Background Stunting reflects a failure to receive adequate nutrition over a long period of time. Stunting is associated with adverse functional consequences including poor cognition, low educational performance, low adult wages, and poor reproductive outcomes. The objective of the study was to investigate spatial variations and factors associated with childhood stunting in Ethiopia. Methods This study is a secondary data analysis of the 2011 Ethiopian Demographic and Health Survey (EDHS). A total of 9893 children aged 0–59 months were included in the analysis. The Getis-Ord spatial statistical tool was used to identify high and low hotspots areas of stunting. A multilevel multivariable logistic regression was used to identify factors associated with stunting. Results Statistically significant hotspots of stunting were found in northern parts of the country whereas low hotspots where there was less stunting than expected were found in the central, eastern, and western parts of the country. In the final model of multilevel logistic regression analysis, individual and community level factors accounted for 36.6 % of childhood stunting. Short birth interval [AOR = 1.68; 95%CI: (1.46–1.93)], being male [AOR = 1.20; 95%CI: (1.08–1.33)], and being from a male-headed household [AOR = 1.18; 95 % CI: (1.01–1.38)] were the factors that increased the odds of stunting at the individual level. Children in the age group between 24–35 months were more likely to be stunted than children whose age was less than one year [AOR = 6.61; 95 % CI: (5.17–8.44)]. The odds of stunting among children with severe anemia were higher than children with no anemia [AOR = 3.23; 95%CI: (2.35–4.43)]. Children with mothers who had completed higher education had lower odds of being stunted compared to children whose mothers had no formal education [AOR = 0.42; 95%CI: (0.18–0.94)]. The odds of being stunted were lower among children whose fathers completed higher education [AOR = 0.58; 95%CI: (0.38–0.89)] compared to children whose fathers had no formal education. Children whose mothers who had high a Body Mass Index (BMI) (≥25.0 kg/m²) were less likely to be stunted compared with children whose mothers had a normal BMI (18.5 kg/m²-24.9 kg/m²)[AOR = 0.69; 95%CI: (0.52–0.90)]. Children from the poorest wealth quintile had higher odds of being stunted compared to children from the richest wealth quintiles [AOR = 1.43; 95 % CI: (1.08–1.88)]. Unavailability of improved latrine facilities and living in the northern parts of the country (Tigray, Affar, Amhara and Benishangul-Gumuzregions) were factors associated with higher odds of stunting from the community-level factors. Conclusion Stunting in children under five years old is not random in Ethiopia, with hotspots of higher stunting in the northern part of Ethiopia. Both individual and community-level factors were significant determinants of childhood stunting. The regions with high hotspots of child stunting should be targeted with additional resources, and the identified factors should be considered for nutritional interventions.

High maternal mortality is a continued challenge for the achievement of the fifth millennium development goal in Sub-Saharan African countries including Ethiopia. Although institutional delivery service utilization ensures safe birth and a key to reduce maternal mortality, interventions at the community and/or institutions were unsatisfactorily reduced maternal mortality. Institutional delivery service utilization is affected by the interaction of personal, socio-cultural, behavioral and institutional factors. Therefore this study was designed to assess factors associated with institutional delivery service use among mothers in Bahir Dar city administration.

Hepatitis B infection is a major public health problem in Ethiopia. Health care workers are at increased risk of acquiring hepatitis B infection due to occupational exposure. There is effective and safe vaccine against hepatitis B infection. But many health care workers in developing countries are not vaccinated. There is no study in Ethiopia that describes hepatitis B vaccine knowledge and vaccination status of health care workers. Therefore, this study was done to assess hepatitis B vaccination status and knowledge among health care workers’ of Bahir Dar city administration, Northwest Ethiopia. Institution based cross sectional study design was employed from April 1 to 30, 2012. All healthcare workers who were working in Health care facilities of Bahir Dar city administration were the study populations. A total of 374 health care workers were included in the study. Simple random sampling technique was used to select eligible study participants from the list of health care workers. Self administered questionnaire was used to collect data. The completeness of questionnaires was checked every day by facilitators and principal investigators. Data were entered and analyzed with statistical package for social sciences version 16.0 software. In this study, 64.7% of respondents perceived their risk of acquiring hepatitis B infection very high or high. Only 52% of the respondents were knowledgeable about hepatitis B infection. In this study, only 62% of health care workers were knowledgeable about hepatitis B vaccine. From the total of 370 respondents, only 20(5.4%) reported that they took three or more doses of hepatitis B vaccine. Hepatitis B vaccination status of health care workers in the study area was low. Health care workers’ knowledge about hepatitis B infection and hepatitis B vaccine was also low as all health care workers should be knowledgeable.

Increasing climate variability as a result of climate change will be one of the public health challenges to control infectious diseases in the future, particularly in sub-Saharan Africa including Ethiopia. To investigate the effect of climate variability on childhood diarrhea (CDD) and identify high risk periods of diarrheal diseases. The study was conducted in all districts located in three Zones (Awi, West and East Gojjam) of Amhara Region in northwestern parts of Ethiopia. Monthly CDD cases for 24 months (from July 2013 to June 2015) reported to each district health office from the routine surveillance system were used for the study. Temperature, rainfall and humidity data for each district were extracted from satellite precipitation estimates and global atmospheric reanalysis. The space-time permutation scan statistic was used to identify high risk periods of CDD. A negative binomial regression was used to investigate the relationship between cases of CDD and climate variables. Statistical analyses were conducted using SaTScan program and StataSE v. 12. The monthly average incidence rate of CDD was 11.4 per 1000 (95%CI 10.8–12.0) with significant variation between males [12.5 per 1000 (95%CI 11.9 to 13.2)] and females [10.2 per 1000 (95%CI 9.6 to 10.8)]. The space-time permutation scan statistic identified the most likely high risk period of CDD between March and June 2014 located in Huletej Enese district of East Gojjam Zone. Monthly average temperature and monthly average rainfall were positively associated with the rate of CDD, whereas the relative humidity was negatively associated with the rate of CDD. This study found that the most likely high risk period is in the beginning of the dry season. Climatic factors have an association with the occurrence of CDD. Therefore, CDD prevention and control strategy should consider local weather variations to improve programs on CDD.

Background. Anemia is a major public health problem worldwide. Adolescent girls are the most vulnerable group of population due to different reasons. The aim of this study was to assess the prevalence of anemia and associated factors among school adolescent girls in rural towns of Bahir Dar City Administration, North West Ethiopia. Methods. A cross-sectional study was conducted from March 5 to April 15, 2017, on 443 randomly selected school adolescent girls. Data were collected using pretested structured questionnaire and anthropometric measurements. Blood sample was also collected to assess the hemoglobin (Hgb) value of study participants. SPSS version 20 was used to analyze data. Descriptive statistics were used to describe data. Bivariate and multivariable logistic regression models were used to identify the associated factors with the outcome variable. Crude and adjusted odds ratios with 95% confidence interval (CI) were calculated to identify the variables significantly associated with the outcome variable. Result. The prevalence of anemia was 11.1%. Household family size [AOR=3.2, 95%CI (1.29-7.89)], average household monthly income <500 ETB [AOR=10; 95%CI (2.49-41.26)], 501-1000 ETB [AOR=6, 95%CI (2.54-14.33)], history of intestinal parasitic infection [AOR=2.7; 95% CI (1.19-6.21)], duration of menstruation flow [AOR=2.4; 95%CI (1.08- 5.44)], and BMI for age [AOR-3.2; 95% CI (1.43-7.05)] were the predictors of anemia. Conclusion and Recommendation. Anemia was a mild public health problem among school adolescent girls in the study area. Household monthly income, family size, intestinal parasite infections, duration of menstruation, and BMI for age are predictors of anemia. Thus, intervention strategies should focus on prevention and early treatment of intestinal parasite, nutritional education, screening, and iron supplementation programs to prevent anemia among school adolescent girls.

According to the WHO/UNICEF Joint Monitoring Programme (JMP) for water supply and Sanitation definition, safe child feces disposal practices include: children defecation into a latrine, disposal of child stools in a latrine or burial. Inappropriate disposal of human feces including unsafe child feces disposal facilitates the transmission of pathogens. However, the factors associated with safe child feces disposal practices have not been yet well explored in Ethiopia. This study aimed to identify factors associated with safe child feces disposal practices in Ethiopia. This study analyzed data from Ethiopian Demographic and Health Survey (EDHS) 2011. The practice of child’s feces disposal was categorized into ‘safe’ and ‘unsafe’ based on the WHO/ UNICEF JMP for water supply & Sanitation definition. Binary and multivariable logistic regression models were employed to identify factors associated with safe child feces disposal practices. The prevalence of safe child feces disposal was 33.68 % (95 % CI: 32.82-34.55). In the final multivariable logistic regression model, the practice of safe disposal of child feces was significantly associated with urban residency (AOR = 1.25, 95 % CI: 1.01-1.55) and having access to an improved latrine (AOR = 1.92, 95 % CI: 1.56-2.36). Households found in the poorer, middle, richer and richest wealth quintile had (AOR = 2.22, 95 % CI: 1.70-2.89), (AOR = 2.94, 95 % CI: 2.27-3.81), (AOR = 4.20, 95 % CI: 3.42-5.72) and (AOR = 8.06, 95 % CI: 5.91-10.99) times higher odds to practice safe child feces disposal respectively as compared households from poorest wealth quintile. Mothers/caregivers with primary, secondary and higher educational status had (AOR = 1.29, 95 % CI: 1.10-1.50), (AOR = 1. 64, 95 % CI: 1.12-2.41) and (AOR = 2.16, 95 % CI: 1.25-3.72) times higher odds to practice safe child feces disposal respectively than those mothers who had no education. Those mothers/caregivers whose child was 48–59 months old had (AOR = 2.21, 95 % CI: 1.82-2.68) times higher odds to practice safe child feces disposal as compared to mothers/caregivers who had a child with age less than 12 months old. The odds of safe child feces disposal among households who had one two and three under five years old children were (AOR = 3.11, 95 % CI: 1.87-5.19),(AOR = 2.55, 95 % CI: 1.53-4.24) and (AOR = 1.92, 95 % CI: 1.13-3.24) times higher respectively than households with four and more children of under five years old. Only one third of the mothers practiced safe child feces disposal in Ethiopia. Being an urban resident, having a higher wealth quintile, high levels of maternal education, older child age, having a lower number of under five years old children, and the presence of an improved latrine were factors associated with safe child feces disposal practices. Therefore interventions designed to improve safe child feces disposal practices should consider those factors identified. Further research is also needed to design intervention that will aim to improve safe child feces disposal.