Purpose The aim of the study was to explore and describe the lived experiences of HIV-positive adults on antiretroviral therapy (ART) initiation in West Shoa Zone, Ethiopia. Materials and Methods A descriptive phenomenological design was utilized in the study to gain insight into participants’ lived experiences regarding ART initiation in West Shoa Zone, Ethiopia. Data were collected through semi-structured in-depth interviews and analyzed by means of thematic analysis. Results The study found that spousal influence, denial of status, inconsistent ART initiation protocol, poverty, fear of side effects, religion and shortages of staff were factors that caused delayed ART initiation. A low CD4 count, the development of opportunistic infections and the prevention of future illness were factors that promoted ART initiation. Conclusion This study provides an overview of experiences of adults living with HIV regarding ART initiation. The study emphasizes the need to improve adequate provision of resources to address issues related to finance, human capital, guidelines and inequity to enhance early ART initiation among HIV-positive adults in West Shoa Zone. The study findings have implications for policy implementation, ART service delivery, and the enhancement of prompt ART initiation in the study settings.

Background: Access to skilled health services during pregnancy, childbirth and postpartum is crucial element which promotes the health and wellbeing of the mother and new born. The aim of the study was to assess women’s knowledge, attitude and practice of skilled assistance seeking for maternal healthcare services in West Shoa zone. Methods: A community based cross sectional quantitative design was conducted in West Shoa zone, Oromia, Ethiopia in 2017. A multistage, random sampling technique was used to select women who had birth in the past one year preceding the study. Interviewed administered structured questionnaire were used to collect the data. A total of 654 women were involved in this study. Data was analysed using SPSS version 20 statistical software package. Pre-tested and structured questionnaires were used to collect the data by trained data collectors. Logistic regression model was used to control the confounding variables at p-value< 0.05. Results: Out of 654 respondents, 416 (63.6%) delivered at health facilities and 268 (36.4%) at home. Skilled assistance seeking for maternal health services was significantly associated with mother’s education (AOR=3.0, 95%CI=1.18-7.84), mother’s access to maternal health information (AOR=3.1, 95% CI=1.13-8.41). Women’s awareness was significantly associated with antenatal‐care attendance (AOR 1.9) and institutional delivery (AOR 3.1). Women who had experience obstetric problems were twice seek skilled provider than those who had not had complications (AOR=2.3, 95%CI=1.39-3.75. P-value=0.001). Women who experiences complications seek a skilled postnatal care more likely compared with those who did not have such characters (AOR=2.2, 95%CI=1.35-3.66. P-value=0.002). Conclusion: The study revealed that low practice of sought care from skilled providers. Hence, it is highly recommended to improve the socioeconomic factors such as maternal literacy, availability of transport facility in case of emergency referral and service availability may increase care seeking from health facilities. Keywords: Skilled assistance, Seeking and Maternal healthcare services.

Objectives: The World Health Organization strongly recommends companion of choice for all women during health facility delivery. However, in the developing countries, it is low and not well studied in Ethiopia. Thus, the study aimed to assess the birth attendants’ attitude and practice of companionship during health facility-based childbirth and associated factors in the West Shoa Zone, Ethiopia. Methods: A cross-sectional study design with a concurrent mixed method approach was employed from 17 August to 23 September 2021. A simple random sampling was used to collect data from 422 birth attendants using a pretested structured self-administered questionnaire. The data was entered into Epi-data 3.1 and exported to the Statistical Package for Social Sciences for analysis. Bivariate and multivariate logistic regressions were done. The qualitative data was analyzed manually using thematic analysis, and the result was triangulated with the quantitative data. Results: About, 208 (51.2%) of birth attendants had favorable attitude, and only 79 (19.5%) of them reported that they practice companion presence during childbirth. Reported job satisfaction (adjusted odds ratio = 5.29, 95% confidence interval: 3.08, 9.1), presence of a screen (adjusted odds ratio (AOR) = 3.4, 95% confidence interval: 1.94, 5.99), and wideness of the delivery room (adjusted odds ratio = 4.74, 95% confidence interval: 2.48, 9.04) were factors associated with the attitude of birth attendants. The number of deliveries per month (adjusted odds ratio = 3.34, 95% confidence interval: 1.37, 8.13), having had training (adjusted odds ratio = 3.286, 95% confidence interval: 1.52, 7.08), and presence of a screen (adjusted odds ratio = 2.88, 95% confidence interval: 1.42, 5.85) were statistically associated with practice of companion presence during childbirth. The main themes that emerged as the key barriers to the practice of companion presence during childbirth include structural factors, societal norms and culture, lack of interest, birth attendant-related barriers, unsupportive administration protocol, and companions’ awareness. Conclusion: The magnitude of favorable attitudes and reported practice of birth attendants regarding companion presence during childbirth is low. Structural related factors were the main barriers. Training of birth attendants and structural interventions are needed to ensure that delivery rooms are designed in ways that facilitate the presence of companions during childbirth.