Papers by Abdulwahid Awol
Pan African Journal of Emergency Medicine and Critical Care
Effective emergency care systems could avert a significant portion of the high morbidity and mort... more Effective emergency care systems could avert a significant portion of the high morbidity and mortality rates attributed to acute illness. Such a system should be structurally integrated, in a continuum style, where care is continuously given in a coordinated sequence. Prehospital care is an important part of the health continuum, but it has been neglected in most African countries for many reasons, mainly due to poor advocacy and a lack of a model to organize the system. A low-resource model was used to establish a formal prehospital care system in Jimma City, the largest city in the southwestern part of Ethiopia. A hybrid hospital-based system complemented by volunteer systems was used to establish a local emergency medical service (EMS) system, named Aayyoo Ambulance. The establishment process was financially supported by the government and officially started its operation in October 2020. Initially, emphasis was placed on the foundation of the core elements of the system, and a toll-free phone number (6238) was dedicated to the dispatch center to receive calls and provide a tier-based response. As of the first anniversary, more than 1600 emergency calls were served while a computer-aided dispatch system was implemented. The purpose of this article is to describe the prehospital care system's establishment process, and lessons learned in Jimma City.
Pan African Journal of Emergency Medicine and Critical Care
Background: Little is known about a burden of acute illness and injury that would be addressed wi... more Background: Little is known about a burden of acute illness and injury that would be addressed with improved prehospital care in Ethiopia. This study aimed to quantify the burden of emergency conditions that potentially benefited from implementation of prehospital care service in Jimma city, Ethiopia.Method: This study is secondary analysis of dataset originally created to characterize the burden of emergency conditions presenting to public hospitals in Jimma city, from 2014 to 2017. We included of 19,885 eligible cases out of 39,537 emergency cases visited to hospitals, and rated for amenability to prehospital care using previous definitions devised for priority emergency conditions in Low-and Middle-Income-Countries. Demographic health report for the same period was also obtained from Jimma health office, and used to quantify the population-normalized rates of demand for prehospital care in the study area. Descriptive analysis was used to summarize demographic data, causes of visi...
Background:Understanding self-care behaviour and its relationship with health-related quality of ... more Background:Understanding self-care behaviour and its relationship with health-related quality of life (HRQoL) in patients with Heart failure help a healthcare provider to identify patients who still need but lack the self-care skills required to manage their disease condition at home. However, despite its growing importance and obvious relationships with positive health outcomes,the evidence to justify its popularity is not well documented. This study aimed to assess the extent of heart failure self-care and its relationship with the HRQoL among patients with heart failure. Methods: An institutional-based descriptive correlational study was conducted on 176 heart failure patients at Jimma Medical Canter. The data were analyzed using SPSS version 26. Both descriptive and analytical statistical tests were utilized. A multivariate linear regression analysis was done to determine the relationship between self-care behaviour and HRQOL and different independent variables. Variables with a...
Pan African Medical Journal
Background: African nations experience a significant proportion of the global burden of death and... more Background: African nations experience a significant proportion of the global burden of death and disability. The provision of prehospital emergency care has been shown to partially reduce excess morbidity and mortality. However, access to prehospital care in Africa is still limited. This study sought to identify barriers to access prehospital care in the city of Jimma, Ethiopia.Methods: This is an interview-based qualitative study of key prehospital stakeholders in Jimma, conducted in February 2018. A purposive sample of individuals from the community and local ambulance organizations was selected for interviews. Interviews were conducted in local languages, translated into English, and then coded for consistent themes. Results: All respondents felt that prehospital care was difficult to access and therefore infrequently utilized. This was due to a combination of a limited number of ambulances, the lack of a toll-free emergency number, the lack of a single organized Emergency Medic...
Pediatric Health, Medicine and Therapeutics, 2019
Background: The neonatal period is the most susceptible phase of life. In Ethiopia changes in neo... more 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 (
Background: African nations experience a significant proportion of the global burden of death and... more Background: African nations experience a significant proportion of the global burden of death and disability. The provision of prehospital emergency care has been shown to partially reduce excess morbidity and mortality. However, access to prehospital care in Africa is still limited. This study sought to identify barriers to access prehospital care in the city of Jimma, Ethiopia.Methods: This is an interview-based qualitative study of key prehospital stakeholders in Jimma, conducted in February 2018. A purposive sample of individuals from the community and local ambulance organizations was selected for interviews. Interviews were conducted in local languages, translated into English, and then coded for consistent themes. Results: All respondents felt that prehospital care was difficult to access and therefore infrequently utilized. This was due to a combination of a limited number of ambulances, the lack of a toll-free emergency number, the lack of a single organized EMS system, a l...
Open Access Emergency Medicine, 2020
Background: Prolonged emergency department stays can adversely affect patient outcomes leading to... more 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.
Open Access Emergency Medicine, 2020
Background: Prolonged emergency department stays can adversely affect patient outcomes leading to... more 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.
Advances in Medical Education and Practice, 2021
Background: Even though lockdown measures contributed to reducing the rate of COVID-19 transmissi... more Background: Even though lockdown measures contributed to reducing the rate of COVID-19 transmission, it resulted in great distraction in clinical learning. Thus, the aim of this study was to assess COVID-19's negative impacts on clinical learning, and proposed compensation mechanisms among midwifery and nursing undergraduate students of Jimma University, southwest Ethiopia. Methods: This study was conducted among 147 midwifery and nursing students of Jimma University in March 2021 using cross-sectional study design. The respondents were selected by simple random sampling method. Data were collected by using a self-administered questionnaire and analyzed descriptively by SPSS v.23. The results were presented in tables, and narrated. Results: Three fifths (88 (59.9%)) of the study participants perceived high negative impacts of COVID-19 on their recent clinical learning. The proposed compensation mechanisms to be implemented before and during the next clinical practice include: using teacher-facilitated skill demonstration laboratory, case scenarios, clinical teaching videos, and clinical conferences. Students' effort to understand the objectives of their clinical learning and using multimedia to achieve it was another proposed compensation mechanism. Also, providing preplacement training and in-service training with priority for students graduating during COVID-19 pandemic were proposed compensation mechanisms. Conclusion: COVID-19's negative impacts on clinical learning were great among the participants of this study. The proposed compensation mechanisms should be applied by all concerned bodies with great emphasis to end the long-term negative impact of the pandemic, thereby ensuring the production of competent midwives and nurses.
International Emergency Nursing
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Papers by Abdulwahid Awol