Adolescent maternal health services utilization and associated barriers in Sub-Saharan Africa: A comprehensive systematic review and meta-analysis before and during the sustainable development goals.

Introduction: Effective and adequate maternal health service utilization is critical for improving maternal and newborn health, reducing maternal and perinatal mortality, and important to achieve global sustainable development goals (SDGs). The purpose of this systematic review was to assess adolescent maternal health service utilization and its barriers before and during SDG era in Sub-Saharan Africa (SSA). Methods: Systematic review of published articles, sourced from multiple electronic databases such as Medline, PubMed, Scopus, Embase, CINAHL, PsycINFO, Web of Science, African Journal Online (AJOL) and Google Scholar were conducted up to January 2024. Assessment of risk of bias in the individual studies were undertaken using the Johanna Briggs Institute (JBI) quality assessment tool. The maternal health service utilization of adolescent women was compared before and after adoption of SDGs. Barriers of maternal health service utilization was synthesized using Andersen's health-seeking model. Meta-analysis was carried out using the STATA version 17 software. Results: Thirty-eight studies from 15 SSA countries were included in the review. Before adoption of SDGs, 38.2 % (95 % CI: 28.5 %, 47.9 %) adolescents utilized full antenatal care (ANC) and 44.9 % (95%CI: 26.2, 63.6 %) were attended by skilled birth attendants (SBA). During SDGs, 42.6 % (95 % CI: 32.4 %, 52.8 %) of adolescents utilized full ANC and 53.0 % (95 % CI: 40.6 %, 65.5 %) were attended by SBAs. Furthermore, this review found that adolescent women's utilization of maternal health services is influenced by various barriers, including predisposing, enabling, need, and contextual factors. Conclusions: There was a modest rise in the utilization of ANC services and SBA from the pre-SDG era to the SDG era. However, the level of maternal health service utilization by adolescent women remains low, with significant disparities across SSA regions and multiple barriers to access services. These findings indicate the importance of developing context-specific interventions that target adolescent women to achieve SDG3 by the year 2030.

Effectiveness and cost-effectiveness of models of maternity care for women from migrant and refugee backgrounds in high-income countries: A systematic review.

BACKGROUND: Different models of care may be appropriate for various groups of women during their perinatal period, depending on their risk level, location, and accessibility of healthcare practitioners and facilities. Evaluating these models' effectiveness and cost-effectiveness is critical to allocating resources and offering sustained care to women from refugee backgrounds. This systematic review aimed to synthesize evidence on the effectiveness and cost-effectiveness of maternity care models among women from migrant and refugee backgrounds living in high-income countries. METHODS: A comprehensive search of major databases for studies published in English between 2000 and 2023 was developed to identify literature using defined keywords and inclusion criteria. Two authors independently screened the search findings and the full texts of eligible studies. The quality of the included studies was appraised, and qualitative and quantitative results were synthesised narratively and presented in tabular form. The review was reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: Forty-seven research papers from six countries were included in the review. The review highlighted the positive impact of community and stakeholders' involvement in the implementation of models of maternity care for women from migrant and refugee backgrounds. The review summarised the models of care in terms of their effectiveness in improving perinatal health outcomes and minimising medical interventions, continuum of care in maternity services, enhancing health literacy, maternity service use and navigating the healthcare system, social support, and sense of belongingness, and addressing cultural and linguistic barriers. Notably, only one study conducted a partial economic evaluation to determine the cost-effectiveness of the model. CONCLUSION AND IMPLICATIONS FOR PRACTICE AND RESEARCH: While the reviewed models demonstrated effectiveness in improving perinatal health outcomes, there was considerable variation in outcome measures and assessment tools across the models. Thus, reaching a consensus on prioritised perinatal outcomes and measurement tools is crucial. Researchers and policymakers should collaborate to enhance the quality and quantity of economic evaluations to support evidence-based decision-making. This includes thoroughly comparing costs and outcomes across various health models to determine the most efficient interventions. By emphasizing the importance of comprehensive economic evaluations, healthcare systems can better allocate resources, ultimately leading to more effective and efficient healthcare delivery.

Trends and disparities in perinatal health outcomes among women from refugee backgrounds in Victoria, Australia: A population-based study.

BACKGROUND: Women from refugee backgrounds generally experience poorer pregnancy-related outcomes compared to host populations. AIM: To examine the trend and disparities in adverse perinatal outcomes among women of refugee background using population-based data from 2003 to 2017. METHODS: A population-based cross-sectional study of 754,270 singleton births in Victoria compared mothers of refugee backgrounds with Australian-born mothers. Inferential statistics, including Pearson chi-square and binary logistic regression, were conducted. Multiple logistic regression was conducted to explore the relationship between adverse perinatal outcomes and the women's refugee status. FINDINGS: Women of refugee background had higher odds of adverse neonatal and maternal outcomes, including stillbirth, neonatal death, low APGAR score, small for gestational age, postpartum haemorrhage, abnormal labour, perineal tear, and maternal admission to intensive care compared to Australian-born women. However, they had lower odds of neonatal admission to intensive care, pre-eclampsia, and maternal postnatal depression. The trend analysis showed limited signs of gaps closing over time in adverse perinatal outcomes. DISCUSSION AND CONCLUSION: Refugee background was associated with unfavourable perinatal outcomes, highlighting the negative influence of refugee status on perinatal health. This evidences the need to address the unique healthcare requirements of this vulnerable population to enhance the well-being of mothers and newborns. Implementing targeted interventions and policies is crucial to meet the healthcare requirements of women of refugee backgrounds. Collaborative efforts between healthcare organisations, government agencies and non-governmental organisations are essential in establishing comprehensive support systems to assist refugee women throughout their perinatal journey.

Correction: Cervical cancer screening utilization and predictors among eligible women in Ethiopia: A systematic review and meta-analysis.

[This corrects the article DOI: 10.1371/journal.pone.0259339.].

Effects of iron supplementation on cognitive development in school-age children: Systematic review and meta-analysis.

BACKGROUND: Iron deficiency is negatively associated with children's cognitive development. Evidence showed that iron supplementation improves cognitive development. Nearly 50% of anemia is caused by iron deficiency. Anemia affects more school-age children, at an age where their brain development continues. The aim of this systematic review and meta-analysis is to review the evidence from published randomized controlled trials to evaluate the effects of iron supplementation on cognitive development and function among school-age children. METHOD: Five databases including MEDLINE, EMBASE, Scopus, Web of Science and CENTRAL were used to search for articles on April 20th, 2021. The search was reconducted on October 13th, 2022 to retrieve new records. Studies were eligible if they included school children 6-12 years of age, were randomized controlled trials, and if they tested iron supplementation and measured cognitive development. RESULT: Thirteen articles were included in the systematic review. Overall, iron supplementation significantly improved intelligence (standardized mean difference, 95% confidence interval) (SMD 0.46, 95%CI: 0.19, 0.73, P<0.001), attention and concentration (SMD 0.44, 95%CI: 0.07, 0.81, P = 0.02) and memory (SMD 0.44, 95%CI: 0.21, 0.67, P <0.001) of school-age children. There was no significant effect of iron supplementation on school achievement of school-age children (SMD 0.06, 95%CI: -0.15, 0.26, P = 0.56). In a subgroup analysis, iron-supplemented children who were anemic at baseline had had better outcomes of intelligence (SMD 0.79, 95%CI: 0.41, 1.16, P = 0.001) and memory (SMD 0.47, 95%CI: 0.13, 0.81; P = 0.006). CONCLUSION: Iron supplementation has a significant positive effect on the intelligence, attention and concentration, and the memory of school-age children but there was no evidence on the effect of iron supplementation on their school achievement.

Dangers associated with assuming robustness of scale reliability and validity: Psychometric properties of the Barkin Index of Maternal Functioning with Ethiopian mothers.

This study was conducted to assess the psychometric properties of the Barkin Index of Maternal Functioning (BIMF) in an Ethiopian context. Data were obtained from 202 women with a child less than 1 year of age. Narrow standard deviations characterized responses to most BIMF items, but a handful of items had wider standard deviations associated with bimodality. Most interitem correlations were < |.15|, and 13 of the 20 BIMF items did not load satisfactorily on any factor in exploratory factor analyses. Two factors emerged from the remaining items, one with three items and the other with four. Although poor reliability results relating to internal (interitem) and temporal consistency could be attributed to limited variability in the data, a number of concerns are raised about the BIMF itself, including its content validity, instructions, response options, and usefulness in healthcare settings. Suggestions are made for improving the assessment of maternal functioning in Ethiopia and other contexts. More generally, this research demonstrates that researchers should not assume that the psychometric properties and appropriateness of scales will remain robust when those scales are used in contexts that differ from the contexts in which they were created.

Birth preparedness and complication readiness among husbands and its association with skilled birth attendance in southern Ethiopia.

INTRODUCTION: Birth preparedness and Complication Readiness (BPCR) promotes prompt use of skilled delivery and readiness for any complications to reduce delays in the provision of emergency care. Husband's involvement in preparation for childbirth is one way to mitigate life-threatening delays in providing care during childbirth. The current study assessed the association of the husband's involvement in birth preparedness and complication readiness with the use of skilled birth attendants. METHOD: A community-based cross-sectional study was conducted among 1,432 husbands. Study participants were selected from Arbaminch university health and demographic surveillance sites. Data were collected electronically using the Open Data Kit. The data were exported to STATA version 16 for analysis. Descriptive statistics were computed to describe the sociodemographic and reproductive variables of the study. The associations between birth preparedness and complication readiness practice and birth in the presence of a skilled birth attendant were assessed using multiple logistic regressions after adjusting for known confounders. Explanatory variables on bivariate logistic regression analysis were entered into multivariable logistic regression analysis, and a p-value of less than 0.05 was used to ascertain statistical significance. RESULTS: Mean age of respondents was 33.7 (SD ± 6.2) years. Of all the respondents, 140 (10.3%) had made at least three preparations according to birth preparedness and complication readiness. After controlling for confounders through multivariable logistic regression, giving birth in the presence of a skilled birth attendant consistently increased with husbands involved in birth preparedness and complication readiness (AOR = 4.1, 95% CI: 2.5-6.9). Husbands whose wives had complications during previous pregnancy were 33% less likely to have skilled birth attendants (AOR = 0.67, 95% CI: 0.49-0.917). Moreover, husbands whose houses were near the health facilities were more likely to have skilled birth attendants for their wives (AOR = 3.93, 95% CI: 2.57-6.02). CONCLUSION: Husband's involvement in birth preparedness and complication readiness is strongly associated with using skilled birth attendants in Ethiopia. It is imperative that when designing husband's involvement programs targeting birth preparedness and complication readiness, programs and strategies should focus on enhancing activities that are inclusive of husbands in birth preparedness and complication education.

Obstructed labor and its effect on adverse maternal and fetal outcomes in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: Obstructed labor is one of the five major causes of maternal mortality and morbidity in developing countries. In Ethiopia, it accounts for 19.1% of maternal death. The current review aimed to assess maternal and perinatal outcomes of obstructed labor in Ethiopia. METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed for this systematic review and meta-analysis. A literature search was made using PubMed/MEDLINE, CINAHL, Summon country-specific search, and Cochrane Libraries' online databases. Search terms were adverse outcome, obstructed labor, maternal outcome, fetal outcome, and Ethiopia. The Newcastle-Ottawa scale (NOS), based on a star scoring system, was used to assess the quality of the included studies. The meta-analysis was conducted using STATA 16 software. The pooled prevalence of an adverse maternal outcome, fetal outcome, and association between adverse outcome and obstructed labor was calculated using a random-effects model. Egger's test and funnel plot were used to evaluate publication bias. RESULT: Eighty-seven studies were included in this review, with an overall sample size of 104259 women and 4952 newborns. The pooled incidence of maternal death was estimated to be 14.4% [14.14 (6.91-21.37). The pooled prevalence of uterine rupture and maternal near-miss was 41.18% (95% CI: 19.83, 62.54) and 30.5% [30.5 (11.40, 49.59) respectively. Other complications such as postpartum hemorrhage, sepsis, obstetric fistula, hysterectomy, bladder injury, cesarean section, and labor abnormalities were also reported. The pooled prevalence of perinatal death was 26.4% (26.4 (95% CI 15.18, 37.7). In addition, the association of obstructed labor with stillbirth, perinatal asphyxia, and meconium-stained amniotic fluid was also demonstrated. CONCLUSIONS: In Ethiopia, the incidence of perinatal and maternal mortality among pregnant women with obstructed labor was high. The rate of maternal death and maternal near miss reported in this review was higher than incidences reported from high-income and most low and middle-income countries. Uterine rupture, postpartum hemorrhage, sepsis, fistula, hysterectomy, and bladder injury were also commonly reported. To improve the health outcomes of obstructed labor, it is recommended to address the three delay models: enhancing communities' health-seeking behavior, enhancing transportation for an obstetric emergency with different stakeholders, and strengthening the capacity of health facilities to handle obstetric emergencies.

Cervical cancer screening utilization and predictors among eligible women in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: Despite a remarkable progress in the reduction of global rate of maternal mortality, cervical cancer has been identified as the leading cause of maternal morbidity and mortality, particularly in sub-Saharan African countries. The uptake of cervical cancer screening service has been consistently shown to be effective in reducing the incidence rate and mortality from cervical cancer. Despite this, there are limited studies in Ethiopia that were conducted to assess the uptake of cervical cancer screening and its predictors, and these studies showed inconsistent and inconclusive findings. Therefore, this systematic review and meta-analysis was conducted to estimate the pooled cervical cancer screening utilization and its predictors among eligible women in Ethiopia. METHODS AND FINDINGS: Databases like PubMed, Web of Science, SCOPUS, CINAHL, Psychinfo, Google Scholar, Science Direct, and the Cochrane Library were systematically searched. All observational studies reporting cervical cancer screening utilization and/ or its predictors in Ethiopia were included. Two authors independently extracted all necessary data using a standardized data extraction format. Quality assessment criteria for prevalence studies were adapted from the Newcastle Ottawa quality assessment scale. The Cochrane Q test statistics and I2 test were used to assess the heterogeneity of studies. A random effects model of analysis was used to estimate the pooled prevalence of cervical cancer screening utilization and factors associated with it with the 95% confidence intervals (CIs). From 850 potentially relevant articles, twenty-five studies with a total of 18,067 eligible women were included in this study. The pooled national cervical cancer screening utilization was 14.79% (95% CI: 11.75, 17.83). The highest utilization of cervical cancer screening (18.59%) was observed in Southern Nations Nationalities and Peoples' region (SNNPR), and lowest was in Amhara region (13.62%). The sub-group analysis showed that the pooled cervical cancer screening was highest among HIV positive women (20.71%). This meta-analysis also showed that absence of women's formal education reduces cervical cancer screening utilization by 67% [POR = 0.33, 95% CI: 0.23, 0.46]. Women who had good knowledge towards cervical screening [POR = 3.01, 95%CI: 2.2.6, 4.00], perceived susceptibility to cervical cancer [POR = 4.9, 95% CI: 3.67, 6.54], severity to cervical cancer [POR = 6.57, 95% CI: 3.99, 10.8] and those with a history of sexually transmitted infections (STIs) [POR = 5.39, 95% CI: 1.41, 20.58] were more likely to utilize cervical cancer screening. Additionally, the major barriers of cervical cancer screening utilization were considering oneself as healthy (48.97%) and lack of information on cervical cancer screening (34.34%). CONCLUSIONS: This meta-analysis found that the percentage of cervical cancer screening among eligible women was much lower than the WHO recommendations. Only one in every seven women utilized cervical cancer screening in Ethiopia. There were significant variations in the cervical cancer screening based on geographical regions and characteristics of women. Educational status, knowledge towards cervical cancer screening, perceived susceptibility and severity to cervical cancer and history of STIs significantly increased the uptake of screening practice. Therefore, women empowerment, improving knowledge towards cervical cancer screening, enhancing perceived susceptibility and severity to cancer and identifying previous history of women are essential strategies to improve cervical cancer screening practice.

Utilization of non-pneumatic anti-shock garment and associated factors for postpartum hemorrhage management among obstetric care providers in public health facilities of southern Ethiopia, 2020.

BACKGROUND: Delays in care have been recognized as a significant contributor to maternal mortality in low-resource settings. The non-pneumatic antishock garment is a low-cost first-aid device that can help women with obstetric haemorrhage survive these delays without long-term adverse effects. Extending professionals skills and the establishment of new technologies in basic healthcare facilities could harvest the enhancements in maternal outcomes necessary to meet the sustainable development goals. Thus, this study aims to assess utilization of non-pneumatic anti-shock garment to control complications of post-partum hemorrhage and associated factors among obstetric care providers in public health institutions of Southern Ethiopia, 2020. METHODS: A facility-based cross-sectional study was conducted among 412 obstetric health care providers from March 15 -June 30, 2020. A simple random sampling method was used to select the study participants. The data were collected through a pre-tested interviewer-administered questionnaire. A binary logistic regression model was used to identify determinants for the utilization of non-pneumatic antishock garment. STATA version 16 was used for data analysis. A P-value of < 0.05 was used to declare statistical significance. RESULTS: Overall, 48.5% (95%CI: 43.73, 53.48%) of the obstetric care providers had utilized Non pneumatic antishock garment for management of complications from postpartum hemorrhage. Training on Non pneumatic antishock garment (AOR = 2.92; 95% CI: 1.74, 4.92), working at hospital (AOR = 1.81; 95% CI: 1.04, 3.16), good knowledge about NASG (AOR = 1.997; 95%CI: 1.16, 3.42) and disagreed and neutral attitude on Non pneumatic antishock garment (AOR = 0.41; 95%CI: 0.24, 0.68), and (AOR = 0.39; 95% CI: 0.21, 0.73), respectively were significantly associated with obstetric care provider's utilization of Non-pneumatic antishock garment. CONCLUSIONS: In the current study, roughly half of the providers are using Non-pneumatic antishock garment for preventing complications from postpartum hemorrhage. Strategies and program initiatives should focus on strengthening in-service and continuous professional development training, thereby filling the knowledge and attitude gap among obstetric care providers. Health centers should be targeted in future programs for accessibility and utilization of non-pneumatic antishock garment.

Obstructed labor and its association with adverse feto-maternal outcome in Ethiopia: a protocol for a systematic review and meta-analysis.

BACKGROUND: Obstructed labor accounted for 22% of obstetrical complications and 9% of all maternal deaths in low- and middle-income countries. Even though there are separate studies regarding obstructed labor and its complication in Ethiopia, their results are inconsistent. The objectives of this review will be to estimate the pooled the prevalence of obstructed labor and to identify adverse feto-maternal outcomes associated with obstructed labor in Ethiopia. METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline will be followed to conduct this systematic review and meta-analysis. The databases we will search will be PubMed, Cochrane Library, Google Scholar, CINAHL, African Journals Online, Dimensions, and Summon per country online databases. To search the relevant literature, we will use the following key search terms: "prevalence," "adverse outcome," "obstructed labour," "maternal near miss," "neonatal near miss," "perinatal outcome," "cesarean section," "obstetric fistula," "uterine rupture," and "Ethiopia." Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument will be used for evaluating the quality of the studies. Appropriate statistical tests will be conducted to quantify the between studies heterogeneity and for the assessment of publication bias. We will check individual study influence analysis and also do subgroup analysis. The STATA version 15 will be used for statistical analysis. DISCUSSION: Our systematic review and meta-analysis will provide the pooled prevalence of obstructed labor and its association with adverse feto-maternal outcomes in Ethiopia. The finding of this study will be helpful to design appropriate preventive and promotive strategies for reducing of obstructed labor-related maternal mortality. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020196153 .

Breast self-examination practice and its determinants among women in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: The survival rate from breast cancer is lowest in African countries and the distribution of breast self-examination practice of and its determinants are not well investigated in Ethiopia. Therefore, this systematic review and meta-analysis was designed to determine the pooled prevalence of breast self-examination and its associated factors among women in Ethiopia. METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed for this systematic review and meta-analysis. The databases used were; PUBMED, Cochrane Library, Google Scholar, CINAHL, African Journals Online, Dimensions and Summon per country online databases. Search terms used were; breast self-examination, breast cancer screening, early detection of breast cancer and Ethiopia. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for critical appraisal of studies. The meta-analysis was conducted using STATA 15 software. The pooled meta-analysis was computed to present the pooled prevalence and relative risks (RRs) of the determinate factors with 95% confidence intervals (CIs). RESULTS: We identified 2,637 studies, of which, 40 articles (with 17,820 participants) were eligible for inclusion in the final meta-analysis. The pooled estimate of breast self-examination in Ethiopia was 36.72% (95% CI: 29.90, 43.53). The regional distribution breast self-examination ranged from 21.2% (95% CI: 4.49, 37.91) in Tigray to 61.5% (95% CI: 53.98, 69.02) in Gambela region. The lowest prevalence of breast self-examination was observed among the general population (20.43% (95% CI: 14.13, 26.72)). Women who had non-formal educational status (OR = 0.4 (95% CI: 0.21, 0.77)), family history of breast cancer (OR = 2.04 (95% CI: 1.23, 3.39)), good knowledge of breast self-examination (OR = 4.8 (95% CI: 3.03, 7.6)) and favorable attitude toward breast self-examination (OR = 2.75, (95% CI: 1.66, 4.55)) were significantly associated with practice of breast self-examination. CONCLUSIONS: Only a third of women in Ethiopia practiced breast examination despite WHO guidelines advocating for this practice among all women of reproductive age. Intervention programs should address the factors that are associated with breast self-examination. Population specific programs are needed to promote breast self-examination.

Prevalence and Associated Risk Factors of Intestinal Parasites among Schoolchildren from Two Primary Schools in Rama Town, Northern Ethiopia.

INTRODUCTION: Worldwide, about 3.5 billion people are affected by intestinal parasitic infections, and the majority of them are children. A perusal of the literature indicates that in Ethiopia, nearly one-third of schoolchildren are found to be infected by some sort of intestinal parasites. This study aimed to determine the prevalence of intestinal parasites among schoolchildren in Rama town in Northern Ethiopia. METHODS: A school-based cross-sectional study was conducted among primary school children from two schools in Rama town during June 2017. A structured questionnaire was used to identify environmental, sociodemographic, and behavioral factors while stool specimens were collected and examined for parasites using direct wet smear with saline preparation. Data analysis was completed using the Statistical Program for Social Sciences version 24 statistical software. RESULTS: A total of 312 school children with a mean age of 11.3 years were included. Among them, 24.4% (76) were found to be positive for at least one of the parasites. The overall infection rate was the highest among the 10-14 age groups (26.7%). Females were predominantly infected (26.7%). Altogether, eight species of intestinal parasites were identified. The most predominant protozoan and helminths were E. histolytica/dispar (10.9%) and Schistosoma mansoni (7.4%), respectively, and infections were mostly mono-parasitic. Coinfections with two and three intestinal parasites were identified among 13 (4.2%, [13/302]) and 2 (0.6%, [2/302]) cases, respectively. Prevalence of intestinal parasites was higher among children who did not wash their hands regularly before meals (AOR: 2.30, CI: 1.32, 4.0, p < 0.001) and those who frequently swam in streams (AOR: 3.12, CI: 1.07, 9.08, p < 0.021). CONCLUSIONS: The study revealed a high prevalence of parasitic infection and inadequate personal hygiene practices like poor handwashing and also the habit of swimming by schoolchildren in contaminated water bodies, especially the study area. To minimize the burden caused by parasitic infection, periodic deworming programs and health education should be provided to enhance the awareness of concerned participants are also warranted.

Mothers' satisfaction with health extension services and the associated factors in Gamo Goffa zone, Southern Ethiopia.

BACKGROUND: Providing compassionate and respectful maternity services in order to bring satisfaction to service users is one of the health extension services packages in Ethiopia. Though the service utilization and its associated factors have been well documented so far, yet there is a dearth of information on client satisfaction; particularly among rural women who are mostly the target groups of health extension services within the Ethiopia. Thus, this study aimed to assess mothers' satisfaction with health extension services and the associated factors in the Gamo Goffa Zone, of Southern Ethiopia. METHODS: A community based cross sectional study was conducted among 478 women from February 1st to February 28th of 2018. A pre-tested and interviewer administered questionnaire was used to collect the data. The study participants were selected using a systematic random sampling technique by allocating a proportion to each rural kebeles. Both bivariate and multivariate logistic regression analysis were performed to identify associated factors. Odds ratio with its 95% confidence interval was used to determine the degree of association. Level of statistical significance was set at a p-value of less than 0.05. RESULT: The overall proportion of mothers who were satisfied with health extension services was 37.4% with 95% CI (33-44%). Mothers who had good family monthly income [AOR = 4.66 (95% CI: 1.1, 20.6)], whose husbands participated in the health extension program [AOR = 4.02 (95% CI: 2.0, 8.1)], who had recent participation in planning of health extension programs [AOR = 5.75 (95% CI: 2.0, 16.5)], who were recognized as a model family [AOR = 2.23 (95% CI: 1.1, 4.6)] had higher odds of satisfaction with health extension services. CONCLUSION: Satisfaction with the health extension services was low among women in the study area. A better household monthly income, women's and their husbands' participation in health extension services and being a member of a model family were positively associated with their satisfaction. Interventions to enhance women's satisfaction in the health extension service need to focus on household-based involvement of them and their husbands in planning and implementing the services. Likewise, expansion of experiences of model families in the community would raise satisfaction levels.