Though the burden of malaria is declining, challenges in control continue globally, regionally and nationally as the transmission of malaria is dynamic and determinants differ by place and time, and across populations. The current level of knowledge on malaria prevalence and associated factors in specific communities, such as pastoralist communities of Ethiopia, is lacking. A community based cross-sectional survey was conducted among pastoralist communities from December 2011 to January 2012. Background information and peripheral blood samples were collected from 461 randomly selected study participants. Multivariate regression analysis was done to explore the risk factors associated to malaria. The prevalence of malaria among 461 examined study participants was 6.1 % (95 % CI = 4.2, 8.5). The infection rate with Plasmodium falciparum and Plasmodium vivax was 64.3 % (95 % CI = 45.5, 80.2) and 21.4 % (95 % CI = 19.8, 54.5), respectively, while mixed infection was 14.3 % (95 % CI = 4.7, 30.9). The infection rate was higher among lactating (22.2 %, 95 % CI =7.5, 45.3) and pregnant (17.6 %, 95 % CI = 4.7, 40.9) women compared with other community groups like infants (12 %). Mosquito net coverage of the study population was 90.1 % with an average of 1.8 per household. Traditional practices related to malaria prevention and treatment were not significantly associated with malaria infection (p > 0.05). Pregnancy (adjusted Odds Ratio [AOR]: 12.6, 95 % CI = 1.7, 94.7) and saving mosquito net for later use (AOR 9.6: 95 % CI = 2.2, 42.8) were independently associated with prevalent malaria infection. In spite of high coverage of mosquito nets, prevalence of malaria in this pastoralist community was high, affecting pregnant and lactating women at a higher rate. Pregnancy and saving mosquito nets for later use were identified as the associated risk factors. Health education on prevalence of malaria and knowledge on risk factors might be able to change the health behavior in this pastoralist community which consequently can decrease the malaria morbidity and mortality. ISRCTN ISRCTN73824458 , Registered 28 September 2014.

Globally, an estimated 289,000 maternal deaths occurred in 2013. Majority of these deaths occurred in sub-Saharan Africa and Southern Asia. Mobility of pastoralists is a well-recognized survival strategy in arid and semi-arid land of sub-Saharan Africa. However governments often encourage settlement as a solution to the difficulty of providing health services for mobile pastoralists. This study aimed to assess utilization of institutional delivery and associated factors among women of reproductive age in the mobile pastoral community of the Liban District in Guji zone, Oromia, Ethiopia. A Community based cross-sectional survey was conducted among the mobile pastoralist community of the Liban District. Seven hundred ninety-one (791) randomly selected women, who had birth within the last 2 years preceding the survey, were interviewed using a pretested structured questionnaire. Data were entered into Epi-Info version 3.5.4 and analyzed by Statistical Package for Social Science (SPSS) version 16. Bivariate and multivariate analyses were done. Out of 791 women who gave birth within the last 2 years preceding the survey, only 110 (13.9%) gave birth in health institutions. Majority (74.1%) of the women gave birth at their home. Ninety-one women (11.5%) gave birth at traditional birth attendant’s home; assisted by traditional birth attendants. Multiple logistic regression shows that women who had readily available cash at the onset of labor (aOR 2.79, 95% CI: 1.29–6.25), delivered the birth preceding the most recent birth in a health institution (aOR 6.8, 95% CI: 3.44–13.45) and had birth related complications during the birth preceding the most recent birth (aOR 1.90, 95% CI: 1.08–3.36) were more likely to deliver at health institutions. Majority of the pastoral women seek institutional delivery, only when labor related complications are perceived. Mechanisms of alleviating indirect health care costs affecting institutional delivery need to be addressed in future studies.

Nutritional status of children is an important outcome measure of their health status. However, nutritional status and associated factors of pastoralist children were not well documented in Benna Tsemay Woreda, South Omo Zone, Southern Ethiopia. Therefore, this study was designed to assess nutritional status and associated factors among pastoralist children aged 6-23 months in Benna Tsemay Woreda, South Omo Zone, Southern Ethiopia. A community-based cross sectional study was conducted among 645 pastoralist children aged 6-23 months from February-March 2016. A stratified random sampling technique was used to select kebeles (smallest administrative unit) and children. Out of thirty-two kebeles, six were randomly selected. Data were collected using a structured questionnaire, 24 hour food recall and anthropometric measurements. Quantitative data were collected and analyzed using SPSS for windows version 20.0. Anthropometric indices were computed using WHO Anthro 2011 software (version 3.2.2). Bivariate and multivariable logistic regression analyses were conducted. Crude odds ratio (COR) and adjusted odds ratio (AOR) with 95% confidence interval (CI) were reported. Prevalence of stunting and underweight were higher in fewer than two children in Benna Tsemay compared to the national average. This study showed, being older child (12-23 months) (AOR=3.29, 95%CI, 2.03-5.32), being from agro-pastoralist (AOR=0.46, 95%CI, 0.24-0.88), middle wealth quantile household (AOR=0.40, 95%CI, 0.20-0.77), use of treated water (AOR=0.60, 95%CI, 0.37-0.96), being second birth order (AOR=2.17, 95%CI, 1.11-4.24), being female child (AOR=0.55, 95%CI, 0.37-0.82) and good child feeding practice of mothers (AOR=0.47, 95%CI, 0.28-0.78) were significantly associated with stunting of pastoralist children in Benna Tsemay Woreda (p<0.05). Having large family size (≥6 individuals) (AOR=30.93, 95%CI, 4.91-194.7), polygamous marriage (AOR=2.46, 95%CI, 1.07-5.61), being from agro-pastoralist (AOR=0.19, 95%CI, 0.05-0.66) and farming as maternal occupation (AOR=3.00, 95%CI, 1.36-6.62) were significantly affected with thinness of children (p<0.05). Being from pastoralist (AOR=3.18, 95%CI, 1.74-5.81) and being female child (AOR=0.35, 95%CI, 0.14-0.89) were significantly predicted underweight in children (p<0.05). In conclusion, high numbers of pastoralist children are suffering from chronic malnutrition with low dietary diversity score (DDS). Large numbers of mothers have poor infant and young child feeding (IYCF) practices. Being from pastoralist and poor family, elder and male child, and poor IYCF practices, polygamous marriage, and poor health service are factors for child under nutrition. Therefore, the authors recommend interventions targeting on community-based nutrition education on IYCF, dietary diversity, cultural food taboos, and family planning in Benna Tsemay pastoralist community.

Background: Water quality and the risk to waterborne diseases are critical public health concerns in many developing countries. Today, close to a billion people most living in the developing world do not have access to safe and adequate water supply. Objective: The objective of this study was to assess the bacteriological and physicochemical quality of drinking water sources and water handling practices at household level among rural communities in Bona District of Sidama Zone. Methodology: A cross-sectional study design was conducted to assess the bacteriological and physicochemical qualities of drinking water at source and to assess water handling practice of households. Data were collected using WHO’s sanitary survey checklist and rapid water testing kit to assess bacteriological and physicochemical parameters of water source and questionnaire to assess water handling practice of randomly selected 604 households. Results: Majority (86 %) of the protected springs and wells in the study area did not fulfill the WHO’s criteria for drinking water quality standards. Water schemes with high sanitary risk scores had high number of E. coli/100 ml of sample water. Majority (73.5%) of the respondents didn’t treat their water at household level, 64.4% of the respondents washed their hands before collecting water, 77.5% of the respondents washed their water container regularly and 74.7% had covered for their water collection container. Respondents who can read and write and those who completed at least a secondary education were more likely to safely handle water at home compared to illiterates, AOR=3.0 (95%CI: 1.5,6.04) and AOR=8.5 (95% CI:1.1,65.7), respectively. Conclusions: The results of this study indicated that protected water sources used by the community in Bona District were subject to contamination and household water handling practices were poor. It is recommended that concerned bodies, such as NGO’s working in WASH projects, Bona district Water and Health Offices need to take appropriate action.

Cereal-based diets contribute to anemia in Ethiopian children. Eggs have nutrients to boost hemoglobin levels as well as counter concurrent anemia and stunting (CAS) and morbidity status. A community trial, targeting 6–18 months old children, was conducted in Halaba. Two clusters were randomly selected and allocated to intervention (N = 122) and control (N = 121) arms. Intervention group (IG) children received egg-laying hens with caging in a cultural ceremony declaring child ownership of the chickens. Parents promised to feed eggs to the child. Health and agriculture extension workers promoted egg feeding, poultry husbandry, and sanitation to IG families. Control group (CG) had standard health and agriculture education. At baseline, groups were not different by hemoglobin, anemia, CAS, and morbidity status. Mean hemoglobin was 11.0 mg/dl and anemia prevalence was 41.6%. About 11.9% of children had CAS and 52.3% were sick. Using generalized estimating equations, the intervention increased hemoglobin by 0.53 g/dl (ß:0.53; p < 0.001; 95%CI: 0.28–0.79). IG children were 64% (p < 0.001; odds ratio [OR]:0.36; 95%CI: 0.24–0.54) and 57% (p = 0.007; OR: 0.43; 95%CI: 0.21–0.73) less likely to be anemic and have CAS, respectively, than CG, with no difference in morbidity. Child-owned poultry intervention is recommended in settings where anemia is high and animal-source food intake is low.

Background: Institutional delivery is one of the key interventions to reduce maternal death. It ensures safe birth, reduces both actual and potential complications, and decreases maternal and newborn death. However, a significant proportion of deliveries in developing countries like Ethiopia are home deliveries and are not attended by skilled birth attendants. We investigated the prevalence and determinants of home delivery in three districts in Sidama administration, Southern Ethiopia. Methods: Between 15–29 October 2018, a cross sectional survey of 507 women who gave birth within the past 12 months was conducted using multi-stage sampling. Sociodemographic and childbirth related data were collected using structured, interviewer administered tools. Univariate and backward stepwise multivariate logistic regression models were run to assess independent predictors of home delivery. Results: The response rate was 97.6% (495). In the past year, 22.8% (113), 95% confidence interval (CI) (19%, 27%) gave birth at home. Rural residence, adjusted odds ratio (aOR) = 13.68 (95%CI:4.29–43.68); no maternal education, aOR = 20.73(95%CI:6.56–65.54) or completed only elementary school, aOR = 7.62(95% CI: 2.58–22.51); unknown expected date of delivery, aOR = 1.81(95% CI: 1.03–3.18); being employed women (those working for wage and self-employed), aOR = 2.79 (95%CI:1.41–5.52) and not planning place of delivery, aOR = 26.27, (95%CI: 2.59–266.89) were independently associated with place of delivery. Conclusion: The prevalence of institutional delivery in the study area has improved from the 2016 Ethiopian Demography Health Survey report of 26%. Uneducated, rural and employed women were more likely to deliver at home. Strategies should be designed to expand access to and utilization of institutional delivery services among the risky groups.