Mirkuzie Woldie

Hypertensive disorders represent the most common medical complications of pregnancy with a reported incidence between 5 and 10%. The disorders are major causes of maternal and perinatal morbidities and mortalities. This study was conducted to determine the pattern and outcomes of pregnancies complicated by hypertensive disorders. Hospital based cross-sectional study was conducted on all mothers who gave birth in the labor ward of Jimma University Specialized Hospital from April 1, 2009 to March 31, 2010. Data was collected by interviewing the mothers and review of their medical records using structured questionnaire and checklist, respectively. Data analysis was performed using SPSS for windows version 16.0. Majority (52.5%) of the mothers were in the age group of 25 - 34 years. The overall prevalence of hypertensive disorders of pregnancy was 8.5%. Severe preeclampsia accounted for 51.9% of the cases followed by eclampsia (23.4%). Residential area of the mothers (urban/rural) was f...

Background: Improving access to health care services through efforts to provide services closer to people where they live and work has been advocated widely since the Declaration of Alma-Ata. Despite the efforts to realize this in Ethiopia, in 2003 that the intention to take a package of essential health services to the kebele (village) level was realized. This was done through the introduction of the Health Services Extension Program (HSEP). Objective: To explore whether HSEP in Jimma Zone has improved coverage and comprehensiveness of primary health care services delivered to the population in the rural areas. Methods: A cross sectional study was conducted in three randomly selected Woredas (districts). Data was collected in May to July 2009. A structured questionnaire was used to interview female heads of sampled households of nine kebeles randomly selected from the three Woredas. Data was analysed using SPSS 16.0 package. Results: Only 64.0% of the kebeles had functional health ...

Many studies have been conducted in the intensive care unit (ICU). But little is known about the outcomes of ICU admissions. This is particularly the case in the ICU of developing countries. Thus, the aim of this study was to assess reasons and outcomes of admissions in the ICU of Jimma University Specialized Hospital (JUSH). A longitudinal study was conducted in the ICU of JUSH from February 7 to April 15, 2011. All patients admitted to the ICU during the study period were followed till discharge or death. Data was coded and entered into the Statistical Package for Social Sciences (SPSS) windows version 16.0 to generate descriptive statistics and chi-square test whenever appropriate. Sixty nine patients admitted to the ICU during the study period were followed prospectively till discharge or death. Diseases of cardiovascular origin (30.4%) followed by surgical interventions (18.8%) were the major reasons of ICU admission. There were 26 (37.7%) deaths during the study period in the ...

Decentralization ultimately involves the execution of most health care activities at lower levels of the health system. However, when poorly implemented, decentralization can create confusion about roles and responsibilities. Therefore, the objective of this study was to assess the presence and use of legislative guidelines depicting the distribution of decentralized authority for decision making in the Jimma Zone health system, Southwest Ethiopia. A cross sectional study employing both qualitative and quantitative methods was undertaken from 16(th) January to 15(th) March 2007 in Jimma Zone. Health managers at relevant departments of the Federal Ministry of Health, Oromia Regional Health Bureau (RHB), Jimma Zonal Health Department, 13 Woreda Health Offices of Jimma Zone and the health centers and health posts in these districts were included in the study. Data was collected using interview guides and self administered structured questionnaires prepared for each level of the health ...

Background:Tuberculosis (TB) remains the most common cause of death in people living with HIV/AIDS. The aim of the present study was to identify predictors of mortality in TB-HIV-coinfected patients.Methods:We conducted an unmatched case-control study among a cohort of TB-HIV-coinfected adults who were on antiretroviral therapy (ART). Cases comprised 69 TB-HIV-coinfected patients who died during this period. For each case, we selected 3 (207) TB-HIV-coinfected patients who were alive during the end of the follow-up period.Results:Male sex (odds ratio [OR] = 2.04, 95% confidence interval [CI]: 1.04-4.02), being bedridden at enrollment (OR = 2.84, 95% CI: 1.17-6.89), and cough of more than 2 weeks during initiation of ART (OR = 4.75 95% CI: 2.14-10.56) were the best predictors of mortality among TB-HIV-infected patients.Conclusion:Mortality among TB-HIV-coinfected patients accounted for a considerable number of deaths among the cohort. Patients with cough at ART initiation and with poor functional status should be strictly followed to reduce death.

Background: Patients have explicit desires or requests for services when they visit hospitals. However, inadequate discovery of their needs may result in patient dissatisfaction. This study aimed to determine the levels and determinants of patient satisfaction with outpatient health services provided at public and private hospitals in Addis Ababa, Central Ethiopia.Methods: A comparative cross-sectional study was conducted from 27 March to 30 April 2010. The study included 5 private and 5 public hospitals. Participants were selected using systematic random sampling. A pre-tested and contextually prepared structured questionnaire was used to conduct interviews. Descriptive statistics, analysis of variance, factor analysis and multiple linear regressions were performed using computer software (SPSS 16.0).Results: About 18.0% of the patients at the public hospitals were very satisfied whilst 47.9% were just satisfied with the corresponding proportions a bit higher at private hospitals. ...

Background: Women are more liable to die during or following delivery than during pregnancy but use of both delivery services and post-partum care is low.Objective: To find out the prevalence and predictors of institutional delivery in Wolaita Sodo (Sodo) town, southern Ethiopia.Methods: A cross-sectional study was used to look at 844 women who had given birth in the previous five years in Sodo town. The study employed a multistage-sampling scheme. Codes were given for all identified women in selected kebeles (neighbourhoods) and a simple random sampling technique was used after generating random numbers using the Statistical Package for Social Sciences (SPSS). SPSS was then used to carry out binary- and multiple logisticregressions. A 95% CI for the odds ratio was applied to judge the presence of relationships between variables.Results: The prevalence of institutional delivery-service utilisation in Sodo town was 62.2%. Husband educational status, parity, number of antenatal clinic...

Improving access to health care services has been advocated widely since the Declaration of Alma-Ata. Despite the efforts to realize this in Ethiopia, it is only in the year 2003 that the intention to take the package of essential health services to the kebele level (smallest administrative unit) was realized through the introduction of the Health Services Extension Program (HSEP). The objective of this study was to explore whether introduction of HSEP has improved the coverage of child health services in the rural areas of Jimma Zone. A cross sectional study was conducted in three randomly selected districts of Jimma Zone, Southwest Ethiopia. The data collection was undertaken during the months of May, June and July, 2009. A structured questionnaire was used to interview female heads of sampled households from nine kebeles randomly selected in three Woredas (districts). Data were collected on the socio-demographic characteristics, use of health posts, child vaccination and childhood diarrhea. Checklists were used for record review. Data obtained were analysed using statistical package for social sciences (SPSS) V14. Only 64.0% of the kebeles had functional health posts, although another 32.0% of the kebeles in the zone had health posts under construction. However, most (93.7%) of the kebeles in the zone already had two health extension workers (HEWs) assigned. Vaccination coverage as measured by DPT3 was 67.9%, and 10% of the under-two year old children included in this survey had diarrhoea during the past two weeks. Of the 34 (51.5%) mothers who sought help during diarrhoeal attacks, 12 (35.3%) of them went to the health post. The first places of treatment seeking were health centres and health posts, with equal proportion for both (43.5%). Treatment was sought within a day or two after commencement of diarrhoea for 70.6% of the children. Thirty nine (69.7%) of the 56 children who were given recommended fluids received oral rehydration solution (ORS) or homemade solution. In addition to continuing efforts to improve coverage, there is a need to ensure that activities are linked with follow up of vaccination, early treatment seeking and proper home management of diarrhoea.

In Ethiopia, it was shown that funding levels are far from compatible to the needs for care and support services for people living with human immuno-deficiency virus (PLHIV) and orphaned and vulnerable children (OVC). The aim in this study is to map the relationship between client needs, actors, care and support services provided for PLHIV and OVC in Ethiopia. A case study of the Ethiopian community care program was carried out using multiple methods of data collection as part of a multi-country research of four countries. Three program cases providing care and support services throughout the country were studied. A total of 35 in-depth interviews, 9 focus group discussions, 60 guided interviews, and 3 community mapping exercises were carried out. Analysis was conducted using the thematic framework approach with coding and mapping of the transcripts in the ATLAS.ti version 5.0. The expansion of antiretroviral therapy (ART) has reduced the number of bed-ridden PLHIV in need of home based nursing care. Currently, inadequate access to food and lack of income to cover health care and other expenses are the major concerns of PLHIV in Ethiopia. Community Home Based Care (CHBC) in Ethiopia can be categorised into two types; clinical and non-clinical. Non-clinical care (psychosocial, economic, home nursing care, material, food, and other social supports) is mainly provided by non-governmental care-giving organizations. Clinical care was provided mainly by government health facilities which comprised services such as early detection and treatment for opportunistic infections (OIs), ART services and PMTCT. A clear shift of the need of PLHIV from basic nursing care at home to social and material support needs was observed. A coordinated effort from the key players including governmental entities, non-governmental organizations (NGOs) and faith-based organizations (FBOs), the community, associations of PLHIV and volunteers is required to meet the current needs of PLHIV and OVC in the country.

Background:  Patient satisfaction is an attitude resulting from a person’s general orientation towards a total experience of health care. It is a key determinant and a legitimate measure for quality of care. In developing countries,
satisfaction studies were conducted mainly on nursing care and outpatient services.
Objective:  This study aims to measure and describe the level of patient satisfaction within inpatient health care
services.
Methods:  Across sectional study design was conducted from 8 May 2011 to 2 June 2011 at Jimma University Specialized Hospital. Systematic random sampling technique was employed to recruit participants. A standardized structured
questionnaire developed by reviewing similar literatures was used to assess the level of patient satisfaction towards
the inpatient services. SPSS version 19 statistical packages were used for data management and analysis.
Result:  A total of 189 patients participated. The proportion of overall net patient satisfaction was 117 (61.9%). Majority of the respondents 148 (78.3%) reported that they got the kind of service they anticipated. Cleanliness of the ward
145 (76.7%) and time to get back to home 27 (14.3%) were found to have the highest and the lowest proportion of
satisfied respondents, respectively. Patients with no formal education 60 (76.9%) and patients from the rural areas 75
(68.8%) were satisfied higher than those from their counterparts. Patients at medical 22 (61.1%) and ophthalmology
10 (62.5%) wards were less satisfied than patients in other departments.
Conclusion:  Nearly two third of the patients were found to be satisfied by the service they received from the hospital. Most of the patients found to be dissatisfied with the nursing, pharmacy and laboratory services, while some
others were still dissatisfied with the level of health education, communication and information they received about
their illness. Therefore, the hospital administration system should best work on new innovative approach to keep and
improve the administrative system, waiting time, hospital stay, hospital accommodation, access for medications and
laboratory services to bring patient satisfaction. Nurses and physicians should have to work best to improve health
education, communication and understanding between doctors/nurses and patients. Hospital reformation and modern hospital administration system could work best to keep and improve the level of patient satisfaction