Background: Cervical cancer is a public health challenge despite the available free screening service in Ethiopia. Early screening for cervical cancer significantly improves the chances of successful treatment of pre-cancers and cancers among women of reproductive age. Therefore, this study aimed to assess the uptake of screening and identify the factors among women of reproductive age. Methods: A community-based cross-sectional study was conducted in Gomma Woreda, Jimma Zone, Ethiopia, from 1st to the 30th of August, 2019. The total sample size was 422. A systematic random sampling technique was employed. Data were collected using a structured questionnaire, entered in epidata, and exported and analyzed using SPSS version 20.0 software packages. Descriptive, bivariate and multivariable logistic regression analyses with 95% CI for odds ratio (OR) were performed to declare a significant predictors. Result: A total of 382 study participants were involved with a response rate of 90.5%. The mean age of the study participants was 26.45 ± 4.76 SD. One hundred forty-eight (38.7%) of participants had been screened for CC. Marital status (AOR = 10.74, 95%, CI = 5.02–22.96), residence (AOR = 4.45, 95%, CI = 2.85–6.96), educational status (AOR = 1.95, 95% CI = 1.12–3.49), government employee (AOR = 2.61, 95%, CI = 1.33–5.15), birth experience (AOR = 8.92, 95% CI = 4.28–19.19), giving birth at health center and government hospitals (AOR = 10.31, 95% CI = 4.99–21.62; AOR = 5.54, 95% CI = 2.25–13.61); distance from health facility (AOR = 4.41, 95% CI = 2.53–9.41), health workers encouragement (AOR = 3.23, 95% CI = 1.57–6.63), awareness on cervical cancer (AOR = 0.37, 95% CI = 0.19–0.72), awareness about CC screening (AOR = 4.52, 95%, CI = 2.71–7.55) and number of health facility visit per year (AOR = 3.63, 95%, CI = 1.86–6.93) were the predictors for the uptake of cervical cancer screening. Conclusion: The uptake of cervical cancer screening was low. Marital status, residence, occupation, perceived distance from screening health facility, health workers encouragement, number of health facility visits, birth experience, place of birth, and knowledge about cervical cancer screening were the predictors. There is a need to conduct further studies on continuous social and behavioral change communication.

Background: Breastfeeding has several benefits for both mothers and their children. Despite strong evidence in support of the practice, its prevalence has remained low worldwide, particularly in Ethiopia. Therefore, this study is aimed to assess breastfeeding knowledge, attitude, and self-efficacy among mothers with index infants and young children in the rural community of Southwest Ethiopia. Methods: A community-based cross-sectional study was conducted between March and April 2022 as baseline data for a cluster of randomized control trials. Multistage sample techniques followed by systematic random sampling techniques were employed. The Chi-square and Fisher’s exact probability tests were used to assess the baseline differences in the socio-demographic characteristics of the two groups. An independent sample t-test was used to determine the mean differences. Multivariate logistic regression analysis was used to evaluate the association. All tests were two-tailed, and a statistically significant association was declared at a p-value ≤ 0.05. Results: A total of 516 mothers (258 from the intervention and 258 from the control group) were interviewed. A total of 516 mothers (258 from the intervention group and 258 from the control group) were interviewed. Except for the child’s sex and age, no significant difference was observed between the intervention and control groups in terms of socio-demographic variables (p > 0.05). Independent t-tests found no significant difference between the two groups (p > 0.05) in terms of the mean score of maternal breastfeeding knowledge, attitude and self-efficacy at baseline. After adjusting for other covariates, maternal age (AOR = 1.44, 95% CI: 0.69, 3.07), educational status (AOR = 1.87, 95% CI: 0.56,2.33), occupation (AOR = 1.79, 95% CI, 1.04, 3.69), ANC (antenatal care) (AOR = 1.88, 95% CI, 1.11, 4.09), received breastfeeding information (AOR = 1.69, 95% CI, 1.33, 5.04), postnatal care (PNC) (AOR = 3.85, 95% CI, 2.01, 5.77) and parity (AOR = 2.49, 95% CI, 1.08, 4.19) were significantly associated high level breastfeeding knowledge. The positive attitude was associated with maternal age (AOR = 2.41, 95% CI, 1.18, 5.67), education status (AOR = 1.79, 95% CI, 0.99,4.03), ANC (AOR = 2.07, 95% CI, 1.44,5.13), last child breastfeeding history (AOR = 1.77, 95% CI, 1.21,4.88) and high level of breastfeeding knowledge (AOR = 2.02, 95% CI, 1.56,4.04). Finally, high breastfeeding self-efficacy was associated with ANC (AOR = 1.88, 95% CI 1.04,3.83), parity (AOR = 4.05, 95% CI, 1.49, 5.03) and high knowledge level (AOR = 1.69, 95% CI, 0.89,2.85). Conclusions: The study concluded that mothers in both the intervention and control groups have a low level of breastfeeding knowledge, a neutral attitude, and medium self-efficacy. Therefore, nutrition education interventions using tailored messages appropriate to the sociocultural context in the rural setting should be developed and evaluated continuously.

Background: Use of substances such as alcohol, khat leaves (Catha edulis) and tobacco has become one of the rising major public health and socioeconomic problems worldwide and dramatically increased in developing countries. The aim of this study was to assess the predictors of substance use among Jimma University instructors. Method: Institutional based cross-sectional study design was conducted in 2018 among Jimma University instructors. A two-stage cluster sampling procedure was employed to select study participants by their departments and data was collected using structured, self-administered questionnaire with severity assessed by the standardized fifth version of a diagnostic statistical manual of mental health criteria for substance use disorder. Multivariate logistic regression was used to identify independent predictors of substance use. Variables with a P-value < 0.05 in the final fitting model were declared to be associated with the outcome variable. Results: A total of 330 instructors were involved in this study, with a response rate of 96.2%. About 225 of the respondents have ever used the substance in life (khat, alcohol, or cigarette or all) making the lifetime prevalence of substance use 68.2%. The lifetime prevalence of khat chewing, alcohol use, and smoking cigarette was 51.6, 81.3, and 17.3% respectively. The prevalence of substance uses disorder among users was 36.9%. Living with family (AOR = 0.220 [2.004–8.536] 95%CI), no family substance use history (AOR = 0.220 [0.098–0.495] 95% CI), friends substance use (AOR = 9.047 [4.645–17.620] 95% CI), Social norm favors substance use, (AOR = 1.123 [1.020–1.238] 95% CI), perceived benefit of substance use (AOR = 1.077 [1.008–1.151] 95% CI) were predictors of substance use. Conclusion: Perception toward substance, the influence of family and peer were associated with substance use. Therefore, designing a multifaceted approach directed to an individual, interpersonal and community-level intervention targeted to substance misperception and social norms contributing to substance use.

Background: Even though the urban health extension program (HEP) has been implemented since 2009, little was known about its implementation, experience and challenges. Therefore, this study was aimed at exploring the implementation, experience, and challenges of the urban HEP. Methods: A qualitative case study was conducted in Addis Ababa from November 15 to December 29, 2017. The study participants were recruited purposefully. The parent populations were health extension professionals (HEPs). However, health post supervisors, health development army leaders (HDAs), Addis Ababa city HEP administrators, and other community members were also involved in the study. Four focus group discussions and 31 in-depth and key informant interviews were conducted. Data were transcribed verbatim, translated into the English, and analyzed by an inductive thematic analysis approach using Atlas ti7.1 software. Result: The study found that there were 15 health service packages of the urban HEP delivered to the community based on the need of the households. The strategies for the program implementation were provision of trainings, home visitation, creation of model households, strengthening of HDAs, supervision and reporting, referral and feedback, and social and community mobilization. However, program implementation was challenged by the health system related challenges (health service package and delivery, workload of HEPs, shortage of trained HEPs, lack of regular supervision or monitoring, lack of logistical or motivational support, poor supply chain management, dissatisfaction of HEPs, assigning of more than expected households for HEPs, etc.), multisectoral related and community related challenges (HDAs need of incentives, and lack of graduating model households as per the plan, etc.). Conclusions: Although the program had a significant contribution to the health of community, it was affected by different challenges that underscore the need to develop different strategies and taking of actions. Therefore, the district health office, health centers and stakeholders from different sectors should have to support and motivate the HEPs and HDAs, and work together with them for successful implementation of the program.

Background: Complementary feeding (CF) is the period when exclusive breastfeeding ends and the introduction of a wide range of foods while breastfeeding should continue until the child is at least 24 months of age. Sub-optimal complementary feeding practices of infants and young children persist due to different factors, which include knowledge, attitude, and self-efficacy of index mothers. Therefore, this study aimed to assess determinants of knowledge, attitude, and self-efficacy towards complementary feeding among rural mothers with index child in rural Ethiopia. Methods: A community-based, cross-sectional study was conducted using multistage sampling techniques followed by systematic random sampling techniques. A structured interviewer-administered questionnaire was used. The Chi-square and Fisher’s exact probability tests were used to assess the baseline differences in the CF knowledge, attitude, self-efficacy and socio-demographic characteristics of the intervention and control groups. An independent sample t-test was used to determine the mean differences. Multiple linear regression models were fitted to assess the predictors of complementary feeding knowledge, attitude, and self-efficacy. All tests were two-tailed, and a statistically significant association was considered at a p-value ≤ 0.05. Results: Overall, 516 mothers were interviewed. 52.5% of the mothers had high complementary feeding (CF) knowledge, whereas only 47.7% and 38.9% had favorable attitude and high self-efficacy, respectively. The socio-demographic characteristics of the intervention and control groups were overall similar. However, there was a significant difference in the child’s sex (p = 0.021) and age (p = 0.002). Independent t-tests found no significant difference between the two groups in terms of the mean score of CF knowledge, attitude, and self-efficacy at baseline. Maternal educational status (p = 0.0001), number of ANC visits (p = 0.025), and CF information received (p = 0.011) were significant predictors of CF knowledge. Child sex (p = 0.021) and the number of ANC visits (p = 0.01) were significant predictors of CF attitude. Family size (p = 0.008) and household food security status (p = 0.005) were significant predictors of maternal CF self-efficacy. Conclusion: Overall, half of the mothers had high knowledge. Whereas maternal attitudes and self-efficacy toward CF were low. Maternal educational status, the number of ANC visits, and the CF information received were predictors of CF knowledge. Likewise, child sex and the number of ANC visits were predictors of CF attitude. Family size and household food security status were predictors of CF self-efficacy. These findings imply that nutrition intervention strategies are mandatory, particularly to enhance maternal knowledge, attitude, and self-efficacy towards optimum complementary feeding.

Background: A timely understanding of the frontline community health care workers’ prevention practices towards COVID-19 is very crucial to combat the pandemic. Despite this, no study has been conducted among frontline community health workers in Africa, particularly in Ethiopia. The study aimed to determine the status of implementation of preventive measures of frontline community health care workers towards COVID-19 and its associated factors. Methods: An institution-based cross-sectional study was conducted on 421 health extension workers among selected districts. Data were collected using a pretested structured questionnaire adapted from different pieces of literature. Respondents who scored above mean score on the item measurement such as knowledge, attitude, and practice questions were categorized as knowledgeable, having positive attitude, and having good prevention practices, respectively. Data were entered in EpiData 3.1 and analyzed using Statistical Package for Social Sciences (SPSS) version 23.0 software. A multivariable logistic regression model was used to identify significant predictors. P– values less than or equal to 0.05 were declared as statistically significant. Results: The mean age of study participants was 31.35 years (± 4.83 SD), and almost half (217; 51.54%) of respondents were single and 273 (62.47%) were trained for COVID-19 prevention measures. Of the total study subjects, 194 (46.08%; 95% CI=41.6– 50.7%) had good prevention practices towards COVID-19. Being married (AOR=3.36, 95% CI=2.20– 5.13), being trained (AOR=2.28, 95% CI=1.39– 3.74), having good knowledge (AOR=2.4, 95% CI=1.52– 3.99), and having positive attitude towards COVID-19 prevention measures (AOR=5.88, 95% CI=3.52– 9.80) increase the likelihood of implementing prevention measures. Conclusion: This study showed that prevention status was low; therefore, government and non-governmental organizations working around the study area should emphasize providing training to increase their level of knowledge and to change the attitude towards implementation of prevention measures, and these can ultimately increase the status of prevention practices.