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Background: Although infant deaths worldwide have reduced, many children die before their first birthday. Infant deaths are widespread in low-income countries, and information about the cause of death is limited. In Ethiopia, 53% of infants' deaths occurred in their neonatal period, and 174 infants' deaths occurred from 3684 births. Hence, this study aimed to assess mothers' experiences with infant death and its predictors in Ethiopia. Methods: A total of 1730 weighted samples of mothers from the 2019 EDHS dataset, which was collected across the regions of Ethiopia, were included for analysis. A two-stage cluster sampling technique with a cross-sectional study design was used. All mothers whose children were under the age of 0–12 months were included in this study. Six count regression models were considered and compared using Akaike's information criteria and Bayesian information criterion with STATA version 15 software. The strength of the association between the number of infant deaths and possible predictors was determined at a P-value less than 0.05, with a 95% confidence interval. The findings were interpreted by using the incident rate ratio. Results: A total of 46.3% of mothers had lost at least one infant by death in the last five years before the 2019 EDHS survey was held. The mean and variance of infant deaths were 2.55 and 5.58, respectively. The histogram was extremely picked at the beginning, indicating that a large number of mothers did not lose their infants by death, and that shows the data had positive skewness. Mothers under 25–29 years of age (IRR: 1.75, 95% CI:1.48, 2.24), and 30–34 years of age (IRR: 1.42, 95% CI: 1.12, 2.82), Somali (IRR: 1.47, 95% CI: 1.02, 3.57), Gambela (IRR: 1.33, 95% CI: 1.10, 2.61), and Harari (IRR: 1.39, 95% CI: 1.02, 2.63) regions, rural resident mothers (IRR: 1.68, 95% CI: 1.09, 1.91, and Protestant (IRR = 1.43, 95% CI: 1.14, 2.96), and Muslim (IRR = 1.59, 95% CI: 1.07, 2.62) religion fellow of mothers were associated with a high risk of infants' deaths. Whereas, being rich IRR: 0.37, 95% CI:.27,.81) and adequate ANC visits (IRR: 0.28, 95% CI:.25,.83) were associated with a low risk of infant death. Conclusion: Many mothers have experienced infant deaths, and the majority of infants' deaths occur after the first month of birth. Encouraging mothers to attend antenatal care visits, creating mothers' awareness about childcare, and ensuring equal health services distribution and utilization to rural residents are essential to minimize infant death. Educating lower-aged reproductive mothers would be a necessary intervention to prevent and control infant deaths. [ABSTRACT FROM AUTHOR]

Background: Remarkable reduction in global under-five mortality has been seen over the past two decades. However, Ethiopia is among the five countries which account for about half (49%) of all under-five mortality worldwide. This study aimed at identifying factors associated with under-five children mortality in Ethiopia using the 2019 Ethiopia mini demography and health survey data. Methods: The most recent national representative demography and health survey data of Ethiopia, 2019 Ethiopia mini demography and health survey data, were used for this study. Count data regression models were applied to identify the factors associated with under-five children mortality. Statistical significance was declared at P-value less than 0.05. Results: Zero-Inflated Poisson (ZIP) regression model was found to be the best model compared to other count regression models based on models comparison Criteria. The ZIP model revealed that decreased risk of under-five mortality was associated with mothers aged 25–34 years, unmarried mothers, mothers delivered in health facility, mothers used Pill/IUD, mothers who had larger number of children at home whereas increased risk of under-five mortality was associated with older mothers at their first births, mothers from rural areas, mothers travel for 1–30 min and >30 min to get drinking water, mothers used charcoal and wood, children with higher birth order and multiple births. Conclusions: In this study, place of residence, region, place of delivery, religion, age of mother, mother's age at first birth, marital status, birth order, birth type, current contraceptive type used, type of cooking fuel, time to get drinking water, and number of children at home were statistically significant factors associated with under-five mortality in Ethiopia. Thus, the Ethiopian Ministry of Health and other concerned bodies are recommended to encourage mothers to deliver at health institutions, give awareness for mothers to use Pill/IUD contraceptive type, and facilitate rural areas to have electricity and drinking water near to homes so as to minimize the under-five mortality to achieve the sustainable development goal. [ABSTRACT FROM AUTHOR]

Background: Evidence suggests ambient fine particulate matter (PM2.5) is a risk factor for cardiovascular diseases, lung cancer morbidity and mortality, and all-cause mortality. Countries that implement strong policies are able to reduce ambient PM2.5 concentration. In Ethiopia, however, PM2.5 monitoring stations, laboratory technicians, and equipment are staggeringly limited. In this study, the spatial and temporal variation of PM2.5 in Ethiopia was assessed. Methods: Satellite-based PM2.5 estimates, from the year 1998 to 2019, by Atmospheric Composition Analysis Group (ACAG) at a spatial resolution of 0.01° X 0.01° was used. The annual mean PM2.5 concentration for all administrative regions and zones in Ethiopia was extracted. The average mean from the twenty-two years was also calculated. The trend of PM2.5 concentration was graphed and quantitatively calculated using the Mann-Kendall test. The slope of the change over time was estimated using the Theil-Sen slope. At the zonal administration level, for the average annual mean, spatial dependency using univariate Global Moran's I and clustering and outlier tests using Anselin Local Moran's were performed. Results: The country's average annual mean PM2.5 concentration was 17 μgm-3. The Afar region had the highest concentration, 27.9 μgm-3. The Mann-Kendall S was positive and significant at p<0.001. The spatial distribution of satellite-based ambient PM2.5 concentration was non-random. Significant highest value clustering of ambient total PM2.5 concentration exists in the Afar, Eastern Tigray, and Eastern and Southeastern Amhara while the significant lowest value dispersing was observed in the Southern Oromia and Somali region. Conclusion: At the national and regional levels, the annual mean ambient PM2.5 concentration is beyond the World Health Organization (WHO)-recommended level. The ambient PM2.5 concentration distribution is spatially dependent and significantly clustered in space. Installation of additional ground-based PM2.5 monitoring devices, particularly in regions where PM2.5 concentration is higher, is recommended. Validating satellite-based PM2.5 data with ground-based measurements in the country is also advised. [ABSTRACT FROM AUTHOR]

Background: Poor health care financing remains a major challenge to health service utilization among the lower socioeconomic society. Consequently, countries have designed different health insurance programs to overcome financial barriers against health services utilization. Similarly, Ethiopia has been implementing community-based health insurance programs since 2011 to improve health care financing system. However, only a small number of people are enrolled which might be attributed to lack of willingness towards the program and the reasons for this remained under reported. This study was intended to examine willingness to join the community-based health insurance program and its associated factors in South Wollo, Northeast Ethiopia. Method: A community-based cross-sectional study was conducted among 421 households. A multistage systematic random sampling technique was employed to recruit the study households. Data were entered into EpiData version 3.1 and was exported into SPSS version 24.0 for analysis. Bivariable and multivariable logistic regression analysis with a backward elimination method was performed to identify the determinants of willingness to join community-based health insurance. Finally, a statistically significant level was declared at a p-value of less than 0.05. Results: Two hundred and ninety-three [73.6% (95%CI:68.8%-77.9%)] households were willing to join community-based health insurance programs. Being male headed household (AOR:0.2, 95%CI: 0.07–0.58), being a member of Idir (AOR:0.46, 95%CI: 0.25-.84), absence of chronic illness in the household (AOR: 0.31, 95%CI: 0.13–0.77), and family size < 4 (AOR: 0.18, 95% CI:0.08–0.41) were barriers to join community-based health insurance program whereas rural residency (AOR:1.9, 95% CI: 1.09–3.32), perceived quality health services (AOR:2.96, 95%CI:1.4–6.24), and having positive attitude (AOR:4.1, 95%CI:2.32–7.22) and good knowledge to programs (AOR:2.62, 95%CI:1.43–4.8) were enabling factors. Conclusion: Nearly three-fourths of the households were willing to join community-based health insurance programs. However, different household and health service-related factors affected their willingness. The ministry of health with the regional and woreda health offices should work towards improving the quality of health services, conduct program advocacy and community sensitization towards the program, and build trust with the community. [ABSTRACT FROM AUTHOR]

Introduction: Moving towards the goal of universal health coverage requires strengthening service delivery and overcoming significant financial barriers. The Government of Ethiopia is rolling out community based health insurance to protect the rural community from high out of pocket health expenditure and improve health service utilization. We investigated the effect of community based health insurance on catastrophic health expenditure in Northeast Ethiopia. Methods: A community based cross sectional study was conducted. A Multi stage sampling technique was used to get a total of 454 (224 insured and 230 uninsured) households. The data were entered using EPI info version 7 and analyzed using SPSS version 20 and STATA version 13 for binary logistic regression analysis and propensity score matching analysis respectively. Wealth status of the households was computed by Principal Component Analysis (PCA). A multivariable logistic regression analysis was done to identify the predictors of catastrophic health expenditure. Propensity score matching analysis was used to determine the effect of community based health insurance on catastrophic health expenditure. The average treatment effect on the treated (ATT) was calculated to compare the means of outcomes across insured and uninsured households. Results: A total of 454 household heads were included in the study, making a response rate of 91.2%.The total level of catastrophic health expenditure was found to be 20%. Among the households with catastrophic health expenditure, 4.41% were insured, whereas the remaining 15.64% were noninsured. Insured households (AOR = 0.19, 95% CI: 0.11–0.34), rich households (AOR = 1.98; 95% CI: 1.07–3.66), having member with chronic illness (AOR = 2.13, 95% CI: 1.01–4.51) and having member encountered any illness during the past 3 months (AOR = 2.44, 95% CI: 1.35–4.40) were statistically associated with catastrophic health expenditure. Community based health insurance contributed to 23.2% (t = -5.94) (95% CI: -0.31_-0.15) reduction of catastrophic health expenditure. Conclusion: The overall level of catastrophic health expenditure was high among noninsured households. Community based health insurance has significant financial protection from catastrophic health expenditure in northeast Ethiopia. Thus, the government need to scale up community based health insurance to protect the noninsured households from catastrophic health expenditure. [ABSTRACT FROM AUTHOR]