Antenatal care service satisfaction and associated factors among pregnant women at public health facilities of Wogera district, Northwest Ethiopia: a cross-sectional study.

Background: Pregnant women's satisfaction with Ante-Natal Care (ANC) is crucial for improving its quality and providing standardized healthcare services. However, studies on pregnant women's satisfaction with antenatal care and associated factors are limited in Ethiopia, particularly in the study area. Therefore, this study aimed to assess satisfaction and associated factors among pregnant women receiving antenatal care in Wogera district. Methods: A facility-based cross-sectional study was conducted in Wogera district from March to April 2024. A total of 458 pregnant women who attended ANC at health facilities were included in the study. Interviewer -administered structured questionnaire was used to obtain the necessary information for this study and systematic random sampling was used to select the study participants. Multivariable and binary logistic regression analysis was used to identify the effect of each independent variable on the outcome (satisfaction). Results: The overall satisfaction of antenatal care services among pregnant women was 92.1% (95% CI: 89.5, 94.5%). The majority (98.3%) of them were satisfied by the provider's greeting and 97.8% were satisfied by the cost of service but pregnant women were less satisfied by waiting time to see the health workers, cleanness of the toilet, and water supply. Satisfaction of pregnant women was associated with housewife occupational status [AOR = 3.05, 95% CI: 1.02, 9.15], civil servants occupational status [AOR = 4.02, 95% CI: 1.02, 15.85], age ≥25 [AOR = 2.78, 95% CI: 1.05, 1.74], advice on family planning [AOR = 7.29, 95% CI: 3.08, 17.05], one ANC visit [AOR = 3.61, 95% CI: 1.84, 8.74] and the respondents pregnant women who have ≥2 pregnancy [AOR = 4.55, 95% CI: 1.88, 11.03] were the predictors of level of satisfaction. Conclusion: Pregnant women's satisfaction with antenatal care was high, influenced by factors such as having two or more pregnancies, timing of the first ANC visit, family planning advice, age ≥25 years, and being a housewife or civil servant. Efforts should focus on reducing wait times, ensuring clean water access, and improving latrine hygiene at healthcare facilities to sustain this satisfaction. Specifically, facilities should streamline appointments, maintain safe drinking water sources, and upgrade toilets for better comfort and hygiene.

Trend and determinants of minimum dietary diversity consumption change among children aged 6-23 months in Ethiopia from 2011 to 2019: A multivariate decomposition analysis.

BACKGROUND: Sustainable Development Goals 2 target 2.2 aimed to end all forms of malnutrition by 2030. However, the prevalence of inadequate minimum dietary diversity (MDD) is high in Ethiopia and the evidence of trends and determinants of MDD consumption change among children over time is limited. Therefore, this study aimed to determine trends and determinants of MDD consumption change among children aged 6 to 23 months in Ethiopia from 2011-2019 Demographic and Health Survey (DHS) data. METHOD: The study used the data on nationally representative weighted samples of 6,971, 7,467, and 3,154 children aged 6-23 months from the 2011, 2016, and 2019 rounds of the DHS. Trend and Multivariate Decomposition analysis was conducted to determine MDD consumption change from 2011-2016, and 2016-2019 into two components: one that was explained by differences in the level of the determinants (endowment), and the other component was explained by differences in the effect of the covariates on the outcome (coefficient effects). RESULT: The trends analysis showed that adequate MDD consumption significantly increased from 2% to 10.41% from 2011 to 2016 but decreased from 10.41% to 7.11% from 2016 to 2019 in Ethiopia. The compositional and behavioral change factors like maternal age, occupational status of parents, sex of the household head, wealth index, residence, and sex of child statistically contributed to changes in MDD consumption from 2011 to 2016, and from 2016 to 2019 at p-value <0.05. CONCLUSION: The trend of minimum dietary diversity consumption among children aged 6 to 23 months in Ethiopia increased from 2011-2016 and decreased from 2016-2019 in the last decade. The study revealed that the changes in behavioral response and population composition contributed to MDD consumption change among children in Ethiopia. The finding highlights the urgent need for targeted interventions and policies to address the issue of MDD consumption change among young children due to population structure changes like wealth status, residence, and behavioral response related to employment, household head, and sex of the child in Ethiopia. Therefore, efforts should be geared to reduce poverty and improve maternal employment status, particularly for women, by producing equitable economic opportunities.

Rural-urban disparity in community-based health insurance enrollment in Ethiopia: a multivariate decomposition analysis using Ethiopian Mini Demographic Health Survey 2019.

Background: In sub-Saharan Africa, achieving universal health coverage (UHC) and protecting populations from health-related financial hardship remain challenging goals. Subsequently, community-based health insurance (CBHI) has gained interest in low and middle-income countries, such as Ethiopia. However, the rural-urban disparity in CBHI enrollment has not been properly investigated using multivariate decomposition analysis. Therefore, this study aimed to assess the rural-urban disparity of CBHI enrollment in Ethiopia using the Ethiopian Mini Demographic Health Survey 2019 (EMDHS 2019). Methods: This study used the latest EMDHS 2019 dataset. STATA version 17.0 software was used for analyses. The chi-square test was used to assess the association between CBHI enrollment and the explanatory variables. The rural-urban disparity of CBHI enrollment was assessed using the logit-based multivariate decomposition analysis. A p-value of <0.05 with a 95% confidence interval was used to determine the statistical significance. Results: The study found that there was a significant disparity in CBHI enrollment between urban and rural households (p < 0.001). Approximately 36.98% of CBHI enrollment disparities were attributed to the compositional (endowment) differences of household characteristics between urban and rural households, and 63.02% of the disparities were due to the effect of these characteristics (coefficients). The study identified that the age and education of the household head, family size, number of under-five children, administrative regions, and wealth status were significant contributing factors for the disparities due to compositional differences between urban and rural households. The region was the significant factor that contributed to the rural-urban disparity of CBHI enrollment due to the effect of household characteristics. Conclusion: There were significant urban-rural disparities in CBHI enrollment in Ethiopia. Factors such as age and education of the household head, family size, number of under-five children, region of the household, and wealth status of the household contributed to the disparities attributed to the endowment, and region of the household was the contributing factor for the disparities due to the effect of household characteristics. Therefore, the concerned body should design strategies to enhance equitable CBHI enrollment in urban and rural households.

Multilevel analysis of healthcare utilization for childhood diarrhea in high under five mortality countries.

Globally, 4.9 million under-five deaths occurred before celebrating their fifth birthday. Four in five under-five deaths were recorded in sub-Saharan Africa and Southern Asia. Childhood diarrhea is one of the leading causes of death and is accountable for killing around 443,832 children every year. Despite healthcare utilization for childhood diarrhea has a significant effect on the reduction of childhood mortality and morbidity, most children die due to delays in seeking healthcare. Therefore, this study aimed to assess healthcare utilization for childhood diarrhea in the top high under-five mortality countries. This study used secondary data from 2013/14 to 2019 demographic and health surveys of 4 top high under-five mortality countries. A total weighted sample of 7254 mothers of under-five children was included. A multilevel binary logistic regression was employed to identify the associated factors of healthcare utilization for childhood diarrhea. The statistical significance was declared at a p-value less than 0.05 with a 95% confidence interval. The overall magnitude of healthcare utilization for childhood diarrhea in the top high under-five mortality countries was 58.40% (95% CI 57.26%, 59.53%). Partner/husband educational status, household wealth index, media exposure, information about oral rehydration, and place of delivery were the positive while the number of living children were the negative predictors of healthcare utilization for childhood diarrhea in top high under-five mortality countries. Besides, living in different countries compared to Guinea was also an associated factor for healthcare utilization for childhood diarrhea. More than four in ten children didn't receive health care for childhood diarrhea in top high under-five mortality countries. Thus, to increase healthcare utilization for childhood diarrhea, health managers and policymakers should develop strategies to improve the household wealth status for those with poor household wealth index. The decision-makers and program planners should also work on media exposure and increase access to education. Further research including the perceived severity of illness and ORS knowledge-related factors of healthcare utilization for childhood diarrhea should also be considered by other researchers.

Adherence to Standard Precautions and Associated Factors Among Healthcare Workers at Public and Private Hospitals in Northeast Ethiopia.

Introduction: Standard precautions are crucial for infection control in healthcare. Studies show public hospitals' adherence, but data on private hospitals are scarce. Understanding this disparity is vital for safety, policy, and better patient outcomes. Hence, this study aimed to assess precautions and associated factors among healthcare workers at public and private hospitals in Northeast Ethiopia. Methods: A comparative cross-sectional study compared healthcare institutions. A total of 470 workers participated via stratified random sampling. Data collection used a pre-tested questionnaire and observation checklist. Epi data managed entry, while STATA analyzed. Binary logistic regression determined significance (P<0.05) for variables. Results: The overall adherence to standard precautions was 51.6% (95% confidence interval (CI): 46.9-56.2). At public and private hospitals, it was 52.2% (95% CI: 45.6-58.6) and 60.4% (95% CI: 53.9-66.9), respectively. In public hospitals adherence was affected by female sex [adjusted odds ratio (AOR): 2.58; 95% CI: 1.32-5.02], availability of written guidelines [AOR: 3.10; 95% CI: 1.62-5.94], having good knowledge [AOR: 2.05; 95% CI: 1.03-4.11] and favorable attitude towards standard precautions [AOR: 2.21; 95% CI: 1.14-4.27]. In private hospitals, it was affected by the availability of running tape water [AOR: 2.36; 95% CI: 1.10-5.04], personal protective equipment (AOR: 2.22; 95% CI; 1.01-4.93), color-coded dust bins [AOR: 2.33; 95% CI: 1.04-5.21], having good knowledge [AOR: 2.10; 95% CI: 1.07-4.13] and favorable attitude [AOR: 2.63; 95% CI: 1.39-4.97]. Conclusion: The adherence to standard precautions was higher among private than public hospital healthcare workers in Dessie City, Ethiopia. Thus, ensuring adequate availability of personal protective equipment, safety materials, and running tap water in working rooms, particularly in public hospitals is highly recommended. The initiatives aimed at promoting adherence to standard precautions should be designed and put into action for public hospitals.

Measuring socioeconomic inequalities in postnatal health checks for newborns in Ethiopia: a decomposition analysis.

Background: Addressing health inequity is a top priority for achieving sustainable development goals. The existing evidences in Ethiopia have shown that there are substantial inequalities in the use of health services among various socioeconomic strata. Therefore, the present study aimed to measure socioeconomic inequalities and the contributing factors in postnatal health checks for newborns in Ethiopia. Methods: We used a secondary data from the recent 2019 Ethiopia Mini Demographic and Health Survey dataset. The study includes a weighted sample of 2,105 women who gave birth in the 2 years preceding to the survey. The study participants were selected using two stage cluster sampling techniques. The socioeconomic inequality in postnatal health checks for newborns was measured using the Erreygers Normalized Concentration Index (ECI) and illustrated by the concentration curve. A decomposition analysis was done to identify factors contributing to the socioeconomic related inequality in postnatal health checks for newborns in Ethiopia. Results: The concentration curve of postnatal health checks for newborns lay below the line of equality, and the Erreygers normalized concentration index was 0.133, with a standard error = 0.0333, and a p value <0.001; indicating that the postnatal health check for newborns was disproportionately concentrated among newborns with higher socioeconomic status. The decomposition analysis reported that antenatal care (ANC) visit (59.22%), household wealth index (34.43%), and educational level of the mother (8.58%) were the major contributors to the pro-rich socioeconomic inequalities in postnatal health checks for newborns. Conclusion: The finding revealed that there is a pro-rich inequality in postnatal health checks for newborns in Ethiopia. To reduce the observed socioeconomic health inequality, the government needs to improve ANC visits, implement strategies to access health service for economically disadvantaged groups, and increase educational attainment among women.

Only 9% of mothers have eight and more ANC visit in 14 sub-saharan African countries; evidence from the most recent DHS 2018-2023: a multilevel analysis.

BACKGROUND: The world health organization's global health observatory defines maternal mortality as annual number of female deaths, regardless of the period or location of the pregnancy, from any cause related to or caused by pregnancy or its management (aside from accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy and an estimated 287 000 women worldwide passed away from maternal causes between 2016 and 2020, that works out to be about 800 deaths per day or about one every two minutes. METHOD: The most recent 2018-2023 DHS data set of 14 SSA countries was used a total of 89,489 weighted mothers who gave at list one live birth 3 years preceding the survey were included, a multilevel analysis was conducted. In the bi-variable analysis variables with p-value ≤ 0.20 were included in the multivariable analysis, and in the multivariable analysis, variables with p-value less than ≤ 0.05 were considered to be significant factors associated with having eight and more ANC visits. RESULT: The magnitude of having eight and more ANC visits in 14 sub-Saharan African countries was 8.9% (95% CI: 8.76-9.13) ranging from 3.66% (95% CI: 3.54-3.79) in Gabon to 18.92% (95% CI: 18.67-19.17) in Nigeria. The multilevel analysis shows that maternal age (40-44, AOR;2.09, 95%CI: 1.75-2.53), maternal occupational status (AOR;1.14, 95%CI; 1.07-1.22), maternal educational level (secondary and above, AOR;1.26, 95%CI; 1.16-1.38), wealth status(AOR;1.65, 95%CI; 1.50-1.82), media exposure (AOR;1.20, 95%CI; 1.11-1.31), pregnancy intention (AOR;1.12, 95%CI; 1.05-1.20), ever had terminated pregnancy (AOR;1.16 95%CI; 1.07-1.25), timely initiation of first ANC visit (AOR;4.79, 95%CI; 4.49-5.10), empowerment on respondents health care (AOR;1.43, 95%CI; 1.30-1.56), urban place of residence (AOR;1.33, 95%CI; 1.22-1.44) were factors highly influencing the utilization of AN. On the other hand higher birth order (AOR;0.54, 95%CI; 0.53-0.66), not using contraceptive (AOR;0.80, 95%CI; 0.75-0.86) and survey year (AOR;0.47, 95%CI; 0.34-0.65) were factors negatively associated with having eight and more ANC visits. CONCLUSION: In the 14 SSA included in this study, there is low adherence to WHO guidelines of eight and more ANC visits. Being educated, having jobs, getting access to media being from rural residence and rich wealth group contribute to having eight and more ANC visits, so we highly recommend policy implementers to advocate this practices.

Work engagement among health professionals in public health facilities of Bench-Sheko zone, southwest Ethiopia.

BACKGROUND: The level of health professional work engagement affects retention, burnout, job satisfaction, patient satisfaction, and outcomes; however, there is a paucity of evidence that benefit health professional work engagement. Therefore, this study aimed to assess work engagement and associated factors among health professionals at public health facilities in the Bench-Sheko zone in southwest Ethiopia. METHODS: Facility-based cross-sectional study was conducted among 605 health professionals from 29 March to 29 April 2021. A simple random sampling technique was used to select the participants. Data were collected using a self-administered questionnaire. Linear regression was fitted and those variables with p-value < 0.2 in simple linear regression were entered into multiple linear regression analysis. Unstandardized ß-coefficient with 95% CI and p-value < 0.05 were used as the cut of points to determine the factors associated with work engagement. RESULTS: Mean score percentage of work engagement was 71.8%. Health center staff (ß = 0.31; 95% CI: 0.22, 0.40), married professionals (ß = 0.10; 95% CI: 0.005, 0.17), co-worker support (ß = 0.06; 95% CI: 0.004, 0.11), role clarity (ß = 0.14; 95% CI: 0.07, 0.21), reward (ß = 0.10; 95% CI: 0.05, 0.15), resilience (ß = 0.14 95%; CI: 0.07, 0.21), self-efficacy (ß = 0.24; 95% CI: 0.16, 0.31) and optimism (ß = 0.20; 95% CI: 0.15, 0.26) were positively associated with work engagement. On the contrary, cognitive demand (ß= -0.06; 95% CI: -0.11, -0.01) was negatively associated with work engagement. CONCLUSION: In this study, health professionals had a moderate level of work engagement. Health facilities shall improve their culture of co-worker support, role clarity, reward, resilience, self-efficacy, and optimism to enhance work engagement. Future researchers shall be done further studies to evaluate the relationship between cognitive demand and work engagement among health professionals.

Outcome evaluation of WASH intervention in rural households at Jawi district, Northwest Ethiopia: Mixed method design, goal based evaluation.

BACKGROUND: The government of Ethiopia revealed that GTP II and SDG were achieved through one Water Sanitation and Hygiene (WASH) program. According to the 2016 Ethiopian Demographic and Health survey, the rural population was more affected by poor sanitation and hygiene. To address this Ethiopian government ratified Rural WASH sanitation and hygiene promotion through a community-centered approach, and to improve WASH service evidence on the effectiveness of an intervention at the household level is needed in developing countries. However, in our country one WASH in rural areas called community centered approach intervention was planned and delivered for 3 years (2018-2020) Nevertheless, as to our review and researchers knowledge, the outcome of this intervention is not evaluated yet in our country as well as in this evaluation study area. METHOD: The evaluation was conducted in rural households of Jawi district by a Quasi-experimental design supplemented with a qualitative in-depth interview, from 01/14/2021-3/28/2021 and 4/22/2021-5/25/2021 for quanitative and qualitative study, respectively. Intervention groups were households that took WASH intervention while the controls did not. The evaluation approach was summative and counterfactual plus participatory and focuses on program outcome. A total of 1280 households were selected using two stage sampling with lottery method simple random sampling. We collected quantitative data through survey and structured observational checklist, while qualitative data through key informant interviews using a semi-structured questionnaire. We assessed program effectiveness and also the analytical study was conducted through propensity score matching to assess program effect through Stata 14.1. Qualitative data were transcribed and translated to English and thematic analysis was done using Atlas.ti.9. RESULT: The overall program effectiveness was very good but the effectiveness in handwashing before eating using soap and water was poor. Also, this intervention increased water treatment utilization in 41.7% point (ATT=0.417, 95% CI= 0.356, 0.478), 24.3% point (ATT =0.243, 95%CI=0.180, 0.300) in exclusive latrine utilization, 41.9% point (ATT=0.419, 95%CI = 0.376, 0.470) in handwashing using water and soap before eating, 50.2% point(ATT=0.502, 95%CI=0.450, 0.550) in handwashing after defecation by using water and soap in intervention households. Our qualitative finding revealed that unable to afford soap and their working place far away from their home were the most frequent reason reported by the respondent for not using soap for hand washing and latrine utilization respectively CONCLUSIONS: This intervention should be scale-up and pay greater attention and deliver innovative strategies to the improvement of handwashing practice and exclusive latrine utilization. AVAILABILITY OF DATA AND MATERIALS: The data sets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Pooled prevalence and determinants of antenatal care visits in countries with high maternal mortality: A multi-country analysis.

Background: Complications during pregnancy and childbirth are the leading causes of maternal and child deaths and disabilities, particularly in low- and middle-income countries. Timely and frequent antenatal care prevents these burdens by promoting existing disease treatments, vaccination, iron supplementation, and HIV counseling and testing during pregnancy. Many factors could contribute to optimal ANC utilization remaining below targets in countries with high maternal mortality. This study aimed to assess the prevalence and determinants of optimal ANC utilization by using nationally representative surveys of countries with high maternal mortality. Methods: Secondary data analysis was done using recent Demographic and Health Surveys (DHS) data of 27 countries with high maternal mortality. The multilevel binary logistic regression model was fitted to identify significantly associated factors. Variables were extracted from the individual record (IR) files of from each of the 27 countries. Adjusted odds ratios (AOR) with a 95% confidence interval (CI) and p-value of ≤0.05 in the multivariable model were used to declare significant factors associated with optimal ANC utilization. Result: The pooled prevalence of optimal ANC utilization in countries with high maternal mortality was 55.66% (95% CI: 47.48-63.85). Several determinants at the individual and community level were significantly associated with optimal ANC utilization. Mothers aged 25-34 years, mothers aged 35-49 years, mothers who had formal education, working mothers, women who are married, had media access, households of middle-wealth quintile, richest household, history of pregnancy termination, female household head, and high community education were positively associated with optimal ANC visits in countries with high maternal mortality, whereas being rural residents, unwanted pregnancy, having birth order 2-5, and birth order >5 were negatively associated. Conclusion and recommendations: Optimal ANC utilization in countries with high maternal mortality was relatively low. Both individual-level factors and community-level factors were significantly associated with ANC utilization. Policymakers, stakeholders, and health professionals should give special attention and intervene by targeting rural residents, uneducated mothers, economically poor women, and other significant factors this study revealed.

Satisfaction with comprehensive emergency obstetric and newborn care services and associated factors among clients in University of Gondar Specialized Hospital, Northwest Ethiopia: A cross-sectional study.

Objective: Emergency obstetric and newborn care services treat 70-80% of maternal deaths. This study aimed to assess satisfaction with comprehensive emergency obstetric and newborn care (CEmONC) services and associated factors among clients in the University of Gondar Specialized Hospital. Methods: Institution-based cross-sectional study was conducted on 404 participants using a systematic random sampling method. The study was conducted from March 5 to May 5, 2020, using interviewer-administered structured questionnaires. Binary logistic regression was used to find the association between independent variables and client satisfaction. The level of statistical significance was declared at a p value less than 0.05. Results: The overall clients' satisfaction with CEmONC services was 65.1% (95% confidence interval (CI): 60.9-69.8). Clients' satisfaction was affected by women who had antenatal care (ANC) of three visits (adjusted odds ratio (AOR): 6.5; 95%, CI: 2.04-20.8), women waited less than 15 min (AOR: 4.15, 95% CI: 1.9-9.06), mothers stayed ⩽1 day (AOR: 0.28, 95% CI: 0.09-0.9) and 2-3 days (AOR: 0.98, 95% CI: 0.1-0.69), obtaining a welcoming environment (AOR: 4.6, 95% CI: 2.15-9.88), and getting providers explanation of examinations (AOR: 3.3, 95% CI: 1.97-5.52). Conclusion: The observed clients' satisfaction with CEmONC services was suboptimal. Having ANC of three visits, waiting less than 15 min, duration of stay, obtaining a welcoming environment, and an explanation of providers' examination were the identified factors of client's satisfaction. Therefore, hospital managers and health professionals should work on the identified factors to increase the client's satisfaction with these services.

Prevalence and associated factors of common childhood illnesses in sub-Saharan Africa from 2010 to 2020: a cross-sectional study.

OBJECTIVE: This study aimed to assess the prevalence and determinants of common childhood illnesses in sub-Saharan Africa. DESIGN: Cross-sectional study. SETTING: Sub-Saharan Africa. PARTICIPANTS: Under-5 children. PRIMARY OUTCOME: Common childhood illnesses. METHODS: Secondary data analysis was conducted using data from recent Demographic and Health Survey datasets from 33 sub-Saharan African countries. We used the Kids Record dataset file and we included only children under the age of 5 years. A total weighted sample size of 208 415 from the pooled (appended) data was analysed. STATA V.14.2 software was used to clean, recode and analyse the data. A multilevel binary logistic regression model was fitted, and adjusted OR with a 95% CI and p value of ≤0.05 were used to declare significantly associated factors. To check model fitness and model comparison, intracluster correlation coefficient, median OR, proportional change in variance and deviance (-2 log-likelihood ratio) were used. RESULT: In this study, the prevalence of common childhood illnesses among under-5 children was 50.71% (95% CI: 44.18% to 57.24%) with a large variation between countries which ranged from Sierra Leone (23.26%) to Chad (87.24%). In the multilevel analysis, rural residents, mothers who are currently breast feeding, educated mothers, substandard floor material, high community women education and high community poverty were positively associated with common childhood illnesses in the sub-Saharan African countries. On the other hand, children from older age mothers, children from the richest household and children from large family sizes, and having media access, electricity, a refrigerator and improved toilets were negatively associated. CONCLUSIONS: The prevalence of common illnesses among under-5 children was relatively high in sub-Saharan African countries. Individual-level and community-level factors were associated with the problem. Improving housing conditions, interventions to improve toilets and strengthening the economic status of the family and the communities are recommended to reduce common childhood diseases.

Continuum of maternal healthcare services utilisation and associated factors among women who gave birth in Siyadebirena Wayu district, Ethiopia: community-based cross-sectional study.

OBJECTIVE: This study aimed to analyse the prevalence and factors associated with continuum of maternal healthcare services among women who gave birth in Siyadebirena Wayu district, Central Ethiopia. DESIGN: Community-based cross-sectional study. SETTING: At eight Kebeles in Central Ethiopia. PARTICIPANTS: The study was done on 614 women aged 15-49 years using interviewer-administered structured questionnaire. Following proportional allocation of the sample, we used simple random sampling technique to select study participants. METHODS: Binary logistic regression model was fitted to identify the factors associated with the outcome. Variables with p<0.2 in the bivariable analysis were the candidates for multivariable analysis. A p<0.05 and adjusted OR (AOR) with 95% CI were taken to declare the factors and the strengths of association with continuum of maternal healthcare utilisation. OUTCOME: Continuum of maternal healthcare utilisation. RESULTS: Only 16.1% (95% CI 13.3% to 19.0%) of the women had used a complete continuum of maternal health services. Variables, such as contraceptive use (AOR 4.95; 95% CI 1.61 to 15.20), autonomy (AOR 4.45; 95% CI 1.69 to 11.60), urban residence (AOR 3.91; 95% CI 1.06 to 14.39), educated women (AOR 5.36; 95% CI 1.15 to 25.06), took less than 30 min to reach a health facility (AOR 3.17; 95% CI 1.38 to 7.25), use public transportation (AOR 2.48; 95% CI 1.12 to 5.52) and good knowledge (AOR 9.88; 95% CI 3.89 to 25.0) were positively associated with continuum of maternal healthcare. In the contrary, women who had third child birth order (AOR 0.22; 95% CI 0.06 to 0.8) was negatively associated. CONCLUSIONS: Overall, the level of the continuum of maternal healthcare services utilisation was low compared with the national and global targets. Therefore, programme planners and implementer had better conduct health education to enhance the awareness of women about continuum of maternal healthcare services. Healthcare sector policy-makers and managers shall also scale up healthcare facilities to improve access to maternal healthcare services.

Correction: Adherence towards COVID-19 mitigation measures and its associated factors among Gondar City residents: A community-based cross-sectional study in Northwest Ethiopia.

[This corrects the article DOI: 10.1371/journal.pone.0244265.].

Knowledge and attitude of the communities towards COVID-19 and associated factors among Gondar City residents, northwest Ethiopia: A community based cross-sectional study.

BACKGROUND: COVID-19 is the novel coronavirus responsible for the ongoing global outbreak of acute respiratory disease and viral pneumonia. In order to tackle the devastating condition of the virus, countries need to attack the virus with aggressive and targeted tactics. Thus, to strengthen the COVID-19 mitigation measures and to give rapid response, there is an urgent need to understand the public's knowledge and attitude about of the pandemic at this critical moment. OBJECTIVE: This study was aimed to assess the knowledge and attitude of communities about COVID-19 and associated factors among Gondar City residents. METHODS: A community based cross-sectional study was done among 623 respondents in Gondar city from April 20-27/2020. Data were collected using a structured questionnaire adapted from different literatures. The data were entered using Epi data version 3.1 and then exported into STATA version 14 for analysis. Bi-variable and multivariable binary logistic regression were performed. Adjusted odds ratio with 95% CI was used to declare statistically significant variables on the basis of p value less than 0.05 in the multivariable binary logistic regression model. RESULTS: The overall knowledge and attitude of the community towards COVID19 was 51.85% [95% CI (47.91%-55.78%)] and 53.13% [95% CI (49.20, 57.06%)], respectively. In this study, being married [AOR = 0.60 at 95% CI: (0.42, 0.86)], educational level; primary [AOR = 3.14 at 95% CI: (1.78,5.54)], secondary [AOR = 2.81 at 95% CI: (1.70,4.63)], college and above [AOR = 4.49 at 95% CI: 7.92, 13.98)], and family size [AOR = 1.80, at 95% CI: (1.05, 3.08)] were emerged as statistically significant factors impacting the knowledge of the community about COVID-19. Besides, educational level; primary [AOR = 1.76 at 95% CI: (1.03, 3.01)], secondary [AOR = 1.69 at 95% CI: (1.07, 2.68)], and college & above [AOR = 2.38 at 95% CI: (1.50, 3.79)], and family size; four to six members [AOR = 1.84 at 95% CI (1.27, 2.67)], above seven members [AOR = 1.79 at 95% CI (1.08, 2.96)] were factors identified as significantly attribute for positive attitude of the communities towards COVID-19. CONCLUSION: More than half of the respondents had better knowledge and attitude regarding COVID-19. Higher educational level and larger family size were significant factors predominantly affecting the knowledge and attitude of the communities towards COVID-19.

Less than one-fifth of the mothers practised exclusive breastfeeding in the emerging regions of Ethiopia: a multilevel analysis of the 2016 Ethiopian demographic and health survey.

BACKGROUND: The burden of low coverage of exclusive breastfeeding (EBF) has a significant impact on the health of a newborn and also on the family and social economy in the long term. Even though the prevalence of EBF practices in Ethiopia is low, the practices in the pastoral communities, in particular, are significantly low and affected by individual and community-level factors. Besides, its adverse outcomes are mostly unrecognised. Therefore, this study aimed to assess the individual and community-level factors of low coverage of EBF practices in the emerging regions of Ethiopia. METHODS: In this analysis, data from 2016 Ethiopian Demographic and Health Survey (EDHS) were used. A two-stage stratified sampling technique was used to identify 1406 children aged 0 to 23 months in the emerging regions of Ethiopia. A multilevel mixed-effect binary logistic regression analysis was used to determine the individual and community level factors associated with exclusive breastfeeding practices. In the final model, variables with a p-value of < 0.05 and Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were found to be statistically significant factors that affect exclusive breastfeeding practices. RESULTS: Overall, 17.6% (95% CI: 15.6-19.6) of the children aged 0 to 23 months have received exclusive breastfeeding. Employed mothers (AOR: 0.33, 95% CI: 0.21-0.53), richer household wealth status (AOR: 0.39, 95% CI: 0.16-0.96), mothers undecided to have more children (AOR: 2.29, 95% CI: 1.21-4.29), a child with a history of diarrhoea (AOR: 0.31, 95% CI: 0.16-0.61) were the individual-level factors, whereas Benishangul region (AOR: 2.63, 95% CI: 1.44-4.82) was the community-level factors associated with the exclusive breastfeeding practices. CONCLUSIONS: Less than one-fifth of the mothers have practised exclusive breastfeeding in the emerging regions of Ethiopia. The individual-level factors such as mother's employment status, household wealth status, desire for more children, presence of diarrhoea and community-level factors such as region have contributed to the low coverage of exclusive breastfeeding. Therefore, the federal and regional health bureaus and other implementers should emphasise to those emerging regions by creating awareness and strengthening the existing community-based health extension program to enhance exclusive breastfeeding practices.

Adherence towards COVID-19 mitigation measures and its associated factors among Gondar City residents: A community-based cross-sectional study in Northwest Ethiopia.

BACKGROUND: Considering its pandemicity and absence of effective treatment, authorities across the globe have designed various mitigation strategies to combat the spread of COVID-19. Although adherence towards preventive measures is the only means to tackle the virus, reluctance to do so has been reported to be a major problem everywhere. Thus, this study aimed to assess the community's adherence towards COVID-19 mitigation strategies and its associated factors among Gondar City residents, Northwest Ethiopia. METHODS: A community-based cross-sectional study was employed among 635 respondents from April 20-27, 2020. Cluster sampling technique was used to select the study participants. Data were collected using an interviewer-administered structured questionnaire. Epi-Data version 4.6 and STATA version 14 were used for data entry and analysis, respectively. Binary logistic regressions (Bivariable and multivariable) were performed to identify statistically significant variables. Adjusted odds ratio with 95% CI was used to declare statistically significant variables on the basis of p < 0.05 in the multivariable logistic regression model. RESULTS: The overall prevalence of good adherence towards COVID-19 mitigation measures was 51.04% (95%CI: 47.11, 54.96). Female respondents [AOR: 2.39; 95%CI (1.66, 3.45)], receiving adequate information about COVID-19 [AOR: 1.58; 95%CI (1.03, 2.43)], and favorable attitude towards COVID-19 preventive measures were significantly associated with good adherence towards COVID-19 mitigation measures. Whereas, those respondents who had high risk perception of COVID-19 were less likely to adhere towards COVID-19 mitigation measures [AOR: 0.61; 95% CI (0.41, 0.92)]. CONCLUSIONS: The findings have indicated that nearly half of the study participants had poor adherence towards COVID-19 mitigation measures. Sex, level of information exposure, attitude towards COVID-19 preventive measures, and risk perception of COVID-19 were factors which significantly influenced the adherence of the community towards COVID-19 mitigation measures. Therefore, it is crucial to track adherence responses towards the COVID-19 preventive measures, scale up the community's awareness of COVID-19 prevention and mitigation strategies through appropriate information outlets, mainstream media, and rely on updating information from TV, radio, and health care workers about COVID-19.

Community Level of COVID-19 Information Exposure and Influencing Factors in Northwest Ethiopia.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is an emerging respiratory infection, and the crisis has become a worldwide issue, and society has become concerned in various aspects. Good information exposure related to transmission, prevention, and risk factors of COVID-19 can be the best means to reduce the risk of disease exposure and mitigate further spread. The countries that have well practiced this strategy (society information exposure) were controlling disease progression, but there is a low practice in sub-Saharan countries, including Ethiopia. Therefore, this study aimed to evaluate the information exposure level about COVID-19 and influencing factors among northwest community of Ethiopia. METHODS AND MATERIALS: Community-based cross-sectional study design was employed among the community of Gondar city from April 20 to 27, 2020. A total of 623 study participants were involved in this interview, and a systematic sampling technique was applied to select the households. Data were entered into EpiData version 4.6 and then exported to STATA version 14 for analysis. A multivariable binary logistic regression was employed to identify factors associated with good information exposure about COVID-19. The adjusted odds ratio (AOR) with 95% confidence interval (CI) was estimated to show the strength of association. A p-value <0.05 was a cut-off point to declare statistical significance. RESULTS: The overall rate of information exposure about COVID-19 was 44.9%. Age 18-26 years [AOR=0.53; 95% CI (0.28-0.99)] and 34-45 years [AOR=0.44; 95% CI (0.24-0.80)], elementary school [AOR=2.48; 95% CI (1.20-5.15)], secondary school [AOR=3.98; 95% CI (1.99-7.99)], college and above [AOR=8.38; 95% CI (4.10-17.26)], browsed or follow social media [AOR=2.21; 95% CI (1.44-3.38)] and those having a discussion with their family members [AOR=2.37; 95% CI (1.44-3.90)] and friends [AOR=2.15; 95% CI (1.38-3.34)] were the factors significantly associated with good information exposure towards COVID-19. CONCLUSION: Communities total level of good information exposure from different information platforms about COVID-19 in this study area remains low. Age, high level of education, browsing social media, and those having interpersonal (family and friends) discussion were the factors that significantly influence communities who have good information exposure related to COVID-19. Therefore, efforts on community mobilization through regional/national mass media and other information conveying platforms are recommended.

Community's perceived high risk of coronavirus infections during early phase of epidemics are significantly influenced by socio-demographic background, in Gondar City, Northwest Ethiopia: A cross-sectional -study.

BACKGROUND: Epidemiological studies during the early phase of the coronavirus (COVID-19) pandemics reported different level of people's risk perception in different countries. There is a paucity of data on perceived high risk of COVID-19 and associated factors in Ethiopia. We sought to assess the prevalence of community's perceived high risk about COVID-19 infections and associated factors among Gondar town community. METHODS: A cross-sectional study was carried out from April 20 to 27, 2020 in Gondar town community, Northwest Ethiopia. Multistage cluster sampling technique was used to recruit 635 participants. Structured and pre-tested questionnaire was used to collect the data. Descriptive statistics, bivariate and multivariable binary logistic regression were used to summarize the results. RESULTS: A total of 623 participants were considered in the analysis with a response rate of 98.1%. The prevalence of coronavirus high risk perceptions of the respondents was found to be 23.11% (95% CI; 19.80%-26.43%). Age above 45 years (AOR = 1.41, 95%CI; 1.19-2.66), college and above educational level (AOR = 0.28, 95%CI; 0.21-0.98), and poor knowledge towards COVID-19 virus (AOR = 1.57, 95%CI; 1.09-2.23) were significantly associated with perceived high risk about COVID-19. CONCLUSIONS: The prevalence of perceived high risk of COVID-19 was found to be low. Factors such as age, educational status, and knowledge about COVID-19 virus were found to be independent predictors of perceived high risk towards COVID-19. Government and non-government organizations should use formal and informal means of educating the community.

Self-Medication Practice and Associated Factors Among University of Gondar College of Medicine and Health Sciences Students: A Cross-Sectional Study.

PURPOSE: Self-medication is the use of medicines by individuals to treat self-recognized illnesses or symptoms without any medical supervision. Such practices may cause antimicrobial resistance, which causes treatment failure, economic loss, serious health hazards, missed diagnosis, delayed appropriate treatment, drug dependency, and adverse drug effects. However, empirical evidence is limited to the current status of its practices and associated factors among university students. Thus, the aim of this study was to assess the magnitude and associated factors of self-medication practices among medicine and health science students at the University of Gondar. METHODS: An institution-based cross-sectional study was employed from February to March 2017. A total of 792 randomly selected students were surveyed with a self-administered structured questionnaire. Epi Info version 7 and SPSS version 20 were used for data entry and analysis, respectively. Binary logistic regression analysis was performed. In multivariable analysis, P-value <0.05 and adjusted odds ratio (AOR) with 95% confidence interval (CI) were used to identify associated factors. RESULTS: Self-medication practice was found to be 52.4% (95% CI: (49%, 56%)) among university students. For most students, the major reason for using self-medication was taking the illness as less serious (71.1%). Females (AOR: 1.48; 95% CI: 1.08-2.01), income category (USD 44.01-175.87) (AOR: 0.47; 95% CI: 0.29-0.78), sixth year students (AOR: 8.71; 95% CI: 4.04-18.77) and health officer students (AOR: 2.36; 95% CI: 1.20-4.63) were found to be significantly associated with self-medication practice. CONCLUSION: More than half of the students practiced self-medication, which is moderately higher than other findings. Gender, income, year of study, and field of study were the major factors that affected self-medication. Therefore, interventions that can halt the high magnitude of self-medication and factors associated with it are crucial. Special attention should be given to students who stay in the university for longer years.