Mortality of acute poisoning and its predictors in Ethiopia: A systematic review and meta-analysis.

Introduction: Poison is defined as any chemical that has the potential to affect or harm human physiology due to its chemical activity. Poisoning is becoming a major preventable public health issue in many countries, including Ethiopia. There is a variation in acute poisoning mortality among the existing evidence in Ethiopia. This study aims to determine the pooled mortality rate from acute poisoning and its predictors in Ethiopia. Methods: We searched available evidence of acute poisoning mortality in databases such as PubMed, Hinari, Cochrane, ScienceDirect, and other search engines. Using the Microsoft Excel data extraction form, three authors independently extracted all relevant data. The Higgins I2 test statistics were used to examine heterogeneity among included studies A random-effects model was used to analyze the pooled estimates and predictors in Stata MP version 17. Results: We retrieved 2685 relevant records from different database sources, and after screening, 21 studies (17 published and 4 unpublished) were included. The pooled mortality rate for acute poisoning was 4.69(95 % CI: 3.69, 5.69 I2 = 94.7 %). The most common poisoning agents are organophosphate (29.9 %), household cleansing agents (17.5 %), and pharmaceuticals/medications (9.3 %). The majority of poisoning cases were intentional poisoning committed suicide. Poisoning cases in rural areas [RR: 3.98(95 % CI: 1.41, 11.25)] and delayed arrival times [RR: 2.90(95 % CI: 1.45, 5.84)] were identified predictors of mortality. Conclusions: In this study, the pooled mortality from acute poisoning was 4.69 %. Poisoned cases from rural areas and delayed arrival times to the hospital were predictors of mortality. To prevent mortality, healthcare professionals should give special attention to rural residents and delayed arrival of poison cases. To control this avoidable death, poison control centers should be strengthened, and other preventive measures implemented at the national level.

Level of technical efficiency and associated factors among health centers in East Gojjam Zone, Northwest Ethiopia: an application of the data envelopment analysis.

BACKGROUND: Besides the scarcity of resources, inefficient utilization of available health service resources has been the bottleneck to deliver quality health services in Ethiopia. However, Information regarding the efficiency of health service providers is limited in the country. Health service managers and policy makers must be well informed about the efficiency of health service providers and ways of using limited resources efficiently to make evidence-based decisions. This study aimed to assess the level of technical efficiency and associated factors among health centers in East Gojjam Zone, Northwest Ethiopia. METHODS: A facility-based cross-sectional study was conducted among 27 randomly selected health centers in East Gojjam zone, Northwest Ethiopia, from October 30, 2022, to April 30, 2023. Using an interviewer-administered questionnaire and document review checklist, health centers' data was collected and entered to Epi-Data version 4.6. The data was exported to Microsoft office excel and Stata version 14 for analysis. A two-stage output-oriented data envelopment analysis with a variable return to scale assumption was employed to determine the level of technical efficiencies. Finally, the tobit regression model was applied to identify the associated factors at 5% level of significance. RESULTS: In this study, 59.3% of the health centers were technically efficient. The mean technical efficiency score of the health centers was 0.899 ± 0.156. Inefficient health centers could provide more 22, 433 outpatient visits, 1,351 family planning visits, 155 referral services, 206 skilled deliveries and 385 fully vaccinations of children if they were technically efficient as their peer health centers for the same year. From the tobit regression, the catchment population and number of administrative staffs were statistically significant determinants of the technical efficiency of health centers. CONCLUSIONS: The mean technical efficiency of the health centers in East Gojjam zone, Northwest Ethiopia was high. However, nearly half of the health centers were technically inefficient, which indicates the exitance of a space for further improvements in the productivity of these health centers. Employing excess number administrative staffs (above the optimal level) should be discouraged and selecting appropriate sites where the health centers to be constructed (to have large catchment population coverage) could improve the productivity of health centers.

Anxiety and depression among cancer patients in Ethiopia: a systematic review and meta-analysis.

Introduction: Anxiety and depression are among the common comorbidities of people diagnosed with cancer. However, despite the progress in therapeutic options and outcomes, mental health care and support have lagged behind for cancer patients. Estimating the extent and determinants of mental health disorders among cancer patients is crucial to alert concerned bodies for action. In view of this, we aimed to determine the pooled prevalence and determinants of anxiety and depression among cancer patients in Ethiopia. Methods: Relevant literatures were searched on PubMed, African Journals Online, Hinari, Epistemonikos, Scopus, EMBASE, CINAHL, Cochrane Library, and Gray literature sources. Data were extracted into an Excel spreadsheet and analyzed using STATA 17 statistical software. The random effect model was used to summarize the pooled effect sizes with their respective 95% confidence intervals. The I2 statistics and Egger's regression test in conjunction with the funnel plot were utilized to evaluate heterogeneity and publication bias among included studies respectively. Results: A total of 17 studies with 5,592 participants were considered in this review. The pooled prevalence of anxiety and depression among cancer patients in Ethiopia were 45.10% (95% CI: 36.74, 53.45) and 42.96% (95% CI: 34.98, 50.93), respectively. Primary and above education (OR= 0.76, 95% CI: 0.60, 0.97), poor social support (OR= 2.27, 95% CI: 1.29, 3.98), occupational status (OR= 0.59; 95% CI: 0.43, 0.82), advanced cancer stage (OR= 2.19, 95% CI: 1.38, 3.47), comorbid illness (OR= 1.67; 95% CI: 1.09, 2.58) and poor sleep quality (OR= 11.34, 95% CI: 6.47, 19.89) were significantly associated with depression. Whereas, advanced cancer stage (OR= 1.59, 95% CI: 1.15, 2.20) and poor sleep quality (OR= 12.56, 95% CI: 6.4 1, 24.62) were the factors associated with anxiety. Conclusion: This meta-analysis indicated that a substantial proportion of cancer patients suffer from anxiety and depression in Ethiopia. Educational status, occupational status, social support, cancer stage, comorbid illness and sleep quality were significantly associated with depression. Whereas, anxiety was predicted by cancer stage and sleep quality. Thus, the provision of comprehensive mental health support as a constituent of chronic cancer care is crucial to mitigate the impact and occurrence of anxiety and depression among cancer patients. Besides, families and the community should strengthen social support for cancer patients. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42023468621.

Intention to leave and associated factors among health professionals working at public hospitals in East Gojjam zone, Northwest Ethiopia, cross-sectional study.

BACKGROUND: The most important element of health systems for meeting the population's healthcare demands is the workforce. The main issue facing the health industry, particularly in emerging nations, has been their shortage and turnover. Thus, the purpose of this study was to assess the intention of leaving and related variables among medical professionals employed at East Gojjam zone public health hospitals. METHODS: An institution based cross-sectional study was conducted among 561 randomly selected health professionals working at public hospitals in East Gojjam Zone from 04 March 2019 to 30 March 2019. Self-administered structured questionnaire was used for data collection. Both bi-variable and multivariable logistic regression analysis were fitted. Variables having P-value less than 0.2 during bi-variable regressional analysis were entered in to multivariable logistic regression analysis and Adjusted Odds Ratio (AOR) with 95% confidence interval (CI) was used to declare the associated factors with intention to leave. RESULTS: Overall, 61.3% (95% CI: 57.2, 65.4) of health professionals were intended to leave their working organizations. Dissatisfaction with work nature (AOR: 3.01; 95% CI: 2.05, 4.43), work environment (AOR: 1.83, 95% CI: 1.25, 2.68), Remuneration (AOR: 1.89; 95% CI: 1.29, 2.76), having low normative commitment (AOR: 0.55; 95% CI: 0.38, 0.81) and being unmarried (AOR: 1.78; 95% CI: 1.23, 2.58) were satistically significant factors with intention to leave their working organizations. CONCLUSIONS: The health professionals' intention to leave their working organizations was high, three-fifth of the health professionals had intention to leave their organization which might result great service quality compromization and decrease the responsiveness of the health institutions in the study area. Dissatisfaction with remuneration, working environment, work nature, low normative commitment and being unmarried were factors associated with health professional's intention to leave their working organizations. Therefore, hospital administrators, supervisors, and Healthcare policymakers need to emphasize on retention of health workers at their working organization by taking into account the above significant variables. Such as, through creating an attractive working environment and designing better benefit mechanisms.

COVID-19 vaccine acceptance and predictors among pregnant women in Ethiopia: Systematic Review and Meta-Analysis.

Objectives: Despite safe and effective multiple vaccines, the COVID-19 pandemic continued to cause morbidity, mortality, and healthcare burden. Pregnant women are among the high-risk population for COVID-19 infection and bad outcomes. Vaccination is one of the most critical public health interventions to halt the devastating impact of a pandemic. However, hesitancy, unwillingness, and refusal to take the COVID-19 vaccines are global health challenges to vaccination roll-out, especially in Africa, including Ethiopia. Country-specific evidence is essential to take appropriate context-specific actions. Some single studies with inconsistent findings are available in Ethiopia. Therefore, this meta-analysis aims to determine pooled COVID-19 vaccine acceptance among pregnant women in Ethiopia. Study design: Systematic review and meta-analysis study design was used to synthesize evidence and overall COVID-19 vaccine acceptance and predictors among pregnant women. Methods: A search of literature from PubMed, Scopus, Web of Science, EMBASE, Cochrane Library, and Google Scholar was conducted until January 30, 2023. All studies that met eligibility criteria were screened, and eight primary studies with 4419 total subjects were included in the meta-analysis. Two authors (DT and MK) independently extracted all the required data using a standardized form. We analyzed the data using STATA version 17 software. Heterogeneity was checked using Chocrane (Q-test) and I2 tests. Finally, the overall COVID-19 vaccine acceptance and predictors were computed using a random-effect model. Result: The meta-analysis revealed that a pooled COVID-19 vaccine acceptance among pregnant women in Ethiopia is 42.46% (95%CI: 28.75-56.18). Further subgroup analysis stratified by region of the primary studies showed that the pooled level of COVID-19 Acceptance among pregnant women in the Amhara region is 35.16% (95% CI: 20.49-49.82), South Nation Nationality and People 50.95% (95%C:12.24-89.67) and Oromia region 62.02% (95%CI: 58.27-65.76). Predictors for COVID-19 vaccine acceptance among pregnant women in Ethiopia were awareness/knowledge of pregnant women to COVID-19 vaccine (OR 3.33, 95%CI:2.13-4.14), maternal education (OR 3.09, 95%CI: 1.67-4.51 and chronic disease (OR 2.81, 95%CI: 1.82-3.79. The lowest level of vaccine acceptance was reported in the Amhara region, while the relatively highest was observed in the Oromia region. Conclusion: The study found a low level of COVID-19 vaccine acceptance among pregnant women in Ethiopia and emphasized the significance of improving awareness and education to increase vaccine uptake. It is crucial to provide interventions that create awareness about the COVID-19 vaccine and promote the importance of vaccination during antenatal care follow-up.

Data quality and associated factors of routine health information system among health centers of West Gojjam Zone, northwest Ethiopia, 2021.

Background: Data quality is a multidimensional term that includes accuracy, precision, completeness, timeliness, integrity, and confidentiality. The quality of data generated by a routine health information system (RHIS) is still very poor in low- and middle-income countries. There is a paucity of studies as to what determines data quality in health facilities in the study area. Therefore, the aim of the present study was to assess the magnitude of the quality of routine health information system data and its determinants among health centers. Methods: A facility-based quantitative study design triangulated by the qualitative method was conducted. A total of 314 health professionals from 32 health centers were selected using a simple random sampling procedure. Data were gathered using a standardized checklist, interviewer-administered questionnaires, and key informant interview guidelines. Descriptive statistics were used to describe variables and binary logistic regression was used to identify factors associated with data quality using STATA version 14. Variables with p-value <0.25 in the bivariate analysis were entered to a multivariable logistic regression analysis. P-values <0.05 at 95% confidence intervals (CI) were taken to be statistically significant. A manual analysis was conducted for the qualitative data collected from purposively selected key informants. Results: The study found that the overall data quality at the health centers of West Gojjam Zone was 74% (95% CI 68-78). The complexity of the routine health information system format [adjusted odds ratio (AOR) 3.8; 95% CI 1.7-8.5], problem-solving skills for RHIS tasks (AOR 2.8; 95% CI 1.2-6.4), and knowing duties, roles, and responsibilities were significantly associated with data quality (AOR 12; 95% CI 5.6-25.8), and lack of human resources, poor feedback mechanisms, delay in completing data records, lack of data use, and inadequate training on health information systems were barriers affecting data quality. Conclusions: The level of data quality among public health centers in the Amhara region was lower than expected at the national level.

Second Dose Measles Vaccination Utilization and Associated Factors in Jabitehnan District, Northwest Ethiopia.

Background: Herd immunity against measles is essential to interrupt measles transmission, and this can only be attained by reaching at least 95% coverage for each of the 2 doses of measles vaccine provided in infancy and early childhood age group. It is important to provide everyone with 2 doses of the measles vaccine in order to effectively safeguard the population. Despite this, little is known about the second dosage of the measles vaccine utilization status and the factors that affect it. Therefore, this study aimed to assess second dose of measles vaccination utilization and its associated factors among children aged 24-35 months in Jabitehnan district, 2020. Methods: A community-based cross-sectional study design was conducted at Jabitehnan District, Northwest Ethiopia, from September 1st, 2020 to October 1st, 2020. Systematic random sampling technique was used to select 845 mothers/caregivers who had children aged 24-35 months. Both bi-variable and multivariable logistic regression was fitted to identify the determinant factors of second dose measles vaccination utilization. Finally, the statistical significant variables were declared by using 95% CI and P value less than .05 in the multivariable logistic regression analysis. The Hosmer and Lemeshow test was used to check the model's fit to the data, and the variance inflation factor was used to assess multi-collinearity. Results: The overall second dose of measles vaccination utilization was 48.1%, (95% CI: 44.7-51.6). Mothers with primary school education (AOR = 1.91, 95% CI: 1.15-3.17), information about MCV2 (AOR = 6.53, 95% CI: 4.22-10.08), distance from vaccination site (AOR = 3.56, 95% CI: 2.46-5.14), knowledge about immunization (AOR = 1.935, 95% CI: 1.29-2.90), and favorable attitude about immunization (AOR = 5.19, 95% CI: 3.25-8.29) were significantly associated factors with second dose of measles vaccination utilization. Conclusion: Second dose measles vaccination utilization in the district was lower than the national target. Maternal education, distances from vaccination site, information about MCV2, and knowledge about immunization were significantly associated variables with second dose measles vaccination utilization. Therefore, in order to increase the utilization of the second dose of the measles vaccine, improved health education and service expansion to difficult-to-reach areas are required.

Self-Care Practice and Its Associated Factors Among Podoconiosis Patients in East Gojjam Zone, North West Ethiopia.

Introduction: Podoconiosis is endemic non-filarial elephantiasis of the lower legs swelling caused by barefoot exposure to red clay soil. The burden of disability occurs among the poorest populations. Self-care practice is the most cost-effective prevention strategy practiced at home to improve lymphedema, working functionality, and quality of life. Despite this, there is a scarce of knowledge about self-care practices and associated factors among podoconiosis patients in Ethiopia. Objective: To determine self-care practice and its associated factors among podoconiosis patients in East Gojjam zone North West, Ethiopia. Methods: Community-based cross-sectional study design was used among 633 podoconiosis patients. Computer-generated simple random sampling technique was used to recruit participants. All patients who started podoconiosis treatment were the source population. Data were entered using Epidata version 3.1 and exported to SPSS version 25 for cleaning and analysis. Variables with 95% CI corresponding AOR were used to identify statistically significant factors for self-care practice. Results: In this study, the self-care practice of podoconiosis patient was 64%. Females [AOR: 0.38 (95% CI: 0.22, 0.65)], 55-65 years age [AOR: 0.41 (95% CI: 0.22, 0.74)], above 65 years age [AOR: 0.22 (95% CI: 0.11, 0.450)], 4-6 km distance from water source [AOR: 0.06 (95% CI: 0.03, 0.12)], above 6 km distance from water source [AOR: 0.03 (95% CI: 0.01, 0.09)], educational level [AOR: 0.05 (95% CI: 0.01, 0.40)], marital status [AOR: 5.40 (95% CI: 2.30, 12.90)], and distance from health institution [AOR: 0.35 (95% CI: 0.23, 0.54)] were statistically identified associated factors for self-care practice of podoconiosis patient. Conclusion: In this study, the self-care practice of podoconiosis patients was not well practiced. Socio-demographic factors are identified as associated factors for self-care practice. Strengthening health education and behavioral changes are required to improve self-care practice.

The time to initiate trophic feeding and its predictors among preterm neonate admitted to neonatal intensive care unit, Multicenter study, Northwest Ethiopia.

BACKGROUND: Trophic feeding is a small volume, hypo-caloric feeding, gut priming or minimal enteral feeding acclimate the immature gut of enteral fasting preterm neonates. Delayed starting of trophic feeding had resulted in short and long-term physical and neurological sequels. The current study aimed to estimate the time to initiate trophic feeding and its predictors among preterm neonates admitted in the neonatal intensive care unit of Debre Markos, Felege Hiwot, and Tibebe Ghion comprehensive specialized hospitals. METHODS: An institutional-based prospective follow-up study was conducted among 210 neonates. The data were collected with interview and chart review, entered into Epi data 3.1 and exported to Stata 14.1 for analysis. Multivariable Cox regression models were fitted to identify predictors of time to initiate trophic feeding. RESULT: A total of 210 neonates were followed for 10136 person-hours of risk time and 191 (90.95%) of neonates were started trophic feeding. The overall incidence of starting trophic feeding was 2 per 100 (95% CI: 2, 2.2) person-hours observations. The median survival time was 42 hours (95% CI: 36, 48). APGAR- score at first minute <7 (AHR: 0.6, 95% CI: 0.44, 0.82), gestational age of <34 weeks (AHR: 0.69, 95% CI: 0.5, 0.94), presence of respiratory distress syndrome (AHR: 0.5, 95% CI: 0.36, 0.68), presence of hemodynamic instability (AHR: 0.37, 95% CI: 0.24, 0.57), presence of perinatal asphyxia (AHR: 0.63, 95% CI: 0.44, 0.89), cesarean section delivery (AHR: 0.63, 95% CI: 0.44, 89) and being delivered within the study hospitals (AHR: 0.54, 95% CI: 0.39, 0.74) were found to be statistically significant predictors of time to initiate trophic feeding. CONCLUSION: There was a significant delay to initiate trophic feeding in the studied hospitals. Gestational age of below 34 weeks, APGAR-score of less than seven, out-born delivery, cesarean delivery, presence of respiratory distress syndrome; perinatal asphyxia, and hemodynamic instability were predictors of delay in starting of trophic feeding. Standardized feeding guideline has to be implemented to overcome delays in enteral feeding initiation.

Sexual and Reproductive Health Problems and Needs of Street Youths in East Gojjam Zone Administrative Towns, Ethiopia: Exploratory Qualitative Study.

Background: About 600,000 children are estimated to depend on street life in Ethiopia. Estimates conclude that about 65% of street children hardly have any access to sexual and reproductive health (SRH) services. However, sexually transmitted infections including HIV/AIDS among street children have been reported as being very high and some studies showed that it can be higher than that of female sex workers, truck drivers and prisoners. Objective: The aim of this study is to explore the sexual and reproductive health problems of street youths and their need in East Gojjam Zone, Ethiopia, 2019. Methods: An explanatory qualitative study design was conducted on street youths residing in East Gojjam Zone town administrations from February to March, 2019. Purposively selected street youths and positioned individuals who were residing in East Gojjam Zone town administrates were included in the study. The data were collected through focus group discussion and in-depth interview and analyzed thematically. Result: A total of 85 street youths and 8 individuals who were working with street children participated in this study. Most street youths had no clear information towards sexual and reproductive health. The existing reproductive health problems were sexual violence, sexually transmitted infection, unplanned pregnancy, abortion and substance abuse. Most street youths were interested in getting sexual and reproductive health information and other services by concerned bodies similar to the general population. Accessibility of job opportunities was also one of their needs to prevent the existing sexual and reproductive health problems. Conclusion and Recommendation: Most street youths were sexually active and attempted unsafe sexual practice which exposed them to sexually transmitted infections, unplanned pregnancies and abortions. So a special reproductive health service is needed to avert these problems.

Patient-Centered Care and Associated Factors among Adult Admitted Patients in South Wollo Public Hospitals, Northeast Ethiopia.

BACKGROUND: The US Institute of Medicine's "quality chasm" report defined patient-centered care as care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions. Services that lack patient-centered care lead to unimproved health status, decreased patient and family satisfaction, and poor patient outcomes. Therefore, this study aimed to assess patient-centered care and associated factors among admitted patients in South Wollo public hospitals in northeast Ethiopia. METHODS: This was a facility-based quantitative cross-sectional study design supplemented with qualitative analysis conducted from February 10 to March 10, 2020 across South Wollo public hospitals. A total of 618 admitted patients were selected using multistage systematic random sampling and interviewed using a structured questionnaire. Five health professionals were selected for in-depth interviews. Binary logistic regression analysis was carried out to identify associated variables, and potential confounders were controlled using a multivariate logistic regression model, and P<0.05 was considered significant. RESULTS: Overall, 60.9% (95% CI 57.1%-64.5%) of patients received patient-centered care. Age 25-35 years (AOR 0.39, 95% CI 0.32-0.64) years, rural residence (AOR 2.61, 95% CI 1.62-4.02), social well-being (AOR 2.34, 95% CI 1.45-3.78), perceived high quality of care (AOR 3.69, 95% CI 2.07-6.04), length of stay (AOR 0.13, 95% CI 0.02-0.79), and routine checkups (AOR 1.92, 95% CI 1.15-3.13) were variables significantly associated with patient-centered care. CONCLUSION: This study revealed that among admitted patients, three in five received patient-centered care. Age, residence, social well-being, length of stay, perceived quality of care, and routine checkups were significantly associated with patient-centered care. Therefore, working on provider improvements in providing consultation and facilitation and decreasing length of stay to improve patient-centered care is needed.

Late antenatal care utilization in Ethiopia: The effect of socio-economic inequities and regional disparities.

Antenatal care (ANC) is one of the most crucial components of maternal health care services. However, less than two-third of pregnant women receive ANC at least once and only 32% had at least 4 ANC visits in Ethiopia. There is dearth of nationally representative data that indicate changes in utilization of ANC services at the end of health sector transformation plan I period (HSTP I) in the country. Therefore, the present study aimed to investigate utilization of ANC the effect of socio-economic inequities and regional disparities in Ethiopia. The 2019 Ethiopian Mini Demographic and Health Survey data were used. A total of 5753 women in the reproductive age who gave live births in the five years preceding the survey were used for this study. Multivariable logistic regression model was fitted to identify factors associated with ANC booking. This study indicated that 74% women had at least one ANC visit during their last pregnancy of which four out of ten did not receive the recommended 4+ visits. The proportion of women who had late ANC booking (i.e., first ANC visit to health facility after 4 months of pregnancy) was found to be 32% and significant disparities were observed across regions. Rural residency (adjusted OR (AOR): 1.62, 95% CI (1.28, 2.05)), being wealth (AOR: 0.69, 95% CI (0.55, 0.85)), education (AOR: 0.25, 95% CI (0.15, 0.40)) and being grand multi-parity (AOR: 1.35, 95% CI (1.005, 1.83)) were significantly associated with late ANC booking. ANC services utilization is far behind its targets and the proportion of pregnant women entering ANC late is high. It is necessary to intensify efforts to raise awareness about the need of early ANC initiation, particularly in rural areas.

Effect of maternity waiting homes use on maternal and perinatal birth outcomes and its challenges in Amhara region, Northwest Ethiopia.

Background: Women's death due to complications of pregnancy and childbirth is still high. Maternity waiting homes are one of the strategies to reduce it. However, there is limited evidence on the effect of using maternity waiting homes on birth outcomes, particularly in this study area. Therefore, this study was aimed to estimate the effect of staying in maternity waiting homes use on maternal and perinatal birth outcomes and its challenges in the Amhara region, Northwest Ethiopia 2018. Methods: Institutional-based comparative cross-sectional study using both quantitative and qualitative approaches was conducted. Data were collected using structured questionnaire interviews, in-depth interview and chart reviews. Propensity score matching analysis was used to estimate the effect of maternity waiting homes use on birth outcomes. Propensity score matching analysis was used to match potential differences in background characteristics that affect pregnancy outcomes between comparison groups. We used thematic analysis for qualitative data. Result: A total of 548 pregnant mothers (274 stayed in maternity waiting homes 274 did not stay) took part in this study. The proportion of adverse birth outcomes of mothers who stayed in maternity waiting homes were 15(5.5%) which is lower than those who didn't stay 35 (12.8%). After matching with baseline covariates, mean difference of adverse maternal birth outcomes, the difference between didn't use maternity waiting home and used was 10.4%, at (t = 3.78) at 5% level of significance. Similarly, the mean adverse perinatal birth outcomes difference between mothers who didn't use MWHs and used was 11% (t = 4.33). Conclusions: Maternity waiting home showed a significant positive effect on birth outcomes. Mothers who stayed in the maternity waiting homes had low adverse maternal and perinatal birth outcomes compared to non-users. Accommodations and quality health care services were the challenges mothers faced during their stay in the maternity waiting homes. Therefore, all concerned bodies should give attention accordingly to maternity waiting home services to reduce adverse birth outcomes through the strengthening of the quality of health care provided.