Background. Under nutrition is one of the leading causes of morbidity and mortality in under-five children in developing countries including Ethiopia. In Ethiopia, many children with severe acute malnutrition (SAM) are treated at inpatient therapeutic feeding centers. However, the survival status and its determinants are not well understood. Therefore, the aim of this study was to estimate the survival status and its determinants among under-five children with severe acute malnutrition admitted to inpatient therapeutic feeding centers (ITFCs). Methods. A record review was conducted on 414 under-five children who were admitted with severe acute malnutrition to ITFCs in South Wollo Zone, northeast Ethiopia, between September 11, 2014, and January 9, 2016. Data were entered into Epi-Info version 7.2 and analyzed using SPSS version 20. Life table analysis was used to estimate cumulative proportion of survival. The relationship between time to recovery and covariates was determined using Cox-proportional hazards regression model. p<0.05 was used to declare presence of significant association between recovery time and covariates. Results. Of the total children recorded, 75.4% of children were recovered and discharged, 10.3% were defaulters, 3.4% died, 7.4% were nonresponders, and 3.4% were unknown. The mean (±standard deviation) time to recovery was 12 (±5.26) days, whereas the median time to recovery was 11 (interquartile range of 8–15) days. Children’s breastfeeding status at admission (AHR: 1.42, 95% CI: 1.10, 1.83) and children without comorbidities at admission (AHR: 1.44, 95% CI: 1.03, 2.00) had statistically significant effect on time to recovery from SAM. Conclusion. All treatment responses in this study were within the recommended and acceptable range of global standards. Policy makers, health facilities, and care providers may need to focus on the importance of breastfeeding especially for those under two years of age and give emphasis for cases with comorbidities.

Background: Appropriate nutrition during infancy and early childhood is a cornerstone of care for ensuring optimal child growth and development during the first 2 years of life. Globally, about 40% of under two years of age deaths are attributed to inappropriate infant and young child feeding practices. In Ethiopia, a large range of inappropriate feeding practices of mothers during infancy and early childhood were documented. This study aims to assess infant and young child feeding practice status and its determinants among mothers of children aged 6-23 months in Kalu district, Northeast Ethiopia. Methods: Community-based cross-sectional study design was applied from May 1-30/2019. A total of 605 mothers-children pair's 6-23 months were included in the study using multi-stage sampling followed by a simple random sampling technique. Data were collected using a pretested semi-structured interviewer-administered questionnaire. Bi-variate and multivariable logistic regression were used to assess determinants associated with child feeding practices. Statistical significance was decided at p-value less than 0.05. Results: Of six hundred five (605) sampled mothers having an infant and young child age 6-23 months, 589 were successfully included in the study making a response rate of 97.35%. In our study, the overall proportion of appropriate infant and young child feeding practices was 57.7%. Place of delivery (AOR=1.977; 95% Cl (1.101, 3.552)), mothers' age being 25-35 years (AOR =2.091; 95% Cl: (1.452, 3.011)) and family size >4 members (AOR=1.873; 95% CI: (1.311, 2.675)) were determinants positively associated with appropriate infant and young child feeding practices in Kalu district at 95% CI. Conclusion:The overall appropriate infant and young child feeding practices were better in general in Kalu district. However, this prevalence is not acceptable to ensure good health and better nutritional status of children. As a result, intervention initiatives should focus on institution delivery services that are crucial to implementing appropriate infant and young child feeding practice. Health facilities need to be strengthened and fully utilized to provide high-quality feeding counseling. Special attention needs to be given to younger mothers, in addition to increasing institution delivery service.

Background Community-based health insurance systems are usually voluntary and characterized by community members pooling funds and protecting themselves against the high costs of seeking medical care and treatment for illness. Client satisfaction with health service provision during the implementation of health insurance schemes has often been neglected. This study aimed to determine client satisfaction with the community-based health insurance scheme and associated factors. Methods An institutional-based cross-sectional study design was applied from February 22–March 11 /2019. A total of 420 study participants were included in the study using a systematic random sampling technique. Data were collected using a pretested semi-structured interviewer-administered questionnaire with a patient exit interview. Bivariate and multivariate logistic regression analyses were used to identify factors associated with Community-based Health Insurance of client satisfaction. Statistical significance was decided at a p-value less than 0.05. Result A total of 420 community-based health insurance clients of health service users participated in the study with a 100% response rate. The overall client satisfaction was 80% at 95% Cl (76.1, 83.9), respondents who have perceived that partially or none availability of prescribing drugs were 0.09 times less likely satisfied as compared to full availability of prescribing drugs (AOR =0.09; 95% Cl: (0.04, 0.19)). Besides, study participants waiting time to consult service providers within 30 min were more satisfied than those who were delayed 60 min and above (AOR =3.16; 95% Cl: (1.19, 8.41)). Conclusion Community-based health insurance client satisfaction provided in the present study was 80% indicating low proportion. Full availability of prescribing drugs, clients renewed their community-based health insurance membership, and preference of clients to use the hospital for future health care need were positively associated with client satisfaction while the perception of waiting time before physician consultation negatively affected client’s satisfaction. Therefore, the hospital management members and service providers need to give attention to reduce waiting time preceding consultation, improve drug availability, and sustain the hospital preference by the client.

IntroductionEthiopia has one of the highest infant and child mortality rates in the world. Starting from the age of 6 months, breast milk alone is not sufficient to cover all nutritional requirements. Infants and young children are at an increased risk of undernutrition. Complementary feeding must, therefore, begin at the age of 6 months. Infant and young child nutrition is a critical factor in human health, nutrition, survival, growth, and development. Therefore, the aim of this study is to evaluate the timely initiation of complementary feeding practices and associated factors in children aged 6–23 months in the Dessie Zuria District of North Ethiopia.MethodsA community-based cross-sectional study design was used for the period between 16 March and 30 March 2019. The study included 770 mother–child pairs aged 6–23 months. A multistage sampling method was used to choose the study participants. Using a simple random sampling technique, nine kebeles in the district were selected from a total of 31, and from 103 Gotts or villages, 31 were selected with 770 HHs out of 2,329 HHs with children aged 6–23 months. Data were collected using a pretested semistructured interviewer-administered questionnaire, which was then entered into Epi Data version 3.1 statistical software before being transferred to SPSS version 21 for further analysis. To summarize the data, descriptive statistics were used, which included a simple frequency table and figures. To evaluate factors, bivariate and multivariable logistic regression were used. A p-value of less than 0.05 was used to determine statistical significance.ResultsThe percentage of children who started complementary feeding practices on time was 70.9. Maternal occupation [AOR = 5.51, 95% CI (1.61–18.81)], radio availability [AOR = 2.03, 95% CI (1.32–3.12)], antenatal care follow-up [AOR = 6.19, 95% CI (4.08–9.40)], place of delivery [AOR = 5.06%, CI (3.34–7.68)], and postnatal care follow-up [AOR = 4.32, 95% CI (2.77–6.72)] were found to be the factors for the timely initiation of complementary feeding.ConclusionWhen compared with WHO cutoff points, timely initiation of complementary feeding practice was relatively low in the study area. Maternal occupation, radio availability, ANC follow-up, place of delivery, and postnatal care visit were all significantly associated with the timely initiation of complementary feeding.

Patient satisfaction is a key element of quality measures that has increasingly become acknowledged as an important tool for service improvement. This study aimed to assess the level of patients' satisfaction and associated factors with clinical laboratory services provided at public health facilities. A cross-sectional study was conducted from May-June 2019 among clients attending 24 health centers and 8 hospitals, northeast Ethiopia. A total of 502 patients were selected using systematic random sampling. Patient's satisfaction towards multiple aspects of laboratory services was assessed using structured exit interview questionnaire, on a rating scale of 1 (very dissatisfied) to 5 points (very satisfied). We assessed test availability and laboratory practices using facility inventory, stepwise accreditation audit checklist and blinded slide rechecking. Data were entered and analyzed using EpiData ver3.1 and STATA ver14.1. Multivariable logistic regression analysis was used to determine the association of factors with overall satisfaction. Overall, majority of the respondents (73.5%) were found to be satisfied. Lowest mean ratings were obtained for waiting area (3.3), and information provided on specimen collection (3.5) and on how and when to receive results (3.7). Patients were more likely to be satisfied in health centers (75.2%) than in hospitals (68.6%) (AOR=1.9, 95%CI: 1.0-3.6, p=0.036). Patients' timely receipt of results (p=0.005) and laboratories' accuracy of results (p< 0.025) also showed significant positive associations with satisfaction. In conclusion, there were specific areas of deficiency that were driving dissatisfaction, particularly in the larger hospital laboratories. Therefore, more and balanced emphasis should be given to the patients' experiences, alongside technical quality improvements, to reduce the disparities and enhance the overall quality of care.