Background: Poor quality routine data contributes to poor decision-making, inefficient resource allocation, loss of confidence in the health system, and may threaten the validity of impact evaluations. For several reasons in most developing countries, the routine health information systems in those countries are described as ineffective. Hence, the aim of this study is to determine the quality of data and associated factors in the routine health management information system in health centers of Shashogo district, Hadiya Zone. Methods: A facility-based cross-sectional study was conducted from June 1, 2021, to July 1, 2021, and 300 participants were involved in the study through simple random sampling. The data was collected with a self-administered questionnaire by trained data collectors. After checking its completeness, the data was entered into EPI data version 3.1 and exported to SPSS version 25 for statistical analysis. Finally, variables with p < 0.05 during multivariable analysis were considered significant variables. Result: A total of 300(100%) participant were included in the interview and HMIS data quality was 83% in Shashogo district health centers. The data quality in terms of accuracy, completeness, and timeliness was 79%, 86%, and 84%, respectively. Conducting supportive supervision [AOR 3.5 (1.4, 8.9)], checking accuracy [AOR 1.3 (1.5, 3.5)], filling registrations [AOR 2.7 (1.44, 7.7)], and confidence level [AOR 1.9 (1.55, 3.35)] were all rated positively found to be factors associated with data quality. Conclusion: The overall level of data quality in Shashogo district health centers was found to be below the national expectation level. All dimensions of data quality in the district were below 90% in data accuracy, content completeness, and timeliness of data. Conducting supportive supervision, checking accuracy, filling registrations and confidence level were found to be factors associated with data quality. Hence, all stakeholders should give all necessary support to improve data quality in routine health information systems to truly attain the goal of providing good quality data for the decision-making process by considering the identified factors.

Background: Globally, millions of people suffer and die because they do not have the money to pay for health care. A voluntary health insurance scheme is a prepayment mechanism to overcome the financial hardship of poor households. There is a high demand to determine the enrolment rate and ability to pay before scale-up of the scheme by the government to be sure of its feasibility and sustainability. Objective: To determine willingness to join and pay for a community-based health insurance scheme and associated factors among rural households of selected districts in Jimma Zone, 2018. Methods: A community-based cross-sectional study design was employed in selected districts of Jimma Zone, Ethiopia. Multistage simple random sampling was used to select 422 households. Data were collected using a semi-structured interviewer-administered questionnaire. A double bounded contingent valuation method was applied to elicit households’ willingness to pay for the scheme. Data were entered into Epi-Data 3.1 and analyzed with SPSS V.23. A binary logistic regression model was fitted to determine the presence of statistically significant associations between the dependent and independent variables at p-value < 0.05 and AOR values with 95% CI. Results: Of 422 sampled respondents, 389 participated in this study with a response rate of 92%. Of these, 305 (78%) were willing to join and 274 (90%) of them were willing to pay. The average amount of money the households were willing to pay per household per annum was 228 ETB (8.27 USD), with a range of 100– 500 ETB. The older age groups, poor households, and experience of local risk-sharing schemes were found to be determinants for willingness to join the community-based health insurance. Similarly, having a large family size, and low economic and education status of households were significant predictors of willingness to pay for this scheme. Conclusion: A high proportion of households were willing to join and pay for the CBHI scheme. The average amount of money they were willing to pay for the scheme was very slightly lower than what is planned by the government. Thus, the government of Ethiopia should strengthen efforts to scale up this scheme in the rural areas of the country specifically to districts not yet enrolled, to reduce direct out-of-pocket payment at service delivery points. This will also contribute to guaranteeing dwellers of rural areas access to quality health services without facing financial hardship, to achieve universal health coverage for all by the end of 2035.

Background: Voluntary Counseling and Testing (VCT) is widely acknowledged globally as an effective method for preventing and treating HIV/AIDS. It allows people to understand their HIV status, make informed choices about getting tested for it, evaluate their personal risk of contracting HIV, and create plans to reduce that risk. The study aimed to evaluate the process of VCT services in public health facilities of Akaki Kality sub-city, Addis Ababa, Ethiopia. Methods and Materials: A case study evaluation design with a mixed method was employed from May 12 to June 12, 2021. A total of 244 clients were interviewed during the study period. Furthermore, 12 direct observations, a review of documents from the past six months to the study period, and 12 key informant interviews were conducted. Quantitative data were entered into Epi data 4.6 and exported to SPSS version 25 for analysis. Univariate analysis was done and presented in tables and texts. Qualitative data were transcribed, translated, coded, and analyzed using thematic analysis. The overall service implementation process was measured on the basis of pre-determined judgmental criteria. Results: The overall level of VCT service implementation was 83.84%, to which the availability of resources (84.8%), compliance of service providers with the national guidelines (85.38%), and client satisfaction (76.93%) contributed. One facility had stock-outs of test kits in the last three months, and all VCT counseling and testing rooms lacked audio-visual privacy. Supportive supervision, the use of IEC materials during counseling, linking all HIV-positive clients to treatment and care services, and sending complete reports were practiced in a way that needs some improvement. Conclusion: Overall, the service implementation was deemed satisfactory, but further action is required to improve resource availability, ensure provider compliance with national guidelines, and enhance the status of the service. In addition, the Woreda Health Office and Addis Abeba Health Bureau should regularly supervise and provide feedback.

Background: Poor access to institutional delivery services has been known as a significant contributory factor to adverse maternal as well as newborn outcomes. Previous studies measured access in terms of utilization while it has different dimensions (geographic accessibility, availability, affordability, and acceptability) that requires to be measured separately. Therefore, this study was conducted to assess the four dimensions of access and factors associated with each of these dimensions. Methods: Community-based cross-sectional study design was used, employing both quantitative and qualitative methods. A simple random sampling technique was used to select 605 mothers who had given birth in the last 6 months preceding the study. Multi-variable binary logistic regression was used to select factors associated with the four dimensions of access by using AOR with 95% CI. Ethical approval was secured from Jimma University Institutional Review Board. Results: Five hundred and ninety-three mothers involved in this study, resulting in a response rate of 98%. Four hundred five (68%), 273(46%), 279(47%), and 273(46%) had geographic, perceived availability, affordability, and acceptability access to institutional delivery services, respectively. Antenatal care [AOR = 3.74(1.56, 8.98)], occupation of mother [AOR = 5.10(1.63, 15.88)], and residence [AOR = 1.93(1.13, 3.29)] were independently associated with geographic accessibility. Household graduation [AOR = 1.46(1.03, 2.06)], residence [AOR = 1.74(1.17, 2.59)], and ANC [AOR = 3.80(1.38, 10.50)] were independently associated with perceived availability. Moreover, wealth quintile [AOR = 11.60(6.02, 22.35)], ANC [AOR = 3.48(1.36, 9.61)], and occupation of husband [AOR = 3.63(1.51, 8.74)] were independently associated with affordability. Lastly, mother’s education [AOR = 2.69(1.42, 5.09)], residence [AOR = 2.60(1.66, 4.08)], and household graduation [AOR = 3.12(2.16, 4.50)] were independently associated with acceptability of institutional delivery services. Conclusions: Moderate proportions of mothers have geographic accessibility to institutional delivery services, but access to the other three dimensions was low. ANC visits of 4 or above, occupation of husband, urban residence, graduation of mother’s household as a model family, higher wealth quintiles, and maternal educational level significantly affect access to institutional delivery services. Thus, it was recommended that concerned bodies should give due attention to ANC services, female education, training of model families, and enhancement of household wealth through job creation opportunities to increase access to institutional delivery services.

Background: Anthrax is a serious infectious disease affecting animals and humans and remains a public health issue in developing countries. Aim: This study assessed the overall anthrax outbreak response and identified strengths, challenges, and best practices during surveillance, preparedness, and response in Ethiopia from May 2022 to July 2022. Setting: Conducted in Arba Minch Town, Gamo Zone, Southern Ethiopia. Methods: An after-action review (AAR) using qualitative methods was performed. Experts included clinicians, public health professionals, and government officials were involved in the outbreak response. Data were collected via focus group discussions, key informant interviews, and observations, recorded digitally. Thematic analysis was used. Results: Strong stakeholder engagement and coordination were evident, with mass vaccinations aiding control. However, gaps included unprepared logistics, poor communication, and insufficient training. Despite anthrax being immediately notifiable, weaknesses in surveillance detection and reporting were found. Coordination was effective with intersectoral collaboration and commitment, leading to a commendable, lifesaving response once initiated. Conclusion: The study revealed effective engagement and coordination but identified gaps in preparedness and communication. Addressing these through capacity-building and stronger preparedness is crucial for future outbreak management. Contribution: This study provides valuable evidence-based insights to improve health preparedness and response in the African context.