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Introduction Folic acid deficiency is the most common pregnancy-related micronutrient deficiency, leading to fetal neural tube defects (NTDs). Periconceptional folic acid supplementation is highly effective in reducing NTDs by 72%-86%. However, awareness of this essential prevention method remains limited in lower-income countries, contributing to a high rate of preventable birth defects. Therefore, this study aims to evaluate the knowledge and factors associated with periconceptional folic acid supplementation among pregnant women attending the Antenatal care clinic at Dilla University Teaching Hospital in 2024. Method This institution-based cross-sectional study was conducted at Dilla University Teaching Hospital from January to December 2024. A systematic random sampling technique was used to enroll 337 eligible pregnant mothers attending Antenatal Care. Bivariate and multiple logistic regression analyses were performed to identify associated factors. The strength of association was reported using the Adjusted Odds Ratio (AOR) with a Confidence Interval (CI), with p-values considered statistically significant. Result Only 8.9% (95% CI: 5.85%-11.96%) of pregnant mothers demonstrated good knowledge of periconceptional folic acid supplementation. Factors significantly associated with improved knowledge included higher education (AOR 5.13), current family planning use (AOR 4.06), having a planned pregnancy (AOR 3.59), being in the 26–30 age group (AOR 2.33), and employment status (AOR 1.63). Conclusion Knowledge of periconceptional folic acid supplementation is extremely poor (8.9%) among pregnant women in the study area. Factors like higher education, family planning use, and planned pregnancy are strong determinants of awareness. There is an urgent need to implement targeted health education programs integrated within Antenatal Care and Family Planning services to improve knowledge and reduce the incidence of preventable NTDs.

Assessing the magnitude of smallholder farmers’ livelihood vulnerability to drought is an initial step in identifying the causal factors and proposing interventions that mitigate the impacts of drought. This study aimed to assess smallholders’ livelihood vulnerability to the drought in the upper Awash sub-basin, Ethiopia. Household (HH) and climate data were used for indicators related to sensitivity, exposure, and adaptive capacity that define vulnerability to drought. The vulnerability of farmers’ livelihood to drought was compared among the studies agroecological zone (AEZ) and farm typologies. The result illustrated a diverse magnitude of vulnerability index (VI) ranging from −1.956 to −4.253 for AEZ. The highest magnitude of VI was estimated for livelihood in the lowland AEZ, while the lowest magnitude of VI was estimated in midland AEZ. This could be accounted for by the fact that lowland farmers shown the highest exposure (0.432) and sensitivity (0.420) and the lowest adaptive capacity (0.288). A closer look at farmers’ livelihood typology, in each of the AEZ, showed substantial diversity of farmers’ livelihood vulnerability to drought, implying potential aggregations at AEZ. Accordingly, the vulnerability index for livestock and on-farm-income-based livelihood and marginal and off-farm-income-based livelihood typologies were higher than the intensive-irrigation-farming-based smallholders’ livelihood typology. Based on the result, we concluded that procedures for smallholders’ livelihood resilience-building efforts should better target AEZ to prioritize the focus region and farmers’ livelihood typology to tailor technologies to farms. Although the result emphasizes the importance of irrigation-based livelihood strategy, the overall enhancement of farmers adaptive capacity needs to focus on action areas such as reducing the sensitivity and exposure of the households, improving farmers usage of technologies, diversify farmers’ livelihood options, and, hence, long-term wealth accumulation to strengthen farmers’ adaptive capacity toward drought impacts.

Drought-related risk is among the major global challenges of our time. It negatively impacts food security and ecosystem health. It is becoming a persistent problem in many parts of sub-Saharan Africa and specifically in Ethiopia. Information on its intensity and spatiotemporal distribution is critical to contextualize interventions and build agroecosystem and community resilience. This study aims at analyzing spatiotemporal characteristics of meteorological drought over eight Agroecological Zones (AEZs) of the Awash Basin, Ethiopia. Annual gridded temperature and precipitation dataset obtained from the National Meteorological Agency of Ethiopia for the period 1983–2016, covering 1655 grid points, were used. The study applied the Standard Precipitation and Evapotranspiration Index (SPEI) and Standard Precipitation Index (SPI) methods to characterize the meteorological droughts. The study applied Arc GIS 10.5 to map the drought hotspots. From the result, the value of SPEI and SPI methods was divergent in characterizing the magnitude and spatial occurrence of drought episodes. SPEI has more advantages in detecting dry months and a small advantage in detecting dry seasons compared to the SPI. Temporally, wet and dry years dominated the 1990s and 2010s, respectively. Drought dominated 1980s and normal years dominated the 2000s. The spatial context of drought hotspot showed that AEZs in the upper and lower parts of the Awash Basin were hit by severe to extreme drought while the escarpments and middle parts of the basin experienced mild to moderate drought. This contrasts with the common perception that the hot to warm arid lowlands AEZs are the only hotspot areas to drought. Moreover, previously none frequent drought AEZs, such as tepid to cool humid mid-highlands were identified as drought hotspots in the basin. This information could help policymakers to target AEZs and implement context-specific and informed drought risk management decisions and adaptation measures.