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Background: Violence against women is a global problem. In pregnant women, it is a particular concern as a virtue of the additional risks to the unborn child. Of different acts of violence, sexual violence shares the major contribution that results in short and long-term physical, sexual, reproductive, and mental health problems of pregnant women. Little is known about sexual violence during pregnancy in Ethiopia. Objective: this study aimed to assess the proportion and factors associated with intimate partners' sexual violence against pregnant women in Northwest Ethiopia. Methods: A cross-sectional study was conducted among 409 pregnant women in Debre Markos town from March to April 2018. The study participants were selected using a systematic random sampling technique. A pre-tested and validated questionnaire was used. Binary logistic regression analyses were done to identify associated factors and the adjusted odds ratio (AOR) with its 95 % confidence interval (CI) at a p-value of <0.05 was used to declare a significant association. Result: Of 409 pregnant women, 19.8% have experienced sexual violence by their intimate partner during their current pregnancy. Accordingly, the major intimate partner sexual violence during pregnancy was having unwanted sexual intercourse due to fear from the partner (13.4%), being forced to do something sexual that is degrading or humiliating (13.0%), and being physically forced to have sexual intercourse (9.8%). Living with her partner/husband (AOR: 3.73, 95% CI: 1.30, 10.69), uneducated educational status of partner (AOR: 2.43, 95% CI: 1.06, 5.56), and frequency of alcohol consumption (AOR: 3.20, 95% CI: 1.24, 8.26) were factors associated with increased occurrence of intimate partner sexual violence during pregnancy. Conclusion: The proportion of sexual violence against pregnant women by their intimate partner(s) was found to be common in our study. Socio-demographic and behavioral-related factors were risk factors for sexual violence. As a result, preventive strategies and interventions centering on the empowerment of those facing the greatest barriers to reproductive freedom require a shift from traditional ways of thinking.

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Background: Institutional delivery is a proxy for skilled birth attendance, which is an important intervention to reduce maternal and neonatal mortality. Even though institutional delivery has such importance, significant numbers of women in Ethiopia do not prefer to give birth in health institutions. This study aimed to assess women's intention to give birth in health institutions and associated factors among women who gave birth in the last 6 months in Debre Berhan town, North Showa Zone, Ethiopia, 2020. Materials and methods: A community-based cross-sectional study was conducted among women who gave birth in the last 6 months in Debre Berhan town from October 30 to November 30, 2020. A cluster sampling technique was used to select study participants. Pretested semi-structured interviewer-administered questionnaires were administered. A logistic regression model was performed, and adjusted odds ratios with a 95% confidence interval based on p < 0.05 were used to identify statistically significant variables. Result: This study found that a total of 689 (88.8%) (95% CI: 86.6, 91%) respondents intended to deliver in the health facility. Being multiparous [AOR = 0.18 (95% CI: 0.08, 0.36)], having planned pregnancy [AOR = 3.1 (95% CI: 1.6, 5.9)], had no complications during previous delivery (AOR = 6.0 (95% CI: 3.5, 10.4)], and received respectful maternity care (RMC) during preceding delivery [AOD = 1.8 (95% CI: 1.05, 3.10)] are significantly associated with women's intention to give birth in the health institution. Conclusion: Childbirth is a special event that requires the safest place to save the lives of both the mother and newborn. In this study, the number of women who do not have the intention to give birth in the health institution is still high. Strategies to promote planned pregnancy, reduce complications during childbirth and provide RMC during childbirth should be designed and interventions should be implemented for all childbearing women.

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Introduction: Human immunodeficiency virus (HIV) infection continues to be a major public health problem in Ethiopia. Previous studies have described risky sexual behavior and associated factors among HIV-positive people. These studies, however, did not use a model of unsafe sexual behavior that could address both subjective and objective factors of sexual activity, and there is no study that examines the distal aspects of risky sexual behavior among people living with HIV/AIDS in Ethiopia. Therefore, this study aimed to examine the risky sexual behavior among people living with HIV/AIDS using a model of unsafe sexual behavior. Methods: An institutional-based study was conducted from March to April 2022. The sample size was determined by using Sloven's formula. In this study, both quantitative and qualitative methods were employed. Study participants were selected using systematic sampling method. An interviewer-administered questionnaire was used to collect the data. Descriptive statistics and correlation tests were computed to analyze the data. The qualitative data was analyzed thematically. Results: This study included a total of 181 PLWHA clients. The average score for participants' perception regarding the facts of HIV/AIDS was 48.7% (95% CI: 38.9, 58.4). Three months prior to the study, 46.3% of study participants had engaged in at least one risky sexual activity (95% CI: 33.8, 65.4). The correlation model revealed a positive correlation between living in a rural area and risky sexual behavior (p-value = 0.001). Furthermore, a poor perception of HIV risks was associated with risky sexual behavior (p-value = 0.003). Economic issues, stigma and discrimination, and usage of substances were also identified as contributing factors to unsafe sexual activity in the qualitative data. Conclusions: A high proportion of PLWHA clients had engaged in at least one risky sexual activity in the 3 months prior to the study. It is not enough to be on ART; additional educational interventions that shape the sexual behavior of PLWHA clients must be considered.

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BACKGROUND: In developing countries, home delivery without a skilled birth attendant is a common practice. It has been evidenced that unattended birth is linked with serious life-threatening complications for both the women and the newborn. Institutional delivery with a skilled birth assistance could reduce 20-30% of neonatal mortality. This study aimed to assess traditional birth attendants' (TBAs) utilization and associated factors for women who gave birth in the last two years in Angolella Tara District, Ethiopia. METHODS: A community-based cross-sectional study was employed among 416 women who gave birth in the last two years at rural Angolella Tara District. Study participants were recruited by using a simple random sampling technique. Data were collected using a structured, pretested, and interviewer-administered questionnaire. Epi Data 4.6 and SPSS version 25 were used for data entry and analysis, respectively. A multivariable logistic regression model was fitted to identify factors associated with women's utilization of traditional birth attendants. The level of significance in the last model was determined at a p-value of <0.05. RESULT: Overall, 131 (31.5%) participants were used traditional birth attendants in their recent birth. Unmarried marital status (AOR 2.63; 95% CI: 1.16, 5.97), age at first marriage (AOR 2.31; 95%CI: 1.30, 4.09), time to reach health facility (AOR = 3.46; 95% CI: 1.94, 6.17), know danger sign of pregnancy and childbirth (AOR = 5.59, 95% CI; 2.89, 10.81), positive attitude towards traditional birth attendants (AOR = 2.56 95% CI; 1.21,5.52), had antenatal care follow-up (AOR: 0.11 95% CI 0.058, 0.21), and listening radio (AOR = 0.43; 95% CI: 0.18, 0.99) were significantly associated factors with the use of traditional birth attendants. CONCLUSION: Nearly one-third of women used traditional birth attendant services for their recent birth. TBAs availability and accessibility in the community, and respect for culture and tradition, problems regarding infrastructure, delay or unavailability of ambulance upon call, and some participants knowing only TBAs for birth assistance were reasons for preference of TBAs. Therefore, effort should be made by care providers and policymakers to ensure that modern health care services are accessible for women in a friendly and culturally sensitive manner. In addition, advocacy through mass media about the importance of maternal health service utilization, particularly antenatal care would be important.

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INTRODUCTION: Various studies have identified different factors that affect adolescent contraceptive uptake in different parts of Ethiopia. However, varying results were reported across primary studies and those results need to be systematically collated to inform policies. Therefore, this systematic review aimed to synthesize the findings of those primary studies to obtain more robust and representative evidence about adolescent contraceptive uptake in Ethiopia. METHODS: Five databases (MEDLINE via PubMed, Google Scholar, Scopus, Science Direct and CINAHL) were searched for papers published from January 2000 up to June 2021 in English. We limited our search to start on January 2000 as the health of adolescents have been given more attention after this period and to avoid time-lapsed biases. Seven studies were included in this systematic review. We used the Newcastle-Ottawa Scale and the Mixed Methods Appraisal Tool for quality assessment of the selected studies. RESULTS: Determinants of adolescent contraceptive utilization were focused on four levels: individual, socio-cultural, healthcare service and knowledge related factors. Individual-related factors that influence adolescents' contraceptive uptake include; being in the age group of 10-15 years, not currently enrolled in school and being from low-income families, while socio-cultural factors include: lack of discussion with family members, arranged marriage, pressure from a partner, harmful traditional practices, discussion with peer groups and sexual partners. Healthcare service-related factors include; lack of information about contraceptives during health facility visits, lack of privacy during service provision and inconvenient service hours at health facilities, and not visiting health facilities, whereas, knowledge related factors include; having knowledge of contraceptive methods and being heard about contraceptives from media. Also, the proportion of adolescent contraceptive uptake ranged from 12 to 79%. CONCLUSIONS: In this systematic, individual, socio-cultural, health-care-related, and knowledge-related characteristics have all been identified as influencing adolescents' contraceptive uptake in Ethiopia. Hence, integrated interventions aimed at overcoming barriers to adolescent contraceptive uptake would be beneficial to improving adolescent contraceptive utilization in Ethiopia.

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Background: Respectful maternity care is one of the key strategies to increase access to use skilled maternity care services. However, limited studies are done about the extent of respectful maternity care during labor and delivery in Ethiopia, particularly in the study area. Objective: This study aimed to determine the proportion and identify the associated factors of respectful maternity care during childbirth among women who gave birth in North Showa zone public health institutions, North Showa zone, Ethiopia, 2020. Methods: An institutional-based cross-sectional study was conducted among women who got birth in North Showa public health institution from October 20 to November 20, 2020. A systematic random sampling technique was used to select study participants. Logistic regression with adjusted odds ratio and 95% uncertainty interval was used to declare statistically significant variables based on p < 0.05 in the multivariable logistic regression model. Result: The overall proportion of respectful maternity care during childbirth was 48.6 % (95% CI: 44.6-52.3%). Urban residence AOR = 2.6 (95% CI: 1.8, 3.6), being multiparous AOR = 1.6 (95% CI: 1.1, 2.3), having planned pregnancy AOR = 2.4 (95% CI: 1.3, 4.3) and giving birth in health center AOR = 1.6 (95% CI: 1.2, 2.8) were statistically significant factors with respectful maternity care during labor and delivery. Conclusions: The proportion of respectful maternity care during childbirth is low. Being from an urban community, being multiparous, having planned pregnancy, and giving birth in a health center were factors that could increase the likely hood of women getting respectful maternity care during childbirth. Based on the identified factors strategies need to be designed and implemented to enhance the level of respectful maternity care.

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Introduction: maternity continuum of care is the continuity of maternity health care services that a woman uses in antenatal care, skill birth attendant, and postnatal care. This continuum of care in maternal health has become one of the government concerns and programs for planning and evaluating strategies within the currently existing maternal health system of Ethiopia. It is an important intervention in reducing maternal and neonatal morbidity and mortality. However, there is no clear information on the proportion of dropouts from the maternity continuum of care in Ethiopia. This study aimed to assess the proportion and associated factors of dropout from the maternity continuum of care among mothers who gave birth in the last 12 months in Debre Markos town, Northwest Ethiopia, 2018. Methods: a dropout from the maternity continuum of care was considered as a woman who had at least one visit of antenatal care but did not use SBA and postnatal care. A community-based cross-sectional study with a cluster sampling technique was conducted among 605 mothers who gave birth in the last 12 months in Debre Markos town. The data were collected from August 1-30/ 2018 using face-to-face interviews through pretested and semi-structured questionnaires. Multivariable logistic regression models were fitted to determine factors associated with dropout from the maternity continuum of care. P<0.05 was considered statistically significant. Results: the percentage of dropping out of the maternity continuum of care was found to be 32.2 % (95%CI: 28.4-36.2). No exposure to media (Adjusted Odds Ratio [AOR] = 2.62, CI: 1.47-4.68), women who heard about Postnatal care (AOR= 0.07, 95%CI: 0.04-0.15), unplanned pregnancy (AOR= 3.40, CI: 1.11-10.39), and having<4 Antenatal care follow up (AOR = 3.03, CI: 1.96-4.69) were statistically significant variables with the dropout from the maternity continuum of care. Conclusion: in this study, the proportion of dropouts from the maternity continuum of care is found to be high. Interventions aiming to improve retention in ANC care should be given emphasis.

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Background: Women's ability to get sleep can be affected by pregnancy-related hormonal changes or other external stressful situations like the coronavirus disease 2019 (COVID-19). Objective: The objective of this study was to assess the proportion of poor sleep quality during the COVID-19 pandemic and its determinants among pregnant women attending antenatal care (ANC) services. Methods: An institutional-based cross-sectional study was conducted among 423 women attending ANC services at the health facilities in Debre Berhan Town, Ethiopia, from May to June 2020. A systematic random sampling technique was used to select the required samples. The tool consisted of questions that assessed (1) socio-demographic characteristics, obstetric and health care service-related characteristics; and media exposure to get information regarding COVID-19 infection; (2) To assess sleep quality; the Pittsburgh Sleep Quality Index (PSQI) was applied. And a global score of >5 indicates poor sleep quality, and a global score of ≤5 indicates good sleep quality. Result: The overall prevalence of poor sleep quality was 62.8%, and was associated with pregnant women aged ≥46 years (AOR = 4.27), being in the third trimester (AOR = 2.51), being multigravida (AOR = 2.72), and having co-morbidity (AOR = 3.57). Conclusion: The prevalence of poor sleep quality among pregnant women during the pandemic was found to be high. Advanced maternal age, third trimester pregnancy, being multigravida, and having comorbidity were determinants of poor sleep quality among pregnant women during the COVID-19 pandemic.

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Vaccine hesitancy remains a serious global threat to achieve herd immunity, and this study aimed to assess the magnitude and associated factors of coronavirus disease-19 (COVID-19) vaccine hesitancy among healthcare workers (HCWs) in Amhara regional referral hospitals. A web-based anonymised survey was conducted among 440 HCWs in the Amhara region referral hospitals. The questionnaire was designed using Google Forms and distributed using telegram and e-mail from 15 May to 10 June 2021 to the randomly selected participants in each hospital. The data were analysed with Stata 14.0 and described using frequency tables. A multivariable binary logistic regression model was fitted and model fitness was checked with the Hosmer-Lemeshow goodness of fit test. Out of 440 participants, 418 were willing to participate in the study and the mean age was about 30 years. Overall, 45.9% (n = 192) of participants reported vaccine hesitancy. After applying multivariate analysis, age ≤25 years (adjusted odds ratio (aOR) = 5.6); do not wear a mask (aOR = 2.4); not compliance with physical distancing (aOR = 3.6); unclear information by public health authorities (aOR = 2.5); low risk of getting COVID-19 infection (aOR = 2.8); and not sure about the tolerability of the vaccine (aOR = 3.76) were associated with COVID-19 vaccine hesitancy. A considerable proportion of HCWs were hesitant towards COVID-19 vaccine, and this can be tackled with the provision of clear information about the vaccine.

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BACKGROUND: Malnutrition is a deficiency or improper intake of energy and nutrients. It includes undernutrition (wasting, stunting, underweight, and mineral and vitamin-related malnutrition) and overnutrition. PURPOSE: To estimate the prevalence and identify the risk factors for undernutrition among under-five children in Debre Berhan Town, North Shewa, Ethiopia. METHODS: A community-based cross-sectional study was conducted in Debre Berhan Town, from October 07, 2019 to January 24, 2020. Three hundred and eighty-five under-five children who were selected using systematic random sampling technique were included in this study. To collect data, a structured questionnaire and anthropometrical measurements were used. Data entry was done through Epi data 4.21, and for data analysis statistical package for social sciences version 20.0 was employed. Bivariate and multivariable logistic regression analysis was used to identify the factors associated with malnutrition. The statistical significance was stated at p value <0.05 with 95% confidence intervals. RESULTS: In the overall sample the total prevalence of undernutrition in below age-5 children was 61 (15.8%), the corresponding figures for underweight, stunted, and wasting were 26%, 41%, and 33%, respectively. Factors that contributed to under-five undernutrition were maternal illiteracy, not breastfeeding exclusively, preterm birth, absence of antenatal care, exposure to infectious diseases and diarrhea. CONCLUSION: There was a higher prevalence of stunting (41%), wasting (33%), and being underweight (26%) in Debre Berhan town than the national (Ethiopia) or regional (Amhara) malnutrition prevalence. Mothers' educational status should be improved by teaching them that proper nutrition is important for their child's growth and development. Antenatal care for all pregnant women, education on child care, infection prevention, and child feeding should be provided and further strengthened.

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BACKGROUND: The continuum of maternity care is the continuity of maternal health care services that a woman practices antenatal care, skilled birth attendant, and postnatal care. Even though there are positive inclinations towards the continuum of maternity care, the problem is still significant. So, the purpose of this study was to assess the utilization of continuum maternity care and associated factors among women who gave birth in the last 12 months before the data collection period in Debre Berhan town. METHODS: A community-based cross-sectional study was conducted from February 17 to March 15/2020. The respondents were selected by using the cluster sampling technique. Face-to-face interview was used for data collection. EpiData software version 3.1 was used for data entry and exported to SPSS version 21 for further analysis. In multivariable logistic regression, a statistically significant association has declared a p-value <0.05. RESULTS: In this study, the proportion of women who completed the continuum of maternity care was 37.2% (95% CI: 33.4-41.1). Completing primary education (AOR: 2.73, 95% CI: 1.17-6.38), secondary education (AOR: 3.11, 95% CI: 1.32-7.31), college and above educational level (AOR: 4.15, 95% CI: 1.79-9.57), initiation of first ANC visit ≤16wks (AOR: 2.57, 95% CI: 1.41-4.68), knowing key pregnancy danger signs (AOR: 1.91, 95% CI: 1.15-3.19), and well prepared on birth and complication readiness (AOR: 1.59, 95% CI: 1.10-2.32) were found to positively increase the chance of completing maternity care in our study area. CONCLUSION: Even if a higher proportion of mothers completed the continuum of maternity care in the study area than the finding at national level of 9.1% basing EDHS 2016 data, further interventions are mandatory to reach the acceptable level. Therefore, health promotion programs targeting mothers with no education and lower educational level are important to increase their awareness about the importance of completing all levels of maternity care, health education, and counseling regarding early initiation of ANC, pregnancy danger signs, and birth preparedness and complication readiness plan.