Husbands play an influential role in women’s access to health care, such as family planning services. However, there is little evidence of the level of husbands’ involvement in family planning services among pastoralist communities, who possess a distinct lifestyle. This study was aimed to assess husbands’ involvement in family planning use and factors associated in pastoralist communities of Afar, Ethiopia. Community-based cross-sectional survey was conducted among randomly selected 418 married women in Afambo district, Afar pastoralist community in 2017. Data were collected using semi-structured questionnaire. Data were entered to EPI-Info version 7 statistical software programs and exported to SPSS. Descriptive and multivariable logistic regression analyses were applied to identify factors associated with husband involvement. Odds ratio at 95% confidence interval were reported and significant association of factors was declared at the p-value of less than 0.05. Four hundred eighteen married women were included in the study, making a response rate of 98%. The magnitude of husbands’ involvement in family planning was found to be 42.2%. Women who ever used family planning (AOR: 7.21; 95%CI: 3.58–14.67), those who participated in community networks, those who reported health center as their source of information for family planning (AOR: 5.56; 95%CI: 1.92–16. o7) were higher likely to report husband involvement compare to their counterparts. Participants’ increased knowledge was also significantly associated with higher odds of husband involvement in family knowledge (AOR = 1.31; 95% CI: 1.16–1.58). . Husbands’ involvement in the district is low. Women’s engagement in community networks aimed at increasing the knowledge of the women may involve in family planning. In addition, due focus among health care providers in lower health care units to provide information for both women and men might have a promising power to improve husbands involvement.

Despite poverty reduction and increased promotion of improved nutrition practices in the community, undernutrition in Ethiopia remains a concern. The present study aimed to explore the demand and supply side barriers that limit the uptake of nutrition services among pregnant women from the rural communities of the Tigray Region, Northern Ethiopia. A community-based qualitative study was conducted in December through January 2017. A total of 90 key informant in-depth interviews and 14 focus group discussions were undertaken. Study participants were purposively selected for specific characteristics, along with health professionals deployed at various levels of the health system, including health posts, health centers, woreda health offices, and the regional health bureau. Study participants were asked to identify the barriers and implementation challenges that limit access to nutrition services for pregnant women. Participants’ responses were transcribed verbatim, without editing the grammar, to avoid losing meaning. The data were imported to ATLAS.ti 7 (qualitative data analysis software) for coding and analyzed using a thematic content analysis approach. The study findings indicated that the dietary quality of pregnant women in the study area remains poor and in some cases, poorer quality than pre-pregnancy. Across study sites, heavy workloads, food taboos and avoidances, low husband support, lack of economic resources, lack of awareness, low educational level of women, poor dietary habits, increased expenditure for cultural and religious festivities, “dependency syndrome”, low physical access to health facilities, poorly equipped health facilities, focus on child health and nutrition, poor coordination among nutrition specific and sensitive sectors, and limited sources of nutrition information were identified as the demand and supply side barriers limiting the uptake of nutrition services during pregnancy. In conclusion, the community would benefit from improved social behavior change communication on nutrition during pregnancy and multi-sectoral coordination among nutrition-specific and nutrition-sensitive sectors.

Food taboo is contributing substantially to malnutrition for pregnant women by restricting and limiting the frequency and variety of foods most of which are nutritious and easily accessible. The practice is common in developing countries and most of the food taboos in East Africa fall on the women and most unfortunately on the pregnant. Foods of animal products, which are the main sources dietary energy of pastoralist communities, are often prone to the practice of food taboos. Nonetheless, the existence of the practice in Ethiopian pastoralist communities, the communities whose way of life is mostly nomadic and based on tending of herds or flocks, is not investigated yet. Therefore, the current study aimed to explore foods tabooed for pregnant women and the reasons behind the practice if exists in Abala district of Afar region, Ethiopia. Exploratory qualitative study was conducted inductively involving homogeneous participants in four focus group discussions and eight key informants in individual in-depth interview who were purposively selected in Aballa district from March 1 to 30, 2016. A semi-structured interview guide was used to collect the data. The investigators audiotaped focus group discussions and interviews and then transcribed them verbatim. Finally, the transcribed data were imported to Atlas.ti 7 software for coding. Analysis was done inductively. Triangulation and peer debriefing were applied to assure data quality. The study revealed that foods tabooed for pregnant women were 1) Eating a large amount of food of any type, 2) fatty foods like meat, milk and yoghurt, 3) Foods that are not in liquid form such as different types of bread and 4) cool/cold foods such as cold milk, cold meat and cold water. The reasons mentioned to adhere with the foods taboo for pregnant women were to avoid difficulty to deliver the fetus, to prevent disease like Gastritis, Diarrhea, Typhoid and skin discoloration of the fetus. Besides, inconveniences like abdominal cramp were reported as reasons to adhere the foods tabooed. Pregnant women in Aballa district avoid eating numerous accessible foods because the foods are believed as tabooed for them. Further studies that focus on the extent of food taboo and uncovering the understanding on how it is being practiced were recommended.

Background: Psychoactive substance use is a major public health concern globally. Though youth attending higher education institutions are considered particularly vulnerable to psychoactive substances, there is a paucity of evidence in Ethiopia. We aimed to determine the prevalence of psychoactive substance use, factors associated with psychoactive substance use and level of dependence among Mekelle University undergraduate students in Ethiopia. Methods: An institution-based quantitative cross-sectional survey was used to randomly (using multistage sampling) invite 1220 undergraduate students in April and May 2017 to participate. Multinomial logistic regression was used to identify factors associated with psychoactive substance use. Level of dependence was determined using the WHO’s Alcohol, Smoking and Substance Involvement Screening Test classification. Results: Among the eligible students approached, 1214 participants completed the survey, which yields a 99.5% response rate. The lifetime prevalence of psychoactive substance use was 66.5% (95% Confidence Interval (CI) = 64% to 69%) while the current prevalence was 49% (95% CI = 46% to 52%). A history of, but not current, psychoactive substance use was reported by 18%, while 33.5% reported never having used psychoactive substances. The current prevalence of alcohol use was 35.5%, tobacco 7.8% and khat 5.7%. Of the current users, 17% (95% CI = 14% to 20%) were at a moderate to high risk of dependency. Being over 21 years of age (adjusted odds ratio (AOR) = 1.6, 95% CI = 1.37 to 2.25), male (AOR = 3.13; 95% CI = 2.26 to 4.34), living in urban areas (AOR = 2.39, 95% CI = 1.77 to 3.23), an Orthodox Christian (AOR = 7.55, 95% CI = 4.56 to 12.48), and being in their 3rd year (AOR = 2.3, 95% CI = 1.49 to 3.55), 4th year (AOR = 2.0, 95% CI = 1.2 to 3.51) and 5th year (AOR = 4.0, 95% CI = 2.81 to 7.67) at university were associated with currently using psychoactive substances. Being male and Orthodox Christian was associated with being an ex-smoker. Conclusions: Approximately half of Mekelle University undergraduate students were using psychoactive substances with almost one in five at risk of dependency. The likelihood of use increased with seniority. Evidence-based strategies are needed to prevent school-aged children from using psychoactive substances and university students becoming dependent on substances. Interventions designed to stop current psychoactive substance use may also have promise for reducing dependency.

Despite the significant benefits of giving birth at a health facility to improve maternal and child health, the practice remains lower than expected in pastoralist communities of Ethiopia. Understanding the intentions of pregnant women to use health facilities for delivery predicts the adoption of the behavior, yet documented evidence of intention in the context of pastoralist populations remains scarce. The current study aimed to assess pregnant women’s intentions to use a health facility for delivery in the Afar region of Ethiopia using the framework of the health belief model (HBM). A community-based, cross sectional survey was conducted from April 1 to April 30 2016 among 357 randomly sampled pregnant women using an interviewer-administered, semi-structured questionnaire. Data were entered into EpiData and exported to SPSS version 20.0 for analysis. Principal component factor analysis was done to extract relevant constructs of the model, and the reliability of items in each construct was assessed for acceptability. Multivariate logistic regressions were applied to identify predictors of pregnant women’s intentions to give birth at a health facility. The odds ratio was reported, and statistical significance was declared at 95% CI and 0.05 p value. Three hundred fifty seven pregnant women participated in the study (104.6% response rate indicating above the minimum sample size required). Among the respondents, only 108 (30.3%) participants intended to use a health facility for the delivery for their current pregnancy. Higher household average monthly income [AOR = 1.23, 95% CI = (1.10 − 2.90), antenatal clinic (ANC) attendance for their current pregnancy [AOR = 1.41, 95% CI = (1.31 − 2.10), perceived susceptibility to delivery-related complications [AOR = 1.52, 95% CI = (1.30 − 2.70), and perceived severity of the delivery complications [AOR = 1.66, 95% CI = (1.12 − 2.31) were positively associated with pregnant women’s intentions to deliver at a health facility. Intention was negatively associated with participants’ perceived barriers to accessing a health facility [AOR = 0.62, 95% CI = (0.36 − 0.85). Conclusions: A low proportion of pregnant women in the sampled community intended to deliver at a health facility. Pastoralist communities may have special needs in this regard, with household income, antenatal care attendance, perceived risk of complications, and perceived barriers to accessing a health facility largely explaining the variance in intention. Community-based interventions providing counseling and messaging on danger signs in the perinatal period and emphasizing benefits of delivering at a facility are recommended, alongside improving access.

Background: Kangaroo mother care (KMC) is an evidence-based approach to reducing morbidity and mortality in low-birth-weight and preterm newborns. Barriers for KMC and its effective practice at a larger scale are highly affected by contextual factors. The purpose of this study is to explore barriers and enablers in the community and health facilities for implementation and continuation of KMC. Methods: This formative study employed a qualitative exploratory approach using focus group discussions and in-depth interviews in five zones of Tigray region, Northern Ethiopia. A total of 16 focus group discussions and 46 in-depth interviews were conducted with health workers and community members. The whole process of data collection took an iterative approach. An inductive thematic analysis was done by going through the transcribed data using ATLAS.ti software. Results: The current study found that problems of infrastructure and equipment for KMC practice, shortage of staff, and absence of trained health workers as the most frequently mentioned barriers by health workers. Low level of awareness, lack of support, mother being responsible for the rest of the family, holding babies in the front being traditionally unacceptable, and preference of incubators for better care of small babies were among the barriers identified in the community. Presence of community health workers and the positive attitude of the community towards them, as well as antenatal and postnatal care were among the favorable conditions for the implementation of KMC at health facilities and continuation of KMC at home. Conclusion: Empowering health workers through training to identify preterm and low-birth-weight babies, to do follow-ups after discharge, and creating awareness in the community to change the perception of kangaroo mother care are necessary.