In Ethiopia, 20,000 women die each year from complications related to pregnancy, childbirth and post-partum. For every woman that dies, 20 more experience injury, infection, disease, or disability. “Maternal near miss” (MNM), defined by the World Health Organization (WHO) as a woman who nearly dies, but survives a complication during pregnancy, childbirth or within 42 days of a termination, is a proxy indicator of maternal mortality and quality of obstetric care. In Ethiopia, few studies have examined MNM. This study aims to identify determinants of MNM among a small population of women in Tigray, Ethiopia. Unmatched case-control study was conducted in hospitals in Tigray Region, Northern Ethiopia, from January 30-March 30, 2016. The sample included 103 cases and 205 controls recruited from among women seeking obstetric care at six (6) public hospitals. Clients with life-threatening obstetric complications, including hemorrhage, hypertensive diseases of pregnancy, dystocia, infection, and anemia or clinical signs of severe anemia (in women without hemorrhage) were taken as cases and those with normal obstetric outcomes were controls. Cases were selected based on proportion to size allocation while systematic sampling was employed for controls. Binary and multiple variable logistic regression (“odds ratio”) analyses were calculated at 95% CI. Roughly 90% of cases and controls were married and 25% experienced their first pregnancy before the age of 16 years. About two-thirds of controls and 45.6% of cases had gestational ages between 37–41 weeks. Among cases, severe obstetric hemorrhage (44.7%), hypertensive disorders (38.8%), dystocia (17.5%), sepsis (9.7%) and severe anemia (2.9%) were leading causes of MNM. Histories of chronic maternal medical problems like hypertension, diabetes were reported in 55.3% of cases and 33.2% of controls. Women with no formal education [AOR = 3.2;95%CI:1.24, 8.12], being less than 16 years of age at first pregnancy [AOR = 2.5;95%CI:1.12,5.63], induced labor[AOR = 3.0; 95%CI:1.44, 6.17], history of cesarean section[AOR = 4.6; 95% CI: 1.98, 7.61] or chronic medical disorder[AOR = 3.5;95%CI:1.78, 6.93], and women who traveled more than 60 minutes before reaching their final place of care[AOR = 2.8;95% CI: 1.19,6.35] had higher odds of experiencing MNM. Macro-developments like increasing road and health facility access as well as expanding education will all help reduce MNM. Work should be continued to educate women and providers about common predictors of MNM like history of C-section and chronic illness as well as teenage pregnancy. These efforts should be carried out at the facility, community, and individual levels. Targeted follow-up with women with history of chronic disease and C-section could also help reduce MNM.

Background: Postpartum depression (PPD) is a serious mood disorder that affects behavioural, physical and mental health of women and newborn after childbirth. Although a wide range of research have been conducted on maternal and infant health outcomes, the effect of postpartum depression on exclusive breastfeeding practices remains ambiguous, and needs addressing. The aim of this study was to assess the effect of postpartum depression on exclusive breast feeding practices in sub-Saharan African countries.Methods: PubMed, Google Scholar, Science Direct and Cochrane Library were systematically searched for relevant articles published between 2001 and 2020. STATA version 14 was used to calculate the pooled odd ratio with 95% confidence intervals (95% CI). The DerSimonian and Laird random effects meta-analysis was used to measure the effect of postpartum depression on exclusive breast feeding practices. The heterogeneity and publication bias were assessed by using I²test statistics and Egger’s test, respectively. This review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis.Result: A total of 1482 published articles and gray literatures were retrieved from different databases. Additional articles were identified from the reference list of identified reports and articles. After assessment of obtained articles, studies not meeting the inclusion criteria were excluded. Twenty six studies involving 30,021 population met the inclusion criteria were included in this review. In sub Saharan Africa the overall estimated level of postpartum depression was 18.6% (95% CI: 13.8, 23.4). This review found that postpartum depression had no significant effect on exclusive breast feeding practices (OR = 0.46, 95% CI: 0.18, 1.14).Conclusion: In Sub Saharan Africa, the prevalence of postpartum depression was lower than the report of World Health Organization for developing Country in 2020. This review reveled that maternal postpartum depression has no significant effect on exclusive breast feeding practices. Thus, the investigators strongly recommend the researchers to conduct primary studies using strong study design in sub-Saharan Africa.

Unintended pregnancy has direct relation with poor utilization of maternal health care services and also associated with unhealthy behaviors during pregnancy. Few studies have examined the association between unintended pregnancy and maternal health behaviors during pregnancy in developing countries including Ethiopia. The purpose of the study was to determine the association of unintended pregnancy with use of antenatal care during pregnancy among pregnant women in Hadiya zone, southern Ethiopia. Community based cross sectional study design was employed in Hadiya zone, southern Ethiopia in 2017. 748 pregnant mothers were included using single population proportion. Study participants were selected by simple random sampling technique. A structured interviewer administered questionnaire was used to collect data. Descriptive, bivariate and multivariate logistic regression was employed to identify the independent effect of unintended pregnancy on the outcomes of interest. The level of significance was confirmed if p-value was less than 0.05. More than one third (36.2%) of women reported unintended pregnancy. Unintended pregnancy was significantly associated with use of antenatal care. Women with unintended pregnancy were 69% less likely to receive ANC (AOR=0.31, 95% CI; 0.21–0.46) and were four times more likely to have late ANC initiation (AOR=4.40, 95% CI; 1.70–11.40) during pregnancy as compared to counterparts. This study finding showed an association between unintended pregnancy and ANC use during pregnancy. Women with unintended pregnancy were less likely to use antenatal care and more likely to delay initiation of antenatal care. Longitudinal studies are recommended on relationship between unintended pregnancy and ANC use.

Background: Severe pneumonia is still the greatest infectious cause of morbidity and mortality in children under the age of five around the world. Each night spent in the hospital raises the chance of bad drug responses, infections, and ulcers by 0.5%, 1.6%, and 0.5%, respectively. In Southern Ethiopia, as well as the research area, little is known regarding death and recovery time from severe pneumonia and their determinants. Objective: To determine time to recovery from severe pneumonia and its predictors among children 2– 59 months of age admitted to pediatric ward of Nigist Eleni Mohammed Memorial Comprehensive Specialized Hospital. Methods: A facility-based retrospective cohort study was conducted among children 2– 59 months of age. Three years’ medical records, from January 2017 to December 2020, were reviewed. A total of 280 children with severe pneumonia were included. In the case of survival time, median was calculated. Kaplan Meier survival curve was used to estimate recovery time from severe pneumonia, and the independent effects of covariates on recovery time were analyzed using multivariable Cox-proportional hazard model. Results: The median time to recovery was 4 days (interquartile range = 3, 5). The incidence rate of recovery was 24.16 per 100 person-days. Underweight (adjusted hazard ratio = 0.56, 95% CI = 0.38– 0.80), age group 12– 35 months (adjusted hazard ratio= 2.0, 95% CI=1.30– 3.30), treatment with ampicillin and gentamicin (adjusted hazard ratio= 0.35, 95% CI: 0.13– 0.80), and antibiotic change (adjusted hazard ratio= 0.34, 95% CI = 0.21– 0.53) were statistically significant predictors of time to recovery from severe pneumonia. Conclusion: The median length of stay in the hospital was short (4 days [interquartile range =3, 5]). Time to recover from severe pneumonia was significantly influenced by being underweight, age, antibiotics administered first, and antibiotic change. Measures such as providing nutritious meals to children and ensuring that underweight children are properly managed should be bolstered.

Background: The world is currently facing a pandemic of Coronavirus Disease 2019 (Covid-19). It has caused significant morbidity and mortality. So far little is known about recovery time (prolonged hospital stay) from Covid-19 and its determinants in Ethiopia as well as in the study area. Therefore, the aim of this study was to determine time to recovery from Covid-19, and identify predictors of time to recovery among patients admitted to treatment centers of Southern Nations Nationalities and Peoples Region (SNNPR). Methods and Materials: A facility-based retrospective cohort study was conducted among Covid-19 patients admitted to care centers of SNNPR from May 30, 2020 to October 15, 2021. A sample of 845 patients was included in the study. Summarization of the data was done using mean (standard deviation) and median (inter quartile range). Kaplan–Meier Survival Curve was used to estimate recovery time from Covid-19 and the independent effects of covariates on recovery time was analyzed using multivariable Cox-proportional hazard model. Results: The incidence density of recovery was 8.24 per 100 person-days (95% CI: 7.67, 8.85). The overall median recovery time was 10 days (IQR: 8– 16 days). Critical stage of Covid-19 (aHR = 0.19, 95% CI: 0.12, 0.29), severe stage of Covid-19 (aHR = 0.40, 95% CI: 0.29, 0.56), mechanical ventilation (aHR = 0.20, 95% CI: 0.073, 0.56) and treatment center (aHR = 0.68, 95% CI: 0.51, 0.90) were significant predictors of recovery rate among Covid-19 patients. Conclusion: The median time to recovery from Covid-19 was relatively short. The incidence density of recovery was 8.24 per 100 person-days. The hazard of recovery was lower for patients at higher levels of Covid-19 severity and for patients in need of mechanical ventilation. Early identification of severity levels of the patients is required at the time of admission. Special attention, critical follow–up and management is warranted for patients at higher levels of Covid-19 severity.

Background: The primary goal of antiretroviral therapy is to prevent human immune deficiency virus (HIV)-related morbidity and mortality. Deferring antiretroviral therapy (ART) until CD4 counts decline puts individuals with HIV at risk of HIV-related morbidity and mortality. Objective: This study aims to assess the effect of the test and treat strategy on mortality among HIV-positive clients on ART in public hospitals in Addis Ababa. Methods: A retrospective cohort study was conducted at five selected public hospitals in Addis Ababa. A cohort of 216 ART clients taken as an exposed group (test and treat” strategy) from 2017 to 2019 and 216 ART clients as an unexposed group taken from 2014 to 2017; totally, 432 clients were included in the study. Multivariate Cox regression was used to estimate the effect of the test and treat strategy on the survival of ART clients adjusting for other covariates. Results: The 432 clients contributed to a total of 1025.17 person-years follow-up. Ninety-one (21.06%) of them died, 14.3% were unexposed and 6.7% were exposed (test and treat). The incidence of death was 92.4 and 81.8/1000 person-years in the unexposed group and exposed group, respectively, with an overall mortality rate of 88.8/1000 person-years. Besides, test and treat strategy (AHR: 0.31; 95% CI: 0.19, 0.52), baseline CD4 counts > 350 cells/mm3 (AHR 0.40; 95%: CI: 0.20, 0.80), bedridden functional status (AHR 2.46; 95% CI: 1.41, 4.27), poor adherence (AHR 3.25; 95% CI: 1.410– 7.51), moderate malnutrition on last visit (AHR 2.56; 95% CI: 1.30– 5.04) and staying on original regimen (AHR 4.68; 95% CI 2.72, 8.07) were independent predictors of mortality. Conclusion: Mortality among HIV patients on treatment decreased significantly since the start of the test and treat strategy. Therefore, test and treat strategy should be strengthened in all public and private facilities throughout the country.