Background Maternal mortality remains unacceptably high in sub-Saharan Africa with 533 maternal deaths per 100,000 live births, or 200,000 maternal deaths a year. This is over two-thirds (68%) of all maternal deaths per year worldwide. The lifetime risk of maternal death in low-income countries is 1 in 45. Most maternal deaths can be prevented if births are attended by skilled health personnel. Therefore, the current study examined the utilization of maternal health services among women in different sociodemographic statuses within different literacy strata in Ethiopia. Methods A total weighted sample of 3,839 women who gave birth within five years preceding the survey and whose literacy status was measured in the survey were included in this study. The dataset from the most recent Ethiopia Mini Demographic and Health Surveys (EMDHS) 2019 was used for this study. The EMDHS was a community-based cross-sectional study conducted in Ethiopia from March 21 to June 28, 2019. The survey used a two-stage stratified cluster sampling technique. Bivariate and multivariable logistic regression analyses were employed. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) was reported and statistical significance was set at a p-value < 0.05. Results In this study, nearly two-thirds (63.8%) of reproductive-age women were illiterate. The overall prevalence of ANC 1, ANC 4, skilled birth attendance, and postnatal care utilization was 74.9%, 43.5%, 51.9%, and 32.0%, respectively. Our analysis also revealed that literate women are more likely to receive ANC 1 (literate vs illiterate, 87.9% vs 67.5%), ANC 4 (59.4% vs 34.5%), skilled birth attendance (73.3% vs 39.7%), and PNC (51.2% vs 21.1) as compared to their illiterate counterparts (p < 0.001). Regional variation, wealth status, age at first birth, birth order, and birth intervals were found significant factors associated with maternal health care service utilization among both literate and illiterate reproductive-age women in Ethiopia. Similar to this, ANC booking timing and utilization, age of household head, and religious affiliation were associated with institutional delivery and PNC utilization. Conclusion Women’s literacy is an important associate for utilizing appropriate maternal healthcare, with other sociodemographic and obstetric related factors as modifying factors. Hence, wholehearted efforts should be directed toward educating and empowering women. On the other hand, literacy levels and other modifying factors should be considered when designing interventions that enhance maternal health care service utilization. For instance, such programs need to stratify the interventions according to the literacy level of the women.

BackgroundHigh-risk fertility behavior (HRFB) among women is the main factor in a wide range of detrimental effects on both the mother's and the child's health, which has an impact on both the mother's and the child's survival. Early childbearing is associated with a higher number of live births and may result in poorer maternal, baby, and child health outcomes. Infant and child mortality are also linked to short birth intervals and higher birth order. Thus, this study aims to examine the link between women's education, contraception use, and high-risk fertility behavior in Ethiopia.MethodsData was drawn from the 2019 Ethiopian Interim Demographic and Health Survey. The analysis covered a total of 5,846 women. The effect of predictor variables on HRFB was quantified using multivariable logistic regression analysis. At a 95% CI of the odds ratio excluding one, a significant association between the HRFB and predictor variables was observed.ResultsAbout 72.8% (95% CI 71.6%–73.9%) of women experience high-risk fertility behaviors. Of these, 32% experience single high-risk fertility behavior, and 40.8% experience multiple high-risk fertility behaviors. Of those who experience high-risk fertility behaviors, 58.7% have birth orders of more than three, 22.4% have short birth intervals (less than 24 months); 35.1% are old (over 34 years old); and 1.6% are young (less than 18 years old). Women with no education (AOR = 4.31; 95% CI: 2.09, 8.89) and primary education only (2.71; AOR = 2.71; 95% CI: 1.63, 4.50) are more likely to engage in high-risk fertility behaviors than women with a higher level of education. Every additional year of schooling reduces the odds of high-risk fertility behavior by 6% (AOR = 0.94; 95% CI: 0.89, 0.98). The use of modern contraception (AOR = 0.74; 95% CI: 0.622, 0.879) and knowledge of modern contraception methods (AOR = 0.80; 95% CI: 0.66, 0.96) reduce the risk of HRFB.ConclusionsPrimary education and a lack of education significantly raise the risk of HRFB. However, in Ethiopia, the risk of experiencing HRFB is reduced through modern contraceptive methods, awareness of modern contraceptive methods, and years of education. All initiatives to decrease maternal and newborn mortalities by reducing the risk of HRFB should educate women and encourage them to use modern contraception.

BackgroundFood security occurs when all people have physical, social, and economic access to sufficient, safe, and nutritious food that fits their dietary needs and food preferences for an active and healthy life at all times. There is limited evidence on this topic and not well studied in Ethiopia.ObjectiveThis study aimed to investigate food insecurity and hunger status among households (HHs) in Debre Berhan town, Ethiopia.MethodsA community-based cross-sectional study was undertaken from 1 January 2017 to 30 January 2017. A simple random sampling technique was used to enroll 395 HHs for the study. An interviewer-administered, structured, and pretested questionnaire was used to collect data through a face-to-face interview. The household food security and hunger status were assessed by using the Household Food Insecurity Access Scale and the Household Hunger Scale, respectively. Data were entered and cleaned using Epiata 3.1 and exported to SPSS software version 20 for statistical analysis. Logistic regression was fitted, and an odds ratio with a 95% confidence interval (CI) and a value of p of less than 0.05 were used to identify factors associated with food insecurity.ResultsA total of 377 HHs participated in the study with a response rate of 95.4%. The proportion of households with food insecurity was 32.4%, among which mild, moderate, and severe food insecurity accounted for 10.3, 18.8, and 3.2%, respectively. The mean score of the Household Food Insecurity Access Scale was 1.88 ± 3.5. Hunger occurred among 3.2% of households. The mean score of the Household Hunger Scale was 2.17 ± 1.03. Husband or male cohabitant’s occupation (AOR = 2.68; 95% CI: 1.31–5.48) and wife or female cohabitant’s literacy (AOR = 3.10; 95% CI: 1.01– 9.55) were the only factors associated with HH food insecurity.ConclusionHH food insecurity and hunger in Debre Berhan town were unacceptably high, which can hamper achieving national targets for food security, nutrition, and health. Intensified efforts are further needed to accelerate the decline in food insecurity and hunger prevalence. Therefore, interventions need to target self-employed merchants in small businesses and women who are uneducated.

BackgroundUniversal health coverage (UHC) is aimed at ensuring that everyone has access to high-quality healthcare without the risk of financial ruin. Community-based health insurance (CBHI) is one of the essential means to achieve the sustainable development goals (SDGs) global health priority of UHC. Thus, this study assessed health insurance enrollment and associated factors among reproductive age women in Ethiopia.MethodsWe computed the health insurance enrollment of reproductive-age women using secondary data from the recent Ethiopian Mini Demographic and Health Surveys (EMDHS) 2019. The EMDHS was a community-based cross-sectional study carried out in Ethiopia from March 21 to June 28, 2019. Cluster sampling with two stages was employed for the survey. The study comprised 8885 (weighted) reproductive-age women. STATA 14 was used for data processing and analysis. Bivariate and multivariable logistic regression analyses were conducted. Adjusted odds ratio (AOR) with 95% confidence interval (CI) was reported and statistical significance was set at a value of p &lt; 0.05.ResultsOf the 8,885 study participants, 3,835 (43.2, 95% CI; 42.1, 44.2%) of women had health insurance. Women aged 20–24 years, 25–29 years, and 30–34 years less likely to enroll in health insurance compared to their younger counterparts (15–19 years). Women living in rural areas, had greater than five family sizes, living with a female household head, and having more than five living children were negatively associated with enrollment in health insurance. Besides, health insurance enrollment among reproductive-age women is significantly affected by region and religious variation.ConclusionThe overall CBHI enrolment among reproductive-age women in Ethiopia was low. To achieve the SDGs of reducing maternal mortality ratio and neonatal mortality, improving reproductive-age women’s access to health insurance is essential. The national, regional, and local officals, policymakers, NGOs, program planners, and other supporting organizations working on improving health insurance enrollment of reproductive age women need to create awareness and support them based on these significant factors.

Background: Vaccine-preventable diseases still claim 1.5 million lives annually because of poor immunization coverage, which could be avoided if global vaccination coverage improves. Though vaccination coverage in Ethiopia has shown steady progress over the years, there are districts within the country that are below the set target for vaccination coverage. Therefore, this study is aimed at investigating the magnitude and determinants of the uptake of recently introduced vaccines among children aged 12–23 months in Ethiopia.Methods: The data analysis was performed using the 2019 Ethiopia Mini Demographic and Health Survey. Considering the hierarchical nature of the data, a multilevel logistic regression analysis was employed, and the adjusted odds ratio (AOR) with 95% confidence interval (CI) was reported to declare significant determinants. The results were considered statistically significant if p-value < 0.05. The intra-class correlation coefficient, median odds ratio, proportional change in Variance, and deviance (-2LL) were used for model comparison and for checking model fitness.Results: A total of 2833 mothers with children of age 12-23 months were included in the analysis. Our analysis revealed that 45.7%, 53.4%, and 43.5% of the children completed vaccination for Pneumococcal Conjugate vaccine (PCV), Rotavirus vaccine (RV), and both PCV and RV respectively. Being in the age group of 20-34 (AOR = 2.03, 95% CI: 1.37, 3.02) and 35-49 (AOR = 2.44, 95% CI: 1.52, 3.91), having at least 4 antenatal care contacts (AOR = 2.73, 95% CI: 2.06, 3.62), having postnatal care (AOR = 1.84, 95% CI:1.42, 2.37), delivery in the health facility (AOR = 1.45, 95% CI: 1.17, 1.79), and having exposure to media (AOR = 1.24, 95% CI:1.09, 1.56), and any of the wealth quintile categories higher than poorest category were positively associated with uptake of newly introduced vaccines Rural residency, on the other hand, was found to be negatively related with the uptake of newly introduced vaccines.Conclusion: The overall full uptakes of newly introduced vaccines among children 12-23 months were significantly lower. Hence, this study emphasizes the need to strengthen maternal and child health clinic services particularly, to the younger age mother and those with lower socio-economic status.