Background: The third delay is a delay in accessing emergency obstetric care timely and appropriately once a woman reaches a health facility. The third delay plays a crucial role as an indicator to assess the quality of obstetrics services and is often the leading contributing factor to maternal mortality in developing countries. Although considerable research has been conducted on pre-facility delays in healthcare access, there is a lack of focus on delays experienced upon arrival at health facilities, particularly in Ethiopia and the specific study areas of Gurage zone. This study aimed to assess the magnitude of the third delay and associated factors among women who gave birth at Public Health Facilities of Gurage Zone, Southern Ethiopia. Method: A facility-based cross-sectional study was conducted with 558 women who gave birth at public health facilities of Gurage Zone from January 01/2020 to March 30/2020. Multi-stage stratified sampling technique was used to select the nine facilities. The data was collected using a structured interviewer administer questionnaire and an observational checklist. Women who waited more than an hour to receive delivery services after arriving at the health facility were classified as experiencing the third delay. The data were entered and analyzed using Epi Data version 3.1 and SPSS version 20.0 software, respectively. Binary logistic regression was employed to identify the determinant factors for the third delay. Variables having a P-value < 0.25 in the binary analysis were a candidate for multivariable analysis. Variables with P < 0.05 were considered statistically significant. Result: The magnitude of the third delay was 193 [(34.8%; 95% CI; (30.8%, 38.8%)]. Complication during labor [AOR = 2.0; 95% CI, (1.4, 3.0)], Presence of functional generator in a health facility [AOR = 2.8; 95% CI, (1.3, 6.3)], level of health institution [AOR = 2.8; 95% CI, (1.04, 7.8)] and BEMONC training in the last two years [AOR = 1.6; 95% CI, (2.0, 6.5)] were significantly associated with third delay. Conclusion: The magnitude of third delay was high compared to some low income countries, which shows most of mothers were not getting the service timely after they arrived at the health facility. Equipping health facilities with trained manpower and with necessary materials and infrastructure will contribute to hastening the provision of obstetric care.

Background: The outpatient therapeutic program (OTP) of children with severe acute malnutrition (SAM) brought the treatment approach closer to the community. In spite of the high coverage and accessibility, a low recovery rate of OTP is often reported. Thus, the aim of this study was to assess the treatment outcomes and identify predictors of recovery among children aged 6– 59 months with SAM enrolled to OTP in Wenago district, Southern Ethiopia. Methods: A facility-based cross-sectional study was conducted by assessing health records and interviewing mothers of 554 children, who were treated between July 2017 and February 2018. A single stage cluster sampling was used to enroll the study participants. The data were coded and entered into EpiData version 3.1, and analyzed by SPSS version 20. Binary logistic regression was used to identify predictors of recovery. All statistical tests in this study were declared significant at P< 0.05. Results: The recovery, average weight gain rate and length of stay were 70.4%, 3.9 g/kg/day and 6.67 weeks, respectively. The adjusted odds ratios to recovery of children who were treated with amoxicillin, born from a mother whose age at first marriage was > 18 years, from a food secured household and had access to safe water sources were (AOR=3.97, 2.75, 3.21 and 2.96; 95% CI= 2.32, 6.78, 1.54, 4.93, 1.86, 5.52, and 1.61, 5.45), respectively. Conversely, children from households with three under-5 year olds had a 86% (AOR=0.14; 95% CI 0.05, 0.38) less risk of recovery as compared to children from households with only one under-5-year-old child. Conclusion: The recovery rate, average daily weight gain and length of stay in the program were not within the acceptable sphere standards. Provision of amoxicillin, numbers of under-5-year-old children in the house, maternal age at first marriage, a source of water and food security status were independently associated with recovery from SAM under OTP.

Background: Research indicates that homelessness is associated with an increased risk of suicide. While street homelessness is a global problem, it is a disproportionately serious concern in low- and middle-income countries such as Ethiopia. Despite their high risk of suicidal thoughts and attempts, there has been limited research on this subject among homeless young people in Ethiopia. Therefore, we assessed the prevalence and factors contributing to suicidal behaviour among homeless young people in the southern region of this country. Methods: We conducted a community-based cross-sectional study from 15 June to 15 August 2020 involving 798 homeless young adults in four southern Ethiopian towns and cities. The Suicide Behaviour Questionnaire-Revised (SBQ-R) was used to assess suicidal behaviour. Data were coded and entered into Epi-Data version 7 and analysed using SPSS version 20. We conducted a multivariable logistic regression analysis to identify factors associated with suicidal behaviour. Variables with a p-value of < 0.05 were considered statistically significant. An adjusted odds ratio with a 95% confidence interval was determined to indicate the association’s strength. Results: The overall prevalence of suicidal behaviour among young homeless individuals was 38.2% (95% CI: 34.8%, 41.5%). The lifetime prevalence of suicidal ideation, planning and attempt was 10.7% (95% CI: 8.6–12.9%), 5.1% (95% CI: 3.6–6.6%) and 3% (95% CI: 1.9–4.3%), respectively. A longer duration of homelessness (1–2 years) (AOR = 2.244, 95% CI: 1.447–3.481), stressful life events (AOR = 1.655, 95% CI: 1.132–2.418) and the stigma associated with homelessness (AOR = 1.629, 95% CI: 1.149–1.505) were significantly associated with suicidal behaviour. Conclusion: The results of our study indicate that suicide is a serious public health problem among homeless young people in southern Ethiopia. We have found associations between suicidal behaviour and stressful events, homelessness lasting for one to two years and stigma. Our study suggests that policymakers and programme planners need to develop a strategy for preventing, detecting and managing suicidal behaviour among street-dwelling homeless young adults, a vulnerable and understudied population. A community-based suicide prevention campaign is also essential for street-dwelling homeless young people in Ethiopia.

Introduction: One of the key strategies to achieve the sustainable development goal by reducing maternal deaths below 70 per 100,000 is improving knowledge of obstetric danger signs (ODS). However, mothers’ knowledge of ODS is low in general and very low in rural settings, regardless of local and national efforts in Ethiopia. Further, there is significant variation of ODS knowledge among women from region to region and urban/rural settings. Most studies are limited only to northern Ethiopia and focused on individual-level determinants. Thus, this study aimed to assess the individual and community-level determinants of knowledge of obstetrics danger signs among women who delivered in the last 12 months in the northern zone of the Sidama region, Ethiopia. Methods: We conducted a community-based cross-sectional study from October 21 to November 11, 2022. A multi-stage sampling procedure was utilized to select study participants. A structured and pretested questionnaire was utilized to collect data. Open Data Kit (ODK) smartphone application was used to collect data at women’s homes. A multi-level mixed-effects negative binomial regression model was used to control effects of clusters and confounders. Results: The overall response rate of this study was 99.12%. The proportion of knowledge of obstetrics danger sign was 22.3% (95% CI: 18.7, 25.9). Government-employed women [adjusted incidence ratio (AIR) = 1.37; 95% CI: 1.20, 1.56], women who had exposure to mass media (AIR = 1.16; 95% CI: 1.08, 1.25), women who had received model family training (AIR = 1.15; 95% CI: 1.10, 1.25), autonomous women (AIR = 1.34; 95% CI: 1.25, 1.46), women who had faced health problems during pregnancy (AIR = 1.21; 95% CI: 1.11, 1.32), and urban women (AIR = 1.22; 95% CI: 1.09, 1.62) were determinants positively affect knowledge of ODS. Conclusion: Only one in five women has good knowledge of ODS in the study setting. Urban residence, mass media exposure, receiving model family training, facing health problems during pregnancy, and women’s autonomy were the main determinants of knowledge of ODS. Any intervention strategies should focus on multi-sectorial collaboration to address determinants of knowledge of ODS at the individual and community level. Reinforcing the existing model family training, particularly focusing on rural women and women who denied autonomy in decision-making about health care, should be considered. Awareness creation should be increased about ODS through mass media exposure.

Background: Growth monitoring and promotion (GMP) is a nutritional intervention designed to identify and address growth faltering before a child’s nutritional status deteriorates into severe malnutrition. Despite GMP being recognized as a priority in Ethiopia’s national nutrition program, there is no national aggregated figure to show the extent of GMP service utilization. Therefore, this systematic review and meta-analysis aimed to assess GMP service utilization and associated factors in Ethiopia. Methods: A systematic literature search was conducted using PubMed/MEDLINE, CINAHL, Hinari, EMBASE, Scopus, and grey literature sources like Google Scholar, WorldCat, and Institutional repository. The Joanna Briggs Institution (JBI) quality assessment tool was used to appraise the quality of the articles, and articles scoring > 50% were included in the analysis. The pooled prevalence and odds ratio of associated factors with 95%CI was computed using STATA version 16. A random-effect model was employed to estimate the effect size, and I-squared statistics and Egger’s test were used to assess heterogeneity and identify potential publication bias, respectively. Subgroup analysis was conducted with publication year, sample size, and region to identify the source of heterogeneity. Results: Nine studies with 4,768 study participants were included in this meta-analysis. The overall pooled utilization of GMP service among children under two years of age in Ethiopia was 23.21% (95% CI: 16.02, 30.41, I² = 97.27% & P = 0.0001). Mothers who received counselling on GMP service (OR = 3.16 (95%CI: 2.49-4.00), parents who use family health card (FHC) (OR = 3.29 (95%CI: 1.49–7.28), and mother who use postnatal care (OR = 3.93 (95%CI: 2.40–6.42), and Anti natal care (OR = 3.15 (95%CI: 1.29–7.69) were the factors associated with GMP service utilization among children under two years of age. Conclusions: The utilization of GMP services among children under the age of two in Ethiopia remains inadequate. Therefore, it is crucial to provide health education and counselling focusing on GMP to the mothers/caregivers of the child and encourage utilization of FHC. In addition, integrating GMP with other maternal health services should be promoted.

Background: COVID-19 causes worse outcomes and a higher mortality rate in adults with chronic medical conditions. In addition, the pandemic is influencing mental health and causing psychological distress in people with chronic medical illnesses. Objective: To assess the knowledge, practice, and impact of COVID-19 on mental health among chronic disease patients at selected hospitals in Sidama regional state. Method: A facility-based cross-sectional study was conducted. A total of 422 study subjects were enrolled in the study using a two-stage sampling technique. Data were coded and entered using Epi Data version 3.1 and exported to SPSS-20 for analysis. Descriptive analysis was used to present the data using tables and figures. Bivariate and multivariate logistic analyses were used to identify factors associated with the initiation of preventive behavior of COVID-19. Variables with a P-value of less than 0.25 in bivariate analysis were considered as candidate variables for multivariable analysis. The statistical significance was declared at a P-value less than 0.05. Result: More than half 237 (56.2%, 95% CI: 50.7–60.9) of the study participants had good knowledge of COVID-19. The practice of preventive measures toward COVID-19 was found to be low (42.4%, 95% CI: 37.9–47.2). Being widowed (AOR = 0.31, 95% CI (0.10, 0.92)), secondary and above educational status (AOR = 2.21, 95% CI (1.01, 4.84)), urban residence (AOR = 2.33, 95% CI (1.30, 4.19)) and good knowledge (AOR = 4.87, 95% CI (2.96, 8.00)) were significantly associated with good practice. In addition, more than one-third of the study participants 37% (95% CI 32.7, 41.5) were experiencing anxiety. While more than a quarter of respondents 26.8% (95% CI 22.5, 31.5) had depression. Conclusion and recommendation: Despite more than half of the participants had good knowledge, the prevention practice was low. Hence, multiple information dissemination strategies should be implemented continuously among chronic disease patients. In addition, the magnitude of concurrent depression and anxiety in the current study was high.