The purpose of this study was to identify factors that contribute to women delaying seeking treatment for obstetric fistula. A stratified random sampling technique was used to select 384 study participants. A cross sectional analytical research design was used; data was collected by structured, closed ended questionnaires. Bivariate and multivariate logistic regression models were applied. Results show a significant correlation between traditional treatment and delay in seeking treatment (P-Value = 0.012). The presence of parents has a significant correlation in reaching treatment centres (p-value = 0.013), those women who are speaking about their fistula have less chance of delay in seeking treatment (p-value = 0.008), having no income significantly associated with delay in seeking treatment (AOR = 0.28) and women living closer to the treatment centres have less chance of delay (p-value = 0.008). Therefore, there are a number of factors that significantly influence women from early seeking of treatment for their fistulae. / Health Studies / M.A. (Public Health)

The purpose of this study was to identify factors that contribute to women delaying seeking treatment for obstetric fistula. A stratified random sampling technique was used to select 384 study participants. A cross sectional analytical research design was used; data was collected by structured, closed ended questionnaires. Bivariate and multivariate logistic regression models were applied. Results show a significant correlation between traditional treatment and delay in seeking treatment (P-Value = 0.012). The presence of parents has a significant correlation in reaching treatment centres (p-value = 0.013), those women who are speaking about their fistula have less chance of delay in seeking treatment (p-value = 0.008), having no income significantly associated with delay in seeking treatment (AOR = 0.28) and women living closer to the treatment centres have less chance of delay (p-value = 0.008). Therefore, there are a number of factors that significantly influence women from early seeking of treatment for their fistulae. / Health Studies / M.A. (Public Health)

Obstetric surgical repair is the common therapeutic intervention available to women with obstetrical fistula. While surgical repair can address the physical symptoms, it may not end the psychological challenges that women with fistula face. This longitudinal study investigated the effects of surgical obstetric fistula repairs on the severity of depression and anxiety associated with obstetric fistula among 219 women admitted at six fistula hospitals in Ethiopia. Data was collected through structured Likert-scale questionnaire both on admission (prior to surgical obstetric fistula repairs) and on discharge (post obstetric fistula repairs).. Statistical Package for Social Science plus Analysis of Moment Structures (SPSS-AMOS) version 20 was used for data analysis. Findings indicate that women with obstetric fistula have higher psychological distress such as depression (91%) and anxiety (78%) pre-surgical repair than post-surgical repair. These psychological distresses were exacerbated by poor social and psychological support of women with obstetric fistula by the family and health care professionals. The findings were used to develop integrated mental health treatment model for women with obstetric fistula in order to address psychological health needs of this population. / Health Studies / D. Litt. et Phil. (Health Studies)

The contribution of Emergency Obstetric Care (EmOC) in reducing maternal mortality in Ethiopia is very minimal as evidenced by poor provision and low utilization of EmOC. Client centred EmOC provision improves the provision and utilization of EmOC; leading to the treatment of the majority of obstetric complications which are the main causes of maternal mortality. This study describes clients’ views and perspectives concerning the quality of EmOC provision in Ethiopian public health facilities. An explorative and descriptive phenomenological qualitative study design was used in the study in order to explore and describe the lived experiences of clients with EmOC services. Key informant interviews with women who had direct obstetric complications and received EmOC at three public health facilities in Addis Ababa generated rich data on their lived experiences. Content analysis was used to analyze the data as it complies with the phenomenological data analysis and Atlas ti version 6.2 qualitative data analysis software was employed. The findings revealed that quality EmOC is a welcoming, life-saving timely care given in a clean environment with humility, respect, equal treatment and encouragement. It is care that is safe for the client, technically sound, responsive and meets clients’ needs and expectations. Accessibility of life saving care at all time and collaborative and coordinated care created good experiences for the clients. The causes of clients’ disappointment with the provision of EmOC were higher expectations from female providers, underestimation by providers, non responsive providers, and ethical misconduct by providers such as mocking, insulting, yelling, advantage taking providers, undelivered promises by providers, expectation with place of delivery, expectation with newborn care and a limited number of health workers attending delivery. Discrimination, high cost of care and asking client to buy drugs and supplies and referrals from centres, are some of the barriers on r the use of EmOC at public health facilities. The provision of EmOC is constrained by overloaded staffs, shortage of space to accommodate clients and inadequate number of beds. In conclusion, clients have expectations and experiences of provision of EmOC that influence their future decision to seek care. Finally, a client centred guideline for the provision of client centred EmOC provision was developed. / Health Studies / D. Litt. et Phil. (Health Studies)

A quantitative, descriptive and cross sectional study was conducted in four (4) health care facilities to determine whether pregnant women attending antenatal care are aware of danger signs of obstetric complications. The objectives of the study were to assess awareness of danger signs of obstetric complications and to associate demographic and obstetric factors with awareness of danger signs of obstetric complications among pregnant women attending antenatal care in Eastern Wollega zone. Data was collected by means of structured questionnaire from 384 pregnant women attending antenatal care in the 4 health facilities and analysed using the Statistical Package for Social Sciences (SPSS) 16 computer program. The findings revealed that the proportion of women who were aware of danger signs of obstetric complications was inadequate. Recommendations were made in line with the research findings / Health Studies / Health Studies / M.A. (Public Health)

A quantitative, descriptive and cross sectional study was conducted in four (4) health care facilities to determine whether pregnant women attending antenatal care are aware of danger signs of obstetric complications. The objectives of the study were to assess awareness of danger signs of obstetric complications and to associate demographic and obstetric factors with awareness of danger signs of obstetric complications among pregnant women attending antenatal care in Eastern Wollega zone. Data was collected by means of structured questionnaire from 384 pregnant women attending antenatal care in the 4 health facilities and analysed using the Statistical Package for Social Sciences (SPSS) 16 computer program. The findings revealed that the proportion of women who were aware of danger signs of obstetric complications was inadequate. Recommendations were made in line with the research findings / Health Studies / Health Studies / M.A. (Public Health)

The contribution of Emergency Obstetric Care (EmOC) in reducing maternal mortality in Ethiopia is very minimal as evidenced by poor provision and low utilization of EmOC. Client centred EmOC provision improves the provision and utilization of EmOC; leading to the treatment of the majority of obstetric complications which are the main causes of maternal mortality. This study describes clients’ views and perspectives concerning the quality of EmOC provision in Ethiopian public health facilities. An explorative and descriptive phenomenological qualitative study design was used in the study in order to explore and describe the lived experiences of clients with EmOC services. Key informant interviews with women who had direct obstetric complications and received EmOC at three public health facilities in Addis Ababa generated rich data on their lived experiences. Content analysis was used to analyze the data as it complies with the phenomenological data analysis and Atlas ti version 6.2 qualitative data analysis software was employed. The findings revealed that quality EmOC is a welcoming, life-saving timely care given in a clean environment with humility, respect, equal treatment and encouragement. It is care that is safe for the client, technically sound, responsive and meets clients’ needs and expectations. Accessibility of life saving care at all time and collaborative and coordinated care created good experiences for the clients. The causes of clients’ disappointment with the provision of EmOC were higher expectations from female providers, underestimation by providers, non responsive providers, and ethical misconduct by providers such as mocking, insulting, yelling, advantage taking providers, undelivered promises by providers, expectation with place of delivery, expectation with newborn care and a limited number of health workers attending delivery. Discrimination, high cost of care and asking client to buy drugs and supplies and referrals from centres, are some of the barriers on r the use of EmOC at public health facilities. The provision of EmOC is constrained by overloaded staffs, shortage of space to accommodate clients and inadequate number of beds. In conclusion, clients have expectations and experiences of provision of EmOC that influence their future decision to seek care. Finally, a client centred guideline for the provision of client centred EmOC provision was developed. / Health Studies / D. Litt. et Phil. (Health Studies)