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Abstract Introduction Contraceptive discontinuation has become a widespread issue on a global basis. Implants, of which Implanon is the most popular, are only the second most widely used form of modern contraceptive in Ethiopia. However, Implanon was discontinued at a rate as high as 23.4% in Ethiopia within the first year of use. Therefore, the purpose of this study was to identify the incidence rate and predictors of unplanned discontinuation of Implanon in the first year of application at public hospitals in the North Shoa zone, Central Ethiopia. Methods A retrospective follow-up study was conducted at public hospitals in the North Shoa zone among women who use Implanon. A total of 429 women who wanted their Implanon removed after insertion were selected as study participants during the data collection period. Data were gathered from the family planning initiation and removal registration books as well as by contacting users directly. A log-rank test was used to assess the significance of observed differences between categorical variable strata. The acceleration failure time model with log-normal distribution was used to fit the survival data. Results The unplanned discontinuation rate Implanon in the first year of insertion was 19.1% with an estimated mean survival time of 10.9 months (95% CI: 10.65, 11.14). Women with an interval period of insertion (AAF = 1.53; 95% CI: 1.06, 2.21), women who chose implanon by themselves (AFF = 1.32; 95% CI: 1.02, 1.71), women who were satisfied with the service (AFF = 1.40; 95% CI: 1.06, 1.83), and women who were given instructions on what to do if they experienced side effects (AFF = 1.85; 95% CI: 1.40, 2.44), had a lower likelihood of discontinuing their implanon in the first year of insertion. Conclusion The risk of unplanned Implanon discontinuation was found to be high in the study area. Health care providers should pay close attention to clients' needs when delivering family planning services, and the client should ultimately decide whether to use the service. Family planning departments must also engage in early-side effects treatment and reassure clients to lessen discontinuation.

Abstract Background Missed nursing care refers to any aspect of care performed by nursing staff that is omitted or significantly delayed. Even though the potential impact of missing nursing care on maternal and fetal outcomes is significant, there is currently limited evidence regarding the extent of this issue specifically within the maternity wards. Therefore, this study aimed to assess missed nursing care and associated factors in the maternity wards of public hospitals in the Sidama region, Ethiopia 2022. Methods A hospital-based cross-sectional study was conducted among 361 nurses and midwives in maternity wards of Sidama region public hospitals from March 28 to April 26, 2022. Simple random sampling was used to select participants. The data was collected using the MISSCARE survey tool and analyzed with SPSS version 26. Simple linear and multiple linear regression analyses were used to identify the factors associated with missed nursing care. Results The overall mean missed nursing care score was 67 out of 130 (95% CI: 65.92, 68.02) and the average score for each nursing intervention was 2.58 out of 5 (95% CI: 2.54, 2.62). The intention to leave the institution (β = 3.812, 95% CI: 2.285, 5.340) and increasing weekly work hours (β = 0.203, 95% CI: 0.134, 0.272) were factors positively associated with missed nursing care. However, increased work experience (β= -0.963, 95%CI: -1.475, -0.452) and job satisfaction (β= -4.976, 95%CI: -6.431, -3.522) were negatively associated with missed nursing care. Conclusion This study found that the level of missed nursing care was significant. Factors positively associated with missed nursing care included an intention to leave the institution and an increase in weekly work hours. In contrast, an increase in work experience and higher job satisfaction were negatively associated with missed nursing care.

Abstract Background Chronic heart failure affects approximately 26 million people globally. World Health Organization data show that only approximately half of chronically ill patients in developed countries adhere to recommended medication, with even lower rates in developing countries. Medication adherence is critical for managing chronic heart failure symptoms, delaying disease progression, and preventing hospitalizations. However, poor adherence increases rehospitalization, morbidity, mortality, and healthcare costs. Objective To assess medication adherence and associated factors among chronic heart failure patients on follow-up at North Shewa Public Hospitals, Oromia Region, Ethiopia, in 2023. Methods This institutional-based cross-sectional study was conducted from March 1 to April 30, 2023, G.C. A total of 603 individuals were selected consecutively among those who underwent chronic OPD after being proportionally allocated to five hospitals in the zone. The data were collected using an interviewer-administered questionnaire and a medical chart review. The data were entered into Epi-data version 3.1 and then exported to SPSS version 26 for analysis. The multivariable logistic regression model included variables with a P value

BackgroundBoth mothers and newborns go through a critical time in their lives during the postnatal period, and the majority of deaths of mothers and neonates happen during this period. Postnatal care is the care given to women and their neonates, starting from delivery to 42 postnatal days. Although the significance of postnatal care in maternal and child health is acknowledged, the influence of husbands in either facilitating or impeding access to these services has been largely unexplored. So it's important to find out husbands’ involvement in postnatal care service utilization in Bishoftu town.ObjectivesTo assess husband involvement in postnatal care services utilization and associated factors in Bishoftu town, Central Ethiopia.MethodsA community-based cross-sectional study was conducted in Bishoftu town, central Ethiopia, between April 1 and 27, 2022, among 624 fathers. After being selected through simple random sampling, 610 husbands were interviewed face-to-face. The data was then entered into Epi-Data version 3.1 and analyzed using SPSS version 26. Binary logistic regression was employed for analysis and variables with a p-value ≤0.2 in the bivariate analysis were entered into multivariable logistic regression analysis. In multivariable analysis, statistical significance was declared at p-value

Objective To identify determinants of puerperal sepsis among postpartum women attending East Shoa Zone public hospitals, Central Ethiopia, 2023.Design and setting An institutional-based, unmatched case–control study was conducted from 19 June 2023 to 4 September 2023, in East Shoa Zone public hospitals.Participants 495 postpartum women (100 cases and 395 controls) were selected using systematic sampling techniques. Data were collected through face-to-face interviews and from medical charts using a pretested, structured questionnaire. The AOR with its corresponding 95% CI was used to identify determinant variables. Findings were presented in texts and tables.Outcome measures The medical charts of participants were reviewed to identify those who had developed puerperal sepsis.Results Anaemia (AOR 6.05; 95% CI 2.57 to 14.26), undernourishment (AOR 4.43; 95% CI 1.96 to 10.01), gestational diabetes mellitus (AOR 3.26; 95% CI 1.22 to 8.74), postpartum haemorrhage (AOR 3.17; 95% CI 1.28 to 7.87), obstructed labour (AOR 2.76; 95% CI 1.17 to 6.52), multiparity (AOR 2.54; 95% CI 1.17 to 5.50), placenta previa (AOR 2.27; 95% CI 1.11 to 4.67) and vaginal examination ≥5 times (AOR 2.19; 95% CI 1.05 to 4.54) were the independent determinants of puerperal sepsis in this study.Conclusion This study found that gestational diabetes mellitus, anaemia, undernourishment, placenta previa, obstructed labour, postpartum haemorrhage and five or more per-vaginal examinations during labour were the determinants of puerperal sepsis. Therefore, it is recommended that obstetric care providers strictly adhere to guidelines on the number of vaginal exams that should be performed throughout labour and that they perform these exams using the appropriate infection-prevention techniques. In addition, they should provide comprehensive health education on nutrition during pregnancy and postnatal periods and the importance of iron supplements.

Objective To assess practice of breast self-examination (BSE) and associated factors among women of reproductive age in the North Shoa Zone, Oromia, Ethiopia.Design Community-based cross-sectional study with a convergent mixed-methods approach.Setting The study was conducted in the North Shoa Zone of Oromia, Central Ethiopia, between 1 May 2022 and 30 June 2022.Participants 1076 women of reproductive age were selected using simple random sampling technique for the quantitative study. For the qualitative part, a total of 46 women were approached purposively to elicit rich ideas and insight into the issue. The quantitative data were collected using an interviewer-administered questionnaire, and focus group discussions were used for the qualitative part. Quantitative data were analysed using SPSS V.26. An adjusted OR with a 95% CI was employed. Thematic analysis approach was applied for the qualitative data analysis.Outcome measures Participants were interviewed to respond whether they practised BSE.Results Overall, 192 (18.2%; 15.7%–20.5%) of the participants had ever performed BSE. Having a family history of breast cancer (BC) (adjusted OR (AOR)=6.9, 95% CI 4.6 to 10.3), being knowledgeable on BSE (AOR=3, 95% CI 1.9 to 4.3), having high perceived susceptibility (AOR=1.7, 95% CI 1.2 to 2.5), having high self-efficacy (AOR=1.5, 95% CI 1.1 to 2.3) and having a high perceived benefit to BSE (AOR=1.5, 95% CI 1.1 to 2.3) were significantly associated with increased odds of BSE practice.Four main themes emerged from the qualitative analysis: BC and BSE-related knowledge, perceived benefits of treatment, barriers to BSE practice and enablers of BSE practice.Conclusion The practice of BSE in this area was considerably low. The North Shoa Zonal Health Office and other stakeholders should disseminate instructional materials that cover the techniques and benefits of regularly performing BSE. Healthcare professionals should engage in the community to address the obstacles women face in practising BSE.

Objective To assess the time to initiation of antenatal care (ANC) and its predictors among pregnant women in Ethiopia.Design Retrospective follow-up study using secondary data from the 2019 Ethiopian Mini-Demographic and Health Survey.Setting and participants 2933 women aged 15–49 years who had ANC visits during their current or most recent pregnancy within the 5 years prior to the survey were included in this study. Women who attended prenatal appointments but whose gestational age was unknown at the first prenatal visit were excluded from the study.Outcome measures Participants were interviewed about the gestational age in months at which they made the first ANC visit. Multivariable mixed-effects survival regression was fitted to identify factors associated with the time to initiation of ANC.Results In this study, the estimated mean survival time of pregnant women to initiate the first ANC visit in Ethiopia was found to be 6.8 months (95% CI: 6.68, 6.95). Women whose last birth was a caesarean section (adjusted acceleration factor (AAF)=0.75; 95% CI: 0.61, 0.93) and women with higher education (AAF)=0.69; 95% CI: 0.50, 0.95) had a shorter time to initiate ANC early in the first trimester of pregnancy. However, being grand multiparous (AAF=1.31; 95% CI: 1.05, 1.63), being previously in a union (AAF=1.47; 95% CI: 1.07, 2.00), having a home birth (AAF=1.35; 95% CI: 1.13, 1.61) and living in a rural area (AAF=1.25; 95% CI: 1.03, 1.52) were the impediments to early ANC initiation.Conclusion Women in this study area sought their initial ANC far later than what the WHO recommended. Therefore, healthcare providers should collaborate with community health workers to provide home-based care in order to encourage prompt ANC among hard-to-reach populations, such as rural residents and those giving birth at home.