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Background: Labor companions often lack clarity about their support roles during childbirth. Therefore, this study aims to analyze factors influencing companions’ adherence to support roles during labor and childbirth. Methods: A convergent parallel mixed-methods design was used to examine factors influencing companions’ adherence to support roles from May to June 2024. Systematic random sampling selected 320 participants from the maternity ward. Data were collected via face-to-face exit interviews. Purposive sampling chose 24 labor companions for in-depth interviews. Adherence to support roles was measured using a four-point Likert scale, ranging from “not at all” to “all of the time.” Ethical approval was obtained from the IRB at Jimma University, and support letters were secured for each study facility. Written consent was obtained from all participants. Results: Companions’ adherence to support roles during childbirth had an overall mean score of 1.39 (95% CI: 1.29–1.49) on the four-point Likert scale. Specifically, 27.5% of companions reported not at all, and 35.63% reported only a little support, while 17.19% reported providing support all of the time. Awareness among companions was associated with increased adherence to support roles (B = 0.238, p = 0.029). Nevertheless, companions with less prior experience (first time: B = −0.377, p = 0.001; second time: B = −0.280, p = 0.031) showed significantly lower adherence to support roles. The qualitative data also explored that, unclear role definition, unwelcoming approach of healthcare providers, and social-cultural factors were associated with minimal adherence to support roles. Conclusion: A structured orientation session for companions is a vital recommendation to address hindering factors to their support roles. Such a session might equip them with techniques how to provide.

Monitoring systems in a broad range of countries are a notable effort to eliminate iodine deficiency disorders (IDDs). This study aimed to gather data on the amount of iodide present in table salt and how household consumption patterns affect children's iodine status and its effect on their growth. A single treatment arm community trial study design was designed. Lower community units (LCUs) were chosen at random from districts assigned either intervention or control. From a list of LCUs, 834 mothers and their paired children were chosen randomly. Urine and table salt samples were collected and examined in the national food and nutrition laboratory. The deference between arms was determined using a t test, and the generalized estimating equation (GEE) was used to forecast parameters. The mean iodide content in the table salt samples of 164 (98.1%) was 45.3 ppm and a standard deviation (SD) of 14.87, which were above or equal to the recommended parts per million (ppm). Between the baseline survey and the end-line survey, the mean urine iodine concentration (UIC) was 107.7 µg/L (+/- 8.64 SD) and 260.9 µg/L (+/- 149 SD). Children's urine iodine excretion (UIE) had inadequate iodine in 127 (15.2%) children at the beginning of the study, but only 11 (2.6%) of the intervention group still had inadequate iodine at the end. The childrens' mean height (Ht) was 83.1 cm (+/-10 SD) at baseline and 136.4 cm (+/-14 SD) at the end of the survey. Mothers knew a lot (72%) about adding iodized salt to food at the end of cooking, and 183 (21.9%) of them did so regularly and purposefully. A total of 40.5% of children in the intervention group had stunted growth at baseline, which decreased to 15.1% at the end of the study but increased in the control group to 51.1%. The mean difference (MD) of urine iodine concentration (UIC) between intervention and control groups was 97.56 µg/L, with a standard error (SE) of 9.83 (  = 0.001). The end-line Ht of children in the intervention group was increased by 7.93 cm (  = 7.93,  = 0.005) compared to the control group. Our research has shown that mothers who embraced healthy eating habits had perceived improvements in both the iodine status and height growth of their children. In addition to managing and using iodine salt, it has also introduced options for other healthy eating habits that will also play a significant role in their children's future development. This sort of knowledge transfer intervention is essential for the sustainability of society's health. Therefore, this trial's implications revealed that the intervention group's iodine status and growth could essentially be improved while the control group continued to experience negative effects. ClinicalTrials.gov Identifier: NCT048460 1.

Background: Continuum of care [COC] for maternal health care [MHC] refers to continuity of care that has been considered as a core principle and framework to underpin strategies and programs to save the lives and promote wellbeing of mothers and newborns. However, the status of the continuum of care for maternal health care is not well studied. Thus, the objective of this analysis is to examine the status of the continuum of care for maternal health care and current recommendations in Low- and Middle-Income Countries. Methods: Our review followed the scoping review methods. We searched for relevant studies in the PubMed, and Cochrane Library databases. Additionally, lateral searching was carried out from google scholar, reference lists of the included studies and supplemented by a gray literature search. One reviewer screened the full list, which was randomly split into two halves and independently screened by other 2 reviewers. The 2 reviewers independently extracted the data and discrepancies were resolved through discussion. Results: A total of 1259 records were identified through the databases and others searching strategies. Of these, 13 studies were included in the review and the year of their publication was from 2015 to 2019, more than half (53.8 %) of the included studies were from African countries. As to the source of data 53.8% of them were from countries’ Demographic Health Survey [DHS], and all of them were cross sectional study by design. The general picture shows a decline in use of the services as women move along the continuum of care from pregnancy to childbirth and postnatal, and the highest gap was noticed between institutional delivery and postnatal care. The completion status differs from country to country and 60% in Cambodia during the 2010 CDHS but, 5% in Ratanakiri, Cambodia in 2015. Conclusion and recommendations: The status of continuum of care for maternal health care is varies across the countries. Also, there is limited studies on the continuum of maternal health care and more than half of the studies on this area were from countries’ Demographic Health Survey and all of them were cross sectional by design. Furthermore, none of the reviewed studies considered status of continuum of care and birth outcomes. Hence, it is decisive to estimate the status of completion of continuum of care, completion, and its effect on birth outcomes in countries like Ethiopia where the burden of maternal and newborn mortality is high. Plain English summary Continuum of care for maternal health care means the continuity of care during prenatal, delivery and postnatal. It has been considered as core strategies to save the lives of mothers and newborns. We searched for relevant studies in the databases and gray literature. Two reviewers performed data extraction independently. A total of 1259 records were identified through searching. Thirteen studies were included in the review. More than half of the studies included were from African countries. Demographic Health Survey [DHS] reported from these countries formed the main source of data. All of them were cross sectional study by design. The general picture shows a decline in the use of the health services as women move along the continuum of care from ANC to PNC. The completion status varies across countries.

Despite progress in access to family planning services in many sub-Saharan African countries in recent decades, advances in effective early postpartum contraceptive adoption remain low, and the unmet need for early postpartum contraceptives is high. In Ethiopia, early postpartum modern contraceptive method uptake is still unacceptably low. The barriers/challenges have not yet been sufficiently explored. A deep and detailed understanding of the contextualized barriers and challenges in the adoption of early postpartum contraceptive methods is crucial in developing future locally-appropriate interventions. This study aimed to explore barriers/challenges to the uptake of early postpartum modern contraceptive methods after childbirth in Dessie and Kombolcha zones, in northeast Ethiopia. Aconventional content analysis qualitative study was deployed in Dessie and Kombolcha town zones, northeast Ethiopia using a theoretical purposive sampling technique. A total of 57 study subjects were participated. The sample size was determined using the rule of information saturation through 7 key informant interviews, 6 in-depth interviews, and 5 focused-group discussions with 8-10 participants each. Data were collected using an unstructured interview guide and recorded using a digital audio recorder and field notes. The trustworthiness of the study was assured using different techniques. The collected data were transcribed and translated from native language to English. Atlas-ti version7 software was used to facilitate conventional content qualitative data analysis approach. Open coding, categories, subthemes, and overreaching themes were developed, and a conceptual model of barriers was organized through network analysis. Barriers to uptake of early postpartum modern contraception quoted by study participants and themed were related knowledge, attitude, family-community, health facility, contraceptive method, cultural, religious, fertility desire, gender issues, and misconceptions. The sub-themes of knowledge-related barriers that emerged were lack of awareness of the time to take birth control methods, not knowing the time pregnancy is likely after childbirth, and not being committed to taking contraceptives early enough after childbirth. Moreover, beliefs that modern contraceptives cause breast milk to dry up and perceived low fecundability after childbirth were indicated as attitude barriers. Health facility barriers were lack of reminders and follow-up mechanisms, sporadic service delivery and opening time, long waiting time, and card withdrawal process and providers' approach. Social stigma, child sex preference, and religious restrictions against contraceptive use were community barriers. Generally individual, facility-based, method-related, misconceptions, societal, and cultural barriers were identified as hindrances to the uptake of early postpartum modern contraceptive methods. There is a need for health-seeking behavioral interventions, innovative contraceptive methods, and facility-level interventions to overcome each identified barrier.

Background Improving quality of sick child care is the primary aim of Integrated Community Case Management services and implementation fidelity is critical to translating an evidence-based intervention to practice. A community-based complex intervention was implemented at the health posts of four agrarian regions of Ethiopia from 2017 to 2018 to improve the coverage and utilization of quality child health services. This study aimed to examine the implementation status of child health care quality improvement interventions in program areas of Oromia region, Ethiopia. Methods A case study design using quantitative and qualitative research methods was conducted from September to October 2018. Implementation data were collected using observations, document reviews, and program staff interviews. Program staffs including health extension workers and their supervisors were included in surveys, and purposefully selected key informants from health posts to zonal health office level were included in the qualitative component of the research. The analysis framework was focused on the fidelity of the interventions’ content, frequency, duration, and coverage, as well as the potential moderating factors of implementation using the model proposed by Carroll et al. conceptual framework for implementation fidelity. Results Performance Review Clinical Mentoring was implemented according to the plan (every 6 months) in all of the districts and around nine in ten (88%) of the core contents were implemented. Though mentoring was provided by trained mentors, the duration of mentoring was less than the plan to fully implement all of the core activities. Overall, the mentoring program has reached 88% of health extension workers. Slightly greater than three-fourths of health extension workers have been supervised (76%) according to the plan and 80% of health posts were supplied with required iCCM medicines regularly. Staff turnover, topographical challenges, lack of transportation, competing priorities, weak support and feedback from the District health office, and security problems were frequently mentioned challenges to implementation. Whereas, the existence of continual partner support, the presence of integration and coordination of activities, and changes observed were the facilitators of implementation. Conclusions The implementation status of the Performance Review Clinical Mentoring Meeting was sufficient, while moderate adherence was observed in supportive supervision and supply of medicines. All of the providers were reached with sick children management training. Therefore, the implementation of community-based interventions should be aware of operational challenges in order to improve and sustain the program’s performance.

Background The institutionalization of village health services with salaried community health workers has been established in Ethiopia for over a decade. However, there are serious concerns about the capacity of health posts to provide quality curative care for children under-five.Understanding the readiness of health posts is crucial for improving the care given to sick children. Therefore, this study aimed to assess the readiness of health posts to deliver quality curative care for children under-five in four regional states in Ethiopia. Methods A facility-based cross-sectional study was conducted at selected health posts across 10 zones in the Amhara, Oromia, SNNP, and Tigray regions. Study participants, including health posts and health extension workers, were selected using a two-stage stratified cluster sampling strategy. The readiness of health post was assessed in terms of infrastructure, human resources, medicines, medical equipment and supplies and job aids. The variations in health post readiness were analyzed using a One-way analysis of variance (ANOVA). Results A survey was conducted on 169 health posts and 276 health extension workers. The majority of health posts had a toilet facility (83%) and water supply (62%). However, less than a quarter had electricity connection (22%) and communication equipment (18%). Over three-fourths of health extension workers were trained (83%) and supervised (78%) on clinical management of sick children. Less than half (44%) had received clinical mentorship. Availability of essential medicines ranged from 81% for zinc tablets to 28% for cotrimoxazole. Similarly, availability of essential medical equipment varied from 57% for blood pressure apparatus to 86% for thermometer and 99% for Mid-Upper Arm Circumference tape. Only a small portion of health posts (8%) had all critical items for infection prevention practices, which are essential for quality care. Overall, the average percentage availability of items to provide quality curative care to children was 66%, with health post preparedness significantly varying across regions ( P  < 0.0001). Conclusions The readiness for delivering quality curative care was below standard and significantly varied among health posts across regions. Serious attention is needed to ensure the sustained availability of critical inputs such as trained health extension workers, medicines, medical equipment, and supplies, which is paramount for delivering quality care.

In light of the growing prevalence of pre-eclampsia within clinical settings and public life in Ethiopia, studies assessing the knowledge extent of pregnant women towards pre-eclampsia are lacking. Hence, this study sought to examine the level of knowledge and its associated factors among pregnant women regarding pre-eclampsia in the South Gondar zone of North Central Ethiopia in 2023. A community-based quantitative study design was conducted. Multi-stage cluster sampling technique was employed in South Gondar zone from May to June 2023, employing a structured questionnaire administered to 855 pregnant women. Simple random sampling is used to select the final study participants. Cross tabular analysis with Chi square and P values were done. Univariate and subsequent multi-variable logistic regression analysis was done for the association between the dependent and independent variable. P values < 0.05 were used to determine the presence of associations. The response rate of the respondents was 98.2%. Approximately half of (51%) the pregnant women had adequate knowledge towards pre-eclampsia (AOR = 51% 95% CI 48, 54). Pregnant women who thought hypertension is extremely dangerous were 57% less likely to have adequate Knowledge of pre-eclampsia (AOR = 0.43 95% CI 0.2, 0.92) than who thought the dangerousness of hypertension as very low. Those pregnant women who thought that diastolic blood pressure was important had 86% less likely to have adequate knowledge (AOR = 0.14 95% CI 0.32,0.63) that who thought the systolic blood pressure measurement was important. In addition, mothers who didn’t try to lower blood pressure had 2.4 more odds of adequate knowledge than pregnant women who tried to control their blood pressure (AOR = 2.4 95% CI 1.4, 4.2). In the study area, nearly half of the pregnant women had adequate knowledge. Pregnant women who thought that hypertension was dangerous, who thought that diastolic blood pressure is an important indicator for hypertension and those who didn’t try anything to lower their blood pressure were variables that are strongly associated with the adequate knowledge of pregnant women towards pre-eclampsia. To enhance the information and knowledge of pregnant women concerning pre-eclampsia in the study area, it is imperative to convey health information through locally accepted and contextually relevant approaches.

Even though maternal hypertensive disorders (MHDs) is the second cause of maternal death in Ethiopia, detail and population based study among pregnant women is lacking in the study area. Hence, this study had assesed the prevalence of MHDs and associated risk factors among pregnant women, in North Central Ethiopia, 2023. A community-based cross-sectional study was conducted using the WHO STEPWISE questionnaire among 855 participants through multi-stage cluster sampling in five districts of North Central Ethiopia from May to June 2023. Binary and multivariable logistic regression analyses were performed, and a P-value of < 0.05 was used to declare statistical significance. Seven percent (95% CI 6%, 8%) of pregnant women had MHDs. Pregnant women who had no history of hypertension had 52% lower odds (adjusted odds ratio (AOR = 0.48, 95% CI 0.44, 0.52) than those with a history of hypertension. Pregnant women, who ate processed food that are high in salt sometimes and rarely had 88% and 81% less odds (AOR = 0.12, 95% CI 0.03, 0.47), (AOR = 0.19, 95% CI 0.07, 0.55) than those who ate always, respectively. Women who didn’t know to express blood pressure measurement had 56% lower odds (AOR = 0.44, 95% CI 0.22, 0.89) of maternal hypertensive disorders than those who expressed the measurement. Seven out of hundred pregnant women had MHDs. Previous history of hypertension, women knew how to express their blood pressure measurement and consumed processed foods high in salt rarely and sometimes were factors strongly associated with MHDs. Zonal health departments and their partners should strengthen advocacy for prevention and control of MHDs in the study area.

Background: Despite progress in access to family planning services in many sub-Saharan African countries in recent decades, advances in early postpartum contraceptive adoption remain low, and the unmet need for early postpartum contraceptives is high. According to the Ethiopia Demographic and Health Survey report, early postpartum modern contraceptive method uptake is still unacceptably low in Ethiopia. Objectives: This study aimed to determine the magnitude of intention to adopt early postpartum modern contraceptive methods and its associated factors among pregnant women in Dessie and Kombolcha town zones, northeast Ethiopia. Methods: A community-based cross-sectional study was deployed from 15 January–15 February 2023, in the Dessie and Kombolcha zones, northeast Ethiopia, among pregnant women. The study involved 780 pregnant women using the cluster sampling technique. A census was conducted in 20 randomly selected clusters to identify eligible pregnant women. Actual data were collected home-to-home in the community through face-to-face interviews. Data were collected by Open Data Kit (ODK) and exported to STATA 17 for analysis. A multivariable logistic regression analysis was performed, and the goodness of the model was checked by Hosmer–Lemeshow’s test statistic and rock curve. An adjusted odds ratio with a 95% confidence interval and p-value < 0.05 was considered statistically significant. Result: The study revealed that 49.6% of pregnant women lack autonomy and 50% lack knowledge about early postpartum contraception, with participants’ wealth index status ranging from rich (36.6%) to poor (33.2%). The study found that 75.8% of pregnant women intended to adopt early postpartum modern contraceptive methods early after childbirth. After controlling the potential confounders, mother’s age (AOR = 6.2 [2.6–14.6], birth interval (AOR = 2.5 [1.6–3.7]), have paid work (AOR = 1.9 [1.3–2.8]), health facility from home (AOR = 2.6 [1.5–4.4]), last delivery Place (AOR = 2.4 [1.1–5.7]), knowledge on (AOR = 1.5 [1.1–2.1]), and antenatal care follow-up (AOR = 1.9 [1.2–3.3]) were significant associated factors of intention to uptake early postpartum modern contraceptive methods among pregnant women. Conclusions: The study found that 75% of the participants had the intention to adopt contraceptive methods during the early postpartum period. Identified factors influencing this intention were age, birth interval, women’s employment status, area of residence, distance to health facilities, last delivery place, knowledge of early postpartum modern contraception, gravidity, and antenatal care follow-up. These findings highlight the need for targeted interventions to address these factors, framing the intended users and enabling access to early adoption of postpartum contraceptive methods.