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Background: Self-medication is the use of drugs without a medical prescription to treat self-identified illnesses; it is also the continued use of drugs without a physician's order for recurring symptoms, either by sharing or purchasing them from unlicensed vendors. It entails substantial risk to pregnant women and fetuses. Magnitude of the problem and its factors among rural pregnant women is not studied in Ethiopia. Objective: This study aimed to assess the prevalence of self-medication practice and identify its associated factors among pregnant women in rural Southwest Shewa, Ethiopia. Methods: A cross-sectional study was conducted on 585 randomly selected pregnant women in selected rural public health institutions from May to July 2021. Data was collected by using an interviewer-administered pretested structured questionnaire. Multivariable logistic regression was used to identify factors associated with self-medication. Variables with p-value < 0.05 for the 95% confidence interval of the adjusted odds ratio were considered statistically significant. Results: A total of 585 pregnant women participated in the study with a response rate of 92.3%. The prevalence of self-medication among pregnant women was 19.8%. Primigravidity (AOR = 2.7, 95% CI: 1.2– 6.1), lower educational status of husbands (AOR = 3.6, 95% CI: 1.02– 12.9), living close to health facilities (AOR = 0.23, 95% CI: 0.09– 0.6) and knowing one's own gestational age (AOR = 0.5,95% CI: 0.30– 0.9) were significantly associated with self-medication practice. Conclusion and Recommendation: One in five of the pregnant women practiced self-medication during the current pregnancy. Primigravidity and lower educational status of husbands were associated with a higher probability of self-medication. Knowing gestational age and living close to health facilities were associated with a lower likelihood of practicing self-medication. Rational drug use has to be promoted among pregnant women. Maternal and child health interventions should also target husbands. Health education has to be strengthened to help pregnant women have a safe pregnancy. [ABSTRACT FROM AUTHOR]

Background: Pregnant women who had full antenatal care follow-up are expected to give birth in health facilities. However, in Ethiopia, after full antenatal care booking, many women still prefer to give birth at home. Thus, the purpose of this study was to explore and describe why women give childbirth at home after full antenatal care follow-up in the study setting. Methods: Exploratory-descriptive qualitative design was conducted in Humbo and Abala Abaya districts, Southern Ethiopia, from June to September 2020. Nine in-depth interviews and four focus group discussions were held with purposively selected participants. Women who gave birth at home after attending equal to or more than four antenatal care appointments in the last year were included. The collected data were majorly analyzed by inductive thematic analysis technique, but deductive analysis was also applied whenever the potential themes needed further enrichment. A thick description of the findings is done in the respective heading and sub-heading using participants' verbatim quotations. Results: A total of 9 in-depth interviews and four focus group discussions comprising 35 participants was conducted. Three major themes and nine sub-themes emerged from the data. Socio-cultural and community influences, socio-economic obstacles, and health system-related barriers are the major themes identified. Traditional practices, personal beliefs, social norms, knowledge, and attitude about institutional delivery, household economic capability, decision-making capacity of the women, delivery service quality, and service providers related barriers are the sub-themes defining the home delivery experience of women after full antenatal care follow-up in the study setting. Conclusion: In this study, socio-economic, cultural, and health system-related barriers are major reasons for home delivery. Improvement of public awareness on the risk of home delivery and elimination of its facilitative social norms, empowerment of women's economic, educational, and decision-making capability and healthcare workers' and health facilities' capacity are recommended. [ABSTRACT FROM AUTHOR]

aimanot Abebe,2 Shegaw Tesfa,2 Seblework Abeje31Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia; 2Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia; 3Department of Biomedical, College of Medicine and Health Sciences, Wolkite University, Wolkite, EthiopiaCorrespondence: Shegaw Geze Tenaw, Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia, Email [email protected] Background: COVID-19 pandemic directly or indirectly increases the burden of unintended pregnancy by limiting women's access to family planning and other reproductive health services. COVID-19 results in extra 15 million unintended pregnancies over a year. Almost all previous studies conducted about unintended pregnancy were before COVID-19 pandemic in Ethiopia. Therefore, the purpose of this study was to assess the prevalence and associated factors of unintended pregnancy during the COVID-19 pandemic among women attending antenatal care in public hospitals of southwest Ethiopia. Methods: This study was cross-sectional and conducted among women attending antenatal care at public hospitals of southwest Ethiopia from June 14 to July 14, 2021. Data were collected using a face-to-face interview. Factors associated with unintended pregnancy were analyzed using binary and multiple logistic regressions with an adjusted odds ratio and 95% confidence interval. Finally, the p-value was used as a graded measure of evidence to quantify the degree of significance. Results: A total of 405 women participated in this study. The overall prevalence of unintended pregnancy was 19.5% (95% CI: 1.44– 6.92) among women attending antenatal care during COVID-19 pandemic. Of which, 50.6% were mistimed and 49.4% unwanted. Urban residence (AOR: 3.1 95% CI: 1.44– 6.92) and not being primary decision-maker (AOR: 2.85 95CI: 1.18– 6.88) had high significance with unintended pregnancy. Not having ANC in a previous pregnancy (AOR: 3.40; 95% CI: 1.02– 11.94) and not being exposed to community education about maternal health care (AOR: 2.36; 95% CI: 1.06– 5.27) had medium significance with unintended pregnancy. Conclusion: One-fifth of women attending antenatal care had unintended pregnancies during the COVID-19 pandemic. Efforts to scale up women's decision-making power on family planning services and access to community education are needed to prevent unintended pregnancy. [ABSTRACT FROM AUTHOR]

Background: Even though antenatal care (ANC) visits seems to be the key strategy to increase adherence to iron and folic acid supplements during pregnancy, the problem still remains unresolved. Therefore, this study planned to assess adherence to iron and folic acid supplements and associated factors among pregnant mothers attending ANC at Gulele sub-city Government Health Centers in Addis Ababa, Ethiopia, 2019. Methods: An institution-based cross-sectional study design was conducted on 403 pregnant women attending ANC at governmental health centers in Gulele sub city of Addis Ababa from May to June, 2019. The study participants were selected by systematic random sampling techniques, and an interviewer administered questionnaire was used to collect data. Descriptive statistics and logistic regression models were used to analyze the data. The results were considered statistically significant at p-value < 0.05. Results: The proportion of mother's adherent to iron and folic acid supplements was 62.3% with a 95% CI of 57.5– 67.0. Women who had no formal education (AOR=2.37; 95% CI=1.25– 4.51), poor knowledge about anemia (AOR=1.97; 95% CI=1.24– 3.13), developing any other health problem during current pregnancy (AOR=2.59; 95% CI=1.55– 4.32), attending health information about iron/folic acid supplement (AOR=2.06; 95% CI=1.08– 3.921 and forgetful (AOR=2.23; 95% CI=1.40– 3.56) mothers were more likely to be non-adherent to the supplement compared with their counterparts. Conclusion and Recommendation: The status of maternal adherence was medium compared with other studies, and maternal educational status, knowledge about anemia, exposure to information, experiencing of health problems, and forgetfulness were associated with adherence behavior. This indicates that improving dissemination of information about the supplements and designing a reminder mechanism was needed to improve the adherence status of mothers to the supplement. [ABSTRACT FROM AUTHOR]

Introduction: Antenatal care (ANC) is a medical care and procedure carried out for pregnant women. Data on ANC visits can help policymakers show gaps in service provision. Therefore, this study assessed the factors associated with the number of ANC visits among women in rural Ethiopia. Methods: We included a total of 6611 women who gave birth within 5 years preceding the survey from the 2016 Ethiopian Demographic and Health Survey. A multi-level negative binomial regression analysis was employed to consider the hierarchical nature of the data. In the multivariable analysis, variables with a p-value < 0.05 were considered to be significantly associated with the number of ANC visits. Results: Overall, 27.3% (95% CI: 14.63, 15.76) of women had at least four ANC visits during pregnancy in rural Ethiopia. Among individual level factors, age group 25– 29 years (adjusted incidence rate ratio (AIRR)=1.13,95% CI:1.02,1.26), household rich wealth status (AIRR=1.17, 95% CI:1.04,1.31), women's educational status (primary, AIRR=1.19,95% CI:1.08,1.32; secondary, AIRR= 1.30,95% CI:1.08,1.55; above secondary, AIRR=1.35, 95% CI:1.07,1.71), partner educational status (primary, AIRR=1.16, 95% CI:1.05,1.28; secondary, AIRR=1.22,95% CI:1.08,1.38), and autonomy to decision to their care (AIRR=1.25,95% CI:1.10,1.42) were positively associated factors whereas having a birth order of five or more (AIRR=0.80,95% CI: 0.69,0.94) was a negative associated with number of ANC visits. Among community-level variables, being in higher community level literacy (AIRR=1.35, 95% CI: 1.14, 1.59) and higher poverty level (AIRR=0.77, 95% CI: 0.64, 0.92) were significant factors with the number of ANC visits. Conclusions and Recommendations: Women's age, wealth status, women's educational status, partner educational status, autonomy to decision making in health care, and birth order were determinants of the number of ANC visits. Furthermore, poverty and literacy are also important factors at the community level. Addressing economic and educational interventions for rural women should be prioritized. [ABSTRACT FROM AUTHOR]

Background: Suicide ideation and attempt are common among pregnant women, risk factors for completed suicide, and associated adverse maternal and fetal outcomes. It is under-recognized and has not been investigated well in low-income countries like Ethiopia. This study aimed to assess the prevalence and factors associated with suicide ideation and attempt among pregnant women attending antenatal care services at public hospitals in southern Ethiopia. Methods: A group of 762 pregnant women who were attending the antenatal service at public hospitals in Hawassa, southern Ethiopia, selected by a systematic random sampling technique, took part in an interview. A Composite International Diagnostic Interview (CIDI) was used to measure suicide ideation and attempt. Chi-square and binary logistic regression analyses were performed to identify the associated factors. An adjusted odds ratio with a 95% confidence interval was used for reporting the result with a p-value< 0.05 statistical significance level. Results: The prevalence of suicide ideation and attempt among pregnant women was 11.8% and 2.7%, respectively. Unplanned pregnancy (AOR=2.01, 95% CI=1.04– 3.88), poor social support (AOR=3.29, 95% CI=1.62– 6.68), common mental disorders (AOR=2.77, 95% CI=1.50– 5.09), and lifetime suicide ideation (AOR=4.63, 95% CI=2.63– 8.16) were factors significantly associated with suicide ideation. Social support was the only correlated factor with suicide attempt among pregnant mothers. Conclusion: The prevalence of suicide ideation and attempt among pregnant women was found to be high. Intervention strategies towards suicidal ideation and attempt should consider improving social support and antenatal related common mental disorders with a primary focus on women with unplanned pregnancy and prior history of suicide ideation. [ABSTRACT FROM AUTHOR]

Background: Regular monitoring and evaluation improves the quality of health services. Client satisfaction is an indicator of the quality of a health service. Poor maternal satisfaction with antenatal care services has negative outcomes. Currently, women's satisfaction with antenatal care services is below standard in low-income countries such as Ethiopia. Therefore, this study aimed to assess women's satisfaction and its associated factors with antenatal care services. Methods: A facility-based cross-sectional study was conducted from September 23 to October 23, 2019. A total of 405 women were involved in the study. A systematic random sampling technique was used. The data were coded manually and checked visually for completeness. The data were entered using Epi Info version 7 and exported to SPSS version 20 for analysis. Descriptive statistic was computed. Thechi-squared test was performed and factors associated with women's satisfaction with antenatal care services were selected for multiple logistic regression at a probability value (p-value) of < 0.2 in the chi-squared analysis. Statistically significant associated factors were identified at a p-value of ≤ 0.05, and with adjusted odds ratios and 95% confidence intervals. Results: Among 405 participants, 53.8% (95% CI=48.7– 59%) of women were satisfied with the antenatal care services. Age of mothers (AOR=6.04, 95% CI=2.3– 15.9), advice on danger signs in pregnancy (AOR=4.53, 95% CI=2.7– 7.52), previous antenatal care visits (AOR=3.8, 95% CI=2.0– 7.52), respectful maternity care (AOR=8.2, 95% CI=3.3– 20.4), and planned pregnancy (AOR=2.8, 95% CI=1.6– 4.8) were statistically significantly associated with women's satisfaction with antenatal care services. Conclusion: About half of the participants were satisfied with the antenatal care services. Age of participants, respectful maternity care, advice on danger signs in pregnancy, previous antenatal care visits, and planned pregnancy were found to be predictors of women's satisfaction with antenatal care services. [ABSTRACT FROM AUTHOR]

Background: The recent coronavirus disease (COVID-19) pandemic has had a disastrous effect on the health-care delivery system, of mainly pregnancy-related healthcare. In order to fill the information gap in the scientific literature and in response to the limited evidence in the country, this study aims to assess the impact of the COVID-19 pandemic on antenatal care utilization among pregnant women attending public facilities in Northeast Ethiopia. Therefore, the result will be beneficial to design strategies for prioritizing maternal healthcare even with the COVID-19 pandemic period. Methods: A facility-based cross-sectional study was conducted from February 2 to August 30, 2020 among pregnant women attending ANC services at public hospitals in Northeast Ethiopia. Thus, a total of 389 women were included in the study with a simple random sampling technique. The bi-variable and multi-variable logistic regression models were employed to identify factors significantly associated with ANC utilization. Adjusted odds ratio (AOR) with 95% CI was estimated to show the strength of association. Finally, a P-value of < 0.05 in the multivariable logistic regression analysis was used to identify predictors of antenatal care utilization. Results: Overall, 114 (29.3%) pregnant women had fully utilized antenatal care services during the pandemic period. Mother age ≥ 35 years (AOR=11.79, 95% CI=1.18– 117.8), secondary education and above (AOR=4.74, 95% CI=1.04– 21.61), history of stillbirth before recent pregnancy (AOR=0.007, 95% CI=0.001– 0.12), interruption and diversion of services due to COVID-19 response (AOR=0.675, 95% CI=0.142– 0.742), fear of COVID-19 (AOR=0.13, 95% CI=0.06– 0.31), and lack of transport access (AOR=4.15, 95% CI=1.04– 16.54) were predictors of full antenatal care service utilization. Conclusion: Three of every ten pregnant women who attended the obstetric outpatient clinics have fully utilized the antenatal care services. Encouraging women's educational status, prioritizing maternal health services during COVID-19, and improving the quality of ANC service should be emphasized more. [ABSTRACT FROM AUTHOR]

Background: Antenatal care is one of the strategies for reducing maternal morbidity and mortality directly by affording increased chances of early detection of high-risk pregnancies. WHO recommends a minimum of four ANC visits. In order to make it effective, monitoring of the content and quality of the ANC is needed. However, a number of studies focus on the frequency of ANC, and evidence on core contents of the ANC was limited in this study area. The aim of this study was to determine factors associated with content of the ANC. Methods and Materials: A cross-sectional study design was employed to collect data from a total of 432 respondents by using a semi-structured questionnaire. Data were entered in EpiData version 3.1 and exported to SPSS version 20 for analysis. Both binary logistic regression and generalized linear regression with Poisson type were applied to determine factors associated with frequency of the ANC and core contents of ANC, respectively. Results: The majority of the mothers (78.7%) visited first ANC lately, and 25.2% of mothers attended ≥ 4 ANC visits. Only 17.1% of mothers received all the eight selected elements of ANC services. Predictors of the core contents of the ANC were the frequencies of ANC (AOR: 0.84 (95%CI: 0.76– 0.93), pre-pregnancy utilization of contraception (0.63 (95%CI: 0.55– 0.72)), pregnancy desire (AOR: 0.82 (95%CI: 0.71– 0.94), and birth preparedness and complication readiness (AOR: 0.90 (95%CI: 0.82– 0.98). Conclusion: This study found that low level of WHO minimum recommended ANC and core contents of the ANC. This study suggests that identifying pregnant mothers early increases frequency of the ANC, which improves core content of care. [ABSTRACT FROM AUTHOR]

Purpose: Enrollment to antenatal care (ANC) is still not universal in Ethiopia. This study examines whether household food insecurity affects antenatal care attendance or not, as well as other factors associated with antenatal care. As optimal antenatal care is vital for the improvement of maternal and child health, the study will contribute to the efforts in improving maternal and child health. Patients and Methods: A community-based cross-sectional study was conducted among 707 pregnant women at or above 3 months of self-reported pregnancy in Southern Ethiopia. Multi-stage sampling was employed to obtain the study units. Data were collected using an interviewer-administered structured questionnaire. Logistic regression analysis was conducted to identify the independent factors associated with study outcome. Results: Out of a total of 707 study subjects, the majority (71%) of the study women visited a health facility for ANC service. The odds of ANC use was lower for women who were not in marital union (adjusted odds ratio (AOR)=0.39, 95% confidence interval (CI)=0.16– 0.97), and those from food insecure households (AOR=0.50, 95% CI=0.32– 0.79). ANC attendance was higher for women from high socio-economic status (AOR=2.62, 95% CI=1.29– 5.29), with planned pregnancy (AOR=1.82, 95% CI=1.16– 2.85) and a perceived risk from danger signs (AOR=4.32, 95% CI=1.60– 11.67). Conclusion: While the overall ANC use was high, women experiencing food insecurity and those with unplanned pregnancy were having lower odds of ANC attendance among others. Interventions targeting at enhancing women's attendance to ANC service might be realized through commitment from the agriculture, economic, as well as health sectors by increasing productivity and providing special attention to women in the pre-pregnancy and pregnancy period. Moreover, educating women so that they can recognize that every pregnancy is risky and promotion of family planning to reduce unplanned pregnancy could improve attendance to the ANC service. [ABSTRACT FROM AUTHOR]

Background: Antenatal care (ANC) is one of the most cost-effective and crucial components of maternal health care services. In developing countries where access to care, empowerment, and decision making power of women is low, ANC service is vital. The time at which first ANC visit was done has the utmost importance to ensure optimal health effects for both women and children. This study aimed to assess the proportion and factors associated with early antenatal care booking among pregnant women who were attending public health institutions in a remote area of Bule Hora district, Southern Ethiopia, from May to July, 2019. Methods: Institutional-based cross-sectional study design was conducted at Bule Hora district public health facilities. Data were collected on systematically selected 377 pregnant women from 1st May to 30th July 2019. The sample size was determined by single population proportion formula and data were collected by using a standardized and pretested questionnaire and entered into Epidata 3.1 version, and then exported to Statistical Package for Social Science (SPSS) version 25 for analysis. The strength of association was measured by odds ratios with 95% confidence interval (CI) at a p-value of < 0.05 and finally obtained results were presented by using simple frequency tables, bar graph, and texts. Results: The proportion of early antenatal care booking among pregnant women attending antenatal care in the study area was 57.8%. Factors contributing to early antenatal care booking were husband's education (Adjusted odds ratio (AOR), 2.5; 95% CI: 1.2, 4.9), knowledge on antenatal care service (AOR,1.99; 95% CI:1.2,3.3), means of approving current pregnancy (AOR,1.8; 95% CI:1.1,2.8), and being advised before starting antenatal care visit (AOR,2.1; 95% CI:1.2,3.6). Conclusion: Generally, the timely initiation of ANC among pregnant mothers is not ideal. Modifiable factors like husband's education, knowledge on antenatal care service, means of recognizing current pregnancy, and access to pre-ANC advice were found determinants for the timely initiation of ANC. Thus, it is advisable to provide proper information about antenatal care services by health care providers and enhancement of health extension program to increase community awareness before and during pregnancy at all levels of health care provision is very important. [ABSTRACT FROM AUTHOR]

Background: Anemia is a significant public health concern in many developing countries, particularly during pregnancy, and it has adverse effects on mother and fetus/baby. Objective: To determine the factors associated with anemia among pregnant women attending antenatal care in Jigjiga public health facilities, Somali Region, East Ethiopia. Methods: An institution-based unmatched case–control study was conducted. The sample size was 228 pregnant women; comprising 114 presenting with anemia and 114 controls. Hemoglobin levels were measured using a portable heme analyzer. Socio-demographic, dietary, medical history, and nutrition-related data were collected using a structured questionnaire. Data were entered into Epidata 3.1 and exported to Statistical Package for the Social Sciences (SPSS) version 23.0 for cleaning and analyses. Bivariate and multivariate logistic regression was performed and statistical significance was considered at a level of p< 0.05. Results: Three predictors of anemia among pregnant women were identified in this study. An inadequate intake of red meat (i.e. those who consumed red meat 1– 2 times a month [AOR=7.245; 95% CI=(2.007– 26.151)] or not at all [AOR=8.690; 95% CI=(1.795– 42.072)]), and insufficient consumption of green vegetables (i.e. 1– 2 times a week [AOR=2.970; 95% CI=(1.012– 8.716)] or 1– 2 times a month [AOR=8.057; 95% CI=(2.358– 27.526)]) were associated with anemia. Also, having a mid-upper arm circumference (MUAC) of less than 23 cm was strongly associated [AOR=16.432; 95% CI= (5.240– 51.526)] with anemia. Conclusion: This study revealed three key factors to be associated with anemia among pregnant women in Jigjiga Town, namely reduced intake of red meat and green vegetables, and low MUAC. Interventions including nutrition counselling and enrolling pregnant women with low nutritional status in nutritional programs should be the core components of anemia control strategies, needed to address the high prevalence of anemia during pregnancy in developing countries. [ABSTRACT FROM AUTHOR]

Background: The maternal morbidity and mortality related to preeclampsia are increasing in developing countries; figures have been estimated to be between 1.8% and 16.7%, including in Ethiopia. However, there is limited research regarding the determinants of preeclampsia in Gedeo Zone. Objective: The aim of the study was to determine the predictors of preeclampsia among pregnant mothers attending ANC and delivery services in southern Ethiopia. Methods: A facility-based unmatched case-control study was conducted in Gedeo Zone. Pregnant mothers attending ANC and delivery service were selected consecutively until the allotted 243 (162 controls and 81 cases) sample size was fulfilled. The collected data were checked for completeness and entered into Epi-data software version 3.1, and exported to statistical package for social science (SPSS) version 20 for analysis. Multivariable logistic regression was employed and a P-value of less than 0.05 with a 95% confidence interval was used to declare the significant association of the independent variables and the outcome variable. Results: A total of 240 mothers, 80 (33.3%) of cases and 160 (66.70%) of controls, responded, with a response rate of 98.76%. The mean age of the participants among both groups was 27.40 with a standard deviation of ± 5.02. Attending education [adjusted odd ratio (AOR) = 0.49; 95% CI (0.006, 0.398)], being a house wife [AOR = 13; 95% CI (1.260, 140.15)], an age range of 20– 34 years [AOR = 0.071; 95% CI (0.015, 0.32)], a family history of diabetes mellitus [AOR = 0.28.2; 95% CI (0.081, 0.985)], a family history of hypertension [AOR = 0.124; 95% CI (0.047, 0.325)], did not eat fruit during pregnancy [AOR = 3.355; 95% CI (1.112, 10.126)], and a maternal history of preeclampsia [AOR = 0.162; 95% CI (0.041, 0.640)] were found to be variables significantly associated among mothers with preeclampsia. Conclusion: The determinant factors for preeclampsia were being a housewife, having a history of hypertension, diabetes mellitus, and preeclampsia among family members. Strengthening early detection and prevention of predictors, improvement of protective factors, and further follow-up study were recommended. [ABSTRACT FROM AUTHOR]

Background: Early antenatal visit is critical for the health and well-being of mothers and babies. However, various individual, family level, and contextual factors influence the timely initiation of antenatal care. Objective: The aim of this study was to examine individual, household, and community-level factors associated with the timing of first ANC visit among mothers who gave birth in the last twelve months before the survey. Methods: A community-based cross-sectional study was conducted in June 2018. A multistage cluster sampling technique was applied, and a sample of 898 women was considered. Data were collected using a questionnaire and checklist. The analysis was made using SPSS. A multilevel logistic regression with random effects at the kebele level was developed to assess the predictors of late initiation of antenatal care. Odds ratio with 95% confidence intervals was used to measure association while the intra-class correlation coefficient and the median odds ratio were used to measure variations. Results: Overall, 78.4% (95% CI: 75.6, 80.9) of women started their first ANC in 4 months of gestation or later and significant heterogeneity was observed between clusters. At level 1, women with intended pregnancy (aOR=0.31; 95% CI: 0.12, 0.79), and being knowledgeable about the timing (aOR=0.43; 95% CI: 0.25, 0.75) and pregnancy-related complications (aOR=0.16; 95% CI: 0.10, 0.26) were less likely to delay their first ANC visit. Conversely, the odds of late ANC visit was higher among women with no formal education (aOR=4.08, 95% CI: 2.20, 7.55). Distance to the health facility (aOR=1.04; 95% CI, 1.01– 1.08) was the only level-2 significant predictor. Conclusion: The study revealed that late ANC initiation was rampant. Several factors operating at different levels were associated with late ANC visits; yet, the role of individual-level factors was relatively stronger. Hence, awareness creation is essential to the underprivileged community using the available communication networks. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to assess the level of knowledge about prevention of mother-to-child transmission option B+ and associated factors among antenatal care clients in Kombolcha town; 2017. Methods: An institutional-based cross-sectional study design was conducted from May 1 to 30, 2017. Simple random sampling techniques were used to select 129 study subjects from May 1 to 30, 2017. A chi-square test was done by using SPSS 20 to assess the association between the dependent and independent variables. Frequency tables, pie chart, and graphs were used to present the findings of the study. Results: Among the total study participants, 61% had adequate knowledge about prevention of mother-to-child transmission Option B+. This study found a strong positive association between knowledge of prevention of mother-to-child transmission B+ option and age, educational status, occupational status, number of ANC follow-up visits for the current pregnancy and number of parity. Conclusion: This study showed more than half of these study participants had adequate knowledge about the prevention of mother-to-child transmission B+ option. Age, educational status, employment, parity and number of antenatal care visits had a statistically significant association with pregnant womens' knowledge of prevention of mother-to-child transmission B+ option. Therefore, it is better to design to give health education on prevention of mother-to-child transmission B+ option particularly for older age, uneducated, unemployed, partiy of one pregnant women. [ABSTRACT FROM AUTHOR]

Background: Acceptance of human immune virus testing is an entry point of intervention to end mother to child transmission of the virus among pregnant women. Methods: Institutional based cross-sectional study design with a sample size of 340 was conducted from May 20 to June 15, 2019. The data were collected by using systematic random sampling technique of interviewer administered questionnaire. Those candidate variables at bivariate analysis with a p-value <0.25 were moved to the multivariate analysis was considered as cutoff point.  Result: Among the total of 340 pregnant women who participated with a response rate of 96%, 234 (68.8%) accepted testing. The odds of acceptance of human immune virus testing was higher among respondents who had awareness about mother to child transmission (AOR=2.602, 95%; CI:1.408–4.809) than their counterparts. It was also higher among respondents who had perceived the benefit of testing (AOR=1.838, 95%; CI:1.089–3.104) than those who did not perceive the benefit of testing. Participants who were knowledgeable about the prevention of mother to child transmission were more likely to accept testing (AOR=1.715, 95%; CI:1.030–2.855) than their counterparts. Besides, the odds of acceptance of testing among pregnant women who attended two and above antenatal appointments were higher (AOR= 2.485, 95%; CI:1.462–4.224) than participants who attended only one appointment. Participants who had no formal education (AOR=0.393, 95%; CI:0.160–0.967) and had a primary level of education (AOR=0.357,95%; CI:0.152–0.842) were less likely to accept human immune virus testing than women who had a diploma and above level of educational status. Conclusion: Acceptance of human immune virus testing among pregnant women attending antenatal care clinics was relatively low. Antenatal caregivers should place emphasis on reducing barriers to testing, like lack of awareness, knowledge, and educational background. [ABSTRACT FROM AUTHOR]

Background: Maternal health remains a major public health problem in Ethiopia. Despite the government's measures to ensure institutional delivery assisted by skilled attendants, home delivery remains high, estimated at over 80% of all pregnant women. Objective: The study aims to identify determinants that sustain home delivery in Ethiopia. Methods: A total of 48 women who delivered their most recent child at home, 56 women who delivered their most recent child in a health facility, 55 husbands of women who delivered within 1 year preceding the study, and 23 opinion leaders in selected districts of Amhara, Oromia, Southern Nations, Nationalities, and Peoples' Region, and Tigray regions were involved in the study. Key informant interview, in-depth interviews, and focus group discussions were conducted to collect data using checklists developed for this purpose. Data reduction and analysis were facilitated by Maxqda qualitative data analysis software version 11. Results: Findings show that pregnancy and delivery is a normal and natural life event. Research participants unanimously argue that such a life event should not be linked with health problems. Home is considered a natural space for delivery and most women aspire to deliver at home where rituals during labor and after delivery are considered enjoyable. Even those who delivered in health facilities appreciate events in connection to home delivery. Efforts are underway to create home-like environments in health facilities, but health facilities are not yet recognized as a natural place of delivery. The positive tendency to deliver at home is further facilitated by poor service delivery at the facility level. Perceived poor competence of providers and limited availability of supplies and equipment were found to maintain the preference to deliver at home. Conclusion: The government's endeavor to improve maternal health has generated positive results with more women now attending antenatal care. Yet over 80% of women deliver at home and this was found to be the preferred option. Thus, the current form of intervention needs to focus on factors that determine decisions to deliver at home and also focus on investing in improving service delivery at health facilities. [ABSTRACT FROM AUTHOR]