Background Infant mortality is defined as the death of a child at any time after birth and before the child’s first birthday. Sub-Saharan Africa has the highest infant and child mortality rate in the world. Infant and child mortality rates are higher in Ethiopia. A study was carried out to estimate the risk factors that affect infant mortality in Ethiopia. Method The EDHS− 2016 data set was used for this study. A total of 10,547 mothers from 11 regions were included in the study’s findings. To estimate the risk factors associated with infant mortality in Ethiopia, several count models (Poisson, Negative Binomial, Zero-Infated Poisson, Zero-Infated Negative Binomial, Hurdle Poisson, and Hurdle Negative Binomial) were considered. Result The average number of infant deaths was 0.526, with a variance of 0.994, indicating over-dispersion. The highest mean number of infant death occurred in Somali (0.69) and the lowest in Addis Ababa (0.089). Among the multilevel log linear models, the ZINB regression model with deviance (17,868.74), AIC (17,938.74), and BIC (1892.97) are chosen as the best model for estimating the risk factors affecting infant mortality in Ethiopia. However, the results of a multilevel ZINB model with a random intercept and slope model revealed that residence, mother’s age, household size, mother’s age at first birth, breast feeding, child weight, contraceptive use, birth order, wealth index, father education level, and birth interval are associated with infant mortality in Ethiopia. Conclusion Infant deaths remains high and infant deaths per mother differ across regions. An optimal fit was found to the data based on a multilevel ZINB model. We suggest fitting the ZINB model to count data with excess zeros originating from unknown sources such as infant mortality.

Background Desire for more children has an impact on couple’s fertility behaviors. It can be a precursor of actual fertility performance. However, the desire for more children is declining over time in Ethiopia. Therefore, this study aimed to identifying the determinants of the desire for more children among women in Ethiopia. Methods The 2016 Ethiopian Demographic and Health Survey data were used for the analysis. The sample consisted of 15,683 women. The binary logistic regression model was used to assess the determinants of desire for more children among women in Ethiopia. The results are presented as crude odds ratios (COR) and adjusted odds ratios (AOR) together with their corresponding 95% confidence intervals. Results No education (having no formal education) (AOR = 1.85, 95% CI 1.61–2.13), attained primary education (AOR = 1.62, 95% CI 1.43–1.83), age at first marriage 10–19 years (AOR = 1.80, 95% CI 1.27–2.54), Orthodox religion (AOR = 1.48, 95% CI 1.01–2.19), Catholic religion (AOR = 2.15, 95% CI 1.17–3.97), Muslim religion (AOR = 1.70, 95% CI 1.15–2.50), living in Amhara (AOR = 1.45, 95% CI 1.18–1.78), Oromia (AOR = 2.10, 95% CI 1.73–2.54), Benishangul (AOR = 1.17, 95% CI 1.01–1.45), SNNPR (AOR = 1.30, 95% CI 1.05–1.60), Gambela (AOR = 1.25, 95% CI 1.02–1.57), Harari (AOR = 2.24, 95% CI 1.82–2.76), ideal number of children four or fewer (AOR = 0.47, 95% CI 0.42–0.53), number of living children four or fewer (AOR = 2.12, 95% CI 1.90–2.37), and not use of contraceptives (AOR = 1.51, 95% CI 1.35–1.68) were associated with a higher desire for more children. Conclusion This finding showed that the age of women, educational level, age at first marriage, religion, region, occupation, ideal number of children, number of living children, and use of contraceptives were significant determinants of desire for more children. Therefore, it is important to adopt programs to encourage the desire for more children, implement policies in an attempt to increase the total fertility rate in Ethiopia ought to critically consider these factors. Moreover, continuous education and knowledge on reproductive health will help for better fertility behaviour for the women.

Background Tetanus is a deadly bacterial infection caused by Clostridium tetani wound contamination characterized muscular spasms and autonomic nervous system dysfunction. Maternal and neonatal tetanus occurs under improper hygiene practices during childbirth. Globally, an estimated 3.3 million newborn deaths occur every year, and about 9,000 babies die every day in the first 28 days of life. This study sought to identify risk factors associated with the immunization of rural women against tetanus in rural areas in ten East African countries. Method The data used in this study were taken from the Demographic and Health Survey (DHS) of ten East African countries (Ethiopia, Burundi, Comoros, Zimbabwe, Kenya, Malawi, Ruanda, Tanzania, Uganda and, Zambia). Multivariable binary logistic regression is used to determine the risk factors associated with tetanus-protected women in east Africa. Results The weighted total samples of 73735 rural women were included in the analysis. The combined prevalence of tetanus immunization among protected rural women in ten East African countries was 50.4%. Those women with age of 24–34 (AOR = 0.778; 95%CI: 0.702–0.861), higher educational level (AOR = 4.010; 95%CI: 2.10–5.670), rich women (AOR = 3.097;95%CI: 2.680–3.583), mass media coverage (AOR = 1.143; 95%CI: 1.030–1.269), having above three antenatal care follow up (AOR = 1.550; 95% CI: 1.424–1.687), big problem of distance to health facility (AOR = 0.676; CI: 0.482–0.978) and place of delivery health facility (AOR = 1.103; 95% CI: 1.005–1.210) had a significant effect on women’s protected from tetanus. Conclusion The coverage of tetanus immunization in East Africa was very low. Public health programs target rural mothers who are uneducated, poor households, longer distances from health facilities, mothers who have the problem of media exposure, and mothers who have not used maternal health care services to promote TT immunization.

Background: Adoption of organic fertilization is low among farmers in rural areas of Ethiopia, affecting yields and general food security in the region. This study aimed to identify the determinants of the utilization of organic fertilizers among smallholder farmers in the South Gondar Zone, Amhara National Regional State (ANRS), Northwest Ethiopia. Methods: A community-based cross-sectional study was used among smallholder farmers in the South Gondar Zone, ANRS, Northwest Ethiopia. Primary data were collected from 420 sample respondents using multistage sampling with a combination of both simple random and cluster sampling techniques. The binary logistic regression model was used to assess the use of organic fertilizers among smallholder farmers in the South Gondar Zone. The results are presented as adjusted odds ratios (AOR) together with their corresponding 95% confidence intervals. Results: head of household age (AOR = 1.099, 95% CI 1.018-1.187), married marital status (AOR = 10.506, 95% CI 1.355-81.427), literate head of household (AOR = 3.323, 95% CI 1.571-7.029), number of laborers (AOR = 1.442, 95% CI 1.060-1.962), farming experience (AOR = 1.132, 95% CI 1.041-1.232), farm size (AOR = 1.063, 95% CI 1.008-1.121), and number of livestock (AOR = 1.368, 95% CI 1.115-1.677) were positively associated with the utilization of organic fertilizer while single marital status (AOR = 0.062, 95% CI 0.004-0.851), cost of laborer (AOR = 0.965, 95% CI 0.951-0.978), household income (AOR = 0.880, 95% CI 0.824-0.939), medium soil fertility (AOR = 0.039, 95% CI 0.007-0.229), fertile soil (AOR = 0.020, 95% CI 0.003-0.120), and home to farm distance (AOR = 0.219, 95% CI 0.067-0.717) were negatively associated with the utilization of organic fertilizer. Conclusions: This finding showed that multiple variables have an effect to determining the use of organic fertilizer by smallholder farmers. Therefore, the finding is important to adopt programs to encourage the use of organic fertilizer, implement policies in an attempt to adapt the use of organic fertilizer among the South Gondar Zone, and critically consider these factors. Furthermore, extension workers should focus on raising awareness about the importance of organic fertilizers to encourage or expand their use among smallholder farmers.

Background Exclusive breastfeeding (EBF) is the most cost-effective intervention to reduce infant morbidity and mortality worldwide. It is crucial since human milk contains nutrients, living cells, and defensive factors which enable infants to have better immunity, physical and mental development. Therefore, this study aimed at identifying the predictors of exclusive breastfeeding practices among mothers in Ethiopia using Ethiopian Demographic and Health Survey (EDHS) 2016 data. Methods EDHS 2016 data were used for the analysis. A total of 1,066 mothers were included in the analysis. The binary logistic regression model was used to identify the determinants of EBF practice among mothers. The result presented using adjusted odd ratio (AOR) with a 95% confidence interval. Results The prevalence of EBF was 58% of infants under age 6 months. Mothers age 25–34 (AOR = 1.74; 95% CI 1.31–2.32), child age 4–5 months (AOR = 0.74; 95% CI 0.66–0.84), married marital status (AOR = 1.26; 95% CI 1.06–1.50), mothers attained secondary education or higher (AOR = 2.00; 95% CI 1.54–2.58), husband attained secondary education or higher (AOR = 1.70; 1.39–2.13), richer wealth index (AOR = 0.35; 95% CI 0.18–0.69), accessed to the media (AOR = 1.77; 95% CI 1.38–2.27), number of living children 3–4 (AOR = 0.49; 95% CI 0.25–0.95), health facility (AOR = 1.87; 95% CI 1.09–3.20), rural residence (AOR = 0.66; 95% CI 0.49–0.89) and mothers living in Afar (AOR = 100.2; 95% CI 15.68–640.61), Somali (AOR = 52.65; 95% CI 8.48–326.77), SNNPR (AOR = 6.94; 95% CI 1.05–45.79), Harari (AOR = 61.94; 95% CI 9.75–393.44), Addis Ababa (AOR = 13.07; 95% CI 2.06–82.99), and Dire Dawa (AOR = 28.91; 95% CI 4.38–190.86) were associated with EBF practice. Conclusions The practice of exclusive breastfeeding remains low in Ethiopia. Therefore, the stakeholders should be taken into consideration those determinant factors identified in this study in policies and programmes to increase EBF practice among mothers. Moreover, designing and implementing specific strategies to enhance the rate of exclusive breastfeeding practices through community-based education is recommended.

Introduction. The primary effect of the fertility process is the birth of the first child. The ages at which women establish marital union and give their first birth depend on and result in varying demographic features. This research demonstrates how to examine the effect of numerous factors on married women’s delay to first birth in Ethiopia using Bayesian parametric models with gamma shared frailty distribution. Methods. This study analyzed data from the 2016 EDHS on factors related to the time of married women to first birth. A sample of 8810 married women from all parts of Ethiopia participated in the study. The Akaike information criterion (AIC) and Bayesian information criterion (BIC) were used to compare several parametric models with gamma shared frailty distributions to find the best model (BIC). Finally, when the prior data was taken into account, the chosen model was proven to be accurate (Bayesian approach). Results. The median survival time for the first birth after marriage is 24 years (95% CI; 23.4, 25.3). The result shows that the place of residence, the access to media, the level of education of the mother, the education level of the husband, the use of the head of the contraceptives, and the sex of the household are statistically associated with the time to first birth of married women. The Weibull-gamma shared frailty model under the Bayesian approach was found to be the best model that fit the time to first birth data in this study. The result also showed that there is heterogeneity between regions of married women. Conclusion. To slow the increase in the Ethiopian population, families must be taught how to use contraception, and rural populations must be educated on the necessity of increasing the length of the first birth gap rather than encouraging early marriage. In general, attempts to reduce fertility by raising the age of the first marriage must consider the social and cultural settings in which marriage takes place. On the other hand, the campaign against early marriage should focus on the sociocultural, physiological, and psychological effects, as well as the reduction of reproduction.

In Ethiopia, community-based health insurance was implemented to promote equitable access to sustainable quality health care and increase financial protection. The purpose of this study was to identify factors associated with community-based Health Insurance, Health Care Service Utilization of Households in the South Gondar Zone. A community-based cross-sectional study was employed. Data were collected among 619 randomly selected households in the south Gondar zone. Chi-square and binary logistic regression analyses with a P-Value of less than .05 were used to determine the association. Out of the total households, 511(82.6%) were using the CBHI scheme for health care service utilization. Residence, marital status, education level, occupation status, family size, presence of under-five children in the household, presence of elders in the households, nearest health institution, presence of chronic illness in the household’s, time taken to reach health institution, an attitude of a household were the determinant factors of community-based health insurance scheme health care service utilization of households. It is recommended that the local, regional and national governments, policymakers on optimal actions, NGOs, and other supporting organizations shall improve or scale-up the scheme by providing awareness to the community based on these significant factors and the attitude of households.

Background Due to the substantial increase in the number of glaucoma cases within the next several decades, glaucoma is a significant public health issue. The main objective of this study was to investigate determinants for the variation of intraocular pressure and time to blindness of glaucoma patients under treatment at Felege Hiwot Referral Hospital, Bahir Dar, Ethiopia. Materials and Method A retrospective cohort study design was conducted on 328 randomly selected glaucoma patients in ophthalmology clinic at the hospital under the follow-up period from January 2014 up to December 2018. A linear mixed effects model for intraocular data, a semi-parametric survival model for the time-to-blindness data and joint modeling of the two responses were used for data analysis. Result The comparison of joint and separate models revealed that joint model was more adequate and efficient inferences because of its smaller standard errors in parameter estimations. This was also approved using AIC, BIC and based on a significant likelihood ratio test as well. The estimated association parameter (α) in the joint model was 0.0160 and statistically significant (p - value = 0.0349). This indicated that there was strong evidence for positive association between the effects of intraocular pressure and the risk of blindness. The result indicated that the higher value of intraocular pressure was associated with the higher risk of blindness. As age increased by one year, the average IOP of the patients was also increased by 0.0726 mmHg (p-value < 0.0001) keeping all variables constant. Conclusion The predictors; age, blood pressure, type of medication and cup-disk ratio were significantly associated with the two responses of glaucoma patients. Health professionals should give more attention for patients who have blood pressure and cup-disk ratio greater than 0.7 during the follow-up time to reduce the risk of blindness of glaucoma patients.