BackgroundThe postpartum period is a critical period for addressing widespread unmet needs in family planning and for reducing the risks of closely spaced pregnancies. However, many women do not realize that they are at risk for pregnancy during this period. Therefore, the aim of this study was to assess utilization and associated factors of modern contraceptives during extended post-partum period.MethodsInstitutional based cross-sectional study was conducted from March to April, 2015 in six health institutions among women who gave birth in the last 12 months prior to the study period in Gondar Town, Northwest Ethiopia. A systematic random sampling technique was used to select the study participants. Data were analyzed using SPSS version 20. Bivariate and multivariate logistic regression models were fitted to identify the determinants of postpartum modern contraceptive use. Adjusted odds ratios with 95% confidence intervals were calculated, and p-values <0.05 were considered to indicate statistical significance.ResultOf the total 404 participants, 45.8% mothers used modern contraceptives during postpartum period. Injectable contraceptive was the most frequently used method. Menstruating [AOR =3.84, 95% CI: (2.33, 6.35)], resumption of sex [AOR= 3.17, 95% CI: (1.80, 5.58)], 37–51 weeks of postpartum period [AOR= 2.48, 95% CI: (1.11, 5.55)], husband approval of contraceptive [AOR= 2.10, 95% CI: (1.16, 3.82)] and current knowledge on FP [AOR= 5.01, 95% CI: (2.23, 11.24)] were factors affecting contraceptive use in postpartum period.ConclusionUtilization of modern contraceptive during the postpartum period was significantly decreased placing women at risk for a pregnancy in the extended postpartum period. Menstruating, resumption of sex, variation on postpartum period and husband approval of contraceptive were factors associated with contraceptive use. Strengthening FP counseling service at the ANC clinic and postnatal care would improve contraceptive use during the postpartum period.

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The paper examines the Ethiopian experience with fiscal federalism which can be used as a lesson by South Sudan and Somalia, the two countries which are struggling to have a stable and viable nation. Ethiopia adopted federal system in 1995 which creates nine states based on ethnic grounds. Of the nine states, six of them have single ethnic group representing more than 80 percent of state's population while remaining three are multi-ethnic states. The fiscal relationships between the federal and state governments are provided in the Constitution addressing the four major components of federal finance. The expenditure assignments among tiers of government appears to be in line with the general principles while taxing power is over concentrated in the hands of federal government which resulted in high level of vertical fiscal imbalance. To correct this imbalance the federal government makes transfers to state governments in the form of formula-based budget subsidy which covers much of their budget. While political forces known to influence division of powers in federal structure, the existing federal finance arrangement in Ethiopia does not face serious challenges. The country, both at federal and state levels, has been ruled by the same political party since the adoption of the federal constitution. The existing fiscal arrangement may face challenge if another political party takes power in some states or the federal government.

Background/Aims The academic performance of midwifery students plays an important role in providing quality midwifery care. However, the current academic performances of students have been found to be unsatisfactory. This study aimed to assess factors associated with the academic performance of midwifery students. Methods An institution-based cross-sectional study was conducted among 149 fourth year midwifery students at the University of Gondar. A structured and pre-tested questionnaire was used to collect the data. Bivariate and multiple logistic regression were calculated and the odds ratio with 95% confidence interval were computed to identify associated factors and determine the strength of association. A P value of <0.05 was considered statistically significant. Results Among the 149 midwifery students, 108 (72.5%) performed well and, of these students, 76 (51%) were males. Coming from a rural residence (adjusted odds ratio=2.64, P=0.017), the teacher being reported as not helpful and effective during the skills laboratory (adjusted odds ratio=2.4, P=0.022), and students' 10th grade achievement >3.25 (adjusted odds ratio=16, P=0.001) were significantly associated with good academic performance. Conclusions Students' academic performance was good. Residence, teacher's role and student's background were significantly associated with good academic performance. Attention should be given to students from urban residences and the teacher's role in the skills laboratory. Additionally, students should be encouraged to perform well academically from high school onwards.