Background Clean Cut is an adaptive, multimodal programme to identify improvement opportunities and safety changes in surgery by enhancing outcomes surveillance, closing gaps in surgical infection prevention standards, and strengthening underlying processes of care. Surgical-site infections (SSIs) are common in low-income countries, so this study assessed a simple intervention to improve perioperative infection prevention practices in one. Methods Clean Cut was implemented in five hospitals in Ethiopia from August 2016 to October 2018. Compliance data were collected from the operating room focused on six key perioperative infection prevention standards. Process-mapping exercises were employed to understand barriers to compliance and identify locally driven improvement opportunities. Thirty-day outcomes were recorded on patients for whom intraoperative compliance information had been collected. Results Compliance data were collected from 2213 operations (374 at baseline and 1839 following process improvements) in 2202 patients. Follow-up was completed in 2159 patients (98·0 per cent). At baseline, perioperative teams complied with a mean of only 2·9 of the six critical perioperative infection prevention standards; following process improvement changes, compliance rose to a mean of 4·5 (P < 0·001). The relative risk of surgical infections after Clean Cut implementation was 0·65 (95 per cent c.i. 0·43 to 0·99; P = 0·043). Improved compliance with standards reduced the risk of postoperative infection by 46 per cent (relative risk 0·54, 95 per cent c.i. 0·30 to 0·97, for adherence score 3–6 versus 0–2; P = 0·038). Conclusion The Clean Cut programme improved infection prevention standards to reduce SSI without infrastructure expenses or resource investments.

Background: Although teenage pregnancy causes a considerable challenge to young women, studies among sexually active teenagers are not widely available. Studies have included both sexually active and not active teenagers in assessing teenage pregnancy which underestimated the actual prevalence. This study aims to determine the prevalence and related factors of teenage pregnancy among teenage girls in dire dawa administrative town, East Ethiopia. Methodology: Institutional-based cross-sectional study was conducted among 677 identified sexually active students from selected schools. Pre-test was conducted on 35 female teenagers. One stage cluster sampling technique was used to recruit study participants. Data was entered into EpiData-version 3.1 and exported to STATA version 16 for analysis. Modified Poisson regression was done to assess the association between outcome and predictor variables. Result: Out of the total sexually active females 135 (19.9%) were pregnant. Teenage pregnancy was higher among teenagers in the 18-19 (APR=3.21, 95% CI: 2.10-5.18) age group, living with either of their biological parents (APR=1.9, 95% CI: 1.29-2.69) and neither of the biological parents (APR=2.7 95% CI: 1.39-3.34), teenagers who had sex due to peer pressure (APR=2.01, 95% CI: 1.51- 2.86) and not knowing the ovation time in the menstrual cycle (APR=1.6, 95% CI: 1.07-2.28). Teenage pregnancy was lower among teens who have good parent-daughter interaction (APR=0.6, 95% CI: 0.50- 0.91). Conclusion: Nearly one-fifth of teenagers had experienced teenage pregnancy. Teenage pregnancy is higher amongst the age group of 18-19, living with either or neither of the parents, having sex due to peer pressure, not knowing the ovulation time in the menstrual cycle, and lower among teens with good parent-daughter interaction. Adolescent sexual and reproductive health education including safe sex practice has to be acknowledged in school and life skill training to enhance self-esteem among teens is essential to reduce teenage pregnancy.