Mixed-methods approach in evaluating safe abortion care services at public health facilities in North Shewa zone, central Ethiopia: a multicenter institutional cross-sectional study.

Background: Of the 55.7 million abortions that were performed globally, 25.1 million (45.1%) were not safe. Nearly 97% of these took place in developing countries. Approximately 71% of economically developed countries allow safe abortion care (SAC) services, whereas only 16% of developing countries permit it. In sub-Saharan Africa, 92% of mothers live in 43 countries where SAC services are restricted by law. Most Ethiopian women continue to self-terminate unwanted pregnancies in hazardous conditions. The aim of this evaluation was to assess input, care providers' compliance with national guidelines, and clients' satisfaction. Methods: A multicenter cross-sectional study design with a mixed-methods approach was used. Seven public health facilities were randomly selected where 75 health caseworkers were directly observed; 296 clients and 14 key informants were interviewed, respectively. A resource inventory checklist was used to assess all inputs. The overall SAC services evaluation was summarized from 40 indicators: 13 resource availability indicators, 14 healthcare workers' compliance to national guidelines indicators, and 13 clients' satisfaction toward SAC services indicators. A multivariate logistic regression model was fit to determine factors that affect client satisfaction at a p-value <0.005. Results: There were 75 healthcare providers in the maternal and child health departments in the study area. Except for the interruption of water and electricity, maternal waiting area, counseling, and procedural room, all are available making 94% of resources availability. All healthcare workers were compliant in providing anti-pain medication during procedures, identifying clients if they were targeted for an HIV/AIDS test, and providing their test results as per the guideline. Nevertheless, they were poorly compliant in respecting the clients (9, 12%) and taking vital sign (33, 44%). The overall compliance was 62.3%, while only 51% were satisfied with waiting time and privacy of counseling room. The overall client satisfaction was 65%. The overall evaluation of SAC services was 72.9%. Conclusion: Resource availability was excellent, which was in line with national SAC expectations while the healthcare workers' compliance to national guidelines was fair, which deviated from expectations. The clients' satisfaction and the overall evaluation were good, which was below the hypothesized expectation.

A five years malaria surveillance data analysis of North Shewa zone, Amhara region, Ethiopia: July 2018 to June 2023.

BACKGROUND: Malaria is a critical public health concern in Ethiopia, with significant socioeconomic consequences. Malaria data trend analysis is essential for understanding transmission patterns and adopting evidence-based malaria control measures. The purpose of this study was to determine the 5 year distribution of malaria in North Shewa zone, Amhara region, Ethiopia, in 2023. METHODS: A descriptive cross-sectional study design was employed to analyse the 5 year trend of malaria surveillance data in the North Shewa zone of the Amhara regional, Ethiopia, spanning from July 2018 to June 2023. The malaria indicator data were gathered from the zone's public health emergency management database. Malaria data from the previous 5 years was collected, compiled, processed, and analysed using Microsoft Excel 2019. RESULTS: Among a total of 434,110 suspected cases 47,889 (11.03%) cases were confirmed as malaria, with an average annual malaria incidence rate of 4.4 per 1000 population in the Zone. Malaria cases exhibited an increase from Epidemiological Week (Epi week) 37 to Epi week 49 (September to November) and again from Epi week 22 to week 30 (May to July). Individuals aged 15 and above, and all districts in the Zone except Angolela were notably affected by malaria. CONCLUSION: Despite implementing various measures to reduce malaria incidence, the disease continues to persist in the zone. Therefore, the Zone Health Department should intensify its preventive and control efforts.

Seroepidemiology of bovine alphaherpesvirus 1 (BoAHV-1) in commercial and smallholder dairy herds in north Shewa, central highlands of Ethiopia.

Bovine alphaherpesvirus 1 (BoAHV-1) is the most important respiratory and reproductive disease-causing pathogen in dairy cattle. Despite BoAHV-1 has become widespread and a major challenge to the dairy industry, little is known about its epidemiology in dairy herds in Ethiopia. A cross-sectional study was conducted from November 2022 to May 2023 to determine the seroprevalence and potential risk factors associated with BoAHV-1 seropositivity in dairy herds in North Shewa, the central highlands of Ethiopia. A total of 511 blood samples were collected from randomly selected cattle herds (n = 142) and examined antibodies against BoAHV-1 using ELISA test. A retrospective survey was also done to gather information related to reproductive disorders. The overall seroprevalence of BoAHV-1 was 61.84% (95% CI: 57.53-65.97) at the animal level and 85.21% (95% CI: 78.28-90.21) at the herd level. Multivariable logistic analysis revealed that the risk of being BoAHV-1 seropositive was nine times higher in cows older than six years (OR = 9.16; 95% CI: 3.09-27.16; P = 0.000), five times higher (OR = 4.51; 95% CI: 1.23-16.53; P = 0.019) in cows with a history of abortion, three times higher (OR = 2.75; 95% CI: 1.72-4.22; P = 0.029) in cows with a history of retained fetal membrane, and three times higher (OR = 2.83; 1.86-9.31; P = 0.03) in animals with clinical signs of ocular and/or nasal discharge. This study demonstrates a significant circulating of BoAHV-1 in the dairy cattle population in study districts. Thus, a comprehensive approach that includes strict farm biosecurity and vaccination should be practiced for effective BoAHV-1 control and prevention and to promote the growing dairy industry in the central highlands of Ethiopia.

InSAR-based landslide hazard mapping and identification of at-risk infrastructures in a selected district of North Shewa Zone, Ethiopia.

The devastating nature of landslides demands a thorough understanding of their spatial distribution and the risks they pose to human settlements and infrastructural assets. In this study, we employed a combination of Interferometric Synthetic Aperture Radar (InSAR) and Geographic Information System (GIS) techniques to explore the western escarpment of the Main Ethiopian Rift, with a focus on selected districts within the northern Shewa Zone, Ethiopia. By analyzing the SAR data, we derived 28 displacement maps and utilized them to create a comprehensive landslide hazard zonation map. The results indicated significant ground displacement, particularly along the rift margins and areas characterized by rugged terrain. The hazard zones were classified based on their level of risk, with 44% classified as very low, 24% as low, 5% as moderate, 13% as high, and 14% as very high hazard zones. The accuracy of our results was evaluated using receiver operating characteristic (ROC) analysis, which was conducted utilizing landslide inventory data. The analysis demonstrated a remarkable area under the curve (AUC) value of 0.848, providing strong evidence for the validity of our findings. Additionally, our study involved a spatial and statistical assessment of major infrastructure, revealing that 20 to 28% of these properties were in hazard zones ranging from moderate to very high levels, which calls for efficient risk-reduction actions. Therefore, this finding enables stakeholders to identify high-risk areas, prioritize mitigation efforts, and minimize the impact of landslide disasters.

Estimating gestational age using the anthropometric measurements of newborns in North Shewa Zone public hospitals, Oromia, Ethiopia.

Background: The accurate estimation of gestational age is crucial in identifying prematurity and other health problems in newborns and in providing appropriate perinatal care. Although there are numerous methods for measuring gestational age, they are not always applicable. During these situations, it becomes challenging to ascertain whether a baby has been born prematurely or not. Therefore, this study aims to estimate gestational age by utilizing newborn anthropometric parameters. Purpose: The objective of this study is to estimate the gestational age of newborns in public hospitals located in the North Shewa Zone of the Oromia Region in Ethiopia, by using anthropometric parameters. Methods: A cross-sectional study was conducted at a facility from February 2022 to April 2022, using an interview-based questionnaire and anthropometric measurements. The anthropometric parameters that were measured include foot length (FL), mid-upper arm circumference (MUAC), and chest and head circumference (CHC). The study's sample size had a total of 420 participants. The data were cleaned, edited, manually checked for completeness, and entered into Epi-data version 3.1. Subsequently, the data were transferred into SPSS for analysis. The data were analyzed using descriptive analysis, simple linear regression, and multiple linear regressions. Finally, the data were presented using statements and tables. Results: There is a significant and positive correlation between anthropometric parameters, including head circumference (r: 0.483), MUAC (r: 0.481), foot length (r: 0.457), and chest circumference (r: 0.482) with gestational age. All anthropometric parameters demonstrated positive and significant estimates of gestational age. The combination of the four measurements yielded the strongest estimate of gestational age. Gestational age can be calculated by the formula: Gestational age (Weeks) = 9.78 + 0.209*CHC + 0.607*MUAC + 0.727*FL + 0.322*HC. Conclusion: Gestational age can be measured using head circumference, mid-upper arm circumference, foot length, and chest circumference. Utilizing the four anthropometric parameters in combination exhibits greater efficacy in estimating gestational age than using them individually. Therefore, it is recommended to use these alternative approaches when standard methods are not applicable.

Sero-Prevalence and Associated Risk Factors of Peste Des Petits Ruminants in Dera and Gerar Jarso Districts of Oromia Region, Ethiopia.

Introduction: Peste des petits ruminants is a transboundary disease of major economic importance and imposes significant constraints on small ruminant production. Methods: A cross-sectional study was employed in Dera and Gerar Jarso districts of the North Shewa zone, Oromia Region from February 2021 to March 2022, to estimate the antibody of PPRV and assess the associated risk factors. Blood samples (n = 662) were collected from sheep and goats. Cluster sampling strategy was employed to collect the data. Villages/Kebeles and individual small ruminants were randomly selected, while households were designated using a systematic random sampling method. Results: An overall individual animal and flock level sero-prevalence was 10.3% (95% CI = 8.2-12.8) and 100% (95% CI = 96.3-100), respectively, from the c-ELISA test result. A sero-prevalence of 11.2% (95% CI = 8.7-14.4) in Dera and 8% (95% CI = 5-12.7) in Gerar Jarso districts was recorded. Discussion: Flock size, age, sex, communal grazing, and watering system, new small ruminant introduction into a flock, and mixed rearing were significantly associated with PPR sero-positivity in sheep and goats. The chance of PPR occurrence in goats was 4 times (OR = 4; P = 0.000) more than sheep. Female sheep and goats were more likely to be sero-positive to PPR by 3 times (OR = 3.2; P = 0.003) than males. The newly introduced small ruminants had 4 times more odds (OR = 4.4; P = 0.000) of sero-positivity than animals being born at home. Small ruminants kept under communal grazing and watering system were nearly 12 times (OR = 11.5; P = 0.024) more likely sero-positive than privately managed small ruminants. Likewise, sheep and goats reared together were almost 9 times (OR = 9.4; P = 0.000) a higher chance of being sero-positive compared with separately reared small ruminants. Conclusion: The finding of PPR virus antibodies in small ruminants from all study areas indicates endemic circulation of the virus. The implementation of regular vaccination could minimize the occurrence of PPR.

Prevalence of anti-seizure medication nonadherence and its associated factors, among people with epilepsy in North Shewa, Ethiopia, 2021.

BACKGROUND: Epilepsy is a worldwide neurologic illness, characterized by recurrent unprovoked epileptic seizures and can affect people of all age groups. Patients who are receiving drug therapy for chronic diseases, such as epilepsy, must fit complex medication regimens into their everyday routines. Managing medication schedules may pose a significant burden on patients' lives. Anti-seizure medication choices should therefore be tailored to patients' factors that may limit medication use. The study aimed to determine the prevalence and Predictors of anti-seizure medication nonadherence among patients with epilepsy. METHODOLOGY: An institutional-based cross-sectional study was conducted among 352 people with epilepsy who were selected by systematic random sampling method at government hospitals in North Shewa Ethiopia. Data were collected by reviewing patients' charts and interviewing people with epilepsy by using structured and pretested questionnaires. Data obtained were encoded into EPI-INFO software and exported to SPSS version 25 for analysis. Logistic regression was employed to assess independent factors associated with medication non-adherence. RESULT: The prevalence of anti-seizure medication non-adherence was 40%. Being female [AOR = 3.37, 95%, CI: 1.84, 6.18], Divorced [AOR = 9.13, 95%, CI: 1.80, 46.34], Being jobless [AOR = 7.33, 95%, CI: 3.24, 16.56], Perceived poor social support [AOR = 2.73, 95%, CI: 1.28, 5.82], perceived stigma [AOR = 5.07, 95%, CI: 2.40, 10.68], polytherapy [AOR = 2.23, 95%, CI: 1.06, 4.71], drug side effects[AOR = 6.03, 95%, CI: 3.17, 11.45], buying medications [AOR = 5.81, 95%, CI: 3.63,16.79] and duration of stay on treatment [AOR = 4.31, 95%, CI: 1.863, 9.97] were significant predictors of anti-seizure medication non-adherence. CONCLUSION: Non-adherence to anti-seizure medication among people with epilepsy in the study area was relatively higher as compared with study reports from different parts of the country. Health and clinical, socio-economy, and patients' psychological mindset were among the determinant factors affecting the consistency of epilepsy treatment adherence. Enhanced professional, health education for patients as well as for society and financial support, are basic pillars to reduce the constraints of effective treatment.

Fatal Road Traffic Accidents and Associated Factors in North Shewa Zone, Central Ethiopia: A Cross-Sectional Study.

Background: Road traffic accidents (RTAs) are among the top three global causes of death among people aged 15 to 44 years. More importantly, it is the main cause of death and permanent disability among young people aged 15 to 29 years. This study aimed to assess the magnitude of fatal traffic accidents and the factors associated with them in the North Shewa Zone, Central Ethiopia, from 2013 to 2018. Method: An institution-based cross-sectional study was conducted in all registered RTAs from July 2013 to June 2018 that had full documentation. The data extraction tool was developed based on the daily RTA registration book format that was utilized. Data was entered into Epi-data version 3.1 and then exported to SPSS version 21 for analysis. Logistic regression analysis was used to assess the relationship between the factors and the fatality of RTA. P-values less than 0.05 were reported as statistically significant. Results: Among 846 RTAs studied, 351 (41.5%) were found fatal, while 495 (58.5%) caused non-fatal injuries. Failure to give priority to pedestrians was 2.8 times (AOR = 2.8, 95% CI: 1.3, 5.9) more likely to cause fatal RTAs than drivers who failed to maintain distance between vehicles. Pedestrians were 2.7 times (AOR = 2.7, 95% CI: 1.1, 6.7) more likely to die in RTAs than drivers. Conclusion: The fatality of RTA was high. Failure to give priority to pedestrians and being a pedestrian were strong predictors of death. The North Shewa Zone Traffic Police Department and police officers should focus on enforcing traffic safety laws.

"Magnitude of community-based health insurance utilization and associated factors in Bassona Worena District, North Shoa Zone, Ethiopia: a community-based cross-sectional study".

INTRODUCTION: The health insurance system has been proven to offer effective and efficient health care for the community, particularly community-based health insurance is expected to ensure health care access for people with low economic status and vulnerable groups. Despite the significance of evidence-based systems and implementation, there is a limited report about the magnitude of CBHI utilization. Therefore, this study was done to assess factors associated with community-based health insurance utilization in Basona Worena District, North Shewa Zone, Ethiopia. METHOD: A community-based cross-sectional study was employed. We have included 530 households from 6 randomly selected kebeles. The data was entered using Epi-Data V 3.1 and exported to SPSS version 20.0 for statistical analysis. Bi-variable and multivariable logistic regression analyses were computed to determine factors associated with community-based health insurance utilization. RESULT: The study finding shows that 58.6% of the respondents were members of community-based health insurance. Respondents who had primary and secondary education levels were 2 times more likely to be members than those who had no formal education. As compared to those who had awareness, respondents who had no awareness about CBHI were 0.27 times less likely to be insured. Respondents who did not experience illness were 0.27 times less likely to be members than respondents who experienced illness. CONCLUSION: Educational status, awareness about CBHI, perception of CBHI scheme and illness experience of family influence CBHI utilization. There is a need to strengthen awareness creation to improve the CBHI utilization.

Magnitude of NNM and associated factors among Newborns delivered at the North Shewa zone Public Health Hospital, Central Ethiopia: A multi-level analysis.

Background: Neonatal near miss refers to a condition where a newborn is close to death within the first 28 days of life but ultimately survives either by chance or because of the quality of care they received. It is considered a major public health problem that contributes to the global burden of disease in less developing countries. For every death due to NMM, many others develop a severe complication. Despite this grim reality, there seems to be a gap in terms of the magnitude of and predictors of NNM in Ethiopia, where the previous study focused on neonatal death investigation. This study aimed to determine the magnitude of NNM and its determinants among the neonates delivered in the North Shewa zone, Central Ethiopia. Methods: A facility-based cross-sectional study was conducted using a systematic random sampling technique among 747 newly delivered babies in the North Shewa zone public hospital from January 30 to June 30, 2021. Neonatal near misses were identified with the help of the World Health Organization labeling criteria. Collected data were coded, entered, and cleaned by using Epi data 4.4.6 and analyzed using SPSS software (version 26) for analysis. Descriptive statistics were used to compute summary statistics and proportions. Variables at a cutoff value of 0.25 on bivariate and 0.05 on multivariate logistic regression were used to identify predictors. Result: The prevalence of NNM was 35.3% (95% CI = 31.9-38.6) per 1,000 live births. Participant occupation [AOR: 0.55, CI: 0.33-0.90], marital status [AOR: 2.19; CI: 1.06-4.51], instrumental delivery [AOR: 1.98; CI: 1.10-3.55], intrapartum hemorrhage [AOR: 2.27; CI: 1.03-5.01], abortion history [AOR: 1.59; CI: 1.03-2.44], mal-presentation [AOR: 1.77; CI: 1.14-2.77], premature rupture of membrane [AOR: 2.36; CI: 1.59-3.51], and pregnancy-related infection [AOR: 1.99; CI: 1.14-3.46] were found to have statistically significant association. Conclusion and recommendation: One-third of neonates face serious neonatal health conditions. Given this, addressing modifiable obstetric risk factors through providing skilled and quality care to mothers during pregnancy and during and after childbirth was important for improving neonatal health. Additionally, strengthening antenatal care services to minimize the infection occurring during pregnancy through the provision of appropriate services and counseling about the consequences of abortion was essential in reversing the problem.

Determinants of maternal near-miss among women admitted to public hospitals in North Shewa Zone, Ethiopia: A case-control study.

Background: A maternal near-miss (MNM) refers to a woman who presents with life-threatening complications during pregnancy, childbirth, or within 42 days of termination of pregnancy but survived by chance or due to the standard care she received. It is recognized as a valuable indicator to examine the quality of obstetrics care as it follows similar predictors with maternal death. Ethiopia is one of the sub-Saharan African countries with the highest rate of maternal mortality and morbidity. Thus, studying the cause and predictors of maternal near-miss is vital to improving the quality of obstetric care, particularly in low-income countries. Objective: To identify determinants of maternal near-miss among women admitted to public hospitals in North Shewa Zone, Ethiopia, 2020. Methods: A facility-based unmatched case-control study was conducted on 264 women (88 cases and 176 controls) from February to April 2020. Data were collected using pretested interviewer-administered questionnaires and a review of medical records. Data were entered into Epi-data version 4.2.2 and exported to SPSS version 25 for analysis. Variables with a p-value <0.25 in the bivariable analysis were further analyzed using multivariable logistic regression analysis. Finally, variables with a p-value <0.05 were considered statistically significant. Result: Severe pre-eclampsia (49.5%) and postpartum hemorrhage (28.3%) were the main reasons for admission of cases. Educational level of women (AOR = 4.80, 95% CI: 1.78-12.90), education level of husbands (AOR = 5.26; 95% CI: 1.46-18.90), being referred from other health facilities (AOR = 4.73, 95% CI: 1.78-12.55), antenatal care visit (AOR = 2.75, 95% CI: 1.13-6.72), cesarean section (AOR = 3.70, 95% CI: 1.42-9.60), and medical disorder during pregnancy (AOR = 12.06, 95% CI: 2.82-51.55) were found to significantly increase the risk of maternal near-miss. Whereas, the younger age of women significantly decreased the risk of maternal near miss (AOR = 0.26, 95% CI: 0.09-0.75). Conclusion: Age, educational level, antenatal care follow-ups, medical disorder during pregnancy, mode of admission, and mode of delivery were significant predictors of maternal near-miss. Socio-demographic development, use of ANC services, early detection and management of medical diseases, reducing cesarean section, and improving the referral systems are crucial to minimizing the maternal near-miss.

Vaccination timeliness and associated factors among children aged 12-23 months in Debre Libanos district of North Shewa Zone, Oromia Regional State, Ethiopia.

Background: Globally, vaccination is one of the most cost-effective interventions in promoting child survival, preventing 2-3 million child deaths annually from vaccine-preventable diseases (VPDs). In Ethiopia, timely vaccination is stated as key to the prevention of unnecessary childhood mortality from measles, pneumonia, diarrheal diseases, and other VPDs. However, Ethiopia ranked fifth among the ten countries with the most unprotected children. Furthermore, previous vaccine timeliness studies produced widely disparate results. As a result, it was suggested that more research be conducted to investigate the potential factors behind the high proportion of untimely vaccination. Therefore, this study was intended to explore the association between different factors and the proportion of vaccination timeliness administered under the Expanded Program on Immunization in Debre Libanos district, Ethiopia. Methods: A community-based cross-sectional study design was employed from 1 May to 30 May 2021 among children aged 12 to 23 months with their mother/caregiver, who had started vaccination and had vaccination cards in the Debre Libanos. Simple random sampling techniques and pretested semi-structured questionnaires were used for data collection. At last, a multivariable logistic regression was used to identify factors associated with the vaccination timeliness. Result: In this study, 413 children aged 12 to 23 months were interviewed with their mother/caregiver. Overall, 33.7% [95% CI (29.1-38.3)] of children received their vaccines timely. Having a female child [AOR: 2.9, 95% CI: 1.58-5.35], mother/caregiver attending primary [AOR: 6.33, 95% CI: 2.66-15.06] and secondary/above education [AOR: 5.61, 95% CI: 2.41-13.04], sufficient vaccination knowledge [AOR: 3.46, 95% CI: 1.87-6.38], mother/caregiver with least hesitant [AOR: 3.35, 95% CI: 1.51-7.41] and middle hesitant [AOR: 1.89, 95% CI: 1.05-3.58], utilization of ANC [AOR: 2.89, 95% CI: 1.32-6.33], and giving birth at health facility [AOR: 4.32, 95% CI: 1.95-9.59] were the factors independently associated with vaccination timeliness. Conclusion: In comparison to Ethiopia's existing vaccination coverage, the proportion of children immunized at the recommended time interval is low in the study district. Policymakers should prioritize vaccine timeliness and integrate it into childhood vaccination strategies.

Survey and Antimicrobial Activity Study of Ethnomedicinal Plants in Selected Districts of North Shewa Zone, Oromia, Ethiopia.

BACKGROUND: The emergency of multidrug resistance due to the global burden of infectious diseases and drug misuse leads to an urgent identification of new medicines from medicinal plants. The study was designed to perform the documentation of ethno-medicinal plants usage, extraction, phytochemical screening and antimicrobial activities of the herbal extracts. METHODS: A cross-sectional study design was conducted in this study. Maceration of plant extraction, phytochemical screening and disc diffusion method for antimicrobial activity tests were employed. RESULTS: The results of the study indicated that Euphorbiaceae, Lamiaceae and Sapindaceae plant families have commonly used for the treatment of infectious diseases in the study areas. The antimicrobial activity test results indicated that Ostegia integrifolia Benth which was extracted with chloroform solvent showed equivalent inhibition zone as compared to standard drug, gentamicin. All the extracts could be considered as broad spectrum, have strong inhibition against E. coli, K. pneumoniae, S. aureus, P. aeruginosa and C. albicans. All extracts against C. albicans were also revealed strong inhibition activity as compared to fungal standard drug, contamazole. CONCLUSION: Phytochemical screening showed the existence of secondary metabolites in the studied plants and thus, supports the traditional healers' claim of such plants use for the treatment of diseases. The study also concluded that chloroform extracts of all plants showed promising antimicrobial activities against K. pneumonia, and C. albicans. Therefore, further in vitro and vivo antimicrobial activity study of chloroform extracts against these bacterial and fungal strains were recommended. Moreover, isolation and structural elucidation of bioactive compounds from chloroform extracts were also recommended.

Determinants of Low Birth Weight Among Women Who Gave Birth at Public Health Facilities in North Shewa Zone: Unmatched Case-Control Study.

Globally, more than 20 million newborns are born with low birth weight (LBW) every year. Most of the LBW occurs in low- and middle-income countries. It is the most critical risk of neonate mortality. Therefore, this study aims to identify determinants of low birth weight among women who gave birth in public health facilities in the North Shewa zone. Institutional-based unmatched case-control study was conducted from February to June 2020 to select 180 cases and 380 controls. Interviewer-administered questionnaire was used to collect data. Data were entered through EPI Info and exported to Statistical Package for Social Science (SPSS) for analysis. Text, percentage and tables were used to present data. Bivariate and multivariate logistic regression analyses were performed to see the association and adjusted odds ratios with 95% confidence interval (CI), and P-value < .05 was considered to declare statistical significance. Lack of nutritional counseling (adjusted odds ratio [AOR] = 2.14; 95% CI = [1.13, 4.04]), unable to take iron-folate supplement (AOR = 2.3.78; 95% CI = [2.1, 6.85]), insufficient additional meal in take (AOR = 6.93; 95% CI = [3.92, 12.26]), restriction of foods (AOR=2.29; 95% CI =[1.81, 4.09]), maternal mid upper arm circumference (MUAC) < 23 cm (AOR=2.85; 95% CI = [ 1.68, 4.85]), maternal height ≤155 cm (AOR=3.58; 95% CI = [1.92, 6.7]), anemia (AOR = 2.34; 95% CI = [1.21, 4.53]), pregnancy-related complications (AOR=3.39; 95% CI = [2.02, 5.68]), and alcohol drinking during pregnancy (AOR = 2.25; 95% CI = [1.24, 4.08]) were significantly associated with LBW. Nutritional counseling, iron-folate supplementation, additional meal intake, restriction of some foods in pregnancy, MUAC of the mother, maternal stature, maternal anemia status, pregnancy-related complications, and a history of alcohol drinking during pregnancy were identified as determinants of low birth weight. The intervention-targeted nutritional counseling, early detection and treatment of anemia, and behavioral change communication to pregnant women are mandatory.

Preparedness and Responses of Healthcare Providers to Combat the Spread of COVID-19 Among North Shewa Zone Hospitals, Amhara, Ethiopia, 2020.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is an emerging respiratory disease that is caused by a novel coronavirus and was first detected in December 2019 in Wuhan, China. The disease is highly infectious, and its main clinical symptoms include fever, dry cough, fatigue, myalgia, and dyspnea. Healthcare providers are in front in fighting the coronavirus spread by making themselves the risk of contracting the disease. OBJECTIVE: To assess the preparedness and responses of healthcare providers to combat the spread of COVID-19 among North Shewa Zone Hospitals, Amhara, Ethiopia. METHODS: Facility-based cross-sectional study was conducted from April to May 2020 among 422 healthcare providers in the North Shewa Zone, Amhara, Ethiopia using a self-administered questionnaire. Study subjects were selected through systematic random sampling based on their proportional distribution of sample size to each hospital. A structured questionnaire was used to collect the data. The data were coded and entered into the Epi data 4.2.1 version and the analysis was carried out in Statistical Package for Social Science 25 versions. RESULTS: Four hundred four participants involved in the study have been given a response rate of 95.7%. The self-satisfaction of healthcare providers revealed 301 (74.5%) of study participants feel unsafe in their workplace. Two-third, 260 (64.4%), of them responded that they feel anxious while working with febrile patients. Nearly one-third (31%), 27.4%, 15.9%, 14.5%, 14.2% of HCPs had access to gloves, facemask, goggle, shoe, and apron respectively in hospitals. CONCLUSION: Protecting healthcare workers is a public health priority. Access to essential personal protective equipment during the COVID-19 pandemic was limited. The poor perception of healthcare professionals about not having enough support from medical institutions and public health authorities raises the need to urgently implement strategies to protect healthcare workers in the time of the COVID-19 pandemic.

Factors associated with low birthweight in North Shewa zone, Central Ethiopia: case-control study.

BACKGROUND: Low birthweight (LBW) is an important predictor of neonatal and post neonatal child morality. Though its risk factors have been extensively studied in the developed world; limited epidemiological evidence is available in developing countries including Ethiopia. The purpose of the study is to determine the risk factors of LBW in North Shewa zone, Central Ethiopia. METHODS: Unmatched case-control study involving 94 cases and 376 controls was conducted from Jan to Mar 2017 in three public hospitals in the zone. A case was defined as a singleton live birth with birthweight less than 2.5 kg; whereas, a control was a newborn that weighs 2.5-4.0 kg. Cases and controls were recruited on an ongoing basis until the required sample sizes were fulfilled. Data were collected by interviewing mothers, reviewing medical records and measuring the anthropometry of the mothers and the newborns. Bivariable and multivariable logistic regression analyses were used to identify risk factors of LBW. The outputs of the analyses are presented using adjusted odds ratio (AOR) with the respective 95% confidence interval (CI). RESULTS: Mothers with no formal education had two times increased odds of delivering LBW babies than women with formal education [AOR = 2.20 (95% CI: 1.11, 4.38)]. Mothers with no history of nutrition counseling during pregnancy had three times increased odds of giving LBW babies than those who were counseled [AOR = 3.35 (95% CI: 1.19, 9.43)]. Non-married women had higher odds of giving LBW newborns as compared to married ones [AOR = 3.54 (95% CI: 1.83, 6.83)]. Mothers from food insecure households had about four times higher odds of LBW as compared to food secure mothers [AOR = 4.42 (95% CI: 1.02,22.25)]. In contrast to mothers who had the recommended four or more antenatal care (ANC) visits, those who were not booked had three times increased odds of giving to LBW baby [AOR = 3.03 (95% CI: 1.19,7.69)]. CONCLUSION: Improving the socio-economic status of mothers, enhancing the utilization of ANC and strengthening the integration of nutrition counseling into ANC help to reduce LBW.