https://orcid.org/0000-0002-1505-7451
Abstract
Background
Obstetric hemorrhage (OH) causes more than 25% of the maternal deaths across the world annually. A significant number of these deaths can essentially be prevented with a skilled birth attendant and having all-inclusive emergency obstetric care technologies. One of these promising technologies is to utilize non-pneumatic anti-shock garment (NASG). Despite this fact, there are limited studies on the utilization of NASG in Ethiopia.
Objective
The aim of this study was to assess the utilization rate and factors associated with non-utilization of NASG in the management of obstetric hemorrhage in public healthcare facilities of Northern Ethiopia.
Methods
An institution-based cross-sectional study was conducted from December 2017 to February 2018 involving 338 randomly selected healthcare providers working in the maternity healthcare facilities. Data were collected using pre-tested and self-administered questionnaires. Data were entered and analyzed using STATA version 14.0 statistical software package. The result was displayed using descriptive, bivariate, and multivariable logistic regression analysis to identify independent predictors of non-utilization of NASG at a P-value≤0.05.
Results
About 121 (35.80%; 95% CI=30.68–41.16%) of the health workers did not utilize NASG, and 217 (64.20%; 95% CI=58.84–69.32%) utilized NASG. Being females, with adjusted odds ratio (AOR)=2.21 (95% CI=1.06–4.63), use of NASG in previous works to manage OH, with AOR=0.1 (95% CI=0.02–0.48), having perceived skill to use the garment in the facility, with AOR=0.10 (95% CI=0.01–0.79), were significantly associated with the non-utilization of NASG.
Conclusion
There was a lower rate of NASG utilization among the healthcare providers for the management of obstetric hemorrhage. Being a male care provider, having no experience of using NASG to manage PPH, and having perceived skill to use the garment in the healthcare facility were significantly associated factors for the non-utilization of the NASG. Due emphasis should be given to the utilization of NASG to manage obstetric hemorrhage by addressing the identified modifiable factors for non-utilization of NASG by healthcare workers.
Abbreviation
AOR, Adjusted Odds Ratio; CEmOC, Comprehensive Emergency Obstetrical Care; CHAI, Clinton Health Access Initiative; CI, Confidence Interval; COR, Crude Odds Ratio; DALYs, Disability Adjusted Life Years; FIGO, Federation of Gynecology and Obstetrics; GLOWM, Global Library of Women’s Medicine; HL, Hosmer–Lemeshow; M, Kilometer; MMR, Maternal Mortality Ratio; MU, Mekelle University; NASG, Non-pneumatic Anti-Shock Garment; OH, Obstetric Hemorrhage; PPH, Post-Partum-Hemorrhage; SD, Standard Deviation; WHO, World Health Organization.
Data Sharing Statement
The data used to support the findings of this study are available from the corresponding author upon reasonable request.
Ethics Approval and Consent to Participate
Ethical approval and clearance were obtained from the ethical review committee of the School of Nursing, Mekelle University (MU). Institutional permission was obtained from the Tigray Regional Health Bureau (TRHB) and Mekelle city health office after communicating with a formal letter from the school of nursing, MU. All participants were informed about the purpose of the study and written consent was obtained from the respondents to participate in the study. All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. There were no personal identifiers in the data collection and report synthesis.
Acknowledgments
We wish to extend our acknowledgement to MU for financing the study. We would also like to thank the data collectors and healthcare providers in the public healthcare facilities in Mekelle city.
Author Contributions
All authors made a significant contribution to the conception, study design, execution, acquisition, analysis, and interpretation. All authors were involved in drafting, revising, or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.
Disclosure
The authors declare that they have no competing interests.