Examining students' level of understanding toward COVID-19 and its associated factors in Ethiopia: a systematic review and meta-analysis.

Background: This systematic review and meta-analysis aim to investigate students' understanding of COVID-19 in Ethiopia and identify associated factors. The primary goal is to pinpoint key contributors shaping students' perception and comprehension of the virus. The study aims to offer valuable insights for developing targeted educational interventions, ultimately enhancing students' overall knowledge and awareness of the pandemic in the specific context of Ethiopia. Methods: The study adhered rigorously to PRISMA criteria, ensuring a standardized methodology. Data from reputable databases like Google Scholar and PubMed were systematically collected. Ten relevant articles were meticulously analyzed using STATA version 11, with heterogeneity assessed by the I2 test. A funnel plot and Egger's test were used to check for publication bias. The determination of the pooled effect size utilized a random-effect model meta-analysis, offering a robust 95% confidence interval. Results: This meta-analysis, based on 10 articles, reveals an overall prevalence of 61.58% (95% CI: 47.26-75.89). Significant contributors to students' comprehension include Social media users (AOR) = 2.38, urban residence AOR = 3.31, news media followers AOR = 2.51, fathers' educational status AOR = 2.35, watching television AOR = 4.71, and health science students AOR = 4.21. These findings underscore crucial elements shaping students' understanding of COVID-19 in Ethiopia. Conclusion: Our analysis indicates that 61.58% of Ethiopian students possess a good understanding of COVID-19. Factors such as active social media engagement, geographic location, frequency of news consumption, father's level of education, television viewing habits, and enrollment in health science programs significantly influence their comprehension. These findings underscore the importance of implementing targeted interventions to enhance health literacy and education among students, thereby facilitating a more effective response to pandemics.

Prevalence of wasting and associated factors among children aged 6-59 months in Wolkite town of the Gurage zone, Southern Ethiopia, 2020. A cross-sectional study.

BACKGROUND: Undernutrition among children is one of the leading major public health problems and about 49.5 million children were wasted worldwide. Asia and African countries contributed 69% and 27.2% of wasting respectively. In Ethiopia, 7% of children were wasted and 1% was severely wasted. Although Ethiopia has achieved remarkable progress in reducing under-five mortality and designed multi-dimensional approaches to address malnutrition, the data on acute malnutrition among children in the study setting is limited. Therefore, this study was aimed to assess the prevalence of acute malnutrition and associated factors among 6-59-month-old children. METHODS: Community-based cross-sectional study design was conducted at Gurage Zone, Southern Ethiopia. A total of 293 study participants were selected using a systematic sampling technique. Data were collected using structured and pre-tested interviewer-administered questionnaires by face-to-face interview. Data entry and analysis were made using Epi Data version 4.6 and Statistical Package for Social Science (SPSS) version 24 respectively. Descriptive statistical analysis and some of the statistical tests like the odds ratio were carried out. Both Bivariable and multivariable logistic regression analysis with 95% confidence interval was carried out to identify associated factors and variables with P value < 0.05 were taken as statistically significant. RESULTS: The prevalence of wasting among children aged from 6-59 months in this study was 14.7% (95% CI: 10.9, 18.8). After controlling for all possible confounding factors, the result revealed that age of children between 6-11 months [AOR = 2.78(95% CI: 1.67, 6.19)], caregivers who were unable to read and write [AOR = 2.23 (95% CI: 1.04, 5.34)], presence of diarrheal disease in the past two weeks [AOR = 1.68 (95% CI: 1.23, 5.89)] and mothers who had a history of poor handwashing practice before food preparation and child feeding [AOR = 2.64(95% CI: 1.52, 4.88)] were found to be significantly associated with wasting. CONCLUSIONS: The study findings indicate that respondents' wasting was mainly affected by age of the child, educational status of caregivers, presence of diarrheal disease and hand washing practice of the mother. Providing acceptable, quality and honorable care for all children is very crucial to prevent child wasting and proper handwashing during breastfeeding and food handling is recommended and interventions aimed at improving maternal health and access to health care services for children are urgently needed.

Utilization of growth monitoring and promotion services and associated factors among children aged 0-23 months in Banja District, Northwest Ethiopia 2020: A cross-sectional study.

BACKGROUND: Growth monitoring and promotion are the basic malnutrition preventive strategies usually used to assess the growth of children using anthropometric measurements in comparison with world health organization standards. However, the utilization of growth monitoring and promotion services is inadequate in most developing countries. Therefore, this study aimed to assess the utilization of growth monitoring and promotion service and associated factors among children aged 0-23-month in Banja District, Northwest Ethiopia, 2020. METHODS: A community-based cross-sectional study was conducted from February 2 to April 1, 2020. A total of 572 children were selected using a simple random sampling technique. Data were collected using structured and pre-tested interviewer-administered questionnaires. Data were entered into Epi data version 4.6 and analyzed using the statistical package for social science (SPSS) version 25. Both binary and multivariable logistic regression analyses with a 95% confidence level were used to identify the associated factors. Statistical significance was set at p <0.05. RESULTS: This finding revealed that the proportion of growth monitoring and promotion services utilization was 38.9% [95%CI: 34.8%, 43.0%]. Child age from 0-11 months [AOR = 4.98 (95% CI: 2.75,8.37)], mothers who can read and write Amharic language [AOR = 2.04 (95%CI: 1.02,4.08)], know the benefits of weighing their child monthly [AOR = 2.9 (95%CI: 1.23, 6.94)], presence of growth monitoring service nearby [AOR = 3.2 (95%CI: 1.59,6.31)] and monthly income ≥2000 Ethiopian birr [AOR = 1.75(95% CI = 1.08, 3.02)] were some of the factors significantly associated with utilization of growth monitoring and promotion services. CONCLUSION AND RECOMMENDATION: The findings indicate that utilization of growth monitoring and promotion services is mainly affected by child age, mother/caregiver ability to read and write Amharic language, having maternal information on the benefit of the weighing child, presence of service nearby health facility, and mother/caregiver monthly income. Preparation of growth monitoring charts in local language (Awigna) and creating awareness on the proper utilization of growth monitoring and promotion services is strongly recommended.

Minimum acceptable diet and associated factors among children aged 6-23 months in Ethiopia.

INTRODUCTION: The health and growth of children less than two years of age can be affected by the poor quality of complementary foods and poor feeding practices even with optimal breastfeeding. In Ethiopia, empirical evidence on the minimum acceptable diet and its associated factors is limited. Therefore, this study was aimed to assess the level of minimum acceptable diet and its associated factors among children aged 6-23 months in Addis Ababa Ethiopia. METHODS: An institution-based Cross-sectional study was conducted among a total of 575 mother-child pairs. A simple random sampling technique was used to recruit participants. For infant and young child feeding practices, the data collection tools were adapted from world health organizations' standardized questionnaire which is developed in 2007. Data entry and analysis were performed using EPI data version 3.1 and SPSS version 20 respectively. Bivariable and multivariable logistic regression analyses were performed to determine predictor variables. Statistical significance was declared at p-value < 0.05. RESULT: In this study, the level of minimum acceptable diet was found to be 74.6%.. About 90.6 and 80.2% of the children received minimum meal frequency and dietary diversity respectively. Having a husband secondary and above educational level [AOR = 4.789(95%CI:1.917-11.967)], being a housewife [AOR = 0.351(95% CI: 0.150-0.819)], having a history of more than three postnatal follow-ups [AOR = 2.616(95%CI:1.120-6.111], Having mothers age between 25 and 34 years [AOR = 2.051(95%CI:1.267-3.320)], being male child [AOR = 1.585(95%CI:1.052-2.388)] and having children age between 18 and 23 months [AOR = 3.026(95%CI:1.786-5.128)] were some of the factors significantly associated with a minimum acceptable diet. CONCLUSION: In this study, the minimum acceptable diet among children aged 6-23 months was significantly associated with the educational status of the husband, mother's occupation, history of postnatal follow-up, age of the mother, sex of the child, and age of the child. Thus, attention should be given to educating the father, empowering mothers to have a job, promoting gender equality of feeding, and counseling on the benefit of postnatal care visits. In addition, the ministry of health should work on educating and advocating the benefit of feeding the recommended minimum acceptable diet to break the intergenerational cycle of malnutrition.

Incidence and predictors of mortality among neonates referred to comprehensive and specialized hospitals in Amhara regional state, North Ethiopia: a prospective follow-up study.

BACKGROUND: Neonatal mortality is a major global public health problem. Ethiopia is among seven countries that comprise 50 % of global neonatal mortality. Evidence on neonatal mortality in referred neonates is essential for intervention however, there is no enough information in the study area. Neonates who required referral frequently became unstable and were at a high risk of death. Therefore, this study aimed to assess the incidence and predictors of mortality among referred neonates. METHOD: A prospective follow-up study was conducted among 436 referred neonates at comprehensive specialized hospitals in the Amhara regional state, North Ethiopia 2020. All neonates admitted to the selected hospitals that fulfilled the inclusion criteria were included. Face-to-face interviews, observations, and document reviews were used to collect data using a semi-structured questionnaire and checklists. Epi-data™ version 4.2 software for data entry and STATA™ 14 version for data cleaning and analysis were used. Variables with a p-value < 0.25 in the bi-variable logistic regression model were selected for multivariable analysis. Multivariable analyses with a 95% confidence level were performed. Variables with P < 0.05 were considered statistically significant. RESULT: Over all incidence of death in this study was 30.6% with 95% confidence interval of (26.34-35.16) per 2 months observation. About 23 (17.83%) deaths were due to sepsis, 32 (24.80%) premature, 40 (31%) perinatal asphyxia, 3(2.33%) congenital malformation and 31(24.03%) deaths were due to other causes. Home delivery [AOR = 2.5, 95% CI (1.63-4.1)], admission weight < 1500 g [AOR =3.2, 95% CI (1.68-6.09)], travel distance ≥120 min [AOR = 3.8, 95% CI (1.65-9.14)], hypothermia [AOR = 2.7, 95% CI (1.44-5.13)], hypoglycemia [AOR = 1.8, 95% CI (1.11-3.00)], oxygen saturation < 90% [AOR = 1.9, 95% (1.34-3.53)] at admission time and neonate age ≤ 1 day at admission [AOR = 3.4, 95% CI (1.23-9.84) were predictors of neonatal death. CONCLUSION: The incidence of death was high in this study. The acute complications arising during the transfer of referral neonates lead to an increased risk of deterioration of the newborn's health and outcome. Preventing and managing complications during the transportation process is recommended to increase the survival of neonates.

Knowledge of neonatal danger signs and associated factors among husbands of mothers who gave birth in the last 6 months in Gurage Zone, Southern Ethiopia, 2020: a community-based cross-sectional study.

OBJECTIVE: To assess knowledge of neonatal danger signs and their associations among husbands of mothers who gave birth in the last 6 months in Gurage Zone, Southern Ethiopia, from 1 February to 28 February 2020. DESIGN: Community-based cross-sectional study. SETTING: Gurage Zone, Southern Ethiopia. PARTICIPANTS: The study was conducted among 633 participants living in Gurage Zone from 1 February to 28 February 2020. 618 completed the questionnaire. A multistage sampling technique was employed to obtain study participants. Data were collected through face-to-face interviews conducted by 20 experienced and trained data collectors using a pretested structured questionnaire. To assess knowledge, 10 questions were adopted from the WHO questionnaire, which is a standardised and structured questionnaire used internationally. Data were entered into EpiData V.3.1 and exported to SPSS (Statistical Package for Social Sciences) V.24 for analysis. Descriptive statistics were performed and the findings were presented in text, figures and tables. Binary logistic regression was used to assess the association between each independent variable and the outcome variable. All variables with p<0.25 in the bivariate analysis were included in the final model and statistical significance was declared at p<0.05. Voluntary consent was taken from all participants. RESULTS: A total of 618 participants were included in the study, with a response rate of 97.6%. Of the participants, 40.7% had good knowledge (95% CI 36.3 to 44.2). Urban residence (adjusted OR=6.135, 95% CI 4.429 to 9.238) and a primary and above educational level (adjusted OR=4.294, 95% CI 1.875 to 9.831) were some independent predictors of husbands' knowledge status. CONCLUSION: Knowledge of neonatal danger signs in this study was low. Urban residence, primary and above educational level, the husband's wife undergoing instrumental delivery and accompanying the wife during antenatal care visits were independent predictors of knowledge. Thus, strong multisectoral collaboration should target reducing the knowledge gap by improving husbands' attitude with regard to accompanying their wives during antenatal care and postnatal care visits, or create a strategy to increase husbands' participation in access to maternal and child health service since husbands are considered decision-makers when it comes to healthcare-seeking in the family. The government should come up with policies that will help promote formal education in the community and increase their media access.

Knowledge of breastfeeding practice and associated factors among fathers whose wife delivered in last one year in Gurage Zone, Ethiopia.

BACKGROUND: Breastfeeding is the feeding of an infant or young child with breast milk directly from female human breasts. It confers short-term and long-term benefits for both child and mother, including helping to protect children against a variety of acute and chronic disorders. In mothers, breastfeeding (BF) reduces postpartum bleeding, enhances accelerated involution of the uterus, and plays a crucial role in child spacing. Fathers have an important but often neglected role in the promotion of healthy breastfeeding practices. Evidence shows that mothers who have a supportive and encouraging partner are more likely to plan to breastfeed for a longer duration. So, this study was aimed to assess knowledge and associated factors towards breastfeeding practice among fathers. METHODS: A community-based cross-sectional study was conducted in Gurage Zone among 597 fathers. One stage cluster sampling technique was used to select study participants. An interviewer-administered questionnaire was used to collect the data and it was checked for consistency and completeness and entered into epi data and exported to SPSS for analysis. Bivariate and multivariate logistic regression analysis was done to identify independent predictors. P-value < 0.05 was considered to declare a result as statistically significant. RESULT: In this study, a total of 585 participants were involved making a response rate of 98%. The overall knowledge status of participants was 341 (58.3%). The mean age of participants was 29.5 (SD±4.5). Urban residence, educational status, exposure to media, having more than one baby at home, and accompany his wife during health-seeking were independent predictors of knowledge status. CONCLUSION: This study has shown the level of knowledge of fathers towards breastfeeding in the study area was low (58.3%). Residence, two or more babies at home, accompany during ANC, and indexed infant illness was independent predictors of knowledge status of fathers towards breastfeeding. Policymakers and possible stack holders should better focus on the improvement of knowledge because the knowledge determines the overall condition of the family including the psychological development of the children that affect their life especially in a country like Ethiopia in which most of the decisions are made by them. Other researchers focus on the interaction of parents and the child and feeding disorders.

Skin-to-Skin Care Practice and Its Associated Factors Among Postpartum Mothers in Gurage Zone, Southern Ethiopia: A Cross-Sectional Study.

BACKGROUND: Skin-to-skin care is placing an unclothed or diaper-only newborn baby on the mother's bare chest, covered with a warm blanket. The World Health Organization recommends immediate, uninterrupted, and continuous mother-newborn skin-to-skin care practice almost immediately after birth. Despite this recommendation, separation of the newborn from the mother is common in many public health institutions. There was a limited study that examined the prevalence of skin-to-skin care practice and associated factors in Ethiopia. Therefore, the main aim of this study was to assess the prevalence of skin-to-skin care practice and its associated factors among postpartum mothers in Gurage Zone public health centers, Southern Ethiopia, 2020. METHODS: An institution-based cross-sectional study was conducted in twenty-two public health centers of Gurage Zone from January 1st up to 30th, 2020. A total of 382 postpartum mothers were selected using a systematic sampling technique. Data were collected using structured and pre-tested interviewer-administered questionnaires. Data were entered into EpiData version 3.1.0 and exported to SPSS version 23 for analysis. Both bivariable and multivariable logistic regression analyses were used to identify significant factors associated with skin-to-skin care practice. Statistical significance was declared at a P-value of <0.05 with a 95% confidence level. RESULTS: About 35.3% (95% CI; 31.3%-40.4%) of new-borns were received skin-to-skin care practice. Being urban residence [AOR=2.23, (95% CI; 1.17-4.23)], normal newborn birth weight (≥2500gm) [AOR=3.1, (95% CI; 2.15-3.89)], early initiation of breastfeeding [AOR=2.93, (95% CI; 1.29-6.64)], colostrum feeding [AOR=4.19, (95% CI; 2.01-8.73)], and having mothers good knowledge on skin-to-skin care practice [AOR=8.51, (95% CI; 4.32-16.75)] were some of factors associated with mother to newborn skin-to-skin care practice. CONCLUSION: The proportion of mother newborn skin-to-skin care practice was low in the study area. Mothers resided in the urban areas, normal newborn birth weight, early initiation of breastfeeding, colostrum feeding, and having good knowledge of the mothers about skin-to-skin care were factors associated with skin-to-skin care practice. Therefore, health care workers should counsel mothers on optimal breastfeeding practice and enhance maternal awareness regarding the merits of skin-to-skin care practice before discharge from the health facilities are recommended.

The determinants of 5th minute low Apgar score among newborns who delivered at public hospitals in Hawassa City, South Ethiopia.

BACKGROUND: Newborn morbidity and mortality are forecasted using the Apgar scores. Obstetricians worldwide have used the Apgar score for more than half a century for the assessment of immediate newborn conditions. It is a simple and convenient evaluation system that offers a standardized and effective assessment of newborn infants. Neonatal morbidity and mortality can be reduced if high-risk neonates are identified and managed adequately. This study aimed to assess the determinants of 5th minute low Apgar score among newborns at Public hospitals in Hawassa city, South Ethiopia. METHODS: A hospital-based unmatched case-control study was conducted at Public Hospitals in Hawassa city. Data were collected from 134 cases and 267 controls using a structured and pre-tested questionnaire by observing, interviewing, and reviewing patient cards. Newborns who delivered with a 5th minute Apgar score < 7 were considered as cases; whereas a similar group of newborns with a 5th minute Apgar score of ≥ 7 were categorized as controls. A consecutive sampling technique was employed to recruit cases, while a simple random sampling technique was used to select controls. Data entry and analysis were performed using Epi Data version 3.1 and SPSS version 20 respectively. Binary and multivariable analyses with a 95 % confidence level were performed. In the final model, variables with P < 0.05 were considered statistically significant. RESULTS: After controlling for possible confounding factors, the results showed that lack of physical and emotional support during labor and delivery [AOR = 3.5, 95 %CI:1.82-6.76], rural residence [AOR = 4, 95 %CI: 2.21-7.34], lack of antenatal care follow up [AOR = 3.5, 95 % CI: 1.91-6.33], anemia during pregnancy [AOR = 2.3,95 %CI: 1.10-4.71] and low birth weight [AOR = 6.2, 95 %CI: 2.78-14.03] were determinant factors of low Apgar scores. The area under the Apgar score ROC curve was 87.4 %. CONCLUSIONS: Lack of physical and emotional support, rural residence, lack of ANC follow-up, low birth weight, and anemia during pregnancy were determinant factors of a low Apgar score. `Effective health education during preconception about anemia during pregnancy and ANC will help in detecting high-risk pregnancies that lead to a low Apgar score. In addition to the standard care of using electronic fetal monitoring, increasing access to compassion ships during labor and delivery is recommended.

Level of Community Readiness for the Prevention of COVID-19 Pandemic and Associated Factors Among Residents of Awi Zone, Ethiopia: A Community-Based Cross-Sectional Study.

BACKGROUND: Novel coronavirus 19 is a contagious disease that affects all most all countries of the world and puts the world in great challenge. Even though, there is a limited testing capacity in Africa the number of cases and deaths is progressively increased. This catastrophic case has a great impact in Africa unless preventive measures are effectively undertaken. In Ethiopia, the number of COVID-19 cases and death are increasing over time. Therefore, this study was aimed to assess the level of community readiness for COVID-19 pandemic prevention and its associated factors in residents of Awi Zone, Northwest Ethiopia. METHODS: A community-based cross-sectional study design was conducted among 1524 study participants from July 28 to August 27, 2020. Data were collected using structured and pre-tested interviewer-administered questionnaires. The collected data were entered into EPI data 4.6 versions and analyzed using Statistical Package for Social Science (SPSS) version 24.0. Those variables with P-value<0.25 were entered into multivariable analyses and those variables with P-value < 0.05 were considered statistically significant. Finally, the findings of the result were explained using texts, figures, and tables. RESULTS: A total of 1423 participants have participated in the study. The finding revealed that the prevalence of knowledge, attitude, perception, and practice towards COVID-19 were found to be 76.6%, 68.4%, 68.5%, and 29% respectively. In final model, being a female [AOR=1.388 (95% CI: 1.050-1.834) P= 0.021], married respondents [AOR=3.116 (95% CI: 1.592-6.099) P= 0.001], Muslim religion followers [AOR=2.392 (95% CI:1.503-3.806) P=0.002], and able to read and write [AOR=1.986 (95% CI:1.311-3.006) P=0.002] were some of the variables significantly associated with the level of community readiness towards COVID-19 preventive measures. CONCLUSION: The study findings indicate that respondent's level of community readiness for COVID-19 prevention was mainly affected by sex, marital status, religion, and educational status. The Health education programs aimed at mobilizing and improving COVID-19 related level of community readiness especially practice are urgently needed. Awareness creation programs on more targeted groups such as men, unmarried and those with low educational level and religious leaders should be teaching the believers by interacting with faith and science on the means of preventing the pandemic.

Essential newborn care practice and its associated factors in Southwest Ethiopia.

BACKGROUND: Essential newborn care is a wide-ranging strategy intended to improve the health of newborns by implementing appropriate interventions. Approximately in 2018, an estimated 2.5 million children died in their first month of life, which is approximately 7000, newborns every day, with about a third of all neonatal deaths occurring within the first day after birth. Even though the most cause of death is preventable the burden of neonatal death is a still high in developing countries including Ethiopia. Therefore this study is aimed to assess the level of essential newborn care practice among mothers who gave birth within the past six months in Gurage Zone, Southwest Ethiopia. METHODS: A community-based cross-sectional study was conducted among mothers who gave birth within the past six months in Gurage Zone, Southwest Ethiopia. For the quantitative part, 624 study participants were involved by using a multi-stage sampling method. A systematic random sampling technique was to reach the study subjects. Data entry was carried out by Epi data version 4.0.0 and analysis was done by SPSS window version 24. Binary and multivariate logistic regressions were used to identify associated factors. For the qualitative part, three focus group discussions (FGD) with purposively selected 30 mothers were involved. The data were analyzed deductively by using the thematic framework analysis approach by using Open code version 4.02. RESULT: Overall good essential newborn care practice was found to be 41.0% [95%CI, 36.6-44.7]. Being urban residence [AOR 1.70, 95%CI: 1.03-2.79], attending antenatal care visit [AOR = 3.53, 95%CI: 2.14-5.83], attending pregnant mothers meeting [AOR = 1.86, 95%CI: 1.21-2.86], had immediate postnatal care [AOR = 3.92, 95% CI: 2.65-5.78], and having good knowledge about ENC [AOR = 2.13, 95% CI: 1.47-3.10] were significantly associated with good essential newborn care practice. CONCLUSION: This study indicated that the magnitude of essential newborn care practice was low. Thus, a primary health care provider should regularly provide ENC for newborns and take opportunities to counsel the mothers about ENC during pregnant mothers meeting and MCH services sessions.

Determinant Factors of Neonatal Near Miss Among Neonates in Gurage Zone Hospitals, Ethiopia: A Case-Control Study.

INTRODUCTION: It is highly economical and commendable to identify the determinants of neonatal near miss which will be utilized as proxy determinants of neonatal mortality rate. However, neither determinants of neonatal mortality rate nor a determinant of a neonatal near miss are adequately investigated specifically within the study area. Therefore, this study is aimed to identify the determinants of neonatal near-miss among neonates admitted in hospitals of the Gurage zone, Southern Ethiopia. METHODS AND MATERIALS: Unmatched case-control study was conducted to identify factors associated with neonatal near-miss among neonates admitted in Gurage zone hospitals. A pre-tested structured interviewer-administered questionnaire was used to collect the data. Besides, data related to the clinical diagnosis of neonates and managements given were extracted from patient records. In this study, a total of 105 cases and 209 controls have participated. To recruit cases and controls consecutive sampling methods and simple random sampling techniques were used respectively. Data were entered using Epi Data software and exported to SPPS for analysis. To identify the determinate factors of the outcome variable binary and multivariable logistic regression were employed. RESULTS: The determinate factors of the outcome variable include a history of abortion with AOR 3.9 [95%C1 3.53-10.15], referred from other health care institution AOR 7.53[95% CI 3.99-14.22], severe maternal morbidity during pregnancy AOR 4.57[95% CI 1.77-11.79], cesarean section mode of delivery 4.45[95% CI 1.76-11.25], and good essential newborn care knowledge AOR 3.33[95% CI 1.54-7.19]. CONCLUSION: In this study, easily modifiable/preventable maternal and health service utilization-related factors are increasing the menace of a neonatal near-miss in the Gurage zone. It is the signal that shows the primary health care program needs to be further enhanced to bring more desirable health outcomes and/or effectiveness of health policies needs to be examined to introduce more impactful strategies.

Respectful focused antenatal care and associated factors among pregnant women who visit Shashemene town public hospitals, Oromia region, Ethiopia: a cross-sectional study.

BACKGROUND: Focused antenatal care is the most significant and inclusive care given to pregnant women to promote and maintain the optimal health of the mother and the fetus. Providing respectful care during focused antenatal care is believed to be the most important cost-effective interventions to increase maternity service utilization. Therefore, this study was aimed to assess respectful focused antenatal care and associated factors among pregnant women who visit Shashemene town public hospitals, Oromia region, Ethiopia, 2019. METHODS: Institution-based cross-sectional study was conducted from July-August, 2019. A total of 423 pregnant mothers were selected using a systematic sampling technique. Data were collected using structured and pre-tested interviewer-administered questionnaires. Data entry and analysis were made using Epi Info version™ 7 and Statistical Package for Social Science (SPSS) version 24.0 respectively. Both bivariate and multivariate logistic regression analyses were used to identify associated factors. Statistical significance was declared at a p value of < 0.05 with a 95% confidence level. RESULTS: A total of 420 women have participated in the study, making a response rate of 99.5%. About 63% of participants received respectful care during focused antenatal care. Having no formal education [AOR = 8.3(95%CI 9.85-17.47)], low average monthly income [AOR = 3.16 (95%CI 1.52-6.57)], having unplanned pregnancy [AOR = 9.90 (95%CI 3.48-8.16)] and being multigravida [AOR = 8.82 (95%CI 2.90-6.80)] were significantly associated with respectful focused antenatal care. CONCLUSIONS: The study findings indicate that respondents' respectful focused antenatal care is mainly affected by educational level, average family monthly income, having an unplanned pregnancy, and gravidity. Providing acceptable, quality, and honorable care for all women regardless of educational status, family income, and status of pregnancy is very crucial to entice more mothers to the health facility.

Client satisfaction with existing postnatal care and associated factors: A study among mothers in Awi Zone, Amhara region, Ethiopia.

BACKGROUND: The majority of maternal and neonatal adverse events take place during the postnatal period. However, it is the most neglected period for the provision of quality care. OBJECTIVE: The aim of this study among mothers in the Awi Zone, Amhara region, Ethiopia, was to assess client satisfaction with existing postnatal care and associated factors. METHODS: An institution-based cross-sectional study was conducted in Awi Zone hospitals from 1 to 30 April 2018. A total of 422 post-partum mothers were selected by systematic sampling. The data were collected using a pre-tested structured questionnaire via a face-to-face interview. Data entry and analysis were completed using EpiData version 3.1 and SPSS version 22, respectively. The data were summarized with frequency and cross-tabulation. Both binary and multiple logistic regressions were used to identify predictor variables using odds ratios and 95% confidence intervals. RESULT: The prevalence of postnatal care satisfaction was 63%. Being from urban area (AOR = 2.1, 95% CI = (1.11-3.99)), having a history of antenatal care follow up (AOR = 1.62, 95% CI = (1.23-1.64)), spontaneous vaginal birth (AOR = 3.14, 95% CI = (1.77-3.28)), and those who did not face any complications during birth (AOR = 2.90, 95% CI = (1.47-1.69)) were some of the factors associated with client satisfaction. CONCLUSION: According to the results of this study, the majority of mothers were satisfied with post-partum care services. The study findings indicate that maternal satisfaction on post-partum care is mainly affected by residency, antenatal care follow up, mode of delivery, and complications during birth. Therefore, health care providers and other concerned bodies should give special attention to those mothers who are from rural areas, who face complications during birth or who have instrumental-assisted or cesarean section birth. Also, every pregnant mother should be supported to have at least four regular antenatal care visits.

Practice and factors associated with active management of third stage of labor among obstetric care providers in Amhara region referral hospitals, North Ethiopia, 2018: A cross sectional study.

BACKGROUND: Active management of third stage of labor is the most indispensable intervention to avert post-partum hemorrhage which is one of the typical causes of maternal morbidity and mortality. Therefore, the aim of the study was to assess practice and factors associated with active management of third stage of labor among obstetric care providers in referral hospitals. METHODS: Institution based cross-sectional study design was conducted from April 1-30, 2018. Simple random sampling technique was used to select a total of 356 obstetric care providers. Data were collected using pretested, structured and self-administered questionnaires. Data were entered to Epi data version 3.1 statistical software and exported to SPSS 23 for analysis. Bivariate and multivariate logistic regression analyses were performed to identify associated factors. P value <0.05 with 95% confidence level were used to declare statistical significance. RESULT: This study revealed that practice of active management of third stage of labor was 61.2%. Age group of 20-30 years [AOR = 1.95 (95%CI;1.13-3.38)], Being male obstetric care provider [AOR = 1.74 (95%CI;1.03-2.94)], having work experience ≥2 years [AOR = 1.95(95%CI;1.13-3.38)], availability of oxytocin [AOR = 5.46 (95%CI; 2.41-12.3)], having exposure to manage third stage of labor [AOR = 2.91(95%CI; 1.55-5.48)], and having good knowledge [AOR = 2.67 (95%CI; 1.46-4.90)], were the factors associated with practice. CONCLUSION: This study showed that practice of active management of third stage of labor was high. Age group between 20-30 years, being a male obstetric care provider, having ≥2years work experience, availability of oxytocin, exposure to third stage management and having good knowledge were factors associated with practice. Therefore, all referral hospitals and concerned bodies need efforts to focus on providing training to increase health care provider's knowledge so as to sustain good practice through appropriate interventions.