Background: The timing of initiation of first antenatal care visit is paramount for ensuring optimal care and health outcomes for women and children. However, the existing evidence from developing countries, including Ethiopia, indicates that most pregnant women are attending antenatal care in late pregnancy. Thus, this study was aimed to assess timely initiation of antenatal care and associated factors among pregnant women attending antenatal care services in Southwest Ethiopia.Methods: Institutional based cross-sectional study was conducted among 375 pregnant women from April 15 to June 15, 2019 in Southwest Ethiopia. A structured and pre-tested face-to-face interviewer-administered questionnaire technique was used to collect data. Systematic random sampling technique was employed to recruit pregnant women. The data were entered into Epi data version 4.4.2 and analyzed using SPSS version 25. Frequency tables, charts and measures of central tendency were used to describe the data. The effect of each variable on timely initiation of antenatal care was assessed using bi-variable logistic regression. A multivariable logistic regression model was used to identify factors associated with timely initiation of antenatal care. The adjusted odds ratio with 95% confidence interval and p<0.05 was used to identify factors associated with timely initiation of antenatal care.Results: The study revealed that 41.9% of pregnant women started antenatal care timely. Pregnant women who had good knowledge of timely initiation of antenatal care (AOR = 3.8, 95% CI: 2.2–6.5), planned to be pregnant (AOR = 5.1, 95% CI: 2.9–8.9), being primigravida (AOR = 2.6, 95% CI: 1.4–4.7) and confirmed their pregnancy by urine test (AOR = 4.1, 95% CI: 2.4–6.9) were found to be significant predictors for timely initiation of antenatal care.Conclusions: Despite the efforts made to make ANC visit services freely available, timely initiation of antenatal care among pregnant women in the study area was low. Pregnant women who had good knowledge of timely initiation of antenatal care, planned to be pregnant, being primigravida and confirmed pregnancy by urine test were found to be significant predictors for timely initiation of antenatal care. Therefore, efforts that strengthen awareness on antenatal care and its right time of commencement, increase pregnant women’s knowledge of timing of antenatal care services and reducing unplanned pregnancies should be organized.

Iodine deficiency disorder is the leading cause of mental retardation and poor economic performance in developing countries. Worldwide, universal salt iodization has been implemented to eliminate iodine deficiency. However, the adequacy of iodine in salts needs close monitoring to meet its intended goal and this study was aimed at investigating the adequacy of iodine in dietary salt at household level in Dessie and Combolcha Towns. A community-based cross-sectional study was employed at household level in Dessie and Combolcha towns from January to February, 2017. Data were collected from 753 households using systematic sampling technique. The adequacy of iodine in salt was analyzed using rapid testing kit. Socio-demographic and economic, dietary sources, labeling, packaging, storage and cooking methods of household’s characteristics were collected via questionnaire developed using open data kit tool and STATA version 12 was used for further statistical analysis. Ordinal Logistic regression was performed to assess associations between explanatory variables and the response variable. Nearly one-thrid (31.2%) of the households used inadequate iodized salt, which was below the World Health Organization recommendation level (≥15 ppm at the household level). Most of the respondents from Combolcha town (64.6%) were affected by inadequate use of iodized salt as compared to Dessie Town residents (22.2%). Being Dessie resident (OR = 2.53; 95% CI: 1.31–4.90), households with better socioeconomic status (OR = 2.54; 95% CI:1.10–5.87), site of labeling and packing (salt from open market (OR = 0.10; 95% CI: 0.04–0.23) and no exposure to sunlight (OR = 2.54; 95% CI:1.31–4.91) were the predictors of adequacy of iodized salt at household level. Availability of adequately iodized salt at the household level in the study area was low. There should be regular quality control and regulatory enforcement of salt iodization at production, labeling and packaging sites of small scale industries and at household level.

Background: Maternity continuum of care is the continuity of maternity health care services that a woman uses for antenatal care, skill birth attendant, and postnatal care. Maternal and child mortality is still big challenge in Ethiopia. Little is known about continuum of maternity care in Ethiopia and where the study area in the district revealed that there is a big discrepancy in the completion of maternity care.Objective: Assessment of maternity continuum of care and associated factors among mothers who gave birth in Legambo district, South, Wollo, and northeast Ethiopia.Method: A community‐based cross‐sectional study design was conducted among 732 mothers from Feb‐Mar 2020. Multistage sampling was used and data were collected through face‐to‐face interviewer‐administered semi‐structured questionnaire. Completed data were entered using Epi‐Data version 3.1, cleaned, and analyzed using SPSS version 25 Statistical Software. Descriptive statistics using Frequency, proportion, summary measures were done. Binary logistic regressions were and model fitness was checked by Hosmer and Lemeshow test which was not significant. Multivariable logistic regression was conducted and P value less than .05 and adjusted odds ratio with 95% confidence interval was considered as statistically significant.Result: The prevalence of maternity continuum of care among mother was found 11.2% (95%, CI: 9.0‐13.8). Residence (AOR:1.837, CI:1.026‐3.288), planned pregnancy (AOR: 2.448, CI:1.361‐4.403), prepregnancy contraceptive utilization (AOR: 2.721, CI:1.469‐5.042), follow mass media (AOR: 2.33, CI:1.146‐4.736) and mother health care decision making autonomy (AOR: 3.712, CI:1.924‐7.161) were determinant factors to continuum of maternity care.Conclusion: The prevalence of maternity continuum of care in the district was low. Information education and counseling about continuum of care are still crucial. Awareness creation for both clients and care provider will improve the service. Efforts on improving and cultivating those significant factors should be done by stakeholders.

Objective: The study aimed to investigate the role of nutrition‐sensitive and specific interventions along with nutrition education on child stunting during the first 1000 days in Ethiopia.Methods: An adequacy evaluation study was used to see changes between the baseline and end‐line data after following for 1 year. A sample of 170 mother‐child pairs who had a 1‐year followed up was used to detect differences. We performed structural equation modeling to elucidate changes in feeding behaviors, socioeconomic status, water, sanitation and hygiene on child linear growth. Furthermore, the independent effect of covariates on child linear growth was handled using a general linear model.Results: A total of 170 and 270 mother‐child dyads were interviewed at baseline and end‐line surveys, respectively. After about 1 year of intervention, the annual rate of stunting prevalence declined from 29.3% (95% confidence interval [CI] = 18.6, 42.7) to 16.4% (95% CI = 10.7, 24.2). There was a significant change in the mean of length‐for‐age Z‐score which changed from −1.18 to −0.45 (P < .034). Adjusting for the different constructs of the health belief model, child sex, age, feeding behaviors, and dietary diversity, one egg consumption per day was responsible for the most significant variability explained (36%) for stunting reduction.Conclusions: Sustainable access to egg consumption for children below 2 years experienced a substantial reduction in childhood stunting. A combination of nutrition‐sensitive agricultural and direct nutrition interventions along with behavioral‐based education is a sustainable strategy in reducing and preventing child growth from faltering in the early life stages.

Background: Treatment failure among the population on second line antiretroviral therapy is a major public health threat. In Ethiopia there has been limited research done on second line treatment failure. Objective: To identify determinants of virologic failure among adults on second line antiretroviral therapy in six public hospitals of Wollo, Amhara regional state, northeast Ethiopia. Methods: An institution-based unmatched case–control study was conducted from February 1, 2020 to April 30, 2020 on a total of 377 clients in six public hospitals of Wollo, Amhara regional state, northeast Ethiopia. Clients whose viral load result > 1,000 copies/mL in two consecutive results at least 3 month apart were cases, while ≤ 1,000 copies/mL were controls. The sample size was calculated by using Epi-Info version 7. Cases (94) and controls (283) were selected using a simple random sampling method in a ratio of cases-to-controls of 1:3. The model fitted and binary logistic assumptions were fulfilled with 95% confidence level and P-values< 0.05 were taken as statistically significant. Results: Virologic failure was predicted by poor adherence (AOR=6.060, 95% CI=2.837– 12.944), not disclosing their HIV status (AOR=4.178, 95% CI=1.431– 12.198), OI (AOR=4.11, 95% CI=1.827– 9.246), CD4 count < 100 cells/mm³ (AOR=3.497, 95% CI=1.233– 9.923) and 100– 350 cells/mm³ (AOR=5.442, 95% CI=2.191– 13.513), low BMI < 16 kg/m² (AOR=7.223, 95% CI=2.218– 23.520), and young age 15– 29 years (AOR=2.898, 95% CI=1.171– 7.170). Conclusion and Recommendations: Determinants of second line ART virologic failure were patients who had poor adherence to ART, not disclosed, opportunistic infection, low CD4 counts < 350 cell/mm³, low BMI (< 16 kg/m²), and young age 15– 29 year patients. Social support, disclosing their HIV status, and getting early treatment for any opportunistic infection is crucial to patients.

Parent-adolescent communication regarding sexual and reproductive health issues is more likely to reduce adolescent risk-taking sexual behaviors. However, there is a paucity of evidence about adolescent parent communication in northern part of Ethiopia.