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Antenatal care (ANC) plays a critical role in improving maternal and neonatal health outcomes. However, incomplete ANC attendance in Somaliland is associated with adverse maternal and birth outcomes. Barriers to ANC attendance may increase the risk of pregnancy-related complications, including maternal morbidity, mortality and poor neonatal health outcomes. Understanding the effect of ANC attendance on maternal and birth outcomes is crucial for informing policies and interventions aimed at reducing these risks. Hence, this study aimed to assess the effect of ANC attendance on maternal and birth outcomes in Somaliland.
A prospective cohort study was conducted among 1205 pregnant women enrolled by systematic sampling method.
The study was conducted in the Republic of Somaliland, which is situated in the Horn of Africa. Baseline data were collected at recruitment, and participants were followed up to delivery for the collection of outcome variables. The number of ANCs was considered to be a dichotomous independent variable; incomplete attendance (≤ 3 visits) and complete attendance (≥4 visits). The risk of pregnancy outcome among those with incomplete ANC was assessed using multi-variable logistic regression.
The outcome variables of the study were the maternal and birth outcomes. The independent variables included socio-demographic characteristics, such as age, residence, educational status, occupation, family size, wealth index and marital status, and reproductive factors, such as parity, gestational age at first ANC visit, current pregnancy desirability and previous pregnancy history.
Out of the total participants, 43.3% of women had complete attendance. The incidence of postpartum haemorrhage was 10.0% (95% CI 8.6 to 12.3); antepartum haemorrhage, 3.6% (95% CI 2.6 to 4.7); caesarean section, 14.8% (95% CI 12.9 to 16.8); preterm delivery, 13.7% (95% CI 11.7 to 15.4); low birth weight, 25.8% (95% CI 23.4 to 28.1); and stillbirth, 3.2% (95% CI 2.3 to 4.2). Complete attendance to ANC significantly reduced the risk of antepartum haemorrhage, caesarean section, preterm delivery and admission to the neonatal intensive care unit and stillbirth.
Nearly more than half of women in Somaliland had less than four ANC visits. The incidence of maternal and birth complications is higher among pregnant women who attended
by Yeshwas Abite Workneh, Desye Melese Sisay, Abebaw Fekadu, Abraham Tesfaye Bika, Alemu Tekewe Mogus, Tesfaye Sisay Tessema
Hepatitis B virus (HBV) contributes substantially to liver cancer, related mortality, and liver transplantation worldwide. The small hepatitis B surface antigen (HBsAg), particularly its major hydrophilic region (MHR) and the “a” determinant, is the primary target of serological diagnostics. However, escape mutant amino acid variants (EMAVs) within this region may reduce diagnostic specificity and sensitivity. In this study, publicly available HBsAg sequences were analyzed to determine the prevalence of EMAVs circulating in Ethiopia. We computationally designed three region-specific recombinant antigens (MeRPYS1, MeRPYS2, and MeRPYS3) by incorporating both wild-type and prevalent EMAV sequences. Linear and conformational B-cell epitopes, as well as T helper cell epitopes, were predicted for each antigen. Homology analyses were also performed to assess similarity to host proteins. Secondary and tertiary structures of the antigens were predicted to generate theoretical molecular models. Molecular docking analyses were performed to explore putative interaction patterns between each designed antigen and an anti-HBsAg-specific antibody. The predicted antigen–antibody complexes were further examined using molecular dynamics (MD) simulations to assess their theoretical stability and behavior over time. The resulting simulations provide predictive computational insights into possible antigenic features and interaction tendencies of the designed constructs. These findings are intended to generate testable hypotheses and should be interpreted cautiously, as the study is limited to in silico analyses and requires experimental validation.To evaluate the psychometric properties of the Hospital Survey on Patient Safety Culture (HSoPSC) version 2.0 in Ethiopian public hospitals.
A cross-sectional study.
Five public hospitals in Eastern Ethiopia.
Healthcare professionals (N=582).
An adapted and contextualised version of HSoPSC 2.0 was used to conduct structural validity using exploratory and confirmatory factor analyses (EFA and CFA). Convergent and discriminant validity were evaluated through item loadings and interfactor correlations, respectively. Reliability was measured using McDonald’s omega and Cronbach’s alpha.
CFA indicated a poor model fit for the original 10-factor, 32-item HSoPSC 2.0 across all statistical indices: relative chi-square (²/df=7.71), root mean square error of approximation (RMSEA=0.108), standardised root mean square residual (SRMR=0.088), comparative fit index (CFI=0.814) and Tucker-Lewis’s index (TLI=0.780). Consequently, a comprehensive EFA was conducted, which identified a revised model comprising 5-factor, 21-item. This model accounted for 62.8% of the total variance and demonstrated strong construct validity, with excellent fit indices (²/df=3.67, RMSEA=0.068, SRMR=0.034, CFI=0.969, TLI=0.945). Internal consistency, assessed via McDonald’s omega and Cronbach’s alpha, exceeded the acceptable threshold of 0.70 across all dimensions, except for Response to Error (0.66). The convergent and discriminant validity of the new model was confirmed, ensuring an accurate representation of the underlying constructs.
The original HSoPSC 2.0 with 10-factor, 32-item failed to demonstrate structural validity in the Ethiopian healthcare context. In contrast, a revised 5-factor, 21-item model showed strong validity and acceptable reliability. This adapted version provides a culturally and contextually relevant tool for assessing patient safety culture in Ethiopian healthcare settings.
FreshRSS 