College of Medicine and Health Sceinces

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College of Medicine and Health Sceinces

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    MAGNITUDE OF ADVERSE EARLY NEONATAL OUTCOMES AND IT’S ASSOCIATED FACRORS AFTER EMERGENCY CESAREAN DELIVERY AT WOLKITE UNIVERSITY SPECIALIZED HOSPITAL, WOLKITE, CERS, ETHIOPIA, 2026: RETROSPECTIVE STUDY
    (wolkite University, 2026-06) ADANE HABTE BEREKA
    Background: Neonatal morbidity and mortality after cesarean delivery varies with the type of cesarean delivery and is greater for neonates delivered by emergency cesarean delivery than elective counterparts. Early neonatal outcomes after cesarean section are influenced by preoperative and intraoperative feto-maternal factors, most of which are preventable. However, evidence from the study area is limited. Objective: amid to assess magnitude of adverse early neonatal outcomes and associated factors after emergency cesarean delivery at Wolkite University comprehensive specialized Hospital, Central Ethiopia. Method: Institution based retrospective study was conducted among 270 emergency cesarean deliveries. Data were collected using a structured checklist and entered to Epi data 4.2 and was exported to STATA version 17 for data analysis. Modified Poisson regression with robust SE was employed to identify factors with the outcome. Significance level was obtained using adjusted relative risk (ARR) with 95% CI and p value < 0.05. Result: Overall, 89 (32.96%: CI; 27.6%-38.81%) of the newborns experienced early neonatal adverse outcomes. Moreover, placental-related hemorrhage (ARR = 1.09; 95% CI: 1.03–1.15; p = 0.004) and second stage of labor during C/S decision (ARR = 1.45; 95% CI: 1.22–1.70; p < 0.001) were associated with early neonatal adverse outcome related to emergency C/S. Conclusion: In the current study, one-third of early neonatal adverse outcomes were associated with emergency cesarean section (CS). Placental-related hemorrhage and cesarean delivery performed during the second stage of labor were significantly associated with early neonatal adverse outcomes following emergency CS. These findings highlight the need for timely identification and management of placental complications and careful decision-making regarding the timing of cesarean delivery to improve neonatal outcomes.
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    ACUTE CORONARY SYNDROME IN-HOSPITA MORTALITY AND ASSOCIATED FACTORS AMONG PATIENTS ADMITTED TO WOLKITE UNIVERSITY COMPREHENSIVE SPECIALIZED HOSPITAL, 2023-2026: A CROSS-SECTIONAL CHART REVIEW
    (wolkite University, 2026-06) ABDULSEMED WORKU
    Background: Acute coronary syndrome remains a major cause of in-hospital mortality in low-resource settings, where access to reperfusion therapy and specialized cardiac care is limited. Evidence on determinants of outcomes in such contexts is scarce, particularly from non-revascularization centers in Ethiopia. Objective: To determine the magnitude of in-hospital mortality and identify its independent predictors among patients admitted with Acute Coronary Syndrome at Wolkite University Specialized Hospital, in the years 2023-2026; Wolkite Ethiopia. Methods: A cross-sectional chart review was conducted among 212 consecutive Acute Coronary Syndrome patients admitted between 2023 and 2026. Sociodemographic characteristics, clinical presentation, laboratory parameters, in-hospital complications, and outcomes were extracted using a structured checklist. The primary outcome was in-hospital mortality (died vs discharged alive). Bivariate logistic regression was performed to identify candidate predictors, followed by multivariable logistic regression using an events-per variable–guided approach. Model fitness was assessed using the Hosmer–Lemeshow test and pseudo R² statistics. Result: The overall in-hospital mortality rate was 16.1%, with substantially higher mortality among patients presenting with ST-segment elevation myocardial infarction. In multivariable analysis, Killip class IV at presentation [AOR=11], ST-segment elevation myocardial infarction diagnosis [AOR= 3.6], elevated serum creatinine indicating acute kidney injury (AOR ≈ 10), and composite in-hospital complications [AOR=14] were independently associated with in-hospital mortality. The final model demonstrated good fit (Hosmer Lemeshow, p = 0.718) and strong explanatory power (Nagelkerke R² = 0.73). Conclusion: In-hospital mortality among Acute Coronary Syndrome patients in our study was high and driven primarily by clinical severity and in-hospital complications. Early risk stratification and improved supportive care for high-risk patients are essential to improve outcomes in resource-limited settings.
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    ADVERSE FETOMATERNAL OUTCOMES AND ASSOCIATED FACTORS OF WOMEN AMONG INSTRUMENTAL VAGINAL DELIVERY AT HOSPITALS FOUND IN GURAGHE ZONE, 2023/2024
    (WOLKITE UNIVERSITY, 2024-01-01) TIZITA TSEGAYE
    Background: Due to instrumental delivery, mothers and their babies in underdeveloped nations like Ethiopia experience varying degrees of morbidity and even death.Unless it is performed by trained and experienced health workers.In our country Ethiopia there are only limited studies and no multi-institutional studies was done on adverse feto maternal outcome of IVD and the results may not be representative of target populations.However this study aimed to fill the existing gap, particularly in this study area. Objective: This study's objective was to assess adverse feto maternal outcomes and associated factors of women among instrumental vaginal delivery at hospitals found in Guraghe zone. Methods: A cross-sectional retrospective investigation was carried out at three hospitals in Guraghe Zone,and Systematic random sampling was employed to review 371 medical records of all women who had instrumental vaginal deliveries from January 1- March 30/2024.Incompletely filled charts were excluded during data review.a check list adapted from previous studies. The collected data was entered in to Epi data version 3.2, and exported to version 25 SPSS for analysis. Those variables with p<0.25 in the bi variable analyses were selected for multi variable logistic regression. Adjusted odds ratio (AOR) at 95% confidence interval (CI) with p < 0.05 was used to report statistically significant association during multi variable logistic regression. Results: In this study the magnitude of adverse feto maternal outcomes following IVD was found to be 199/ 53.6%(95%CI: 48.5-59.0).forceps delivery (AOR: 3.89; 95%CI: 1.07, 14.13),fetal heartbeat <120b/m (AOR: 2.37; 95%CI: 1.05, 5.31),induced labour (AOR: 8.11; 95%CI:1.58,41.55),GIIMSAF(AOR:5.35;95%CI:1.48,19.33),episiotomy during labour(AOR:0.32;95%CI:0.56,0.64) and weight <2500gm (AOR:7.58; 95%CI: 2.04,28.18) were significantly associated with adverse feto maternal outcomes of IVD.Conclusion and Recommendation:My study revealed that the overall adverse feto maternal outcomes during instrumental delivery are found to be relatively higher in Guraghe zone hospitals than in studies done at other places in Ethiopia In this study episiotomy found to be strongly protective for adverse feto maternal outcomes so liberal use of episiotomy during instrumental delivery is encourage. Vacuum is encouraged and has worldwide acceptance because of technical simplicity to apply and relatively less maternal trauma.And neonates with lower birth weight in IVD are more susceptible to birth injury,cesarean section is recommended to reduces the number of stillbirths and infant deaths.
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    WOMEN’S AUTONOMY ON MATERNALAND CHILD HEALTH SERVICE UTILIZATION AND ASSOCIATED FACTORS IN GURAGE ZONE, CENTRAL ETHIOPIA, 2025: ACOMMUNITY BASED CROSSSECTIONAL STUDY
    (WOLKITE UNIVERSITY, 2025-05-01) WORKINEH DENDIR
    Background: women status often has impact on their autonomy and decision making ability about different aspects of their own lives. While women’s autonomy is basic for prevention of maternal and child mortality, it has not been given more attention. Beyond that maternal mortality is still remains as a public concern, it is necessary to assess women's autonomy and associated factors on the use of maternal and child health care services in the Gurage zone. Objective: To assess women's autonomy on maternal and child health services utilization and associated factors in Gurage Zone, central Ethiopia in 2025. Method: A Community-based cross-sectional study was employed on 601 participants from December 15/2024 to January 15/2025. Women's autonomy is the capacity and freedom of women in the reproductive age group to act independently and make decisions. Epi data version 3.2 was used to store the collected data, which was then exported to SPSS 25 for analysis. Multivariable and bi-variable logistic regression models have both been applied. A P-value of < 0.05 was used as statistically significant at a 95% confidence interval. Result: - Respondent rate of this study was 98 %. About 355 (59 %, 95% CI: 56 % - 62 %) of women had higher autonomy. women who had attended primary school (AOR: 2.28, 95% CI: 1.40-3.69), secondary school and above (AOR: 3.40, 95% CI: 2.03, 5.69), Women of aged 36-49 years (AOR: 3.68, 95% CI: 2.18, 6.21), having media exposure (AOR: 4.71, 95% CI: 3.13-7.09), women whose wedding ceremony practice were by partners agreement (AOR: 4.12, 95% CI: 1.95-5.02) ,who married by their custom based ceremony (AOR: 2.55, 95%CI: 1.39-4.66),and women who have selected their boyfriend by their own decision (AOR: 2.85, 95% CI: 1.61-5.02) were significantly associated with women’s decision-making autonomy. Conclusion: The prevalence of women decision making autonomy regarding maternal and child health service utilization in this study was 59 %. But, still which found to be low. Women education and media exposure are necessary for their health service utilization at the community level. Recommendation: An inclusive strategy needs to be applied in order to empower women to have access and health services utilization and to enhance women decision making ability in household performances through education and media exposure.
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    HIGH RISK FERTILITY BEHAVIOR AND ASSOCIATED FACTORS AMONG MOTHERS IN WOLKITE TOWN GURAGE ZONE CENTRAL ETHIOPIA
    (WOLKITE UNIVERSITY, 2024-04-01) ZERIHUN WOLDEGEBRIEL
    Background: High risk fertility behavior is a serious concern of public health. These risk factors result in premature birth, reduced birth weight, anemia, perinatal death, increase need of caesarean sections and unsafe abortion. Also result in increased chance of maternal and child mortality and hindering economic growth of individual and country. In addition to commons socio-economic-demographic variables, individual beliefs are introduced as new. Objective: To assess High risk fertility behavior and associated factors among mothers in wolkite town, Gurage zone, central Ethiopia 2024. Methods: A community based cross sectional study was conducted among 300 women in Dec 2024 using systematic random sampling. Data were collected through interviews. One or more of condition listed below was classified as HRFB; giving birth at < 18 or >34 years (old primi), a birth interval of < 24 months or having > 3 children. HRFB was coded as "1" and non-HRFB as ‖0‖. Epi data version 4.6 was used for data entry and analysis was done by SPSS version 25. Variables with p-value < 0.25 in bivariate were moved to multivariate analysis to control confounding factors. P-values and AOR <0.05 with 95% CI were used to state the significance. Result; Findings indicated that 74.1% (CI:68.3-79.7) of the women had experienced HRFB. The results show that single women are at lower odd of engaging in HRFB compared to their married counterpart (AOR = 0.732 CI: 0.0113-0.472). Women who were nonautonomous had higher odd experiencing HRFB (AOR=2.47,CI:1.349-4.53) compared to those with autonomous. Similarly, Poor knowledge of contraception increases the prevalence by 2.42 times (AOR= 2.42 CI:1.125-5.24). Also, Belief on having a large family is often seen as symbol of wealth and divine blesse is significantly associated with HRFB (AOR =2.16 CI:1.23-3.79). Conclusion; This study concluded that the prevalence of HRFB was higher. Marital status, autonomy, belief on large number of children and knowledge of contraception were identified as factors, increase health education, behavioral change education communication should be given attention to the reduction of the magnitudes as well as associated factor.
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    SELF-MEDICATION PRACTICE AND ASSOCIATED FACTORS AMONG PREGNANT WOMEN IN RURAL KEBELES OF CHEHAWEREDA GURAGE ZONE CENTERAL ETHIOPIA
    (WOLKITE UNIVERSITY, 2024-10-01) SHIKURIA ABDELA
    Introduction: Self-medication practice is the use of drugs without a medical advice to treat selfidentified illnesses. This could lead to a multiple health problems for the mother and the fetus during pregnancy. However, the prevalence is reported to be high both in developed and developing countries. A large proportion of pregnant women in Ethiopia live in rural areas with low healthcare coverage and a lack of basic drug safety information. Despite this, studies are limited in rural Ethiopia and at the community level, and as a result, limited scientific evidence on SMP during pregnancy in the Gurage zone. Objective: To assess the prevalence of self-medication practice and identify its associated factors among pregnant women in rural Keble of Cheha Woreda Method: A community-based cross-sectional study design supplemented with qualitative data was employed on 607 pregnant women and 40 key informants in the rural kebele of Cheha woreda from March 1 to April 30/2024 GC. A multi-stage sampling technique was used to select study participants; the quantitative data was collected using a structured interview questionnaire and analyzed with Binary logistic regression and thematic analysis for qualitative data. Results: Out of the sample pregnant women, 555 pregnant women and 38 key informants participated in the study with a response rate of 91.5%. The overall prevalence of SMP among pregnant women was 286(51.5%).Age of the pregnant women(AOR = 0.34, 95% CI (0.04-3.013)), ANC follow up (AOR=2.94, 95%CI (1.08-8.0)), Pregnancy related problem (AOR =0.056, 95% CI (0.03-0.09)), Knowledge(AOR = 2.02, 95% CI (1.06-3.84)), Distance from health facility (AOR =3.52 95% CI (1.13-10.9)) and Drug availability in the nearest health facility (AOR=2.6,95% CI: (1.44-4.7)) were significantly associated with self-medication practice. Minor illness, low cost alternative and time saving were the reasons to SMP. Conclusion and Recommendation: Almost half of the pregnant women practiced self-medication in the study setting. An awareness-building campaign and health education for pregnant mothers and general population, focusing on rural areas, need to be advocated.
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    ADOLESCENT PARENT SEXUAL AND REPRODUCTIVE HEALTH COMMUNICATION AND ASSOCIATED FACTORS AMONG SECONDARY SCHOOL STUDENTS IN CHEHA WOREDA, GURAGE ZONE, CENTRAL ETHIOPIA
    (WOLKITE UNIVERSITY, 2024-10-01) YALFAL ALEMU
    Background: Adolescent-parent sexual and reproductive health communication is a vital way of improving sexual and reproductive health outcomes for adolescents. However, there is limited evidence regarding communication between adolescent and their parents about sexual and reproductive health in Ethiopia. Objective: To assess adolescent parent sexual and reproductive health communication and associated factors among students attending secondary schools at Cheha Woreda, Gurage Zone, Central Ethiopia. Method: A cross-sectional quantitative study, supplemented with qualitative data, was carried out among 550 secondary school students from February 1–30, 2024. A systematic sampling method was employed to select participants. Data collection involved self-administered questionnaires, and Focus Group Discussions were held with a purposively chosen group of students. The quantitative data was entered using EpiData version 4.6 and analyzed with SPSS version 26. Binary and multivariable logistic regression analyses were performed to identify associations, with a 95% confidence interval and a pvalue of <0.05 considered for statistical significance. Qualitative data was analyzed using manual thematic analysis. The results were presented in the form of tables, figures, and text. Results: Five hundred fifty participants completed the questionaries’ making the response rate 95.2%. More than half of the participants, 57.1% (95% CI: 0.528–0.613), reported communicating about sexual and reproductive health issues with their parents. The study identified significant associations with adolescent-parent sexual and reproductive health communication, including being female (AOR = 1.62, 95% CI: 1.08–2.6), having a mother whose occupation was farmer (AOR = 0.27, 95% CI: 0.1–0.7), receiving information about SRH (AOR = 1.74, 95% CI: 1.12–2.7), and being knowledgeable about SRH (AOR = 1.59, 95% CI: 1.04–2.4). The qualitative findings identified shame and fear of parents as primary barriers to SRH communication. Conclusions and recommendations: Around two third of the participants were aware of various sexual and reproductive health services; however, the proportion of sexual and reproductive health communication with parents was low. Therefore, providing detailed information on the importance of communicating such sensitive issues with parents is recommended. Further research is needed to identify barriers from the parents' perspective
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    SELF-MEDICATION PRACTICE AND ASSOCIATED FACTORS AMONG PREGNANT WOMEN IN RURAL KEBELES OF CHEHAWEREDA GURAGE ZONE CENTERAL ETHIOPIA
    (WOLKITE UNIVERSITY, 2024-04) -SHIKURIA ABDELA
    Introduction: Self-medication practice is the use of drugs without a medical advice to treat self identified illnesses. This could lead to a multiple health problems for the mother and the fetus during pregnancy. However, the prevalence is reported to be high both in developed and developing countries. A large proportion of pregnant women in Ethiopia live in rural areas with low healthcare coverage and a lack of basic drug safety information. Despite this, studies are limited in rural Ethiopia and at the community level, and as a result, limited scientific evidence on SMP during pregnancy in the Gurage zone. Objective: To assess the prevalence of self-medication practice and identify its associated factors among pregnant women in rural Keble of Cheha Woreda Method: A community-based cross-sectional study design supplemented with qualitative data was employed on 607 pregnant women and 40 key informants in the rural kebele of Cheha woreda from March 1 to April 30/2024 GC. A multi-stage sampling technique was used to select study participants; the quantitative data was collected using a structured interview questionnaire and analyzed with Binary logistic regression and thematic analysis for qualitative data. Results: Out of the sample pregnant women, 555 pregnant women and 38 key informants participated in the study with a response rate of 91.5%. The overall prevalence of SMP among pregnant women was 286(51.5%).Age of the pregnant women(AOR = 0.34, 95% CI (0.04-3.013)), ANC follow up (AOR=2.94, 95%CI (1.08-8.0)), Pregnancy related problem (AOR =0.056, 95% CI (0.03-0.09)), Knowledge(AOR = 2.02, 95% CI (1.06-3.84)), Distance from health facility (AOR =3.52 95% CI (1.13-10.9)) and Drug availability in the nearest health facility (AOR=2.6,95% CI: (1.44-4.7)) were significantly associated with self-medication practice. Minor illness, low cost alternative and time saving were the reasons to SMP. Conclusion and Recommendation: Almost half of the pregnant women practiced self-medication in the study setting. An awareness-building campaign and health education for pregnant mothers and general population, focusing on rural areas, need to be advocated.
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    PREVALENCE AND ASSOCIATED FACTORS OF UTERINE FIBROIDS AMONG REPRODUCTIVE AGE WOMEN ATTENDING GYNECOLOGY UNIT IN GURAGE ZONE HOSPITALS, CENTRAL ETHIOPIA, 2024.
    (WOLKITE UNIVERSITY, 2024-04) MUNTAHA KEDIR
    Introduction: Uterine fibroid is one of the most common benign smooth muscle tumors of the uterus that affect women of reproductive age. The prevalence of fibroids is significant with esti mates that 20-25% of women and about 235 million of women who represent 6.6% of global women population estimated to be affecting worldwide. In our country the prevalence and asso ciated factors of uterine fibroids among reproductive age women is still unclear, thus, this study aimed to assess the prevalence and associated factors of uterine fibroids among women attending gynecological unit in Gurage Zone Hospitals, 2024. Methods: An institution based cross-sectional study was conducted in 2024, involving 342 study participants who were selected consecutively during the study period. The data were collected by using pre-tested structured questioners and data were entered into epi-data manager Version 4.2 and subsequently exported to SPSS version 20 for analysis. Bivariable and Multivariable Lo gistic regressions analysis were performed to identify associated factors for uterine fibroids con sidering of 95% CI and P-value of < 0.05. Results: The prevalence of uterine fibroids among reproductive age women was 22.1%. The mean age of respondents was 33.4 and SD ± 6.8 years. Factors such as, age between 36-45 years (AOR = 8.635, 95% CI (1.179 - 63.223); participants educational status of secondary level (AOR = .040, 95% CI (.003-.485); experiencing infertility (AOR = 18.626, 95% Cl (4.336 - 80.011); obstetrics and gynecology related surgeries (AOR = 15.520, 95% Cl (5.755 - 41.854); ever used of contraceptives (AOR = .267, 95% Cl (.094 - .759); late age of menarche (AOR = .031,95% Cl (.001- .646); and family history of uterine fibroids (AOR = 6.705, 95% Cl (2.464 18.248); were significantly associated with uterine fibroids. Conclusion In this study, the prevalence of uterine fibroids found to be relatively high. Major predictors such as age of women, participant educational status, infertility, obstetrics and gynecology related op eration, contraceptives, family history, and late menarche age was found to be predictors of uter ine fibroids. Therefore, encourage of the women early childbirth, promotion of contraceptives pills through long times should be promoted by health information and health education pro gram.
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    UTILIZATION OF EIGHT ANTENATAL CARE CONTACTS AND ASSOCIATED FACTORS AMONG POSTNATAL WOMEN IN GURAGE ZONE, CENTERAL ETHIOPIA, 2024
    (WOLKITE UNIVERSITY, 2025-04) AMINAT ALI
    Background: Antenatal care refers to the care provided by skilled healthcare professionals to a woman from the start of her pregnancy until the onset of labor. It serves as a gateway for pregnant women in order to receive a broad range of health promotion and preventive services, including screening for warning signs during pregnancy, delivery and postpartum period. However, there is limited evidence on the utilization of the recent eight ANC contacts. Objective: To assess the utilization of eight ANC contacts and associated factors among postnatal women in Gurage zone, Central, Ethiopia. Methods: A cross-sectional study was conducted at Gurage Zone Hospital from February 23 to May 22, 2024, using consecutive sampling technique. A pretested structured questionnaire was employed via face-to-face interview and collected data was entered into EpiData version 4.6. Data analysis was done using SPSS version 25. Binary logistic regression was applied to assess association between the dependent and independent variables with a p-value below 0.05 was used to define statistical significance. The analyzed data was presented in frequency, percentage, mean, tables and figures. Results: A total of 392 pregnant women were included with response rate of 93%. The mean age of participants was 28 (SD +5). Overall, 147 (37.5 %; 95% CI:32.5 -42.5%) pregnant women had completed eight ANC contacts. Up on multivariable logistic regression model, age Conclusion: Eight ANC contact utilization is found to be low the national of reaching every pregnant woman and associated with age, residence, gestational age, knowledge of mother on 8 ANC contacts, perceived barriers, perceived cue to action, and ANC satisfaction. These findings help health care programmers and policymakers to introduce appropriate policies and programs to ensure increase the coverage of eight ANC contact.