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Abstract Background Cervical cancer is a leading cause of cancer mortality globally, especially in Africa, including Ethiopia. This review assesses predictors of cervical cancer screening uptake among Ethiopian-eligible women using the Health Belief Model. Higher education levels, perceived susceptibility, severity, and fewer barriers are associated with increased screening. Effective HBM-based interventions could enhance screening rates, potentially reducing cervical cancer incidence and mortality. Objective The review aimed to synthesize the existing literature on the prevalence of Cervical Cancer Screening Service Uptake and Associated Factors among Eligible Women using the Health belief model in Ethiopia, 2024. Method This systematic review and meta-analysis searched Google Scholar, PubMed, and the Cochrane Library engine. Key terms such as "Cervical cancer screening", "uptake", "utilization", "factors", "barriers", and "Ethiopia" were used to identify relevant articles. Data extraction utilized a detailed form, and the methodological quality of each study was assessed using the JBI quality appraisal checklist for cross-sectional studies. Statistical analysis was conducted using STATA version 17, and the meta-analysis findings were presented using forest plots and tables. Result The result of seven studies revealed that the overall prevalence of Cervical Cancer Screening Service Uptake among eligible women in Ethiopia was 21% (95% CI: 15%-27%). Factors independently associated with Cancer Screening Service Uptake included: Knowledge (OR = 4.563, 95% CI: 1.012–4.188), age 30 up to 49 (OR = 4.106, 95% CI: 1.562–6.650), history of STD (OR = 2.59, 95% CI: 1.694–4.486), high perceived susceptibility (OR = 3.814, 95% CI: 2.312–5.316), high perceived severity (OR = 2.603, 95% CI: 2.203–3.003), low perceived barrier (OR = 4.390, 95% CI: 1.331–8.449), high perceived self-efficacy (OR = 4.77, 95% CI: 4.102–5.431), high perceived benefit (OR = 3.67, 95% CI: 1.851–5.489), and education level greater than primary level (OR = 4.497, 95% CI: 3.619–5.375). Conclusion Cervical cancer is a major public health challenge in Ethiopia. Consequently, there is a pressing need for the governments to formulate comprehensive, multi-sectorial policies and strategies. These initiatives should be designed to address the problem influenced by interconnected factors, to reduce the prevalence of cervical cancer in Ethiopia.

Abstract Background Sexually transmitted infections (STIs) are illnesses mainly spread through unprotected sexual activity. There is a scarcity of aggregate evidence in Ethiopia. The aim of this review was to assess the pooled prevalence of STI, and its associated factors among students in Ethiopia to fill the aforementioned gap. Methods We extensively searched the bibliographic databases of PubMed, Scopus, and Google Scholar to obtain eligible studies. Further screening for a reference list of articles was also done. The Microsoft Excel Spreadsheet was used to extract data, and Stata 17 was used for analysis. The PRISMA-guidline and Newcastle-Ottawa quality assessment scale were used for quality appraisal. To check heterogeneity, the Higgs I2 and Cochran’s Q tests were employed. Sensitivity and subgroup analysis were implemented. To detect publication bias, Egger’s test and funnel plots were used. Results The pooled prevalence of STI among students in Ethiopia was 13.6% with a 95% CI (10.2, 17). Findings from sub group analysis based on student category shows that the pooled prevalence of STI were 14.5% among University students, 14.2% among college students and 10.6% among high school students. Having multiple sexual partners (AOR 3.31; 95% CI: 2.40–4.57), not using condoms during sexual intercourse (AOR 2.56; 95% CI: 1.72–3.81), and having poor knowledge about sexually transmitted infections were 3.08 times (AOR 3.08; 95% CI: 1.84–5.15) significantly associated with STI. Conclusion The pooled prevalence of STIs among students in Ethiopia was high, and factors like having multiple sexual partners, not using condoms during sexual intercourse, and having poor knowledge about sexually transmitted infections were significantly associated with STIs. Hence, reduce STIs among students, strengthening sexual and reproductive health services, raising awareness about transmission and prevention, and promoting consistent condom use through health information dissemination is crucial. Further qualitative studies are suggested to explore the barriers and facilitators of STI prevention.

Abstract Introduction There has been extensive research conducted on open defecation in Ethiopia, but a notable gap persists in comprehensively understanding the spatial variation and predictors at the household level. This study utilizes data from the 2021 Performance Monitoring for Action Ethiopia (PMA-ET) to address this gap by identifying hotspots and predictors of open defecation. Employing geographically weighted regression analysis, it goes beyond traditional models to account for spatial heterogeneity, offering a nuanced understanding of geographical variations in open defecation prevalence and its determinants. This research pinpoints hotspot areas and significant predictors, aiding policymakers and practitioners in tailoring interventions effectively. It not only fills the knowledge gap in Ethiopia but also informs global sanitation initiatives. Methods The study comprised a total weighted sample of 24,747 household participants. ArcGIS version 10.7 and SaT Scan version 9.6 were used to handle mapping, hotspots, ordinary least squares, Bernoulli model analysis, and Spatial regression. Bernoulli-based model was used to analyze the purely spatial cluster detection of open defecation at the household level in Ethiopia. Ordinary Least Square (OLS) analysis and geographically weighted regression analysis were employed to assess the association between an open defecation and explanatory variables. Results The spatial distribution of open defecation at the household level exhibited clustering (global Moran’s I index value of 4.540385, coupled with a p-value of less than 0.001), with significant hotspots identified in Amhara, Afar, Harari, and parts of Dire Dawa. Spatial analysis using Kuldorff’s Scan identified six clusters, with four showing statistical significance (P-value

Abstract Introduction Worldwide, breast cancer is the primary cause of illness and death. Unless early detected and treated breast cancer is a life-threatening tumor. Advanced-stage presentation is greatly linked with short survival time and increased mortality rates. In Ethiopia nationally summarized evidence on the level of advanced-stage breast cancer diagnosis is scarce. Therefore, this systematic review and meta-analysis aimed to determine the pooled prevalence of advanced-stage breast cancer diagnosis and its determinants in Ethiopia. Method By following PRISMA guidelines, a systematic review and meta-analysis were carried out. To include relevant publications, a broad literature search was conducted in the African Online Journal, PubMed, Google Scholar, and Embase which are published until last search date; June 15, 2023. To prevent further duplication this review was registered in PROSPERO database with ID no of CRD42023435096. To determine the pooled prevalence, a weighted inverse variance random effect model was applied. I2 statistics and the Cochrane Q-test were computed to determine heterogeneity. To evaluate publication bias, a funnel plot, and Egger’s regression test were used. Result A total of 924 articles were sought and finally 20 articles were included in this review. The pooled prevalence of advanced-stage breast cancer diagnosis in Ethiopia was 72.56% (95%CI; 68.46-76.65%). Use of traditional medicine as first choice (AOR = 1.32, 95% CI: (1.13–1.55)), delay of > 3 months in seeking care (AOR = 1.24, 95% CI: (1.09–1.41)), diagnosis or health system delay of > 2 months (AOR = 1.27, 95% CI: (1.11–1.46)), rural residence (AOR = 2.04, 95% CI: (1.42 − 2.92)), and chief complaint of a painless breast lump (AOR = 2.67, 95% CI: (1.76–4.06)) were significantly associated to advanced-stage diagnosis. Conclusion In Ethiopia, more than two-thirds of breast cancer cases are diagnosed at an advanced stage. Use of traditional medicine before diagnostic confirmation, delay in seeking care, health system delay, rural residence, and chief complaint of painless breast lump were positively associated with an advanced-stage diagnosis. Policymakers and program designers give great focus to those delays so as to seek and access modern diagnosis and treatment as early as possible specifically focusing on those who are rurally residing.

Abstract Introduction Ethiopia strives to achieve Universal Health Coverage (UHC) through Primary Health Care (PHC) by expanding access to services and improving the quality and equitable comprehensive health services at all levels. The Health Extension Program (HEP) is an innovative strategy to deliver primary healthcare services in Ethiopia and is designed to provide basic healthcare to approximately 5000 people through a health post (HP) at the grassroots level. Thus, this review aimed to assess the magnitude of health extension service utilization in Ethiopia. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist guideline was used for this review and meta-analysis. The electronic databases (PubMed, Cochrane Library, and African Journals Online) and search engines (Google Scholar and Grey literature) were searched to retrieve articles by using keywords. The Joanna Briggs Institute (JBI) meta-analysis of statistics assessment and review instrument was used to assess the quality of the studies. Heterogeneity was assessed using the I2 statistic. The meta-analysis with a 95% confidence interval using STATA 17 software was computed to present the pooled utilization of health extension services. Publication bias was assessed by visually inspecting the funnel plot and statistical tests using Egger’s and Begg’s tests. Result 22 studies were included in the systematic review with a total of 28,171 participants, and 8 studies were included in the meta-analysis. The overall pooled magnitude of health extension service utilization was 58.5% (95% CI: 40.53, 76.48%). In the sub-group analysis, the highest pooled proportion of health extension service utilization was 60.42% (28.07, 92.77%) in the mixed study design, and in studies published after 2018, 59.38% (36.42, 82.33%). All studies were found to be within the confidence interval of the pooled proportion of health extension service utilization in leave-out sensitivity analysis. Conclusions The utilization of health extension services was found to be low compared to the national recommendation. Therefore, policymakers and health planners should come up with a wide variety of health extension service utilization strategies to achieve universal health coverage through the primary health care.

Abstract Background Health literacy is the important for the prevention of non-communicable disease to make informed health decisions, and practice healthy and protective behaviours. Therefore, application of socioecological model to this study aimed to identify multilevel factors on health literacy among patients and develop scientific health communication interventional strategies to improve health literacy on non-communicable disease prevention and care. Objective To explore barriers of health literacy on non-communicable disease prevention and care among patients in north wollo zone public Hospitals, Northeast Ethiopia, 2023. Method In this study phenomenological study design was conducted from February 5 to 30/2023.We have used purposive sampling technique to select study participants from chronic follow up clinics. Data were collected using in-depth interview and focused group discussion in which audio was recorded, transcribed verbatim and translated to English. Thematic analysis was performed with atlas ti. 7 software. Result In this study four main themes with seven subthemes were developed. The main themes were factors at the organizational, community, interpersonal, and intra-personal factors. The poor knowledge, lack of enough money for transportation and medication at the hospital were identified as barrier to get early diagnosis and treatment. Some participants explored that they have no any support from family or others. The cultural norms like weeding and funeral ceremonies enforce patients to consume prohibited substances like alcohol and salty foods. Conclusion In this study different barriers of health literacy were explored. Lack of knowledge, economic problems, lack of social support, poor communication with health care providers, cultural influences, lack of regular health education, lack of access to health care services and poor infrastructure were main barriers of health literacy in patients with NCD. Therefore, we recommended all concerned bodies to work on social and behavioral change communication intervention focusing on awareness creation, supply of drugs and create supportive environment to get accessible and affordable health care service to decrease the impact of non-communicable disease at personal, community and national level.

IntroductionSeveral studies have been done on the utilization of sexual and reproductive health services by high school students in Ethiopia, but they have yielded inconsistent results. This study aimed to evaluate the extent to which high school students in Ethiopia are using sexual and reproductive health services by conducting a systematic review and meta-analysis.MethodsVarious electronic databases such as PubMed, Cochrane Library, AJOL, Google Scholar, and Grey Literature were used to search for relevant articles. Preferred Reporting Items for Systematic Reviews and Meta-Analysis Guidelines were followed for this review and meta-analysis. Heterogeneity was assessed using I2 and Cochrane Q statistical tests, and data analysis was done with STATA 17 software. Random effect meta-analyses were used to determine the overall utilization rate of sexual and reproductive health services.ResultThis review included 20 studies with 12, 215 study participants. The pooled magnitude of sexual and reproductive health service utilization among high school students in Ethiopia was 29.79% (95% CI: 25.14, 34.43). Students with grades 11–12 (AOR = 2.33, 95% CI: 1.39, 3.90), aged between 20 and 24 years (AOR = 2.61; 95% CI: 1.79–3.81), having higher level of knowledge towards sexual and reproductive health issues (AOR = 3.10; 95% CI: 1.67–5.77), previous history of sexual intercourse (AOR = 4.18; 95% CI: 2.59–6.75), previous history of sexually transmitted infection (AOR = 3.74; 95% CI: 2.22–6.31), presence of a reproductive health service facility in the school (AOR = 2.55; 95% CI: 1.72–3.77), and ever-discussed reproductive health issues (AOR = 4.04; 95% CI: 1.62–10.03) were more likely to utilize sexual and reproductive health services.ConclusionsThe overall utilization of sexual and reproductive services among high school students in Ethiopia was found to be low as compared to SDG 3.7. Older individuals with higher education levels and knowledge about sexual and reproductive health services, as well as those who have had previous sexual experiences or discussions about sexual health, are more likely to utilize reproductive health services. To increase utilization, the Ministry of Health and the Ministry of Education should prioritize these factors.

IntroductionThis study delves into individual and community-level factors influencing the availability of water, soap, and cleansing agents for handwashing in Ethiopia. Its comprehensive exploration offers nuanced insights, informing targeted interventions and policies to effectively enhance handwashing resources across Ethiopia. Therefore, this study aimed to assess individual and community-level factors of availability of observed water, soap, and other cleansing agents for hand washing practices in Ethiopia.MethodsData from the 2021 PMA-ET, encompassing 24,747 household participants, informed this study. Employing STATA version 17.0, a multi-level mixed-effect logistic regression analysis was performed to identify individual and community-level factors. Adjusted odds ratios with a 95% confidence interval conveyed the strength and direction of associations, with significance determined at p

Abstract Introduction Despite efforts to promote exclusive breastfeeding for the first six months of life, pre-lacteal feeding remains prevalent in Ethiopia. The study will use data from the 2019 Performance Monitoring for Action Ethiopia (PMA-ET), which is a nationally representative survey that collects information on maternal and child health indicators. Therefore, this study aims to identify individual and community-level factors associated with the plan to pre-lacteal feeding for the first six months among mothers in Ethiopia. Methods The datasets from the 2019 Performance Monitoring for Action Ethiopia Survey were analyzed in this study, which included 685 mothers from the survey. Stata version 17.0 was used for data analysis. Multi-level mixed-effect logistic regression was utilized to identify individual and community-level factors that are linked with the plan to pre-lacteal feeding. The strength and direction of the association were presented using an adjusted odds ratio with a 95% confidence interval, and statistical significance was declared at a P value less than 0.05. Results The study found that factors significantly associated with the plan to pre-lacteal feeding included mothers without higher education (AOR = 2.5, 95% CI: 1.204–1.204), mothers belonging to poor households (AOR = 11.1, 95% CI: 3.482–35.175), and women in clusters with poor wealth status (AOR = 0.2, 95% CI: 0.043–0.509). Conclusion As per the findings of the study, both individual and community-level factors were found to influence the decision to practice pre-lacteal feeding. Educational status and household wealth were significant individual-level factors associated with pre-lacteal feeding, whereas community wealth status was a significant community-level factor. To address this issue, it is recommended to focus on increasing the education level of mothers from lower socioeconomic backgrounds and providing education on the benefits of exclusive breastfeeding and the risks associated with pre-lacteal feeding. These efforts can help in reducing the prevalence of this harmful practice.

Abstract Background Globally, one in three adults has hypertension, a condition that causes 51% of all deaths from stroke. Stroke is becoming a major public health problem and the most common cause of morbidity and mortality among non-communicable diseases in the world and Ethiopia. Therefore, this study assesses the incidence of stroke and its predictors among hypertensive patients in Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Ethiopia 2021. Methods A hospital-based retrospective follow-up study design was used, simple random sampling technique was used to select 583 hypertensive patients that had follow-up registration between January 2018 and December 30th, 2020. Data were entered into Epi-data version 3.1 and exported to STATA version 14. The adjusted hazard ratio for each predictor with a 95% confidence interval was calculated using the Cox proportional hazards regression model, and a P-value ≤ 0.05 was used to denote statistical significance. Results From 583 hypertensive patients 106(18.18%) [95% CI 15–20] were developed stroke. The overall incidence rate was 1 per 100 person-years (95% CI 0.79–1.19). Comorbidities (Adjusted hazard ratio(AHR): 1.88, 95% CI 1.0–3.5), stage two hypertension (AHR = 5.21, 95%CI 2.75–9.8), uncontrolled systolic blood pressure (AHR: 2, 95% CI 1.21–354), uncontrolled diastolic blood pressure (AHR:1.9, 95% CI 1.1–3.57), alcohol consumption (AHR = 2.04, 95%CI 1.2–3.49), age 45–65 (AHR = 10.25, 95%CI 7.47–11.1); and drug discontinuation (AHR = 2.05,95% CI 1.26–3.35) were independent predictors for the incidence of stroke among hypertensive patients. Conclusion The incidence of stroke among hypertensive patients was high and various modifiable and non-modifiable risk factors highly contributed to its incidence. This study recommends early screening of blood pressure, giving priority to comorbid patients and patients with advanced stage hypertension, and giving health education about behavioral risks and drug adherence.

Abstract Knowing the level of behavioral intention and tooth-brushing practices is crucial for the implementation of the intervention. However, such studies are too limited in Ethiopia. The current study employed a health behavior model to identify predictors that can serve to support primary school children's attitudes, intentions, knowledge, environmental constraints, and practices of tooth brushing. Thus, this study aimed to assess tooth brushing practices and their predictors among primary school children in Bahir Dar city, Ethiopia. An Institutional based cross-sectional study was conducted among primary school children in Bahir Dar city. A multi-stage sampling technique was used to select 610 participants. Data were collected using pre-tested interviewer-administered questionnaires. Questionnaires adapted from items' previous literature were used for integrated behavioral model constructs incorporated with elicitation study results. Data were entered into Epi data and then analyzed by Stata. Descriptive statistics were done. Confirmatory factor analysis was performed to check the convergent validity of the measurement. The Internal reliability of the items was also checked using composite reliability. Multivariable logistic regression was used to predict the role of independent variables in toothbrushing practices. Moreover, path analysis was performed to check the causal effect of integrated behavioral model constructs on toothbrushing practices. The goodness of fit of the final model was checked using the Hosmer and Lemeshow test of best fit with a large p value = 0.97 and Area under receiver operating characteristics curve = 0.98. The overall prevalence of the current practice of toothbrushing among the respondents was 45.4%. The prevalence of brushing frequency was 243 (89.01%), 27 (9.89%), and 3 (1.09%) brushed once a day, twice a day, and more than twice a day respectively. Female child's [AOR 3.23, 95% CI 1.48–7.02], mothers' education [AOR 4.6; 95% CI 1.22–17.44], past experience of toothbrushing [AOR 0.042; CI 0.018–0.101], knowledge about tooth brushing practices [AOR 1.3; 95% CI 1.09–1.60], behavioral intention [AOR 2.01; 95% CI 1.74–2.32], experiential attitude [AOR 1.09; 95% CI 1.01–1.17],instrumental attitude [AOR 1.02; 95% CI 1.01–1.03], and descriptive norm [AOR 1.07; 95% CI 1.01–1.14] were predictors of toothbrushing practices. The findings indicate that the practice of toothbrushing practices among primary school students was low. Sex, mother's education, knowledge, intention, experience, experiential attitude, instrumental attitude, and descriptive norm, have significant effects on toothbrushing practices; indicating that the integrated behavioral model showed adequate utility in predicting toothbrushing practices in the study area. School-based toothbrushing practices change interventions such as communication strategy.