Search

Demlie Mekonnen Marye,1 Desta Debalkie Atnafu,1,2 Melesse Belayneh,1 Ayenew Takele Alemu3 1Department of Health System Management and Health Economics, School of Public Health, Bahir Dar University, Bahir Dar, Ethiopia; 2International Centre for Evidence in Disability, London School of Hygiene and Tropical Medicine, London, UK; 3Department of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, EthiopiaCorrespondence: Desta Debalkie Atnafu, Email destad2a@gmail.comBackground: Increasing free and skilled delivery is a top priority in the global effort to reduce maternal and newborn mortality. Reducing user-fees through exemption policy has contributed to universal health coverage. However, there is scant evidence regarding the effect of exempted maternal services on adherence to utilization in Ethiopia. Thus, this study aimed to assess the effect of fee exemption policy on adherence to maternal health service utilization and its predictors.Methods: A community-based comparative cross-sectional study was conducted in Bahir Dar City. A two-stage multistage sampling was employed; 497 women participated. Data were collected by face-to-face interview; entered and cleaned using Epi-Data 3.1. SPSS version 25 was used for further analysis. Bivariable and multivariable logistic regression models were computed to assess the association between explanatory and outcome variables. An adjusted odds ratio with a 95% confidence interval was used to interpret the degree of association. The effect of fee exemption policy on adherence to maternal health service utilization was measured by propensity score matching.Results: The overall adherence to maternal service utilization was 54.2%. Factors associated with adherence to maternal health service utilization were pregnancy complications [AOR: 4.1, 95% CI (2.32, 7.28)], secondary and above education [AOR: 4.6, 95% CI (1.38, 15.08)], early ANC1 booking [AOR: 3.1, 95% CI (1.83, 5.16)], autonomous women [AOR: 2.1, 95% CI (1.02, 4.39)], user fee exemption [AOR: 2.3, 95% CI (1.20, 4.47)] and high parity [AOR: 0.39, 95% CI (0.2, 0.75)]. User fee exemption induced a 22.7% increment in adherence to maternal service utilization (ATET=0.227, t=2.13).Conclusion: User fee exemption policy significantly improved adherence to maternal health service utilization. Promoting a fee exemption policy through third-party financing can enhance maternal health service utilization adherence in hard-to-reach settings of Ethiopia by targeting mothers with higher pregnancies, no complications, no autonomy, and less education.Keywords: user fee exemption, maternal health services, Bahir Dar city, Ethiopia

IntroductionThe double burden of malnutrition (DBM) at the household level has increased in sub-Saharan African countries as a result of rapid changes in global food systems and growing urbanization. The presence of overweight or obese mothers with undernourished (stunted, wasted, or underweight) children within the same household holds particular significance. However, no comprehensive study or meta-analysis has been conducted to summarize the national evidence of the double burden of malnutrition in mother–child pairs. Therefore, the purpose of this study was to determine the pooled prevalence of the double burden of malnutrition at the household level in Ethiopia in 2024.MethodsThis systematic review and meta-analysis was conducted on the prevalence of the double burden of malnutrition and associated factors among households in Ethiopia, using an advanced search of electronic databases and search engines. The standardized Joanna Briggs Institute (JBI) method was used to extract data from a Microsoft Excel spreadsheet and evaluate the quality of each article. The analysis was performed using STATA V.17. A random-effects model was used to conduct the meta-analysis. Heterogeneity was assessed using the I2 and Q tests.ResultsA total of seven publications met the inclusion criteria, including data from 56,877 and 43,770 mother–child pairs for the systematic review and meta-analysis, respectively. The pooled prevalence of the double burden of malnutrition among the mother–child pairs was 8.30% (95% confidence interval (CI): 1.51, 15.09). The heterogeneity test revealed extremely high heterogeneity (I2 = 99.91%; p = 0.00). In the subgroup analysis based on sample size, the pooled estimated prevalence of the double burden of malnutrition was high for a sample size of fewer than 1,000 mother–child pairs (11.69% (95% CI: 3.11, 20.28)). The pooled estimate from the subgroup analysis of the data collected 8 years ago was 8.61% (95% CI: 1.11, 22.33). Residence, household size, housing quality, wealth index, household food security status, mother’s age and educational status, and child’s age are some of the factors that influence the double burden of malnutrition among mother–child pairs.ConclusionIn Ethiopia, the double burden of malnutrition among mother–child pairs is rapidly emerging. As a result, double-duty interventions should be implemented to address this issue, taking into account multiple factors at the household level.Systematic review registrationThe protocol for the systematic review and meta-analysis was registered under the registration ID CRD42024517778 with the PROSPERO (International Prospective Register of Systematic Review and Meta-analysis).

Abstract Background The way the healthcare delivery system is reflected by patient satisfaction. Establishing a health system with better results depends on it. It has been assumed that higher patient satisfaction levels correlate with quality healthcare outcomes. There is little national data to support patient satisfaction with inpatient health services in Ethiopia. In order to estimate the pooled proportion of patient satisfaction and determine the associated factors with inpatient health services at public hospitals, a systematic review and meta-analysis were conducted. Methods The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were followed in the extraction of the data. To get the included studies, the following electronic databases were searched: Pub-Med, Google Scholar, Med-Line, Web of Science, Scopus and Repositories. Software called STATA version 17 was used to analyze statistical data using the random effects model. Forest plots were used to display the pooled results. Results Of the 1583 records resulted in electronic databases searching, 11 studies with 3,958 participants were included in this systematic review and meta-analysis. The estimated pooled proportion of patient satisfaction with inpatient health services was found to be 57.4% (95% CI: 50.88–64.59, I 2 = 95.25%). Assuring privacy for patients (OR = 7.44, 95% CI: 3.63–15.25, I 2 = 0.0%), availability of direction signs (2.96, 95% CI: 1.91–4.57, I 2 = 0.0%), providing adequate information (OR = 3.27, 95% CI: 1.63–6,58, I 2 = 65.60%), history of previous admission (OR = 0.29, 0.18–0.46, I 2 = 86.36%) and providing on time treatment (OR = 1.63, 95% CI: 1.21–2.20, I 2 = 86.36%) were statistically significant factors associated with patient satisfaction with inpatient health services. Conclusion The estimated pooled level of patient satisfaction with inpatient health services is low in Ethiopia. A higher level of patient satisfaction with inpatient health treatments was predicted by factors such as privacy assurance, fast services, availability of direction signs, provision of services with adequate information transfer, and no history of previous admission. To improve patient satisfaction, the Ministry of Health and hospital administration must place a strong emphasis on ensuring the provision of high-quality, standard-based inpatient healthcare.

Abstract Background Dental caries (decay or cavities) is the breakdown of teeth as a result of bacteria. Dental caries is one of the most preventable oral health problems and the most common chronic disease in primary school children. Poor dental and oral health affects the quality of children’s lives. Objectives The study aimed to synthesize the existing literature on the prevalence and associated factors of dental caries among primary school children in Ethiopia in 2024. Methodology Studies were searched through the search engines of Google Scholar, PubMed, Scopus, MEDLINE, and the Cochrane Library. Searching was made using keywords and MeSH terms for dental caries, dental plaque, primary school children, and Ethiopia. Heterogeneity was assessed using the Cochran Q test and I2 statistics. A random-effects model with a 95% confidence interval was used for prevalence and odds ratio estimations. Result The result of seven studies disclosed that the overall prevalence of dental caries in primary school children in Ethiopia was 35% (26–45%). high intake of sweets (OR = 2.71,95%CI:1.968–3.451), a poor habit of tooth cleaning (OR = 2.46; 95% CI: 2.761–5.045), Grade level 1–4(OR = 2.46; 95% CI: 1.523–3.397), having a history of toothache(OR = 2.99; 95% CI: 2.679–3.314), absence of toothpaste use(OR = 1.42; 95% CI: -1.278-4.109), reduction of the previous year’s academic score(OR = 5.51; 95% CI: 1.952–9.066), had a significant microbial load(OR = 3.82, CI: 3.439–4.192) and have acid bacillary pH on their teeth(OR = 2.42, CI: 1.494–3.335) were independent variables associated with dental carries among primary school children. Conclusion The overall prevalence of dental caries among primary school children in Ethiopia is 35%, ranging from 26 to 45%. However, variations in prevalence rates are observed based on sampling techniques. Studies using simple random sampling report a higher prevalence rate of 42%, while those employing multi-stage random sampling and systematic random sampling show lower rates of 30% and 35%, respectively. This indicates that the choice of sampling technique can impact reported prevalence rates, with simple random sampling yielding higher estimates compared to other methods.