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Background Ethiopia’s Community-based health insurance (CBHI) is currently providing financial protection to more than 54 million beneficiaries (64% of the target population). Beneficiaries’ satisfaction with health service provision is among the important factors that influence the decision to enroll and renew. Despite the importance of satisfaction in influencing such important decisions, there is limited evidence on systematic studies conducted at a national level on CBHI beneficiaries’ satisfaction with health care service provision. Hence, this study aimed to measure the level of CBHI beneficiaries’ satisfaction with health service provision and identify its determinants in Ethiopia. Methods This study employed a health facility-based cross-sectional study design. A total of 1,836 patients who made OPD visits were sampled, yielding a 99.9% response rate. The mean value of a composite variable derived from satisfaction items, was used to measure the level of satisfaction. Factors determining patient satisfaction were measured using binary logistic regression model, and variables with p-values < 0.05 were considered the final predictors of satisfaction. Results Overall, 58% [(95% CI: 55.8, 60.4)] of the patients were satisfied with the health service they received. Factors associated with higher satisfaction include fully receiving prescribed medicines [AOR = 5.31, 95% CI; 3.74, 8.12], partially receiving prescribed medicines [AOR = 1.92, 95% CI; 1.27, 2.9], being informed about health problem [AOR = 1.84, 95% CI; 1.47, 2.31], being informed about recovery methods [AOR = 1.61, 95% CI; 1.28, 2.03], patient’s perception about conformity of service with benefit package [AOR = 1.4, 95% CI; 1.12, 1.73], visiting urban health facility [AOR = 1.34, 95% CI; 1.07, 1.67], and being in older age group. The study revealed a lower satisfaction at hospitals (53%) compared with health centers (61%). Conclusion Notably, a substantial proportion of patients (42%) were not satisfied, a rate higher than reported in comparable studies. Dissatisfaction was predominantly associated with shortages of prescribed medicines, inadequate laboratory services, and exposure to out-of-pocket payments. These findings highlight the need for coordinated efforts among health authorities and service providers to ensure uninterrupted availability of prescribed medicines and diagnostic services in alignment with the CBHI benefit package. Addressing these gaps is critical to fostering trust and improving satisfaction among CBHI beneficiaries.

Background Workplace violence is the intentional use of power, threatened or actual, against another person or against a group, in work-related circumstances, that either results in or has a high degree of likelihood of resulting in injury, death, psychological harm, mal development, or deprivation. The aim of this study is to assess magnitude and predictors of workplace violence among healthcare workers in health facilities of Gondar city. Methods Institutional based cross sectional study design was employed to conduct this study. The study conducted in Gondar town from February 21 to march 21, 2016. Five hundred fifty three health care workers selected from health facilities of Gondar City administration. A stratified sampling technique was used for selecting the study subjects through simple random sampling. Data was collected by structured self administered questionnaire which is adapted from ILO/ICN/WHO/PSI after it is pretested & prepared in Amharic. The data was coded and entered in to EPI info version 7 and exported to SPSS version 20 software for analysis. The degree of association for variables was assessed using odds ratios with 95% confidence interval and p-value ≤0.05. Results The prevalence of workplace violence was found to be 58.2% with [95% confidence interval (CI): (53.7, 62.3)] in which verbal abuse 282(53.1%) followed by physical attack 117(22.0%) and 38(7.2%) sexual harassment. Working at emergency departments [AOR = 3.99,95% CI:(1.49,10.73)], working at shifts [AOR = 1.98,95%, CI: (1.28,3.03)],short experiences [AOR = 3.09,95% CI: (1.20,7.98)], being nurse or midwife [AOR = 4.06, 95% CI: (1.20,13.74)] were positively associated with workplace violence. The main sources of violence are visitors/patient relatives followed by colleagues and patients. Conclusion workplace violence is major public health problem across health facilities and the Ministry of Health should incorporate interventions in its different health sector development & management safety initiative.

BackgroundAs Ethiopia advances towards efficient resource utilization and UHC through strategic health purchasing, the institutionalization of HTA will play a critical role. This study aims to identify key stakeholders, analyze the political economy surrounding HTA and priority setting in Ethiopia, and assess existing skills and capacities for a robust and sustainable HTA system.MethodsWe employed a mixed-method approach, combining 16 key informant interviews, 24 document reviews, and a cross-sectional survey (n=65) to assess national HTA capacity. We employed the Walt and Gilson policy analysis triangle framework, alongside Campos and Reich’s framework, to evaluate the context, process, content, and actors influencing HTA institutionalization, and to explore the complex interplay of institutions, positions, power, and interests among various stakeholders.ResultsWhile there is a general commitment to implementing HTA across various government agencies and stakeholder groups, the institutionalization process faces several challenges, involving multiple agencies with overlapping mandates, raises bureaucratic challenges and potential conflicts, risking horizontal fragmentation as agencies compete for authority, budget, and influence. The involvement of other key stakeholders, such as professional associations, patients, and the public, is notably lacking. Challenges such as limited HTA expertise, high professional turnover, and gaps in specific HTA knowledge areas persist, with capacity-building efforts often failing to address organizational needs effectively.ConclusionsThe complexity of HTA institutionalization in Ethiopia underscores the necessity of managing intricate inter-agency dynamics, establishing a robust legal framework for an inclusive and transparent HTA process, building local capacity, and securing sustainable, domestically aligned funding.

Background Acute respiratory infection (ARI) remains the leading cause of morbidity and mortality among children under five years worldwide. However, in Ethiopia, evidence on the distribution and determinants of ARI is limited. This study aimed to assess the geographical distribution and determinants of ARI among Ethiopian children under five years. Methods A nationwide community-based cross-sectional study was conducted from September to December 2022. Mothers with at least one child under five years were selected using a two-stage stratified cluster sampling approach. Data were collected through face-to-face interviews using structured questionnaires. A total of 8747 mothers were included in the analysis. Multilevel logistic regression was employed to identify determinants of ARI. Four models were fitted, and the model with the lowest Deviance Information Criterion (DIC) and Akaike Information Criterion (AIC) values was selected as the best-fitting model. Results The 2-week prevalence of ARI among children under five was 21.3% (95% CI 20.5–22.2). The highest prevalence was observed in the Tigray region (36.1%), while the lowest was reported in Oromia (9.1%). Higher odds of ARI were observed among children aged 6–12 months (AOR = 1.6; 95% CI 1.1–2.3) and those older than 12 months (AOR = 1.5; 95% CI 1.1–2.1), children not vaccinated with PCV3 (AOR = 1.5; 95% CI 1.2–1.8), and children with diarrhea (AOR = 2.9; 95% CI 2.4–3.4) or malaria (AOR = 6.8; 95% CI 5.5–8.5). Children from households in the second (AOR = 1.3; 95% CI 1.1–1.6) and fourth (AOR = 1.3; 95% CI 1.1–1.6) wealth quintiles also had increased odds of ARI. Conversely, children living at very high altitudes had lower odds of ARI (AOR = 0.6; 95% CI 0.4–0.9). Vaccination coverage was suboptimal, with only 81.1%, 71.3%, and 64.5% of eligible children receiving PCV3, measles vaccine, and vitamin A supplementation, respectively. Conclusion ARI remains a major public health problem among Ethiopian children under five years, with marked regional variation in prevalence. Both individual- and household/community-level factors significantly influence ARI risk. Strengthening targeted interventions, particularly improving vaccination coverage and addressing socio-economic disparities, is essential for reducing the burden of ARI.

Introduction The World Health Organization initially recommends a minimum of four antenatal care (ANC) visits during pregnancy. However, the utilization of Focused antenatal care (FANC) services remains low in many low- and middle-income countries, including Ethiopia. Therefore, this study aimed to investigate the magnitude and determinants of FANC utilization among Ethiopian women aged 15 to 49. Methods A nationwide community-based cross-sectional study was conducted between September and December 2022. Respondents were selected using a two-stage stratified cluster sampling method. Data were collected through face-to-face interviews using structured questionnaires. A total of 5,358 weighted samples were included in the analysis. Multilevel logistic regression analysis was conducted to measure the strength of associations and identify determinants of FANC utilization. Four models were fitted, and the model with the lowest values of the Deviance Information Criterion (DIC) and Akaike’s Information Criterion (AIC) was chosen. Results In this study, 59.9% of the women attended four or more ANC visits during their pregnancy. In the multilevel logistic regression analysis, respondents aged 30 to 34 years (adjusted OR = 1.5; 95% CI 1.03, 2.32), aged 35 to 39 years (AOR = 1.6; 95% CI 1.08, 2.49), those with secondary education (AOR = 1.5; 95% CI 1.21, 1.80), those with above secondary education (AOR = 1.7; 95% CI 1.25, 2.29), married respondents (AOR = 2.3; 95% CI 1.08, 4.47), divorced/separated individuals (AOR = 2.6; 95% CI 1.17, 5.89), housewives (AOR = 1.7; 95% CI 1.01, 2.73), daily workers (AOR = 1.5; 95% CI 1.10, 2.15), those with a family size below four (AOR = 1.3; 95% CI 1.08, 1.50), those in the middle wealth category (AOR = 1.3; 95% CI 1.09, 1.62), those in the richer wealth category (AOR = 2; 95% CI 1.66, 2.49), and those in the richest wealth category (AOR = 4.3; 95% CI 3.39, 5.55) were significantly associated with ANC utilization. Conclusion The study identified many individual and community-level factors influencing ANC utilization. The utilization of the Focused ANC visits or contacts remains low. Targeted education for younger and less educated women, and financial support for low-income households, is needed to improve ANC utilization.