Background: In the context of WHO's "task shifting" project and growing global consensus on primary HPV-based cervical cancer screening, self-sampling is a promising new tool to expand screening access, uptake and coverage for women worldwide. We aimed to explore perceptions and acceptability of HPV self-sampling-based cervical cancer screening among community members and health professionals in rural northwest Ethiopia and to identify preferences and socio-cultural barriers regarding self-sampling in order to design a suitable high-coverage screening intervention for a rural African setting. Methods: Four community-based focus group discussions (FGD) were conducted in the rural district of Dabat, Northwest Ethiopia, each comprising 8 to 14 female participants, counting a total of 41 participants. The groups were homogenously composed in terms of their socioeconomic status in the community. They included health centre attendees, community members, nurses and health development army leaders (HDAL). Two qualitative data collection experts conducted the interviews in the local language, using a FGD guide with several thematic areas. All participants granted written informed consent prior to the conduct of the interviews. As a concrete example of an existing self-sampling approach for cervical cancer screening we used the Evalyn® Brush. Results: Emerging themes included (i) misconceptions and low awareness about cervical cancer among community residents and primary health care providers in rural northwest Ethiopia, (ii) stigmatization and social exclusion of affected women, (iii) delay in seeking of health care due to poor access and availability of services, and lacking of a concept of early cancer prevention, (iv) need of spousal permission, (v) fear of financial burden and (vi) fear of social marginalization. The self-sampling device was regarded to be acceptable and was judged to be easy to use for most women. The existing Ethiopian health care structure could facilitate a community approach. Conclusion: Home-based self-sampling for cervical cancer screening is a socially acceptable and feasible "task shifting" method that will increase cervical cancer screening access and coverage in the Ethiopian study community. Education, awareness creation, community mobilization and family inclusion are identified as key activities to promote, implement and facilitate "task shifting" approaches like self-sampling.

Background Delivering modern contraceptive methods only may not provide much insight into the quality of family-planning services. Informed choice emphasizes that clients select the method that best satisfies their needs by informing them about all available contraceptive methods, side effects of the methods, and how to deal with the side effects if experienced. This study investigated informed choice regarding contraceptives and associated factors among women in Ethiopia. Methods Data were extracted from the 2016 Ethiopian Demographic and Health Survey. Information on informed choice was extracted from the individual women’s data. Subjects comprised 3,511 (weighted) reproductive-age women aged 15–49 years using selected contraceptive methods. Bivariate and multivariate logistic regression models were used to assess factors associated with informed of contraceptive choice among women in Ethiopia. P <0.05 was considered statistically significant. Results Only 36.2% of the participants were informed on contraceptive methods. Increased age, watching television less than once per week, and visiting health facilities in the last 12 months were associated with higher odds of being informed on contraceptive methods. Being affiliated with other religious groups, primary education only, having a husband employed in agriculture, being unskilled, with an unknown job, living in Amhara and Oromia regions, watching television at least once a week, and receiving the service from private clinics and pharmacies were associated with lower odds of being informed on contraceptive methods. Conclusion A substantial proportion of reproductive-age women in Ethiopia were inadequately informed about side effects or other methods. This varied by socio-demographic factors, sources of contraception, method, and frequency of visiting health institutions. This study suggests that interventions that increase family-planning counseling to the level that clients understand the methods are needed. Private health facilities also need to focus on delivering essential messages about methods they provide and assure women’s rights and choices.

Background: Poor lifestyle choices contribute to the continued growth of chronic illness and disability. Patients with diabetes require continuous self-care choices and management to minimize the short-and long-term impact of the disease. This study aimed at assessing the use of the health belief model to describe self-care practices among patients with diabetes. Methods: An institutional-based cross-sectional study was conducted from February to March 2019 in Gondar City, Northwest Ethiopia. A total of 396 diabetics patients were selected using a systematic random sampling technique. Pretested, structured, and interview administered questionnaire was used for data collection. The collected data were analyzed using STATA 14. Bivariate and multivariate logistic regression models were fitted to identify the factors associated with self-care behavior. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and p-values <0.05 were used to declare statistical association. Results: Health belief model described 48% of the variance in self-care practices of patients with diabetes. More than half (55.6%) of diabetic patients had good self-care practice. Of the participants, 45.8% and 49.9% had low perceived susceptibility and perceived severity, respectively. The strongest correlation was found between cues to action and perceived severity of health belief model constructs (P<0.001). Formal education, longer duration of diabetes, high social support, high perceived severity, and high self-efficacy contributed to good self-care practices, whereas comorbidities, high perceived benefit, and high perceived barrier were associated with poor self-care practices. Conclusion: Self-care practice of diabetes patients in Gondar City was considerably low. Health professionals need to strengthen delivering tailored health messages on the benefit self-care practices and means of overcoming the potential barriers. Health communication programs are also better to consider for individuals with comorbidities, lack of social support, and lower education.

PurposeIn Ethiopia, more than 26 million students have been out of the classroom for nearly 9 months. On 18 September, the Ethiopian Minister of Health advised the Parliament the possibility of reopening schools provided certain conditions were met. Schools are currently reopening in the country for the first time since March 2020.ObjectiveThis study assessed the knowledge and preventive health behaviours toward COVID-19 and associated factors among secondary school students.Design, setting, participants and outcome measuresAn institution-based cross-sectional study was conducted from October to December 2020 in Gondar city, Northwest Ethiopia. A total of 370 secondary school students were included. Bivariable and multivariable ordinal logistic regression model were fitted to identify the predictors of knowledge about COVID-19. Simple and multiple linear regression analysis were done to identify factors associated with preventive behaviour. A p<0.05 was used to declare statistical significance.ResultsOnly one-fourth (23.5%, 95% CI 19.5% to 28.1%) of the participants had a good knowledge about COVID-19. The mean score of preventive behaviour was 22.8±SD 6.2. Marital status, religion, father education, living arrangement and sources of information were significantly associated with knowledge about COVID-19. Being female and using health professionals as source of information increased the engagement in preventive behaviours. On the other hand, student whose father employed in non-governmental organisation and other jobs had decreased engagement in preventive health behaviours.ConclusionSignificant number of the students had inadequate knowledge about COVID-19 and poorly engaged in COVID-19 preventive behaviour. Thus, it is suggested to include and disseminate about COVID-19 in related academic sessions, using school clubs and minimedias. The sources of COVID-19-related information need to strengthen the dissemination of tailored, credible and timely message to enhance the knowledge and engagement of the students in preventive behaviours.

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Background. Childhood vaccination continues to increase dramatically. In spite of the success of immunization programs to date, millions of children continued to die each year, and sub-Saharan Africa (SSA) accounted for the world’s highest neonatal deaths. Childhood vaccination was designed as one of the most effective ways to reduce child mortalities from fatal vaccine-preventable diseases. Therefore, this study is aimed at investigating the individual- and community-level determinants of childhood complete vaccination in Ethiopia. Methods. A secondary data analysis was done based on the 2016 Ethiopian Demographic and Health Survey (EDHS). A total weighted sample of 1,984 children aged 12-23 months was included for analysis. Considering the hierarchical nature of EDHS data, a two-level multilevel analysis for assessing individual- and community-level determinants of childhood complete vaccination was done. The intraclass correlation coefficient (ICC), Median Odds Ratio (MOR), Proportional Change in Variance (PCV), and deviance (-2LL) were used for model comparison and for checking model fitness. Variables with p value < 0.2 in the bivariable multilevel analysis were considered for the multivariable multilevel analysis. In the multivariable multilevel logistic regression analysis, the Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was reported to declare significant determinants of complete childhood vaccination. Results. Overall complete vaccination status among children aged 12-23 months was 39% (95% CI: 36.8, 41.2). In the multilevel analysis, secondary or above educated mothers (AOR=2.48; 95% CI: 1.41, 4.36), richest wealth status (AOR=2.24; 95% CI: 1.16, 4.32), ≥four ANC visits (AOR=2.77; 95% CI: 1.90-4.02), employed mothers (AOR=1.66; 95% CI: 1.26, 2.18), urban residence (AOR=1.84; 95% CI: 1.00, 3.51), and children in city administration (AOR=2.66; 9% CI: 1.53, 4.62) were positively associated with vaccination status. On the other hand, children with a female household head (AOR=0.68; 95% CI: 0.48, 0.96) were negatively associated. Conclusion. Overall, childhood full vaccination status was low compared with the WHO targets. Maternal education, wealth status, ANC visit, maternal occupation, residence, region, and sex of household head were significant predictors of childhood complete vaccination. As a result, it is better to design a compensation mechanism to the costs associated with childhood vaccination for the poor households and strengthen awareness creation for rural residents to improve the access, utilization, and continuum of vaccination service.

BackgroundHead injuries account for 650,000 annual deaths worldwide. The cost for treating head injury was estimated at US $200 million annually. This contributes to economic impoverishment in low income countries like Ethiopia. Hence, this study was aimed to assess the cost of Traumatic Head Injury (THI) and associated factors in the University of Gondar Specialized Referral Hospital.MethodAn institution-based cross-sectional study was conducted from March 01 to May 30, 2017. A total of 387 THI patients were included in the study. An interviewer-administered questionnaire was used for data collection. Direct costs and indirect costs were measured by using the bottom-up approach. Data were entered into Epi-Info version 7 and imported to SPSS version 20 for analysis. Simple and multiple linear regression analysis were done to identify factors associated with cost of THI.ResultsThe mean cost of THI per patient was 4673.43 Ethiopian Birr (ETB), 95% CI (4523.6-4823.3), and length of hospital stay averaged 1.73, 95% CI (1.63–1.82). Direct non-medical cost, like transportation fee 1896.19 ETB (±762.56 SD) and medical costs 1101.66 ETB (±534.13 SD) were account for 40.57 and 23.58% of total costs respectively. The indirect cost, loss of income by patient and their attendant due to injury, was 1675.58 ETB (+ 459.26 SD). Patients with moderate and severe levels of injury have 635.167 ETB (Standardized coefficient = 0.173, p < 0.001) and 773.621 ETB (Standardized coefficient = 0. 132, p < 0.001) increased costs, respectively, compared to mild level THI patients. Costs for patients ages 31–45 years were 252.504 ETB (Standardized coefficient = − 0.066, p = 0.046) lower than costs for those 5–14 years old. The cost of THI patients increased by 1022.853 ETB for each additional day of hospital length of stay (Standardized coefficient = 0.648, p < 0.001).ConclusionMost expenses of the THI were from direct non-medical cost. Prior health service use, length of stay, level of injury, and age were significant predictors of cost of THI.

Background Sexually transmitted infections (STIs) are the most common communicable diseases that affect the health and life of people. Even though there is little information on the prevalence of STIs in Ethiopia, the problem is likely similar to other developing countries. Therefore, the objective of this study was to measure STIs related care-seeking behavior and associated factors among reproductive-age women in Ethiopia. Methods The study was based on the data from the 2016 Ethiopian Demographic and Health Survey (EDHS). Information on STIs related care-seeking was extracted from the individual women dataset. A total of 474 (weighted) reproductive age women (15–49 years) who reported STIs or STI symptoms were included in the study. Bivariate and multivariable logistic regression models were fitted to assess factors associated with STIs related care-seeking behavior. The adjusted odds ratio (AOR) with the corresponding 95% confidence intervals (CI) was used to show the strength of associations between the outcome and independent variables. Variables with a p value of less than 0.05 were considered statistically significant. Results The prevalence of STIs related care-seeking behavior among women was 33.3% (95% CI 29.2–37.3%). STIs related care-seeking behavior was significantly associated with higher women educational status (AOR = 0.16, 95% CI 0.03, 0.87), having a husband working an unskilled job (AOR = 6.99, 95% CI 1.34, 36.48), women who did not know their husband’s job (AOR = 12.79, 95% CI 2.24, 73.11), having an educated husband (AOR = 5.66, 95% CI 1.36, 23.51), being currently pregnant (AOR = 4.87, 95% CI 1.93, 12.28), being in the richer (AOR = 4.68, 95% CI 1.52, 14.39) and richest (AOR = 6.89, 95% CI 1.90, 24.81) wealth index. Conclusion STIs related care-seeking behavior was significantly low among Ethiopian women. Surprisingly, STIs related care-seeking behavior was lower among an educated woman. In contrast, having an educated husband, women who didn’t know their husband’s job, a husband working an unskilled job, being pregnant, and high wealth status were positively associated with STIs related care-seeking behavior.