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Background The world Health Organization recommended that all mothers be supported to initiate breastfeeding as soon as possible after birth, within the first hour. This study examined the determinants of early initiation of breastfeeding in Ethiopia by using data from the 2019 Ethiopia Mini Demographic and Health Survey. Methods The data for this study was extracted from the 2019 Ethiopia Mini Demographic and Health Survey. A total of 1948 children aged less than 24 months at the time of the survey were included for analysis from the nine regional states and two city administrations. The analysis was carried out in STATA Version 14.2 software using survey commands to account for the complex sample design and apply sampling weights. A manual backward stepwise elimination approach was applied. Result The prevalence of early initiation of breastfeeding in Ethiopia was noted to be 75.2% [95% CI (71.9, 78.5%)]. In the multivariable analysis, mothers who had vaginal deliveries [AOR = 3.02 (95% CI: 1.55, 5.88)] had 3 times higher odds practicing early initiation of breastfeeding compared to mothers who had a cesarian section. Mothers aged between 35 and 49 years [AOR = 2.40, 95% CI: 1.20, 4.49] had 2.4 times higher odds of practicing early initiation of breastfeeding compared to mothers aged below 20 years. In addition, early initiation of breastfeeding was also associated with the region where mothers resided, in particular mothers in Amhara and Somali region, had lower odds of practicing early initiation of breastfeeding as compared with mothers residing in Tigray region. Conclusion Early initiation of breastfeeding in Ethiopia was found to be significantly associated with mode of delivery, mother’s age, and region. As a result, raising awareness about early initiation of breastfeeding is especially important for mothers who have had a cesarean section, which could be accomplished with the help of the health extension workforce.

Background Immunization is essential to prevent between 2 and 3 million deaths globally each year and it is widely accepted that it is one of the most cost-effective health interventions. Despite all its advantages, immunization in Ethiopia is still far from the target set by the United Nations Sustainable Development Goals to achieve universal immunization by all countries in 2030. The 2016 Ethiopian Demographic and Health Survey (EDHS) reported an overall full immunization rate of only 38.3%. The objective of this study was to evaluate the spatial distribution of under immunization in 12 to 23 months old children and further identify the determinants of under immunization clustering in the Butajira Health and Demographic Surveillance Site (HDSS). Methods We conducted a community based sectional survey from March to April, 2016 in Butajira HDSS. We collected data on immunization status from a total of 482 children between the age of 12 to 23 months. We randomly selected household and interviewed mothers and /or observed vaccination cards when available to collect data on child’s immunization status. We also collected the geographic location of all villages within the ten Kebeles using a Handheld Global Positioning System (GPS) (Garmin GPSMAP®). We analyzed the spatial distribution of under immunization and clustering using the SatScan® software which employs a purely spatial Bernoulli’s model. We also ran a logistic regression model to help evaluate the causes of clustering. Results We found that only 22.4% [95% CI: 18.9, 26.4%] of children were fully immunized. This study identified one significant cluster of under immunization among children 12–23 months of age within the Butajira HDSS (relative risk (RR) = 1.24,P < 0·01). We found that children residing in this cluster had more than 1.24 times risk of under immunization compared with children residing outside of the identified cluster. We found significant differences with regard to Maternal Tetanus Toxoid immunization status and place of delivery between cases found within a spatial cluster and cases found outside the cluster. For example, the odds of home delivery is more than two times [AOR 2.21: 95%CI; 1.06, 4.63] among children within an identified spatial cluster than the odds among children found outside the identified cluster. Conclusions Under immunization of 12–23 months old children and under immunization with specific vaccines such as Polio, BCG, DPT (1–3) and Measles clustered geographically. Spatial studies could be effective in identifying geographic areas of under immunization for targeted intervention like in this study to gear health education to the specific locality.

Introduction: Quality management system is a set of coordinated activities to direct and control an organization in order to continually improve the effectiveness and efficiency of its performance. So, information about the status of health sector quality management system implementation is necessary. However, there is limited information about the quality management system implementation in the study area as well as at national level.Objective: the aim of this study is to assess quality management system implementation and its associated factors at governmental hospitals in Addis Ababa, Ethiopia. Methods: An institution-based cross-sectional study was conducted among 422 health care providers working in public hospitals in Addis Ababa. Simple random technique was used to select both the study settings and study participants. Data were collected by using structured written questionnaire after obtaining written consent from the respondents. The collected data were entered into Epi-data version 3.1 and analyzed using SPSS Version 25. Bivariate and multivariate analysis was done. Variables which had p-value <0.05 at 95%CI were considered as statistically significant association with dependent variable in multivariate analysis. Result was presented in text, table and figures. Result: A total of 422 study participants were participated in the study with the response rate 100%. The mean age of the study participants was 31.46 (SD=5.77) years. The majority (44.5%) of the study participants were below 30 years of age and 55.0% were female by sex. This study revealed that nearly 52% of quality management system were not implemented in the selected health facilities. Being 35 years and above (AOR =1.99) in age, ever heard about QMS (AOR 1.56) by the staff, and those staff knows the availability of QMS (AOR= 2.31) were among variables that identified as predictors of QMS implementation in the study area.Conclusion and recommendation; This study concluded that the level of QMS implementation in the current study area is suboptimal. Age of the study participants, previous hearing about QMS, and knows the availability of QMS were among variables that identified as predictors of QMS implementation in the study area. Therefore, health facilities are recommended to educate their staff about QMS implementation.

Background: Vitamin A is a nutrient that is required in a small amount for normal visual system function, growth and development, epithelia’s cellular integrity, immune function, and reproduction. Vitamin A has a significant and clinically important effect since it has been associated with a reduction in all-cause and diarrhea mortality. The aim of this study was to determine factors associated with national vitamin A supplementation among children aged 6-35 months by using data from the 2019 Ethiopia Mini Demographic and Health Survey.Method: The study used a population-based cross-sectional study design to assess factors associated with vitamin A supply among children aged 6 to 35 months in the six months before the survey's start. Descriptive statistics were used to identify the proportion of children who had taken vitamin A supplements, after which multivariable logistic regression analysis was carried out to determine the predictors of vitamin A supplementation. Result: The overall coverage of vitamin A supplementation among children aged 6-35 months for the survey included was 46 %. In the multivariable analysis, children who resided in urban areas [AOR = 1.34 (95 % CI: 1.00, 1.81)] were more likely to receive vitamin A supplementation than children living in rural areas. Postnatal care recipients were 1.5 times more likely than non-recipients to obtain vitamin A capsules for their children [AOR = 1.54 (95 % CI: 1.20, 1.97)]. Mothers [AOR = 1.26, 95% CI: 1.029, 1.57] who delivered at health facilities were 26% more likely to receive vitamin A capsules for their children than those who delivered at home. Other factors that were associated with higher a likelihood of vitamin A supplementation were: number of antenatal visits, age of child, and household wealth index.Conclusion: The coverage of vitamin A supplementation set by the Ethiopia ministry of health remains low and it is strongly associated with antenatal visit, postnatal checkups and place of delivery. Expanding institutional delivery and maternal health services like ANC and PNC should be prioritized.