Postabortion contraceptives uptake and its associated factors among clients visiting abortion care services in public hospitals in West Shewa Zone, Oromia regional state, Ethiopia, 2021

Background

Postabortion contraception is the initiation and use of postabortion contraceptive methods immediately after an abortion. It is a critical approach for preventing unwanted pregnancy, alleviating its complications, and avoiding repeated abortions by promoting immediate postabortion contraceptives provision.

Objective

To assess the level of postabortion contraceptives uptake and its associated factors among clients visiting abortion care services in public hospitals in West Shewa Zone, Oromia regional state, Ethiopia.

Methods and materials

An institutional-based cross-sectional study was conducted in public hospitals in the West Shewa Zone from 1 March 2021 to 30 May 2021, among 227 proportionally allocated clients based on the proportion of the client served in the previous 3 months of the study period. Data were collected through face-to-face interviews using semi-structured and pretested questionnaire from women who received the abortion services. Bivariable and multivariable logistic regression were used to assess the association of independent variables with postabortion contraceptive uptake. Findings with p-value of 0.05 at 95% confidence interval were considered as statistically significant.

Results

The overall postabortion contraception uptake among abortion service clients in public hospitals was 164 (74%) while about 42% of them used long-term contraceptive methods. Postabortion contraceptive uptake was significantly associated with media exposure to postabortion family planning information (adjusted odds ratio: 3.4 (95% confidence interval: 1.03-11.27)) and counseling on postabortion family planning (adjusted odds ratio: 20.48 (95% confidence interval: 5.02-83.64)).

Conclusion

Level of postabortion contraceptive method uptake in West Shewa was low as compared to the national target. Greater attention should be given on providing postabortion contraceptive counseling to increase the postabortion contraceptive uptake.

Explore the reasons for SARS-CoV-2 vaccine hesitancy among healthcare workers: a cross-sectional study

Vaccine hesitancy is described by the WHO as "a delay in acceptance or refusal of safe immunizations notwithstanding the availability of vaccine services." In Ethiopia, the cumulative acceptance rate of the COVID-19 vaccination was 57.8%. Ethiopia had a lower rate of COVID-19 vaccination acceptance than was required to create herd immunity. This study was carried out to determine the prevalence of COVID-19 vaccine reluctance and its contributing factors. Based on the findings of the study, recommendations were made to the relevant bodies in order to reduce vaccine hesitancy and increase vaccination acceptability.

Objectives

A cross-sectional online-based study was conducted to better understand the reasons for SARS-CoV-2 vaccine hesitancy among healthcare workers (HCWs) in Oromia regional state, Ethiopia.

Materials and methods

A cross-sectional survey using an internet platform was conducted from 18 June 2021, to 29 June 2022. A multistage cluster sampling strategy was used to find participants, with each cluster representing a sampling unit made up of a set of population elements. Participants are then randomly chosen from those clusters. The data were entered in Epi Info 7.2.0.1, then exported to Microsoft Excel and imported into statistical programs for social sciences (26.0 version) for statistical analysis. Statistical significance was considered to be a P value of less than 0.05.

Results

Four hundred twenty-two HCWs completed the online survey. The majority of the HCWs were male (n=234, 55.5%), urban residents (n=396, 93.8%), protestants (n=168, 39.8%), and married people (n=232, 55.0%). The prevalence of HCWs reluctant to receive the SARS-CoV-2 vaccination was 69.7% (n=294). Age from 19 to 34 [adjusted odds ratio (AOR) =1.48, 95% CI: 1.69-7.42, P=<0.001], female sex (AOR =3.68, 95% CI =1.370-6.413, P=0.002), income between 3501 and 8500 ETB (AOR =1.67, 95% CI =1.380-5.697, P=0.048), information from websites (AOR =1.79, 95% CI =1.720-31.179, P=0.013), vaccine skepticism (AOR =4.75, 95% CI =3.210-8.152, P=0.009), and potential adverse effects of a SARS-CoV-2 vaccine (AOR =2.18, 95% CI =1.732-5.248, P=0.043) were independent predictors of SARS-CoV-2 vaccine hesitancy among HCWs.

Conclusion and recommendations

HCWs were reluctant to get the SARS-CoV-2 immunization at a high percentage overall. To reduce hesitancy to receive the SARS-CoV-2 vaccination among HCWs, the Oromia regional state health bureau should be required to increase HCWs' knowledge of the COVID-19 vaccine by providing proper training for all HCWs.

Technical Efficiency of Maternal and Reproductive Health Services in Public Hospitals of Oromia Regional State, Ethiopia

As the Ethiopian health system faced critical resource constraints, wise use of the available health resources is a priority agenda. Therefore, our study aimed to assess technical efficiency of maternal and reproductive health services in public hospitals of Oromia regional state, Ethiopia. Two-stage data envelopment analysis was performed among 14 hospitals with input orientation and variable returns to scale assumptions. Technical efficiency scores were computed at the first stage, and predictors were determined using Tobit regression at the second stage. The assessment revealed that 12 (85.7%) hospitals were pure technical efficient and 9 (64.29%) hospitals were scale efficient. Level (primary/general) (β = 1.17, 95% confidence interval [CI] = 0.16-2.18), service years (β = 0.02, 95% CI = 0.003-0.03), and size of catchment population (β = 5.58E–07, 95% CI = 2.95E–08 to 1.09E–06) were positively associated with technical efficiency of maternal and reproductive health service, whereas average waiting time for maternal health service (β = –0.03, 95% CI = –0.05 to −0.01) was negatively associated with efficiency. In conclusion, most of the hospitals were technically efficient and around two-thirds were operating scale efficient. Allocation of more resources to older secondary hospitals with larger catchment population could result in more efficient use of resources for maternal and reproductive health service delivery.