BackgroundMany countries continue to have high fertility rates and most of the predicted increase in the world’s population until 2100 comes from these countries. Among family planning methods, Long Acting and Permanent Methods are convenient for users and effectively prevent pregnancy. The objective of this study was to assess factors associated with unmet need of Long Acting and Permanent Methods of contraception among women in the reproductive age group (15-49) using contraception in health facilities of Shashemene town, Oromia Region, Ethiopia.MethodsFacility based cross sectional quantitative study and stratified sampling technique was used. Total of 382 females in reproductive age group were enrolled in the study in January 2012. Pretested, structured and close-ended questionnaire was used to interview study participants. Collected data was entered by using EPI Info 17 and analyzed by SPSS version 20 statistical software.ResultsUtilization of Long Acting and Permanent Methods (LAPMs) of contraception in Shashemene town was found to be 28.4 % (104/366). From study participants, 71.6 % (262/366) used short acting methods and from these current short acting users, 127(41.5 %) desired to use LAPMs and unmet need of LAPMs was 122(33.3 %). Factors significantly associated with unmet need of LAMPs of contraception were: Education of women (< secondary level) AOR [3.8, 95 % CI: 2.9, 7.6; P < 0.001]; lack of discussion between partners AOR [2.9, 95 % CI: 1.8, 9.6; P = 0.01]; lack of proper counseling for women AOR [5.3, 95 % CI: 1.7, 11.2; P = 0.04]; and women’s occupation as a housewife AOR [4.7, 95 % CI: 3.1, 11.3; P = 0.02].ConclusionUnmet need of LAPMs of contraception in health facilities in Shashemene town was high. Women education, partner discussion and proper client counseling were found the main factors associated women LAPMs utilization.

BackgroundUnmet need for family planning in Oromia region was very high (28.9%) compared to other regions in Ethiopia. To address problems associated with unmet need for family planning locally available evidences are essential, however, there were no clear evidences on unmet need for family planning in Tiro Afeta district. This study aims to assess the magnitude and associated factors of unmet need for family planning among currently married women in Tiro Afeta district, South West Ethiopia, 2017.MethodsCommunity based cross sectional study was conducted in April, 2017. A total of 348 currently married women of reproductive age were enrolled from eight villages selected by simple random sampling and using proportional to size allocation. Data were entered using EpiData 3.1 and analyzed by SPSS version 22. Adjusted odds ratios at 95% confidence interval with p-value of < 0.05 were considered as significant variables.ResultsUnmet need for family planning among currently married women in Tiro Afeta was 26.1%. Factors significantly associated with unmet need for family planning were: never use of family planning before survey (AOR: 5.09, 95% CI: 2.73–9.50); multiparity (AOR: 3.02, 95% CI: 1.56–5.85); perceived husband’s attitude as disapproval (AOR: 2.75, 95% CI: 1.43–5.26); lack of counseling from health workers (AOR: 2.07, 95% CI: 1.11–3.85); and unavailability of Radio and/or Television in the house (AOR: 2.05, 95% CI: 1.15–3.66).ConclusionUnmet need for family planning in Tiro Afeta was higher than national average but lower than Oromia region. Never use of family planning, women’s parity, husband’s attitude towards contraceptives, women counseling and unavailability of Radio and/or Television in the respondent’s home were significantly associated factors with unmet need for family planning. Therefore, the service providers and the district health office should strengthen counseling and partner involvement to reduce unmet need for family planning.

Dexamethasone can reduce mortality in hospitalised COVID-19 patients needing oxygen and ventilation by 18% and 36%, respectively. Here, we estimate the potential number of lives saved and life years gained if this treatment were to be rolled out in the UK and globally, as well as the cost-effectiveness of implementing this intervention. Assuming SARS-CoV-2 exposure levels of 5% to 15%, we estimate that, for the UK, approximately 12,000 (4,250 - 27,000) lives could be saved between July and December 2020. Assuming that dexamethasone has a similar effect size in settings where access to oxygen therapies is limited, this would translate into approximately 650,000 (240,000 - 1,400,000) lives saved globally over the same time period. If dexamethasone acts differently in these settings, the impact could be less than half of this value. To estimate the full potential of dexamethasone in the global fight against COVID-19, it is essential to perform clinical research in settings with limited access to oxygen and/or ventilators, for example in low- and middle-income countries.

Objectives:The aim of this study is to identify the influence of perceived geographic barriers to the utilization of maternity waiting homes (MWHs) and to explore factors associated with current delivery complications among MWH users and nonusers.Methods: An observational cross-sectional study was conducted between December 2017 and June 2018 in eight health facilities with MWH in the Gurage zone of Ethiopia. The associated factors were identified by using the combination of a directed acyclic graph (DAG) concept and multiple logistic regression for data analysis. Results: A total of 716 women were included in the study, of whom 358 were MWH users. MWH users had lower odds of having delivery complications. Lower odds of delivery complications were found among women who gave birth in non-cesarean section (CS) facilities. Women with pregnancy complications and did not used MWH were more likely to develop delivery complications. Women with delivery complications had higher odds of undergoing cesarean delivery and neonatal death. Conclusions: Geographic barriers influenced the utilization of MWH. The women who used MWH had lower delivery complications. This study strengthens the evidence of MWH utilization as a useful strategy to overcome geographic barriers and lower delivery complications.

Summary Objective To compare the health care expenditures between maternity waiting home (MWH) users and nonusers in Ethiopia. Methods A cross‐sectional study was done in Ethiopia between December 2017 and June 2018. The study setting included eight health facilities in the Gurage zone of Ethiopia. Health expenditure for delivery care was the outcome variable that was then classified into out‐of‐pocket (OOP) payments, women's costs, total costs, and overall costs. Those health expenditures were then compared among MWH users and nonusers. OOP payments were further analyzed using quantile regression to explore associated factors. Results A total of 812 postpartum women were included in this study of whom half were MWH users. Significantly higher OOP payment, women's costs, total costs, and overall cost were found among MWH users compared with nonusers regardless of duration of MWH stay. The MWH users were more likely to have higher OOP payment compared with MWH nonusers in linear and quantile regressions for both unadjusted and adjusted analyses. Higher OOP payments were observed for longer distance traveled and cesarean section (CS) delivery women at the 75th and 90th quantiles of expenditure. Using public transportation was significantly associated with higher OOP payment in all quantile levels. Conclusion Utilization of MWH incurred higher OOP payments, total costs, women's costs, and overall costs compared with MWH nonusers. Higher OOP payments for delivery care among MWH users were observed in all quantiles of expenditure.