Health facilities readiness to provide comprehensive abortion care and factors associated with client satisfaction in Central Oromia Region, Ethiopia: a multilevel modeling approach
Abstract Background In Ethiopia only 53% of induced abortions were performed in a health facility. Even though efforts have been made to improve comprehensive abortion care (CAC), still several health facilities fail to provide the services. Even in facilities where such care is provided, significan...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-05-01
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| Series: | Reproductive Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12978-023-01610-2 |
| _version_ | 1797827502002929664 |
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| author | Fikru Abebe Gebremariam Ephrem Mannekulih Habtewold Dereje Tegene Degife Habte Bekele Geneti Damen Hailemariam Gebrekiros |
| author_facet | Fikru Abebe Gebremariam Ephrem Mannekulih Habtewold Dereje Tegene Degife Habte Bekele Geneti Damen Hailemariam Gebrekiros |
| author_sort | Fikru Abebe Gebremariam |
| collection | DOAJ |
| description | Abstract Background In Ethiopia only 53% of induced abortions were performed in a health facility. Even though efforts have been made to improve comprehensive abortion care (CAC), still several health facilities fail to provide the services. Even in facilities where such care is provided, significant numbers of clients report their dissatisfaction with the service. Hence, this study sought to assess availability and readiness to meet the need for CAC, client satisfaction with the service and associated factors in public health facilities of East Shawa Zone, from March 1 to July 31, 2020. Method Cross-sectional study was conducted taking a random sample of 30 health facilities and 900 women who received CAC and providers who delivered the services. Data were collected using interviewer-administered questionnaire and observational checklist. The analysis was performed using Stata-13. Descriptive summaries were used to characterize study participants, to determine service availability and readiness of facilities. The levels of satisfaction were estimated using proportion with a 95% confidence interval (CI). Multilevel ordinal logistic regression analysis was performed to identify factors associated with service satisfaction. The magnitude of association was estimated by adjusted odds ratios (AOR) with a 95% CI, and a p-value < 0.05 was used to declare statistical significance. Results The study found that all health facilities fulfilled at least three-fourth (75%) of the requirements that ensure CAC services availability. However, the percentage of facilities that fulfilled at least three-fourth of equipment was 60%; medicines, 56.7%; and basic amenities, 46.7%. Overall, 19.3% of women (95% CI 16.9%, 22.0%) reported very high level of satisfaction with CAC services. The levels of Satisfaction with the services were associated with being treated with second trimester abortion (AOR) = 2.07; 95% CI 1.03, 4.15) and having good procedure outcome (AOR = 2.09; 95% CI 1.09, 4.15), being treated by younger service provider, less than 35 year old (AOR = 8.58; 95% CI 3.66, 20.12), by a nurse (AOR = 2.96; 95% CI 1.49, 5.87), provider with three to five years of experience (AOR = 0.46; 95% CI 0.23, 0.92) and with the availability of essential medicines (AOR = 4.34; 95% CI 1.06, 18.20). Conclusions The availability of essential medicines was below the standards set by World Health Organization. The levels of satisfaction with CAC is comparably lower than other studies findings and affected by the availability of essential medicines, procedure outcome, and gestational age of terminated pregnancy, the health care provider’s age, profession and years of experience. |
| first_indexed | 2024-04-09T12:49:20Z |
| format | Article |
| id | doaj.art-51270987505c4931a06acabbef941320 |
| institution | Directory Open Access Journal |
| issn | 1742-4755 |
| language | English |
| last_indexed | 2024-04-09T12:49:20Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Reproductive Health |
| spelling | doaj.art-51270987505c4931a06acabbef9413202023-05-14T11:18:50ZengBMCReproductive Health1742-47552023-05-0120111810.1186/s12978-023-01610-2Health facilities readiness to provide comprehensive abortion care and factors associated with client satisfaction in Central Oromia Region, Ethiopia: a multilevel modeling approachFikru Abebe Gebremariam0Ephrem Mannekulih Habtewold1Dereje Tegene Degife2Habte Bekele Geneti3Damen Hailemariam Gebrekiros4Department of Gynecology and Obstetrics, Adama Hospital Medical CollegeDepartments of Public Health, Adama Hospital Medical CollegeDepartment of Gynecology and Obstetrics, Adama Hospital Medical CollegeDepartment of Gynecology and Obstetrics, Adama Hospital Medical CollegeDepartment of Preventive Medicine, School Public Health, College of Health Sciences, Addis Ababa UniversityAbstract Background In Ethiopia only 53% of induced abortions were performed in a health facility. Even though efforts have been made to improve comprehensive abortion care (CAC), still several health facilities fail to provide the services. Even in facilities where such care is provided, significant numbers of clients report their dissatisfaction with the service. Hence, this study sought to assess availability and readiness to meet the need for CAC, client satisfaction with the service and associated factors in public health facilities of East Shawa Zone, from March 1 to July 31, 2020. Method Cross-sectional study was conducted taking a random sample of 30 health facilities and 900 women who received CAC and providers who delivered the services. Data were collected using interviewer-administered questionnaire and observational checklist. The analysis was performed using Stata-13. Descriptive summaries were used to characterize study participants, to determine service availability and readiness of facilities. The levels of satisfaction were estimated using proportion with a 95% confidence interval (CI). Multilevel ordinal logistic regression analysis was performed to identify factors associated with service satisfaction. The magnitude of association was estimated by adjusted odds ratios (AOR) with a 95% CI, and a p-value < 0.05 was used to declare statistical significance. Results The study found that all health facilities fulfilled at least three-fourth (75%) of the requirements that ensure CAC services availability. However, the percentage of facilities that fulfilled at least three-fourth of equipment was 60%; medicines, 56.7%; and basic amenities, 46.7%. Overall, 19.3% of women (95% CI 16.9%, 22.0%) reported very high level of satisfaction with CAC services. The levels of Satisfaction with the services were associated with being treated with second trimester abortion (AOR) = 2.07; 95% CI 1.03, 4.15) and having good procedure outcome (AOR = 2.09; 95% CI 1.09, 4.15), being treated by younger service provider, less than 35 year old (AOR = 8.58; 95% CI 3.66, 20.12), by a nurse (AOR = 2.96; 95% CI 1.49, 5.87), provider with three to five years of experience (AOR = 0.46; 95% CI 0.23, 0.92) and with the availability of essential medicines (AOR = 4.34; 95% CI 1.06, 18.20). Conclusions The availability of essential medicines was below the standards set by World Health Organization. The levels of satisfaction with CAC is comparably lower than other studies findings and affected by the availability of essential medicines, procedure outcome, and gestational age of terminated pregnancy, the health care provider’s age, profession and years of experience.https://doi.org/10.1186/s12978-023-01610-2Comprehensive abortion careEthiopiaOromiaReadinessSatisfactionShawa |
| spellingShingle | Fikru Abebe Gebremariam Ephrem Mannekulih Habtewold Dereje Tegene Degife Habte Bekele Geneti Damen Hailemariam Gebrekiros Health facilities readiness to provide comprehensive abortion care and factors associated with client satisfaction in Central Oromia Region, Ethiopia: a multilevel modeling approach Reproductive Health Comprehensive abortion care Ethiopia Oromia Readiness Satisfaction Shawa |
| title | Health facilities readiness to provide comprehensive abortion care and factors associated with client satisfaction in Central Oromia Region, Ethiopia: a multilevel modeling approach |
| title_full | Health facilities readiness to provide comprehensive abortion care and factors associated with client satisfaction in Central Oromia Region, Ethiopia: a multilevel modeling approach |
| title_fullStr | Health facilities readiness to provide comprehensive abortion care and factors associated with client satisfaction in Central Oromia Region, Ethiopia: a multilevel modeling approach |
| title_full_unstemmed | Health facilities readiness to provide comprehensive abortion care and factors associated with client satisfaction in Central Oromia Region, Ethiopia: a multilevel modeling approach |
| title_short | Health facilities readiness to provide comprehensive abortion care and factors associated with client satisfaction in Central Oromia Region, Ethiopia: a multilevel modeling approach |
| title_sort | health facilities readiness to provide comprehensive abortion care and factors associated with client satisfaction in central oromia region ethiopia a multilevel modeling approach |
| topic | Comprehensive abortion care Ethiopia Oromia Readiness Satisfaction Shawa |
| url | https://doi.org/10.1186/s12978-023-01610-2 |
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