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Background Social capital has become an important concept in the field of public health, and is associated with improved health services uptake. This study aimed to systematically review the available literature on the role of social capital on the utilization of maternal and child health services in low- and middle-income countries (LMICs). Methods Mixed-methods research review and synthesis using three databases PubMed, Scopus, and Science Direct for peer-reviewed literature and Google Scholar and Google search engines for gray literature were performed. Both quantitative and qualitative studies conducted in LMICs, published in English and in grey literature were considered. Prior to inclusion in the review methodological quality was assessed using a standardized critical appraisal instrument. Results A total of 1,545 studies were identified, of which 13 records were included after exclusions of studies due to duplicates, reading titles, abstracts, and full-text reviews. Of these eligible studies, six studies were included for quantitative synthesis, and seven were included for qualitative synthesis. Of the six quantitative studies, five of them addressed the association between social capital and health facility delivery. Women who lived in communities with higher membership in groups that helps to form intergroup bridging ties had higher odds of using antenatal care services. Synthesized qualitative findings revealed that women received some form of emotional, informational, and instrumental support from their network members. Receiving health information from trusted people and socio-cultural factors influenced the use of maternal and child health services. Conclusions Social capital has a great contribution to improve maternal and child health services. Countries aiming at improving maternal and child health services can be benefited from adapting existing context-specific social networks in the community. This review identified limited available evidence examining the role of social capital on maternal and child health services uptake and future studies may be required for an in-depth understanding of how social capital could improve maternal and child health services. Systematic review registration PROSPERO CRD42021226923.

BackgroundAs the burden of cardiovascular disease increases in sub-Saharan Africa, there is a growing need for low-cost interventions to mitigate its impact. Providing self-care health education to patients with chronic heart failure (CHF) is recommended as an intervention to prevent complications, improve quality of life, and reduce financial burdens on fragile health systems. However, little is known about health education’s effectiveness at improving CHF self-management adherence in sub-Saharan Africa. Therefore the present study aimed to assess the effectiveness of an educational intervention to improve self-care adherence among patients with CHF at Debre Markos and Felege Hiwot Referral Hospitals in Northwest Ethiopia.MethodsTo address this gap, we adapted a health education intervention based on social cognitive theory comprising of intensive four-day training and, one-day follow-up sessions offered every four months. Patients also received illustrated educational leaflets. We then conducted a clustered randomized control trial of the intervention with 186 randomly-selected patients at Debre Markos and Felege Hiwot referral hospitals. We collected self-reported data on self-care behavior before each educational session. We analyzed these data using a generalized estimating equations model to identify health education's effect on a validated 8-item self-care adherence scale.ResultsSelf-care adherence scores were balanced at baseline. After the intervention, patients in the intervention group (n = 88) had higher adherence scores than those in the control group (n = 98). This difference was statistically significant (β = 4.15,p p p p ConclusionsWe find that self-care education significantly improved self-care adherence scores among CHF patients. This suggests that policymakers should consider incorporating self-care education into CHF management.Trial registration number: PACTR201908812642231

BackgroundHealth care workers (HCWs) are at an increased risk of acquiring tuberculosis (TB) compared to the general population, because of the frequent face to face contact or potential exposure to TB through shared air or space with infectious patient(s), regardless of economic setting and local TB incidence. Information on the burden of active TB disease among HCWs will help guide control measures, can be utilized to evaluate the effectiveness of TB infection prevention programs in the health care setting, and guide necessary actions. However, data on TB among HCW in Ethiopia is limited. Therefore, this study aimed to determine the prevalence of active TB disease among healthcare workers and support staff in healthcare settings in the Amhara region of Ethiopia.MethodsA cross-sectional study design was used to recruit a total of 580 randomly selected study participants in the Amhara region. Data were collected over four months in selected hospitals and health centers. Implementation of TB prevention and control measures was evaluated using a standardized checklist. The main outcome indicator was active TB as measured by a laboratory diagnosis using GeneXpert technology.ResultsA total of 580 study participants were enrolled. The mean age was 31.3 (±7.8 standard deviation) years, with about two-thirds (65.3%) aged between 18–24 years. A total of 9 (1.6%) MTB cases were detected, 4 (1.4%) in HCWs and 5 (1.7%) in support staff, which did not significantly differ (P = 0.50). About 90% of the participants had not received TB infection prevention and control training ever. More than half (54%) of the study participants worked in poorly ventilated rooms. Triage of coughing patients was not practiced in 32% of the studied facilities (health centers and hospitals).ConclusionsThe magnitude of TB among healthcare workers and support staff in healthcare settings was higher than in the general population (140 per 100000 population). The status of implementation of tuberculosis prevention and control measures indicated missed opportunities. Hence, strict implementation of developed infection control plans of TB in healthcare settings needs to be improved.

Background. Neonatal sepsis is one of the major public health problems globally, particularly, in developing countries. Klebsiella, Staphylococcus aureus, Coagulase-negative Staphylococcus, and Escherichia coli are the common pathogens for neonatal sepsis in developing countries. However, the pooled estimate of common pathogens causing neonatal sepsis in developing countries is still unknown. Therefore, this study is aimed at computing the pooled proportion of the leading cause of pathogens for neonatal sepsis in developing countries. Methods. We strictly followed the Preferred Reporting Items for Systemic Reviews and Meta-analysis guidelines to report this systematic review and meta-analysis. PubMed, Cochrane Library, Web of Science, CINAHL, Science Direct, and other search engines such as Google Scholar, Africa Journals Online, and Hinari were used to obtain studies related to the leading cause of pathogens for neonatal sepsis in developing countries. The search was done from October 1 to December 30, 2018, by considering both published and gray literature. Studies were evaluated based on the PRISMA guideline checklist by using their titles, abstracts, and full texts. Studies were extracted using Microsoft Excel spreadsheets, and STATA software version 14 was used to analyze data. Heterogeneity between studies was checked based on Cochran’s Q-test and the corresponding I2 statistic test. Results. The pooled prevalence of the leading cause of pathogens of neonatal sepsis in developing countries were Klebsiella (26.36%), Staphylococcus aureus (23.22%), Coagulase-negative Staphylococcus (23.22%), and Escherichia coli (15.30%). Common pathogens were varied across regions; for instance, pooled isolated Coagulase-negative Staphylococcus was 25.98% in Africa, 16.62% in Asia, and 36.71% in Latin America, and Klebsiella was 29.80% in Africa, 23.21% in Asia, and 22.00% in Latin America. Also, Staphylococcus aureus was 27.87% in Africa and 18.28% in Asia, and Escherichia coli was 22.97% in Asia and 9.43% in Africa. Conclusions. This study highlights that the more prevalent common isolated pathogens in developing countries were Klebsiella, Staphylococcus aureus, Coagulase-negative Staphylococcus, and Escherichia coli, Klebsiella, and Staphylococcus aureus pathogens were predominantly high in Africa as compared to other Asian and Latin American countries. At the same time, Coagulase-negative Staphylococcus was more prevalent in Latin America compared to other regions. Escherichia coli is more dominant in Asia as compared to Africa and Latin America.

Background: Neonatal intensive care settings are important to save the lives of sick neonates; however, parents are challenged by many stressful conditions during their stay outside the rooms of intensive care units. Therefore, this study aimed to explore the lived experiences of parents in a neonatal intensive care unit at Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Northwest Ethiopia. Methods: In this study, a phenomenological qualitative approach was used to explore parental experience and data were collected using in-depth interviews from purposively selected parents. In addition, a thematic approach was used to analyze the data using Open Code Software Version 4.02. Results: In this study, parents found to developed psychological problems like anxiety, stress, worry, hopelessness and state of confusion. Emotional related conditions were anger, crying, sadness, frustration, dissatisfaction, regret, disappointment, feeling bad, self-blaming, nervousness, disturbance and lack of self-control. Parents expressed that health care providers showed indiscipline, lack of commitment and not cooperative at all. Conclusion: Parents of neonates in the intensive care unit were challenged due to a shortage of money and traveling a long distance. Psychological and emotional factors were identified as major stressors of parents during their stay in the NICU. Hence, providing psycho-emotional supports, strengthening parents–healthcare providers’ interaction, and scale up neonatal intensive care unit service into the primary health care unit are recommended.

Background. Neonatal sepsis is one of the major public health problems globally, particularly, in developing countries. Klebsiella, Staphylococcus aureus, Coagulase-negative Staphylococcus, and Escherichia coli are the common pathogens for neonatal sepsis in developing countries. However, the pooled estimate of common pathogens causing neonatal sepsis in developing countries is still unknown. Therefore, this study is aimed at computing the pooled proportion of the leading cause of pathogens for neonatal sepsis in developing countries. Methods. We strictly followed the Preferred Reporting Items for Systemic Reviews and Meta-analysis guidelines to report this systematic review and meta-analysis. PubMed, Cochrane Library, Web of Science, CINAHL, Science Direct, and other search engines such as Google Scholar, Africa Journals Online, and Hinari were used to obtain studies related to the leading cause of pathogens for neonatal sepsis in developing countries. The search was done from October 1 to December 30, 2018, by considering both published and gray literature. Studies were evaluated based on the PRISMA guideline checklist by using their titles, abstracts, and full texts. Studies were extracted using Microsoft Excel spreadsheets, and STATA software version 14 was used to analyze data. Heterogeneity between studies was checked based on Cochran’sQ-test and the correspondingI2statistic test. Results. The pooled prevalence of the leading cause of pathogens of neonatal sepsis in developing countries were Klebsiella (26.36%), Staphylococcus aureus (23.22%), Coagulase-negative Staphylococcus (23.22%), and Escherichia coli (15.30%). Common pathogens were varied across regions; for instance, pooled isolated Coagulase-negative Staphylococcus was 25.98% in Africa, 16.62% in Asia, and 36.71% in Latin America, and Klebsiella was 29.80% in Africa, 23.21% in Asia, and 22.00% in Latin America. Also, Staphylococcus aureus was 27.87% in Africa and 18.28% in Asia, and Escherichia coli was 22.97% in Asia and 9.43% in Africa. Conclusions. This study highlights that the more prevalent common isolated pathogens in developing countries were Klebsiella, Staphylococcus aureus, Coagulase-negative Staphylococcus, and Escherichia coli, Klebsiella, and Staphylococcus aureus pathogens were predominantly high in Africa as compared to other Asian and Latin American countries. At the same time, Coagulase-negative Staphylococcus was more prevalent in Latin America compared to other regions. Escherichia coli is more dominant in Asia as compared to Africa and Latin America.

Background Malnutrition is still a global public health problem contributing for under-five morbidity and mortality. The case is similar in Ethiopia in which severe acute malnutrition is the major contributor to mortality being an underlying cause for nearly 45% of under-five deaths. However, there is no recent evidence that shows the time to death and public health importance of oxygen saturation and chest in drawing in the study area. Therefore, estimated time to death and its predictors can provide an input for program planners and decision-makers. Methods A facility -based retrospective cohort study was conducted among 488 severe acute malnourished under-five children admitted from the 1st of January 2016 to the 30th of December 2019. The study participants were selected by using simple random sampling technique. Data were entered in to Epi-Data version 3.1 and exported to STATA version15 statistical software for further analysis. The Kaplan Meier was used to estimate cumulative survival probability and a log-rank test was used to compare the survival time between different categories of explanatory variables. The Cox-proportional hazard regression model was fitted to identify predictors of mortality. P-value Results Out of the total 488 randomly selected charts of children with severe acute malnutrition, 476 records were included in the final analysis. A total of 54(11.34%) children died with an incidence rate of 9.1death /1000 person- days. Failed appetite test (AHR: 2.4; 95%CI: 1.26, 4.67), altered consciousness level at admission (AHR: 2.4; 95%CI: 1.08, 4.67), oxygen saturation below 90% (AHR: 3.3; 95%CI: 1.40, 7.87), edema (AHR 2.9; 95%CI: 1.45, 5.66) and HIV infection (AHR: 2.8; 95%CI: 1.24, 6.36) were predictors of mortality for children diagnosed with severe acute malnutrition. Conclusion The overall survival status of severe acute malnourished children was low as compared to national sphere standards and previous reports in the literature. The major predictors of mortality were oxygen saturation below 90%, altered consciousness, HIV infection, edema and failed appetite test. Therefore, early screening of complications, close follow up and regular monitoring of sever acute malnourished children might improve child survival rate.

Background Contraceptive use is an essential care to reduce maternal and child mortality by preventing unwanted pregnancy and abortion. Despite different studies are conducted related to family planning services, difference in characteristics of changes and the effects of population behavior were not well addressed. Therefore, the aim of this study was to assess the trend of modern contraceptive use, and investigate the difference in characteristics of changes and the effects of population behavior in the use of modern contraceptives.Methods The data source were from a four consecutive Ethiopia demographic and health surveys of women with complete interview file from 2000 -2016. The total sampled married women considered for this study were 9,380 (2000), 8,644(2005), 10,204(2011) and 9,824 (2016). Descriptive analysis was applied to describe socio demographic variables, fertility desire and media exposure. Multivariate decomposition analysis was carried out to investigate the changes in characteristics and effect of population behavior in modern contraceptive use.Results The trend of modern contraceptive use was steadily increased from 6% in 2000 to 35% in 2016. The overall decomposition change in modern contraceptive use among married women was 8.3% (2000 to 2016); due to difference in characteristics. Variables contribute for the change are religion, residence, women’s and partners’ education, women’s and partners’ occupation, head of house hold, history of abortion and media of exposure.Conclusion The trend of modern contraceptive use was steadily increased in all surveys. The change in contraceptive use was due to change in characteristics and population health behavior.

Background Common mental illness has a substantial impact on seizure control and negatively affects the overall quality of life among individuals with epilepsy. However, there is a dearth of studies that examined the associated factors of common mental illness among epilepsy patients in Ethiopia, particularly in the study area. This study aimed to assess the magnitude and factors associated with common mental disorders in epilepsy patients who attended government health institutions in Bahir Dar city, Ethiopia. Method Health institution based cross-sectional study was conducted using a systematic sampling technique among people living with epilepsy in Bahir Dar City Administration. Common mental illness was assessed using a self-reporting questionnaire and a semi-structured questionnaire was employed to collect data on socio-demographic and clinical related characteristics. Data were analyzed using descriptive statistics, univariate logistic regression, and multivariable logistic regression. Results The magnitude of comorbid common mental illness among people living with epilepsy was found 35.4%. High magnitude of common mental illness was reported among females (39.9%) when compared to males (32.3%). The most prevalent common mental disorders symptoms include being worried, unhappy feeling, trouble thinking clearly, and difficult to enjoy daily activities. Family history of epilepsy, frequent seizures attacks, side effects of antiepileptic drugs, lack of social support and not adherent to antiepileptic drugs were factors associated with common mental illness. Conclusions Common mental illness was found to be prevalent among people living with epilepsy. Therefore, it is recommended that great attention should be given to mental illness besides controlling seizure attacks.

Purpose Neonatal sepsis is the major cause of mortality and morbidity globally, particularly in developing countries. Despite studies revealed the extent of neonatal sepsis in developing countries, the findings were inconclusive. Therefore, the main aim of this study was to determine the pooled prevalence of neonatal sepsis in developing countries. Methods We used a systematic review and Meta-analysis study method. The reviewed studies were accessed through an electronic web-based search strategy from the electronic database (PUBMED), advanced google scholar, different journal sites. The data extraction was done by two researchers using a data extraction table and the disparity between data extractors was resolved by the third researcher. The analysis was done using STATA version 11. The I2 test was used to assess heterogeneity across studies. The Funnel plot, Begg's test, and Egger's test were used to check for publication bias. The random-effect model was used to determine the pooled effect size. All studies related to neonatal sepsis which fulfill the inclusion criteria were considered into this study. The quality of each study was checked using the Newcastle-Ottawa Scale and studies graded low score were excluded from the study. Results At the end, 36 articles fit with our study objectives. Studies conducted in Ethiopia were significant the source of heterogeneity of the study with a coefficient = 90, P-value = 0.025. The overall pooled prevalence of the study was 29.92%. The limitations of this study would be the authors were only used articles reported in the English language, and publication bias. Conclusion The pooled prevalence of neonatal sepsis was found to be high which accounted for a third of the neonates. Despite countries have established possible prevention and treatment mechanisms, neonatal sepsis is the major public health problem in lower and middle-income countries till now.

Introduction Khat is a well-known natural stimulant and is widely used in Ethiopia, particularly in Bahir Dar city. Khat chewing is linked with risky sexual behaviors. Objective The study was aimed to determine the prevalence of chewing khat and its relation with risky sexual behaviors among residents of Bahir Dar City administration, Northwest Ethiopia. Methods A community based cross-sectional study was conducted from January to February, 2016. The data were collected using an interviewer administered structured questionnaire. Logistic regression analysis was applied to assess association between dependent and explanatory variables. Results The proportion of lifetime and current chewing khat among the study participants were 25.7 and 19.5%, respectively. Males (AOR 5.0; 95% CI 3.0–8.2) than females, merchants (AOR 4.9; 95% CI 2.6–9.3) than government employees, and those with average monthly income of ≥ 3001 Ethiopian birr (AOR 2.4; 95% CI 1.2–4.8) than ≤ 1000 had an increased current chewing khat prevalence. Having lifetime history of chewing khat was significantly associated with ever had sexual intercourse, having extra sexual partners, watching pornographic film and self-reported sexually transmitted infections. Conclusion Chewing khat is associated with increment of having risky sexual behaviors and self-reported sexually transmitted infections. Harm reduction measures are needed to prevent the community from engaging in khat use and risky sexual behaviors.

Irrational use of medicines is a key reason for the increase and spread of antimicrobial resistance and it is a global concern. It is a fast mounting universal crisis. The main of this study of this study was to assess knowledge, attitude and practice of university students on antimicrobial resistance at Debre Markos University. Institutional based comparative cross-sectional survey was conducted from June to July with total sample size of 670. Participants were selected using simple random sampling method using random number table. Data clerk double entered the data into Epi data version 3.1 and transferred to SPSS Windows software version 21.0. Those variables that had associations at binary stage with p-value < 0.1, not collinear and biologically important variables were entered in to multiple logistic regression models. The cut off point for association was p-value < 0.05. About 14.8% study participants had adequate knowledge towards drug resistance. Rural residences of the participants were significantly associated with drug resistance as compared to urban residence. Knowledgeable participants were significantly protective to self- medication and drug resistance as compare to those who had inadequate knowledge and participants who had positive attitude were positively associated with self-medication as compare to those who had negative attitude. The overall knowledge of participants regarding to antimicrobial resistance was low. In the other hand, majority of participants had positive attitude. Those participants who had positive attitude were significantly associated with antimicrobial resistance as compared to who had negative attitude.

Introduction The discrepancy regarding maternal mortality continues to be a health concern between developing and developed countries. The majority of global maternal deaths occur in developing countries, specifically, in the sub-Sahara African region which alone accounts for more than half of these deaths. It has been indicated that utilization of the partograph was significantly associated with improved maternal and neonatal outcomes of labour and that is why the World Health Organization recommends the universal use of the tool during labour. Therefore, this study has assessed the level of partograph use and its associated factors among obstetric caregivers in East Gojam Zone, Northwest Ethiopia. Methods A health facility based cross-sectional study was conducted among randomly selected obstetric caregivers in Northwest Ethiopia. The data were collected using a self-administered questionnaire and a clinical observation checklist. The data were entered into Epidata version 3.1, and cleaned and analyzed using SPSS version 24.0 statistical software. Result About three quarters, or 198 (72.53%), of the obstetric caregivers, had attained diploma level of education. However, 153 (56.04%) of the obstetric caregivers had what was considered to be good knowledge about the partograph, but utilization of the tool was slightly lower than their level of knowledge, 147 (53.85%). Utilization of the partograph was significantly higher among obstetric caregivers holding a Bachelor of Science degree and above, than Diploma holders (AOR (95% C.I) 2.07 (1.15–3.75)) and the use was higher among those who were regularly working in the delivery ward compared to those regularly working in the Adult Outpatient Department (AOR (95% C.I): 2.25 (1.07–4.72)). Moreover, caregivers who had a good knowledge about the partograph and who had received on the job training in obstetric care were also more likely to use the partograph during labour and delivery (AOR (95% C.I): 1.79 (1.05–3.06) and 4.85 (2.63–8.96)) respectively. Conclusion The results of this study revealed that although more than half of obstetric caregivers had a good knowledge of the partograph, the actual utilization of the tool was slightly lower than the knowledge they had. Therefore, in this study, we suggest that providing on the job obstetric care training for obstetric caregivers, about the partograph in particular, would improve partograph utilization.

Background. Malnutrition is the major public health problem over the world. Developing countries are highly affected. Asian and Sub-Saharan African countries, including Ethiopia, contribute the highest of all. The main aim of this study was to assess the prevalence of undernutrition and its associated factors among children below five years of age.Methods. Community-based cross-sectional survey was conducted on 342 study participants. Simple random sampling technique was used to select sampling kebeles and study units. Weight and height were measured using calibrated instruments. The data were entered into EpiData version 3.1 software and calculated using SPSS version 20.0 statistical software and/or World Health Organization Anthro software with aid of Stat/Transfer.Results. Overall prevalence of undernutrition was 35.5%, of which 85 (24.9%), 38 (11.1%), and 49 (14.3%) were stunting, wasting, and underweight, respectively. Male children were more affected in both severe and moderate nutritional problems compared to female children. The finding showed that 27 (7.9%) had severe stunting, 15 (4.4%) had severe wasting, and 11 (3.2%) had severe underweight, respectively.Conclusion. Undernutrition was high in Bure town among children below five years of age. Male sex, maternal educational status, low household income, preterm babies, absence of antenatal follow-up, diarrhea, and respiratory infections within one-month duration were factors affecting undernutrition.

Introduction: Diarrhoea is one of the major causes of morbidity and mortality in under five Children all over the world, special in developing counters due to lack of Knowledge and practice in Diarrhoeal disease management. Objective: The main aim of this study was to assess mothers’ knowledge and practice among mothers who have under five children, in Fenote Selam Town, West Gojjam zone, Amhara Regional State, Northwest Ethiopia. Methods: A community based cross-sectional study deign was conducted. The study was done from April- May, 2014. To determine the sample size a single proportional formula was used. According to this formula the sample size of the study was 846. Multi-stage sampling technique was employed in order to select the study areas and study units. Among five kebeles, two kebeles were selected by simple random sampling techniques. Standardized interview questionnaires were adapted and modified from related articles and journals to collect data on the socio-demographic variables and factors associated with it. Pre-test was done in none sampling kebeles. Data were entered into Epi-info (version 3.5.1) statistical software package then exported to SPSS software package version 16.0 for further analysis. Results: A total of 846 participants were included in the study. Of these, the response rate was 830(98.1%). Five hundred twenty eight 528(63.6%) of them had good knowledge and 381(45.9%) of them had good practice. Conclusion: The finding of this research indicated that 63.6% of mothers had good knowledge towards Diarrhoea management while 54.1% of mothers had poor practice on Diarrhoea management.

Background: Stunting is a major public-health problem in low and middle-income countries, and it increases risk of morbidity and mortality during childhood. In Ethiopia, it is a major public health problem. Objective: To assess prevalence and associated factors for stunting among school children at Debre Markos town and Gozamen woreda, East Gojjam Zone, Amhara regional state, Ethiopia. Methods and materials: Cross-sectional quantitative study design was employed. The study area and study sites were selected by random sampling method and the study subjects were taken by systematic random sampling technique. The study was conducted at eight selected schools. The study was carried out from March 2013 up to June 2013. Statically analysis: Data were entered into Epi-info (version 3.5.1) satirical software then exported in to SPSS version 16.0 statistical programs and anthroplus software was used to determine HAZ score of individual values. Result: The overall prevalence of stunting was 48.1%, out of which, 5% were severely stunted, 14.3% moderately stunted and 28.8% mildly stunted, and the mean was 1.72 with standard division of 0 .887. 3.1% boys and 1.9% girls were severely stunted. As the age increased stunting was significant. Rural school children were highly stunted as compared to urban children. Conclusion: This study showed that stunted rate was alarming magnitude. Total prevalence of stunting in this study was 48.1%; 5% were severely stunted (

Introduction: Global deaths of children aged less than five years from diarrhea have been estimated, resulting in about 800 000 fatalities worldwide annually, most occurring in sub-Saharan Africa and south Asia. More than 80% of these deaths occur in Asia and Africa (46% in Africa alone). Objective: The aim of this study was to assess attitude of mothers towards diarrhea management and prevention in under five children, in Fenote Selam Town, West Gojjam Zone, Amhara, Northwest Ethiopia, 2014. Methods: Community based Cross-sectional study was conducted from April-May 2014. The sample size was 846. Multi-stage sampling technique was employed to select sampling kebeles. Simple random sampling technique was used to select study units. Pretest was done in none sampling kebeles. Data were entered into Epi-info (version 3.5.1) statistical software package and then exported to SPSS software package version 16.0 for further analysis. Results: A total of 830 mothers were participated in the study. Overall, 416(50.1%) of mothers had favorable attitude. Of these, 337 (40.6%) of mothers had favorable attitude towards ORS usage and 192(23.1%) of mothers had favorable attitude towards immunization to prevent diarrhea. Conclusion: Overall, half of mothers of the Fenote Selam community had unfavorable attitude towards diarrhea management and prevention.

Introduction: Gender based violence (GBV) is a common reproductive health problem especially in developing countries. It commonly occurs among women and young girls than men, and it has several sexual and reproductive health complications like STIs including HIV/AIDS, unwanted pregnancy, abortion and other complications. So, this research is done to assess the prevalence of GBV and associated factors among Menkorer high school female students in Debre Markos town, Ethiopia. Methodology: Institutional based cross sectional study was conducted among 140 female high school students of Debre Markos town. All randomly selected regular female students were included in the study. Self-administered questionnaire was used to collect the data. For data entry EpiData version 3.1 and for analysis SPSS version 22 software were used. Descriptive analysis was done to describe the frequency and percentage of dependent and independent variables. To identify possible factors associated with the dependent variable, bivariate and multivariate analysis were done. 95% confidence interval (CI) and p-value less than 5% were used to determine the association. Result: The prevalence of Gender based violence (physical or/and sexual violence) during the current academic year was 72 (57.3%), while life time prevalence of GBV was 67.7%. The prevalence of life time physical violence and physical violence during the current academic year was 82 (66.1%) and 68 (54.8%) respectively. Thirty (24.2%) have experience life time sexual violence. Factors associated with gender based violence were educational performance of good and above (AOR=0.09, 95%CI 0.009-0.88), and never drinking alcohol (AOR=0.38, 95%CI 0.15-0.93). Conclusion and Recommendation: This study found that gender based violence is still a common problem among high school female students. The prevalence of current and life time physical and sexual violence among female students was high. So, school and community based services like awareness creation for both male and female students on GBV and laws related with GBV should be strengthened.

Background: Sexual activities during adolescence have been characterized as dynamic and constantly changing, and it has an impact on reproductive life of young peoples, which is related to the increased susceptibility to HIV transmission, unwanted pregnancy and its complications when the sexual activities are unprotected. So, the objective of this study was to identify the prevalence of early sexual initiation and its associated factors among Debre Markos University students, North West Ethiopia, 2014. Methods: Institution based cross sectional study design was conducted among 273 Debre Markos university students. Study participants were selected by stratified sampling technique and self- administrated questionnaire was distributed to collect information. EpiData version 3.1 was used for data entry and SPSS version 16 was used for analysis. To identify factors associated with sexual initiation, bivariate and multivariate logistic regression with 95 % Confidence interval was used. Results: From 260 respondents, 116(44.6%) had sex prior to the data collection period, while 144(55.4%) had never had sexual intercourse. Almost two third (64.7%) of respondents start sexual intercourse during the age range of 16-19 years old. The mean and standard deviation for the age at first sex was 18.28 and 2.04 years respectively. Factors which were significantly associated with early sexual initiation (< 18 years old) were; being female (AOR=5.7, 95%CI=1.16-27.72), lack of discussion on sexual and reproductive health issues (SRH) with their mother (AOR=, 95%CI= 1.23-41.5) and cigarrate smoking (AOR=7, 95%CI=1.06-46.92). Conclusions: Early sexual initiation was high. Factors which were associated with early sexual initiation were being female, lack of discussion on SRH with mother and cigarrate smoking. So, awareness creation for both male and female young peoples through the use of religious leaders, school teachers and parents on sexual and reproductive health issues is important. Young peoples should be encouraged to discuss with their parents on SRH through the use of reproductive health centers and emphasis should also be given for adolescents who use drugs like cigarrate smoking.