Background: The neonatal period is the most susceptible phase of life. In Ethiopia changes in neonatal mortality are not as significant as changes in post-neonatal and child mortality. The aim of this study was to assess the causes and factors associated with neonatal mortality at Jimma Medical Center. Materials and methods: A cross-sectional study was conducted for 11 days from February 12, 2018 at the Neonatal ICU of Jimma Medical Center. Data were extracted from the medical records of neonates admitted during a three year period from September 07, 2014 to August 31, 2017, using pretested checklists. Bivariate and multivariate logistic regressions were used to determine factors associated with neonatal mortality and P-values <0.05 were considered statistically significant. Results: Of 3,276 neonates admitted during the study period, 412 (13.3%) died, equating to a rate of 30 deaths per 1,000 institutional live births. The majority (249, 60.4%) of deceased neonates had low birth weight, while 230 (55.8%) were premature and 169(41%) had Respiratory Distress Syndrome (RDS). Residency being outside Jimma city (AOR 1.89, 95% CI: 1.43, 2.51) and the length of stay <7Days (AOR 3.93, 95% CI: 2.82, 5.50), low birth weight (AOR 1.54, 95% CI: 1.06, 2.25), prematurity (AOR 2.2, 95% CI: 1.41, 3.42), RDS (AOR 4.15, 95% CI: 2.9, 5.66), perinatal asphyxia (AOR 4.95, 95% CI: 3.6, 7.34), and congenital malformations (AOR 4, 95% CI: 2.55, 2.68) were significantly associated with neonatal mortality. Conclusions: A significant proportion of neonates attending the neonatal ICU died. Parental residency, the length of stay, low birth weight, prematurity, RDS, perinatal asphyxia, and congenital malformations were factors associated with neonatal mortality, which could be avoidable. Therefore, preventive measures such as enhancing the utilization of antenatal care services and, early identification and referral of high risk pregnancy and neonates could reduce the neonatal deaths.

Background: Preterm birth is the second leading cause of death next to pneumonia in children aged <5 years and the single-most important cause of death in the first month of life. Research examining determinants of preterm birth in Ethiopia is limited. Therefore, this study aimed to determine risk factors associated with preterm births at Jimma University Medical Center in southwest Ethiopia. Methods: This unmatched case–control study was conducted from March 15 to April 1, 2017 from medical records of mothers and newborns delivered at Jimma University Medical Center from January 1 to December 30, 2016. Data were extracted using a structured checklist for cases (preterm) and controls (term) by reviewing maternal and newborn medical records using a simple random-sampling technique. Risk factors for preterm delivery were determined using bivariate and multivariate logistic regression models. Statistically significant associations were declared at P<0.05. Results: The present study evaluated 218 maternal and newborn cases and 438 controls. Risk factors identified were history of previous preterm birth (AOR 6.4, 95% CI 2.9–13.9), preeclampsia (AOR 6.6, 95% CI 3.3–13.4), premature membrane rupture (AOR 11.7, 95% CI 6.2–21.9), antenatal care of fewer than four visits (AOR 4.8, 95% CI 1.2–19), birth interval <2 years (AOR 2.7, 95% CI 1.7–4.5), and multiple pregnancies (AOR 4.5, 95% CI 2.4–8.5). Conclusion: History of previous preterm births, preeclampsia, premature membrane rapture, antenatal care of fewer than four visits, birth interval <2 years, and multiple pregnancies were found to have a possible causal relationship with preterm births. Therefore, similar further studies should be conducted to generate more population-based evidence on determinants of preterm births.

Background: Prolonged emergency department stays can adversely affect patient outcomes leading to an increased length of hospital admission and higher mortality. Despite this fact, there are few data describing emergency department length of stay and associated factors in Ethiopia. Objective: To assess length of stay in the emergency department and its associated factors among patients visited adult emergency department of Jimma Medical Center, Jimma town, southwest of Ethiopia. Methods: Institution-based cross-sectional study was conducted from April 9, 2018 to May 11, 2018. Overall, 422 patients presented during study period were sequentially included in the study. A semi-structured questionnaire was used to collect data through interview, observation and medical record review. The collected data were cleaned, entered to Epi-data 3.1 and exported to SPSS version 21 for binary and multivariable logistic regression analysis. To identify factors associated with outcome variable, candidate variables were fitted to multivariable analysis, and those with P-values < 0.05 were considered as significantly associated. Results: More than one-third, 162 (38.4%), experienced prolonged length of stay in the emergency department. The odds of prolonged stay were higher among rural area residency (AOR, 3.0; CI, 1.279– 7.042), evening presentation (AOR, 4.25; CI, 1.742– 10.417), and night-time presentation (AOR, 14.93; CI, 4.22– 52.63), and having at least one diagnostic investigation (AOR, 4.48; CI, 1.69– 11.88). However, participants who did not experience shift changes of nurses during their stay (AOR, 0.003; CI, 0.001– 0.010) had a less prolonged stay. Conclusion: A significant proportion of patients experienced a prolonged stay at the emergency department. Age, rural residency, evening and night-time presentation, shift change and having a diagnostic investigation were predictors of prolonged stay. Thus, establishing time-targeted service for patients can reduce the length of stay.

Introduction: Although self-care has a therapeutic effect on heart failure (HF), patients experience a marked reduction in physical and executive function, resulting in poor quality of life (QoL). A literature review revealed limited evidence regarding the possible relationship between self-care and QoL in HF patients. Therefore, this scoping review aimed to identify scientific evidence that examines the extent of self-care, QoL, and relationship between self-care and QoL in patients with HF. Methods: Full-text research published from March 23, 2010, to March 23, 2020, written in English, that had content on both self-care and QoL among adult patients with HF was included. A literature search of electronic databases and web searches was conducted for published articles. Four databases were used: MEDLINE, Scopus, Web of Science, and the Cochrane Library. Studies collected from Google and Google Scholar web searches were also included. Results: Of 1,537 papers identified by the search, 12 were included. The reviewed studies included 3,127 patients. Ten articles used a cross-sectional study design, whereas the remaining articles used a longitudinal and quasi-experimental design. This review found that the extent of self-care practices among patients with HF was inadequate, a significant proportion of patients enrolled in the reviewed studies had a moderate QoL, and higher self-care practices were associated with a better QoL. Self-care behavior and QoL were affected by social support, sex, age, educational level, place of residence, illness knowledge, presence of comorbidities, and functional classification of HF. Conclusion: Self-care behavior was positively correlated with QoL in patients with HF. Self-care and QoL in these patients have been reported to be affected by several factors. Further research with a rigorous study design is recommended to investigate the influence of self-care practices on QoL in patients with HF.

Background: Breast milk substitutes are used commonly worldwide with bottle feeding which should be avoided due to its impact on optimal breastfeeding and appropriate complementary feeding. Moreover, feeding bottles are associated with diarrheal disease morbidity and mortality as it is difficult to keep it clean especially in developing countries where sanitation is poor. Objectives: To assess the utilization of bottle feeding practices and associated factors among mothers who have infant (from birth-12 months of age) in Agaroo town, Jimma zone Oromia region south west Ethiopia, 2018. Methodology: A community based cross sectional study was conducted from March 15 to 30, 2018 in Agaroo town. A systematic sampling method was applied to select 222 respondents among mothers who have infant (from birth-12 months of age). Data was collected through face to face interview using pretested questionnaire. Data analysis was done by using SPSS and to identify associated factor chi-square was used. The data was presented by graph and tables. Result: From the total of 222 mothers participated in the study the prevalence of bottle feeding was 207 (93.2%). Mothers return to work 104 (46.8) was the main reasons for initiation of bottle feeding reported by the mothers who started bottle feeding practice. The percentage was high among mothers with educational background of illiterate 92 (41.4%) governmental employer 10 (4.8%) and whose monthly family income was 1000-1499 birr 100 (45%). There was significant association between bottle feeding practices and Mothers’ education status, occupational status, place of delivery and family monthly income. Conclusions: The utilizations of bottle feeding was high at the study area. Educational status, monthly family income, employments was associated with utilization of bottle feeding. The provision of formal and information education to the mothers, increasing family monthly income, the number months for maternal leave and institutional delivery could reduce the bottle feeding utilizations among mothers.

Effective learning-teaching process is ensured when students interact and actively participate in the learning process. Though most instructors stressed the value of active participation in classrooms of universities and colleges, achieving success in eliciting it appears more difficult. There is high tendency of instructors in higher institutions to cover the tasks and responsibilities of their students. The main aim of this study was to assess the knowledge of and to identify strategies for improving active participation in classroom among nursing and midwifery students. Institution based cross-sectional survey was conducted in Jimma University onrandomlyselected 126 students (81 nursing and 45 midwifery). The collected data were coded, checked and cleaned and entered into SPSS version 23 for analysis. Simple descriptive statistics was used to see the frequency distribution whereas cross-tabulation and Pearson Chi-square test were used to see the association between variables. Majority, 106 (84.1%) of the students had good knowledge about the benefits of active participation in classroom and they suggested strategies to be used by regular classroom teachers to improve students’ participation. Students’ academic year has shown statistically significant association with their knowledge about active participation. The authors of this study strongly recommend instructors to use active learning methods and department heads need to follow teaching methods implemented by their respective faculty.