Background Sub-Saharan Africa is one of the highest under-five mortality and low childhood immunization region in the world. Children in Sub-Saharan Africa are 15 times more likely to die than children from high-income countries. In sub-Saharan Africa, more than half of under-five deaths are preventable through immunization. Therefore, this study aimed to identify the determinant factors of full childhood immunization among children aged 12–23 months in sub-Saharan Africa. Methods Data for the study was drawn from the Demographic and Health Survey of nine sub-Saharan African countries. A total of 21,448 children were included. The two-level mixed-effects logistic regression model was used to identify the individual and community-level factors associated with full childhood immunization Result The prevalence of full childhood immunization coverage in sub-Saharan Africa countries was 59.40% (95% CI: 58.70, 60.02). The multilevel logistic regression model revealed that secondary and above maternal education (AOR = 1.38; 95% CI: 1.25, 1.53), health facility delivery (AOR = 1.51; 95% CI: 1.41, 1.63), fathers secondary education and above (AOR = 1.28, 95% CI: 1.11, 1.48), four and above ANC visits (AOR = 2.01; 95% CI: 1.17, 2.30), PNC visit(AOR = 1.55; 95% CI: 1.46, 1.65), rich wealth index (AOR = 1.26; 95% CI: 1.18, 1.40), media exposure (AOR = 1.11; 95% CI: 1.04, 1.18), and distance to health facility is not a big problem (AOR = 1.42; 95% CI: 1.28, 1.47) were significantly associated with full childhood immunization. Conclusion The full childhood immunization coverage in sub-Saharan Africa was poor with high inequalities. There is a significant variation between SSA countries in full childhood immunization. Therefore, public health programs targeting uneducated mothers and fathers, rural mothers, poor households, and those who have not used maternal health care services to promote full childhood immunization to improve child health. By enhancing institutional delivery, antenatal care visits and maternal tetanus immunization, the government and other stakeholders should work properly to increase child immunization coverage. Furthermore, policies and programs aimed at addressing cluster variations in childhood immunization need to be formulated and their implementation must be strongly pursued.

Background. Evidence shows that in Ethiopia, a gradual decrease of under-five mortality is observed, but it is still high in the rural settings of the country. We are motivated to investigate the socioeconomic, demographic, maternal and paternal, and child-related associated risk factors of under-five mortality given birth from rural resident mothers. Methods. Demographic and Health Survey data from Ethiopia (2016) were used for analysis. The chi-square test of association and logistic regression were used to determine the associated risk factors of under-five children mortality. Study Settings. Rural Ethiopia. Results. Secondary school and above completed fathers (AOR = 0.77; 95% CI: 0.63–0.94) and primary school completed mothers (AOR = 0.82; 95% CI: 0.72–0.93); multiple twin child (AOR = 4.50; 95% CI: 3.38–5.98); public sector delivery (AOR = 0.65; 95% CI: 0.55–0.76); had working of mother (AOR = 1.28; 95% CI: 1.16–1.42) and of father (AOR = 1.45; 95% CI: 1.25–1.69); mothers aged above 16 at first birth (AOR = 0.41; 95% CI: 0.37–0.45); breastfeeding (AOR = 0.60; 95% CI: 0.55–0.66); birth order of 2-3 (AOR = 1.18; 95% CI: 1.02–1.37); religious belief of Muslim (AOR = 1.20; 95% CI: 1.02–1.41); users of contraceptive method (AOR = 0.80; 95% CI: 0.71–0.90); vaccinated child (AOR = 0.52; 95% CI: 0.46–0.60); family size of 4–6 (AOR = 0.74; 95% CI: 0.63–0.86) and of seven and above (AOR = 0.44; 95% CI: 0.36–0.52); mother’s age group: aged 20–29 (AOR = 3.88; 95% CI: 3.08–4.90), aged 30–39 (AOR = 16.29; 95% CI: 12.66–20.96), and aged 40 and above (AOR = 55.97; 95% CI: 42.27–74.13); number of antenatal visits: 1–3 visits (AOR = 0.50; 95% CI: 0.43–0.58), and four and above visits (AOR = 0.46; 95% CI: 0.39–0.54); and preceding birth interval of 25–36 months (AOR = 0.55; 95% CI: 0.48–0.62) and above 36 months (AOR = 0.30; 95% CI: 0.26–0.34) are significant determinant factors of under-five mortality in rural settings. Conclusions. Differences in regions, educated parents, born in singleton, public sector delivery, nonavailability of occupation of parents, mothers older than 16 at first birth, breastfeeding, use of a contraceptive method, child vaccination, higher number of family size, repeated antenatal visits, and preceding birth interval play a significant role regarding the survival of under-five children. These, among other differences, should be addressed decisively as part of any upcoming strategic interventions to improve the survival of children in line with the target of 2030 Sustainable Development Goals (SDGs).

Background Ethiopia is one of the Sub-Saharan Africa countries with the lowest modern contraceptive prevalence rate and the highest fertility rate. This study aimed to assess individual and community-level predictors of modern contraceptive use among sexually active rural women in Ethiopia. Data and methods A sample of 9450 sexual active rural women aged 15-49 was extracted from the 15, 683 nationally representative samples of 2016 Ethiopian Demographic and Health Survey (EDHS). Multi-level logistic regression model was considered to identify determinant factors of modern contraceptive use among sexually active rural women in Ethiopia. Result The prevalence of modern contraceptive use among respondents was 20% in rural Ethiopia. Injection (66.35%) was the most common type of modern contraceptive use. In the last full model of the multilevel analysis, individual and community-level factors accounted for 86.69% of the variation in the use of modern contraceptive methods. Secondary and above-educated women (AOR = 1.39, 95%CI: 1.06, 2.81), having 1-4 living children (AOR = 2.70, 95%CI: 2.07, 3.53), rich wealth status (AOR = 2.26, 95%CI: 1.96, 2.60), married women (AOR = 17.31, 95%CI: 10.72, 27.94), having primary educated husband (AOR = 1.45, 95%CI: 1.27, 1.67) and being working husband (AOR = 2.26, 95%CI: 1.96, 2.60) were significantly positively associated with individual-level factors of the use of modern contraceptive methods. Besides, modern contraceptive use was negatively associated with Muslim women (AOR = 0.29, 95%CI: 0.25, 0.33). Compared to the Tigray region, women living in the Afar, Somali, Harari, and Dire Dawa regions had lower use of modern contraceptive methods. Women who had access to mass media (AOR = 1.35, 95%CI: 1.16, 1.57) were more likely to use contraceptives than their counterparts. Conclusion The prevalence of modern contraceptive use among rural women has very low. Both individual and community-level factors were significant predictors of modern contraceptive use. Consequently, the government and other stakeholders need to address educational opportunities; creating awareness about modern contraception and valuable counseling would increase modern contraceptive methods utilization.

Introduction Institutional delivery is a major concern for a country’s long-term growth. Rapid population development, analphabetism, big families, and a wider range of urban-rural health facilities have had a negative impact on institutional services in Sub-Saharan Africa (SSA) countries. The aim of this study was to look into the factors that influence women’s decision to use an institutional delivery service in SSA. Methods The most recent Demographic and Health Survey (DHS), which was conducted in nine countries (Senegal, Ethiopia, Malawi, Rwanda, Tanzania, Zambia, Namibia, Ghana, the Democratic Republic of Congo) was used. The service’s distribution outcome (home delivery or institutional delivery) was used as an outcome predictor. Logistic regression models were used to determine the combination of delivery chances and different covariates. Results The odds ratio of the experience of institutional delivery for women living in rural areas vs urban area was 0.44 (95% confidence interval (CI) 0.41–0.48). Primary educated women were 1.98 (95% CI 1.85–2.12) times more likely to deliver in health institutes than non-educated women, and secondary and higher educated women were 3.17 (95% CI 2.88–3.50) times more likely to deliver in health centers with facilities. Women aged 35–49 years were 1.17 (95% CI 1.05–1.29) times more likely than women aged under 24 years to give birth in health centers. The number of ANC visits: women who visited four or more times were 2.98 (95% CI 2.77–3.22) times, while women who visited three or less times were twice (OR = 2.03; 95% CI 1.88–2.18) more likely to deliver in health institutes. Distance from home to health facility were 1.18 (95% CI 1.11–1.25) times; media exposure had 1.28 (95% CI 1.20–1.36) times more likely than non-media-exposed women to delivery in health institutions. Conclusions Women over 24, primary education at least, urban residents, fewer children, never married (living alone), higher number of prenatal care visits, higher economic level, have a possibility of mass-media exposure and live with educated husbands are more likely to provide health care in institutions. Additionally, the distance from home to a health facility is not observed widely as a problem in the preference of place of child delivery. Therefore, due attention needs to be given to address the challenges related to narrowing the gap of urban-rural health facilities, educational level of women improvement, increasing the number of health facilities, and create awareness on the advantage of visiting and giving birth in health facilities.

BackgroundClean water is an essential element for human health, wellbeing, and prosperity. Every human being has the right to access safe drinking water. But, in now day, due to rapid population growth, illiteracy, lack of sustainable development, and climate change; it still faces a global challenge for about one billion people in the developing nation. The discontinuity of drinking water supply puts in force households either to use unsafe water storage materials or to use water from unimproved sources. This study aimed to identify the determinants of water source types, use, quality of water, and sanitation perception of physical parameters among urban households in North-West Ethiopia.MethodsA community-based cross-sectional study was conducted among households from February to March 2019. An interview-based pre-tested and structured questionnaire was used to collect the data. Data collection samples were selected randomly and proportional to each kebeles’ households. MS Excel and R Version 3.6.2 was used to enter and analyze the data; respectively. Descriptive statistics using frequencies and percentages were used to explain the sample data concerning the predictor variable. Both bivariate and multivariate logistic regressions were used to assess the association between the independent and the response variables.ResultsFour hundred eighteen (418) households have participated. Based on the study undertaken, 78.95% of households used improved and 21.05% of households used unimproved drinking water sources. Households drinking water sources are significantly associated with age of participant (x2 = 20.392, df=3), educational status (x2 = 19.358, df=4), source of income (x2 = 21.777, df=3), monthly income (x2 = 13.322, df=3), availability of additional facilities (x2 = 98.144, df=7), cleanness status (x2 =42.979, df=4), scarcity of water (x2 = 5.1388, df=1) and family size (x2 = 9.934, df=2). The logistic regression analysis also indicated as those factors are significantly determined (p 0.05) the water source types used by households. Factors such as availability of toilet facility, household member type, and sex of head of the household are not significantly associated with the drinking water sources.ConclusionThe study showed that being an older age group of the head of the household, being government employer, merchant and self-employed, being a higher income group, the presence of all facilities in the area, lived in a clean surrounding and lower family size are the determinant factors of using drinking water from improved sources. Therefore; the local, regional, and national governments and other supporting organizations shall improve the accessibility and adequacy of drinking water from improved sources through short and long time plans for the well-being of the community in the area.