Background. Preconception care is a set of interventional care for the better maternal and childbirth outcome. Nevertheless, this area still faces implementation problems in most of the developing countries including Ethiopia. Objective. To assess the knowledge of preconception care and associated factors among healthcare providers working in public health institutions in Awi zone, North West Ethiopia. Method. An institutional-based cross-sectional study was conducted among 660 healthcare providers working in public health institutions in Awi zone, North West Ethiopia. A pretested structured self-administered questionnaire was used to collect the data from individual healthcare providers who were selected randomly using a multistage sampling technique. The data entry and analysis were conducted using SPSS version 25 software. Frequency, proportions, means, and standard deviations were used to describe the data. Candidate variables at bivariate logistic regression with a p value > 0.2 were moved to multivariable logistic regression models, and statistical significance was declared at p value < 0.05 with 95% confidence interval. Result. Among the total of 660 healthcare providers, 344 (52%) had good knowledge of preconception care. The odds ratio of having good knowledge of preconception care was high among healthcare providers working at hospitals [AOR=2.316, 95% CI: 1.900-5.528], using smartphones [AOR=3.177, 95% CI: 1.945-5.167], presence of preconception care guidelines at health institutions [AOR=3.166, 95% CI: 1.872-5.299], taking training on preconception care education and counseling [AOR=3.812, 95% CI: 2.241-6.581], taking training about human immune virus [AOR=4.911, 95% CI: 3.008-8.123], and attending training on increasing public awareness of preconception health and care [AOR=2.345, 95% CI: 3.922-5.488] which were independent predictors associated with knowledge of preconception care among healthcare providers. Conclusion. Healthcare providers’ knowledge of preconception care was low. Study participants working at hospitals, using smartphones, presence of preconception guidelines at health institutions, taking training on preconception education and counseling, taking training about human immune virus testing and management, and increasing public awareness of preconception care affect knowledge of health providers positively. The provision of updated training on preconception and linkage of internet service with health service should be enhanced among healthcare providers.

Background Exclusive breastfeeding tops the table of life-saving interventions for newborns. A child who is exclusively breastfed is 14 times less likely to die in the first six months compared to its counterpart. Approximately 18,000 children globally still die every day and if current trend continues, some 60 million children under age 5 will die between 2017 and 2030, and half of them will be newborns. Five countries, including Ethiopia, accounted for half of all newborn deaths in the world. Objective To assess the prevalence and associated factors of exclusive breastfeeding practice among mothers who have infants 6-12 months of age in Boditi Town, Wolaita Zone, Southern Ethiopia, 2018. Methods Community-based cross-sectional study was conducted among 412 randomly selected mothers having 6 to 12 month infants from April 1 to 14, 2018. A pretested interviewer administered questionnaire was used for data collection. The data were entered using Epi Data version 3.1 and analyzed using SPSS version 20. Descriptive statistics was made. Bivariate and multivariate logistic regression was also carried out to see the effect of each independent variable on the dependent variable. Results Of 412 mother-infant pairs sampled, 403 were participated, which made a response rate of 97.8%. Prevalence of EBF computed using since birth dietary recall method was 64.8% (95% C.I= 60.0, 69.0). From multivariable analysis, child birth attended by health care provider (AOR = 5.303, 95% C.I = 1.613, 17.436), postnatal care utilization (AOR = 1.91, C.I = 1.083, 3.370), and mothers who did not report any breast related problem for the first six months after child birth (AOR = 1.864, C.I = 1.090, 3.189) were factors positively associated with exclusive breastfeeding practice. Conclusion Although the prevalence of exclusive breastfeeding practice in this study was relatively high, more effort to meet World Health Organization (WHO) recommendations is still necessary to benefit from its intervention. There is a need to promote child births to be attended by health care providers and postnatal care utilization. Further, women should be educated on what to do and where to seek care if breast problem occurs after child birth.

response to commentary

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 &lt; 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 Cervical cancer is a malignant neoplasm from cells originating in the cervix uteri. Any woman who is sexually active is at risk of getting HPV. Women in sub-Saharan Africa region have higher chance of developing the disease. There are nearly 26 million Ethiopian women who are over the age of 15 and believed to be at risk of getting HPV. Regrettably, Ethiopian women typically present for cervical cancer care at a late stage in the disease, where treatment is most ineffective. Objectives To explore communities’ perceptions of cervical cancer and screening among women in Wolaita zone, southern Ethiopia. Methods A qualitative research using focused group discussions and in-depth interviews was used to explore communities’ perceptions of cervical cancer and screening among women in Wolaita zone, southern Ethiopia from March 2018-November 2019. The study participants were men, women and communities who were residents of the study settings and were not health professionals. All focused group discussions (FGDs) and key informant interviews were transcribed and entered into Microsoft Word and thematic content analysis was done. Results A total of fifty-nine participants participated in both FGD (three with men and six with women) and in-depth interviews (IDIs). Most participants have not heard about cervical cancer but know cancer in general. Participants mentioned that the disease usually relates to many births and unprotected sexual intercourse but none mentioned HPV infection. Most of the participants perceive that cervical cancer is incurable and assume that it could be prevented but they think they are not vulnerable to the disease and screening is not necessary. Conclusion This study indicates that rural communities in the zone had limited knowledge about cervical cancer and even less about risk factors, screening, treatment and prevention. There is a great need for cancer education and prevention in Ethiopia.