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Background: Patients with mental disorders have high rates of co-existing alcohol use disorder and vice versa. Alcohol use disorder has emerged as a major challenge to intervene patients with severe mental disorders. It is under-recognized and has not been investigated well in low-income countries like Ethiopia. The aim of this study was to assess the prevalence and associate factors of alcohol use disorder among patients with severe mental disorders attending psychiatric follow-ups at the University of Gondar comprehensive specialized hospital, northwest Ethiopia., Methods: A total of 384 patients with severe mental disorders selected by a systematic random sampling technique took part in the interviews for this cross-sectional study. The alcohol use disorder identification test was used to assess the problem. Univariate and multivariate binary logistic regressions were computed to examine the associated factors. An adjusted odds ratio with a 95% confidence interval (CI) was used for reporting the result., Results: The prevalence of alcohol use disorder among patients with severe mental disorders was 36.2%. Of the participants, 23.5%, 8.6%, and 4.1% had hazardous, harmful alcohol drinking and alcohol dependency, respectively. In the multivariate analysis, male sex, younger age, psychotic and bipolar disorder diagnoses, having poor social support, moderate and high perceived stress, and current tobacco smoking were factors significantly associated with alcohol use disorder., Conclusion: The prevalence of alcohol use disorder among patients with severe mental disorders was found to be high. Early intervention and integrating treatment services for co-existing mental disorders and alcohol use disorder is important. The special treatment, where it is offered for young male patients and those with the diagnosis of psychotic and bipolar disorders, is recommended to promote the uptake of alcohol and mental health treatment services., Competing Interests: The authors declare that they have no conflict of interest., (© 2021 Kassew et al.)

Background: Absence of reliable health insurance schemes is a key challenge to meet the universal health coverage target of the Sustainable Development Goals (SDGs). Ethiopian health system is characterized by under financing, low protection mechanisms for the poor, and lack of mechanisms of risk pooling and cost sharing. Ethiopia is implementing social health insurance (SHI) scheme to reduce out of pocket payment (OOP) and improve access and use of healthcare. This study aimed to determine the demand for SHI among civil servants and associated factors in Northwest Ethiopia., Methods: An institution-based cross-sectional study was conducted in Bahir Dar city from 557 randomly selected civil servants using structured and self-administered questionaire. The questionnaire included questions measuring demand for SHI and demographic, socio-economic, healthcare related and personal and behavioral factors. Data were first entered in Epi-Info version 7.0 and transferred to SPSS version 20 for analysis. Descriptive statistics, bivariate and multivariable logistic regression analysis were performed., Results: From the total calculated sample size of 557, 488 respondents returned the questionnaire giving a response rate of 88%. Nearly three-fourth of the respondents, 355 (72.7%), reported their need to be enrolled in a SHI scheme. Two-third of the respondents 325 (66.6%) were willing to pay for their enrollment. Overall, three hundred and two (61.9%) were demanding SHI. Having good awareness about health insurance [AOR = 4.39, 95% CI = (1.82-12.89)] and trust on a health insurance agency [AOR = 3.0, 95% CI = (1.57-5.72)], were significantly associated with the demand for SHI among civil servants., Conclusion: The demand for SHI among civil servants were higher. The awareness towards SHI and trust on the SHI agency were significantly associated with demand for SHI. As Ethiopia aspires to insure all employees of the formal sector, and improving the awareness of civil servants about SHI and the agency providing the service could improve demand for SHI. Further research is important on healthcare organizational and professional readiness to handle the upcoming insurance driven quality health service need and health seeking behavioral change., Competing Interests: Institutional Review Board (IRB) of the Institute of Public Health, University of Gondar reviewed and approved the proposal to conduct the study and written ethical permission letter was received. Additional permission letters to conduct this study were obtained from all selected government institutions in Bahir Dar town. Verbal consent was obtained from each respondents after explaining the purpose of the study. Participants were also informed that they have full right to discontinue or refuse to participate in the study. They were also informed that all data obtained from them will be kept confidential and personal identifiers were not used. Finally, the data collection facilitators arranged a separate room to help respondents fill the questionnaire privately.Not applicable.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.