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Background When medical cases are difficult to manage at the level of primary health care units (PHCU), formal referral assists patients transferring to a higher level of care. In contrast, self-referral and bypassing are synonymously used in literature to describe the phenomenon of patients skipping their units to get basic medical services, even though they are close to their residence. Though proper and timely referral prevents the majority of deaths from obstetric complications in developing countries, more than 50% of referrals are self-referral trends. Such patient practice is increasingly becoming a concern for many health-care systems. Objective To assess the magnitude of self-referrals and associated factors among laboring mothers at Gedeo Zone, Ethiopia. Methods Facility-based cross-sectional study was conducted from August 1-September 30/2021 among laboring mothers at Dilla University Referral Hospital. A systematic random sampling technique was used to select 375 laboring mothers. Data were collected using a face-to-face interview with a structured questionnaire. Data were entered into a computer using Epi-Data 4.6 statistical program and then exported to STATA version 16 for analysis. In bivariate analysis variables with a p-value ≤ 0.25 were selected as a candidate variable for the multivariable analysis. P-value < 0.05 at 95% confidence interval considered as a statistically significant associations in the multivariable analysis. Result 375 eligible mothers participated in the study, with a response rate of 98.16%. The magnitude of self-referrals among laboring mothers was 246 (65.6%) with 95% CI (0.60–0.70). Time ≥ 30 min to reach nearby facilities (AOR = 1.74, 95% CI, 1.08, 2.81), having no medicine supplies at nearby facilities (AOR = 1.75, 95% CI, 1.08, 2.82), having no equipment and supplies at nearby facilities (AOR = 1.70, 95% CI, 1.03, 2.78), having ANC visits ˃ 3 times (AOR = 0.29, 95% CI, 0.15, 0.55) and having poor perception of health provider technical competence at nearby facilities (AOR = 2.97, 95% CI, 1.83, 4.79) were found as significant factors for self-referral. Conclusion The magnitude of self-referral was high. Frequent Antenatal visits were protective, however time to reach the nearest facilities, perception towards health care providers, medicine, equipment and supplies at the nearest facilities were positive influencing factors. Government stakeholders should keep working on improving the quality of health service, especially at primary health care units(PHCU).

Background: Obstetric ultrasound is a harmless, cheap, and noninvasive imaging modality that helps to scan a pregnant mother and delivers parents with a real-time image of the fetus. As the number of pregnancies rises globally, the demand for obstetric ultrasound becomes even more pressing. Objectives: To assess pregnant women’s knowledge, attitude, and associated factors toward obstetric ultrasound in public hospitals, Ethiopia. Methods: Institutional based cross-sectional study was employed. Systematic random technique was used to select 419 pregnant women from 10 April 2021 through 2 June 2021. A structured questionnaire was used to collect data during a face-to-face interview. Then the data were coded, cleaned, and entered into Epidemiological data version (EPIDATA) 3.1 and exported to the statistical package for Social Science version 23.0 for analyses. Bivariate and multivariable logistic regression model was used to identify statistically significant associations between dependent and independent variables. The odds ratio at 95% confidence interval with p-value 0.05% was considered statistically significant. Result: The majority of the study participants, 179 (42.8%), have ages ⩾ 25 years. Magnitude of having good knowledge and positive attitude of pregnant women toward obstetric ultrasound was 35.5% and 69.5%, respectively. Residence (adjusted odds ratio: 3.934; 95% confidence interval: 3.125–6.761), educational status (adjusted odds ratio: 3.614; 95% confidence interval: 1.986–5.964), and parity (adjusted odds ratio: 2.7621; 95% confidence interval: 1.68–3.275) were significantly associated with knowledge. Whereas exposure to obstetrical ultrasound in current pregnancy (adjusted odds ratio: 2.726; 95% confidence interval: 1.632–3.629), knowledge on obstetrical ultrasound (adjusted odds ratio: 3.92; 95% confidence interval: 1.324–3.120), and educational status (adjusted odds ratio: 2.84; 95% confidence interval: 1.337–3.381) were significantly associated with attitude. Conclusion: The level of good knowledge and positive attitude toward obstetric ultrasound was 35.5% and 69.5%, respectively, and it can be improved with appropriate interventions like ensuring the practice of obstetric ultrasound scan to all antenatal women. Obstetric care providers at the antenatal care units should advice pregnant women for obstetric ultrasound scan as per World Health Organization recommendations of one obstetric ultrasound scan before 24 weeks of gestation.

Introduction Obstetric violence is a specific form of violence against women that violates their human rights. Conducted by obstetric care providers regarding the body and reproductive processes of the woman, being characterized by dehumanized assistance, abuse of interventionist actions, medicalization, and reversion of the process from natural to pathological. Objective To assess the magnitude of obstetric violence and associated factors among women during childbirth in Gedeo Zone, South Ethiopia. Method Community based cross-sectional study was conducted among randomly selected 661 mothers in Gedeo Zone, South Ethiopia, from May 1 to May 30 2020. Multi-stage sampling technique was used to get a total of 661 mothers from their kebeles. Data was collected by using face-to--to-face interview with a structured questionnaire and in-depth interview was also employed. Data entry and analysis was done by Epi data version 3.1 and SPSS 23.0 statistical software. Bivariate and multivariable logistic regression models were used to determine the important predictors of obstetric violence. Association between outcome and independent variables was presented by adjusted odds ratio with 95% CI. Results From the total of 661 mothers, about 79.7% (527) of mothers experienced obstetric violence with 95% CI (76.9–82.8). educational status (AOR = 2.2573, 95%CI = 1.44,3.54), ANC utilization (AOR = 2.365, 95%CI = 1.62–3.21), duration of stay (AOR = 0.5367,95%CI = 0.28,0.86)), and facing complication during labor and delivery (AOR = 3.1382, 95%CI = 2.34,5.17) were the major factors associated with obstetric violence. Conclusion The magnitude of obstetric violence was high. Non dignified care and non-consented care was the most common form of obstetric violence which may lead a woman to choose for home delivery instead of health facility care, this in turn leads to a great increase in maternal morbidity and mortality as supported by qualitative approach of the study.

Breakfast skipping and its relationship with academic achievement among primary school children were investigated in this study. A cross-sectional study was conducted among 848 primary school children. Breakfast skipping was analyzed using a 2-item questionnaire. A 19-item Social Academic and Emotional Behavior Risk Screening questionnaire was used to collect data on children’s behavior. The prevalence of breakfast skipping was found to be 38.1%. Living in a rural area (AOR = 5.2; 95% CI: 3.54, 7.71); having illiterate parents (AOR = 6.66; 95% CI 3.0, 14.7); having parents with a primary education level (AOR 5.18, 95% CI: 2.25, 11.94); living with guardians or other relatives (AOR = 4.06; 95%CI: 2.1, 7.9); and having lower academic achievement (AOR = 2.76; 95% CI: 1.44, 5.29) were factors associated with skipping breakfast.In conclusion, breakfast skipping has been identified as a significant public health concern that requires an immediate response from stakeholders. It is recommended to intervene based on the identified factors.

Background. Problematic Internet use is characterized by excessive or poorly controlled preoccupations, urges, or behavior regarding computer use and Internet access which lead to impairment or distress. It has been found that the occurrence rate of problematic Internet use among university students ranges from 0.8% to 47.7%. Despite this, there are multiple challenges that relate to problematic Internet use, which remain underrecognized and largely ignored by stakeholders and are not well known, especially in low-income countries, including Ethiopia. Therefore, this study was conducted aiming to assess the prevalence of problematic Internet use and its associated factors among undergraduate students. Methods. Cross-sectional study was employed from May 1st to June 1st, 2019. A multistage sampling technique was used to get a total of 846 undergraduate students. Data were collected by using self-administered structured questionnaires of Young’s Internet Addiction Test. The collected data were coded and entered into EpiData 3.1 and analyzed by using SPSS version 22; bivariate and multivariate logistic regression analysis was conducted to identify factors associated with problematic Internet use, and statistical significance was considered at P value <0.05. Results. For a total of 846 study participants, the response rate was 761 (90%) and the prevalence of problematic Internet use was 19.4%. Multiple logistic regression model revealed that being male [AOR = 1.69, 95% CI: 1.80, 6.41], depression [AOR = 3.61, 95% CI: 2.40, 5.43], and khat or caffeinated drinks [AOR = 1.86, 95% CI: 1.21, 2.87] were significantly associated with problematic Internet use. Conclusion. This study revealed that there was high prevalence of problematic Internet use among Dilla University students and there were various factors associated with increased prevalence of problematic Internet use. Therefore, students need to be educated about the safe, valuable, and healthy practices of Internet use. Furthermore, it is better to counsel on substance use and its consequences to overcome the anticipated increase in problematic Internet use.

Background Smartphone and social media use are supposed to be integral parts of university students’ daily lives. More specifically, smartphones and social media are frequently used for communication in daily life during the COVID-19 pandemic. Nonetheless, uninterrupted and persistent use of these technologies may lead to several psychological problems. Even though smartphones and social media were used more frequently during the pandemic, there is no evidence suggesting that the studies were not undertaken in low-income countries, including Ethiopia. Therefore, the current study aimed to assess problematic smartphone use and social media use among undergraduate university students in southern Ethiopia. Methods A cross-sectional study was carried out among 1,232 university students using a simple random sampling technique. The Bergen Social Media Addiction Scale and Smartphone Application-Based Addiction Scale were used to collect data on social media and smartphone use, respectively. The Beck Depression Inventory, Generalized Anxiety Assessment Tool, Rosenberg Self-Esteem Scale, and Pittsburg Sleep Quality Index were standardized tools used to measure other independent variables. To identify factors, simple and multiple linear regression analyses were performed. A p-value of 0.05 was used to determine statistical significance. Results The overall response rate was 95%. The mean scores for problematic smartphone and problematic social media use were 17 ± 3.3/36 and 12.7 ± 2.2/30, respectively. A linear regression model revealed that being female, first-year students and poor sleep quality were significantly associated with problematic smartphone use. Factors associated with problematic social media use (PSMU) were depression, substance use, and urban residence. Conclusions This study identified significant problems with smartphone and social media use among university students. Therefore, it is preferable to provide psychological counselling, educate students about safe, beneficial, and healthy internet use, and focus on recognized high-risk groups in order to give them special attention. It is also preferable to seek counselling about substance use. It is preferable to regularly screen and treat individuals with psychological problems in collaboration with stakeholders.

Introduction: The term ‘unintended pregnancy’ refers to a pregnancy that occurred when no children were desired or occurred earlier than desired. Unintended births account for one out of every three births in Ethiopia, and they are the leading cause of maternal morbidity and mortality. During the coronavirus disease (COVID-19) pandemic, this could be useful. COVID-19 has a significant impact on maternal health care utilization, including family planning services. As a result, this study aimed to assess unintended pregnancy and associated factors in Ethiopia during the COVID-19 pandemic. Method: A community-based cross-sectional study was conducted in Gedeo zone, Ethiopia, from April 1 to May 30, 2021. A simple random sampling technique was utilized to get 383 pregnant women from their respective kebeles. A structured questionnaire was used to collect data during a face-to-face interview. The data were coded, cleaned, and entered into Epidemiological Data Version 3.1 before being exported to the Statistical Package for Social Science Version 23.0 for analysis. A bivariate and multivariable logistic regression model was used to identify statistically significant associations between dependent and independent variables. The odds ratio, with a 95% confidence interval and a P value of 0.05%, was considered statistically significant. Result: A total of 383 pregnant women participated in the study, giving a response rate of 90.8%. During the COVID-19 pandemic, 140 (36.6%) participants stated that their current pregnancy was unintended. Unintended pregnancy was significantly associated with respondents’ age (adjusted odds ratio (AOR) = 5.214 (1.449–18.762)), primary decision maker for family planning services (AOR = 9.510 (5.057–17.887)), and fear of COVID-19 to visit a health care facility (AOR = 7.061 (2.665–18.710)). Conclusion: During the COVID-19 era, more than one-third of women had unintended pregnancies. Unintended pregnancy was significantly associated with respondents’ age, autonomy to use contraceptive methods, and fear of COVID-19, which required them to attend a health care institution.