Background Despite the efforts made by the government of Ethiopia, the community-based health insurance (CBHI) enrollment rate failed to reach the potential beneficiaries. Therefore, this study aimed to assess the enrollment status of households for community-based health insurance and associated factors in peripheral areas of Southern Ethiopia. Methods We conducted a community based cross-sectional study design with both quantitative and qualitative methods. Systematic random sampling was employed to select 820 households from 27, April to 12 June 2018. A pretested structured questionnaire, in-depth interview, and focus group discussion guiding tool were used to obtain information. A binary logistic regression model was used to assess the association between independent and outcome variables. A P-Value of less than 0.05 was taken as a cutoff to declare association in multivariable analysis. Qualitative data were analyzed manually using the thematic analysis method. Results Out of 820 households, 273[33.30%; 95% CI: 29.9–36.20] were enrolled in the community based health insurance scheme. Having good knowledge [AOR = 13.97, 95%CI: 8.64, 22.60], having family size of greater than five [AOR = 1.88, 95% CI: 1.15, 3.06], presence of frequently ill individual [AOR = 3.90, 95% CI: 2.03, 7.51] and presence of chronic illness [AOR = 3.64, 95% CI: 1.67, 7.79] were positively associated with CBHI enrollment. In addition, poor quality of care, lack of managerial commitment, lack of trust and transparency, unavailability of basic logistics and supplies were also barriers for CBHI enrollment. Conclusion and recommendation The study found that lower community based health insurance enrollment status. A higher probability of CBHI enrollment among higher health care demanding population groups was observed. Poor perceived quality of health care, poor managerial support and lack of trust were found to be barriers for non-enrollment. Therefore, wide-range awareness creation strategies should be used to address adverse selection and poor knowledge. In addition, trust should be built among communities through transparent management. Furthermore, the quality of care being given in public health facilities should be improved to encourage the community to be enrolled in CBHI.

Background Trachoma is the leading infectious cause of irreversible blindness. In areas where trachoma is endemic, active trachoma is common among preschool-aged children, with varying magnitude. There is a dearth of information on the prevalence of active trachoma among preschool-aged children (the most affected segment of the population). Purpose The study aimed to assess the prevalence of clinically active trachoma and its associated risk factors among preschool-aged children in Arba Minch Health and Demographic surveillance site, Southern Ethiopia. Patients and Methods A community-based cross-sectional study was conducted among 831 preschool-aged children from May 01 to June 16, 2019. A pre-tested and structured interviewer-administered Open Data Kit survey tool was used to collect data. The study participants were selected using a simple random sampling technique by allocating a proportion to each kebeles. Both bivariable and multivariable logistic regression analyses were performed to identify associated factors. The level of statistical significance was set at a p-value of less than 0.05 in multivariable logistic regression. Results The overall prevalence of clinically active trachoma among preschool-aged children was 17.8% with 95% CI (15%, 20%). Time taken to obtain water for greater than thirty minutes (AOR=2.8,95% CI: 1.62, 5.09), presence of animal pens in the living compound (AOR=5.1, 95% CI: 3.15, 8.33), improper solid waste disposal (AOR=7.8,95% CI: 4.68,13.26), improper latrine utilization (AOR=2.5, 95% CI: 1.63,3.94), a child with unclean face (AOR=3.5, 95% CI: 2.12,5.97) had higher odds of active trachoma. Conclusion The prevalence of clinically active trachoma among pre-school aged children was high. “Facial cleanliness” and “Environmental improvement” components of the SAFE strategy are vital components in working towards the 2020 target of eliminating trachoma. Therefore, stakeholders at different hierarchies need to exert continuing efforts to integrate the trachoma prevention and control programs with other public health programs, with water sanitation and hygiene programs and with the education system.