Labor and delivery are unpredictable events, which if not monitored properly can result in a disabled or a fatal state. The World Health Organization (WHO) promotes the use of the partograph to monitor and improve the management of labor and to support decision-making regarding interventions. However, little is known about the status of knowledge and utilization of the partograph in Amhara region, Ethiopia. Therefore, this study aimed to assess the level of knowledge of the partograph and its utilization. A facility based cross-sectional study was conducted from September 1 to 30, 2012 among 292 health professionals working in public health institutions of the region, using a structured interviewer administered questionnaires. The collected data were analyzed using SPSS version 16. Binary logistic regression analysis was used to identify factors associated with knowledge of the partograph and obstetric care. Utilization status of the partograph was assessed from 160 purposively selected delivery charts using structured checklists. More than half (53.4%) of the study participants had good knowledge of the partograph. Females were 2 times more likely to have good knowledge of the partograph than males (AOR=2.0, 95% CI= (1.2, 3.6). Similarly, those who had previous obstetric training were 2 time more likely to have good knowledge of the partograph than otherwise (AOR=2.1, 95% CI= (1.3, 3.7). However, participants' level of knowledge of components ofthe partograph was very poor. While only 26.6% of participants were able to mention 50%or more of componentsof the partograph; females, midwives, and those having prior obstetric training were found to have better knowledge of components of the partograph than their counter parts (AOR=3.3, 95% CI (1.9, 5.6), (AOR=4.9, 95% CI (2.4, 9.9)and (AOR=2.0, 95% CI (1.1, 3.6)) respectively. In this study, the level of knowledge of obstetric care was found to be poor. Although it wasrevealed that majority of the participants had favorable attitude towards the use of partograph, only 29% of the paragraph papers reviewed was properly filled to monitor the progress of labor. Despite significant number of study participants reported that the partograph is useful to monitor laborand make timely decision, their level of knowledge of the partograph and its components was generally poor. Presence of prior training, participants' sex and profession were the variables that had influenced the level of knowledge of the partograph and obstetric care. Favorable attitude by itself was inadequate to ensure use of the partograph. Periodic on-job training regarding to obstetric care and on the partograph should be provided to all obstetric care providersparticularly to males and nurses by profession in the region. Regular supportive supervision is also needed to motivate staffs to utilize the partograph and help them become dedicated to record and document their findings.

Background: Malnutrition among children remains common in many parts of the world, particularly in developing countries. In Ethiopia, it is one of the most important health and welfare problems among infants and young children. Ethiopian Somali regional state is one of the most underserved regions in terms of access to essential services and characterized by a high level of child malnutrition, food insecurity, and vulnerable livelihoods. Therefore, the current study was undertaken to assess the magnitude and factors associated with malnutrition among children aged 6-59 months in Shinille Woreda, Ethiopian Somali regional state. Methods: Community-based cross-sectional survey, involving 694 study participants selected by multistage sampling technique, was conducted in Shinile Woreda from February to March, 2014. Data were collected using structured questionnaire and anthropometric measurement. Anthropometric indices were calculated using ENA for SMART software 2011, and SPSS V.16 was used for data analysis. Associations were computed using the OR and 95 % CI. P-value less than 0.05 were considered as statistically significant. Results: The overall prevalence of stunting, underweight and wasting were 33.4 %, 24.5 % and 20 %, respectively. The main associated factors of stunting and wasting were family size, child's sex and monthly income of the households. Immunization status was the only variable associated with all forms of malnutrition. Non-immunized children were 2.5 times more likely become underweight than their counterparts. The prevalence of stunting was 3. 8 times higher in households with large family size. Female children were 1.5 times more likely become wasted than their counterparts. Conclusion: Prevalence of malnutrition among under five children in Shinile Woreda is still high. Our finding highlighted the importance of childhood vaccination, family planning and poverty alleviation as potential targets for intervention.

Background: Poor birth outcomes are common health problems everywhere in the world. Hence institutional delivery in Ethiopia is very low, improving birth outcomes through recent evidence remained critical. The objective of the study was to determine the prevalence of poor birth outcomes and associated factors among women who delivered in selected health facilities of North Wollo Zone. Methods: A facility based cross-sectional survey was conducted on 295 laboring mothers from May to June 2009. Interviewer administered questionnaire was used to collect the data. Patient’s chart was reviewed to retrieve medical information. Anthropometry of the neonate was taken by standard measurement tools. Data were analyzed using statistical package for social sciences (SPSS), version 15. Binary logistic regression analyses were used to identify predictors of poor birth outcomes. P-value ≤ 0.05 was considered statistically significant. Results: All the data resulted from 295 laboring mothers were made part of the analyses. A total of 266 (90.2%) laboring mothers gave live birth. A quarter, 68 (23.1%) of the laboring mothers had a poor birth outcome. The common adverse outcomes were intrauterine fetal death (IUFD, preterm, and birth defects with the proportion of 29 (42.6%), 22 (32.4%), and 3 (4.4%), respectively). Mother whose husband’s occupation was merchant (AOR = 4.4, 95% CI: 1.0-19.0), driver (AOR = 4.2, 95% CI: 1.12-15.76), & women who were illiterate (AOR = 4.0, 95% CI: 1.2-13.5), primary school completed (AOR = 4.3, 95% CI: 1.3-13.8), non-antenatal care visited (AOR = 3.4, 95% CI: 1.12-10.2), rural residence, (AOR = 2.6, 95% CI: 1.11-5.80), & mother’s HIV status, (AOR = 34.2, 95% CL 5.6, 207.0) were independent predictors of poor birth outcomes. Conclusions: Poor birth outcomes were very common in the study area where low birth weight accounted for much of all adverse pregnancy outcomes. Occupation, residence, antenatal care visit, income, maternal education and HIV status were determinants of poor birth outcomes. Accessing antenatal care in early trimester, mild physical work, maternal education to secondary level and above should be encouraged.

BackgroundPrompt and effective treatment of malaria is critical because delays increase the risk for serious illness, disability and death.ObjectiveTo assess determinants of delay in seeking treatment among malaria patients at Dera district, NorthWest Ethiopia.MethodsA case control study was conducted from September 01 to October 15, 2014. A total of 318 malaria patients diagnosed using microscopy or rapid diagnostic test, and who sought treatment in health centers were interviewed. Multivariable logistic regression was done to identify determinants of delay.ResultsDelay was high when a patient earned less than 25.0 USD [AOR=15.7, 95% CI: 4.8 – 51.2] and 9.6 times higher if he/she was not a member of community based health insurance [AOR= 9.6, 95% CI: 4.4 – 21.3]. Respondents who travelled for more than 30 minutes to get to a health facility [AOR= 4.4, 95% CI: 1.2 – 15.9] were more likely to be late in seeking treatment for malaria.ConclusionIncome, community based health insurance, previous history of malaria infection, decision making and distance were determinants of delay in seeking treatment for malaria. To reduce the delay, interventions should focus on outreach malaria services and increase enrollment to community based health insurance.

Background Following successful malaria control during the last decade, Ethiopia instituted a stepwise malaria elimination strategy in selected low-transmission areas. Methods Cross-sectional surveys were conducted in Babile district, Oromia, Ethiopia from July to November 2017 to evaluate malaria infection status using microscopy and nested polymerase chain reaction (nPCR) and serological markers of exposure targeting Plasmodium falciparum and Plasmodium vivax apical membrane antigen-1 (AMA-1). Results Parasite prevalence was 1.2% (14/1135) and 5.1% (58/1143) for P. falciparum and 0.4% (5/1135) and 3.6% (41/1143) for P. vivax by microscopy and nPCR, respectively. Antibody prevalence was associated with current infection by nPCR for both P. falciparum (p<0.001) and P. vivax (p=0.014) and showed an age-dependent increase (p<0.001, for both species). Seroconversion curves indicated a decline in malaria exposure 15 y prior to sampling for P. falciparum and 11.5 y prior to sampling for P. vivax , broadly following malaria incidence data from district health offices, with higher antibody titres in adults than children for both species. Conclusions Malaria transmission declined substantially in the region with continuing heterogeneous but measurable local transmission, arguing in favour of continued and tailored control efforts to accelerate the progress towards elimination efforts.