Background Community-based health insurance (CBHI) is a prepayment method of financial contributions for healthcare which aims to risk pooling, avoidance of catastrophic and impoverishing health expenditure. However, a high dropout from the scheme remains the biggest challenge to effective and sustainable progress towards universal financial protection in low- and middle-income countries. While large literature had examined initial enrollment and factors associated with it, only a few studies dealt with dropout. So the study aimed to assess the magnitude and determinants of dropout from community-based health insurance among households in Manna district, Jimma zone, Oromia Regional State, Ethiopia. Methods A community-based cross-sectional study design was employed to collect data from 634 household heads from March 1 to 30, 2020. A multistage sampling technique was carried out and interviewer-administered questionnaires were used to collect data. Descriptive statistics and multivariable logistic regression analyses were performed, and variables with a P -value<0.05 were considered as having a statistically significant association with the dropout from the CBHI. Results Magnitude of dropout from CBHI was 31.9% with 95% confidence interval (CI)=28.2–35.8% and relatively older age [adjusted odds ratio (AOR) (95% CI)=0.26 (0.10–0.78)], educational level [AOR (95% CI)=0.16 (0.06–0.41)], family size [AOR (95% CI)=0.36 (0.19–0.66)], poor perceived quality of service [AOR (95% CI)=5.7 (2.8–11.8)], trust in health facility [AOR (95% CI)=0.43 (0.3–0.61)], trust in the scheme [AOR (95% CI)=0.61 (0.45–0.84)], providers’ attitude [AOR (95% CI)=10 (4.0–25.4)], and benefit package [AOR (95% CI)=4.9 (2.4–9.9)] were statistically significant determinants associated with dropout. Conclusion Dropout from CBHI in this study area was high. Household heads’ age, educational level, family size, perceived quality of service, providers’ attitude, a benefits package, trust in the contracted health facility, and the scheme were the significant predictors of dropout. We strongly recommend that greater efforts should be made toward the providers’ attitude, promised benefit package, and quality of services.

Background: Ethiopia has received 2.2 million doses of COVID-19 vaccine from the COVID-19 Vaccines Global Access (COVAX) facility and planned to vaccinate 20% of its population by the end of 2021. However, evidence on the current uptake of the vaccine in our country is scanty. Therefore, this study aimed to assess COVID-19 vaccine uptake and associated factors among health professionals in Ethiopia. Methods: A national online cross-sectional E-survey was conducted on COVID-19 vaccine Uptake and associated factors among health professionals in Ethiopia from June 1 to 30, 2021. A semi-structured questionnaire was created on Google forms and disseminated online. The snowball sampling technique through the authors' network with Ethiopian residents on the popular social media like Facebook, telegram, and email was used. Descriptive statistics were performed. Multivariable logistic regression analysis was performed using Statistical Package for Social Sciences version 25, and all variables with P-value <0.05 and adjusted odds ratio at 95% CI were used to declare the predictors of the outcome variable. Results: A total of 522 health professionals participated in the survey, of which about 324 (62.1%) of them were vaccinated with any of the COVID-19 vaccines at least once. The study indicated that COVID-19 vaccine uptake was associated with age range from 35 to 44 years [AOR = 12.97, 95% CI: 2.36-71.21], age beyond 45 years [AOR = 18.95, 95% CI = 2.04-36.29], being male [AOR = 2.91, 95% CI = 1.05,8.09], being only an academician [AOR = 0.23, 95% CI: 0.10-0.49], academicians working in University hospitals [AOR = 0.19, 95% CI: 0.05-0.83], perceiving their family as healthy [AOR = 4.40, 95% CI: 2.21-8.75], no history of receiving other vaccine before as an adult [AOR = 4.07, 95% CI: 2.07-8.01] and no history of contact with confirmed COVID-19 patients or clients [AOR = 0.42, 95% CI: 0.20-0.86]. Conclusion:The study found that COVID-19 vaccine uptake among health professionals was low. This was not sufficient to achieve herd immunity as at least nine out of ten health professionals are required for herd immunity. Ages, sex, place of work, perceived family health status, previous experience of receiving a vaccine as an adult and history of contact with COVID-19 clients or patients were the factors that influence the vaccine uptake among health professionals in Ethiopia. Hence, decision makers and health managers should consider instituting mandatory vaccination for health professionals and design strategies for the provision of the vaccine.

BackgroundPatient self-referral is a condition when patients refer themselves to higher level health facilities without having to see anyone else first or without being told to refer themselves by health professional. Despite the expansion in the number of health facilities, it has been seen when patients routinely accessed referral hospitals. The study aims to determine the magnitude and identify determinants of outpatient self-referral at referral hospitals.MethodsFacility based cross sectional study design was used to collect data from December 01- 30; 2017.The sample size was determined by using single population proportion formula. Data entry and analysis were made using SPSS version 20. Descriptive statistics of frequency, bivariate and multivariate logistic regression were performed.ResultsA total of 404 outpatients were included making response rate 96.8%. Among 391 outpatients interviewed 330(84.4%) were self-referred.The factors significantly associated with outpatient self-referral were referral information (AOR and 95%CI=0.324(0.150-0.696), illness severity (AOR and 95% CI=3.496(1.473-8.297), confidence of patients to get providers (AOR and 95 CI=3.027(1.510-6.070), availability of laboratory (AOR and 95%CI=4.966(2.199-11.216) and drugs (AOR and 95%CI=2.366(1.013-5.526) and quality of services (AOR and 95%CI=2.996(1.418-6.328).ConclusionThe proportion of outpatients’ self-referral was high and that associated with referral information, patient confidence to get health care providers, severity of illness, availability of laboratory and drugs, and quality of services. There should be monitoring system of referral linkage of health facilities at all levels and the health facilities should create awareness in the community about referral linkages of health facilities.

Health care workers are potentially exposed to infections through contact with blood and bodily fluids while performing their duties. Compliance with the standard precautions reduces the risks of health care workers' exposure to blood and bodily fluids. However, the compliance level among health care workers is not well studied in the study area. Therefore, this study aimed to assess the level of compliance with standard precautions and its associated factors among health care workers in all public hospitals of East Wallaga Zone, Western Ethiopia. Materials and Methods: Multi-facility-based cross-sectional study was conducted among 392 health care workers, from January to February, 2022. Simple random sampling technique was used to select study participants. Logistic regression model was fitted to determine presence of statistically significant associations. A p-value of less than or equal to 0.05 along with the adjusted odds ratio of 95% confidence interval was used to declare statistical significance. Results: The proportion of health care workers who comply with standard precautions was found to be 51.6% [95% CI; 46.9-56.7%]. Having positive attitude towards standard precautions (AOR=2.71; 95% C.I: 1.68-4.39), having training on standard precautions (AOR=3.27; 95% C.I: 2.019-5.29), and working in referral hospitals (AOR=1.83; 95% C.I: 1.13-2.96) were the associated factors of good compliance with standard precautions. Conclusion:In this study, half of the health care workers comply with standard precautions. Positive attitude, training, and level of hospitals were factors for compliance with the standard precautions. As a result, to sustain and improve compliance of health care workers on standard precautions, periodic in-service training is needed to bring about behavioral changes among health care workers, particularly for those working in other settings than referral hospitals.

Background The medical equipment is any instrument, appliance, material, or other articles, whether used alone or in combination including the software necessary for the purpose of diagnosis, prevention, monitoring, treatment, or alleviation of the disease. The importance of efficient utilization of medical equipment has been brought to full public attention. The association between hospital characteristics and utilization of medical equipment has received more attention for its complicated consequences on health care costs and quality. So, the study aimed to assess factors affecting efficient utilization of medical equipment at public referral hospitals in East Wollega zone, Oromia regional state. Methods The study was conducted at public referral hospitals in East Wollega, Oromia Regional National State, Ethiopia from July 30-August 30, 2021. Cross-sectional study design was conducted mixed with observation and document review. About 192 equipment were included in the study. The descriptive statics and Pearson Chi-square (χ2) were performed to identify association between each independent and dependent variables at p < 0.05 to declare level of significance. Results Using 95% confidence interval, the level of utilization coefficient was estimated to be 0.49(0.44–0.55). Accordingly, 111(57.8%) equipment were efficiently utilized whereas 81(41.2%) of the equipment were underutilized. The form in which the hospitals received (χ2 = 7.7.2; P = 0.005), regularly availability (χ2 = 19.30; P = 0.000), the equipment breakdown (χ2 = 11.57; P = 0.001), availability of adequate trained staffs operating the equipment (χ2 = 26.14; P = 0.000), performing preventive maintenance (χ2 = 91.54; P = 0.000), availability of adequate spare parts (χ2 = 32.36; P = 0.000), and availability accessories(consumables) (χ2 = 43.91; P = 0.000) were the statistically significant associated factors affecting efficient utilization of the equipment. Conclusion On average, the utilization coefficient of medical equipment in the study hospitals was low compared to other study findings which indicated that about 42.2% of the equipment were inefficiently utilized. The significant associated factors that could affect the efficient utilization of the equipment were the form in which the hospital received, regularly availability of the equipment, the equipment breakdown, availability of trained staffs operating the equipment, performing preventive maintenance, availability of adequate spare parts, and accessories. Every hospital should develop appropriate strategic framework to manage and utilize the available medical diagnostic equipment based on their level and demand.