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Introduction: Balance impairment is one of the common impairments in patients after stroke. It can lead to depression reduced speed of mobility, dependent on assistive device and reduce quality of life. However, evidence on balance impairment and its risk factors among stroke survivors in Ethiopia was lacking particularly in the study area. Therefore, this study aimed to investigate prevalence and associated factors of balance impairment among stroke survivor's attendee at an outpatient clinic in Amara regional state comprehensive specialized hospital., Methods: An institutional based cross-sectional study was conducted from April1-June 30, 2022. A total of 400 participants were selected using the systematic random sampling technique. Standard Berg balance scale tool and semi-structure questionnaire was used. Multicollinearity and model fitness were checked. Variables with a p-value of less than 0.25 in the Bivariable regression were entered into a multivariable logistic regression and p value < 0.05 was used as cutoff point for significant variables., Result: The prevalence of balance impairment was 51.5% (95% CI (46.58, 56.39). Being depressed (AOR = 12.25:95% CI (4.727, 31.779), using walking aids (AOR = 8.76:95%CI3.469, 22.117)), abnormal speed (AOR = 6.73:95%CI (2.671, 16.977)), did not have physiotherapy treatment (AOR = 3.96:95%CI (1.483, 10.586), and unmarried (AOR = 2.71, 95% CI = 1.061, 6.903) were significantly associated with balance impairment., Conclusion and Recommendation: The prevalence of balance impairment in the study was high. Being depressed, use walking aids, did not have physiotherapy treatment, abnormal speed of mobility, and unmarried were significantly associated factors. Therefore; it is better to give greater emphasis for those factors., (© 2024. The Author(s).)

Introduction: Decisions made at the household level have great impact on the welfare of the individual, the local community, as well as the welfare of the nation. Women's independent decision on reproductive health increases women's access to health information and utilization of reproductive services. This has great impact on maternal and child health outcomes. However, women in developing or low-income countries often have limited autonomy and control over their household decisions. Therefore the main purpose of this research project is to investigate the potential determinants of rural women's household decision making autonomy., Methods: A multi level analysis was performed using the fourth Ethiopian Demographic and Health Survey (EDHS) 2016 data set. A weighted sample of 8,565 married rural women was included in the final analysis. Women were considered to be autonomous if they made decisions alone or jointly with their husband in all three household decision components. It was dichotomized as yes = 1 and no = 0. Multico linearity and chi-square tests were checked and variables which did not fulfill the assumptions were excluded from the analysis. Four models were fitted. Variables with p-value ≤ 0.25 in the bi-variable multilevel logistic regression were included in the multivariable multilevel logistic regression. The Adjusted Odds Ratio (AOR) with a 95% confidence interval (95% CI) was computed. Variables with a P-value of less than 0.05 in the multi-variable multilevel logistic regression were declared as statistically significant predictors., Result: A total of 8,565 weighted participants involved. From the total respondents, 68.55% (CI: 67.5%, 69.5%) of women had decision making autonomy. wealth index (poor: AOR: 0.84; 95% CI: 0.72, 0.97 and middle: AOR: 0.85; 95% CI 0.73, 0.98), literacy (illiterate: AOR: 0.75; 95% CI: 0.66, 0.86), respondents working status (Not working; AOR 0.68; 95% CI; 0.60, 0.76) ,who decides on marriage (parents: AOR 0.76; 95% CI; 0.67, 0.87), and proportion of early marriage in the community (high proportion of early marriage AOR: 1.35; 95% CI; 1.10, 1.72)., Conclusion: Women decision making autonomy was significantly determined by women economic participation (their wealth and their working status), women's literacy, proportion of early marriage in the community and women's involvement in decision of their marriage. Improving women's economic participation and enhancing women's participation to decide on their marriage will enhance women's decision making autonomy., (© 2024. The Author(s).)

Common mental disorders (CMDs) are a wide term that includes disorders like depression, anxiety, and somatic manifestations. Chronic kidney disease (CKD) patients are at high risk of developing a common mental disorders, which leads to a lower survival rate, poor clinical outcome, longer hospitalization, increased health-care utilization, difficulty adhering to medications, an increased risk of initiation of dialysis, poor quality of life, and an increased risk of mortality. However, there is limited study done related to common mental disorders and associated factors among chronic kidney disease patients in Ethiopia. This study aimed to assess the prevalence of common mental disorders and associated factors among chronic kidney disease patients attending referral hospitals in Amhara Regional State. An institution-based cross-sectional study design was conducted at the University of Gondar Comprehensive Specialized and Felege Hiwot Referral Hospitals from January to April 2020. The study participants were selected using systematic random sampling techniques. Common mental disorders were assessed using the Self-Reporting Questionnaire-Falk Institute (SRQ-F) tool. Data were entered into Epi Data Version 3.0 then exported into STATA 14 for analysis. Both bivariable and multi-variable binary logistic regressions were done to identify factors associated with common mental disorders. In multivariable logistic regression analysis, variables with a p-value of ≤ 0.05 were declared as a statistically associated with common mental disorders. In this study, 424 CKD patients were included, with a response rate of 100%. Among screened CKD patients, 40.8% was positive for common mental disorders, with a 95% CI (36-45%). Independent predictors of common mental disorders among CKD patients were poor social support [(AOR 3.1, 95% CI (1.67-5.77)], family history of mental disorders, [AOR 3.6, 95% CI (1.12-11.8)], comorbidity [AOR 1.7, 95% CI (1.03-2.78)], being female [AOR 2.69, 95% CI (1.72-4.20)], and duration of CKD (AOR 3.5; 95% CI (2.28-5.54). Two out of five CKD patients screened for CMDs were found to be positive. Common mental disorders were more common among CKD patients with poor social support, a family history of mental disorders, comorbidity, being female, and the duration of CKD. Therefore, screening CKD patients for common mental disorders is recommended., (© 2024. The Author(s).)

Background: The institutional delivery dropout (IDD) is a major problem that disproportionately affects low- and middle-income countries (LMICs). It is associated with increased risks of adverse birth outcomes among pregnant women. Hence, this study assessed the pooled estimate and determinants of IDD after antenatal care (ANC) visit among women in LMICs., Method: The Demographic and Health Survey (DHS) data from 29 LMICs were used for this study. Data analysis was performed with STATA version 14. The forest plot was used to estimate the pooled prevalence of IDD. Multilevel binary logistic regression was fitted to identify determinants of IDD. The statistical significance level between the outcome and independent variables was determined through the adjusted odds ratio (AOR) with 95% CI and p-value less than 0.05., Result: The pooled prevalence of IDD after ANC booking among reproductive age women in LMICs was 22.25% (95%CI: 18.25, 26.25). Additionally, the prevalence of IDD was highest (29.83%) among women from the South and Central Europe and the Caribbean countries and lowest (13.72%) in Central/Western Asia and the Oceania. In the multilevel analysis; no education (AOR = 2.92; 95% CI: 2.72, 3.13), poorest wealth index (AOR = 3.46; 95% CI: 3.28, 3.66), inadequate ANC visits (AOR = 1.73; 95% CI: 1.39, 1.77), no media exposure (AOR = 1.27; 95% CI: 1.23, 1.30), rural (AOR = 1.50; 95% CI: 1.43, 1.54), distance a big problem (AOR = 1.28; 95% CI: 1.25, 1.31), and women located in the South/Eastern Europe and Caribbean region 6.67 (AOR = 6.67; 95% CI: 6.20, 7.20), women lived in low-income countries 7.05 (AOR = 7.05; 95% CI: 6.57, 7.56), and women from lower middle-income countries 5.34 (AOR = 5.57; 95% CI: 4.93, 5.78), had increased odds of IDD after ANC among women in LMICs. However, women who had ever born one child (AOR = 0.29; 95% CI: 0.28, 0.31), and women from Central and Western Asia and the Oceania (AOR = 0.78; 95%CI: 0.74, 0.82) had decreased odds of IDD., Conclusion: The IDD was high among women in LMICs and significantly increased among women with no education, from poorest household, had inadequate ANC visit, no media exposure, rural, distance a big problem. Hence, interventions to reduce IDD should focus on addressing the gaps related to maternal education, access to media, and number of ANC visits among women in LMICs., (© 2023. The Author(s).)

Introduction: The majority of maternal and newborn deaths take place during the first few hours and days after birth and thus postnatal contacts should begin as early as possible, especially within the first 24 h, then again within two to three days after delivery. Globally, early postnatal discharge has increased over the past 50 years and currently too. Even if Ethiopia has very low PNC coverage, there is no evidence on who is discharged early. Hence, the aim of this study was to determine the magnitude and the predictors for early postnatal discharge in Ethiopia., Methods: This study was based on the secondary data analysis using the Ethiopian Demographic and Health survey (EDHS) 2016 data set. The weighted sample of 2,225 delivered mothers were included for the final analysis. The model was best fitted as assessed by Hosmer-Lemeshow test (p value = 0.1988). The variables with P-value ≤ 0.2 in the bi- variable binary logistic regression analysis were included in to the multi-variable binary logistic regression analysis. The Adjusted Odds Ratio (AOR) with 95% confidence interval (95% CI) was computed to assess the strength of association between the outcome and independent variables. The variables with a P-value of less than 0.05 in the multi-variable binary logistic regression analysis were declared as statistically significant predictors of the outcome variable., Result: The overall magnitude of early discharge was 70.41% (CI: 68.48, 72.30). Residence (rural; AOR: 0.61, 95% CI: 0.46, 0.80), educational status (No education; AOR: 1.87, 95% CI: 1.19, 2.94), religion (Muslim; AOR: 0.69, 95% CI: 0.55, 0.87, Others; AOR: 0.24, 95% CI: 0.10, 0.57), wealth index (Poor; AOR: 0.77; 95% CI: 0.59, 0.99), marital status (Not married; AOR: 0.29; 95% CI: 0.13, 0.67), ANC visits (No ANC visits; AOR: 0.63; 95% CI: 0.46,0.86), parity (3rd parity; AOR: 1.48; 95% CI: 1.03, 2.11), and size of the child (larger size; AOR: 0.63;95% CI: 0.50,0.79, (smaller size; AOR: 0.72; 95% CI: 0.56,0.92) were independent determinants of early discharge., Conclusion: A substantial proportions of mothers in Ethiopia had been discharged early (before 24 h). Residence, education, wealth index, religion, marital status, ANC follow up, parity and size of the child were predictors of early discharge. Adequate hospital stay should be promoted. Since the early discharge in Ethiopia is very high, home based postnatal visit should be strengthened focusing the identified predictors., (© 2023. The Author(s).)

Introduction: Contraception is the most effective method of preventing unwanted pregnancies and their associated disadvantages. It is critical to recognize one's desire to utilize contraceptives before drafting and implementing a good family planning program, especially in developing nations like Ethiopia., Objective: This study aimed to identify the geospatial variations and determinants affecting the utilization of contraceptives among married reproductive age women in Ethiopia., Method: This study was based on an extensive national survey, the Ethiopian Demographic and Health Survey. A total weighted sample of 5,743 married reproductive-age women was included. Because of the hierarchical nature of the DHS data, a spatial analysis multilevel logistic regression model was used to study individual and community-level factors that may influence contraceptives. The Bernoulli model was used by applying Kulldorff methods using the SaTScan software to analyze the purely spatial clusters of contraceptive usage. ArcGIS version 10.3 was used to visualize the distribution of contraceptives. A 95% confidence interval and a p -value of less than 0.05 were used to declare statistical significance., Result: The overall utilization of contraceptives was discovered at 41.25% (39.98, 42.53). Participants age range of 25-34 years [AOR = 0.80, CI: (0.66, 0.96,)] and 35-49 years [AOR = 0.50, CI 95%:(0.66, 0.96)] times less likely to use contraceptives than 15-24 years old respectively. Having primary [AOR = 1.47, CI 95%: (1.25, 1.73)], secondary [AOR = 1.42, CI 95%: (1.09, 1.83)] and higher education level [AOR = 1.92, CI 95%: (1.41, 2.60)], middle wealth [AOR = 1.48, CI 95%: (1.14, 1.90)], richer [AOR = 1.41, CI 95%: (1.07, 1.86)] and richest [AOR = 2.17, CI 95%: (1.52, 3.11)], having 1-4 ANC follow up have [AOR = 1.60, CI 95%: (1.26, 2.03)], gave birth at age of 35-44 [AOR = 0.29, CI 95%: (0.22, 0.37)], having 3-5 children [AOR = 1.26, CI 95%: (1.03, 1.52)], being from community of high level women education [AOR = 1.61, CI 95%: (1.21, 2.15)] were associated positively. Participants from Amhara, Oromia, Benishangul and SNNPR regions have revealed [AOR = 2.40, CI 95%: (1.53, 3.77)], [AOR = 1.64, CI 95%: (1.05, 2.56)], [AOR = 1.62, CI 95%: (1.01, 2.62)] and [AOR = 2.04, CI 95: (1.31, 3.19)], in contrast, Somali and Afar regions have shown [AOR = 011, CI 95%: (0.05, 0.22)] and [AOR = 0.31, CI 95%: (0.18, 0.54)] times less likely to use contraceptive services than Tigray Region respectively. The spatial analysis of contraceptive usage discovered that the northern, central and southern parts of the country had higher utilization of contraceptives than the eastern and northeastern of the country., Conclusion: The study revealed that contraceptive usage among married women is comparatively low, with wide regional variation. Raising awareness among mothers about the importance of antenatal care and assisting mothers who are financially disadvantaged or do not have access to health facilities will aid in providing better family planning services. Improving contraceptive information dissemination at community and regional levels is key to averting potential barriers., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Terefe, Getnet, Akalu, Belsti, Diress, Gela, Getahun, Bitew and Belay.)

Anemia is a risk factor for adverse cardiovascular disease outcomes in hypertensive patients. Chronic anemia increases preload, reduces afterload, and leads to increased cardiac output in hypertension patients. In the long term, this may result in maladaptive left ventricular hypertrophy, which in turn is a well-recognized risk factor for cardiovascular disease outcomes and all-cause mortality in hypertension. Low hemoglobin and hematocrit levels might be strongly indicate hypertensive end-organ damage, specifically kidney failure. Therefore, this study determined the prevalence of anemia and associated factors among hypertensive patients in Referral Hospitals, Amhara Regional State, Ethiopia, in 2020. An institution-based cross-sectional study was conducted in Amhara Regional Referral Hospitals from February 20 to April 30, 2020. Random and systemic sampling techniques were used to select 428 study participants. Data were entered and coded in to Epi data version 3.0 and then exported into STATA 14 for analysis. In bivariable logistic regression, variables with a p-value of < 0.25 were included in multivariable logistic regression. Using a 95% confidence interval, variables having a p-value ≤ 0.05 in multivariable logistic regression were declared as statistically significant variables. In this study, a total of 428 study participants were involved with 99.5% response rate. The prevalence of anemia among hypertensive patients was 17.6%, with a 95% CI (14.3-21.5%). Estimated glomerular filtration rate (eGFR) < 90 ml/min (AOR = 2.77, 95% CI 1.56- 4.92)], duration of hypertension (HTN) ≥ 5 years (AOR = 2.37, 95% CI 1.36-4.15), uncontrolled blood pressure (AOR = 1.91, 95% CI 1.08-3.35), and higher pulse pressure (AOR = 1.05 (95% CI 1.02-1.08) were significantly associated with anemia. Nearly one out of five hypertensive patients had anemia. Impaired estimated glomerular filtration rate, duration of HTN, blood pressure status, and pulse pressure were the independent predictors of anemia among hypertensive patients. Screening hemoglobin level at a regular interval is recommended for the hypertensive patients to take an appropriate intervention., (© 2023. Springer Nature Limited.)

Introduction: Women's strong decision-making abilities are essential to reducing maternal mortality rates. Because women's involvement in decision-making would increase uptake for healthcare services like maternal healthcare, which includes prenatal care (ANC), postnatal care (PNC), and facility delivery. Studies have revealed that women's decision-making autonomy is low, particularly in underdeveloped nations like Ethiopia. Investigating potential factors that may influence women's participation in household decision-making is the primary goal of this study project., Methods: Secondary data analysis was carried out using data from the 2016 Ethiopian Demographic and Health Survey (EDHS). For the final analysis we used a weighted sample of 10,223 currently married women. All the frequencies and the percentages in the result section are weighted. The model's fitness was assessed using the Hosmer-Lemeshow test. It is the best fit (p value = 0.19). Variables with p values ≤ 0.2 in the bi-variable binary logistic regression analysis were included in the multivariable binary logistic regression analysis. The Adjusted Odds Ratio (AOR) with 95% confidence interval (95% CI) was computed. Variables with a P -value of less than 0.05 in the multi variable binary logistic regression analysis were declared as statistically significant predictors of the outcome variable., Result: The overall magnitude of women's participation in decision making among was 70.55% (CI: 69.65, 71.42). Residence (rural; AOR: 0.83, 95% CI: 0.70, 0.980), educational status (None educated; AOR: 0.43, 95% CI: 0.30, 0.62, primary education AOR: 0.49, 95% CI: 0.34, 0.69), religion (protestant AOR: 0.72, 95% CI: 0.64, 0.81), Muslim; AOR: 0.87, 95% CI: 0.78, 0.96, Others; AOR: 0.66, 95% CI: 0.50, 0.87), wealth index (poor; AOR: 0.70, 95% CI: 0.63, 0.79, middle; AOR: 0.75, 95% CI: 0.66, 0.85), working status (Not working; AOR: 0.73, 95% CI: 0.66, 0.80), husband working status (husband not working; AOR:1.69, 95% CI: 1.43, 2.0) and sex of household head (female heads; AOR: 1.29, 95% CI: 1.08, 1.54) were statistically significant factors., Conclusion: Generally women's participation in household decision making in our study was high (70.55%). It is highly affected by socio demographic and economic characteristics of women and husbands characteristics. This study indicates that educating women, improving their economic status through employment opportunities, empowering women to be head of household will enhance their participation on household decision making., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Author(s).)

Background: Due to additional roles and emotional changes that occur during postpartum period, women use contraceptives differs from other times in their life. However, there is limited information about the unmet need for family planning (FP) among women in the extended postpartum period in the study area. Therefore, this study aimed to assess magnitude of unmet need for family planning and associated factors among women in the extended postpartum period in Dabat district, Northwest Ethiopia., Methods: A secondary data analysis was performed using the Dabat Demographic and Health Survey 2021. A total sample of 634 women during the extended postpartum period was included in this study. Stata version 14 statistical software was used for data analysis. Descriptive statistics were described using frequencies, percentages, mean, and standard deviation. Multicollinearity was tested using the variance inflation factor (VIF) and we computed Hosmer and Lemeshow goodness of fit. Both bivariable and multivariable logistic regression analyses were carried out to determine the association between independent variables and outcome variable. Statistical significance was declared at a p-value ≤ 0.05 with a corresponding 95% confidence interval., Results: The overall unmet need for FP during the extended postpartum women was 42.43% (95% CI: 38.62, 46.33), of which 33.44% was unmet need for spacing. Place of residence (AOR = 2.63, 95%CI: 1.61, 4.33), place of delivery (AOR = 2.09, 95%CI: 1.35, 3.24), and availability of radio and or TV (AOR = 1.58, 95% CI: 1.22, 2.13) were significantly associated with unmet need for family planning., Conclusion: The magnitude of unmet need for family planning among women during the extended postpartum period in the study area was high when compared to the national average and the United Nations sphere standard of unmet need for family planning. Place of residence, place of delivery, and availability of radio and or TV were significantly associated with unmet need for family planning. Hence, the concerned bodies are recommended to promote intuitional delivery and give spatial attention to those who are residing in rural areas and to those who have had no media exposure in order to reduce the unmet need for family planning among postpartum women., (© 2023. The Author(s).)

Introduction: Birth interval is the time period from live birth to a successive pregnancy or successive live birth which is the recommended to be at least 2 years or at least 33 months respectively. Both short and long birth intervals are associated with poor health outcomes for both mothers and babies. Therefore, the main objective of this study is to assess the length of birth intervals and its predictors among reproductive-age women in Dabat district.Methods: community-based cross-sectional survey conducted from December 10/2020 to January 10/2021. This study was done on 1262 multi para women. Five days training was given for the data collectors and supervisors. Bivariable and multivariable ordinal logistic regression analysis were done. Those variables which had P -value less than 0.25 in the bi variable analysis were entered to multivariable ordinal logistic regression analysis. An adjusted odds ratio with a 95% confidence interval and P -value less than 0.05 was used to determine significant determinants of birth interval., Result: This study revealed that the magnitude of short and long birth interval was 30.59% and 22.82% respectively. Wealth status (poor: AOR = 0.72, CI: 0.53, 0.97), maternal education (Diploma and above: AOR = 2.79, CI: 1.18, 6.56), ANC follow up (having ante natal care: AOR = 2.15, CI: 1.72, 2.69), husband occupation (Employed: AOR = 1.77, CI: 1.03, 3.01) and history of abortion (abortion: AOR = 2.48, CI: 1.08, 5.66) were statistically significant factors., Conclusion: Higher percentage of mothers have either short or long birth interval. Birth interval is affected by socio demographic characteristics of mothers and husbands., Competing Interests: The authors have declared that no competing interests exist., (© 2023 The Authors.)

Background: A high fertility rate can have a number of expensive consequences for developing nations, such as limiting economic growth, adversely impacting women and their children's health, and reducing access to quality education, nutrition, and employment. The problem is more obvious in Ethipia's high fertility regions. Therefore, this study aimed to assess predictors of desire to limit childbearing among reproductive age women in high fertility regions in Ethiopia., Methods: The analysis was based on secondary data using the 2016 Ethiopian Demographic and Health Survey. Stata version 14 software was used for analysis. A multi-level mixed-effect logistic regression analysis was fitted. Adjusted Odds Ratio at 95% confidence interval was used to show the strength and direction of the association. Statistical significance was declared at a P- value less than 0.05., Results: The overall desire to limit childbearing in high fertility regions in Ethiopia was 37.7% (95% CI: 36.28, 39.17). Age; 25-34 (AOR = 3.74; 95% CI: 2.97, 4.73), 35-49 years (AOR = 14; 95% CI: 10.85, 18.06), women education; Primary education (AOR = 0.73; 95% CI: 0.61, 0.88), secondary and higher (AOR = 0.29; 95% CI: 0.19, 0.43), from the community level variables Oromia National Regional state (AOR = 5.86; 95% CI: 2.82, 12.23), high proportion of community level poverity (AOR = 0.67; 95% CI: 0.45, 0.98), and high proportion of community level media exposure (AOR = 1.53; 95% CI: 1.07, 2.19) were statistically significant factors for desire to limit childbearing in high fertility regions of Ethiopia., Conclusion: Nearly four in ten women had the desire to limit childbearing in high fertility regions in Ethiopia. Thus, to fulfill the women's desire to limit childbearing, Ministry of Health and health facilities are needed to increase financial support strategies and Family planning programs that enable pregnant women from poor households to use health services. In addition, increasing community level media exposure are important interventions., (© 2023. The Author(s).)

Background: Conflict-affected areas are considered to contribute a substantial proportion of worldwide maternal deaths. However, research on maternal health care in conflict-affected countries is very limited. In the absence of recent data, it is impossible to monitor progress made in mitigating the effect of conflict on maternal survival. As a result, this study targeted to assess institutional delivery services usage and influencing factors in a fragile and conflict-affected situation in Sekota town, Northern Ethiopia., Methods: A community-based cross-sectional study was employed among 420 mothers in Sekota town, Northern Ethiopia from July 15th to 30th, 2022. The desired sample size was determined using a single population proportion formula. The data were collected by using interviewer administered structured questionnaire; entered via EpiData version 4.6 and analyzed using SPSS version 25 software. To identify the associated factors, a bivariable and multivariable logistic regression model was applied. The level of significance was declared at a p-value of <0.05. An adjusted odds ratio with a 95% confidence interval was considered to see the strength of the association between dependent and independent variables., Results: Of the total respondent, 202 (48.1%), 95% CI: (43.0%, 53.0%) mothers utilized institutional delivery service. The use of institutional delivery services was associated with the maternal educational level of secondary school and above (AOR = 2.06, 95% CI: 1.08-3.93), antenatal care during the most recent pregnancy (AOR = 5.24, 95% CI: 3.01-9.11), being informed on birth preparedness and complication readiness (AOR = 1.93, 95% CI: 1.23-3.02) and displacement of the respondents from their usual place of residence due to conflict (AOR = 0.41, 95% CI: 0.21-0.68)., Conclusion: Institutional delivery service utilization was very low in the study setting. Healthcare for women in conflict-prone areas requires critical attention and should be given priority during the conflict. More prospective research is needed to fully understand and reduce the impact of conflict on maternal and neonatal health care., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors. Published by Elsevier Ltd.)

Introduction: Childhood immunization is one of the most cost-effective public health strategies to prevent children's mortality and morbidity from infectious diseases, but the Covid-19 pandemic and associated disruptions have strained health systems, and worldwide 25 million children missing out on vaccination in 2021. Of the 25 million, more than 60% of these children live in 10 countries including Ethiopia. Therefore, this study aimed to assess complete childhood vaccination coverage and associated factors in the Dabat district., Method: A community-based cross-sectional study was conducted from December 10/2020 to January 10/2021Gregorian Calendar. The data for this study was extracted from information collected for the assessment of maternal, Neonatal, and Child Health and health services utilization in the Dabat demographic and health survey site. Vaccine-related data were collected using an interviewer-administered questionnaire. An adjusted odds ratio with a 95% confidence interval was used to identify the presence and the direction of the association., Results: Based on vaccination cards and mothers/caretakers' recall 30.9% (95%CI: 27.9-34.1%) of children aged 12-23 months in the Dabat district were completely immunized. Urban residency [AOR 1.813, 95% CI: (1.143, 2.878)], delivered in the health facility [AOR = 5.925, 95% CI: (3.680, 9.540)], ANC follow-up during their pregnancy [AOR 2.023, 95% CI: (1.352, 3.027)], rich wealth index [AOR = 2.392, 95% CI: (1.296, 4.415)], and parity [AOR 2.737, 95% CI: (1.664, 4.500)] were significantly associated with complete child vaccination., Recommendation and Conclusion: Complete vaccination coverage among children aged 12-23 months in the Dabat district was lower than the Global vaccine plan and Ethiopian ministry of health goal in 2020. Therefore, Health care providers and other stakeholders should mobilize the community to improve mothers' health-seeking behavior toward pregnancy follow-up and health facility delivery to improve childhood vaccination. Besides, expanding the service to remote areas are necessary to increase the immunization access., (© 2023. The Author(s).)

Background: Globally, intimate partner violence (IPV) during pregnancy is the most common and major public health problem. It has a negative effect on the lives of both mother and fetus. Despite its prominence, many countries in East Africa have paid little attention to this issue. This study assessed the prevalence and associated factors of intimate partner violence among pregnant women in East African countries., Methods: The study adopted a secondary method data analysis that utilized recent Demographic and Health Surveys of 10 countries in East Africa between 2012 and 2018. A total of 23,521 women who gave birth in the 5 years preceding the survey were included. A multilevel mixed-effect logistic regression model was fitted to identify factors associated with IPV. Variables with a p-value < 0.05 were declared as significant factors associated with IPV., Results: The overall prevalence of IPV in East Africa was 37.14 (95% CI 36.53, 37.76). Women with age 25-34 (AOR = 1.20;95%CI; 1.06, 1.36), 35-39 (AOR = 1.40;95%CI; 1.24, 1.58), and 40-49 (AOR = 1.66;95%CI; 1.43, 1.95), women with no education (AOR = 1.27;95%CI; 1.16, 1.39), women with no occupation (AOR = 1.36; 95%CI; 1.27, 1.47), women from households with the poorest (AOR = 1.51; 95%CI: 1.33, 1.71), poorer (AOR = 1.40;95% CI:1.24, 1.58), middle (AOR = 1.32;95%CI:1.17, 1.48), and richer (AOR = 1.26;95%CI: 1.13, 1.40), husband drinks alcohol (AOR = 2.54; 95%CI 2.39, 2.71), ≥ 5 number of living children (AOR = 1.28; 95%CI: 1.31, 2.57) and rural areas (AOR = 1.14; 95%CI: 1.03, 1.25) were significantly associated with IPV., Conclusion: More than one-third of pregnant women experienced intimate partner violence in East Africa. Promoting the educational status of women, the economic capacity of women, and the healthy behavior of the husband by reducing alcohol consumption, with particular attention to rural women and violence during pregnancy, is vital to reduce the prevalence of IPV., (© 2023. The Author(s).)

Objective: This study is aimed to assess the magnitude of modern contraceptives utilisation and associated factors among reproductive age women in high fertility regions of Ethiopia., Design: Cross-sectional study., Setting: High fertility regions of Ethiopian., Participants: A total weighted sample of 3822 married reproductive age women., Methods: In this study, data were obtained from the recent Ethiopian Demographic and Health Surveys. A total weighted sample of 3822 women of reproductive age was included. A multilevel mixed-effect binary logistic regression model was fitted to identify the significant associated factors of modern contraceptive utilisation. Statistical significance was determined using adjusted OR (AOR) with 95% CI., Results: The overall modern contraceptive utilisation was 29.75% (95% CI 28.2% to 31.2%). Among the factors associated with utilisation were women's age 25-34 years (AOR 1.3; 95% CI 1.01 to 1.66) and ≥35 (AOR 1.71; 95% CI 1.37 to 2.70), husband's occupation (AOR 1.49; 95% CI 1.03 to 1.99), number of alive children: 1-4 (AOR 2.20; 95% CI 1.47 to 3.30), 5-8 (AOR 1.74; 95% CI 1.09 to 2.77), husband's desired number of children (AOR 0.77; 95% CI 0.61 to 0 .96), residency (AOR 2.37; 95% CI 1.20 to 4.67), community media exposure (AOR 1.77; 95% CI 1.01 to 3.08), region (AOR 0.13; 95% CI 0.03 to 0.52) and religion (AOR 0.49; 95% CI 0.36 to 0.66) were significantly associated with modern contraceptive utilisation., Conclusion: Modern contraceptives utilisation in high fertility regions of Ethiopia was low. Women age, husband occupation, number of living children, husband's desired number of children, residency, community media exposure, region and religion were significantly associated with modern contraceptive utilisation. Therefore, to improve the utilisation of modern contraceptives, public health policy makers should consider creating awareness through mass media, male involvement in family planning, as well as family planning programmes, should be encouraged in rural areas., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.)

Background: Iron-rich food consumption has an invaluable effect for neonatal and fetal brain development as well as metabolic activities. Despite the public health importance of the consumption of iron-rich foods, there was no study, that assessed iron-rich food consumption in Rwanda. Therefore this study aimed to assess iron-rich food consumption and associated factors among children aged 6-23 months using Rwanda Demographic and Health Survey (RDHS)., Methods: Secondary data analysis was done using RDHS-2019/20. Total weighted samples of 2455 children aged 6-23 months were included. Data coding, cleaning, and analysis were performed using Stata 16. Multilevel binary logistic regression were performed to identify factors associated with iron-rich food consumption. Adjusted Odds Ratio (AOR) with a 95% CI, and p-value <0.05 were used to declare statistical significance., Results: The prevalence of good iron-rich food consumption was 23.56%(95% CI: 21.92,25.28). Northern province of Rwanda (AOR  =  0.26,95%CI: 0.15,0.46), mothers secondary education and above (AOR: 2.37, 95% CI: 1.41, 4.01), married mothers (AOR:1.31, 95% CI: 1.01,1.71), rich wealth status (AOR = 2.06, 95% CI: 1.48, 2.86), having post-natal visit (AOR = 1.45, 95% CI: 1.10,1.91), mothers media exposure (AOR: 1.75, 95% CI: 1.22, 2.52) and drugs given for intestinal parasite (AOR = 1.37, 95% CI: 1.04, 1.80) were associated with iron-rich food consumption., Conclusions: This study shows that overall iron-rich foods consumption was low in Rwanda. The residing in the North province, mother's secondary and higher educational status, married marital status, rich and middle wealth status, having media exposure, drugs given for intestinal parasites, and having child's post-natal checkup were variables significantly associated with iron-rich food consumption. The region-based intervention will improve the consumption of iron-rich food. In addition, health policies and programs should target educating mothers/caregivers, encouraging parents to live together, improving their wealth status, working on mass media access by the women, and encouraging mothers post-natal checkups to improve iron-rich food consumption., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Eshetu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Although substantial progress has been made in reducing child mortality over the last three decades, the magnitude of the problem remains immense. Ethiopia is one of the countries with a high under-five mortality rate due to childhood illnesses including acute respiratory infections, diarrhea, and fever that varies from place to place. It is vital to have evidence of the factors associated with childhood illnesses and the spatial distribution across the country to prioritize and design targeted interventions. Thus, this study aimed to investigate the spatial cluster distribution and associated factors with common childhood illnesses. Secondary data analysis based on the 2016 Ethiopian Demographic and Health Survey data was carried out. A total weighted sample of 10,417 children was included. The study used ArcGIS and SaTScan software to explore spatial distribution. For associated factors, a multilevel binary logistic regression model was fitted using STATA V.14 software. Adjusted Odds Ratios (AOR) with a 95% Confidence Interval (CI) and p-value ≤ 0.05 in the multivariable model were used to declare significant factors associated with the problem. ICC, MOR, PCV, and deviance (-2LLR) were used to check model fitness and model comparison. In this study, the prevalence of common childhood illnesses among under-five children was 22.5% (95% CI: 21.6-23.3%). The spatial analysis depicted that common childhood illnesses have significant spatial variation across Ethiopia. The SaTScan analysis identified significant primary clusters in Tigray and Northern Amhara regions (log-likelihood ratio (LLR) = 60.19, p < 0.001). In the multilevel analysis, being rural residence [AOR = 1.39, 95% CI (1.01-1.98)], small child size at birth [AOR = 1.36, 95% CI (1.21-1.55)], high community poverty [AOR = 1.26, 95% CI (1.06-1.52)], mothers aged 35-49 [AOR = 0.81, 95% CI (0.69-0.94)], the household had electricity [AOR = 0.77, 95% CI (0.61-0.98)], the household had a refrigerator [AOR = 0.60, 95% CI (0.42-0.87)], improved drinking water [AOR = 0.82, 95% CI (0.70-0.95)], improved toilet [AOR = 0.72, 95% CI (0.54-0.94)], average child size at birth [AOR = 0.83, 95% CI (0.75-0.94)] were significantly associated with common childhood illnesses. Common childhood illnesses had spatial variations across Ethiopia. Hotspot areas of the problem were found in the Tigray, Northern Amhara, and Northeast SNNPR. Both individual and community-level factors affected common childhood illnesses distribution and prevalence in Ethiopia. Therefore, public health intervention should target the hotspot areas of common childhood illnesses to reduce their incidence in the country., (© 2023. The Author(s).)

Under age (teenage) pregnancy is a pregnancy that occurs under the age of 20 years old. Its magnitude is increasing globally. It is much higher in low-income countries compared to high-income countries. Teenage pregnancy exposed teenagers to various obstetric and perinatal complications. However, its predictors are not well investigated in highly prevalent regions of Ethiopia. Therefore, this study assessed individual and community-level predictors of teenage pregnancy using a multi-level logistic regression model. An in-depth secondary data analysis was performed using the fourth Ethiopian Demographic and Health Survey (EDHS) 2016 data set. A weighted sample of 2397 teenagers was included in the final analysis. Multi co linearity and chi-square tests were checked and variables which did not fulfill the assumptions were excluded from the analysis. Four models were fitted. Variables with p value ≤ 0.2 in the bi-variable multilevel logistic regression were included in the multivariable multilevel logistic regression. The adjusted odds ratio (AOR) with a 95% confidence interval (95% CI) was computed. Variables with a p value of less than 0.05 in the multi-variable multilevel logistic regression were declared as statistically significant predictors. A total of 2397 weighted participants aged from 15 to 19 were involved. About 15% of teenagers were pregnant. Age [17 (AOR = 9.41: 95% CI 4.62, 19.13), 18 (AOR = 11.7: 95% CI 5.96, 23.16), 19 (AOR = 24.75: 95% CI 11.82, 51.82)], primary education (AOR = 2.09: 95% CI 1.16, 3.76), being illiterate (AOR = 1.80: 95% CI 1.19, 2.73), religion [being Muslims (AOR: 2.98:95% CI 1.80, 4.94), being Protestants (AOR = 2.02: 95% CI 1.20, 3.41)], contraceptive non use (AOR = 0.18: 95% CI 0.11, 0.31), a high proportion of family planning demand (AOR = 3.52: 95% CI 1.91, 6.49), and a high proportion of marriage (AOR = 4.30: 95% CI 2.25, 8.21) were predictors of teenage pregnancy. Age, educational status, religion, contraceptive non-use, literacy proportion of marriage and proportion of demand for family planning were the most significant predictors of teenage pregnancy. The ministry of education shall focus on universal access to education to improve female education. The government should work in collaboration with religious fathers to address reproductive and sexual issues to decrease early marriage and sexual initiation. Especial attention should be given to teenagers living in a community with a high proportion of marriage., (© 2023. The Author(s).)

Background: Myopia is the most common form of uncorrected refractive error with a growing burden worldwide. It is the principal complaint of most women during pregnancy. Although myopia has led to several consequences across the standard life of pregnant women, there is no previous study in Ethiopia regarding this topic. Thus, this study determined the prevalence of myopia and identifies its associated factors among pregnant women attending antenatal care units at governmental health institutions in Gondar City District, Northwest Ethiopia., Methods: An institution-based cross-sectional study design was conducted from 08 February to 08 April 2021. From the selected health centres, study participants were recruited by systematic random sampling technique. A pre-tested, structured-interviewer-administered questionnaire consisting of socio-demographic variables, obstetric and clinical-related variables was used to collect the required data. Non-cycloplegic refraction was performed using trial lenses, trial frames, and retinoscopy in a semi-dark examination room. EpiData 3 and STATA 14 were used for data entry and statistical analysis respectively. Both bivariable and multivariable binary logistic regression analyses were executed to identify associated factors of myopia. Variables with a p -value ≤0.05 in the multivariable logistic regression analysis were declared as statistically significant with myopia. Model fitness was checked by Hosmer and Lemeshow goodness of test (at p  > 0.05)., Results: A total of four-hundred and twenty-three pregnant women participated with a 100% response rate in this study. The overall prevalence of myopia among pregnant women was 26.48% (95% CI: 22.48-30.91). Eighty-Eight (20.81%) and Eighty-Four (19.85%) of the study participants had myopia in their right and left eyes respectively. The prevalence of myopia was significantly associated with age (AOR = 1.17; 95% CI: 1.09-1.28), the third trimester of gestation (AOR = 2.05, 95% CI: 1.08-3.90), multi & grand multipara (AOR = 3.15; 95% CI: 1.59-6.25), and history of contraceptive use (AOR = 3.30; 95% CI: 1. 50-7.28)., Conclusion: The finding of our study shows that there is a higher prevalence of myopia among pregnant women in our study area. Further prospective analytical studies regarding visual systems among pregnant women, particularly as a result of pregnancy, are strongly recommended., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Diress, Getnet, Akalu, Dagnew, Belsti, Gela, Chilot, Belay, Bitew, Terefe and Getahun.)

Background: Women's independence in reproductive health is crucial to the health of mothers and children. Couples are, however, restricted from discussing their relationship openly. Regarding this, information about women's decision-making autonomy is low in developing countries including Ethiopia. Therefore, this study was aimed to assess married women's decision-making autonomy on contraceptive use in high fertility regions of Ethiopia., Methods: The study was based on secondary data analysis of the Ethiopian Demographic and Health Survey 2016 data. A total weighted sample of 1157 reproductive age women was included. A multilevel mixed-effect binary logistic regression model was fitted to identify the significant associated factors of decision making autonomy on contraceptive use. Statistical significance was determined using Adjusted Odds Ratio (AOR) with 95% confidence interval., Results: Overall prevalence of decision making autonomy on contraceptive use was observed to be 17.2% (15.1, 19.5). Women's age 25-34 (AOR = 3.19; 95% CI:1.55, 6.54), and 35-49 (AOR = 3.59; 95% CI: 1.5, 8.36), secondary and above educational level (AOR = 3.38; 95% CI: 1.07, 10.67), being married before 18 years (AOR = 0.42; 95% CI:0.26, 0.68), being Muslim in religion (AOR = 0.47; 95% CI: 0.23, 0.98), women being in urban area (AOR = 2.73; 95% CI: 1.97, 6.35), and community media exposure (AOR = 1.85; 95% CI: 1.15, 2.48) were associated with decision making autonomy on contraceptive use., Conclusion: Women's decision-making autonomy on contraceptive use in this study was low. Age of mothers, educational status of mothers, age at first marriage, residence, religion, and community media exposure were significant factors. Therefore, the government should promote women's autonomy on contraceptive use as an essential component of reproductive health rights through mass media, educating, with particular attention for, youth women, and women living in rural settings., (© 2023. The Author(s).)

Background: One of the major factors contributing to newborn morbidity and mortality across the globe is respiratory distress. In resource-constrained developing nations like Ethiopia, it is a significant issue. Depending on the quality of the care provided, the incidence and time to recovery may differ amongst medical facilities. However, Ethiopia still lacks appropriate data on the incidence and time to recovery from respiratory distress., Objective: The aim of the study was to assess the incidence, time to recovery, and predictors among neonates admitted with respiratory distress in the neonatal intensive care unit at the University of Gondar Comprehensive Specialized Hospital., Methods: An institution-based retrospective follow-up study design was conducted among 452 neonates with respiratory distress. Data were collected using a data extraction checklist from the medical registry. The extracted data were entered into EPI INFO version 7.2.1.0 and then exported to STATA version 14 for analysis. The median time to recovery, the Kaplan Meier curve, and the log-rank test was computed. Both bi-variable and multivariable Cox regression models were applied to analyze the data. p-value ≤ 0.05 was considered statistically significant., Results: Of all respiratory distressed neonate,311 were recovered. The overall incidence rate of neonates admitted with from respiratory distress was 11.5 per 100-neonate day (95% CI: 10.30-12. 87) with 2,703-person day observation and the median time to recovery from respiratory distress was 7 days with (IQR = 3-13 days). Predictors of time to recovery from respiratory distress were very low birth weight (AHR = 0.17, 95% CI: 0.08-0.41), low birth weight (AHR = 0.50, 95% CI: 0.31-0.81), very preterm (AHR = 0.42,95% CI:0.20-0.89), sepsis (AHR = 0.50 95% CI: 0.38-0.65), hypothermia (AHR = 0.61, 95% CI: 0.39-0.81), and Apgar scores less than seven at first (AHR = 0.35, 95% CI: 0.15-0.79) and fifth minute (AHR = 0.45, 95% CI: 0.20-0.97)., Conclusion: The incidence and time to recovery in this study were discreetly acceptable as compared to previous study. The aforementioned predictors could be used to identify neonates with respiratory distress who are at risk of developing a long-term illness and guide prompt referral to hospitals. This will also provide clinicians with prognostic information, as longer recovery times have economic and social implications in resource limited countries like Ethiopia., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2022 Enyew et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: In developing countries, including Ethiopia, maternal mortality is a major public health concern. The Ethiopian Demographic Health Survey (EDHS) reported that the maternal mortality ratio (MMR) was 420 per 100,000 live births in 2016. Iron-folic acid supplementation (IFAS) is a key intervention to reduce these deaths. Therefore, this study aimed to assess the magnitude of poor adherence to IFAS and associated factors among pregnant women who had at least four antenatal care in Ethiopia., Methods: Secondary data analysis was used using 2016 Ethiopian Demographic and Health Survey (EDHS). We analyzed the data using Stata version 14. To identify factors associated with poor adherence to IFAS, a multilevel mixed-effect logistic regression model was fitted. Variables with a p < 0.05 in the multilevel mixed-effect logistic regression model were declared as significant factors associated with poor adherence to IFAS., Result: The magnitude of poor adherence to IFAS was 82.87% (95% CI: 80.96-84.65). Women education; primary [adjusted odds ratio (AOR) = 0.48; 95% CI: 0.31-0.75] and secondary (AOR = 0.52; 95% CI: 0.29-0.96), husband education; primary (AOR = 0.56; 95% CI: 0.36-0.86) and secondary (AOR = 0.51; 95% CI: 0.29-0.95), and community media exposure (AOR = 0.47; 95% CI: 0.27-0.79) were significantly associated with poor adherence to IFAS., Conclusion: In the current study, more than eight out of ten pregnant women who had at least four antenatal care had poor adherence to IFAS. Thus, promoting maternal and husband education and establishing community media with a priority on iron-folic acid supplementation and health-related programs are essential strategies to reduce poor adherence to IFAS., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Asmamaw, Debebe Negash, Bitew and Belachew.)

Background: Demand satisfied with modern contraceptive can be seen on both a health and economic level. Additionally, family planning helps to regulate fertility, prevent unintended pregnancies and their consequences. Thus, the aim of this study was to identify the magnitude of demand satisfied with modern contraceptive among married/in-union women in ten high fertility sub Saharan African countries., Methods: Recent Demographic and Health Surveys that included a weighted sample of 43,745 women of reproductive age provided the data for this study. All statistical analyses were conducted once the data had been weighted, and Stata version 16.0 was used. A multilevel mixed-effect binary logistic regression model was fitted. To determine statistically significant individual and community-level factors associated with demand satisfied for modern contraceptive, odds ratios with a 95% confidence interval was generated. A p-value less than 0.05 was declared as statistical significance., Results: Overall, demand satisfied to use modern contraceptive in high fertility sub-Saharan Africa countries was 39.53% (95%CI: 39.06, 39.98). Women aged 25-34 (AOR: 1.34, 95%CI: 1.26, 1.42) and 35-49 (AOR: 1.28, 95%CI: 1.20, 1.38), women education: primary (AOR: 1.35, 95%CI: 1.27, 1.44) and secondary (AOR: 2.05, 95%CI: 1.90, 2.21), husband education: primary (AOR: 1.26, 95%CI: 1.18, 1.35) and secondary (AOR: 1.54, 95%CI: 1.43, 1.66), husband residence (AOR: 1.75, 95%CI: 1.60, 1.91), media exposure (AOR: 1.22, 95%CI: 1.15, 1.29), wealth index: poorer (AOR: 1.1, 95%CI: 1.02, 1.19), middle (AOR: 1.18, 95%CI: 1.08, 1.28), richer (AOR: 1.37, 95%CI: 1.26, 1.49) and richest (AOR: 1.34, 95%CI: 1.56, 1.89), number of children: 4-6 (AOR: 0.48, 95%CI: 0.43, 0.55) and above 6 (AOR: 0.39, 95%CI: 0.29, 0.59), perceived distance to the health facility not big problem (AOR: 1.11, 95%CI: 1.04, 1.15), urban residence (AOR: 1.18, 95%CI: 1.10, 1.27), high community level poverty (AOR: 0.85, 95%CI: 0.74, 0.97) were significantly associated with demand satisfied for modern contraceptives., Conclusion: Only four in ten married reproductive age women demands satisfied with modern contraceptives in high fertility Sub Saharan African countries. Modern contraceptives should therefore be more widely available, especially in rural areas and for those living away from health facilities. Also, increasing media exposure and education, providing financial support, and making contraceptive access easier for married women from poor households are important interventions that need to be put in place., (© 2022. The Author(s).)

Background: Although a safe and effective vaccine is available, measles remains an important cause of mortality and morbidity among young children in Sub-Saharan Africa (SSA). The WHO and UNICEF recommended measles-containing vaccine dose 2 (MCV2) in addition to measles-containing vaccine dose 1 (MCV1) through routine services strategies. Many factors could contribute to the routine dose of MCV2 coverage remaining far below targets in many countries of this region. This study aimed to assess the prevalence of MCV2 utilization among children aged 24-35 months and analyze factors associated with it by using recent nationally representative surveys of SSA countries., Methods: Secondary data analysis was done based on recent Demographic and Health Surveys (DHS) data from eight Sub-Saharan African countries. In this region, only eight countries have a record of routine doses of measles-containing vaccine dose 2 in their DHS dataset. The multilevel binary logistic regression model was fitted to identify significantly associated factors. Variables were extracted from each of the eight country's KR files. Adjusted Odds Ratios (AOR) with a 95% Confidence Interval (CI) and p-value ≤ 0.05 in the multivariable model were used to declare significant factors associated with measles-containing vaccine dose 2 utilization., Result: The pooled prevalence of MCV2 utilization in SSA was 44.77% (95% CI: 27.10-62.43%). In the multilevel analysis, mothers aged 25-34 years [AOR = 1.15,95% CI (1.05-1.26), mothers aged 35 years and above [AOR = 1.26, 95% CI (1.14-1.41)], maternal secondary education and above [AOR = 1.27, 95% CI (1.13-1.43)], not big problem to access health facilities [AOR = 1.21, 95% CI (1.12-1.31)], four and above ANC visit [AOR = 2.75, 95% CI (2.35-3.24)], PNC visit [AOR = 1.13, 95% CI (1.04-1.23)], health facility delivery [AOR = 2.24, 95% CI (2.04-2.46)], were positively associated with MCV2 utilization. In contrast, multiple twin [AOR = 0.70, 95% CI (0.53-0.95)], rural residence [AOR = 0.69, 95% CI (0.57-0.82)] and high community poverty [AOR = 0.66, 95% CI (0.54-0.80)] were found to be negatively associated with MCV2 utilization., Conclusions and Recommendations: Measles-containing vaccine doses 2 utilization in Sub-Saharan Africa was relatively low. Individual-level factors and community-level factors were significantly associated with low measles-containing vaccine dose 2 utilization. The MCV2 utilization could be improved through public health intervention by targeting rural residents, children of uneducated mothers, economically poor women, and other significant factors this study revealed., (© 2022. The Author(s).)

Background: Human Immunodeficiency Virus (HIV) is the major public health concern in Ethiopia with more profound effect on women. Discriminatory attitude towards people living with HIV (PLWH) impose a significant impact on patient outcomes and related issues. Hence, this study aimed to investigate the hotspot areas and determinant factors of women's discriminatory attitude towards people living with HIV., Methods: An in-depth secondary data analysis was conducted based on Ethiopian demographic and health survey (EDHS) 2016. A total of weighed 13,822 reproductive-age women were included in the analysis. The non-spatial analysis was conducted using Stata 16. A mixed effect multi-level logistic regression model was fitted to identify determinant factors of discriminatory attitude towards PLWH. A p-value < 0.2 and 0.05 were used as a cut-off point to declare statistical significance for the bi- and multi-variable regression models, respectively. Four separate models i.e. the null, individual, community level model, and a fourth combined model were fitted. Model comparison was done using deviance. Random effect parameters such as correlation coefficient, median odds ratio, and proportional change in variance were used to explain the variation between and within clusters. Global and local level spatial analyses were conducted using Global Moran's index, GetisOrd Gi* statistics, and Spatial scan statistics were conducted., Results: The magnitude of women's discriminatory attitude towards PLWH was 62.66% (95%CI: 60.12, 65.10). The discriminatory attitude of women towards PLWH was spatially clustered (Moran's index = 0.41, P < 0.01). The hotspots of discriminatory attitude towards PLWH were detected in most parts of the Tigray region; Northern, and southeast borders of the Amhara region; Addis Ababa city; Central, Southern, and western Oromiya region; and East, south, and northeastern parts of South Nations, Nationalities and Peoples Region (SNNPR). Being rural resident, and having no media exposure were positively associated while better educational statuses, better wealth index, unmarried, having comprehensive HIV knowledge, Orthodox religion fellow, and ever being tested for HIV were negatively associated with women's discriminatory attitude towards people living with HIV., Conclusion: Discriminatory attitude of women towards PLWH was high in Ethiopia. Hotspots were detected in Amhara, Oromiya, SNNPR, Tigray regions, and Addis Ababa city. Socio-demographic, socio-economic, and HIV knowledge-related factors determine the women's discriminatory attitude towards PLWH., (© 2022. The Author(s).)

Background: Sub-Saharan Africa (SSA) preschool age children are more vulnerable to soil-transmitted helminths (STH) which caused millions of morbidity because of low socioeconomic status and lack of clean water and sanitation. Despite this problem, there is minimal evidence on the prevalence and factors associated with deworming medication utilization among preschool age children (pre-SAC) in SSA regions. Hence this study aimed to assess the prevalence and determinants of deworming among preschool age children in SSA., Methods: Demographic and Health Survey (DHS) data were used for this study with a total weighted 192,652 children aged 24-59 months. Taking deworming medication in the 6 months preceding the interview was our outcome of interest. A multi-level binary logistic regression model was fitted. Adjusted odds ratio (AOR) with 95% confidence interval (CI) was taken to identify significant variables., Results: The prevalence of deworming medication utilization among preschool age children in SSA was 45.03% (95% CI 44.46%, 45.60%), ranging from 41.82% in Malawi to 50.5% in Lesotho. It was 44.91% (95% CI 44.32%, 45.51%) among countries having endemic STH infection and 46.01% (95% CI 43.64%, 48.38%) for none endemic countries. Factors such as; secondary and above women education [AOR = 2.18; 95% CI 2.10, 2.26], occupation [AOR = 1.31; 95% CI 1.27, 1.34], having ≥ 11 family members [AOR = 0.68; 95% CI 0.64, 0.70], household media exposure [AOR = 1.16; 95% CI 1.13, 1.19] and richer wealth status [AOR = 1.23; 95% CI 1.16, 1.27], vitamin A supplementation [AOR = 6.18; 95% CI 6.02, 6.33] and living rural residence [AOR = 0.94; 95% CI 0.92, 0.98] have significantly associated with deworming among preschool age children., Conclusions: Utilization of deworming medication among pre-SAC children in sub-Saharan Africa is below half. Factors, such as the education status of women, family size, household media exposure, wealth status, diarrhea, vitamin A supplementation, and residence were significant variables. To increase the utilization of deworming medication for pre-SAC, WHO should work as an integrated approach with other stakeholders, by strengthening women's education, and media exposure. Maternal employment should be promoted and prior attention should be given to rural children., (© 2022. The Author(s).)

Introduction: Ventilator-associated pneumonia is a common nosocomial infection that occurs in critically ill patients who are on intubation and mechanical ventilation. Nurses' lack of knowledge may be a barrier to adherence to evidence-based guidelines for preventing ventilator-associated pneumonia. This study aimed to assess the knowledge of intensive care nurses' towards the prevention of ventilator-associated pneumonia., Methods: A multicenter cross-sectional study was conducted among nurses working in the intensive care unit from April to July 2021. A pre-tested and structured questionnaire was used to collect data. All intensive care nurses working in the study area were included in the study. Data was entered into Epi-data 4.1 version (EpiData Association, Denmark) and transferred to STATA version 14 (College Station, Texas 77845-4512 USA) statistical software for analysis. Both bi-variable and multivariable binary logistic regression analysis was used to identify factors associated with knowledge of intensive care unit nurse. Variables with a p-value less than <0.2 in the bi-variable analysis were fitted into the multivariable logistic regression analysis. Both Crude and Adjusted Odds Ratio with the corresponding 95% Confidence Interval was calculated to show the strength of association. In multivariable analysis, variables with a p-value of <0.05 were considered statistically significant., Result: A total of 213 intensive care nurses were included in the study, with a response rate of 204(95.77%). The mean knowledge score of intensive care nurses regarding the prevention of ventilator-associated pneumonia out of 20 questions is (10.1 ± 2.41). There are 98 (48.04%) of the participants have been found to have good knowledge and 106 (51.96%) of them are rendered poor knowledge about the overall knowledge related to the prevention of ventilator-associated pneumonia. Higher academic qualifications and taking intensive care unit training were significantly associated with good knowledge of ventilator-associated pneumonia prevention in multi-variable logistic regression., Conclusion: Our study indicates that the knowledge of intensive care nurses about ventilator-associated pneumonia prevention is not sufficient. Higher academic qualifications and taking intensive care unit training are significantly associated with a good level of knowledge. Therefore it shows the necessity for thorough training and education., Competing Interests: There is no conflict of interest., (© 2022 The Authors.)

Background: Bottle feeding is associated with diarrheal disease morbidity and mortality and risk of pyloric stenosis, especially in developing countries. Even though, World Health Organization (WHO) recommended avoiding bottle feeding among children, still higher magnitude was reported in developing countries. This study aimed to assess the spatial distribution and determinants of bottle feeding among children 0-23 months in Ethiopia., Methods: This study was conducted based on Ethiopian Demographic and Health Surveys data (EDHS). The data were weighted using sampling weight for probability sampling and non-response to restore the representativeness of the data and get valid statistical estimates. Then a total of 4,275 weighted samples of under two years children were used to investigate the study. The data were cleaned using MS excel and extracted and analyzed using STATA V.16 software. A multilevel binary logistic regression model was fitted. P-value < 0.05 was taken to declare statistical significance. A spatial analysis was done using ArcGIS and SaTScan software., Results: The prevalence of bottle feeding practice among under two years children in Ethiopia were 13.5% (95%CI: 11.16, 15.29) and ranges from the lowest 5.16% (95% CI: 3.28, 78.73) Amhara region to the highest 55.98% (95% CI: 47.98, 61.46) Addis Ababa region. Women with secondary and above education status [AOR=2.49; 95%CI; 1.66, 3.74], women from richest household [AOR=1.33; 95%CI; 1.01, 1.78], child 12-23 months age [AOR= 1.59; 95%CI; 1.23, 2.05], multiple birth [AOR=4.30; 95%CI; 1.88, 9.84], rural residence [AOR=0.49; 95%CI; 0.16, 0.82] and large central region [AOR= 0.15; 95%CI; 0.08, 0.27] have significantly associated with bottle feeding. Addis Ababa, Central Oromia, Dire Dewa, Somali and Harari regions were the hot spot areas for bottle feeding practice among under two years children., Conclusion and Recommendations: The prevalence of bottle feeding practices in Ethiopia is relatively moderate. Maternal education, wealth index, child age, multiple births, residence and region were significant predictors of bottle feeding. These findings highlight that, the Ministry of Health Ethiopia (MOH), policymakers, and other stakeholders had better give prior attention to preventable factors such as empowering women, enhancing household wealth status to decreasing bottle feeding practice in Ethiopia., (© 2022. The Author(s).)

Introduction: The first birth is the most significant events in a woman's life that indicates the beginning of undertaking the intensive responsibilities of motherhood and childcare. Age at first birth has health, economic and social consequences and implications. But little has been known on the time to first birth and its determinants in Ethiopia. Therefore, this research is planned to address this issue., Objectives of the Study: To assess the time to first birth and its determinants among married female youths in Ethiopia, 2020., Methods: The data was accessed freely through ( https://www.dhsprogram.com ). Survival analysis of time to first birth was done based on EDHS 2016 data among 2597 weighted study subjects. The data was extracted using STATA version 14.0. Kaplan Meier's survival and Log rank test were used to compare survival experiences of respondents using categorical variables. Proportional hazard assumption was checked and was not violated. Cox proportional hazard model was applied, hazard ratio with 95% CI was computed and variables with p value < 0.05 in the multivariable analysis were taken as significant determinants., Results: Overall median survival time was 18 years (IQR = 17-20). The significant determinants of time to first birth are place of residence (being rural (AHR = 1.49, 95% CI 1.13, 1.97),Religion (being Muslim [AHR = 1.57, 95% CI 1.22, 2.02),being protestant (AHR = 1.73, 95% CI 1.34, 2.24)], age at first sex [first sex < 15 years (AHR = 1.68, 95% CI 1.23, 2.29)] and first sex between 15 and 17 years (AHR = 1.54, 95% CI 1.29, 1.85), age at first marriage (marriage < 15 years (AHR = 6.52, 95% CI 4.91, 8.64), marriage between 15 and 17 (AHR = 2.63, 95% CI 2.20, 3.14), unmet need for family planning (AHR = 1.23, 95% CI 1.00, 1.52) CONCLUSION: In this study, the median age at first birth was 18 years. This show, about 50% of study participants give birth for the first time before their 18th birth day. This age is the ideal age for schooling and to do other personal development activities. Therefore giving birth before 18 year will limit female youths from attending school and performing personal development activities in addition to health and demographic consequences of early child bearing., (© 2021. The Author(s).)