Socio-Demographic Characteristics of Respondents
Out of a total 280 eligible Obstetrics care workers, 268 respondents were participated in this study with 95.7% response rate. About more than half 157(58.6%) of the respondents were in the age group of 20-29 years; the mean age of respondents at which they attend Obstetric ward was 29.14 year with SD±4.722, ranging from 20 to 50 years. Nearly two third of the respondents, 172(64.2%) were married. One hundred sixty one(60.1%) of the respondents were Nurses and 152(56.7%) were degree holder; 199(74.3%) were male, and nearly half 124(46.3%)of the participants were protestants by religion. Two hundred fourteen (79.9%) of them were Oromo in ethnicity (Table.3).
Table 2: Socio-demographic characteristics of Obstetric care workers, West Guji, June, 2021
Characteristics
|
Category
|
Number
|
Percentage
|
Age in years
|
20-29
|
157
|
58.6
|
30-39
|
100
|
37.3
|
>=40
|
11
|
4.1
|
Total
|
268
|
100
|
Sex of respondents
|
Male
|
199
|
74.3
|
Female
|
69
|
25.7
|
Total
|
268
|
100
|
Residence
|
Urban
|
189
|
70.5
|
Rural
|
79
|
29.5
|
Total
|
268
|
100
|
Marital status
|
Single
|
82
|
30.6
|
Married
|
172
|
64.2
|
Widowed
|
10
|
3.7
|
Divorced
|
4
|
1.5
|
Total
|
268
|
100
|
Religion
|
Muslim
|
37
|
13.8
|
Orthodox
|
93
|
34.7
|
Protestant
|
124
|
46.3
|
Catholic
|
2
|
.7
|
Wakefata
|
12
|
4.5
|
Total
|
268
|
100
|
Ethnicity
|
Oromo
|
214
|
79.9
|
Amhara
|
40
|
14.9
|
Tigre
|
2
|
.7
|
Burji
|
7
|
2.6
|
Other
|
5
|
1.9
|
Total
|
268
|
100
|
Profession of the respondents
|
Medical doctor
|
12
|
4.5
|
Anesthesia
|
4
|
1.5
|
Nurse
|
161
|
60.1
|
Midwife
|
47
|
17.5
|
Health officer
|
36
|
13.4
|
Emergency surgery
|
3
|
1.1
|
Others
|
5
|
1.9
|
Total
|
268
|
100
|
Qualification of respondents
|
Gynecologist
|
4
|
1.5
|
MSc
|
11
|
4.1
|
GP
|
11
|
4.1
|
BSc
|
152
|
56.7
|
Diploma
|
90
|
33.6
|
Total
|
268
|
100
|
Experience of the respondents
|
<1year
|
32
|
11.9
|
1-5years
|
129
|
48.1
|
5-10years
|
68
|
25.4
|
10-15years
|
30
|
11.2
|
>15years
|
9
|
3.4
|
Total
|
268
|
100
|
Current position of respondent
|
House officer
|
9
|
3.4
|
Medical director
|
6
|
2.2
|
Staff member
|
250
|
93.3
|
Hospital manager
|
3
|
1.1
|
Total
|
268
|
100
|
Prevalence of Practice of labor pain management
Information on labor pain management practice was collected from the obstetric care workers. Accordingly, from the total respondents, 116 (43.3%) respondents used any form of labor pain management to clients for laboring mother, while those 152(56.7%) were not (Fig2.)
Knowledge of Obstetric care workers related to labor pain management
About 240 (89.6%) participants had knowledge about labor pain management. Ninety eight(40.8%) of them responded that they use non pharmacological method and 76(31.7%) of respondents were using both pharmacological and nonpharmacological methods and of nonpharmacological about 115(42.9%) respondents were used massage the back. About 66 (27.5%) of study subjects are used pharmacological method. Of pharmacological method users 158(59%) of them used intramuscular method.
Attitude of Obstetric care workers related to Labor pain management
Concerning the attitude of the respondents, more than half (53.7%) of the study participants agreed that using labor pain influences the progress of labor and 145(54.1%) of respondents recommended that all mothers have to receive labor pain to relief the pain during labor, while 220 (82.1%), of the respondents believed that labor pain is natural and mothers have to face it. About 209(78%) of respondents had thought of pharmacologic obstetric analgesia has effect on the labor and delivery outcomes, of these 116(55.5%) of study subjects think that it had the effect on labor outcome.About 118 (43.3%) of respondents had the practice of labor pain management; of those of respondents who practiced labor pain management,nearly more than half (52.6%) of them are used labor pain management for Episiotomy.And nearly 50% of these study participants were applying pharmacologic method.
Institutional related factors of respondents
The main institutional related reason that hindered from practicing labor pain management by respondents routinely were,54 (20.1%) of respondents had no reason, 145(54.1%) of study subjects complained that there is no drug, 12(4.5%) of them said that there is no equipment, 32(11.9%) of them inappropriate setting of the hospital, and 13(4.9%) of respondents had no knowledge/skill. Similarly, all of the participants responded that lack of trained health care providers, guidelines and protocols were the most common bottlenecks for utilizing the methods to relief labor pain.
Factors associated with practice of labor pain management among respondent
In bivariable analysis age of respondents, sex of respondents, current residence,experience of respondents,qualification of respondents,knowledge of obstetric analgesia,types of nonpharmacological method,thought of every mother should receive labor analgesia and thinking that pharmacologic obstetric has effect on the labor and delivery outcomes were showed significant association at p<0.25, but marital status of respondents did not show association. (Table 3)
Multivariable analysis revealed that: qualification of respondents, knowledge of obstetric analgesia and thought of pharmacologic obstetric analgesia has effect on the labor and delivery outcomeswere remained statistically significant of labor pain management practice at p-value < 0.05.(Table 3)
Being Diploma holder of obstetric care workers were 0.3times less likely to practice labor pain management as compared to the counterparts (AOR, 0.3; 95% CI: 0.2,0.6).
Respondents who had knowledge on obstetric analgesia were 9.4times more likely to practice labor pain management as compared to the referent (AOR, 9.4; 95% CI:1.8,9.9).
Obstetric care workers who had thought of pharmacologic obstetric analgesia has effect on the labor and delivery outcomeswere 2.9times more likely to practice labor pain management as compared to the referents (AOR, 2.9; 95% CI: 1.4,6.2).(Table 3).
Table 3:Bivariable and Multivariable logistic regression analysis of associated factors among Obstetric care workers, West Guji Zone, July 2021
Characteristics
|
Labor pain management practice
|
COR(95%CI)
|
AOR(95%CI)
|
Yes
No.(%)
|
No
No.(%)
|
Age of respondents
|
20-29
30-39
=>40
|
62(53.4%)
48(41.4%)
6(5.2%)
|
95(62.5%)
52(34.2%)
5(3.3%)
|
0.5(0.2,1.9)
0.8(0.2,2.7)
1
|
0.8(0.2,3.6)
0.9(0.2,4.5)
|
Sex of respondents
|
Male
Female
|
93(80.2%)
23(19.8%)
|
106(69.7%)
46(30.3%)
|
0.6(0.32,1.01)
1
|
1.6(0.8,3.1)
|
Residence
|
Urban
Rural
|
91(78.4%)
25(21.6%)
|
98(64.5%)
54(35.5%)
|
2.0(1.2,3.5)
1
|
1.7(0.9,3.2)
|
Experience of respondents
|
<1 year
1-5Years
5-10Years
10-15Years
>15 years
|
10(8.6%)
55(47.4%)
38(32.8%)
10(6.8%)
3(2.6%)
|
22(14.5%)
74(48.7%)
30(19.7%)
20(13.2%)
6(3.9%)
|
1
0.9(0.2,4.4)
1.5(0.4,6.2)
2.5(0.6,10.9)
1.0(0.2,4.8)
|
1.4(0.24,8.4)
2.7(0.6,13.4)
2.4(0.5,12.3)
2.3(0.4,13.9)
|
Qualification of respondents
|
Gynecologist
MSc
GP
BSc
Diploma
|
1(0.9%)
3(2.6%)
7(6.0%)
60(43.1%)
55(47.4%)
|
3(2%)
8(5.3%)
4(2.6%)
102(67.1%)
35(23%)
|
1
0.2(0.02,2.12)
0.24(0.6,0.96)
1.1(0.3,4.1)
0.3(0.2,0.54)
|
0.9(0.3,2.7)
1.8(0.9,3.5)
1.6(0.7,3.6
0.3(0.2,0.6)*
|
Knowledge of obstetric analgesia
|
Yes
No
|
113(97.4%)
3(2.6%)
|
127(83.6%)
25(16.4%)
|
7.4(2.2,25.2)
1
|
9.4(1.8,9.9)*
|
Types of nonpharmacological method
|
Acupuncture
Diversional therapy
Psychotherapy
Massage the back
Hypnosis
Show the pt to bear down
Help to do labor exercises
|
3(2.6%)
5(4.3%)
51(41.4%)
49(42.2%)
1(0.9%)
4(3.4%)
6(5.2%)
|
2(1.3%)
12(7.9%)
51(33.6%)
66(43.4%)
1(0.7%)
1(0.7%)
19(12.5%)
|
1
4.8(0.64,15.5)
1.3(0.3,5.3)
2.9(1.1,8.1)
2.4(0.9,6.3)
3.2(0.2,28.7)
12.7(1.2,13.6)
|
7.9(0.8,8.9)
1.7(0.4,7.8)
3.5(1.2,10.1)
1.8(0.6,5.2)
1.8(0.1,3.6)
|
Thought of every mother should receive labor analgesia
|
Yes
No
|
74(63.8%)
42(36.2%)
|
71(46.7%)
81(53.3%)
|
2.0(1.2,3.3)
1
|
1.7(0.9,2.9)
|
Thought of pharmacologic obstetric analgesia has effect on the labor and delivery outcomes
|
Yes
No
|
101(87.1%)
15(12.9%)
|
108(71.1%)
44(28.9%)
|
2.7(1.4,5.2)
1
|
2.9(1.4,6.2)*
|
Note: * shows statistically significant at P value<0.05