Introduction:Maternal mortality remains persistently high in low- and middle-income countries, driven by inequities in access to and use of maternal healthcare. A life-course perspective offers critical insights into the underlying drivers of these disparities, linking historical, social and structural factors across women's lives to health outcomes. By contextualising maternal health within lifelong trajectories, the analysis aims to inform targeted strategies to reduce inequities and improve care access across generations. Objectives:To analyse the generational differences in the maternal health services utilisation across the maternal life course and its social determinants in Kersa, Eastern Ethiopia. Methods:This study involved secondary analysis of pre-existing longitudinal health and demographic surveillance system (HDSS) data, comparing mothers born during three distinct historical periods. Reproductive-age women from three different generations, specifically those born in the 1970s, 1980s and 1990s. A linear mixed-effects modelling approach was used, employing the logit link function for the binomial family. The statistical analysis was done using RStudio. A 5% p value threshold and a 95% confidence level were used to assess the statistical significance of the findings. Results:Prenatal care coverage was lowest among the 1970s cohort (29.6%), rising to 33.2% for the 1980s cohort and 36.2% for the 1990s cohort. Skilled birth care utilisation showed a similar generational gap: 27.2% (1970s), 26.4% (1980s) and 30.6% (1990s). Adjusted analyses revealed maternal education (adjusted OR (AOR) 1.66 (95% CI 1.443 to 1.916), husband's education and husband's unemployment (AOR 3.44 (95% CI 1.936 to 6.112)) as key predictors of prenatal care use. Younger age at first marriage (eg, <16 years: AOR 0.747 (95% CI 0.594 to 0.872)) and unintended pregnancy reduced prenatal care utilisation. For skilled birth attendance, household wealth (highest vs lowest wealth: AOR 2.28 (95% CI 1.926 to 2.708)), prior prenatal care use (AOR 2.89 (95% CI 2.514 to 3.33)) and birth cohort (1980s vs 1990s: AOR 0.79 (95% CI 0.681 to 0.914)) were significant determinants. Early marriage (eg, <24 years) and unintended pregnancy similarly decreased skilled care utilisation. Conclusion:The persistent generational disparities in maternal healthcare utilisation, with later-born cohorts (1990s) demonstrating improved coverage compared with earlier generations (1970s-1980s). These disparities are driven by intersecting generational differences in educational opportunity, employment patterns and technological modernisation. Key determinants include maternal and spousal education, household wealth, age at first marriage, pregnancy intention and generational differences in acceptance of modern healthcare. Addressing these disparities requires targeted policies to enhance educational access, economic equity and reproductive health autonomy, ensuring equitable maternal healthcare utilisation across generations.

BACKGROUND:Investing in adolescents' sexual and reproductive health (SRH) yields great benefits, as this period marks a crucial transition from childhood to adulthood. Many young people face SRH challenges due to limited knowledge and inability to make informed decisions about their sexual and reproductive health rights (SRHR). This study aimed to assess the effectiveness of digital health interventions in improving SRH among school adolescents and youths in Jimma, Ethiopia. METHODS:A quasi-experimental design was employed and data were collected from school youths. Analysis was conducted using EpiData version 4.6 and Stata version 17.0. Propensity score matching was applied to estimate average treatment effects and sensitivity analysis was conducted using a difference-in-differences approach. RESULTS:There was a significant improvement in SRH outcomes between baseline and the end line. Knowledge of SRHR increased by 26.8 percentage points (95% confidence interval [CI] 14.5 to 38.6), knowledge of SRH by 11.5 percentage points (95% CI 1.7 to 21.4) and positive attitudes toward SRHR by 27.4 percentage points (95% CI 17.5 to 37.3) following the digital intervention. CONCLUSIONS:The digital health intervention significantly enhanced knowledge and attitudes related to SRHR among school adolescents. Further studies should explore whether improvements in knowledge and attitudes translate into longer-term reproductive health outcomes, such as contraceptive uptake, teenage pregnancy and unmet need for family planning.

Introduction: An intrauterine device (IUD) is a highly effective long-acting and reversible contraceptive method widely available around the world and safe for nearly all women. However, very few women in Southwestern Ethiopia use.Objectives: To identify factors influencing an intention to use the intrauterine device among family planning users in Southwestern, Ethiopia.Methods: A facility-based cross-sectional study was conducted among 784 modern family planning users from 15th October to 15th November 2020. An interviewer-administered questionnaire was used. Estimates were generated using logistic regression model.Results: Thirty percent intended to use IUD. The most commonly cited reasons for their lack of an intention to use IUD were fear of side effects, lack of knowledge, and husband disapproval. Being able to read and write (AOR = 3.33 [95% C.I. 1.48, 7.49]) compared to those unable to read and write; Being rich (AOR = 1.69 [95% C.I. 1.02, 2.82]) compared to the poor; being knowledgeable about IUD (AOR = 2.74 [95% C.I. [1.67, 4.51]); having higher reproductive health autonomy (AOR = 1.53 [95% C.I. [1.09, 2.16]) were found to be significant factors influencing women's intention to use an IUD.Conclusion: Nearly one-third of women who attend health facilities are currently using contraception reported an intention to use an IUD in the future. Public health interventions should focus on the cited reasons reaching all the community in need, and give priority for women who unable read and write, and lowest wealth status. Further interventional studies were recommended to determine effective interventions to increase women's intention to use intrauterine device.

Objective:Adverse pregnancy outcomes (APOs) are major drivers of maternal and child mortality, especially in low-income countries like Ethiopia. Studies examining such inequities from a life course lens are lacking. Hence, this study investigates generational disparities in the risk of APOs. Study Design:An accelerated cohort design was utilized, recruiting 7,286 women from three birth cohorts (1970s, 1980s, and 1990s) in Kersa, Eastern Ethiopia. A generalized linear mixed-effects model using STATA version 17.0 was used. Results:Pregnancy outcomes varied across generations. Stillbirths were highest in earlier life course (13.8%) and lowest in later (7.3%). Preterm births declined slightly (9.5% to 8.1%), but risks were greater in later life course. Miscarriages were lowest in Cohort 2 (2.9%). Poor maternal nutrition (MUAC <21 cm; AOR = 2.87 for preterm birth, AOR = 1.71 for stillbirth) and high gravidity (AOR = 2.26 for preterm birth, AOR = 1.51 for stillbirth) were strongly associated with adverse pregnancy outcomes, while lack of maternal education (AOR = 1.45) also increased risk of preterm birth. In contrast, later age at first birth (AOR = 0.43 for preterm birth) and higher household wealth (medium AOR = 0.73; highest AOR = 0.63 for preterm birth) were protective factors. These findings underscore the importance of maternal nutrition, reproductive history, and socioeconomic conditions in determining pregnancy outcomes. Conclusion:Generational disparities highlight the need for multilevel strategies addressing social determinants and maternal care. Future studies to elucidate the biological pathways, such as epigenetic changes, linking early-life exposures to pregnancy outcomes are recommended. Key Points:· Adverse pregnancy outcomes were observed.. · Study used an accelerated cohort design. · Findings were interpreted through life course perspectives..

Malaria control in African cities faces challenges mainly due to unplanned urbanization and the spread of Anopheles stephensi. Urbanization is changing malaria dynamics, driven by environmental changes and population growth, with nearly 70

One of the Sustainable Development Goals of the United Nations is to bring the global maternal mortality ratio down to less than 70 per 100,000 live births by 2030. Therefore, pinpointing the factors that influence maternal near-misses would help expedite the accomplishment of this goal. Studies on these topics are, nevertheless, scarce in the Hadiya zone and throughout Ethiopia as a whole. Therefore, the purpose of this study was to determine the factors that contribute to maternal near-misses among women who are admitted to public hospital maternity wards in the Hadiya zone in central Ethiopia. A facility-based, unmatched case-control study was conducted from February 17 to August 16, 2019. The study covered all secondary and tertiary public healthcare facilities in the Hadiya zone, which includes three district hospitals and one referral hospital offering comprehensive emergency obstetric care services. The study included 279 women in total (70 cases and 209 controls). Mothers who had had a near-miss were the cases, and mothers who had not had one were the controls. The Statistical Package for Social Sciences version 24 was used to analyze the data, and the multivariable binary logistic regression model was used to control confounders. The odds ratios (OR) and 95% confidence intervals (CI) were used to determine statistical significance at a p-value of less than 0.05. Living in a rural area [adjusted OR (AOR)=3.16; 95% CI: 1.62, 6.16], no birth preparedness (AOR=3.50; 95% CI: 1.66, 7.41), ever gave birth by cesarean section (AOR=3.68; 95% CI: 1.63, 8.31), previous history of hypertension (AOR=3.69; 95% CI:1.52, 8.96), and poor knowledge of pregnancy danger signs (AOR=3.15; 95% CI: 1.32, 7.52) were all determinants of maternal near-miss. Thus, strengthened public health and clinical interventions in these arenas need to prioritize rural women and women with a previous history of hypertension.

Introduction: Every year, millions of induced abortions, stillbirths, and preterm births occur worldwide. Ethiopia has high rates of stillbirths and unsafe abortions contribute to maternal deaths. Preterm births are the leading cause of death among children under five. Despite interventions, adverse pregnancy outcomes remain prevalent, especially in low-income and middle-income countries. The life course perspective is vital for understanding the impact of social factors on pregnancy outcomes, including early life exposure to famine. This study aims to explore these relationships in in Kersa, Eastern Ethiopia to mitigate the burden of adverse pregnancy outcomes. Methods: An accelerated cohort design utilized to capture all reproductive age mothers in Kersa, Eastern Ethiopia. A total 7,286 pregnant women with 13,299 complete observations from Kersa Health and Demographic Surveillance System (HDSS) dataset were analyzed. The generalized linear mixed-effects model was conducted using STATA version 17.0, specifying the family as binomial and the link function as logit. Result: Adverse pregnancy outcomes varied significantly among three distinct birth cohorts, indicating the impact of early-life famine exposure throughout the maternal life course. Women who experienced the famine at birth (Adjusted Odds Ratio [AOR] = 1.50, 95%, C.I [1.27, 1.77]), who experienced the famine throughout childhood (AOR = 1.84, 95% C.I [1.40, 2.43]), women who had never attended formal education (AOR = 1.57, 95% C.I [1.30, 1.90]), those who gave birth before age of 18 (AOR = 1.44, 95% C.I [1.26, 1.66]), mid-upper arm circumference less than 21cm (AOR = 2.49, 95% C.I [2.01, 3.09]), those 21-23cm (AOR = 1.54, 95% C.I [1.32, 1.79]), compared to greater than 23cm. Conclusion: Adverse pregnancy outcomes varied significantly among three birth cohorts, indicating the impact of early-life famine exposure. Factors such as famine at birth or throughout childhood, lack of formal education, giving birth before age 18, and low mid-upper arm circumference were associated with higher odds of adverse outcomes. Addressing these factors is crucial for improving pregnancy outcomes.

Abstract Background Investments in youths’ sexual and reproductive health (SRH) has greatest gain as they are in a critical time across the period of transition from childhood to adulthood. This segment of population disproportionately from SRH ill health problems due to lack of adequate knowledge to make informed decisions and exercise their sexual and reproductive rights (SRHR). Objectives To examine effectiveness of digital health interventions on SRH among school adolescent and youth in Jimma Town, Southwest Ethiopia. Methods A quasi-experimental study conducted in Jimma town among school youths. The data were entered into Epidata™ manager v4.6 and analyzed using to STATA™ v 17.0. A propensity score matching (PSM) analysis was conducted to estimate the average treatments (ATE). In addition, two sample tests of proportion, and sensitivity analysis done using difference-in-differences (DID) analysis. Result A significant increase in SRH outcomes between baseline and end-line was found. The knowledge of SRHR increases by 26.8 percentage points (95% CI 14.5, 38.6), knowledge of SRH increases by 11.5 percentage points (95% CI 1.7, 21.4), and attitude towards SRHR increases by 27.4 percentage points (95% CI 17.5, 37.3) because of the digital health intervention among school adolescents and youths. Conclusion The digital health intervention significantly improved knowledge of SRHR, knowledge of SRH, and attitude towards SRHR among school adolescents and youths. Further studies on impacts of digital health interventions on reproductive health outcomes of public health importance such as teenage pregnancies, and unmet need for family planning are recommended.

Abstract Background COVID-19 is still threatening the world and has health, social, economic and political crisis. COVID-19 preventive measures are of having paramount importance for the disease mitigation. Governmental and private employees’ compliance with COVID-19preventive measures are highly important in influencing their friends, spouse, families and community at the large to adhere to the preventive measures. Objectives Compliance with COVID-19 preventive measures and associated factors among employees of Seka and Kersa districts, Jimma zone, Ethiopia, 2020. Methods A cross-sectional study was conducted from 4–22 January 2021. A total of 395 employees from randomly selected of public and private institutions were participated in the study. The data were collected using a pre-tested structured tool. The collected data were entered to EPI data manager version 4.6 and exported to Stata version 16.0 for analyses. Descriptive analyses were performed as necessary. Binary and multivariable logistic regression models were fitted to identify determinants of compliance with COVID-19 preventive measures. Adjusted odds ratios with 95% confidence intervals were used to determine the presence and strength of association. Results This study showed that nearly three fourth (74.68%) of employees were compliant with the COVID-19 preventive measures. Being employees of private institution (adjusted β = 3.12; 95% CI 0.31 to 5.94; p = 0.030), having history of chronic illness (adjusted β = 4.06; 95% CI 1.58 to 6.54; p = 0.001), perceived susceptibility to COVID-19 (adjusted β = 0.38; 95% CI 0.16 to 0.61; p = 0.001), self-efficacy to utilize the preventive measures (adjusted β = 0.70; 95% CI 0.54 to 0.86; p < 0.001) and existence of reminders/cues to utilize the preventive measures (adjusted β = 0.47; 95% CI 0.27 to 0.67; p < 0.001) had statistically significant association with COVID-19 preventive measures. Conclusions We found that one fourth of the employees were non-compliant with COVID-19 preventive measures. Type of working institution, respondents’ history of chronic illness, perceived susceptibility to COVID-19, self-efficacy to utilize the preventive measures and existence of reminders /cues to utilize the preventive measures predicted employees’ compliance with COVID-19 preventive measures. Therefore, behaviour change communication and interventions strategies guided by health belief model need to be considered by stakeholders.

IntroductionPreconception care is an important preventive intervention for adverse pregnancy outcomes. It is recognized as a strategy to optimize women's health and pregnancy outcomes in Western countries. However, preconception care is underutilized in sub-Saharan Africa, like Ethiopia, where maternal mortality is high. Evidence is scarce in the study area about the prevalence and factors associated with preconception care utilization. Therefore this study aimed to assess the proportion of preconception care utilization and associated factors among pregnant mothers in Fiche town, central Ethiopia, 2021.MethodA community-based cross-sectional study was done from May 10 to June 25, 2021. A systematic random sample technique was used to choose 393 pregnant women for the study. A structured, pre-tested, interviewer-administered questionnaire was used to collect data. The data were entered into Epi Data version 3.1 and then exported into SPSS version 25 for analysis. A Bivariable and multivariable logistic regression analysis was used to check for the association. Odds ratio along with 95% was used to describe the association. Finally, a significant association was declared at a p-value less than 0.05.Results388 respondents participated in this study, making the response rate 98.7%. Of total study participants only 84 (21.6%; 95% CI, 18, 25.8) utilized preconception care. The study found that diploma or higher level of education (AOR = 3.47, 95% CI: 1.27, 9.53), psychological and financial support from a partner (AOR = 3.86, 95% CI: 2.1, 7.10), joint discussion and plan with a partner (AOR = 3.32, 95% CI: 1.55, 7.13), history of chronic disease (AOR = 3.47, 95% CI: 1.67, 7.25), and good knowledge about preconception care (AOR = 2.42, 95% CI: 1.34, 4.38) were significantly associated with preconception care utilization.ConclusionsOverall, less than a quarter of the pregnant mothers utilized preconception care, indicating that awareness is very low. Pregnant mothers who have a higher educational level, have good communication and support from their partners, have chronic health problems, and have good knowledge about preconception care were more likely to utilize the service. Preconception care is a better opportunity to intervene and maintain the mother in the continuum of care.

IntroductionAn intrauterine device (IUD) is a highly effective long-acting and reversible contraceptive method widely available around the world. However, only a small proportion of women in developing countries, including Ethiopia, are currently using the method. Therefore, this study aimed to identify why IUD utilization is low in southwestern Ethiopia. Material and methodsA mixed-method study involving health facilities and communities was conducted. The focus group discussions and key informant interviewees for the qualitative study were selected purposively, whereas 844 women family planning users were selected using systematic random sampling from November 1-30, 2020. Quantitative data was collected using Open Data Kit and analyzed using Stata version 16.0. Multivariable logistic regression analyses were done to identify significant factors influencing IUD use. The qualitative data were tape-recorded, transcribed, and finally, thematic analyses were done. ResultsA total of 784 participants were involved in the study yielding a response rate of 92.9%. Among all respondents, only 1.3%, 2.4%, and 30.0% had been using an IUD, preferred an IUD, and had the intention to use an IUD, respectively. The main reported barriers to use an IUD among qualitative participants were fear of side-effects, religious prohibitions of contraception use, husband disapproval, lack of training by health workers, misconceptions, and longer duration of use. IUD information (AOR = 2.19 [CI: 1.56-3.08]), and rich wealth status (AOR = 1.70 [CI: 1.13-2.56]) were associated with the intention to continue or start to use an IUD. ConclusionsIUD use and information on IUDs in the study area was very low. Information about IUDs, wealth status, and partner disapproval were determinant factors for intention to use an IUD. Thus, a regular awareness creation program using accessible media platforms by the government and stakeholders on IUD use is necessary to provide reliable information to the community and resolve misconceptions. In addition, women's empowerment to balance partner dominance on decision-making of contraception use and health care worker training on long-acting reversible contraceptives (LARCs) to increase access to LARC services are necessary to increase uptake of LARCs in general and of IUDs, in particular in the study regions.

An intrauterine device (IUD) is a highly effective long-acting and reversible contraceptive method widely available around the world. However, only a small proportion of women in developing countries, including Ethiopia, are currently using the method. Therefore, this study aimed to identify why IUD utilization is low in southwestern Ethiopia. A mixed-method study involving health facilities and communities was conducted. The focus group discussions and key informant interviewees for the qualitative study were selected purposively, whereas 844 women family planning users were selected using systematic random sampling from November 1–30, 2020. Quantitative data was collected using Open Data Kit and analyzed using Stata version 16.0. Multivariable logistic regression analyses were done to identify significant factors influencing IUD use. The qualitative data were tape-recorded, transcribed, and finally, thematic analyses were done. A total of 784 participants were involved in the study yielding a response rate of 92.9%. Among all respondents, only 1.3%, 2.4%, and 30.0% had been using an IUD, preferred an IUD, and had the intention to use an IUD, respectively. The main reported barriers to use an IUD among qualitative participants were fear of side-effects, religious prohibitions of contraception use, husband disapproval, lack of training by health workers, misconceptions, and longer duration of use. IUD information (AOR = 2.19 [CI: 1.56–3.08]), and rich wealth status (AOR = 1.70 [CI: 1.13–2.56]) were associated with the intention to continue or start to use an IUD. IUD use and information on IUDs in the study area was very low. Information about IUDs, wealth status, and partner disapproval were determinant factors for intention to use an IUD. Thus, a regular awareness creation program using accessible media platforms by the government and stakeholders on IUD use is necessary to provide reliable information to the community and resolve misconceptions. In addition, women's empowerment to balance partner dominance on decision-making of contraception use and health care worker training on long-acting reversible contraceptives (LARCs) to increase access to LARC services are necessary to increase uptake of LARCs in general and of IUDs, in particular in the study regions.

Objective A dimensional shift in the health service delivery in the primary healthcare setting is required to raise maternal and child well-being. This study aimed to evaluate the effect of US Agency for International Development-funded obstetric ultrasound service on maternal and perinatal health outcomes at Ethiopia’s primary healthcare facilities.Design We employed a quasi-experimental study design.Setting The study was conducted in primary health centres located in four regions of Ethiopia.Participants We used 2 years’ data of 1568 mothers from 13 intervention and 13 control primary health centres. Data were obtained from Vscan, antenatal care (ANC), delivery and postnatal care registers.Intervention Use of portable obstetric ultrasound service during pregnancy.Outcome measures The primary outcome variables include complete four ANC visits, referral during ANC, delivery in a health facility and having postnatal care and continuum of care. The secondary outcome variable was perinatal death.Results With the kernel matching approach, we have found that having four or more ANC visits was decreased after the intervention (average treatment effect (ATE): −0.20; 95% CI: −0.23 to –0.09), and the rest of the indicators, including referral during ANC (ATE: 0.01; 95% CI: 0.15 to 0.34), institutional delivery (ATE: 0.24; 95% CI: 0.15 to 0.34) and postnatal care (ATE: 0.26; 95% CI: 0.10 to 0.37), were significantly raised because of the intervention. Similarly, we have found that perinatal death dropped considerably due to the intervention.Conclusion The findings show a consistent increase in maternal health service use because of the introduction of obstetric ultrasound services at the primary health centre level. Furthermore, early detection of complications and following referral for specialty care were found to be high. The consistent rise in maternal health service use indicators calls for additional trial to test the effect of obstetric ultrasound service in other locations of the country. Furthermore, evaluating the predictive values, sensitivity and specificity of the obstetric ultrasound service is important.

Abstract Background The minimum acceptable diet (MAD) has been used globally as one of the main indicators to assess the adequacy of feeding practices. More than half of the causes of under-five child mortality in developing countries including Ethiopia are attributed to malnutrition. With the exception of anecdotal information on the subject, progress overtime and how it influences the MAD has not been studied or well understood. Thus, this study aimed to determine the trends and determinants of MAD intake among infants and young children aged 6–23 months in Ethiopia. Methods A community-based national survey dataset from the Ethiopian demographic and health survey (EDHS) 2019 were to identify predictors of MAD. In addition, the 2011, 2016, and 2019 EDHS data was used for trend analysis. The World Health Organization indicators were used to measure MAD. A weighted sample of 1457 infants and young children aged 6–23 months. A mixed-effects multi-level logistic regression model was employed using STATA version 16.0. Results The proportions of infants and young children who received the MADs in Ethiopia were 4.1%, 7.3%, and 11.3% during the survey periods of 2011, 2016, and 2019, respectively. Having mothers who attended primary education [adjusted odds ratio (aOR) =2.33 (95% C.I 1.25 to 4.35)], secondary education [aOR = 2.49 (95% C.I 1.03 to 6.45)], or higher education [aOR = 4.02 (95% C.I 1.53 to 10.54)] compared to those who never attended formal education. Being in a medium househoold wealth [aOR = 4.06 (95% C.I 1.41 to 11.72)], higher-level wealth [aOR = 4.91 (95% C.I 1.49 to 16.13)] compared to those in the lowest househoold wealth. Being in 12–18 months age group [aOR = 2.12 (95% C.I 1.25 to 3.58)] and in 18–23 months age category [aOR = 2.23 (1.29 to 3.82)] compared to 6–11 months age group; and having postnatal check-ups [aOR = 2.16 (95% C.I 1.31 to 3.55)] compared to their counterparts. Moreover, residing in urban [aOR = 3.40 (95% C.I 1.73 to 6.68)]; living in a communities’ where majority had a media exposure [aOR 1.80 (95% C.1.17 to 2.77)] were found to be significantly influenc consumption of the MAD. Conclusions The trends of MAD among children of 6–23 months was steady in Ethiopia. Sociodemographic and socioeconomic factors such as maternal education, child age, household wealth; and health system related factors such as maternal postnatal check-ups had a significant influence on infants’ and young children’s MAD feeding. Indeed, commnity-level factors such as place of residence, and media exposure affect the MAD of infants and young children. Thus, behavioral change communication interventions are recommended to improve dietary practices in infants and young children.

Objectives Although nationally representative data are helpful in designing strategies and policies of programmes in a country, there is paucity of evidence with regard to trends and factors influencing utilisation of long-acting contraceptives (LACs). Thus, this study aimed to assess the trends and factors influencing LAC utilisation among contraceptive users in Ethiopia. Design A repeated cross-sectional study. Setting and participants The Performance Monitoring and Accountability (PMA2020) national community-based survey data were used, and 2035 contraceptive users participated. To identify trends, proportions of LAC users were analysed using PMA data from round 1 in January 2014 to round 6 in July 2018. Main outcome measures Users using LAC methods or otherwise. Results There was a difference in trends in LAC utilisation in the last 4.5 years. There was a 7% increase in the proportion of implant users, while there were no significant changes in utilisation of intrauterine device and female sterilisation. Women in the middle wealth quintile were 1.7 times more likely than those in the lowest quintile to use LAC, while contraceptive users who received recommendations from healthcare providers as well as those who made decisions jointly with healthcare providers were more likely to use LAC compared with those who decided on their own. Women with access to their desired method of contraception were less likely to use LAC, while those informed about intrauterine contraceptive device were more likely to use LAC compared with their counterparts. Women served at health posts, private hospitals and others (family planning clinics, pharmacies and non-governmental organisations) were less likely to use LAC compared with women served at public hospitals. Conclusion Overall the utilisation of LAC in Ethiopia is low. Therefore, much has to be done in terms of raising awareness about intrauterine device, how healthcare providers can help users in choosing contraceptive methods, and sharing of experiences between public hospitals and other family planning service delivery points.

BACKGROUND: Risky sexual behavior increases the risk of contracting sexually transmitted disease including HIV and other reproductive health problems.There have been varying assumptions and different reported result explaining the relationship between risky sexual behavior and wealth. This review was intended to examine the disparity of risky sexual behavior among the two extremes of wealth in sub-Saharan African countries. METHOD: This study reviewed demographic and health survey reports of sub-Saharan African countries. We excluded older reports and reports published in languages other than English. Finally, reports from 16 countries were considered for review. Data were entered in excel and transported to stata for analysis. Metaprop and Metan command were used to compute proportions and odds ratio. Standard chi-square and I square tests were used to assess heterogeneity. RESULT: Pooled prevalence of having multiple sexual partner ranges from 2 to 12%. Over 80% of the countries reported that more than half of the individuals did not use condom at their last risky sexual intercourse. Poorest females were 0.62 [OR: 0.62, 95% CI (0.50, 0.78)] times less likely to have multiple sexual partners than males. Both males and females from the poorest wealth quantile had higher odds of not using condom at their last risky sexual intercourse, 1.41 [OR: 1.41, 95% CI (1.29, 1.53)], 1.41 [OR: 1.46, 95% CI (1.23, 1.73)], respectively. CONCLUSION: Multiple sexual partners is relatively low in the region. Condom non-use is high in both genders. Additionally, poorest males and females were at higher risk of not using a condom at last risky sexual intercourse.

Background Worldwide cardiovascular disease is the major cause of disability and premature death. This is due to the ascending trend of consuming an unhealthy diet and obesity which increases the risk of hypertension and type 2 diabetes mellitus. Thus this study aimed to determine the pooled prevalence of the cardiovascular disease in Ethiopia. Methods Medline, Scopus, and Google Scholar search engines were accessed using medical subject heading (MeSH) terms for studies based in Ethiopia, from 2000 to 2018. However, studies done among a specific group of the population were excluded from the study. Data were extracted by one reviewer and then checked independently by a second reviewer. Studies were qualitatively synthesis in terms of design, quality, study population, outcomes, and result. Sub-group analysis and sensitivity tests were conducted to identify potential influences on the prevalence estimates. Quantitative results were pooled in a statistical meta-analysis using STATA version 14 software. Result Nine eligible cross-sectional studies were included in the analysis. The prevalence ranges from 1 to 20%. The pooled prevalence of cardiovascular disease (CVD) was 5% (95% CI: 3–8%). The prevalence was higher in the population who visits hospitals, 8% (95% CI: 4–12%) compared to the general population, 2% (95% CI: 1–5%). There was no significant difference in the overall prevalence of CVD between males and females. Conclusion The prevalence of cardiovascular disease was high. A higher prevalence of CVD was found among patients who visited health institutions than the general population and no observed significant sex difference in the prevalence

Background: Postnatal care is provided to women and their babies within 42 days after delivery. Although the first two days after birth was a critical time in maternal health, it was the most neglected period of maternal health services. Therefore, this study aims to determine the maternal and community-level factors of postnatal check-ups in Ethiopia Methods: Ethiopian Demographic and Health Survey (EDHS) in 2016 was utilized. A total of 3,948 women aged 15-49 giving birth in the two years before the survey were included. A multi-level mixed-effects logistic regression model was employed. Result: Only 17% [95% C.I; 16.46%-17.53%] of the women had a postnatal check-up (PNC) within 2 days of giving birth in Ethiopia. Institutional delivery AOR 2.14 [95% C.I 1.70, 2.0] and giving birth by cesarean section AOR 1.66 [95% CI 1.10, 2.50] were found to be maternal factors. Whereas, administrative regions (Oromia 69%, Somali 56%, Benishangul 55%, SNNPR 43%, Gambela 66%, Afar 50% and Dire Dawa 55% which less likely to utilize PNC as compared to Addis Ababa), higher community-level wealth AOR 1.44 [95% C.I 1.08, 1.2], ANC coverage AOR 1.52 [95% C.I 1.19, 1.96] and perceived distance of the health facility as a big problem AOR 0.78 [95% C.I 0.60, 0.99] were the community level factors. Conclusion: Both maternal factors and community factors are found to be a significant association with PNC, however, based on the ICC maternal factors prevail the community-level factors. Therefore, public health interventions to increasing improve postnatal care services should focus on community level determinants.

Background Subdermal contraceptive implant is the most widely used method of long-acting reversible contraception among Ethiopian women. Many, however, discontinue use early, which results in unwanted pregnancies and induced abortions and their associated complications. The aim of this study is to determine the rate of and reasons for discontinuation of the contraceptive implant among users in the Kersa district of southwestern Ethiopia. Methods A mixed-method study was carried out between March and April 2019 among 475 women who had been using the contraceptive implant between January 2015 and August 2016 in the Kersa district. Systematic random sampling was used for quantitative data collection and purposive sampling was used for qualitative data collection using 8 focus group discussion and 56 In-depth interviews. A binary logistic regression was carried out for bivariate and multivariable analyses. Results One hundred and ten (23.2 %) contraceptive implant users requested removal before 2.5 years of use. The main reasons for the discontinuation were side effects, followed by a desire for pregnancy or to switch to another contraceptive method and misconceptions. Implant discontinuation was associated with a lack of information prior to insertion on the effectiveness of modern contraception (adjusted odds ratio [OR] 2.0; 95 % confidence interval [CI] 1.13, 3.55), being served by a midwife or nurse (adjusted OR 1.8; 95 % CI 1.04, 3.23), and not being told to return to the health facility if any side effects were experienced (adjusted OR 1.8; 95 % CI 1.01, 3.19) (all p < 0.05). Conclusions Almost a quarter of the study participants discontinued use of the contraceptive implant before the due date. Public health interventions should focus on providing adequate awareness for family planning users, trainings for the health care workers on effective counselling services, especially on side effect and misconceptions.

Background Prenatal care is an important component for the continuum of care in maternal and child health services. Despite increased attention on prenatal care service coverage, the adequacy of service provision has not been well addressed in Ethiopia. Therefore, this study aimed to describe the status of the adequacy of prenatal care and its associated factors in Southern Ethiopia. Method A longitudinal study done by the Performance care Monitoring and Accountability (PMA2020) project was used. The study was conducted from August 2016 to January 2017 in Southern Ethiopia. A multistage stratified cluster design in which all enumeration areas were randomly selected using probability proportional to size and all households were screened to identify 324 pregnant women of six or more months. Questions regarding early attendance of prenatal care, enough visits, and sufficient services were asked to measure the adequacy of prenatal care. Finally, an ordered logistic regression analysis was employed to assess factors associated with the adequacy of prenatal care services. Results Of the total pregnant women 44.21 % attended enough visits, 84.10 % had early visits, and 42.03 % received sufficient services. The women residing in urban areas had 2.35 odds of having adequate prenatal care in reference to rural areas (adjusted odds ratio (aOR) 2.35 [95 % CI 1.05–5.31]). Women who attended primary and secondary education had 2.42(aOR 2.42 [95 % C.I. 1.04, 5.65]), and 4.18 (aOR 4.18 [95 % CI 1.32, 13.29]) odds of adequate prenatal care in reference with those who never attended education respectively. The women participating in one to five networks have 2.18 odds of adequate prenatal care in reference to their counterparts (aOR 2.78 [95 % CI 1.01, 7.71]). Conclusions The adequacy of prenatal care services in Southern Ethiopia is very low. The Ethiopian health care system should strengthen one to five networks to discuss on family health issues. Further research, should validate the tools and measure the adequacy of the services in different contexts of Ethiopia using a mixed method study for an in-depth understanding of the problem.