No abstract

Background: Worldwide, an estimated 2.3 million children under the age of 15 are HIV positive. The main source of HIV infection in children is vertical transmission of HIV from mother-to-child during pregnancy, labor and delivery, or breastfeeding. Prevention of Mother-to-Child Transmission of HIV has been expanded in accelerated fashion throughout Ethiopia with all public hospitals and health centers providing the services. However, published studies on the services' provision in the country are generally limited. If at all, they did not comprehensively examine quality of the services. Objective: The study aimed to assess the quality of Prevention of Mother-to-Child Transmission of HIV services in Gebretsadiq Shawo Memorial Hospital in Kafa Zone, Southwest Ethiopia. Methods: Facility based cross-sectional study involving both quantitative and qualitative methods was conducted in September 2012. A total of 311 pregnant mothers were interviewed and a one year (2011) record of PMTCT clients was reviewed and service provision processes were observed for 10 counseling sessions. Donabedian's Structure-Process-Outcome model was used to conceptualize the study. Data were analyzed using SPSS for windows version 17 software. Descriptive statistics were computed to summarize the findings. Results: Almost all of the minimum required resources such as test kits, prophylactic drugs and other supplies were available in the hospital; counselors followed the national guideline in providing HIV counseling and testing services; and most (90%) of clients were satisfied or very satisfied by the PMTCT services they received. However, from 858 pregnant mothers who visited the ANC clinic in 2011, only 330(38.5%) were offered HIV pretest counseling, while 281 (33%) were tested. Conclusion: Although clients' satisfaction by PMTCT service is very high, considerable proportion of pregnant mothers who utilize ANC services are not offered HIV counseling and testing services. Therefore, appropriate quality improvement interventions against the missed opportunities are highly recommended.

Introduction: Health management information system is a building block for the health system. Even if using health facility data at all levels is critical, it is poorly practiced in developing countries. There is limited evidence about the utilization of routine health information from the health management information system in the study area. This study aimed to assess the utilization of routine health information from health management information system and associated factors among health professionals at health centers in Oromia special zone, Amhara region, Ethiopia. Methods: A facility-based cross-sectional study was conducted from February to March 2019. A total of 369 health professionals who were the focal person for each service delivery point were taken from the selected health centers. The data analysis was done using STATA version 14. A multilevel mixed-effect logistic regression model was carried out to identify factors associated with utilization of routine health information from the health management information system. Adjusted odds ratio with 95% CI was reported to show the strength of association. A P-value of <0.05 was used to declare statistical significance. Results: The magnitude of good routine health information utilization among health care professionals was 52.8%. Training (AOR=2.40, 95% CI=1.35, 4.26), availability of standard indicator definition (AOR=2.01, 95% CI=1.13, 3.57), data analysis skills (AOR=2.59, 95% CI=1.45, 4.62), regular feedback (AOR=2.29, 95% CI=1.29, 4.05), performance evaluation (AOR=2.60, 95% CI=1.19, 5.68) and timely reporting (AOR=2.89, 95% CI=1.54, 5.42) were significantly associated with routine health information utilization. Conclusion: The overall utilization of routine health information from the health management information system was low. Therefore, the Zone health department and woreda health offices need to give training on HMIS data use, and avail standard indicator definition for all health care workers at all service delivery points.

Background: Antenatal care is the care that women receive during pregnancy to ensure a healthy outcome for women and newborns. In spite of its clear importance, such services continued to be important determinants of maternal mortality and morbidity throughout the world. Methods: A case study was conducted in Higher 2 Town Health Center, using client exit interviews of 265 clients who came to the health institution. In addition, 10 observations of client-provider interactions, document reviews of 246 clients' documents selected by systematic random sampling technique, and 5 in-depth interviews of the focal persons were conducted. Quantitative data were analyzed using SPSS for windows (SPSS 16.0). Qualitative data were categorized into major thematic areas and presented as narratives in triangulation with the quantitative results. In each evaluation dimension, indicators were used to judge the quality of antenatal care services. Results: Most of the minimum required basic resources recommended by World Health Organization were available in the study site. But there were incomplete sets of laboratory reagents and shortage of some drugs. Comprehensive history was recorded for 93.4% of clients. Only 34.3% of clients received prescriptions for iron supplementation. Majority (94.6%) of the clients were satisfied with the accommodations of antenatal care service. The compliance of the health care providers towards routine laboratory investigations ranged from 25.4% to 50.1%. Conclusions: The overall quality of the service was judged as fair (69.5%). Majority of the clients were satisfied with accommodation of ANC services. However, the availability of laboratory reagents and drugs remained to be challenges. Providers' compliance towards standard basic investigations was also far below World Health Organization recommendations and judged as critical. Thus it is recommended that responsible bodies should strive to improve provision of supplies and compliance of the care providers to step-up the quality of care at president capacity level.

Background Ethiopia has low skilled birth attendance rates coupled with low quality of care within health facilities contributing to one of the highest maternal mortality rates in Sub-Saharan Africa, at 412 deaths per 100,000 live births. There is lack of evidence on the readiness of health facilities to deliver quality labor and delivery (L&D) care. This paper describes the structural quality of routine L&D care in government hospitals of Ethiopia. Methods A facility-based cross-sectional study design, involving census of all government hospitals in Southern Nations Nationalities and People’s Region (SNNPR) (N = 20) was conducted in November 2016 through facility audit using a structured checklist. Data collectors verified the availability and functioning of the required items through observation and interview with the heads of labor and delivery case team. An overall mean score of structural quality was calculated considering domain scores such as general infrastructure, human resource and essential drugs, supplies, equipment and laboratory services. Summary statistics such as proportion, mean and standard deviation were computed to describe the degree of adherence of the hospitals to the standards related to structural quality of routine labor and delivery care. Results One third of hospitals had low readiness to provide quality routine L&D care, with only two approaching near fulfilment of all the standards. Hospitals had fulfilled 68.2% of the standards for the structural aspects of quality of L&D care. Of the facility audit criteria, the availability of essential equipment and supplies for infection prevention scored the highest (88.8%), followed by safety, comfort and woman friendliness of the environment (76.4%). Availability skilled health professionals and quality management practices scored 72.5% each, while availability of the required items of general infrastructure was 64.6%. The two critical domains with the lowest score were availability of essential drugs, supplies and equipment (52.2%); and laboratory services and safe blood supply (50%). Conclusion Substantial capacity gaps were observed in the hospitals challenging the provision of quality routine L&D care services, with only two thirds of required resources available. The largest gaps were in laboratory services and safe blood, and essential drugs, supplies and equipment. The results suggest the need to ensure that all public hospitals in SNNPR meet the required structure to enable the provision of quality routine L&D care with emphases on the identified gaps.