Background Advanced maternal age generally denotes age after 35 years during the time of delivery. Despite the fact that being pregnant at any reproductive age is not risk-free, older gravidity usually culminates with adverse outcomes both to the mother and fetus or neonate. This study aimed to determine the association of adverse obstetrical and perinatal outcomes with advanced maternal age pregnancy. The study was conducted in Ayder comprehensive specialized hospital, north Ethiopia, from 2015 to 2017. Methods chart review comparative cross-sectional study was employed. Data were retrieved from medical charts of 752 pregnant mothers (376 each for both the study;> 35-year-old and reference group;20-34 year old). Data was collected using a pretested and structured checklist using systematic sampling and data was entered & analyzed using SPSS version 20. Binary and multivariable logistic regression was run to determine the association of independent variables with dependent variables. Results This study revealed that advanced maternal age pregnancy was significantly associated with pregnancy induced hypertension [AOR 4.15, 95% CI (2.272–7.575), p <  0.001], ante partum hemorrhage [AOR 2.54, 95% CI (1.32–4.91), P = 0.005] & cesarean delivery [AOR 2.722, 95% CI (1.777–4.170), p <  0.001]. Furthermore, advanced maternal age pregnancy was also increasingly associated with adverse perinatal outcomes like preterm delivery [AOR 3.622, 95% CI (1.469–8.930), p = 0.005], low birth weight [AOR 3.137, 95% CI (1.324–7.433), p = 0.009], perinatal death [AOR 2.54, 95% CI (1.141–5.635), p = 0.022] and low fifth minute APGAR score [AOR 7.507, 95% CI (3.134–17.98), p <  0.001]. Notwithstanding this, maternal age was not found to be associated with amniotic fluid disturbances, premature rupture of membranes and post-term pregnancy. Conclusions Advanced maternal age is markedly linked with adverse obstetrical and perinatal outcomes. Therefore, it is better for health care providers to counsel couples, who seek to have a child in their later ages, about the risks of advanced maternal age pregnancy. In addition, health care workers need to emphasize on how to improve advanced age mothers’ health through the utilization of contraception to reduce pregnancy in this age group.

Background: Inter-professional collaboration between professionals is crucial in health care where most of the activities are undertaken in a team. One of these collaborations is the collaboration of nurses and midwives with physicians. The main objective of this study was to assess interprofessional collaboration of nurses and midwives with physicians and associated factors at Jimma University specialized teaching hospital from March 20 to April 8, 2019. Methods: An institution-based cross-sectional study was conducted among 358 nurses and 52 midwives who are working in Jimma University Specialized teaching hospital using a structured self-administered questionnaire. Study units were selected by simple random sampling using the lottery method. The result was summarized using descriptive statistics and statements. The level of significance was set at a p < 0.05. Result: The overall response rate was 99.76%. Around two-third, 66.7% (n = 273) of participants had a satisfactory inter-professional collaboration with physicians and 238 (58.2%) had good relationship with physicians. Again 234 (57.2%) of participants had a favorable attitude towards interprofessional collaboration with physicians. Moreover, statistical significance was obtained on the relationship of participants with physicians (p = 0.000), the experience of disruptive behavior (p = 0.000), attitude towards interprofessional collaboration with physicians (p = 0.000) and occupational status (p = 0.001). Conclusion: The majority of the participants had a satisfactory inter-professional collaboration with physicians and four of the many possible factors under consideration were finally found statistically significant. Again, it was revealed that nurses and midwives did not significantly differ in their inter-professional collaboration with physicians.

No abstract

This study was conducted in November, 2015 in selected Woredas of Amhara region with the aim of assessing the impact of veterinary cost recovery on efficiency of public private livestock services and to share the experience of the region with other regional states. Structured questionnaire and a field survey with focus group discussion were applied on a total of 475 randomly selected households. Animal health service in the Amhara region is clearly dominated by the public sector. Private-sector involvement was prominent only in the veterinary drug sales and treatment services. Seventy five percent of livestock owners responded that they received veterinary services from their residence within 1km radius. The results indicated that only 18% of respondents were satisfied by clinical examination provided by public sector. There was wide disparity in the effectiveness of delivery of animal health services between public and private sectors in the study Woredas. Majority of farmers were not been satisfied with the services provided by private sector. The supply of drugs is increasing especially after implementation of veterinary cost recovery scheme but with the limited ranges. Most respondents had positive views regarding availability of veterinary drugs (62.2%) and vaccines (78.1%). Many livestock owners believed that illegal veterinary drug sales have decreased after implementation of veterinary cost recovery scheme (VCRS). The fact that payment for veterinary services has already been adopted by livestock owners in the study Woredas could be considered as a good opportunity to start a full cost recovery scheme as well as pave the way for initiating veterinary privatization in some pilot Woredas.