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Background: Male partner involvement in antenatal care is a key factor that cannot be ignored in the quest for improvement in maternal health and is recommended as an essential intervention to improve maternal and neonatal health outcomes. However, little attention has been given to male partners' involvement in maternity care, particularly in developing countries., Objective: This study aimed to assess male partners' involvement in antenatal care and its associated factors among male partners whose wives gave birth within the last one-year in Bichena town, Westcentral, Ethiopia, 2019., Methods: A community-based cross-sectional study design was conducted from October 1/2018 to June 15/2019, in Bichena town, among 406 male partners. The data was collected by a simple random sampling technique and analyzed using the Statistical Package of the Social Science 23.0 version. Bivariate and multivariable logistic regression analyses were employed to estimate the crude and adjusted odds ratio with a confidence interval of 95% and a P-value of < 0.05 considered statistically significant., Results: In this study, 53.4% [95% CI: 48.3- 58.1%] of male partners had high involvement in antenatal care. The age group of 20-29 years [AOR = 2.14, 95% CI = 1.04-4.38], having primary, secondary, and diploma and above educational level [AOR = 2.04, 95% CI = 1.02-4.07], [AOR = 3.02, 95% CI = 1.49-6.11] and [AOR = 4.03, 95% CI = 2.06-7.89] respectively, ≤ 10 years marriage length [AOR = 2.92, 95% CI = 1.46-5.87], good knowledge of the services provided in antenatal care [AOR = 2.68, 95%, CI = 1.62-4.42], good awareness of the danger signs of pregnancy [AOR = 1.77, 95 CI = 1.10-2.85], favorable attitude towards antenatal care [AOR = 2.62, 95% CI = 1.64-4.19], travel less than 15 min to reach a nearby health facility [AOR = 3.43, 95% CI = 1.54-7.65] and making decision together to seek care in health facility [AOR = 2.44, 95% CI = 1.19-5.03] were associated with male partners involvement in antenatal care., Conclusions: Male partners' involvement in antenatal care was encouraging in the study area compared to previous studies done in Ethiopia. We suggest strengthening awareness among male partners about their shared responsibility during pregnancy. Male partners should be invited to attend the antenatal care. Policymakers and healthcare planners should design programs and plans that will encourage male partners' involvement in maternal healthcare services utilization., (© 2024. The Author(s).)

Background: In sub-Saharan Africa, the number of maternal deaths due to unsafe abortions has been gradually rising. In Ethiopia, unplanned pregnancies contribute to 25% of births, accounting for 6%-9% of the maternal deaths resulting from unsafe abortions. Despite several disjointed cross-sectional studies that have been carried out in the past, there is no comprehensive data on the attitudes of healthcare practitioners and other related aspects regarding safe abortion in Ethiopia. This study attempted to measure pooled health care providers' attitudes and determinants of safe abortion in Ethiopia., Methods: African Journals Online, Medline/PubMed, EMBASE, Science Direct, Hinari, and Google Scholar were the databases that were accessed. The studies were evaluated critically by using the Joanna Briggs Critical Appraisal methods. The study followed the recommendations set forth by Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). Data were extracted in an Excel spreadsheet and imported to STATA versions 17 software for meta-analysis. The random- effects model was used to pooled the health care providers' attitudes toward safe abortion. Heterogeneity between studies was evaluated using the Cochrane Q-test and I2 statistics (I squared statistics). To evaluate publication bias, egger's tests and funnel plots were employed. Forest plot was used to present the odds ratio (OR) with a 95% confidence interval., Results: In this review and meta-analysis, a total of eight papers with a 2,826 sample size were considered. Overall, 65.49% of Ethiopian health care professionals had a positive attitude towards safe abortion (95%CI: 49.64, 81.34; I2 = 99.20%, P = 0.000). Knowledge of the abortion law (OR = 2.25, 95% CI: 1.06, 3.43), being a male provider (OR = 1.89, 95% CI: 1.23, 2.54), receiving training on abortion (OR = 2.91, 95% CI: 1.17, 4.65), working as a midwife (OR = 3.029, 95% CI: 1.605, 4.453) and practicing abortion procedures (OR = 2.55, 95% CI: 1.32, 3.78) were positively associated with the attitudes of the providers regarding safe abortion in Ethiopia., Conclusion: In Ethiopia, there was a low pooled prevalence of positive attitude towards safe abortion. Safe abortion services in Ethiopia are more likely to be viewed favorably by health care professionals who have received abortion service training and are familiar with abortion laws. As a result, it is imperative that all healthcare facilities and other relevant parties ensure that health professionals receive training on safe abortion services and are aware of Ethiopia's abortion laws., Competing Interests: There is no any competing interest., (Copyright: © 2024 Bante 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.)

Importance: Breast cancer is the most prevalent cancer globally with tremendous disparities both within specific regions and across different contexts. The survival pattern of patients with breast cancer remains poorly understood in sub-Saharan African (SSA) countries., Objective: To investigate the survival patterns of patients with breast cancer in SSA countries and compare the variation across countries and over time., Data Sources: Embase, PubMed, Web of Science, Scopus, and ProQuest were searched from inception to December 31, 2022, with a manual search of the references., Study Selection: Cohort studies of human participants that reported 1-, 2-, 3-, 4-, 5-, and 10-year survival from diagnosis among men, women, or both with breast cancer in SSA were included., Data Extraction and Synthesis: Independent extraction of study characteristics by multiple observers was performed using open-source software, then exported to a standard spreadsheet. A random-effects model using the generalized linear mixed-effects model was used to pool data. The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guideline for reporting was followed., Main Outcome and Measures: Survival time from diagnosis., Results: Forty-nine studies were included in the review with a sample size ranging from 21 to 2311 (total, 14 459; 196 [1.35%] men, 13 556 [93.75%] women, and 707 [4.90%] unspecified; mean age range, 38 to 71 years), of which 40 were summarized using meta-analysis. The pooled 1-year survival rate of patients with breast cancer in SSA was 0.79 (95% CI, 0.67-0.88); 2-year survival rate, 0.70 (95% CI, 0.57-0.80); 3-year survival rate, 0.56 (95% CI, 0.45-0.67); 4-year survival rate, 0.54 (95% CI, 0.43-0.65); and 5-year survival rate, 0.40 (95% CI, 0.32-0.49). The subgroup analysis showed that the 5-year survival rate ranged from 0.26 (95% CI, 0.06-0.65) for studies conducted earlier than 2010 to 0.47 (95% CI, 0.32-0.64) for studies conducted later than 2020. Additionally, the 5-year survival rate was lower in countries with a low human development index (HDI) (0.36 [95% CI, 0.25-0.49) compared with a middle HDI (0.46 [95% CI, 0.33-0.60]) and a high HDI (0.54 [95% CI, 0.04-0.97])., Conclusions and Relevance: In this systematic review and meta-analysis, the survival rates for patients with breast cancer in SSA were higher in countries with a high HDI compared with a low HDI. Enhancing patient survival necessitates a comprehensive approach that involves collaboration from all relevant stakeholders.

Preterm birth is one of the most common obstetric complications in low- and middle-income countries, where access to advanced diagnostic tests and imaging is limited. Therefore, we developed and validated a simplified risk prediction tool to predict preterm birth based on easily applicable and routinely collected characteristics of pregnant women in the primary care setting. We used a logistic regression model to develop a model based on the data collected from 481 pregnant women. Model accuracy was evaluated through discrimination (measured by the area under the Receiver Operating Characteristic curve; AUC) and calibration (via calibration graphs and the Hosmer-Lemeshow goodness of fit test). Internal validation was performed using a bootstrapping technique. A simplified risk score was developed, and the cut-off point was determined using the "Youden index" to classify pregnant women into high or low risk for preterm birth. The incidence of preterm birth was 19.5% (95% CI:16.2, 23.3) of pregnancies. The final prediction model incorporated mid-upper arm circumference, gravidity, history of abortion, antenatal care, comorbidity, intimate partner violence, and anemia as predictors of preeclampsia. The AUC of the model was 0.687 (95% CI: 0.62, 0.75). The calibration plot demonstrated a good calibration with a p-value of 0.713 for the Hosmer-Lemeshow goodness of fit test. The model can identify pregnant women at high risk of preterm birth. It is applicable in daily clinical practice and could contribute to the improvement of the health of women and newborns in primary care settings with limited resources. Healthcare providers in rural areas could use this prediction model to improve clinical decision-making and reduce obstetrics complications., (© 2024. The Author(s).)

Anemia is characterized by a decline in the number or size of red blood cells and Hb concentration, which results in impairment capacity to transport oxygen. It is a major cause of indirect maternal mortality. Anemia is largely preventable and easily treatable, if detected in time; however, it remains one of the leading causes of maternal morbidity and mortality, especially in developing countries. This study aimed to assess factors associated with anemia among pregnant women who attended antenatal care., Methods: A health facility-based cross-sectional study was conducted from 1 February 2020 to 2 March 2020 among 420 pregnant women. The data were collected by systematic random sampling technique, entered into a computer using EpiData 3.5, and analyzed using the Statistical Package of Social Sciences 23.0 version. Bivariate and multivariable logistic regression analyses were done to estimate the crude and adjusted odds ratio with a CI of 95% and a P -value of less than 0.05 considered statistically significant. Frequency tables, figures, and descriptive summaries were used to describe the study variables., Results: The overall prevalence of anemia was 32.9% (95% CI: 28.6-37.4), and it was higher in rural than urban pregnant women (45 vs. 23%), respectively. In multivariable analysis women who are found in the age group of greater than or equal to 30 years (AOR=3.45, 95% CI=1.22-9.78), rural residency (AOR=3.51, 95% CI=1.92-6.42), low family income (AOR=3.10, 95% CI=1.19-8.08), multiparty (AOR=2.91, 95% CI=1.33-6.38), a short interpregnancy gap (AOR 3.32, 95% CI=1.69-6.53), not taking iron and folate (AOR=4.83, 95% CI=2.62-9.90), third trimester of pregnancy (AOR=3.21, 95% CI=1.25-8.25), poor minimum dietary diversity score (AOR=3.54, 95% CI=1.58-7.95), undernourished (AOR=4.9, 95% CI=2.19-7.64), poor knowledge of anemia (AOR=3.19, 95% CI=1.72-5.93), consumption of coffee always after meal per day (AOR=3.24, 95% CI=1.42-7.42), having a history of irregular menstruation, and antepartum hemorrhage were significantly associated with anemia in pregnant women., Conclusion: This study showed that the prevalence of anemia in pregnant women in this study area was a moderate public health problem. The author suggest emphasizing the education and counseling of women on the advantage of taking the supplemented iron and folic acid. Health care providers should have to advise women to stay for at least 2 years before the next pregnancy to reduce the risk of adverse maternal and infant outcomes. Awareness creation in the community on the utilization of insecticide-treated bed nets is also needed., Competing Interests: All authors declare that they don’t have any conflicts of interest., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Introduction: COVID-19 has rapidly crossed borders, infecting people throughout the whole world, and has led to a wide range of psychological sequelae. Midwives who come close in contact with women while providing care are often left stricken with inadequate protection from contamination with COVID-19. Therefore, this study aimed to assess the level of depression, anxiety, and stress (DASS) among midwives in Ethiopia., Methods: A cross-sectional study was conducted from 20 June to 20 August 2020, among 1,691 practicing midwives in Ethiopia. A simple random sampling technique was used to select study participants. Data were collected through a structured telephone interview. A 21-item depression, anxiety, and stress scale (DASS-21) was used. Data were entered using the Google forms platform and were analyzed with SPSS version 24. Both bivariate and multivariable logistic regression analyses were employed. Variables with a p- value < 0.05 in the final model were declared statistically significant. Adjusted odds ratio ( AOR ) with the corresponding 95% confidence interval (95% CI ) was used to determine independent predictors., Results: The prevalence of DASS among midwives in Ethiopia was 41.1, 29.6, and 19.0%, respectively. Being female [ AOR = 1.35; 95% CI : 1.08, 1.69], working in rural areas [ AOR = 1.39; 95% CI : 1.06, 1.82], having poor knowledge of COVID-19 [ AOR = 1.40; 95% CI : 1.12, 1.75], having poor preventive practice [ AOR = 1.83; 95% CI : 1.47, 2.28], and substance use [ AOR = 0.31; 95% CI : 0.17, 0.56] were significantly associated with depression; while, working in the governmental health facility [ AOR = 2.44; 95% CI : 1.24, 4.78], having poor preventive practice [ AOR = 1,47; 95% CI : 1.16, 1.85], and having poor attitude [ AOR = 2.22; 95% CI : 1.04, 1.66] were significantly associated with anxiety. Furthermore, working in rural areas [ AOR = 0.57; 95% CI : 0.39, 0.83], substance use [ AOR = 2.06; 95% CI : 1.51, 2.81], having poor knowledge [ AOR = 1.44; 95% CI : 1.20, 1.90], and having poor preventive practice [ AOR = 1.60; 95% CI : 1.23, 2.10] were associated with stress., Conclusion: In this study, the overall magnitude of depression, anxiety, and stress were high. Addressing knowledge gaps through information, training, and safety protocols on COVID-19 and the provision of adequate personal protective equipment (PPE) is essential to preserve the mental health of Midwives during COVID-19., 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 Kassahun, Kassie, Tilahun and Bizuneh.)

Introduction: fetal adverse birth outcomes are abnormal outcomes such as prematurity, low birth weight, stillbirth, and birth defects. It is the main cause of neonatal and child deaths in the world and is the major public health problem in developing countries including Ethiopia. This study aims to assess the proportion and factors associated with fetal adverse birth outcomes among mothers who gave birth at Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar city, North-west, Ethiopia 2019., Methods: institution-based cross-sectional study was conducted from March 1- to April 30 in 2019 among 371 delivered mothers. The data were collected by systematic random sampling technique, entered into a computer using Epi data 3.5, and analyzed using Statistical Package of Social Sciences version 23.0. Bivariate and multivariable logistic regression analyses were done to estimate the crude and adjusted odds ratio with a confidence interval of 95% and a P-value of less than 0.05 considered statistically significant., Results: in this study, the proportion of fetal adverse birth outcome was 33.2%. Mothers who lived in rural area [AOR=4.37, 95% CI=2.44-7.83], < 4 antenatal care visit [AOR=1.91, 95% CI=1.08-3.40], bad obstetrical history [AOR=2.01, 95% CI=1.03-3.93], complication in the antepartum period [AOR=4.32, 95% CI=2.44-7.65], medical illness [AOR=2.44, 95% CI=1.25-4.79], and maternal hemoglobin level < 11 mg/dl [AOR=4.63, 95% CI=2.40-8.93] were significantly associated with fetal adverse birth outcomes., Conclusion: the proportion of fetal adverse birth outcomes in this research was high. Living in a rural area, the number of antenatal care visits, bad obstetrical history, current pregnancy complications, medical illness, and hemoglobin levels less than or equal to 11 mg/dl were significantly associated with fetal adverse birth outcomes. Getting full service of antenatal care visits and advance in the quality of maternal health services could minimize fetal adverse birth outcomes., Competing Interests: The authors declare no competing interests., (Copyright: Bezawit Abeje Alemayehu et al.)

Unintended pregnancy is among the major challenges of public health and a major reproductive health issue, due to its implications on the health, economic and social life of a woman and her family mainly in low and middle-income countries, particularly sub-Saharan Africa. The study aimed to assess unintended pregnancy and associated factors among pregnant women in Ethiopia using multilevel analysis from the EDHS 2016. We used the data from the 2016 Ethiopian Demographic and Health Survey, comprised of 1122 pregnant women. The prevalence of unintended pregnancy was determined through descriptive statistics and multilevel logistic regression was performed to identify factors associated with unintended pregnancy. Variables with a p-value < 0.05 in the selected model were considered as significantly associated and an adjusted odds ratio was used to determine the strength and direction of the association. The prevalence of unintended pregnancy was 29.7% (CI 27.0%, 32.4%), of which 20.4% were mistimed and 9.3% unwanted. Being multi-para and fertility preference to have no more child were associated with a higher risk of unintended pregnancy whereas husbands' polygamy relation, having no women autonomy, and living in Afar and Somali regions showed a less likely risk of experiencing an unintended pregnancy. This study showed that the proportion of women who experienced unintended pregnancy is considerably high. Parity, fertility preference, polygamy relation, women autonomy, and region were identified factors associated with unintended pregnancy. Therefore, policymakers at all levels, reproductive health experts, and concerned organizations should emphasize minimizing unintended pregnancy targeting the regional variation at large. Researchers have to explore the regional variations through a qualitative study.

Introduction: Nonreassuring fetal heart rate patterns (NRFHRP) suggest fetal conciliation or a deteriorating ability to handle the stress of labor. Nearly half of stillbirths occurring worldwide are due to hypoxia which is primarily manifested by NRFHRP. Hence, this study assessed the proportion and associated factors of NRFHRP in the Finote Selam primary hospital, North West Ethiopia., Methods: An institution-based retrospective cross-sectional study was conducted from March 1 to April 1, 2019, on 364 charts of mothers who gave birth from January 2017 to January 2018 at the Finote Selam primary hospital. A computer-based simple random sampling technique was used to select charts. A secondary data was collected using a structured questionnaire adapted from different literatures. The data was entered and analyzed using Epi Info version 7 and Statistical Package for the Social Sciences (SPSS) version 23.0. Binary logistic regression was executed, and all explanatory variables with p value < 0.2 were entered into multivariable logistic regressions. Multivariable logistic regression was used to control the effect of confounding variables and to identify factors affecting NRFHRP. Odds ratios with 95% confidence intervals were computed, and statistical significance was declared if p < 0.05., Result: Out of 364 total deliveries, NRFHRP was detected on 55 (15.1%) fetuses, and the commonest NRFHRP detected was bradycardia 44 (80%). Most NRFHRP (38.18%) occurred on the deceleration phase of labor. There was no identified possible cause for NRFHRP on 34.5% of cases. Referral from nearby health institutions [AOR = 2.832 (95% CI 1.457, 5.503)], primigravida [AOR = 2.722 (95% CI 1.377, 5.381)], augmentation of labor [AOR = 3.664 (95% CI 1.782, 7.534)], and meconium-stained amniotic fluid [AOR = 6.491 (95% CI 3.198, 13.173)] were significantly associated with NRFHRP., Conclusion: The proportion of NRFHRP is high. Referral from nearby health institutions, primigravida mothers, augmentation of labor, and meconium-stained amniotic fluid were significantly associated with NRFHRP. Implementing a better referral link and close monitoring during follow-up could minimize NHFHRP., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2020 Eden Asmare Kassahun et al.)

Background: COVID-19 has a devastating effect on social, economic, and political crises that will leave deep pockmarks on victims of the virus. Having poor knowledge and attitude of the disease among health care providers could bring in impeded effect in the supportive treatment and, it increases the spread of the pandemic., Objective: The study aims to assess the knowledge and attitude towards COVID-19, and associated factors among health care providers in Northwest Ethiopia in 2020., Methods: Institution based cross-sectional study was conducted from the mid of March to the end of April 2020 among 408 participants who were selected by a simple random sampling technique. Pretested and structured self-administered questionnaire was used to collect data. The data were entered using EPI-info v. 7, and were exported to SPSS version 20 for further analysis. Bivariate and multivariable logistic regression analyses were used to identify factors associated with Knowledge and Attitude towards COVID-19. Variables having p-value < 0.05 were taken as variables which were significantly associated with the dependent variable., Result: A total of 408(97.1%) participants have participated in the study. Most of the participants (67.3%) were males. One-third (35.5%) of the participants were nurses. About 62% of the health care providers were Bachelor degree holders. The prevalence of Knowledge and attitude towards COVID-19 found to be 73.8% (95%CI: 69.9, 77.9) and 65.7% (95%CI: 61.5, 70.1) respectively. Master degree level of education (AOR = 2.85; 95% CI: 1.25, 6.00) was associated with knowledge of the participants. Similarly, having good knowledge (AOR = 3.17; 95%CI: 1.97, 5.06) was positively associated with the attitude of health care providers towards COVID-19., Conclusion and Recommendation: Health care providers found to have good knowledge and attitude towards COVID-19. Being Master's Degree holder and having good knowledge are associated with the knowledge and attitude of the respondents towards COVID-19 respectively. Thus, improving awareness through health education is a significant approach to address the global agenda of COVID-19 Pandemic., Competing Interests: The authors have declared that no competing interests exist.

Introduction: Globally, sexually transmitted infections (STIs) remain a major public health problem. University students tend to practices sex which predisposes them to sexually transmitted infections, unwanted pregnancies, and unsafe abortions due to their freedom from families. Therefore, the study aimed to assess the prevalence of sexually transmitted infections and associated factors among the University of Gondar students, northwest Ethiopia., Methods: An institution based cross-sectional study was conducted on 845 the University of Gondar students selected using the multistage sampling technique from March 7-10, 2016. The data were collected using a structured, pre-tested self-administered questionnaire. Bivariate and multivariable logistic regression analyses were employed through SPSS version 20 to identify factors associated with sexually transmitted infections. Odds ratio with a 95% confidence interval was computed to determine the level of association. In the multivariable analysis, variables with p-value less than 5% were considered as statistically significant association between covariates and sexually transmitted infections., Result: Sexually transmitted infections among university students were found to be 18.20% (95%CI,15.40,20.80). Previous history of sexually transmitted infections (AOR = 2.1; 95%CI: 1.04, 4.38), multiple sexual partners in life (AOR = 2.7; 95%CI:1.70, 4.40), not use of condoms during sexual intercourses (AOR = 2.4; 95%CI:1.50,3.75) and poor knowledge of sexually transmitted infections (AOR = 3.3; 95%CI:1.09,5.32) were significantly associated with sexually transmitted infections., Conclusion: The prevalence of STIs was high among university students. The previous history of sexually transmitted infections, multiple sexual partners, not using condoms during sexual intercourse and poor knowledge of sexually transmitted infections were found to be associated with the infections. Opening and strengthen reproductive health centers on the campuses, popularizing sexual, and reproductive health information and education, particularly on STI modes of transmission, prevention, and health-seeking behaviors, and providing information on accessing of condoms is recommended to reduce sexually transmitted infections.

Objective: Unintended pregnancy is one of the most public health issues in the world, and it is the major sexual and reproductive health problem which carries a higher risk of morbidity and mortality for women, often due to unsafe abortion. Even though family planning services are effective and available than ever before, unintended pregnancy and unsafe abortion are the major public health problems in the study area. Therefore, this study aimed at assessing the magnitude and associated factors of unintended pregnancy among pregnant women attending antenatal care follow up in Maichew town, northern Ethiopia. An institution based cross-sectional study was conducted on 329 pregnant women selected with a systematic sampling technique from April 5 to May 4, 2017., Result: The magnitude of unintended pregnancy among pregnant women attending antenatal care in Maichew was found to be 29.7% (95% CI 24.30, 35.50). On the other hand, single in marital status (AOR = 38.6, 95% CI 10.07, 148.01), living alone (AOR = 9.9, 95% CI 1.80, 53.40) and having three or four children (AOR = 3.5, 95% CI 1.10, 11.04) were factors associated with an unintended pregnancy. Creating awareness about unintended pregnancy associated factors and implication of unintended pregnancy is highly recommended.

Objective: Pregnancy is a happy time for women and their families although it can also a period of concern and anxiety, for some women, lose their babies during early or late pregnancy, give birth earlier than the expected date or face low birth weight. Therefore, this study aimed to assess the prevalence of adverse birth outcomes and associated factors among women who delivered in the North Wollo zone, northeast Ethiopia., Result: The prevalence of adverse birth outcomes among women who delivered in North Wollo zone was 31. 8%. Living in rural area (AOR = 1.8; 95% CI 1.13, 2.78), age ≥ 34 years (AOR = 2.2; 95% CI 1.21, 4.05), mid-upper-arm circumference < 23 cm (AOR = 3.1; 95% CI 1.90, 4.94), multigravida women (AOR = 1.8; 95% CI 1.08, 3.06), lack of antenatal care visit (AOR = 2.1; 95% CI 1.02, 4.40) and complications during pregnancy (AOR = 2.1; 95% CI 1.23, 3.55) were significantly associated with adverse birth outcomes. The prevalence of adverse birth outcomes was high and is a major public health problem in Ethiopia particularly in the study area. Hence, increasing the access to health institutions, developing strategies to prevent and treat complications, and providing focused antenatal care follow-up for pregnant women is recommended.

Background: Early initiation of sexual activity affects the sexual and reproductive health of the young population. The youth are at a high risk of risky sexual behaviours, including multiple partners and inconsistent condom use. There has been limited research on the level and determinants of early sexual initiation in Woldia town. Thus, this study aimed to assess the prevalence of early sexual initiation and associated factors among preparatory and high school students in Woldia town, northeast Ethiopia., Methods: An institution based cross-sectional study was conducted on 723 students selected by the simple random sampling technique on March 7, 2016. A pre-tested and structured self-administered questionnaire was used for data collection. Descriptive statistics, bivariate and multivariable logistic regression were computed. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) was calculated to examine the strength of association. In the multivariable analysis, a p-value < 0.05 was considered as statistically significant., Result: The prevalence of early sexual initiation among preparatory and high school students in Woldia town was 18.4% (95% CI:15.50,21.30%). Not attending religious programs (AOR = 3.2, 95% CI:1.84,5.44), peer pressure (AOR = 1.9, 95% CI:1.14,3.25), cigarette smoking (AOR = 2.3, 95% CI:1.06,4.85), poor parental monitoring (AOR = 2.8, 95% CI:1.77,4.53), and exposure to pornographic materials (AOR = 2.7, 95% CI:1.68,4.40) were significantly associated with early sexual initiation., Conclusion: A large number of students initiated sexual activity at an early age. The practiced is associated with sexual and reproductive health problems. Therefore, raising awareness of students about the risk factors for and implication of early sexual initiation through teachers, religious leaders, and parents is highly recommended.