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Mathewos Mekonnen,1 Kumera Bekele,1 Kemal Jemal,1 Dejene Hailu,1 Bikila Tesfa,1 Teshale Mulatu2 1Department of Nursing, College of Health Sciences, Salale University, Fiche, Oromia, Ethiopia; 2Department of Midwifery, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Oromia, EthiopiaCorrespondence: Mathewos MekonnenDepartment of Nursing, College of Health Sciences, Salale University, P.O. Box 245, Fiche, Oromia, EthiopiaTel +251- 917-04-43-69Email matemek2010@gmail.comBackground: Oral rehydration therapy reduces mortality and morbidity due to diarrheal diseases. However, Oral rehydration therapy remains to be underused worldwide and particularly in low-income countries. This study aims to assess the prevalence of oral rehydration therapy use during diarrheal episode and associated factors among mothers of under-five children visiting public health facilities in North Showa zone, Oromia region, Ethiopia.Methodology: Institutional based cross-sectional study design was employed for one month in June 2020. A structured interview administered questionnaire was used to collect data. Data were entered into EPI-info 3.5.2 then transported to SPSS 21 version. Descriptive statistical analysis was done, and an association between dependent variables and independent variables were examined in logistic regression models.Results: The overall prevalence of oral rehydration therapy use during diarrheal episode was 51.5%. Maternal literacy [AOR= 2.175, 95% CI: (1.178, 4.015)], mothers occupation being farmer [AOR= 0.394, 95% CI: (0.203, 0.762)], post natal care visit [AOR= 2.565, 95% CI: (1.468, 4.480)] and good knowledge of oral rehydration therapy [AOR= 1.919, 95% CI: (1.132, 3.253)] were significantly associated with oral rehydration therapy use.Conclusion: In this study oral rehydration therapy use was moderate. Maternal literacy, good knowledge of oral rehydration therapy, maternal occupation being a farmer, and postnatal care visit were the independent predictors of oral rehydration therapy use. Therefore, programmers and stakeholders who are working on child health programs should design interventions that focus on factors deterring child oral rehydration therapy use during diarrheal episode morbidity and mortality.Keywords: diarrhea, oral, practice, rehydration solution, under-five children

Yitagesu Sintayehu, Assefa Desalew, Biftu Geda, Kasiye Shiferaw, Getahun Tiruye, Teshale Mulatu, Haymanot Mezmur Haramaya University College of Health and Medical Sciences, School of Nursing and Midwifery, Harar, EthiopiaCorrespondence: Yitagesu Sintayehu Email yitagesu.sintayehu@gmail.comBackground: Neonatal resuscitation is a means to restore life to a baby from the state of asphyxia. It is a single intervention of birth asphyxia. Over 1.2 million African babies are supposed to die in the first four weeks of their life and many of them in the first 24 hours of birth in Sub-Saharan Africa. The major cause of early neonatal death is neonatal asphyxia, which can be prevented by neonatal resuscitation. However, there is limited evidence on midwives’ and nurses’ knowledge of neonatal resuscitation in the study area. Therefore, this study aimed to assess the knowledge of midwives and nurses about neonatal resuscitation and its associated factors.Methods: This facility-based cross-sectional study was done on 427 midwives and nurses, who were selected using simple random sampling technique. Data were collected on facility type, availability of essential equipment, socio-demographic characteristics, working unit, professional experience, in-service training, and knowledge of neonatal resuscitation. First-degree holder midwives collected the data using a pre-tested face-to-face interviewer-administered questionnaire. Bivariate and multivariate logistic regression was used to analyze the association between the dependent and independent variables.Results: The study showed that 9.8% of the study participants had good knowledge about neonatal resuscitation. Factors significantly associated with knowledge of neonatal resuscitation were being trained on newborn resuscitation (AOR = 3.79, 95% CI: 1.73, 8.32), being unmarried (AOR = 2.36, 95% CI: 1.11, 5.02), holding bachelor sciences degree or above (AOR = 2.67, 95% CI: 1.11, 6.47), and working under West Hararghe health institutions (AOR = 0.30, 95% CI: 0.10, 0.88).Conclusion: The study participants had low knowledge of neonatal resuscitation. Being unmarried, holding bachelor sciences degree or above, being trained on neonatal resuscitation, and working under West Hararghe health institutions were factors associated with the knowledge of the study participants on neonatal resuscitation.Keywords: neonate, neonatal resuscitation, newborn, knowledge

Understanding climate science is essential for effective policy development, adaptation, mitigation, and risk management. Given the inherent limitations in climate models, this study evaluates the performance of CORDEX Africa regional climate models to simulate precipitation and temperatures over the Melka-Wakena catchment. To accomplish this, the performance evaluation utilizes techniques such as multi-metric weighted ranking to select top-1 (best individual model), specific multi-model ensembles (top-N ensemble), multi-model ensemble, and average hybrid (top-N ensemble with MME) approaches at various temporal scales. Also, Taylor diagrams and empirical cumulative distribution functions are other useful elements for model comparison visualization. This study finds that, top-3 ensemble (for temporal scale tasmin, monthly pr), top-7 ensemble (monthly and seasonal tasmax), average hybrid (top-1 with MME (daily pr and tasmax), HadGEM2ES_RACMO22T for seasonal and yearly pr), and HadGEM2ES_RCA4 for yearly tasmax) are preferable, with weighted scores of 0.29, 0.44, 0.22, 0.20, 0.35, 0.40, 0.39, 0.33, 0.45, 0.25, and 0.33, respectively. In short, RCA4 and RACMO22T efficiently mimic air temperatures and precipitation in the Melka-Wakena catchment. While ensemble approaches are generally more resilient and possible, single-best-performing model approaches can be quite effective for long-term periods. Finally, these studies have an important implication for improving climate change assessment, adaptation, and mitigation measures.

This study investigates the geotechnical factors influencing a recent landslide event in Gera Woreda, Ethiopia. The primary objective was to identify the soil properties contributing to landslide occurrence and understand the triggering mechanisms. Field investigations, soil sampling from both affected and unaffected areas, and subsequent laboratory characterization were conducted. The analysis revealed a dominance of fine-grained soils, such as clay and silt, which are susceptible to weakening upon saturation, thereby increasing landslide susceptibility. Rainfall is identified as the primary trigger for the landslide. Numerical stability assessments using the Limit Equilibrium Method (software, Slide™) and the Finite Element Method (software, PLAXIS®) were performed to assess the stability of the slopes. The stability analysis revealed a notable decrease in the factor of safety (FS) under rising groundwater levels. For example, the FS for Slope 1 decreased from 1.42 under dry conditions to 0.73 at a 2 m groundwater depth. Similarly, Slope 2's FS decreased from 2.06 to 1.18 under similar conditions. These results emphasize that rainfall is the primary trigger for landslides in the area. To address this, the study proposes surface drainage systems and the planting of Vetiver grass to improve slope stability. These findings provide critical insights for developing proactive mitigation strategies to protect local communities and infrastructure from landslide hazards.

Abstract Online digital market platform business model designers, marketers, and retailers can further expand their marketing strategies to draw in and keep customers to gain a competitive edge globally if they are aware of the elements influencing consumers' purchasing intentions. The purpose of this research is to identify the crucial variables impacting Addis Ababa University, Graduating Engineering Students’ desire to purchase on online digital market platforms, and narrow the research gap on determinants of online purchase intention of Ethiopian consumers. This study adopted a descriptive and inferential survey design, epistemology assumption, and employed the positivism research philosophy approach to test the research hypotheses. The primary study technique used to collect relevant data was a closed-ended 5-point Likert scale questionnaire. The information was gathered from 100 Ethiopian, Addis Ababa University, graduating engineering students. With the use of SPSS version 23 and SmartPLS version 3.0 software, the data were examined using descriptive statistics and the inferential partial least square structural equation modeling (PLS-SEM) technique. The results of this study highlighted five useful decision-making elements that have an impact on the selected consumers' intention to buy on online digital market platforms including Website Design, Perceived Usefulness, Perceived Ease of Use, Trust, and Subjective Norms. The Practical Implication of this research is that with a clear understanding of the key determinants of consumers’ purchase intention on online digital market platforms; manufacturers, online marketers, and retailers can create effective market strategies, enhance technology, and make smart marketing choices that will help them gain global competitive advantage. This study is unique in that it uses a new conceptual research framework and the partial least square structural equation modeling (PLS-SEM) technique to analyze relationships between determinant variables and consumers’ intention to purchase on online digital market platforms. The major finding of this research provides empirical evidence towards the key determinant variables of consumers’ purchase intention on online digital market platforms. The small sample size is one of the limitations to generalize the finding of this research. Future studies should focus on enlarging the sample size and assessing more determinant variables to get a generalizable result.

Landslides pose a significant threat to infrastructure, property, and human lives in many regions worldwide, including Chira town in Ethiopia. This study presents an integrated geotechnical and geophysical investigation aimed at identifying the contributing factors to landslides in Chira town, Ethiopia, with a focus on a recent landslide event. The methodology employed a combination of geotechnical and geophysical techniques to comprehensively analyze the landslide problem. The geotechnical investigation involved a detailed analysis of the soil characteristics in the area, including the composition of fine-grained soil and the determination of cohesion and angle of internal friction through triaxial testing. The geophysical investigation utilized electrical resistivity tomography to assess the subsurface soil profile. The findings revealed the presence of a massive basaltic tertiary volcanic rock layer underlying a very low resistivity layer of sticky clay soil. Through this study, it was established that rainfall, soil type, land use, elevation, and proximity to streams, slopes, and aspects were the main factors contributing to the landslide, accounting for 22.03%, 18.89%, 15.75%, 15.46%, 10.87%, 9.7%, and 7.5% of the overall influence, respectively. Based on these findings, the study proposes a range of interventions to enhance resilience against landslides, including surface drainage, the implementation of appropriate land use management practices, and the introduction of vetiver vegetation. The integration of geotechnical and geophysical methodologies provided a comprehensive understanding of the landslide problem in Chira town. The proposed interventions aim to inform future land use planning, infrastructure development, and disaster risk reduction efforts in the region. By expanding our knowledge of the mechanisms driving landslides, this study offers valuable insights that can be utilized in similar regions facing comparable geotechnical and geophysical conditions.

Industrialization and urbanization have run into situations where the construction of buildings is close to each other. This closeness arises due to the restricted available space in a practical construction manner. Such a situation was a reason for the cause of footing of the same and adjacent structures coming closer. This condition causes interference effects, soil-structure interaction, and the stress zone impact to behave differently other than the continuum soil media in the vicinity under the base of the foundation due to overlap stress distribution, which results in excessive foundation settlement. Therefore, the study aims to assess the interference effect of closely spaced footing on settlement variation. In this regard, comprehensive experimental soil properties were conducted using the American Society for Testing and Materials (ASTM) testing procedures to characterize soil behavior. The interference of two footings in the settlement is studied using 3D finite element analysis. The hardening soil was used to model the foundation soil medium using the Plaxis 3D program. Certain vital factors of two neighboring footings for differing maximum loads, distance, embedment ratio, soil layer, and groundwater level are discovered to impact overlapping footing influence. It is observed that the spacing between the footings increases, and the interference impact on the overlapping footings declines, reaching the isolated footing condition at spacing higher than five foundation footing dimensions and increasing when the spacing between the footings decreases.

Culicoides, among the tiniest and most abundant hematophagous insects globally, serve as vectors for a variety of pathogens such as viruses, bacteria, parasites, protozoa, and nematodes. This study aimed to identify Culicoides species and assess their spatial distribution and seasonal occurrence in selected districts of the Central, South, and West Gondar zones, Northwest Ethiopia. A cross-sectional study was conducted between January to July 2023. A total of 44 UV light- onderstepoort traps were deployed in the study districts near specific areas. The traps were operational from dusk (6:00 PM) until dawn (6:00 AM) and were suspended at a height of 1.5 to 2 m above the ground. Poisson regression was used to assess associations, the Shannon diversity index to measure diversity, and QGIS 3.22.6 to create maps. In this study, 8,857 Culicoides were captured across the 44 trapping sites. Of the total flies captured flies, 8,838 were identified as belonging to 12 distinct species, while the classification of the remaining 19 flies remained unclear. Notably, C. kingi (54.01%) was the most prevalent species, followed by C. imicola (44.55%). The abundance of Culicoides observed from January to late April (3505) was significantly lower compared to the wet season (5355), with a marked increase in the capture of C. kingi (2499) from May to late July. A statistically significant association (p < 0.05) was observed between the occurrence of Culicoides and factors such as district, sampling point, and season. Spatial analysis revealed that C. kingi had a broader range of suitability than other Culicoides species, with high suitability observed in East Dembia. The diversity index analysis indicated that Culicoides species diversity was higher in samples from animal pens (H = 0.73) and during the wet season (H = 0.75). Additionally, this study documented the presence of eight Culicoides species namely C. corsicus, C. kibunensis, C. reioxi, C. kiouxi, C. saharienines, C. desertorum, C. reithi, and C. festivipennis, which have not been previously documented in Ethiopia. In conclusion, the study highlighted that the occurrence of Culicoides species was higher in East Dembia, with moderate presence in Wegera and West Armacho. Further research is needed to assess the impact of various Culicoides species on animal and human health, as well as their economic implications, and to develop corresponding control strategies based on these findings., (© 2024. The Author(s).)

Introduction: Maternal and neonatal complications related to pregnancy and childbirth pose a significant risk of morbidity and mortality to both the mother and the child. Despite its benefits in reducing maternal and neonatal mortality and morbidity associated with pregnancy and childbirth, the majority of Ethiopian mothers were dropped from the maternal continuum of care. Furthermore, there is a dearth of data regarding the status of the maternal continuum of care and its underlying factors in southern Ethiopia., Objective: This study aimed to assess the completion of the maternity continuum of care and its predictors among postpartum women who had given birth in the previous six months in the Gedeb district of Gedio Zone, southern Ethiopia., Methods: A community-based cross-sectional survey was conducted among 625 postpartum women selected by simple random sampling from June 1 to 30, 2022. The data was collected through face-to-face interviews using pretested, structured questionnaires. The association between the explanatory variables and the maternity continuum of care was examined using bivariate and multivariable logistic regression models. The adjusted odds ratio (AOR) with a 95% confidence interval was employed to measure the strength of association and the level of significance was set at p<0.05., Results: In this study, only 32.00% (95% CI: 28.45, 35.77) of the women completed the maternal continuum of care. Attending primary education (AOR = 2.09; 95% CI: 1.23, 3.55), secondary and above education (AOR = 1.97; 95% CI: 1.01, 3.87), receiving counseling during ANC (AOR = 1.89; 95% CI: 1.22, 2.92), being well prepared for birth and complications readiness (AOR = 4.13; 95% CI: 2.23, 7.62), and having good knowledge of pregnancy danger signs (AOR = 4.13; 95% CI: 2.60, 6.55) were all significantly associated with completing the maternity continuum of care., Conclusion: Nearly one-third of the women completed the maternity continuum of care. Enhancing women's knowledge, offering counseling during prenatal visits, ensuring women's awareness of pregnancy danger signs, and implementing health promotion programs targeted at enhancing birth preparedness and complications readiness for all are crucial., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Alemayehu 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: Intimate partner violence (IPV) is recognized as a main public health challenge, with serious consequences for women's physical, mental, sexual, and reproductive health. Despite its public health importance, most studies of IPV in Ethiopia mainly focused on individual characteristics and didn't identify how factors operating at different levels affect IPV. Thus, there is limited evidence regarding the hierarchical-level factors of IPV and the effect of individual and community-level determinants of IPV. The aim of this study is to assess the individual and community-level factors associated with violence against women among ever-married reproductive-age women in Ethiopia., Methods: A retrospective analysis of secondary data retrieved from the Ethiopia Demographic and Health Survey was conducted among reproductive age group women (15-49 years of age) who reported ever being married within the available data set for the domestic violence module. STATA 14 was used to conduct the analysis. A two-level mixed-effects logistic regression analysis was used to determine associations between IPV and individual- and community-level factors. IPV variability across the community was assessed using ICC and PCV. The model's fitness was assessed using the Akaike information criterion (AIC), the Bayesian information criterion (BIC), and the likelihood ratio test., Result: The life time prevalence of IPV in this study was 33% [95% CI: 30.74, 34.25]. Women's age 20-24 (AOR = 5.85, 95% CI: 201 3.10, 11.04), 25-29 age group (AOR = 6.41, 95% CI; 3.34, 12.32), 30-34 age group (AOR = 9.48, 95% CI: 4.71, 19.06), 35-39 age group (AOR = 9.88, 95% CI: 4.79, 20.39), 40-44 age group (AOR = 11.10, 95% CI: 5.16, 23.89), and 45-49, (AOR = 14.15, 95% CI: 6.01, 32.80), early marriage (AOR = 1.21, 95% CI: 1.08, 1.47), witnessing inter-parental violence during childhood (AOR = 2.80, 95% CI: 2.16, 3.96), having a lot of living children (AOR = 0.45, 95% CI: 0.26, 0.74), having a partner who drank alcohol (AOR = 3.00, 95% CI: 2.42-3.67), decision-making autonomy of the women (AOR = 0.77, 95% CI: 0.62, 0.97), Poor wealth index (AOR = 1.64, 95% CI: 1.23, 2.18), middle wealth index (AOR = 1.86, 95% CI: 1.36, 2.54) and exposure to media (AOR = 1.47, 95% CI: 1.06, 2.00) were all significantly associated with IPV., Conclusion and Recommendation: This study showed that one-third of the women experienced IPV in their lifetime. The finding suggested that community based interventions and multi-sectorial collaborations are needed to reduce the IPV and its adverse consequences., (© 2024. The Author(s).)

Introduction: Maternal morbidity and mortality has remained a major public health concern worldwide. Basic emergency obstetric care is the primary intervention to prevent obstetric complications and maternal death. Episiotomy is one of the basic obstetrical procedures used to facilitate vaginal delivery, shorten the second stage of labor and prevent complications. However, there is a paucity of evidence on the prevalence and factors associated with episiotomy among women who gave birth in eastern Ethiopia., Objective: This study aimed to determine the prevalence of episiotomy and its associated factors among women who gave birth at public health facilities in Jigjiga town, eastern Ethiopia., Methods: A facility-based cross-sectional study was conducted among women who gave birth vaginally from May 1 to June 30, 2022. A total of 422 study participants were recruited using systematic random sampling. Data were collected using structured questionnaires through a face-to-face interview supported with standard observational checklist and reviewing medical records. A logistic regression analysis was carried out to examine the association between explanatory variables and episiotomy. An adjusted odds ratio (AOR) at a 95% confidence interval (CI) at a P-value <0.05 was used to declare significant association., Results: The prevalence of episiotomy among women was 52.6% (95% CI: 47.8%, 57.0%). Obstetric complications during current pregnancy (AOR:3.92, 95% CI: 1.59, 9.68), birth weight ≥4000 gm (AOR: 4.30, 95% CI: 1.53, 12.04), induction of labor (AOR: 3.10, 95% CI: 1.62, 5.93), meconium-stained amniotic fluid (AOR:2.10, 95% CI: 1.14, 3.88), duration of the second stage of labor ≥90 minutes (AOR:3.09, 95% CI: 1.53, 6.23), instrumental delivery (AOR: 2.69, 95%, CI: 1.39, 5.19), and female genital mutilation (AOR: 2.91, 95% CI: 1.83, 4.64) were factors significantly associated with episiotomy., Conclusion: Slightly more than half of the women who gave birth at public health facilities in the study area underwent episiotomies. In addition to the common obstetric factors, having a female genital mutilation scar increased the risk of women's experiencing episiotomies. Therefore, intervention should be tailored to address the identified obstetric risk factors and avoid female genital mutilation in the community to reduce women's experiences of episiotomies in the future., Competing Interests: The authors have declared that no competing interest exist., (Copyright: © 2024 Belay 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: Pre-labor rupture of membrane (PROM) refers to a membrane rupture that occurs after the 28th week of pregnancy but before the start of labor. If not appropriately managed, it poses a significant risk to the health of the mother and fetus. However, information on the magnitude of PROM, contributing factors, and its perinatal outcomes was limited in Eastern Ethiopia. This study assessed the prevalence, predictors, and perinatal outcomes of PROM among pregnant women admitted to Hiwot Fana Comprehensive Specialized University Hospital (HFCSUH) in Eastern Ethiopia so as to guide specific preventive measures., Methods: A hospital-based retrospective cross-sectional study was carried out from May 15 to June 14, 2022, and data were gathered by reviewing the chart records of 424 pregnant women who were admitted to maternity and labor wards in the previous two years, from January 1, 2019 to December 31, 2020. Records were chosen using a simple random sampling method. Mother's socio-demographic traits, previous obstetric and gynecologic history, current pregnancy history, habit-related history (khat chewing), ultrasound findings, laboratory investigations, mode of delivery, maternal and perinatal outcomes were extracted from the maternal charts. Bi-variable and multivariable logistic regression analyses were performed to identify predictors of pre-labor membrane rupture. The association between the explanatory and outcome variables was expressed using an adjusted odds ratio with a 95% confidence interval., Results: The prevalence of pre-labor membrane rupture was 16.27% with 95% CI: (13.05-20.11). Among 69 women who experienced pre-labor rupture of membrane, 50 (72.5%) of them had adverse perinatal outcomes. Of all 69 neonates 17 (24.64%) were delivered with low birth weight and 20 (29%) of them were born preterm. The overall perinatal mortality rate was 10.1% or 101 per 1,000 live births. History of abortion [AOR = 2.61; 95% CI (1.09, 6.24)], urinary tract infection [AOR = 2.59; 95% CI (1.23, 5.42)], antepartum hemorrhage [AOR = 3.35; 95% CI (1.38, 8.13)], and khat chewing (a leafy plant which contains psychoactive chemical) in the current pregnancy [AOR = 2.63; 95% CI (1.49, 4.63)] were all significantly associated with pre-labor rupture of membrane., Conclusion: In this study, the magnitude of pre-labor membrane rupture was relatively high compared to the global rate. Prenatal risk identification and early detection of complications among mothers with a history of abortion, antepartum hemorrhage, urinary tract infection, and counseling on the effects of khat chewing during pregnancy are crucial to reduce the likelihood of pre-labor membrane rupture and its adverse perinatal outcome., 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 © 2024 Wolde, Mulatu, Alemayehu, Alemayehu and Assefa.)

Background: Respiratory distress syndrome (RDS) is the leading cause of respiratory failure and death of a neonate in today's world, especially in developing countries like Ethiopia., Methods: We used an institutional-based cross-sectional study in the selected hospitals of the Gurage zone admitted from June 2019 to June 2021. The data were collected using a structured questionnaire. Data were entered into Epi data 3.1 and exported to SPSS version 25 for analysis., Result: The prevalence of respiratory distress syndrome (RDS) in the study area was 45.1%. The odds of RDS in neonates from mothers with gestational age between 35 &37 were 3.99 times higher compared to term gestation. The odds of RDS among neonates with jaundice and sepsis are 4.33- and 1.92-times higher odds compared to their counterparts. The odds of RDS in neonates born via Caesarean section were 1.7 times higher compared with those delivered via spontaneous and instrumental delivery. RDS was also higher in neonates born to mothers <20 years of age and >=35 years old., Conclusion: the prevalence of RDS in the study area was high. Thus, healthcare providers should act on those factors with appropriate follow-up for early detection of the problem and prevent the risk., Competing Interests: The authors have declared that there is no conflict of interest., (© 2023 Chekole B et al.)

Introduction: The incidence of a pressure ulcer in intensive care units (ICU) is significantly higher than in noncritical care settings. The patients in the ICU are the most vulnerable group to disruption of the skin's integrity. Prior studies in Ethiopia failed to evaluate pressure ulcers in intensive care units and were limited to general wards. The purpose of this study was to identify the incidence and predictors of pressure ulcers in adult patients admitted to intensive care units in Southern Ethiopia., Methods: A single-arm prospective open cohort of 216 patients was used to determine the presence of a pressure ulcer in the intensive care units from June 2021 to April 2022. A consecutive sampling was used until the sample size was reached. The data were collected using a structured questionnaire and analyzed using Stata 14. A cumulative incidence of a pressure ulcer was computed. The life table was used to estimate the cumulative survival. A multivariable Cox proportional hazard regression was used to identify independent predictors of a pressure ulcer. An adjusted hazard ratio with a 95% CI was used to measure the degree of association; a P value ≤ 0.05 was considered significant., Results: Twenty-five patients developed a pressure ulcer (PU), making a cumulative incidence of 11.57%. Out of 25 incident cases of pressure ulcers, four-fifths (80%) of the study patients developed PU within 6 days of their admission to the ICUs. The incidence rate was 32.98 PU per 1000 person-days of ICU stay. Pressure ulcers were most commonly found on the sacrum, followed by the shoulder. Among the incident cases, 52% were stage 2 ulcers. The presence of friction or shearing forces, as well as being 40 years of age or older, was independently associated with pressure ulcers., Conclusion: The overall cumulative incidence of the pressure ulcer was lower than that in other studies but occurred at a faster rate. Age (40 years of age or older) and the presence of friction or shearing forces were the main predictors of pressure ulcers in the intensive care units. Therefore, nurses working in ICUs should continually anticipate the risk of a pressure ulcer. Moreover, special attention should be given to patients of advanced ages. Furthermore, monitoring the installation of a mattress, keeping bed linens unwrinkled, and keeping patients in a proper position on a bed to prevent or reduce friction or shearing forces are very crucial in the prevention of pressure ulcers., Competing Interests: The authors have no conflict of interest., (Copyright © 2023 Lankamo Ena Digesa et al.)

Background: Antenatal care (ANC) is the care given to pregnant women to prevent poor feto-maternal outcomes during pregnancy. The World Health Organization recommends first ANC visit be started as early as possible within in 12 weeks of gestation. Although there is improvement in overall ANC coverage, a sizable proportion of pregnant women in Ethiopia delay the time to initiate their first ANC visit. Therefore, this study aimed to investigate factors associated with late ANC initiation among pregnant women attending public health centers in Addis Ababa, Ethiopia., Methods: A facility-based cross-sectional study was conducted among 407 randomly selected pregnant women who attended ANC at selected public health centers in Addis Ababa from December 2020 to January 2021. Data were collected using pretested and structured questionnaires through a face-to-face interview and reviewing medical records. Binary and multivariable logistic regressions were fitted sequentially to identify predictors for late ANC initiation. Adjusted odds ratios with 95% CI were computed to measure the strength of associations and statistical significance was declared at a p-value < 0.05., Result: This study showed that 47% of pregnant women started their first ANC visit late.The age of 30 years and above, being married, unplanned pregnancy, having a wrong perception about the timing of the first ANC visit, and not having ANC for previous pregnancy was significantly associated with late ANC initiation., Conclusion: Nearly half of the women initiated their first ANC visit late. Tailored interventions aimed at promoting early ANC initiation should target married women, women with an unplanned pregnancy, women who perceived the wrong timing of their first ANC, and those who have no ANC for their previous pregnancy., (© 2023. The Author(s).)

Objectives: The evidence on utilization of immediate postpartum intrauterine contraceptive devices (IPPIUCDs) and its associated factors are limited in Ethiopia. Hence, this study intended to assess IPPIUCD utilization and related factors among women who gave birth in Adama town public hospitals, Ethiopia., Method: A facility-based cross-sectional study was done among 493 postpartum mothers at selected government health facilities in Adama town from January 20 to February 20, 2021. All women who gave birth in selected government health facilities and within 48 h of postpartum were included in the study. Data were collected using an interviewer-administered questionnaire. Logistic regression models were used to identify the factors associated with IPPIUCD utilization. Adjusted odds ratios (AORs) with 95% confidence interval (CI) were calculated to measure the strength of association and statistical significance was declared at p  < 0.05., Result: In this study, 22.1% (95% CI: 17.3-25.2) of the mothers used IPPIUCDs within 48 h of giving birth. Having three or more children (AOR = 4.18, 95% CI: 1.79-9.79), having no desire to have another child (AOR = 3.9, 95% CI: 1.86-8.17), counseling after delivery (AOR = 3.1 95% CI: 1.52-6.34), and having good knowledge about PPIUCD (AOR = 3.82, 95% CI: 1.94-7.49) were significantly associated with IPPIUCD utilization., Conclusion: The utilization of IPPIUCD in this study was low. Strategies to raise pregnant mothers' awareness of IPPIUCD through mass media, and integrating standard counseling on immediate postpartum intrauterine device (IPPIUD) during antenatal care, and the immediate postpartum period are required to improve IPPIUD utilization., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)

Background: Mental health and other health professionals working in mental health care may contribute to the experiences of stigma and discrimination among mental health service users but can also help reduce the impact of stigma on service users. However, few studies of interventions to equip such professionals to be anti-stigma agents took place in high-income countries. This study assesses the feasibility, potential effectiveness and costs of Responding to Experienced and Anticipated Discrimination training for health professionals working in mental health care (READ-MH) across low- and middle-income countries (LMICs)., Methods: This is an uncontrolled pre-post mixed methods feasibility study of READ-MH training at seven sites across five LMICs (China, Ethiopia, India, Nepal and Tunisia)., Outcome Measures: knowledge based on course content, attitudes to working to address the impact of stigma on service users and skills in responding constructively to service users' reports of discrimination. The training draws upon the evidence bases for stigma reduction, health advocacy and medical education and is tailored to sites through situational analyses. Its content, delivery methods and intensity were agreed upon through a consensus exercise with site research teams. READ-MH will be delivered to health professionals working in mental health care immediately after baseline data collection; outcome measures will be collected post-training and 3 months post-baseline, followed by qualitative data collection analysed using a combined deductive and inductive approach. Fidelity will be rated during the delivery of READ-MH, and data on training costs will be collected. Quantitative data will be assessed using generalised linear mixed models. Qualitative data will be evaluated by thematic analysis to identify feedback about the training methods and content, including the implementability of the knowledge and skills learned. Pooled and site-specific training costs per trainee and per session will be reported., Conclusions: The training development used a participatory and contextualised approach. Evaluation design strengths include the diversity of settings, the use of mixed methods, the use of a skills-based measure and the knowledge and attitude measures aligned to the target population and training. Limitations are the uncertain generalisability of skills performance to routine care and the impact of COVID-19 restrictions at several sites limiting qualitative data collection for situational analyses., (© 2022. The Author(s).)

Background: Maternal mortality from pregnancy and childbirth remains a major public health problem. Increasing access to institutional delivery is one of the key strategies to reduce childbirth-related maternal mortality. Despite all the efforts, institutional deliveries in Ethiopia remain low. Understanding factors associated with institutional delivery is important to devise strategies to improve facility based child birth. Hence, this study assessed the prevalence of institutional delivery and associated factors to bridge the gap., Methods: A community-based cross-sectional study was employed from March-April 2020. Multi-stage sampling was employed to select 500 mothers who gave birth within the last 12 months in Mandura district, Benishangul Gumuz Region, Ethiopia. Data were collected using pre tested structured questionnaire through face-to-face interview. Logistic regression models were fitted to assess the predictors of institutional delivery. Adjusted Odds ratios with 95% CI was used to show associations and statistical significance was set at a p < 0.05., Results: This study indicated that the prevalence of institutional delivery was 28.8% CI (25-33.3%). Having a positive attitude (AOR = 9.6,95%CI:2.5-35.9), attending antenatal care (ANC) at least once (AOR = 16.1,95%CI:9.6-22), attending ANC more than three times (AOR = 17.2, 95% CI:13.5-43.8), having good knowledge (AOR = 11.1, 95%CI: 2.7-45.4), and facing complications during pregnancy (AOR = 4.04, 95%CI: 1.0-16.0) were significantly associated with institutional delivery., Conclusion: The prevalence of institutional delivery in this study was low. Positive attitude toward institutional delivery, attending ANC, having good knowledge about institutional delivery, and facing complications during pregnancy were identified predictors of institutional delivery. Strategies with a focus on increasing ANC uptake, improving mothers' knowledge, and promoting institutional delivery at the community level are critical., 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 Arega, Mulatu, Alemayehu, Mussa and Dheresa.)

Background: Rift Valley fever virus (RVFV) is the cause of one of the most important mosquito-borne emerging diseases negatively affecting the health of humans and animals, particularly in Africa. In Ethiopia, the status of RVFV and the existence of potential vectors are unknown., Objectives: This study aimed to survey the mosquito vectors of RVFV and the detection of the virus in selected sites (Batu, Hawassa, Arba Minch and Borana) in Ethiopia., Methods: CDC light traps baited with the sugar-yeast solution were set up at various locations for a total of 29 trap nights. Mosquitoes identification were made morphologically using a stereomicroscope and for RVFV detection by reverse transcriptase-polymerase chain reaction (RT-PCR)., Results: Among a total of 132 trap efforts conducted, 60 (45%) captured the mosquitoes. A total of 1576 adult mosquitoes were collected and identified. Including Aedes (n = 407; 25.8%), Anopheles (n = 493; 32.3%), Culex (n = 466; 29.6%) and Mansonia (n = 210; 13.32%). The genome material of RVFV was not detected by RT-PCR., Conclusions: The existence of a potential Aedes species may pose a risk for the occurrence of the RVF outbreak in Ethiopia. Based on the current study, we recommend further monitoring for potential mosquito vectors of RVFV, particularly with a view to targeting the seasons during which the mosquitoes can be abundant along with a serological survey of susceptible hosts., (© 2022 The Authors. Veterinary Medicine and Science published by John Wiley & Sons Ltd.)

Background: A compassionate and respectful care during pregnancy and childbirth is one of the essential components of safe motherhood. However, most of the women in developing countries experience disrespectful and abusive maternity care during childbirth. Hence, this study assessed the status of respectful maternity care and associated factors to bridge the gap., Methodology: Facility-based cross-sectional study was conducted among mothers who delivered in public Hospitals in the Hadiya Zone, South Ethiopia from March 01 to 30, 2020. Data were collected using a pretested questionnaire through face-to-face interviews. Descriptive statistics was computed and multivariable logistic regression was fitted to identify predictors. Adjusted Odds Ratio (AOR) with 95% Confidence Interval was used to show the strength of association and level of significance was declared at P -value < 0.05., Result: This study showed that 67.8 % (95% CI: 62.4-70.8%) of mothers received respectful maternal care. Being married [AOR: 2.17, 95% CI (1.03-6.93)], Cesarean section delivery [AOR: 2.48, 95% CI (1.03-5.97)], and absence of complications during child birth [AOR: 4.37, 95% CI (1.41-13.56)], were significantly associated with respectful maternity care., Conclusions: The level of RMC in this study was moderate. Being married, Cesarean section delivery, and absence of complications during child birth were identified predictors of respectful maternity care. Therefore, tailored interventions aimed at improving respectful maternity care should target unmarried women, and women with complications of labor regardless of mode of delivery., 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 Mengistie, Mulatu, Alemayehu, Yadeta and Dheresa.)

Objective: The aim of this study is to assess the magnitude of sexual violence, its adverse reproductive health outcomes, and associated factors among female youth in the Northern Shoa zone, Oromia region, Ethiopia., Methods: A community-based cross-sectional study design was employed among 590 female youth from 1 December to 30 January 2021. A multi-stage sampling technique and a pretested structured interviewer-administered questionnaire were used. The data were entered into EpiData version 3.1 and then transferred to SPSS 23 for analysis. Descriptive statistical analysis was done, and an association between an outcome variable and independent variables was examined in logistic regression models., Results: According to the study, the respective rates of sexual violence and harmful sexual reproductive consequences were 20.7% and 11.9%. Sexual violence was significantly associated with alcohol consumption (adjusted odds ratio = 2.549, 95% confidence interval = (1.548, 4.195)) and childhood exposure to inter-parental violence (adjusted odds ratio = 1.66, 95% confidence interval = (1.002, 2.888)). Rural childhood residence (adjusted odds ratio = 0.037, 95% confidence interval = (0.007, 0.192)), fathers with college degrees (adjusted odds ratio = 0.037, 95% confidence interval = (0.013, 0.106)), and readiness for first sex (adjusted odds ratio = 0.073, 95% confidence interval = (0.028, 0.189)) were all independent predictors of adverse reproductive health outcomes., Conclusion: In this study, young females frequently experience sexual violence and poor reproductive health outcomes. Alcohol consumption and having experienced parental conflict as a child were found to be risk factors for sexual violence, while residing contracts during childhood, the father's level of education, and willingness to engage in the first sexual encounter were linked to adverse reproductive health outcomes., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)

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

Culicoides biting midges (Diptera: Ceratopogonidae) are the major vectors of bluetongue, Schmallenberg, and African horse sickness viruses. This study was conducted to survey Culicoides species in different parts of Ethiopia and to develop habitat suitability for the major Culicoides species in Ethiopia. Culicoides traps were set in different parts of the country from December 2018 to April 2021 using UV light Onderstepoort traps and the collected Culicoides were sorted to species level. To develop the species distribution model for the two predominant Culicoides species, namely Culicoides imicola and C. kingi, an ensemble modeling technique was used with the Biomod2 package of R software. KAPPA True skill statistics (TSS) and ROC curve were used to evaluate the accuracy of species distribution models. In the ensemble modeling, models which score TSS values greater than 0.8 were considered. Negative binomialregression models were used to evaluate the relationship between C. imicola and C. kingi catch and various environmental and climatic factors. During the study period, a total of 9148 Culicoides were collected from 66 trapping sites. Of the total 9148, 8576 of them belongs to seven species and the remaining 572 Culicoides were unidentified. The predominant species was C. imicola (52.8%), followed by C. kingi (23.6%). The abundance of these two species was highly influenced by the agro-ecological zone of the capture sites and the proximity of the capture sites to livestock farms. Climatic variables such as mean annual minimum and maximum temperature and mean annual rainfall were found to influence the catch of C. imicola at the different study sites. The ensemble model performed very well for both species with KAPPA (0.9), TSS (0.98), and ROC (0.999) for C. imicola and KAPPA (0.889), TSS (0.999), and ROC (0.999) for C. kingi. Culicoides imicola has a larger suitability range compared to C. kingi. The Great Rift Valley in Ethiopia, the southern and eastern parts of the country, and the areas along the Blue Nile and Lake Tana basins in northern Ethiopia were particularly suitable for C. imicola. High suitability for C. kingi was found in central Ethiopia and the Southern Nations, Nationalities and Peoples Region (SNNPR). The habitat suitability model developed here could help researchers better understand where the above vector-borne diseases are likely to occur and target surveillance to high-risk areas., (© 2022. The Author(s).)

Background: People with mental illnesses are at an increased risk of experiencing human rights violations, stigma and discrimination. Even though mental health stigma and discrimination are universal, there appears to be a higher burden in low- and middle-income countries. Anti-stigma interventions need to be grounded in local evidence. The aim of this paper was to synthesize evidence on mental health stigma and discrimination in Ethiopia to inform the development of anti-stigma interventions., Methods: This evidence synthesis was conducted as a part of formative work for the International Study of Discrimination and Stigma Outcomes (INDIGO) Partnership research program. Electronic searches were conducted using PubMed for scientific articles, and Google Search and Google Scholar were used for grey literature. Records fulfilling eligibility criteria were selected for the evidence synthesis. The findings were synthesized using a framework designed to capture features of mental health stigma to inform cultural adaptation of anti-stigma interventions., Results: A total of 37 records (2 grey literature and 35 scientific articles) were included in the evidence synthesis. Some of these records were described more than once depending on themes of the synthesis. The records were synthesized under the themes of explanatory models of stigma (3 records on labels and 4 records on symptoms and causes), perceived and experienced forms of stigma (7 records on public stigma, 6 records on structural stigma, 2 records on courtesy stigma and 4 records on self-stigma), impact of stigma on help-seeking (6 records) and interventions to reduce stigma (12 records). Only two intervention studies assessed stigma reduction- one study showed reduced discrimination due to improved access to effective mental health care, whereas the other study did not find evidence on reduction of discrimination following a community-based rehabilitation intervention in combination with facility-based care., Conclusion: There is widespread stigma and discrimination in Ethiopia which has contributed to under-utilization of available mental health services in the country. This should be addressed with contextually designed and effective stigma reduction interventions that engage stakeholders (service users, service providers, community representatives and service developers and policy makers) so that the United Nations universal health coverage goal for mental health can be achieved in Ethiopia., (© 2022. The Author(s).)

Background: Stillbirth, which accounts for half of all the perinatal mortality, is not counted on policy, program, and investment agendas around the globe. It has been underestimated public health burden, particularly in developing countries. Ethiopia is among the top countries with a large prevalence of stillbirth in the world. However, there is a dearth of study on the current magnitude of stillbirth in the study area. Therefore, this study intended to assess the prevalence of stillbirth and its associated factors to bridge the gap., Methods: A hospital-based retrospective study was conducted from 1 to 28 February 2019 and data were collected by reviewing the chart records of all the women who gave birth in the past 2 years (January 2016 to December 2018) at Hiwot Fana Specialized University Hospital. Data were entered into EpiData version 4.2.0.0 software and transported to SPSS version 23 for analysis. Descriptive statistics such as frequency, mean, and SDs were generated. Determinants of stillbirth were analyzed using a binary logistic regression and presented by adjusted odds ratio (AOR) with a 95% CI., Results: The prevalence of stillbirth was 14.5% (95% CI: 11.7%, 17.6%). Low birth weight (AOR = 2.42, 95% CI: 1.23-4.76), prematurity (AOR = 2.10, 95% CI: 1.10-4.01), premature rupture of membranes (AOR = 2.08, 95% CI: 1.14-3.77), antepartum hemorrhage (AOR = 3.33, 95% CI: 1.66-6.67), obstructed labor (AOR = 2.87, 95% CI: 1.48-5.56), and preeclampsia (AOR = 2.91, 95% CI: 1.28-6.62) were an independently associated with stillbirth., Conclusion: The prevalence of stillbirth in this study was high. Low birth weight, preterm birth, premature rupture of membranes, antepartum hemorrhage, obstructed labor, and preeclampsia were independently associated with a stillbirth. Therefore, much study is needed involving different stakeholders to reduce stillbirths by improving the health status of women through the provision of quality maternal care including referral systems., 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 Mengistu, Debella, Mulatu, Mesfin, Danusa and Dheresa.)

Introduction/objectives: Male involvement in family planning refers to all organizational actions focused on men as a distinct group to increase the acceptability and uptake of family planning among either sex. Despite the growing evidence of male involvement in increasing family planning uptake among couples, a little success has been achieved in Ethiopia, especially in rural areas. Hence, this study aimed to assess male involvement in family planning and its associated factors among currently married men in selected rural areas of Eastern Ethiopia., Methods: A community-based cross-sectional survey was conducted among 577 randomly selected currently married men, using a simple random sampling method in randomly selected rural districts of Eastern Ethiopia. Data were collected using a pretested interviewer-administered questionnaire. The collected data were entered into a computer using Epi-Data Version 3.1. The analysis was performed using the Statistical Package for the social sciences software version 21. Logistic regression analysis was used to analyze the association between the dependent and independent variables. Finally, adjusted odds ratio with 95% confidence intervals at P -value < 0.05 was considered to be significantly associated with the outcome variable., Results: Out of 577, a total of, 555 married men were included in the study, resulting in a response rate of 96.2%. The magnitude of male involvement in family planning use was 59.3% (95% confidence interval: 47.1, 68. 2). Ever use of family planning by a spouse (adjusted odds ratio: 2.37; 95% confidence interval: 1.59, 3.52), ever discussion of spouse on sexual and reproductive health/family planning issues (adjusted odds ratio: 2.05; 95% confidence interval: 1.40, 3.02), and the husband's approval of family planning (adjusted odds ratio: 2.45; 95% confidence interval: 1.34, 4.96) were significantly associated with higher odds of male involvement in family planning use than their counterparts., Conclusion: The number of men involved in the family planning was low. Ever use of family planning methods by a spouse, ever discussion of spouse on sexual and reproductive health/family planning issues, and husband approval on family planning use were found to be important predictors of male involvement in family planning use. To improve modern family planning uptake among men and women, it is imperative to include men in family planning programs, such as family planning messaging, sensitizations, and services., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)

Introduction/objectives: Stillbirths are an adverse birth outcome and a significant public health problem in low- and high-income countries. Ethiopia is ranked seventh among ten countries that constitute 66% of the world's stillbirths. However, there is a dearth of evidence about stillbirths and the determinants in the country, particularly in Eastern Ethiopia. Hence, this study aimed to assess the prevalence and determinants of stillbirths among women who gave birth at Hiwot Fana Specialized University Hospital, Eastern Ethiopia., Methods: We conducted a hospital-based cross-sectional study among women who gave birth from October to December 2017. The study participants were selected through a systematic random sampling method. We collected the data using a pretested questionnaire through face-to-face interviews and maternal medical record reviews. The multi-variable logistic regression model was applied to identify the determinants with adjusted odds ratios at a 95% confidence interval. Statistical significance was declared at a p -value less than 0.05., Results: Five hundred fifty-five women were included in the study, and 6.7% ((95% confidence interval = 4.7%, 9.2%)) experienced a stillbirth. Previous history of adverse birth outcome (adjusted odds ratio = 9.55; 95% confidence interval = (4.37, 20.85), p  = 0.003), multiple pregnancies (adjusted odds ratio = 7.04; 95% confidence interval = (2.12, 23.40), p  = 0.000), and spontaneous vaginal delivery (adjusted odds ratio = 0.17; 95% confidence interval = (0.05, 0.51), p  = 0.002) were the identified determinants of stillbirth., Conclusion: The prevalence of stillbirth in this study was similar to previous reports in the country. Early detection and treatment of complications among mothers with multiple pregnancies and prior history of adverse outcomes are vital to alleviate the problem., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)

Collaborative approaches are seen as a promising way to strengthen Water, Sanitation, and Hygiene (WASH) service delivery systems when challenges exceed the mandates and capabilities of any single entity. While collaborative approaches are well studied in high-income country contexts, current understanding of their application to international development contexts is limited. This paper uses fuzzy-set Qualitative Comparative Analysis to assess what conditions and pathways drove or impeded progress within eleven collaborative approaches for WASH service delivery in Eastern Africa. Evidence supported three main findings: (1) Government uptake of recommendations is necessary for progress but cannot be guaranteed solely by government participation in the collaboration, (2) different forms of problem identification are possible; problem scopes are often predefined to align with funders and partner government agendas, but flexible scopes that foster collective problem identification can reap benefits, and (3) hub convening power can be critical and convening power can be gained in different ways. Political dynamics, shifting priorities, and turnover undermine collaborative efforts, but collaborative approaches can still make progress in spite of turnover if funds are available for implementation of activities (i.e. in addition to funds for meetings and hub roles) and program implementers either facilitate collective problem identification or establish a hub with convening power. Yet even these tactics are vulnerable to instability, thus in highly unstable contexts, stakeholders and funders should be realistic from the outset about what they may be able to achieve. Building on existing theories of collaborative approaches, this work revealed that there is no single best design for collaborative approaches in WASH, rather, core elements worked together in different ways depending on the context., Competing Interests: Declaration of competing interest 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., (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Lack of exclusive breastfeeding during the first 6 months of infant life contributes to childhood morbidity and mortality. This study aimed to investigate the association of exclusive breastfeeding and childhood illnesses in Ethiopia., Methods: A secondary data analysis was conducted using data from the 2016 Ethiopian Demographic and Health Survey (EDHS). Descriptive and multivariable logistic regression analyses were carried out., Results: A total of 1034 mother-infant pairs were included in the analysis. The overall magnitude of exclusive breastfeeding among infants aged under 6 months was 87.6% (95% CI: 84.3-90.3%). Compared to infants who were non-exclusively breastfed, the odds of having an illness with fever in the last 2 weeks among infants who were exclusively breastfed decreased by 66% (AOR: 0.34; 95% CI: 0.16, 0.75). Similarly, exclusively breastfed infants had lower odds of having an illness with a cough (AOR: 0.38; CI: 0.20, 0.72) and having diarrhea (AOR: 0.33; CI: 0.13, 0.83) compared to non-exclusively breastfed infants., Conclusion: Exclusive breastfeeding lowers the odds of an illness with fever, illness with cough and diarrhea. The findings of this study implicate the need for promotion of exclusive breastfeeding in the country., (© 2021. The Author(s).)

Background: Since maternal mortality is a rare event, maternal near miss has been used as a proxy indicator for measuring maternal health. Maternal near miss (MNM) refers to a woman who nearly died but survived of complications during pregnancy, childbirth or within 42 days of termination of pregnancy. Although study of MNM in Ethiopia is becoming common, it is limited to public facilities leaving private facilities aside. The objective of this study was to assess MNM among women admitted in major private hospitals in eastern Ethiopia., Methods: An institution based retrospective study was conducted from March 05 to 31, 2020 in two major private hospitals in Harar and Dire Dawa, eastern Ethiopia. The records of all women who were admitted during pregnancy, delivery or within 42 days of termination of pregnancy was reviewed for the presence of MNM criteria as per the sub-Saharan African MNM criteria. Descriptive analysis was done by computing proportion, ratio and means. Factors associated with MNM were assessed using binary logistic regression with adjusted odds ratio (aOR) along with its 95% confidence interval (CI)., Results: Of 1214 pregnant or postpartum women receiving care between January 09, 2019 and February 08, 2020, 111 women developed life-threatening conditions: 108 MNM and 3 maternal deaths. In the same period, 1173 live births were registered, resulting in an MNM ratio of 92.1 per 1000 live births. Anemia in the index pregnancy (aOR: 5.03; 95%CI: 3.12-8.13), having chronic hypertension (aOR: 3.13; 95% CI: 1.57-6.26), no antenatal care (aOR: 3.04; 95% CI: 1.58-5.83), being > 35 years old (aOR: 2.29; 95%CI: 1.22-4.29), and previous cesarean section (aOR: 4.48; 95% CI: 2.67-7.53) were significantly associated with MNM., Conclusions: Close to a tenth of women admitted to major private hospitals in eastern Ethiopia developed MNM. Women with anemia, history of cesarean section, and old age should be prioritized for preventing and managing MNM. Strengthening antenatal care and early screening of chronic conditions including hypertension is essential for preventing MNM.

Background: The use of modern family planning methods among women of reproductive age (15-49 years) is of public health importance in Ethiopia. Nationally, modern family planning method use remains as low as 35%. Understanding factors associated with the use of modern family planning methods may help to improve maternal and child health. Hence, this study is aimed at assessing modern family planning method use and its determinants among women of reproductive age in the rural districts of Eastern Hararghe zone, Eastern Ethiopia. Methodology . A community-based, cross-sectional survey was conducted among 577 randomly selected, currently married, reproductive-aged women in selected rural districts of Eastern Hararghe, Eastern Ethiopia. Data were collected using a pretested, interviewer-administered questionnaire about women's sociodemographic information, knowledge about contraception, reproductive history, contraceptive use and fertility desire, couple's communication, and decision-making on family planning. Binary and multivariable logistic regression was used to analyze the association between the dependent and independent variables., Result: A total of 555 study participants participated, yielding a 96.2% response rate. The overall modern family planning utilization among the study participants was 18.4%. Knowledge of modern family planning methods (AOR = 16.958, CI: 4.768, 60.316), husband approval (AOR = 3.590, CI: 2.170, 5.936), couple's discussion (AOR = 2.852, CI: 1.759, 4.623), male involvement in decisions about family planning (AOR = 2.340, CI: 1.531, 3.576), desire for additional child (AOR = 2.295, CI: 1.528, 3.447), and previous use of contraception (AOR = 0.018, CI: 0.005, 0.063) were significantly associated with modern contraceptive utilization., Conclusion: Even though knowledge of modern family planning methods was very high, the overall modern family planning method use in the study area was low. The government should focus on increasing modern family planning method availability. It must also ensure family planning method security and create awareness on modern family planning methods through community-based education and proper counselling to empower women to make an appropriate choice., Competing Interests: The authors declare that they have no conflicts of interests., (Copyright © 2020 Teshale Mulatu et al.)

Background: Neonatal resuscitation is a life-saving intervention for birth asphyxia, a leading cause of neonatal mortality. Worldwide, four million neonate deaths happen annually, and birth asphyxia accounts for one million deaths. Improving providers' neonatal resuscitation skills is critical for delivering quality care and for morbidity and mortality reduction. However, retention of these skills has been challenging in developing countries, including Ethiopia. Hence, this study aimed to assess neonatal resuscitation skills retention and associated factors among midwives and nurses in Eastern Ethiopia., Methods: An institution-based cross-sectional study was conducted using a pre-tested, structured, observational checklist. A total of 427 midwives and nurses were included from 28 public health facilities by cluster sampling and simple random sampling methods. Data were collected on facility type, availability of essential resuscitation equipment, socio-demographic characteristics of participants, current working unit, years of professional experience, whether a nurse or midwife received refresher training, and skills and knowledge related to neonatal resuscitation. Binary logistic regression was used to analyse the association between neonatal resuscitation skill retention and independent variables., Results: About 11.2% of nurses and midwives were found to have retention of neonatal resuscitation skills. Being a midwife (AOR, 7.39 [95% CI: 2.25, 24.24]), ever performing neonatal resuscitation (AOR, 3.33 [95% CI: 1.09, 10.15]), bachelor sciences degree or above (AOR, 4.21 [95% CI: 1.60, 11.00]), and good knowledge of neonatal resuscitation (AOR, 3.31 [95% CI: 1.41, 7.73]) were significantly associated with skill retention of midwives and nurses., Conclusion: Basic neonatal resuscitation skills of midwives and nurses in Eastern Ethiopia are not well retained. This could increase the death of neonates due to asphyxia. Being a midwife, Bachelor Sciences degree or above educational status, ever performing neonatal resuscitation, and good knowledge were associated with skill retention. Providers should be encouraged to upgrade their educational level to build their skill retention and expose themselves to NR. Further, understanding factors affecting how midwives and nurses gain and retain skills using high-level methodology are essential., Competing Interests: The authors have declared that no competing interests exist.

Introduction: Podoconiosis is a non-filarial swelling of the lower extremity endemic in tropical regions, North America and India. The aetiology and pathophysiology of the disease remain unknown. We propose conducting a systematic review and meta-analysis to evaluate the burden and risk factors of podoconiosis in Ethiopia reported in studies from 2009 to 2019., Methods and Analysis: We will search the following electronic databases: PubMed (MEDLINE), EMBASE, Hinari, Cumulative Index to Nursing and Allied Health Literature, ISI (Web of Science) and Google Scholar. Medical subject headings will be used to extensively search relevant literature on electronic databases using related keywords such as epidemiology or prevalence, magnitude or burden, podoconiosis, and Ethiopia. Grey literature and manual search will also be performed to retrieve unindexed research articles. Two reviewers will screen all retrieved articles, conduct data extraction and then critically appraise all identified studies. We will analyse data using STATA V.14 statistical software. We will demonstrate pooled estimates of podoconiosis and associated factors with effect size and 95% CI. The presence of heterogeneity among studies will be examined by forest plot as well as the I 2 heterogeneity test. Potential causes of heterogeneity will be explored by carrying out sensitivity and subgroup analyses. The presence of publication bias will also be examined by observing funnel plots and objectively by Egger's regression test. If the funnel plot is asymmetric and/or Egger's test was found to be statistically significant (p<0.05), the trim and fill (Duval and Tweedie's) analysis will be performed., Ethics and Dissemination: The study will use publicly available data and will not identify the authors of the publication by name. In light of these and as has been indicated, research ethics clearance is not required for evidence syntheses in such reviews. The results of this study will be published in a peer-reviewed journal and presented at national and international conferences., Prospero Registration Number: CRD42019127459., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Culicoides imicola is a midge species serving as vector for a number of viral diseases of livestock, including Bluetongue, and African Horse Sickness. C. imicola is also known to transmit Schmallenberg virus experimentally. Environmental and demographic factors may impose rapid changes on the global distribution of C. imicola and aid introduction into new areas. The aim of this study is to predict the global distribution of C. imicola using an ensemble modeling approach by combining climatic, livestock distribution and land cover covariates, together with a comprehensive global dataset of geo-positioned occurrence points for C. imicola. Thirty individual models were generated by 'biomod2', with 21 models scoring a true skill statistic (TSS) >0.8. These 21 models incorporated weighted runs from eight of ten algorithms and were used to create a final ensemble model. The ensemble model performed very well (TSS = 0.898 and ROC = 0.991) and indicated high environmental suitability for C. imicola in the tropics and subtropics. The habitat suitability for C. imicola spans from South Africa to southern Europe and from southern USA to southern China. The distribution of C. imicola is mainly constrained by climatic factors. In the ensemble model, mean annual minimum temperature had the highest overall contribution (42.9%), followed by mean annual maximum temperature (21.1%), solar radiation (13.6%), annual precipitation (11%), livestock distribution (6.2%), vapor pressure (3.4%), wind speed (0.8%), and land cover (0.1%). The present study provides the most up-to-date predictive maps of the potential distributions of C. imicola and should be of great value for decision making at global and regional scales.

Culicoides imicola is the main vector transmitting viruses causing animal diseases such as Bluetongue, African Horse Sickness, and Schmallenberg. It has become widely distributed, with reports from South Africa to southern Europe, and from western Africa to southern China. This study presents a global compendium of Culicoides imicola occurrence between 1943 and 2018, reflecting the most recently compiled and harmonized global dataset derived from peer-reviewed literature. The procedures used in producing the data, as well as the geo-coding methods, database management and technical validation procedures are described. The study provides an updated and comprehensive global database of C. imicola occurrence, consisting of 1 039 geo-coded records from 50 countries. The datasets can be used for risk mapping of the diseases transmitted by C. imicola as well as to develop the global habitat suitability for the vector.

Background: Adverse perinatal outcomes are still high in developing countries. Contradicting evidences were reported about the effect of parity on adverse perinatal outcomes. The aim of this study was to compare perinatal outcomes in grand multiparous and low multiparity women in Hawassa University Comprehensive Specialized Hospital and Adare General Hospital of Ethiopia., Methods: Comparative cross-sectional study design was employed to include 461 mothers from February to June 2018. Data were collected by structured questionnaire using interview and from patient charts. Data were entered using EPI-DATA version 4.4.2.0. Descriptive statistics and logistic regression analyses were computed using STATA version 14 computer software., Results: Of all study participants, 24.9% (95% Confidence interval: 21.1%-29.1%) had at least one adverse perinatal outcome. Stillbirth (38.9), low Apgar score (51.9%), and congenital malformation (3.70%) were frequently occurred complications in grand multiparas compared to low multiparous women. Nevertheless, meconium aspiration, need for resuscitation, and macrosomia were higher in low multiparous women (9.84%, 14.75%, and 57.38%, respectively). Less than four prenatal visits (AOR: 1.74; 95% CI: 1.04, 2.92) and previous home delivery (AOR: 1.87; 95% CI: 1.04, 3.33) were independent predictors of adverse perinatal outcomes. However, parity did not show statistically significant difference in perinatal outcomes., Conclusion: This finding underscores the fact that frequency of antenatal care and place of delivery are significant predictors of perinatal outcomes. However, parity did not show statistically significant difference in perinatal outcomes. Women empowerment, promoting health facility delivery, and early, comprehensive antenatal care are needed.

Background: Knowledge of danger signs of obstetric complications during pregnancy, labour, and postnatal period is the first essential step for appropriate and timely referral. This study aimed to investigate predictors of knowledge about obstetric danger signs during pregnancy, delivery, and postpartum period among mothers of reproductive age women who gave birth in the last 12 months., Methods: A quantitative community based cross-sectional study was employed during March 2016. The study included 493 mothers who were selected by multi-stage sampling technique. Data were collected by face-to-face interview. Logistic regression analyses were employed to identify factors associated with knowledge of obstetric danger signs. Variables with a p-value <0.05 were identified as statistically significant factors., Results: About forty-seven percent (46.7%), 27.8%, and 26.4% of the mothers were knowledgeable about obstetric danger signs during pregnancy, delivery, and postpartum period, respectively. Vaginal bleeding was the most frequently cited danger sign during the three periods. Mothers' secondary or above education level increased odds of knowledge about danger signs during pregnancy (AOR: 3.63; 95% CI 1.19, 11.07) and postpartum period (AOR: 5.31; 95% CI 2.13, 13.22). Additionally, being employed (AOR: 5.41; 95% CI 1.03, 28.32), delivery at health institution (AOR: 2.14; 95% CI 1.17, 3.92) and number of ANC visits were statistically significant factors., Conclusion: Knowledge of mothers about obstetric danger signs was low in the study area. Empowering women, improving the quality of health information about danger signs during ANC follow up, and promoting institutional delivery are the recommended interventions.

Background: Accurate information on the distribution of the tsetse fly is of paramount importance to better control animal trypanosomosis. Entomological and parasitological surveys were conducted in the tsetse belt of south-western Ethiopia to describe the prevalence of trypanosomosis (PoT), the abundance of tsetse flies (AT) and to evaluate the association with potential risk factors., Methods: The study was conducted between 2009 and 2012. The parasitological survey data were analysed by a random effects logistic regression model, whereas the entomological survey data were analysed by a Poisson regression model. The percentage of animals with trypanosomosis was regressed on the tsetse fly count using a random effects logistic regression model., Results: The following six risk factors were evaluated for PoT (i) altitude: significant and inverse correlation with trypanosomosis, (ii) annual variation of PoT: no significant difference between years, (iii) regional state: compared to Benishangul-Gumuz (18.0%), the three remaining regional states showed significantly lower PoT, (iv) river system: the PoT differed significantly between the river systems, (iv) sex: male animals (11.0%) were more affected than females (9.0%), and finally (vi) age at sampling: no difference between the considered classes. Observed trypanosome species were T. congolense (76.0%), T. vivax (18.1%), T. b. brucei (3.6%), and mixed T. congolense/vivax (2.4%). The first four risk factors listed above were also evaluated for AT, and all have a significant effect on AT. In the multivariable model only altitude was retained with AT decreasing with increasing altitude. Four different Glossina species were identified i.e. G. tachinoides (52.0%), G. pallidipes (26.0%), G.morsitans submorsitans (15.0%) and G. fuscipes fuscipes (7.0 %). Significant differences in catches/trap/day between districts were observed for each species. No association could be found between the tsetse fly counts and trypanosomosis prevalence., Conclusions: Trypanosomosis remains a constraint to livestock production in south-western Ethiopia. Four Glossina and three Trypanosoma species were observed. Altitude had a significant impact on AT and PoT. PoT is not associated with AT, which could be explained by the importance of mechanical transmission. This needs to be investigated further as it might jeopardize control strategies that target the tsetse fly population.