International Journal of Reproductive Medicine

Background. Client satisfaction is an important and commonly used indicator for measuring the quality of health care as it affects clinical outcomes, patient retention, and medical malpractice claims. To limit unintended pregnancies and avoid repeated abortions promoting abortion care services is crucial. In Ethiopia, problems related to abortion were neglected, and access to quality abortion care was very limited. Similarly, information related to abortion care service, particularly clients’ satisfaction, and associated factors are limited in the study area that the study will be going to fill. Methods. A facility-based cross-sectional study design was employed on 255 women who came for abortion service in public health facilities of Mojo town and were included consecutively. The data was coded and entered into Epi info version 7 software and exported to SPSS version 20 for analysis. Bivariable and multivariable logistic regression models were applied to identify the associated factors. Model fitness and multicollinearity were checked by using the Hosmer-Lemeshow goodness of fit test and the variance inflation factor (VIF). Adjusted odds ratios and their 95% confidence were reported. Results. A total of 255 study subjects were included in this study with a 100% response rate. The study depicted that 56.5% (95% CI: 51.3, 61.7 of the clients were satisfied with abortion care service. Having college and above educational level (AOR: 0.27; 95% CI: (0.14, 0.95), employee occupation (AOR: 1.86; 95% CI: (1.41, 2.93), medical abortion as a type of uterine evacuation (AOR: 3.93; 95% CI: (1.75, 8.83), and natural method of family planning users (AOR: 0.36; 95% CI: (0.08, 0.60) were factors associated with women’s satisfaction. Conclusion. The overall satisfaction towards abortion care was considerably lower. Waiting time, cleanness of rooms, lack of laboratory service, and availability of service providers are mentioned factors for client dissatisfaction.

Background. Pregnancy risk perception affects a pregnant woman’s decision about health care services such as prenatal care, place of birth, choices about medical interventions, adherence to medical procedures, and recommendations. Therefore, the study is aimed at assessing pregnancy risk perception and associated factors among pregnant women attending antenatal care at health centers in Jabi Tehnan District. Methods. An institutional-based cross-sectional study was conducted among 424 mothers attending ANC at health centers in the Jabi Tehnan District from April 1 to 30, 2021. Data was collected through a face-to-face interview using a structured questionnaire which was developed according to the health belief model. The logistic regression model was used using an adjusted odds ratio with 95% CI and to declare significance and associations. Result. Four hundred twenty four (424) pregnant women were interviewed of which nearly half of the respondents 48% (43.2%, 52.7%) had good pregnancy risk perception. Women who had a history of obstetric complications (AOR: 95% ), those who knew at least one pregnancy danger sign (AOR: 95% ), pregnant women who had a bad obstetric history (AOR: 95% ), and knowing women who died due to pregnancy-related complications (AOR: 95% ) were more likely to have good perception towards pregnancy risk compared to their counterparts. Conclusion. Obstetric complications, awareness of pregnancy danger signs, bad obstetric history, and known women who died due to pregnancy-related complications were found to be significantly associated with pregnancy risk perception.

Background. The World Health Organization recommends the use of effective contraception for the prevention of unintended pregnancy and unsafe abortion. The main aim of postabortion contraceptive services is to prevent recurrent pregnancy and ultimately mitigate the associated maternal mortality. Objective. To assess postabortion contraceptive utilization (PACU) and postabortion contraceptive preferences (PACP) and the associated factors among women receiving abortion care services in Ambo town, Oromia Region, Western Ethiopia. Methods. A cross-sectional study was conducted at the health facilities in Ambo town from 22 July to 24 September 2021. The data was collected using a structured questionnaire. Bivariate and multivariable logistic regression was done to determine the factors associated with postabortion contraceptive utilization and preferences. Results. Out of 388 participants who were included in the final analysis, 262 (67.5%) had utilized postabortion contraceptives of which 173 (66%) received contraceptive methods of their primary preference. The multivariate logistic regression showed that cohabiting couples showed lower utilization (; 95% CI: 0.06-0.21; value = 0.004) than married ones and planning to have an additional child within 1-3 years (; 95% CI: 2.18-11.41; value = 0.005) or after 3-5 years (: 95% CI: 5.12-10.18; value = 0.033) was identified to be significantly associated with postabortion contraceptive utilization. Having a secondary education level (; 95% CI: 1.54-6.07; value = 0.001) and having experience of domestic violence (; 95% CI: 1.27-3.81; value = 0.005) were significantly associated with unsatisfied postabortion contraceptive preference. Conclusions and Recommendations. About two-thirds of the women who were given abortion services received postabortion contraceptives whereas almost two-thirds of them received a contraceptive method of their primary preference. Marital status, duration before additional child planned, and being counseled on contraceptive determined postabortion contraceptive utilization. Having a secondary education level and having experienced domestic violence were significantly associated with unsatisfied PACP.

Background. The primary objective of this research was to investigate how socioeconomic and demographic factors influence the usage of contraceptives by women in 18 developing countries. Methods. The study used the latest DHS data from 18 developing countries in order to acquire a broad perspective of contraceptive methods. We applied meta-analysis techniques for 18 developing countries to find out the summary results. Results. The overall summary effect showed that the variable respondent education (; 95% CI: 1.17 to 1.65), husband education (; 95% CI: 1.32 to 1.93), type of place of residence (; 95% CI 0.78 to 0.98), current working status (; 95% CI 1.30 to 1.66), age of the respondent (; 95% CI 2.35 to 4.93), breastfeeding status (; 95% CI 1.11 to 1.62), and desire for more children (; 95% CI 0.43 to 0.65) were the significant factors for contraceptive utilization in developing countries. Conclusions. According to the findings of this descriptive study, the respondent’s age, level of education, and work status were shown to be the most significant factors that influence the usage of contraceptives in developing countries. It is necessary to take reasonable steps in order to increase the rate of utilizing methods of contraception among women of reproductive age who are uneducated, living in rural areas, and unemployed.

Background. An obstetric fistula is an abnormal opening between the vagina, rectum, and/or bladder. Obstetric fistula has a devastating impact on women’s physical, social, and psychological health. Despite the numerous health consequences in developing countries, including Ethiopia, there have been few studies on the determinants of time to recovery from obstetric fistula. Therefore, this study is aimed at addressing the gap. Methods. A retrospective cohort study was employed to include 328 randomly selected records of women admitted for obstetric fistula treatment at Mekelle Hamlin Fistula Center from January 2015 to 2020. Data collected from the medical records was coded and entered into SPSS software version 20 and exported to STATA 10 and R statistical software for data cleaning and data analysis. The Kaplan-Meier and log-rank tests were computed to explore the data. The log-logistic inverse Gaussian shared frailty model was employed using a 95% CI, and variables with a value < 0.05 were declared as determinants of recovery time. Results. Of 328 fistula patients, 293 (89.33%) were physically cured. The Kaplan-Meier result showed that the overall mean and median survival time of time to recovery from obstetric fistula patients at Mekelle Hamlin Fistula Center is 42 and 33 days, respectively. In a log-logistic inverse Gaussian shared frailty model analysis, extensive fistula size (AHR : 1.282; 95% CI = 1.175-1.388), secondary and above education level (AHR : 0.830; 95% CI = 0.693-0.967), rural residence (AHR : 1.357; 95% CI = 1.236-1.479), and physiotherapy use (, 95% -0.940, 95% -1.388) were statistically significant predictors of recovery from obstetrics fistula. Conclusion. Rural place of residence, home delivery, and large and extensive size of the fistula prolong the timing of healing from the obstetric fistula. However, having tall height, physiotherapy treatment, secondary and above-educated women, and RVF type of fistula has a short time of healing for obstetric fistula in Mekelle Hamlin Fistula Center. Therefore, we recommend that health professionals promote institutional delivery and physiotherapy, shorten the duration of catheterization, and manage urine incontinence. In addition, we recommend that the regional health bureau promotes female education and pregnancy after 18 years. The survival probability of patients with obstetric fistulas is better predicted by the log-logistic inverse Gaussian shared frailty model. Therefore, it would be good for future researchers to take this model into account.

Background. Adequate antenatal care is essential for the health of the mother and the development of the fetus. The World Health Organization recommends at least four antenatal care (ANC) visits during pregnancy. In Ethiopia, only 32% of women of childbearing age attend four or more ANC visits. This figure is significantly lower than the average for least developed countries. This study is aimed at calculating the magnitude and identifying the factors associated with optimal antenatal care utilization in the South Gondar Zone, Northwest Ethiopia. Methods. A community-based cross-sectional study was conducted in the South Gondar Zone of Northwest Ethiopia from September 2020 to May 2021. A total of 434 participants were selected using multistage cluster sampling. Data were gathered through face-to-face interviews using a structured questionnaire. A multivariate binary logistic regression model was used to determine the factors associated with the optimal use of antenatal care. Result. The magnitude of optimal antenatal care utilization was 59% (95% CI; 54.20, 63.65). The study showed that mothers who completed their secondary school (; 95% CI: 3.406, 19.767), women who completed their tertiary school (; 95% CI: 2.229, 18.416), women whose husbands’ level of education is secondary school (; 95% CI: 2.753, 12.936), those with a planned pregnancy (; 95% CI: 1.117, 3.271), those with a wanted pregnancy (; 95% CI: 1.366, 4.009), women whose husbands work in the government or nongovernment sector (; 95% CI: 2.093, 6.669), those not being exposed to the media (; 95% CI: 0.345, 0.783), and rural women (; 95% CI: 0.164, 0.435) were significantly associated with optimal ANC utilization. Conclusion. The findings suggest that more emphasis should be placed on education-based programs for women and their husbands that highlight the benefits of a planned pregnancy, desired pregnancy, and maternal health care. Meanwhile, the government and other concerned bodies should focus on expanding road accessibility, health institutions, and ambulance distribution to improve optimal ANC utilization in the area.