Summary Background Comprehensive and comparable estimates of health spending in each country are a key input for health policy and planning, and are necessary to support the achievement of national and international health goals. Previous studies have tracked past and projected future health spending until 2040 and shown that, with economic development, countries tend to spend more on health per capita, with a decreasing share of spending from development assistance and out-of-pocket sources. We aimed to characterise the past, present, and predicted future of global health spending, with an emphasis on equity in spending across countries. Methods We estimated domestic health spending for 195 countries and territories from 1995 to 2016, split into three categories—government, out-of-pocket, and prepaid private health spending—and estimated development assistance for health (DAH) from 1990 to 2018. We estimated future scenarios of health spending using an ensemble of linear mixed-effects models with time series specifications to project domestic health spending from 2017 through 2050 and DAH from 2019 through 2050. Data were extracted from a broad set of sources tracking health spending and revenue, and were standardised and converted to inflation-adjusted 2018 US dollars. Incomplete or low-quality data were modelled and uncertainty was estimated, leading to a complete data series of total, government, prepaid private, and out-of-pocket health spending, and DAH. Estimates are reported in 2018 US dollars, 2018 purchasing-power parity-adjusted dollars, and as a percentage of gross domestic product. We used demographic decomposition methods to assess a set of factors associated with changes in government health spending between 1995 and 2016 and to examine evidence to support the theory of the health financing transition. We projected two alternative future scenarios based on higher government health spending to assess the potential ability of governments to generate more resources for health. Findings Between 1995 and 2016, health spending grew at a rate of 4·00% (95% uncertainty interval 3·89–4·12) annually, although it grew slower in per capita terms (2·72% [2·61–2·84]) and increased by less than $1 per capita over this period in 22 of 195 countries. The highest annual growth rates in per capita health spending were observed in upper-middle-income countries (5·55% [5·18–5·95]), mainly due to growth in government health spending, and in lower-middle-income countries (3·71% [3·10–4·34]), mainly from DAH. Health spending globally reached $8·0 trillion (7·8–8·1) in 2016 (comprising 8·6% [8·4–8·7] of the global economy and $10·3 trillion [10·1–10·6] in purchasing-power parity-adjusted dollars), with a per capita spending of US$5252 (5184–5319) in high-income countries, $491 (461–524) in upper-middle-income countries, $81 (74–89) in lower-middle-income countries, and $40 (38–43) in low-income countries. In 2016, 0·4% (0·3–0·4) of heal...

Background Hypoxic perinatal brain injury is caused by lack of oxygen to baby’s brain and can lead to death or permanent brain damage. However, the effectiveness of therapeutic hypothermia in birth asphyxiated infants with encephalopathy is uncertain. This systematic review and meta-analysis was aimed to estimate the pooled relative risk of mortality among birth asphyxiated neonates with hypoxic-ischemic encephalopathy in a global context. Methods We used the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines to search randomized control trials from electronic databases (PubMed, Cochrane library, Google Scholar, MEDLINE, Embase, Scopus, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), and meta register of Current Controlled Trials (mCRT)). The authors extracted the author’s name, year of publication, country, method of cooling, the severity of encephalopathy, the sample size in the hypothermic, and non-hypothermic groups, and the number of deaths in the intervention and control groups. A weighted inverse variance fixed-effects model was used to estimate the pooled relative risk of mortality. The subgroup analysis was done by economic classification of countries, methods of cooling, and cooling devices. Publication bias was assessed with a funnel plot and Eggers test. A sensitivity analysis was also done. Results A total of 28 randomized control trials with a total sample of 35, 92 (1832 hypothermic 1760 non-hypothermic) patients with hypoxic-ischemic encephalopathy were used for the analysis. The pooled relative risk of mortality after implementation of therapeutic hypothermia was found to be 0.74 (95%CI; 0.67, 0.80; I2 = 0.0%; p<0.996). The subgroup analysis revealed that the pooled relative risk of mortality in low, low middle, upper-middle and high income countries was 0.32 (95%CI; -0.95, 1.60; I2 = 0.0%; p<0.813), 0.5 (95%CI; 0.14, 0.86; I2 = 0.0%; p<0.998), 0.62 (95%CI; 0.41–0.83; I2 = 0.0%; p<0.634) and 0.76 (95%CI; 0.69–0.83; I2 = 0.0%; p<0.975) respectively. The relative risk of mortality was the same in selective head cooling and whole-body cooling method which was 0.74. Regarding the cooling device, the pooled relative risk of mortality is the same between the cooling cap and cooling blanket (0.74). However, it is slightly lower (0.73) in a cold gel pack. Conclusions Therapeutic hypothermia reduces the risk of death in neonates with moderate to severe hypoxic-ischemic encephalopathy. Both selective head cooling and whole-body cooling method are effective in reducing the mortality of infants with this condition. Moreover, low income countries benefit the most from the therapy. Therefore, health professionals should consider offering therapeutic hypothermia as part of routine clinical care to newborns with hypoxic-ischemic encephalopathy especially in low-income countries.

BackgroundBreast self-examination (BSE) is a simple, very low-cost, non-invasive early detection method used to detect breast cancer at early stage. It should be done for all women older than 20 years. The aim of this study was to assess BSE practice and associated factors among female undergraduate students in Addis Ababa University, Addis Ababa, Ethiopia.MethodsInstitution-based cross-sectional study design was conducted. Departments were selected from College of Business and Economics by using lottery method. A simple random sampling technique was used to select a total of 407 female students from each department. Data were collected by using structured self-administered and pretested questionnaire. Quantitative method was employed. Binary logistic regression and multiple logistic regressions were done to confirm association between variables.ResultsThe finding of this study revealed that 87 (21.4%) of the study participants have practiced BSE. Of whom, 45 (51.7%) participants perform BSE every month and 9 (10.5%) of the study participants perform BSE at the right time, which is 2–3 days after menstruation. Family history of breast cancer, knowledge, and attitude of BSE were found to be significantly associated with BSE practice.ConclusionThis study revealed that majority of study subjects did not practice BSE. So, It’s recommended that the concerned bodies create awareness around BSE and train students on how to practice BSE.

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ObjectiveThe aim of this study was to assess the prevalence of needle-stick and sharp object injuries among staff nurses in Dessie referral hospital, Amhara region, Ethiopia, 2018.ResultsAmong the 151 study participants, 98 (65%) respondents were males. Seventy-five (48.1%) participants had 4–10 years of experience. The overall prevalence of needle stick and sharp object injury among staff nurses in Dessie referral hospital was 43%. In this study, nurses who worked in the emergency department were 11× more likely to experience needle stick and sharp object injury compared with nurses who worked in outpatient department P = 0.004 [AOR = 11.511 95% CI 2.134, 62.09)]. Participants who were worked in adult health department were 10× more likely experience needle stick and sharp object injury when compared with participants who were worked in outpatient department P = 0.006 [AOR = 9.742 95% CI 1.904, 49.859)]. The major implication of these study findings on the health system is the importance of given emphasis for nurses in relation with needle stick and sharp injury.Electronic supplementary materialThe online version of this article (10.1186/s13104-018-3930-4) contains supplementary material, which is available to authorized users.

Background. Worldwide lack of sanitation is a serious health risk, affecting billions of people around the world, particularly the poor and disadvantaged of people around the world. In Sub-Saharan Africa, the number of people who defecate remains the open field 215 million. According to the 2016 Ethiopian Demographic and Health Surveys report, 56% of the rural households use unimproved toilet facilities. One in every three households in the country has no toilet facility. However, achieving real gains in increasing latrine use and quality remained as a challenge. This study was used to assess the latrine utilization and associated factors in Mehal Meda town in North Shewa zone, Amhara region, Ethiopia, 2019. Result. In this study, a total of 558 participants were included. Out of households, 509 (91.2%) utilized their latrine facility. On the other way, 503 (98.8%) households utilized latrine regularly. Significant variables that were associated to latrine utilization were the occupational status of head of households, observing feces around the compound/latrine, duration of latrine utilization, shape and structure of latrine facility, latrine status during observation, and distance between water well and latrine. According to this study, the magnitude of latrine utilization in Mehal Meda district was 91.2%. It was lower than Ethiopia national expected target of MDGs (100%). Significant variables that were associated to latrine utilization were occupational status of head of households, observing feces around the compound/latrine, shape and structure of latrine facility, latrine status during observation, and distance between water well and latrine facility. Therefore, health education about latrine utilization and its advantage should be given for community in the study area.

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Background Low birth weight puts a newborn at increased risk of death and illness, and limits their productivity in the adulthood period later. The incidence of low birth weight has been selected as an important indicator for monitoring major health goals by the World Summit for Children. The 2014 World Health Organization estimation of child death indicated that 4.53% of total deaths in Ethiopia were due to low birth weight. The aim of this study was to assess trends of proximate low birth weight and associations of low birth weight with potential determinants from 2011 to 2016. Methods This study used the 2016 Ethiopian Demographic and Health Survey data (EDHS) as data sources. According to the 2016 EDHS data, all the regions were stratified into urban and rural areas. The variable “size of child” measured according to the report of mothers before two weeks of the EDHS takes placed. The study sample refined from EDHS data and used for this further analysis were 7919 children. A logistic regression model was used to assess the association of proximate low birth weight and potential determinates of proximate low birth weight. But, the data were tested to model fitness and were fitted to Hosmer-Lemeshow-goodness of fit. Results The prevalence of proximate low birth weight in Ethiopia was 26.9% (2132), (95%CI = 25.4, 27.9). Of the prevalence of child size in year from 2011 to 2016, 17.1% was very small, and 9.8% was small. In the final multivariate logistic regression model, region (AOR = xx), (955%CI = xx), Afar (AOR = 2.44), (95%CI = 1.82, 3.27), Somalia (AOR = 0.73), (95%CI = 0.55, 0.97), Benishangul-Gumz (AOR = 0.48), (95%CI = 0.35, 0.67), SNNPR (AOR = 0.67), (95%CI = 0.48, 0.93), religion, Protestant (AOR = 0.76), (95%CI = 0.60, 0.95), residence, rural (AOR = 1.39), (95%CI = 1.07, 1.81), child sex, female (AOR = 1.43), (95%CI = 1.29, 1.59), birth type, multiple birth during first parity (AOR = 2.18), (95%CI = 1.41, 3.37), multiple birth during second parity (AOR = 2.92), (95%CI = 1.86, 4.58), preparedness for birth, wanted latter child (AOR = 1.26), (95%CI = 1.09, 1.47), fast and rapid breathing (AOR = 1.22), (95%CI = 1.02, 1.45), maternal education, unable to read and write (AOR = 1.46), (95%CI = 1.56, 2.17), and maternal age, 15–19 years old (AOR = 1.86), (95%CI = 1.19, 2.92) associated with proximate low birth weight. Conclusions The proximate LBW prevalence as indicated by small child size is high. Region, religion, residence, birth type, preparedness for birth, fast and rapid breathing, maternal education, and maternal age were associated with proximate low birth weight. Health institutions should mitigating measures on low birth weight with a special emphasis on factors identified in this study.