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Background Perceptions of insufficient breast milk quantity and the use of some traditional food items and local herbs to increase it are a common phenomenon worldwide, particularly in low-resource countries like Ethiopia. But the food items and herbs used are variable and inconsistent in different areas. So far, studies are scarce nationally and in the study area, and therefore, this study was aimed at assessing the use of traditional food items and local herbs for the perceived benefit of breast milk increment and its associated factors. Methodology : A community-based mixed study was conducted from October 01–30, 2022 in the Dire Dawa administration, eastern Ethiopia. A systematic random sampling technique was used to select 722 participants for the quantitative study and purposive sampling for the qualitative study. Data were collected through face-to-face interviews using a pre-tested structured questionnaire and semi-structured questions for focus group discussion. Quantitative data were entered and cleaned by Epi DATA (Version 3.1) and analyzed using SPSS (Version 22). A P-value

Background: Indigenous herbal medicine use during pregnancy is a common phenomenon worldwide, particularly in low resource countries like Ethiopia, mainly due to their cost, perceived efficiency in treatment, and ease of access. But so far, studies across Ethiopia are variable and inconsistent and in the study area. Therefore, this study was aimed at assessing indigenous herbal medicine use and its associated factors among pregnant women. Methods: A facility-based cross-sectional study was conducted in public health facilities in the Dire Dawa Administration, eastern Ethiopia, from October 10 to November 10, 2022, among pregnant women selected using a simple random sampling technique. Data were collected through face-to-face interviews using a pre-tested structured questionnaire, and data were entered and cleaned by Epi DATA (Version 3.1) and analyzed using SPSS (Version 22). A P-value < 0.25 at bivariate to select variables for multivariate and ≤ 0.05 at multivariate with 95% confidence intervals was considered statistically significant. Results: A total of 628 participants were included, yielding a response rate of 95.15 %. During their current pregnancy, 47.8% (95% CI: 43.8–51.6%) pregnant women used indigenous herbal medicine(IHMs). The predictors were education level: no formal education (AOR: 5.47, 95%CI: 2.40-12.46), primary level (AOR: 4.74, 95%CI: 2.15-10.44), rural residence (AOR: 2.54, 95%CI: 1.71-3.77), being a housewife (AOR: 4.15, 95%CI: 1.83-9.37), number of antenatal care visits (AOR: 2.58, 95%CI: 1.27-5.25), and knowledge of IHMs (AOR: 4.58, 95% CI: 3.02-6.97). Conclusion: The use of indigenous herbal medicine during pregnancy was as common and widespread as other research done in different areas. The predictors were residence, education level, occupation, number of antenatal care visits, and knowledge. The most commonly used herbal medicines were Lepidium sativum, Vernonia amygdalina, Moringa oleifera, Linum usitatissimum, Zingiber officinale, Eucalyptusglobulus, and Trigonella foenum-graecum. The most common indications were related to gastro-intestinal problems: intestinal parasites, nausea and vomiting, constipation, stomach aches, indigestion, and abdominal cramps. It was recommended that, considering their residence and education level, pregnant women during their ANC visits be made aware of the potential benefits and risks of indigenous herbal medicine, and that more research be conducted to confirm their efficacy and safety during pregnancy.

Background The highest rate of preterm birth in the world is in Sub-Saharan Africa and Asia. However, there is limited data in this study area. Therefore, this study aims to assess the prevalence and associated factors of preterm birth in Dire Dawa City, Eastern Ethiopia. Method An institutional-based, cross-sectional study was conducted with 420 respondents. Conclusion Preterm birth is still a major public health problem in Dire Dawa City.

Background: Premature rupture of membranes is the spontaneous leakage of amniotic fluid from the amniotic sac that occurs at least one hour before the onset of labor. It is a common complication of pregnancy that leads to neonatal and maternal morbidity and mortality. There is little evidence of the prevalence and associated factors among pregnant women admitted to the obstetrics ward in the study area..Objective: To assess the prevalence and associated factors among pregnant women admitted to Dire Dawa hospitals in eastern Ethiopia.Method: A facility-based cross-sectional study was conducted from May 17 to June 17, 2021. A systematic random sampling technique was used to select 392 pregnant women admitted to an obstetric ward. Data was collected using an interviewer-administered questionnaire and checklist to obtain data from the medical record. Data was collected with Kobo tool software and exported to SPSS version 24. The crude odds ratio and the AOR with 95% CI were calculated to assess the association among variables and control the confounding factors. The level of significance was declared at a p-value < 0.05. Result: All 392 (100%) pregnant women were included in the study. The prevalence of PROM was found to be 22.4%. Pregnant women who had a history of previous preterm labor (AOR = 2.449, 95% CI: 1.422, 4.217), history of PROM (AOR = 2.663, 95% CI: 1.567, 4.526), history of anemia (AOR = 2.497, 95% CI: 1.371, 4.550), history of UTI (AOR = 2.715, 95% CI: 1.575, 4.679) and history of chewing khat (AOR = 1.936, 95% CI: 1.055, 3.552) were significantly associated with pre-labor rupture of membrane.Conclusion: The prevalence of pre-labor rupture of membranes in the study was high when compared to previous studies. An intervention that focuses on strengthening the integration of messages on health promotion and disease prevention, routine early screening, diagnosis and quick treatments of UTI and anemia, nutritional counseling, iron supplementation, and giving information regarding substance use during pregnancy should be recommended.

Bezabih Amsalu,1 Alemu Guta,1 Zinabie Seyoum,2 Nigus Kassie,1 Alekaw Sema,1 Wondifraw Dejene,2 Yitagesu Fikadu Woldemedhen,2 Mekdes Kasahun,2 Yitagesu Sintayehu,1 Yalelet Belay1 1College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia; 2College of Social Science and Humanities, Dire Dawa University, Dire Dawa, EthiopiaCorrespondence: Alemu Guta Tel +251920470061Email chelsea0061@gmail.comIntroduction: COVID-19 is a current health concern in the world. People applying the prevention methods of COVID-19 are vital determinants of curbing the spread of the coronavirus. This study aimed to assess the practices and associated factors of the COVID-19 preventive measures among Dire Dawa residents.Methods: A community-based, cross-sectional mixed method was used. We conducted the study between June 15th and July 15th, 2020. The subjects of the study were selected by using systematic random sampling. We collected data through face-to-face and in-depth interviews. Both bivariate and multiple logistic regression were employed to determine the predictor variables with the practice of COVID-19 prevention measures. Thematic content analysis analyzed qualitative data.Results: The practice of COVID-19 preventive measures was 40.7% (95% CI: 37– 44.4%). Being female [AOR= 1.8; 95% CI: 1.17– 2.72], married [AOR=2.75; 95% CI: 1.68– 4.48], family income > 10,000 Ethiopia birr [AOR=7.3; 95% CI: 3.8– 13.9], having history of a chronic disease [AOR=3.46 (1.69, 7.08)], not chewing khat [AOR= 2.15; 95% CI: 1.1– 4.2], had a good knowledge about COVID-19 [AOR=5.23; 95% CI: 3– 9], and had a favorable attitude about COVID-19 [AOR=3.87; 95% CI: 2.4– 6.14] were significantly associated with practice of COVID-19 preventive measures. The qualitative result revealed the communities are not willingly practicing prevention measures because of carelessness and ignorant of the consequences of COVID-19, and some communities believed that COVID-19 is not a real pandemic rather government uses it merely to gain political profit.Conclusion: The proportion of practice of COVID-19 preventive measures was low. Sex, marital status, income, history of chronic disease, history of khat chewing, knowledge, and attitude about COVID-19 were associated factors with COVID-19 preventive practices. The communities were not practicing the COVID-19 prevention method because of poor knowledge and a negative attitude.Keywords: COVID-19, practice, preventive measures, Dire Dawa, Ethiopia

Alemu Guta,1 Alekaw Sema,1 Bezabih Amsalu,1 Yitagesu Sintayehu2 1Department of Midwifery, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia; 2School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, EthiopiaCorrespondence: Yitagesu Sintayehu Tel +251913276896Email Yitagesu.sintayehu@gmail.comIntroduction: Neonatal mortality is one of the challenging issues in current global health. Globally, about 2.5 million children die in the first month of life, out of which Sub-Saharan Africa accounts > 40% per annual. Currently, the neonatal mortality rate in Ethiopia is 30/1000 live births. In the study area, there was a limitation of data on mothers’ knowledge towards neonatal danger signs. Therefore, this study aimed to assess mothers’ knowledge of neonatal danger signs and associated factors.Patients and Methods: A community-based cross-sectional design study was conducted in Dire Dawa from March 01/2019 to April 30/2019. Data were collected from 699 randomly selected mothers through a face-to-face interview. Bivariate logistic regression with p-value < 0.25 was entered into the multivariable logistic regression analysis. Finally, AOR with 95% confidence intervals at P-value < 0.05 was considered a significant association with the outcome variable.Results: About 285 (40.8%) (95% CI: 37.3– 44.3) of mothers had good knowledge of neonatal danger signs, and 97.1% (95% CI: 94.1, 99.3) of mothers sought medical care at a health facility. Mothers who were governmental employed (AOR = 2.14, 95% CI: 1.17– 3.9), whose fathers’ educational level is secondary or above (AOR=2.3, 95% CI: 1.18– 4.49), four/more antenatal care visit (AOR=4.3, 95% CI: 1.5– 12.3), whose baby developed danger signs (AOR=3.5, 95% CI: 2.13– 5.73), and those mothers received education on neonatal danger sign (AOR=7, 95% CI: 4.2– 11.5), had a significant association with knowledge of neonatal danger signs.Conclusion: Maternal knowledge toward neonatal danger signs was low and a high number of mothers sought medical care at a health facility. Mother’s occupation, fathers’ education, development of neonatal danger signs, frequency of antenatal care visit, and received health education on neonatal danger signs were factors associated with mothers’ knowledge towards neonatal danger signs.Keywords: neonatal danger signs, knowledge, healthcare-seeking, Dire Dawa

Mickiale Hailu,1 Mengstu Welday,2 Abera Haftu,2 Daniel Tadesse,1 Taddese Weldeamanel,1 Bezabih Amsalu,1 Alemu Guta,1 Nigus Kassie,1 Alekaw Sema,1 Aminu Mohammed,1 Neil Abdurashid,1 Yonatan Solomon,1 Feyso Bati,1 Meklit Girma,2 Yitagesu Sintayehu,1 Yalelet Belay,1 Sewmehon Amsalu1 1Midwifery Department, Dire Dawa University, Dire Dawa, Ethiopia; 2College of Health Sciences, Department of Midwifery, Mekelle University, Mekelle, EthiopiaCorrespondence: Daniel Tadesse Email danitaddese@gmail.com; daniel.tadesse@ddu.edu.etBackground: Competence is defined as the ability to perform a task with desirable outcomes. Globally, an estimated 530,000 women and 2 million newborns die each year, because of no access to competent health professionals. But half of those deaths can be prevented with competent health professionals. However, the existing literature shows that most new graduates have a lack of competence in the clinical environment, none of them have assessed whether student or preceptor factors have an association with clinical competence or not. So, this study is crucial to fill data scarcity.Objective: To determine the clinical practice competence and associated factors among midwifery and nursing students at Dire Dawa.Methods: Institutional cross-sectional study was conducted on nursing and midwifery students from February 10/2020 to February 30/2020. Self-administered questionnaires were given to 318 students through a simple random lottery. Multivariate logistic regression analysis was done for variables with a p-value < 0.2 in binary logistic regression. The odds ratio was used to measure the degree of association.Results: Only 19.2% are clinically competent. Students who were oriented about assessment methods were 4 times more likely competent [AOR = 4.096 p-value 0.035]. Students who have staff encouragement and have preceptors were 5 times [AOR = 4.900 p-value 0.12] and 11 times [AOR = 11.052 p-value 0.00] more likely competent, respectively. Confident students were 4 times more likely competent [AOR = 4.460, p-value 0.005].Conclusion: The prevalence of clinical competence is very minimal. This is due to assessment methods orientation, staff encouragement, clinical preceptor support and students’ confidence. This finding contributes to the federal ministry of health should work closely with teaching institutions, health facilities, and other stakeholders to overcome those gaps.Keywords: competence, clinical practice, clinical practice competence

Introduction The neonatal near-miss cases are subject to factors that are major causes of early neonatal deaths. For every death, more newborns suffer a life-threatening complication. Nearly 98% of neonatal death unduly existed in developing countries. Though there were few prior studies in other regions, they failed in identifying the factors of NNM. Besides, there has been no prior study in the study area. Therefore, this study aimed to assess factors associated with neonatal near-miss. Methods A case-control study was employed on a total of 252 cases and 756 controls using a systematic random sampling technique. Data were collected using pre-tested and interview administered questionnaires adapted from similar studies and medical records from December 2020 –March 2021. Pragmatic and management criteria definition of neonatal near miss were utilized. Epi-Data version 3.1 and SPSS version 23 were used for data entry and analysis respectively. Bivariable and multivariable analyses were done to identify factors associated with a neonatal near-miss by using COR and AOR with a 95% confidence interval. Finally, the statistical significance was declared at a p-value < 0.05. Results There were a response rate of 100% for both cases, and controls. Factors that affects neonatal near miss were non-governmental/private employee (AOR, 1.72[95%CI: 1.037, 2.859]), referral in (AOR, 1.51[95%CI: 1.079, 2.108]), multiple birth (AOR, 2.50[95%CI: 1.387, 4.501]), instrumental assisted delivery (AOR, 4.11[95%CI: 1.681, 10.034]), hypertensive during pregnancy (AOR, 3.32[95%CI: 1.987, 5.530]), and male neonates (AOR, 1.71[95%CI: 1.230, 2.373]), paternal education of secondary school (AOR, 0.43[95%CI: 0.210, 0.868]) and college/above (AOR, 0.25[95%CI: 0.109, 0.578]), monthly income (1500–3500 birr) (AOR, 0.29[95%CI: 0.105, 0.809]) and >3500 birr (AOR, 0.34[95%CI: 0.124, 0.906]). Conclusion Maternal occupation, paternal education, income, referral, multiple births, mode of delivery, hypertension during pregnancy, and sex of the neonate have identified factors with neonatal near-miss. Better to create job opportunities, improving education, and income generation. Counseling on multiple birth and hypertension, and minimizing instrumental delivery should be done at the health facility level.

Introduction Neonatal mortality is one of the challenging issues in current global health. Globally, about 2.5 million children die in the first month of life, out of which Sub-Saharan Africa accounts >40% per annual. Currently, the neonatal mortality rate in Ethiopia is 30/1000 live births. In the study area, there was a limitation of data on mothers’ knowledge towards neonatal danger signs. Therefore, this study aimed to assess mothers’ knowledge of neonatal danger signs and associated factors. Patients and Methods A community-based cross-sectional design study was conducted in Dire Dawa from March 01/2019 to April 30/2019. Data were collected from 699 randomly selected mothers through a face-to-face interview. Bivariate logistic regression with p-value