Factors associated with health care provider knowledge on abortion care in Ethiopia, a further analysis on emergency obstetric and newborn care assessment 2016 data
Abstract Background Abortion is one of the major direct causes of maternal death, accounting for 7.9% globally. In Africa, 5.5 million women have unsafe abortions annually. Although maternal deaths due to complications of abortion have declined in Ethiopia, women still die from complications. Few st...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2019-12-01
|
| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-019-4857-8 |
| _version_ | 1818953043151945728 |
|---|---|
| author | Tefera Taddele Theodros Getachew Girum Taye Misrak Getnet Atkure Defar Habtamu Teklie Geremew Gonfa Sheleme Humnessa Aster Teshome Zenebe Akale Kasahun Mormu Abebe Bekele |
| author_facet | Tefera Taddele Theodros Getachew Girum Taye Misrak Getnet Atkure Defar Habtamu Teklie Geremew Gonfa Sheleme Humnessa Aster Teshome Zenebe Akale Kasahun Mormu Abebe Bekele |
| author_sort | Tefera Taddele |
| collection | DOAJ |
| description | Abstract Background Abortion is one of the major direct causes of maternal death, accounting for 7.9% globally. In Africa, 5.5 million women have unsafe abortions annually. Although maternal deaths due to complications of abortion have declined in Ethiopia, women still die from complications. Few studies have focused on providers’ clinical knowledge. This study investigates the level of health workers’ knowledge of comprehensive abortion care and its determinants in Ethiopia. Methods Data from the national emergency obstetric and newborn care (EmONC) assessment was used. A total of 3804 facilities that provided institutional deliveries in the 12 months before the assessment were included. Provider knowledge was assessed by interviewing a single provider from each facility. Criteria for selection included: having attended the largest number of deliveries in the last one or two months. A summary knowledge score was generated based on the responses to three knowledge questions related to immediate complications of unsafe abortion, how a woman should be clinically managed and what the counselling content should contain. The score was classified into two categories (< 50% and > =50%). Logistic regression was used to determine individual and facility-level factors associated with the summary knowledge score. Result A total of 3800 providers participated and the majority were midwives, nurses and health officers. On average, providers identified approximately half or fewer of the expected responses. The multivariate model showed that midwives and nurses (compared to health officers), being female, and absence of training or practice of manual vacuum aspiration were associated with lower knowledge levels. Important facility level factors protective against low knowledge levels included employment in Addis Ababa, being male and having internet access in the facility. Conclusion To increase knowledge levels among providers, pre- and in-service training efforts should be particularly sensitive to female providers who scored lower, ensure that more midlevel providers are capable of performing manual vacuum aspiration as well as provide special attention to providers in the Gambella. |
| first_indexed | 2024-12-20T09:59:59Z |
| format | Article |
| id | doaj.art-6dce5172be314c54b00c57c60dafcc8e |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-20T09:59:59Z |
| publishDate | 2019-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-6dce5172be314c54b00c57c60dafcc8e2022-12-21T19:44:22ZengBMCBMC Health Services Research1472-69632019-12-011911810.1186/s12913-019-4857-8Factors associated with health care provider knowledge on abortion care in Ethiopia, a further analysis on emergency obstetric and newborn care assessment 2016 dataTefera Taddele0Theodros Getachew1Girum Taye2Misrak Getnet3Atkure Defar4Habtamu Teklie5Geremew Gonfa6Sheleme Humnessa7Aster Teshome8Zenebe Akale9Kasahun Mormu10Abebe Bekele11Health System and Reproductive Health Research Directorate, Ethiopian Public Health InstituteHealth System and Reproductive Health Research Directorate, Ethiopian Public Health InstituteHealth System and Reproductive Health Research Directorate, Ethiopian Public Health InstituteHealth System and Reproductive Health Research Directorate, Ethiopian Public Health InstituteHealth System and Reproductive Health Research Directorate, Ethiopian Public Health InstituteHealth System and Reproductive Health Research Directorate, Ethiopian Public Health InstituteHealth System and Reproductive Health Research Directorate, Ethiopian Public Health InstituteMaternal & Child Health directorate, Federal Ministry of HealthDepartment of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of GondarDepartment of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of GondarThe David and Lucile Packard FoundationHealth System and Reproductive Health Research Directorate, Ethiopian Public Health InstituteAbstract Background Abortion is one of the major direct causes of maternal death, accounting for 7.9% globally. In Africa, 5.5 million women have unsafe abortions annually. Although maternal deaths due to complications of abortion have declined in Ethiopia, women still die from complications. Few studies have focused on providers’ clinical knowledge. This study investigates the level of health workers’ knowledge of comprehensive abortion care and its determinants in Ethiopia. Methods Data from the national emergency obstetric and newborn care (EmONC) assessment was used. A total of 3804 facilities that provided institutional deliveries in the 12 months before the assessment were included. Provider knowledge was assessed by interviewing a single provider from each facility. Criteria for selection included: having attended the largest number of deliveries in the last one or two months. A summary knowledge score was generated based on the responses to three knowledge questions related to immediate complications of unsafe abortion, how a woman should be clinically managed and what the counselling content should contain. The score was classified into two categories (< 50% and > =50%). Logistic regression was used to determine individual and facility-level factors associated with the summary knowledge score. Result A total of 3800 providers participated and the majority were midwives, nurses and health officers. On average, providers identified approximately half or fewer of the expected responses. The multivariate model showed that midwives and nurses (compared to health officers), being female, and absence of training or practice of manual vacuum aspiration were associated with lower knowledge levels. Important facility level factors protective against low knowledge levels included employment in Addis Ababa, being male and having internet access in the facility. Conclusion To increase knowledge levels among providers, pre- and in-service training efforts should be particularly sensitive to female providers who scored lower, ensure that more midlevel providers are capable of performing manual vacuum aspiration as well as provide special attention to providers in the Gambella.https://doi.org/10.1186/s12913-019-4857-8Comprehensive abortion careProviders’ knowledgeEmONCKnowledge score |
| spellingShingle | Tefera Taddele Theodros Getachew Girum Taye Misrak Getnet Atkure Defar Habtamu Teklie Geremew Gonfa Sheleme Humnessa Aster Teshome Zenebe Akale Kasahun Mormu Abebe Bekele Factors associated with health care provider knowledge on abortion care in Ethiopia, a further analysis on emergency obstetric and newborn care assessment 2016 data BMC Health Services Research Comprehensive abortion care Providers’ knowledge EmONC Knowledge score |
| title | Factors associated with health care provider knowledge on abortion care in Ethiopia, a further analysis on emergency obstetric and newborn care assessment 2016 data |
| title_full | Factors associated with health care provider knowledge on abortion care in Ethiopia, a further analysis on emergency obstetric and newborn care assessment 2016 data |
| title_fullStr | Factors associated with health care provider knowledge on abortion care in Ethiopia, a further analysis on emergency obstetric and newborn care assessment 2016 data |
| title_full_unstemmed | Factors associated with health care provider knowledge on abortion care in Ethiopia, a further analysis on emergency obstetric and newborn care assessment 2016 data |
| title_short | Factors associated with health care provider knowledge on abortion care in Ethiopia, a further analysis on emergency obstetric and newborn care assessment 2016 data |
| title_sort | factors associated with health care provider knowledge on abortion care in ethiopia a further analysis on emergency obstetric and newborn care assessment 2016 data |
| topic | Comprehensive abortion care Providers’ knowledge EmONC Knowledge score |
| url | https://doi.org/10.1186/s12913-019-4857-8 |
| work_keys_str_mv | AT teferataddele factorsassociatedwithhealthcareproviderknowledgeonabortioncareinethiopiaafurtheranalysisonemergencyobstetricandnewborncareassessment2016data AT theodrosgetachew factorsassociatedwithhealthcareproviderknowledgeonabortioncareinethiopiaafurtheranalysisonemergencyobstetricandnewborncareassessment2016data AT girumtaye factorsassociatedwithhealthcareproviderknowledgeonabortioncareinethiopiaafurtheranalysisonemergencyobstetricandnewborncareassessment2016data AT misrakgetnet factorsassociatedwithhealthcareproviderknowledgeonabortioncareinethiopiaafurtheranalysisonemergencyobstetricandnewborncareassessment2016data AT atkuredefar factorsassociatedwithhealthcareproviderknowledgeonabortioncareinethiopiaafurtheranalysisonemergencyobstetricandnewborncareassessment2016data AT habtamuteklie factorsassociatedwithhealthcareproviderknowledgeonabortioncareinethiopiaafurtheranalysisonemergencyobstetricandnewborncareassessment2016data AT geremewgonfa factorsassociatedwithhealthcareproviderknowledgeonabortioncareinethiopiaafurtheranalysisonemergencyobstetricandnewborncareassessment2016data AT shelemehumnessa factorsassociatedwithhealthcareproviderknowledgeonabortioncareinethiopiaafurtheranalysisonemergencyobstetricandnewborncareassessment2016data AT asterteshome factorsassociatedwithhealthcareproviderknowledgeonabortioncareinethiopiaafurtheranalysisonemergencyobstetricandnewborncareassessment2016data AT zenebeakale factorsassociatedwithhealthcareproviderknowledgeonabortioncareinethiopiaafurtheranalysisonemergencyobstetricandnewborncareassessment2016data AT kasahunmormu factorsassociatedwithhealthcareproviderknowledgeonabortioncareinethiopiaafurtheranalysisonemergencyobstetricandnewborncareassessment2016data AT abebebekele factorsassociatedwithhealthcareproviderknowledgeonabortioncareinethiopiaafurtheranalysisonemergencyobstetricandnewborncareassessment2016data |