Retention rate of vaccination card and its associated factors among vaccinated children aged 12─23 months in Ethiopia: Multilevel logistic regression analysis.

BACKGROUND: Vaccine card is a crucial tool for gauging vaccine coverage. It is imperative to hold these health cards to have well-fitted data which are crucial in reaching data-driven decisions in the era of immunization surveillance and monitoring processes. However, there is limited knowledge about the retention rate of vaccination card and its associated factors in Ethiopia. OBJECTIVE: This research aimed to assess the retention rate and associated factors of vaccination card in Ethiopia, using data from the 2016 Ethiopian demographic health survey. METHODS: This study included a total of 1304 (weighted) children aged 12─23 months who were vaccinated and provided with a vaccination card. We used a multilevel logistic regression model to analyze factors associated with vaccination card retention. We considered factors to be statistically significant if they had a p-value of less than 0.05 with a respective 95% confidence interval. RESULT: Among the cohort of 1,304 immunized children, it was observed that 684, representing 52.5% (95% CI: 49.7%─55.2%), were able to present their respective vaccination card during the interview time. According to the results of the multilevel logistic analysis, there is a considerable reduction in the rate of vaccination card retention by 65% (adjusted OR 0.35, 95% CI: 0.19─0.65) and 37% (adjusted OR 0.63, 95% CI: 0.4─0.91) for individuals who are rural residents and those who are fully vaccinated, respectively. Furthermore, it is noteworthy to mention that individuals originating from socio-economic backgrounds with low poverty levels exhibit a 59% increase in vaccination card possession (adjusted OR 1.59, 95% CI: 1.11─2.50). CONCLUSION: This study revealed a low rate of holding vaccination cards. Place of residency, wealth status, and vaccination status were factors that contributed to the change in the vaccination card retention rate. It is advisable to customize the interventional strategy by taking into account the individual's residency, immunization status, and degree of poverty within the community, to achieve a favorable rate of holding vaccination cards.

Healthcare Professionals' Attitude to Using Mobile Health Technology and Its Associated Factors in a Resource-Limited Country-An Implication for Digital Health Implementers: A Cross Sectional Study.

Background: Mobile health has become widely used within the healthcare system, and there is an increasing worldwide trend toward employing this innovation for behavior management, disease monitoring, the control and prevention of various health issues, and rising enrollment in healthcare services. Although mHealth is becoming more widely available, there is no evidence about the attitude of healthcare professionals toward mHealth in southwest Ethiopia. Therefore, this study is aimed at assessing the attitude of healthcare professionals to using mHealth technology and associated factors in Ethiopia. Methods: An institutional cross-sectional study was conducted among 422 healthcare professionals. Data were collected using a pretested interviewer-administered questionnaire, and the study was conducted from January 08 to February 10, 2023. EpiData Version 4.6 for entering the data and STATA Version 14 for analyzing the data were used. A multivariable logistic regression analysis was carried out to identify factors associated with healthcare professionals' attitudes to using mobile health technology. Results: A total of 415 study participants were included in the study. About 180 (43.4%) respondents had a favorable attitude toward mHealth technology in southwest public hospitals. Master's degree and above (adjusted odds ratio [AOR]: 3.67; 95% CI: 1.22, 4.10), good knowledge of mobile health technology (AOR: 4.08; 95% CI: 1.35, 5.31), more than 5 years of work experience (AOR: 3.09; 95% CI: 1.76, 5.60), had ICT infrastructure (AOR: 2.70; 95% CI: 1.38, 5.31), had own smart mobile (AOR: 3.67; 95% CI: 3.20, 4.31), and had taken computer-related training (AOR: 1.96; 95% CI: 1.03, 3.73) were positively associated with healthcare professionals' attitude to using mobile health technologies in southwest Ethiopia. Conclusions: Overall, healthcare professionals' attitude to using mobile health technologies in southwest Ethiopia was relatively low. Education level, good knowledge, years of work experience, ICT infrastructure, having a smart mobile, and having taken computer-related training were significant factors of attitude to using mobile health technologies. Considering these factors could provide insight into developing and adopting mobile health technologies in Ethiopia.

Spatial distribution and determinants of Early sexual initiation in Ethiopia.

INTRODUCTION: Early sexual initiation has negative health, social, and economic consequences for both women and future generations. The trend of early sexual initiation is increasing globally, leading to higher rates of sexually transmitted diseases and unplanned pregnancies. Ethiopia has been challenged various disasters that makes women vulnerable and position them at heightened risk of early sexual initiation in the last four years. The spatial patterns and factors of early sexual initiation in the post-conflict-post pandemic settings is not well understood. Hence this research aimed at mapping Spatial Patterns and identifying determinant factors in the Post-COVID-Post-Conflict Settings. METHODS: The study was conducted on secondary data from the PMA 2021 cross-sectional survey which conducted nationally from November 2021 to January 2022 which is in the post pandemic and post-war period. Total weighted sample of 6,036 reproductive age women were included in the analysis. ArcGIS Pro and SaTScan software were used to handle spatial analysis. Multilevel logistic regression model was used to estimate the effects of independent variables on early sexual initiation at individual and community level factors. Adjusted odds ratio with the 95% confidence interval was reported to declare the strength and statistical significance of the association. RESULT: The spatial distribution of early sexual initiation was clustered in Ethiopia with a global Moran's I index value of 0.09 and Z-score 6.01 (p-value < 0.001).Significant hotspots were detected in East Gojjam zone of Amhara region, Bale, Arsi, West Hararge, East Wellega and Horo Gudru Wellega zones of Oromia region. The odds of having early sexual initiation was higher in women with primary education (AOR = 1.23, 95%CI: 1.03, 1.47), secondary or above education (AOR = 4.36, 95%CI: 3.49, 5.44), Women aged 26 to 25 (AOR = 1.91, 95%CI: 1.61, 2.26), women aged 36 to 49(AOR = 1.51, 95%CI: 1.24, 1.84). However, there was a significant lower likelihood of early sexual initiation in rural resident women (AOR = 0.53, 95%CI: 0.35, 0.81) and women living in 5 to 7 family size (AOR = 0.79, 95%CI: 0.68, 0.92), and more than 7 members (AOR = 0.63, 95%CI: 0.49, 0.81). CONCLUSIONS: The spatial distribution of early sexual initiation was clustered in Ethiopia. Interventions should be taken to eliminate the observed variation by mobilizing resources to high-risk areas. Policies and interventions targeted to this problem may also take the identified associated factors into account for better results.

The association between children's exposure to pesticides and asthma, wheezing, and lower respiratory tract infections. A systematic review and meta-analysis.

Background: Exposure to pesticides is a global public health problem, especially for children. Its association with chronic respiratory disease among children has attracted considerable attention, but the existing evidence remains inconclusive and cannot be certain. Therefore, this systematic review and meta-analysis aim to determine the global pooled effect size of association with pesticide exposure and asthma, wheezing, and respiratory tract infections among children. Methods: A comprehensive search was conducted for relevant literature from electronic databases, including PubMed, Google Scholar, Hinari, Semantic Scholar, and Science Direct. Studies that provided effect size on the association between pesticide exposure and childhood asthma, wheezing, and respiratory tract infections in children were included. The articles were screened, data was extracted, and the quality of each study was assessed with four independent reviewers. Random effects models for significant heterogeneity and fixed effect models for homogeneous studies were conducted to estimate pooled effect sizes with 95% confidence intervals using Comprehensive Meta-Analysis version 3.3.070 and MetaXL version 2. Funnel plot and Higgins I 2 statistics were used to determine the heterogeneity of the included studies. Subgroup analyses were computed based on the types of pesticide exposure, study design, sample size category, and outcome assessment technique. Result: A total of 38 articles with 118,303 children less than 18 years of age were included in this meta-analysis. Pesticide exposure among children increased the risk of asthma by 24%; (OR = 1.24, 95% CI: 1.14-1.35) with extreme heterogeneity (I 2 = 81%, p < 0.001). Exposure to pesticides increased the odds of developing wheezing among children by 34% (OR = 1.34, 95% CI: 1.14-1.57), with high heterogeneity (I 2 = 79%, p < 0.001) and also increased the risk of developing lower respiratory tract infection by 79% (OR = 1.79, 95% CI: 1.45-2.21) with nonsignificant low heterogeneity (I 2 = 30%, p-value = 0.18). Conclusion: This meta-analysis provided valuable evidence supporting the association between childhood asthma, wheezing, and lower respiratory tract infection with pesticide exposure. The findings would contribute to a better understanding of the estimate of the effect of pesticide exposure on respiratory health in children and inform evidence-based preventive strategies and public health interventions.

Using geographically weighted regression analysis to assess predictors of home birth hot spots in Ethiopia.

BACKGROUND: Annually, 30 million women in Africa become pregnant, with the majority of deliveries taking place at home without the assistance of skilled healthcare personnel. In Ethiopia the proportion of home birth is high with regional disparity. Also limited evidence on spatial regression and deriving predictors. Therefore, this study aimed to assess the predictors of home birth hot spots using geographically weighted regression in Ethiopia. METHODS: This study used secondary data from the 2019 Ethiopian Mini Demographic and Health Survey. First, Moran's I and Getis-OrdGi* statistics were used to examine the geographic variation in home births. Further, spatial regression was analyzed using ordinary least squares regression and geographically weighted regression to predict hotspot area of home delivery. RESULT: According to this result, Somalia, Afar, and the SNNPR region were shown to be high risk locations for home births. Women from rural residence, women having no-education, poorest wealth index, Muslim religion follower, and women with no-ANC visit were predictors of home delivery hotspot locations. CONCLUSION: The spatial regression revealed women from rural resident, women having no-education, women being in the household with a poorest wealth index, women with Muslim religion follower, and women having no-ANC visit were predictors of home delivery hotspot regions. Therefore, governmental and other stakeholders should remain the effort to decrease home childbirth through access to healthcare services especially for rural resident, strengthen the women for antenatal care visits.

Micronutrient intake and associated factors among pregnant women in East Africa: Multilevel logistic regression analysis.

BACKGROUND: Micronutrient deficiencies during pregnancy pose significant public health issues, considering the potential for negative consequences not only during pregnancy but also throughout life. Anemia in pregnant women is becoming a significant problem in developing countries, with scientific evidence indicating that 41.8 percent of women worldwide suffer from anemia. As a result, investigating the pooled prevalence and factors associated with micronutrient intake among pregnant women in East Africa is critical to alleviate the burden of micronutrient deficiency among pregnant women. METHOD: The pooled prevalence of micronutrient intake with a 95% Confidence Interval (CI) was reported and presented in a forest plot for East Africa Countries using STATA version 14.1. Intra-class Correlation Coefficient (ICC), Likelihood Ratio (LR) test, Median Odds Ratio (MOR), and deviance (-2LLR) values were used for model comparison and fitness. Adjusted Odds Ratios (AOR) with a 95% Confidence Interval (CI) and p-value ≤0.05 in the multilevel logistic model were used to declare significant factors associated with micronutrient intake. RESULT: The pooled prevalence of micronutrient intake in East African countries was 36.07% (95% CI: 35.82%, 36.33%). In the multilevel logistic regression model, women from the highest wealth quintile were 1.06 [AOR = 1.09, 95%CI: 1.00, 1.11] more likely to take micronutrients compared to their counterparts. Mothers who attained primary education, secondary education, and tertiary education had 1.20 times [AOR = 1.20, 95% CI: 1.15, 1.26], 1.28 times [AOR = 1.28, 95% CI: 1.19, 1.36] and 1.22 times [AOR = 1.22, 95% CI: 1.07, 1.38] more likely take micronutrient compared to mothers who attained no education, respectively. CONCLUSION: The overall prevalence of micronutrient intake in East Africa was low. Only 36% of the study participants had micronutrient intake practice. Socioeconomic factors (education level, and household wealth status) have been shown to influence micronutrient intake. Therefore, it is necessitates the continuation of ongoing projects as well as the development of fresh ones that concentrate on these variables and include effective treatments and programs, especially among underprivileged and vulnerable populations.

Pooled prevalence and associated factors of pregnancy termination among youth aged 15-24 year women in East Africa: Multilevel level analysis.

BACKGROUND: Most of unwanted pregnancies among adolescent girls and young women (AGYW) in Africa result in pregnancy termination. Despite attempts to enhance maternal health care service utilization, unsafe abortion remains the leading cause of maternal death in Sub-Saharan Africa (SSA), there is still a study gap, notably in East Africa, where community-level issues are not studied. Therefore, this study aimed to assess pooled prevalence pregnancy termination and associated factors among youth (15-24 year-old) women in the East Africa. METHODS: The study was conducted based on the most recent Demographic and Health Surveys (DHS) in the 12 East African countries. A total weighted sample of 44,846 youth (15-24) age group women was included in this study. To detect the existence of a substantial clustering effect, the Intra-class Correlation Coefficient (ICC), Median Odds Ratio (MOR), and Likelihood Ratio (LR)-test were used. Furthermore, because the models were nested, deviance (-2LLR) was used for model comparison. In the multilevel logistic model, significant factors related to pregnancy termination were declared using Adjusted Odds Ratios (AOR) with a 95%Confidence Interval (CI) and p-value of 0.05. RESULT: The pooled prevalence of pregnancy termination in East African countries was 7.79% (95% CI: 7.54, 8.04) with the highest prevalence in Uganda 12.51% (95% CI: 11.56, 13.41) and lowest was observed in Zambia 5.64% ((95% CI: 4.86, 6.41). In multilevel multivariable logistic regression result, age 20-24 [AOR = 1.93; 95% CI: 1.71, 2.16], media exposure [AOR = 1.22; 95% CI: 1.12, 1.34], married [AOR = 1.32, 95% CI: 1.21, 1.43], had working [AOR = 1.13; 95% CI: 1.04, 1.23],no education[AOR = 3.98, 95% CI: 2.32, 6.81], primary education [AOR = 4.05, 95% CI: 2.38, 6.88], secondary education [AOR = 2.96, 95% CI: 1.74, 5.03], multiparous [AOR = 0.85; 95%CI: 0.79, 0.93], sexual initiation greater or equal to 15 [AOR = 0.82; 95%CI: 0.74, 0.99] were significantly associated with pregnancy termination. CONCLUSION: The pooled prevalence of pregnancy termination in East Africa was high in this study. Maternal age, marital status, education status, parity, age at first sex, media exposure, working status and living countries were significantly associated with pregnancy termination. The finding provides critical information for developing health interventions to decrease unplanned pregnancies and illegal pregnancy termination.

Determinants of change in unintended pregnancy in Ethiopia using the 2005 and 2016 EDHS: non-linear multivariable decomposition analysis.

BACKGROUND: Unintended pregnancy is a pregnancy either mistimed or unwanted. The main consequence of unintended pregnancy is inducing abortion. In Ethiopia, more than half of unintended pregnancies end up in abortion. OBJECTIVE: This study aims to measure the change in unintended pregnancy among women of reproductive age between survey years 2005 and 2016 and to identify the socio-demographic factors that most significantly contributed to the change. METHODS: Data from the two most recent Ethiopian Demographic and Health Surveys (EDHS) were analyzed. We quantified the contribution of socio-demographic factors in the change of unintended pregnancy, using Oaxaca-Blinder decomposition for non-linear regression models by applying the STATA command 'mvdcmp'. RESULT: Unintended pregnancy decreased from 37% in 2005 to 27% in 2016 in Ethiopia. Both changes in population characteristics and coefficient were the contributing elements to the observed change in unintended pregnancy. Among population characteristics factors, being a partial decision-maker and being a slum in the Somali region contributed 10 and 14% to the change of unintended pregnancy between the 2005 and 2016. Of the coefficient factors, knowledge of modern family planning, being a partial decision-maker, media exposure, distance to health facilities, and health facility visits contributed to the change by 93, 43, 17, and 10% respectively. CONCLUSION: The majority of the change in unintended pregnancy from 2005 to 2016 survey was due to differences in coefficients (85%). The principal contributing factors to the change of unintended pregnancy were FP knowledge, decision making, media exposure and health facility visits. Therefore, an interventional plan will be efficient, better, and more effective if focused on the larger contributing factors.

Spatial variation of overweight/obesity and associated factor among reproductive age group women in Ethiopia, evidence from EDHS 2016.

BACKGROUND: Globally, at least 4.7 million people die from being overweight or obese. In Ethiopia, the level of overweight and obesity among women grew from 3% to 8%. However, as far as my literature searching, studies concerning the spatial variation of overweight/obesity and factors associated are not researched in Ethiopia using geospatial techniques. Therefore, this study aimed to explore the spatial variation of overweight/obesity and factor associated among reproductive age group women in Ethiopia using geospatial techniques. MOTHED: A total weighted sample of 10,928 reproductive age women were included in the study. ArcGIS version10.7 was used to explore the spatial variation of overweight/obesity. Bernoulli based model was used to analyze the purely spatial cluster detection of overweight/obesity through SaTScan version 9.6.1 software. Ordinary Least Square analysis and geographically weighted regression analysis was employed to assess the association between an outcome variable and explanatory variables by using ArcGIS 10.7 software. P value of less than 0.05 was used to declare statically significant. RESULT: The spatial distribution of overweight/obesity in Ethiopia was clustered. Statistically, a significant-high hot spot overweight/obesity was identified at Addis Ababa, harrari, Dire Dawa. SaTScan identified 66 primary spatial clusters (RR = 4.17, P < 0.001) located at Addis Ababa, southeast amhara, central part of oromia region and northern part of SNNP region. In geographically weighted regression, rich wealth index, women's age (35-39 and 40-44 years), watching TV, internet use and not working were statistically significant that affecting spatial variation of overweight/obesity. CONCLUSION: In Ethiopia, overweight/obesity varies across the region. Statistically, significant-high hot spots of overweight/obesity were detected in Addis Ababa, Harari, Dire Dawa, some parts of Amhara and afar region, most of the Oromia and Somalia region, and the South Nation Nationality and People region of Ethiopia. Therefore, the ministry of health and the Ethiopian public health institute, try to initiate policies and practices that could include providing funding for physical education as well as recreational centers in communities most in need. In addition, public and private mass media create awareness of healthy lifestyles is promoted by health education regarding increased physical activity and reduced sedentary behavior through various media platforms.

Modeling spatial determinants of initiation of breastfeeding in Ethiopia: A geographically weighted regression analysis.

BACKGROUND: The World Health Organization (WHO) encourages breastfeeding to begin within the first hour after birth in order to save children's lives. In Ethiopia, different studies are done on the prevalence and determinants of breastfeeding initiation, up to our knowledge, the spatial distribution and the spatial determinants of breast feeding initiation over time are not investigated. Therefore, the objectives of this study were to assess spatial variation and its spatial determinant of delayed initiation of breastfeeding in Ethiopia using Geographically Weighted Regression (GWR). METHODS: A cross-sectional study was undertaken using the nationally representative 2016 Ethiopian Demographic and Health Survey (EDHS) dataset. Global Moran's I statistic was used to measure whether delayed breastfeeding initiation was dispersed, clustered, or randomly distributed in study area. Ordinary Least Squares (OLS) regression was used to identify factors explaining the geographic variation in delayed breastfeeding initiation. Besides, spatial variability of relationships between dependent and selected predictors was investigated using geographically weighted regression. RESULT: A total weighted sample of 4169 children of aged 0 to 23 months was included in this study. Delayed initiation of breastfeeding was spatially varies across the country with a global Moran's I value of 0.158 at (p-value<0.01). The hotspot (high risk) areas were identified in the Amhara, Afar, and Tigray regions. Orthodox religion, poor wealth index, caesarian section, baby postnatal checkup, and small size of a child at birth were spatially significant factors for delayed breastfeeding initiation in Ethiopia. CONCLUSION: In Ethiopia initiation of breastfeeding varies geographically across region. A significant hotspot was identified in the Amhara, Afar, and Tigray regions. The GWR analysis revealed that orthodox religion, poor wealth index, caesarian section, baby postnatal checkup, and small birth weight were spatially significant factors.

Trends and predictors of change of unmet need for family planning among reproductive age women in Ethiopia, based on Ethiopian demographic and health surveys from 2005-2016: Multivariable decomposition analysis.

BACKGROUND: By spacing births and preventing unintended pregnancies, family planning is a crucial technique strategy for controlling the fast expansion of the human population. It also improves maternal and child health. women who are thought to be sexually active but who do not use modern contraception methods, who either do not want to have any more children (Limiting) or who want to delay having children for at least two years are considered to have an unmet need for family planning (Spacing). OBJECTIVE: This study carried out to determine which socio-demographic factors are the key contributors to the discrepancies in the unmet need for family planning among women of reproductive age between surveys years 2005 and 2016. METHODS: The data for this study arrived from the Ethiopia Demographic Health Surveys in 2005, 2011, and 2016 to investigate trends and Predictors of change of unmet need for family planning among reproductive age women in Ethiopia. Pooled weighted sample of 26,230 (7761 in 2005, 9136 in 2011 and 9,333 in 2016 Ethiopian demographic health surveys) reproductive-age women were used for this study. For the overall trend (2005-2016) multivariable decomposition analysis for non-linear response outcome was calibrated to identify the factors that contributed to the change of unmet need for family planning. The Logit based multivariable decomposition analysis utilizes the output from the logistic regression model to assign the observed change in unmet need for family planning over time into two components. Stata version 16.0 was used to analyze the data. RESULT: The percentage of Ethiopian women of reproductive age who still lack access (unmet need) for family planning declined from 39.6% in 2005 to 23.6 percent in 2016. The decomposition analysis revealed that the change of unmet need for family planning was due to change in characteristics and coefficients. The difference in coefficients accounted for around nine out of 10 variations in unmet family planning need. Education level, birth order, and desired number of children were all factors that changed over the course of the last 11 years in relation to the unmet need for family planning. CONCLUSION: Between 2005 and 2016, there were remarkable changes in unmet need for family planning. Women with birth orders of five and up, women with secondary education, and women who wanted fewer children overall were the main causes of the change in unmet need for family planning.

Pooled prevalence and associated factors of diarrhea among under-five years children in East Africa: A multilevel logistic regression analysis.

BACKGROUND: Worldwide, diarrhea is the second most common cause of death and morbidity among under -five years' children. In sub-saran Africa, access to water, sanitation, and hygiene are very scanty and the burden of diarrhea diseases is countless relative to the rest of the world. Prior studies conducted in East Africa vary in design, sample size, and other data collection tools. Through those studies, it is hard to make regional comparisons. Combining datasets that are studied on similar people and having common variable identified enhances statistical power due to the large sample size, advance the ability to compare outcomes, and create the opportunity to develop new indicators. Hence, this study aimed to assess the prevalence and associated factors of diarrhea among under five years' children using the most recent national representative Demographic and Health Surveys from 12 East African countries. The information generated from this pooled datasets will give good insight into the sub-regional prevalence of diarrhea. METHODS: This study utilized secondary data from 12 East African countries' most recent demographic health survey. Variables were extracted and appended together to assess the pooled prevalence of diarrhea and associated factors. A total of 90,263 under-five years of age children were encompassed in this study. STATA version was used to cross-tabulate and fit the models. To account for the hierarchical nature of the demographic health survey, multilevel logistic regression was calibrated. BIC, AIC, deviance, and LLR were used as Model comparison parameters. Variables with a p-value of <0.2 were considered for multivariable analysis. Adjusted odds ratio with 95% CI and p-value <0.05 were used to declare statistical significances of factors. RESULTS: The pooled prevalence of diarrhea in under five years children was 14.28% [95%CI; 14.06%, 14.51%]. Being child whose mother age is 15-24 years [AOR = 1.41, 95% CI; 1.33, 1.49], 25-34 years[AOR = 1.17, 95%CI; 1.10, 1.23], being 7-12 months child [AOR = 3.10, 95%CI; 2.86, 3.35], being 12-24 months child [AOR = 2.56, 95%CI; 2.38, 3.75], being 25-59 months child [AOR = 0.88, 95%CI; 0.82, 0.95], being child from poor household [AOR = 1.16, 95%CI; 1.09, 1.23], delayed breast feeding initiation (initiated after an hour of birth) [AOR = 1.15, 95%CI; 1.10, 1.20], and being a child from community with low educational status [AOR = 1.10, 95%CI; 1.03, 1.18] were factors associated with diarrheal diseases. CONCLUSION: The pooled prevalence of diarrhea among under five years of children in East African countries is high. Maternal age, child's age, wealth status of the household, the timing of breast feeding initiation, sex of the child, community level of educational status, working status of the mother, and the number of under five children were factors that were associated with diarrheal diseases. Scaling up of maternal and child health services by government and other concerned bodies should consider those economically marginalized communities. Additionally, awareness should be created for those uneducated mothers concerning the nature of childhood diarrhea.

Healthcare providers' readiness for electronic health record adoption: a cross-sectional study during pre-implementation phase.

BACKGROUND: The adoption of an electronic health record (EHR) in the healthcare system has the potential to make healthcare service delivery effective and efficient by providing accurate, up-to-date, and complete information. Despite its great importance, the adoptions of EHR in low-income country settings, like Ethiopia, were lagging and increasingly failed. Assessing the readiness of stakeholders before the actual adoption of EHR is considered the prominent solution to tackle the problem. However, little is known about healthcare providers' EHR readiness in this study setting. Accordingly, this research was conducted aiming at examining healthcare providers' readiness for EHR adoption and associated factors in southwestern Ethiopia. METHODS: An institutional-based cross-sectional study was conducted from September 1 to October 30, 2021. A total of 423 healthcare providers working in public hospitals were selected using a simple random sampling technique. Multivariable logistic regression was fitted to identify determinant factors of overall healthcare providers' readiness after the other covariates were controlled. RESULT: In this study, the overall good readiness level of EHR adoption was 52.8% (n = 204) [95% CI of 47.9% to 56.6%]. Age, computer literacy, computer access at health facilities, attitude towards EHRs, awareness about EHRs, perceived benefit, and perceived technology self-efficacy were significantly associated with the overall health care providers' readiness for the adoption of EHR using a cut point of P-value less than 0.05. CONCLUSION: Around half of the respondents had a good level of overall healthcare providers' readiness for the adoption of EHR which was considered inadequate. This finding implied that a huge effort is required to improve readiness before the actual implementation of EHRs. The finding implied that younger-aged groups were more ready for such technology which in turn implied; the older one needs more concern. Enhancing computer literacy, confidence building to raise self-efficacy of such technology, addressing the issue of computer availability at health facilities, building a positive attitude, awareness campaign of EHR, and recognizing the usefulness of such systems were the necessary measures to improve EHR readiness in this setting. Additionally, further studies are recommended to encompass all types of EHR readiness such as organizational readiness, technology readiness, societal readiness, and so on. Additionally, exploring the healthcare provider opinion with qualitative study and extending the proposed study to other implementation settings are recommended to be addressed by future works.

Vaccination status and factors associated among children age 12-23 months in Ethiopia, based on 2016 EDHS: Logit based multinomial logistic regression analysis.

BACKGROUND: Childhood immunization is one of the most cost-effective prevention measures for children's mortality and morbidity, saving 2-3 million lives per year. In Ethiopia, under-five mortality rates, about 190,000 children die each year. Different research conducted in Ethiopia on childhood vaccination have focused on either vaccination coverage of individual vaccine or complete and incomplete vaccination. As far as my literature searching, studies separated the vaccination status into non-vaccinated, partially vaccinated and full vaccinated and assorted factors among children age 12-23 month in Ethiopia were limited. Therefore, the aim of this study was to identify factors associated with vaccination status among children 12-23 months of age in Ethiopia. METHOD: A secondary data analysis was done based on the 2016 Ethiopian Demographic and Health Survey (EDHS). A total weighted sample of 1911 children age 12-23 months of age were included in the study. Logit based Multinomial logistic regression analysis was computed to distinguish factors associated with routine vaccination of children aged 12-23 months. P-value less than 0.05 was used to declare statistical significance of each independent variables, and adjusted odd ratio (AOR) with 95% confidence interval were used to present the result and STATA 14 was utilized for data management and analysis. RESULT: Overall the prevalence of full vaccinated children was 35%, while 49% of children were partially vaccinated and 16% were non-vaccinated. In multinomial analysis, having focused ANC (at least four visits) contrasted to no ANC visits at all had 9.7 higher odd of being fully vaccinated than not vaccinated [AOR = 9.74, 95% CI = 3.52-26.94], and 5 times higher odd of being partially vaccinated than not vaccinated [AOR = 4.97, 95% CI = 2.00-12.33]. CONCLUSION: The present study found that childhood full vaccination status was low compared with the World Health Organization targets. Frequency of ANC visit and visited by field worker were significantly associated both partially and full vaccination whereas, visited health facility last 12 months and wealth status were significantly associated with childhood full vaccination.