Nursing process is a framework used to provide an effective, coordinated, and organized quality care for patients. Effective implementation of this framework leads to improved quality of care and decreases potential complication, hospital length of stay, and the cost of care. To assess implementation of nursing process and its hindering factors, a quantitative cross-sectional study was conducted among nurses in Afar region hospitals from October 2016 to December 2016. The data were collected from 102 nurses using primary Brooking's ward nurses' self-report questionnaire and with some newly prepared questions. The collected data were entered using Epi-Data version 3.1 and analyzed by SPSS version 20 and then presented by tables, graphs, and figures. Forty-three (42.1%) nurses were implementing nursing process at the time of data collection. Assessment and diagnosis were carried out by 57 (56.9%) nurses, planning by 46% of nurses, implementation by 38.2% of nurses, and evaluation by 36.2% of nurses in Afar region. Among the hindering factors towards nursing process implementation, lack of preparedness or knowledge about the nursing process or some part of it (83.3%) and absence of in-service training pertinent to nursing process (75.5%) were the most mentioned ones. Generally, nursing process was poorly implemented in Afar region mainly due to lack of knowledge and absence of in service training. Therefore, giving emphasis for cognitive parts of students about nursing process during their school time and refreshing nurse staffs with continuous training will definitively improve level of nursing process implementation.

Introduction: Focused antenatal care improves the survival and health of the mother as well as the babies. However, there are real challenges in keeping the subsequent antenatal care follow up in Ethiopia. Hence, the aim of this study was to assess missed antenatal care follow up and associated factors in the Eastern zone of Tigray. Methods: Hospital based cross-sectional study was conducted among systematically selected 548 women who came for de- livery services from March to April 2016. The data were collected using pre-tested and structured questionnaire through face to face exit interview. Data entry and analysis were made using EPI info version 7 software and SPSS version 20 respectively. Both binary and multiple logistic regression was performed. Results: This study revealed that 33.4% of participants were missing their Antenatal care follow-up. Having no formal ed- ucation [AOR=1.778 (1.102, 2.869)], attending primary education [AOR= 1.756 (1.040, 2.964)], self-employee [AOR=1.589 (1.030, 2.452)], government employee [AOR=0.503 (0.503, 0.953)], being unmarried [AOR=2.36 (1.11, 5.04)], didn’t in- formed about institutional delivery [AOR=3.34 (1.44, 7.78)], and travel distance more than two hours to hospital [AOR=1.93 (1.08, 3.44)] were factors significantly associated with missed Antenatal care follow-up. Conclusion: The proportion of missed antenatal care follow-up was lessened as compared to local and national evidences. Nevertheless, still a coordinated effort on tracking of pregnant women who missed their antenatal care appointment is re- quired by health policy implementers so as to increase the uptake of four complete visits. Keywords: Antenatal care follow-up; missed antenatal care; Tigray region; Ethiopia.

Background. Neonatal sepsis is one of the major public health problems globally, particularly, in developing countries. Klebsiella, Staphylococcus aureus, Coagulase-negative Staphylococcus, and Escherichia coli are the common pathogens for neonatal sepsis in developing countries. However, the pooled estimate of common pathogens causing neonatal sepsis in developing countries is still unknown. Therefore, this study is aimed at computing the pooled proportion of the leading cause of pathogens for neonatal sepsis in developing countries. Methods. We strictly followed the Preferred Reporting Items for Systemic Reviews and Meta-analysis guidelines to report this systematic review and meta-analysis. PubMed, Cochrane Library, Web of Science, CINAHL, Science Direct, and other search engines such as Google Scholar, Africa Journals Online, and Hinari were used to obtain studies related to the leading cause of pathogens for neonatal sepsis in developing countries. The search was done from October 1 to December 30, 2018, by considering both published and gray literature. Studies were evaluated based on the PRISMA guideline checklist by using their titles, abstracts, and full texts. Studies were extracted using Microsoft Excel spreadsheets, and STATA software version 14 was used to analyze data. Heterogeneity between studies was checked based on Cochran’s Q -test and the corresponding I 2 statistic test. Results. The pooled prevalence of the leading cause of pathogens of neonatal sepsis in developing countries were Klebsiella (26.36%), Staphylococcus aureus (23.22%), Coagulase-negative Staphylococcus (23.22%), and Escherichia coli (15.30%). Common pathogens were varied across regions; for instance, pooled isolated Coagulase-negative Staphylococcus was 25.98% in Africa, 16.62% in Asia, and 36.71% in Latin America, and Klebsiella was 29.80% in Africa, 23.21% in Asia, and 22.00% in Latin America. Also, Staphylococcus aureus was 27.87% in Africa and 18.28% in Asia, and Escherichia coli was 22.97% in Asia and 9.43% in Africa. Conclusions. This study highlights that the more prevalent common isolated pathogens in developing countries were Klebsiella, Staphylococcus aureus, Coagulase-negative Staphylococcus, and Escherichia coli, Klebsiella, and Staphylococcus aureus pathogens were predominantly high in Africa as compared to other Asian and Latin American countries. At the same time, Coagulase-negative Staphylococcus was more prevalent in Latin America compared to other regions. Escherichia coli is more dominant in Asia as compared to Africa and Latin America.

Background: HIV infected children who started highly active antiretroviral therapy in antiretroviral therapy clinics have survived to older age, and disclosure has become an essential part of their care. Hence, this study tried to (a) estimate the prevalence of HIV disclosure among school-aged children in Bahir Dar, North West Ethiopia, and (b) assess caregivers' barriers to disclose their children's HIV positive status receiving highly active antiretroviral therapy in pediatric antiretroviral therapy clinics. Methods: Institution based cross sectional study were conducted among 231 caregivers of pediatric antiretroviral therapy children on highly active antiretroviral therapy aged 6-14 years in four centres in Bahir Dar, North West Ethiopia. Caregivers were obtained proportionally and interviewed consecutively with convenience to respond for the structured pre-tested questionnaire. Data were entered into Epi Info version 3.5 and analyzed by using SPSS version 20 software for windows. Bivariate and multivariate logistic regression analyses were done. Results: The prevalence of disclosure of children's HIV positive status on highly active antiretroviral therapy was 31.5%. Religion of caregivers (AOR = 4.27 [95% CI = 1.24, 14.73]), family number (AOR = 3.73 [95% CI = 1.11, 12.48]), age of child (AOR = 9.87 [95% CI = 3.47, 28.07]), child age when ART started (AOR = 6.15 [95% CI = 1.76, 21.50]), and children time on ART (AOR = 5.40 [95% CI = 1.87, 15.55]) were found to have statistically significant association with disclosure of HIV positive status to HIV infected children. Conclusion: Addressing and scaling up efforts on stigma and discrimination in neighbourhood, communities, and school settings; and developing guideline for disclosure of children with HIV/AIDS in Ethiopian context will increase the rate of disclosure of children's HIV positive status on highly active antiretroviral therapy. J o ur nal o f A ID S & Cli n ic a l R es earc h

Objective: The aim of this study was to investigate the knowledge and attitude regarding advanced cardiac life support among healthcare workers, 2022. Methods: A cross-sectional study was conducted from March to May 2022 among healthcare workers who were working in Felege Hiwot Comprehensive Specialized Hospital Bahir Dar, Ethiopia. All physicians and nurses who were willing to participate this study were involved. A structured self-administered questionnaire was used for data collection. The data were entered into the statistical software Epi Data version 4.6.0.4 and analyzed with statistical package for social science version 26. Logistic regression analysis was used to differentiate the effects of each independent variable on the dependent variable. Results: Among the total study participants (400) with a response rate of 96%, most (238) (59.5%) healthcare workers (nurses and physicians) had poor knowledge toward advanced cardiac life support. Two hundred twenty-five (56.25%) healthcare workers had positive attitude. Being a physician, having more than 6 years of work experience, working in an emergency department for more than 10 years, and having advanced cardiac life support training all contribute to superior knowledge of advanced cardiac life support. Conclusion: Most healthcare workers, especially, nurses, have under estimated knowledge and a negative attitude toward advanced cardiac life support. This implies they require knowledge building and attitude empowerment regarding advanced cardiac life support. Being a physician, having training in advanced cardiac life support, having work experience of more than 6 years, and working in an emergency unit for more than 10 years were positively associated with better knowledge of advanced cardiac life support among healthcare workers.