SummaryThe 1983 Somali Family Health Survey showed that polygamy and monogamy selected women with different social characteristics. Wives in polygamous unions were prone to be younger at first marital cohabitation and to have previous marital disruptions. Since a young age at first cohabitation and number of previous marriages have opposite effects on the cumulative fertility rate of women, the difference in this rate between wives in polygamous and monogamous unions vanished when both factors were controlled in a multivariate analysis.

Malnutrition remains prevalent and existing health problem globally. Particularly Undernutrition is a major public health issue in developing countries. Globally the causes of severe acute undernutrition varies across context. The aim of this study was to identify the determinants of severe acute malnutrition to uncover contextual factors based on UNICEF conceptual framework, as there was no study done in a similar context in Ethiopia. Health facility based (health post) un-matched case control study with Key informant interview was conducted to identify determinant factors of severe acute malnutrition (SAM) among children between 6 and 36 months. 246 children (82 cases and 164) with their mothers or care takers participated the study which was conducted between December 20, 2019 to January 20, 2020 in Kalafo district in Shebele River. Odds ratio with 95% confidence interval was calculated to identify the determinants of SAM among children aged 6–36 months using multivariate logistic regression. The odds of severe acute malnutrition was 2.28 (1.22, 4.26); 4.68 (2.29, 9.58); 2.85 (1.26, 6.45); 2.39 (1.16, 4.96) and 3.262 (1.46, 7.31) and 3.237 (1.45, 7.23); respectively for mothers with three or more under five children, Children with inadequate dietary diversity, experienced diarrhea in past 2 weeks, their mothers had not nutrition counselling during pregnancy and younger (6–11 and 12–17 months) children as compared to controls. The finding of this study reveals the main determinants of severe acute malnutrition in riverine context are multi-level. In addition to this, poor childcare and polygamy identified in qualitative finding. Decisive and multi-sectoral approach is required to addressing SAM in the riverine area.

BackgroundEthiopia launched community-based health insurance scheme in 2011 as part of the revised health care financing strategy to ensure universal health coverage and implementation has started in most part of the country since the launching of the scheme. However, the roll out of the scheme started in Somali Region in 2020—much later the rest of the country. The aim of this study was to assess determinants of enrollment of community-based health insurance among households in Awbarre Woreda, Somali Region, EthiopiaMethodsCommunity based unmatched case control study using a mixed approach of quantitative and qualitative methods was conducted between March and April 2021 and the study participants were selected using multi-stage sampling technique. The quantitative method used interviewer administered structured questionnaire among 216 participants (54 enrolled and 162 non-enrolled), while the qualitative method used key informant interview and focus group discussions in two rural and two urban kebeles of the woreda. The quantitative data was analyzed using SPSS version 20 and thematic analysis was used for the qualitative data. Multivariable logistic regression was used to determine the determinants of enrollment for the community-based health insurance and statistical significance was set at p value of <5%. Result Awareness about CBHI scheme AOR = 9.41(1.16,76.19), households income AOR = 2.73(0.77, 9.57); and being a member of community-based solidarity groups AOR = 2.88(1.17, 7.12) were the determinants for CBHI enrollment and reaffirmed by the qualitative findings. ConclusionsThe enrollment for community-based insurance was determined by being well informed about the scheme, household income, and being a member of solidarity groups at community level. Given the early stage of implementation, enhancing sensitization of the community about the scheme using various community platforms, promotion of the existing community based solidarity groups/associations, diligent targeting of the poor households/indigents and ensuring linkage with any existing social protection program would help to increase enrolment for the scheme.

Background Early neonatal mortality occurs when a newborn dies within the first seven days in life. Despite interventions, newborn mortality in Ethiopia has grown over time(33  death per 1000 live birth). Determinants varies on level of neonatal mortality. The study's goal was to magnitude of early neonatal death, as well as its causes and drivers, in Newborn Intensive care Unit of Referral Hospital in Ethiopia's Somali region. Methods Health facility based rertrospective study review was conducted between May 2019 to May 2021 in Shiek Hassan Yabare Referral Hospital of Jigjiga University of Ethiopia. All neonates between 0 to 7 days admitted at NICU and get registered using the new NICU registration book from May 2019 to May 2021 with complete data were included.Koobo toolkit was used for data collection and analyzed in SPSS 20. Logistic regression model was used to estimate determinants. Result  The magnitude of early neonatal mortality rate( defined as death between 0-7 days) of Ethiopia's Somali region is estimated to be 130 death per 1000 live births-That is 130 newborn couldn't celebrate their seventh day in every 1000 live births. Hypothermia, prematurity, maternal death at birth and shorter length of stay in NICU were increasing the chance of  neonatal mortality at early stage while neonatal resuscitation had shown protective effect against neonatal mortality. Similarly birth Asphyxia, preterm, sepsis and congenital abnormalities were major causes of admission and death in the NICU. Conclusion The magnitude of early neonatal mortality is considerable and causes are preventable. enhancing quality of care including infection prevention and hypothermia through mentorship and encouraging Kangaroo Mother Care practice is necessary at child birth and NICU of the Hospital.

Background: Malnutrition remains prevalent and existing health problem globally. Particularly Undernutrition is a major public health issue in developing countries.Globally the causes of severe acute undernutrition varies across context. The aim of this study was to identify the determinants of severe acute malnutrition to uncover contextual factors based on UNICEF conceptual framework, as there was no study done in a similar context in Ethiopia.Methods: Health facility based (health post) un-matched case control study with Key informant interview was conducted to identify determinant factors of severe acute malnutrition(SAM) among children between 6 to 36 months. 246 children (82 cases and 164) with their mothers or care takers participated the study which was conducted between December 20, 2019 to January 20, 2020 in Kalafo district in Shebele River. Odds ratio with 95% confidence interval was calculated to identify the determinants of SAM among children aged 6-36 months using multivariate logistic regression.Results: The Odds of Severe Acute Malnutrition was 2.28(1.22,4.26); 4.68(2.29,9.58); 2.85(1.26,6.45); 2.39(1.16,4.96) and 3.262(1.46,7.31) and 3.237(1.45,7.23); respectively for mothers with three or more under five children, Children with inadequate dietary diversity, experienced diarrhea in past two weeks, their mothers had not nutrition counselling during pregnancy, Children’s age between 6-11 and 12-17 months as compared to controls.Conclusion: The finding of this study reveals that the main determinants of severe acute malnutrition in riverine context are multi-level. On top of poor childcare and polygamy in qualitative finding, Diarrhea and inadequate dietary intake under the category of immediate cause of malnutrition. Having more than (≥3) under-five children, young age (6-11 and 12-17months) and not having nutrition counseling during pregnancy were also among basic determinants of severe acute malnutrition in riverine context. Decisive and multi-sectoral approach is required to addressing SAM in the riverine area.