information about patients’ medical care among health care professionals. Medical record completeness is a key performance indicator that is related with delivery of health care services in the hospital. Medical recording system has faced challenges related with resources and lack of infrastructure in worldwide trend. Studies have indicated that medical record systems are lacking medical record management quality in low income countries. Objective- To asses quality of medical records in public hospital of Wolaita zone, south Ethiopia, 2023 Methods- Institutional based cross-sectional study concurrently with qualitative study using stratified sampling method was conducted from March 1-15, 2023. A purposive criterion sampling method key interview method was used qualitative data. A total of 406 Medical records were reviewed at three public hospitals in Wolaiyta zone. Review of medical records was done using a checklist and key informant interviews of health professionals and medical record staff. The quantitative data were collected kobo toolkits and exported and analyzed by SPSS version 26.0.the qualitative data was collected analyzed manually by thematic analysis. Results. A total of 406 medical records were reviewed during data collection period of medical records of three public hospitals, with 100% retrieval rate. In the assessment of quality of medical record, clinical components were lowered (76%) compared to Administrative components (87%).Majority of the respondents said that|“… Since lack of regular monitoring and evaluation process, there was problem in quality of medical records in the hospital According to the expected national standard, the study also showed that average quality of medical records of the study area was 68%. Records tertiary hospitals were 44.5% less likely to be quality record as compared to records in primary hospitals Conclusion: The majority of medical records had poor completeness of administrative data, clinical, financial, and legal contents. The overall quality of medical records in Wolaita Zone was very low for components of the quality of medical records as per the standard of hospital requirements.
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    Willingness to Renew Community Based Health Insurance Membership and Associated Factors in Maraka woreda, Dawuro zone, South-west Regional State, Ethiopia
    (hawassa universty, 2023-11) Mikiyas Zelalem
    Background: Although potential instrument to achieve Universal Health Coverage, Community Based Health Insurance schemes commonly suffer from low membership renewal, which threatens the schemes’ sustainability in many developing countries. Hence, this study investigated the willingness to renew Community Based Health Insurance membership and associated factors among enrolled households in Maraka woreda, Dawuro zone. Objective: To assess willingness to renew Community Based Health Insurance membership and associated factors in Maraka woreda, Dawuro zone. Methodology: Community based cross-sectional mixed methods design with sequential explanatory qualitative methods was employed. Using multi-stage random sampling, 5 kebeles were included in the study, from which 693 enrolled households were selected through systematic random sampling (k=5). Descriptive, bivariate, and multivariate logistic regression analyses of data was done using SPSS version 25 software, with statistical significance considered at P-value <0.05. Qualitative data were collected through focus group discussions and key informant interviews, with samples selected using maximum-variation methods. The obtained data were coded and thematically analyzed using ATLAS.ti 9 software. Results: Willingness to renew Community Based Health Insurance membership was shown to be 79.1%. Presence of chronic illness (AOR = 0.30; CI: 0.18-0.52), proportion of household members with poor self-rated health status (AOR = 2.01; CI: 1.04-3.72), recent hospitalization history (AOR = 0.2; CI: 0.11-0.35), perceived availability of medications (AOR = 2.52; CI: 1.48-4.29), premium affordability (AOR = 2.2, CI: 1.26-4.79), perceived benefit packages adequacy (AOR = 2.90; CI: 1.76-4.79), enrollment duration (AOR = 4.01; CI: 2.12-7.56), and participation in scheme related meetings (AOR = 2.40; CI: 1.27-4.58) were predictors shown to be significantly associated with members’ willingness to renew membership. Conclusion: Magnitude of willingness to renew Community Based Health Insurance membership in the woreda was shown to be relatively lower than the woreda’s renewal target for 2016 E.C. Therefore, increased scheme transparency and community engagement, along with policy interventions involving differential premium pricing based on ability to pay and upgrading of the current scheme design to a larger regional or federal pool are recommended to increase members’ desire to renew membership.
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    MAGNITUDE OF URBAN MALARIA AND ITS ASSOCIATED RISK FACTORS IN DAMBOYA TOWN, KEMBATA ZONE, CENTRAL ETHIOPIA
    (hawassa universty, 2023-11) BIRUK MULACHEW GELESHO
    Background: In Africa, urban malaria is emerging as a potential Health problem. Because of the rapidly growing number of towns in Ethiopia, there is a persistent need to improve the understanding of the epidemiology of urban malaria. Objective: This study aimed to determine the prevalence of urban malaria and its associated risk factors in Damboya town Kambata Zone, Central Ethiopia region. Methods: A Community-based cross-sectional study was carried out in Damboya town from March 7 to May 29, 2023. A total of 422 individuals were randomly selected and a structured questionnaire was employed to collect socio-demographic data and malaria-associated risk factors. Finger/ heel prick blood was used to detect malaria parasites by light microscopy and malaria rapid diagnostic test. Data were entered in Epi data 3.1 and analyzed in SPSS version 25 software. The association between dependent and independent variables was explored by using binary logistic regression analyses. An adjusted odds ratio with a 95% confidence interval was calculated and the association was declared at a P-value of <0.05. Result: The overall prevalence of malaria was 5% (95%CI:3.1-7.5) with the predominant P. vivax infections accounting for 61.9%. The presence of stagnant water (AOR=3.88, 95% CI: 1.14-13.22, P=0.030), unavailability of insecticide-treated bed net (AOR=3.24, 95% CI: 1.01 10.41, P=0.048), living in a house with eaves (AOR=4.22, 95%CI: 1.17-15.00, p=0.027), were more significantly associated with malaria prevalence. Conclusion: Malaria is still a public health problem in Damboya town. Thus, improved access to all malaria interventions is needed to interrupt the transmission in the community of this town.
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    LEVEL OF PATIENT SATISFACTION AND ASSOCIATED FACTORS AMONG PRIVATE WING PATIENTS OF WOLAITA SODO UNIVERSITY COMPREHENSIVE SPECIALIZED HOSPITAL, WOLAITA, ETHIOPIA: A HEALTH FACILITY-BASED CONVERGENT PARALLEL MIXED STUDY
    (hawassa universty, 2023-11) BINYAM DANIEL
    Background: To improve the quality of health care given in the private wing, the health care provider needs to know what factors influence patient satisfaction. Although few studies have been conducted on patient satisfaction in private-wing health services it was never been done in this study area. Objective: To assess the level of Patient Satisfaction and associated factors among Private wing patients of Wolaita Sodo University Comprehensive and Specialized Hospital, Wolaita, Ethiopia 2023 G.C Methods: A health facility-based convergent parallel mixed study was conducted. A Systematic random sampling technique was used to select 300 patients. Data was collected by the ODK collect app and was then imported to SPSS version 25 for analysis. The views of 7 qualitative participants selected conveniently until data saturation were explored using in-depth interview. Frequency distribution of variables was tabulated. Bivariate and multivariable logistic regressions were fitted to identify the factors that determine patient satisfaction. Qualitative data analysis used a thematic analysis technique which was supported by ATLAS.ti 7.5.16 data management software. Result: A total of 300 patients were included in the study and 260 (86.7%) (95% CI= 82.3-90.3) of the patients were satisfied with the service they had gotten. Age between 18-34 (AOR= 0.26, 95% CI= 0.17-0.36), doctors explain medical terms (AOR= 3.50, 95%CI= 1.21-10.07), pharmacist explains about the medication (AOR= 3.16, 95%CI= 1.06-9.41) were significantly associated with patient satisfaction. Similarly, the lack of drugs and supplies in the hospital pharmacies and laboratory, and the unavailability of private toilets and showers were also major problems that led to less satisfaction with the overall private wing services. Conclusion and recommendation: In conclusion, the net overall level of satisfaction was high. Regarding this study, significant predictors of patient satisfaction were age, doctors explain medical terms, and pharmacists explains about the medication. Making all the essential laboratory investigations, drugs, and standard medical equipment available in the hospital along with toilets and showers available in every private room is important to improve patient satisfaction in the private wing setting
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    VACCINE COLD CHAIN MANAGEMENT PRACTICE AND ITS ASSOCIATED FACTORS IN PUBLIC HEALTH INSTITUTIONS OF WEST ARSI ZONE, OROMIA, ETHIOPIA, 2023
    (hawassa universty, 2023-11) ABDO HAJO JARSO
    Background: In spite of high immunization coverage still there is high range of child mortality due to vaccine preventable diseases (VPDs).This problem is attributed to reduced vaccine potency resulted because of failure in cold chain management system which is less considered in developing countries including Ethiopia, particularly in this study area. Objective: The aim of this study was to assess vaccine cold chain management practice and its associated factors in public health institutions of west Arsi zone, Oromia, Ethiopia 2023. Methods: A facility-based cross-sectional study was conducted in all health institutions of randomly selected woredas in the west Arsi zone. A structured self-administered questionnaire and on-spot observation checklists were used to collect data from the healthcare facilities. Epi-data version 4.6.0.6 was used for data entry and Statistical Package for Social Sciences (SPSS) version 26 was used for analysis. The bivariate and multiple logistic regression analyses were conducted. Adjusted odd ratio (AOR) with a 95% confidence interval (CI) was used to determine the strength of association and the level of significance was set at P-value < 0.05. Result: In this study, more than half (54.1%) of the public health institutions had good vaccine cold chain management practices. Good knowledge of vaccine handlers Adjusted Odds Ratio( AOR) (95% Confidence Interval(CI) = 3.85(1.32-11.25), regular supportive supervision AOR (95% CI)= 4.81(1.60-14.4), availability of Expanded program of immunization (EPI) guideline in healthcare facilities AOR (95% CI)= 5.21(1.67-16.3), no workloads AOR (95% CI)= 3.20(1.06-9.71) and using of vaccine request format AOR (95% CI)= 3.67(1.21-11.10) were positively associated with good vaccine cold chain management practice. Conclusion: Vaccine handlers working in the study area of public health facilities had poor vaccine cold chain management practice. Enhancing the knowledge of vaccine handlers, providing guidelines, vaccine request forms, supportive supervision, and monitoring their practice toward cold chain management may help to improve practice towards vaccine cold chain management.
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    PREVALENCE AND ASSOCIATED FACTORS OF MALARIA AMONG THE COMMUNITY OF LOKA ABAYA DISTRICT, SIDAMA REGIONAL STATE, SOUTHERN ETHIOPIA
    (hawassa universty, 2023-11) SIRATU SEYOUM
    Background: Malaria remains a major public health concern in Ethiopia, despite the widespread use of insecticide-treated mosquito nets. In most rural Ethiopian settings, insecticide-treated net coverage and proper use are major challenges. The goal of this study was to determine the prevalence of malaria, the proportion of Plasmodium species, and the risk factors for disease transmission in the study area. Methodology: From April to May of 2023, a community-based cross-sectional study was conducted among 419 participants in Loka Abaya District, Sidama. A face-to-face interview and visual observation were used to collect socio-demographic data and other associated factors. A capillary blood sample from each study participant was collected and tested with smear microscopy and rapid diagnostic tests for the presence of malaria parasites. Epi-data manager version 4.6 was used to enter and clean the data, and SPSS version 26 was used to analyze it. Bivariate and multivariate logistic regression results were used to assess the association between the dependent and independent variables. Statistical significance was defined at p-value < 0.05. Result: The overall prevalence of malaria infection was 61 (14.6%) with 95% CI: 11.0 - 18.0. The relative proportions of P. falciparum and P. vivax infection were 59.0% and 36.1% respectively, while the proportion of mixed (P. falciparum and P. vivax) infection was 4.9%. No formal education (AOR: 2.56; 95% CI: 1.10 - 5.94) compared to secondary and above education, low monthly income (AOR: 2.97; 95% CI: 1.07 - 8.25) compared to high monthly income, those who did not have ITN (AOR: 2.56; 95% CI: 1.14 - 5.75), never used ITN during sleep (AOR: 2.875; 95% CI: 1.130 - 7.317), living in areas with stagnant water (AOR=2.12, 95% CI: 1.14 - 3.99) were independent predictors of malaria infection. Conclusion: The prevalence of malaria in the study population was high, with P. falciparum being the most common causative agent. Regarding associated factors, educational status, monthly income, ITN availability and utilization, and the presence of stagnant water around the house were all potential determinants of malaria. Continued community health interventions focusing on the proper use of ITN, drainage of stagnant water, and increased public awareness about reducing the risk of insect bites have the potential to reduce infection.
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    A research paper to be submitted to Hawassa University College of Medicine and Health Science School of Public Health in Partial Fulfillment of the Requirement for Degree of Masters in Public Health in Reproductive Health
    (hawassa universty, 2023-11) Simegn Anbese
    Background: Vaginal birth after cesarean (VBAC) is giving birth through vagina after giving birth previously by cesarean section. Repeated caesarean deliveries associated with maternal and child complication. It had expanded hospital duration, and high risk of postpartum hemorrhage. However vaginal birth after cesarean is the best choice to reduce repeated CS. But there was insufficiency of evidence to predict determinants of successful vaginal birth after cesarean. So the aim of this study to identify determinants of successful vaginal birth after cesarean section to decreases the overall CS rate and related complication. Objective: To identify determinants of successful vaginal delivery after Caesarean Section at Public hospital in Hawassa city, Sidama Region, Ethiopia, 2023. Methodology: A facility based un-matched case control study was conducted at public hospitals in Hawassa city, Sidama region. A total of 107 consecutive cases and 214 controls were included. Data were collected using pre-tested interviewer administered questionnaire and chart reviewing. Then the data were exported to SPSS for analysis. Descriptive statistics analysis was done. A bi variable regression analysis was done for all independent variables .Variables with p values < 0.25 in bi variable analysis were taken and analyses in multivariable logistic regression .Finally the multivariable logistic regression model were considered statistically significant p values of <0.05 with corresponding 95% CI. Result: In this study 321 mothers were participated from those 107 give birth through birth canal after trial of lobour and 214 mothers end the labour with repeated CS. Mothers who have counseling about trial of labour during Anti natal follow up (AOR2.808; 95%CI1.543-5.112) ,mother who have history of successful vaginal birth after cesarean section(AOR4.170; 95%CI 2.317-7.504), membrane ruptured on admission (AOR 4.891; 95%CI 2.728-8.771) and BISHOPE score >6(AOR 2.661; 95%CI 1.415-4.881) significantly associated with successful VBAC. Conclusion Successful VBAC is reduced repeated cesarean delivery and related complication. So in our study counseling about TOLAC during ANC follow up, History of successful VBAC, Membrane ruptured on admission and BISHOPE score >6 were determinants of successful VBAC
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    KNOWLEDGE OF NEONATAL DANGER SIGNS AND ASSOCIATED FACTORS AMONG FATHERS AND MOTHERS WHO GAVE BIRTH IN THE LAST SIX MONTHS IN HAWASSA CITY ETHIOPIA 2023
    (hawassa universty, 2023-11) SELAMAWIT ABERA
    Introduction Preventable neonatal mortality and morbidity remain challenging in many sub Saharan African countries including Ethiopia. The majorities of neonatal death were due to avoidable causes and occurred at home. In a developing country like Ethiopia, since husbands are considered decision-makers when it comes to healthcare-seeking in the family, care-seeking behavior toward their neonates highly relies on their knowledge about neonatal danger signs. Lack of knowledge about neonatal danger signs contributes to delays in seeking help which in turn increases neonatal morbidity and mortality. Objective: The aim of this study is to assess the knowledge of neonatal danger signs and associated factors among fathers and mothers who gave birth in the last six months in Hawassa city. Method: A community based comparative cross-sectional study was conducted with a sample size of 633 couples in selected kebeles of Hawassa city from February 6 to 20. Data was collected by face-to-face interview using semi structured questionnaire. The data was entered into EPI data version 4.2 and exported to SPSS for further analysis. Bivariate and multivariate logistic regression analysis was performed using SPSS version 25 to determine significant factors associated with knowledge of neonatal danger signs. Result: The result of this study showed that mothers and fathers who have good knowledge of neonatal danger sign were found to be 56 %( 95%CI 52-60) and 40.1% (95% CI 36-44) respectively. The odds of having good knowledge among fathers were positively associated with accompanying spouse during ANC follow-up (AOR=2.674, 95% CI 1.532to 4.66). Having three or more children (AOR=2.155, 95% CI 1.287to 3.61) history of neonatal illness (AOR=3.431, 95% CI 1.715 to 6.862). And the odds of having good knowledge among mothers were having a history of neonatal death, (AOR=2.371, 95%CI 1.145-4.911), having three or more children. (AOR=1.49, 95%CI 1.061-2.120) and being counseled by health care professionals at postnatal (AOR=1.482, 95%CI 1.016-2.161) Conclusion and recommendations in this study, Mothers’ and fathers’ knowledge about neonatal danger signs was found to be low. Therefore, an intervention modality that focuses on reducing the knowledge gap through health education was pinpointed
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    TREATMENT OUTCOMES AND ASSOCIATED FACTORS AMONG CHILDREN ADMITTED TO PEDIATRIC EMERGENCY UNIT OF DILLA UNIVERSITY REFERRAL HOSPITAL, ETHIOPIA, 2023.
    (hawassa universty, 2023-11) SAMUEL JIGSO DUBE
    Background: Children in pediatric emergency units are those who need special attention, and unless treated early, they are a vulnerable population to unwanted outcomes. However, the majority of the children admitted to pediatric emergency units was improving and discharged; a significant number of children are still experiencing death, discharge against medical advice or referral from emergency units within 24 hours. However, there is limited information regarding their outcomes and determinants of outcomes. Objectives: To assess treatment outcome and associated factors among children admitted to pediatric emergency unit of Dilla university referral hospital, Ethiopia 2023. Methods: An institution-based cross-sectional study design was employed among children admitted to the pediatric emergency unit at Dilla University Referral Hospital from May 8, 2023 –June 8, 2023. A one year all charts of the children aged 29 days -14 years were reviewed for the study with final (complete) charts of 885. Data was collected based on a structured checklist developed on the Kobo Toolbox mobile application. Collected data was exported into and analyzed using STATA version 14. Frequency and percentage was used to describe variables. A multinomial logistic regression model was used to determine factors associated with treatment outcome. Model goodness of fit was checked using likelihood ratio test and it showed goodness of model fit. Bivariable and multivariable multinomial logistic regression analysis were employed. After multivariable analysis, variables with an adjusted odds ratio and a p-value of <0.05 at 95% confidence interval (CI) were declared as factors significantly associated with treatment outcome. Result: Out of the complete 885 patient charts reviewed, the magnitude of patients improved, transferred, died, referred and discharged against medical advice was 51%, 40.9%, 7.6%, 0.1%, and 0.4%, respectively. Children presented with diarrhea [AOR=2.92, 95%CI (1.46-5.84)], severe respiratory distress [AOR=5.08, 95%CI (2.49-10.35)], coma [AOR=3.71, 95%CI (1.24 11.13)], comorbidity [AOR=3.33, 95%CI (1.49-7.41)] and staying home without seeking health care for > two days since the onset of signs and symptoms [AOR=1.99, 95CI (1.03-3.83)] were significantly associated factors with emergency unit mortality, whereas pneumonia [AOR=1.76, 95%CI (1.16-2.65)] and severe acute malnutrition [AOR=3.46, 95%CI (2.06-5.81)] were significantly associated factors with intra-hospital unit/ward transfer. Conclusion: The findings of this study showed that the magnitude of mortality, transfer to the ward and discharge against medical advice was relatively higher. Presenting with diarrhea, respiratory distress, comorbid illnesses, coma, delay to present, pneumonia and severe acute malnutrition are factors associated with pediatric emergency treatment outcomes. Interventions focused on early diagnoses and the initiation of appropriate treatments was of the utmost relevance to improve patient‟s outcomes.
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    UTILIZATION LEVEL OF ELECTRONIC COMMUNITY HEALTH INFORMATION SYSTEM AND ASSOCIATED FACTORS AMONG HEALTH EXTENSION WORKERS IN SIDAMA REGION, ETHIOPIA
    (hawassa universty, 2024-11) KIDEST FEKADU
    Background: Effective community health management information systems are important in low-resource countries that rely heavily on community-based health care providers. However, there is no evidence of the level of utilization of electronic community health information systems. The aim of this study is to assess the utilization of electronic community health information systems and associated factors among health extension workers in the Sidama region of Ethiopia in 2023. Methods: Concurrent mixed methods design was used: Quantitative cross-sectional studies and qualitative phenomenology designs among 402 health extension workers and 8 participants for qualitative study from April to June 2023. Multi-stage sampling techniques have been used. Data were extracted by interview methods using the Kobo toolbox and then exported to SPSS version 25 for analysis. Variables having P<0.25 in bivariate analysis were fitted for multivariable regression. Whereas, an explorative qualitative study was employed, involving key informant interviews and in-depth interviews with a purposefully chosen interviewee, and the data was analyzed using Atlas software. Result: The study revealed the overall utilization level of the community health information system in Sidama was 40.3% (95% CI: 35.5%, 45.3%). Supportive supervision from primary health care units (AOR = 0.46, 95% CI = 0.28, 0.55), supportive supervision from Woreda Health Office (AOR = 0.51, 95% CI = 0.29, 0.91), connectivity (AOR = 0.55, 95% CI = 0.32, 0.94), receiving electronic community health information system guidelines (AOR = 0.45, 95% CI = 0.27, 0.75), and perceived competency (AOR = 0.54, 95% CI = 0.34, 0.86) were significant factors. The budget constraint, infrastructure, follow-up problem, technological problems, lack of commitment, and role confusion were challenges for the utilization of the system. Conclusion and Recommendation: More than half of the health extension workers had no electronic health information system utilization . Supervision from primary health care units , Supervision fromworeda health offices, connectivity, guidelines and perceived competency were responsible for the result. Therefore, Improving, boosting internet connectivity, supportive follow-up, training access for their competency and fulfilling the guidelines are important to scale up the utilization. This finding is supported by qualitative study.
Academic and research outputs of the College of Medicine and Health Sciences.