Background:In low-and middle-income countries, it is challenging to provide basic healthcare services even before the COVID-19 pandemic outbreak. The purpose of this study was to evaluate the early indirect impact of COVID-19 on the utilization of reproductive, maternal, and newborn health services at government health facilities in South West Ethiopia, and its consequences. Methods: A comparative cross-sectional study was employed. The collected data were entered into Microsoft excel 2010 and then exported to SPSS 25 and R3.5.0 software for analysis. Independent sample t-test and two-sample test of proportion were computed, and the results were presented in text, tables, and graphs. P-value <0.05 was considered statistically significant. Results: This study showed that there was a significant reduction in mean utilization of antenatal care (943.25 visits vs 694.75 visits), health facility birth (808.75 births vs 619 births), family planning (4744.5 visits vs 3991.25 visits), and newborn immunization (739.5 given vs 528.5 given) between March-June 2019 and March-June 2020. However, there were significant increases in proportion of teenage pregnancy (7.5% vs 13.1%), teenage abortion care user (21.3% vs 28.5%), institutional stillbirth (14% vs 21.8%) and neonatal death (33.1% vs 46.2%) during the same period. Conclusion and Recommendation:This study showed that utilization of reproductive, maternal, and newborn health-care services was affected by the pandemic with deterioration of maternal and perinatal outcomes. An increase in the proportion of teenage pregnancy who seeks abortion care and the rising cesarean section rate with no improvement in perinatal outcome is a great concern that needs further investigation. Further research is also needed to explore the main reason for an increase in teenage pregnancy, abortion care users, stillbirth, and neonatal death during COVID-19.

Background It is known that antiretroviral therapy reduces the transmission of human immunodeficiency virus and AIDS-related morbidity. The coverage of HIV drugs is increasing to control further spread of HIV and children living with HIV are the target groups in using these medications. However, loss to follow-up remains a critical challenge among these groups of the population. The aim of this study was therefore to assess the incidence and predictors of loss to follow-up among children attending antiretroviral therapy clinics. Methods A ten-year institution-based retrospective cohort study was employed among 448 children enrolled in antiretroviral therapy. Data were entered and cleaned using EpiData version 3.1 and then exported to STATA version 14 for further statistical analysis. The Kaplan–Meier survival curve was used to estimate the survival time and the Log rank test was used to compare the survival time between different categories of the explanatory variables. Multivariable Cox proportional hazards model was fitted to identify predictors of loss to follow-up and p-value < 0.05 was considered statistically significant. Results The incidence rate of loss to follow-up was 6.3 per 100 children years of observation. Being male (AHR = 2.1, CI = 1.37, 3.34), aged 1–5 years (AHR = 1.6, CI = 1.05, 2.46), poor adherence to antiretroviral therapy (AHR = 6.6; CI = 4.11, 10.66), fair adherence to antiretroviral therapy (AHR = 2.2; CI = 1.13, 4.20), regimen was not changed (AHR = 4.1; CI = 2.59, 6.45), World Health Organization stage III and IV (AHR = 2.2; CI = 1.40, 3.33) and height for age <−2 z score (AHR = 2.2; CI = 1.43, 3.44) were predictors of loss to follow-up. Conclusion Nearly seven out of 100 HIV-infected children were lost to follow-up from their link to ART clinics within a one-year follow-up. Non-modifiable demographic characteristics, clinical stage and nutritional status, and ART-related variables were associated with children’s loss to follow-up. Therefore, close monitoring of the “at risk” groups might decrease the rate of loss to follow-up. Improving adherence to antiretroviral therapy and nutritional support are also recommended.

Background Current data suggest that far more women around the world are exposed to abuse by health care providers while receiving maternity care. This predisposes them to psychological distress; abstain from accessing health facilities for care and end up with avoidable death and disability. Objective To assess the level of respectful care during delivery among mothers giving birth in public health facilities in Ilu AbaBor, Southwest Ethiopia, 2019. Materials and methods An institution-based cross-sectional study was conducted among 285 randomly selected mothers in the post-natal ward from 17 health facilities in 2019. Data were collected through interviewer-administered pre-tested questionnaires. The collected data were entered into Epi-data version 3.1 statistical and analyzed by SPSS version 21. Both bivariable and multivariable logistic regression models were employed. Results The proportion of respectful care during maternity care in health care institutions of Ilu Ababor zone was 47.3%. In the multivariable logistic regression; age (AOR 0.25, 95% CI 0.08, 0.81), occupation (AOR 4.16: (1.34, 12.9)), planned pregnancy (AOR 0.28: (0.12, 0.67)), mode of delivery (AOR 0.05: (0.01, 0.33)), and receiving care from providers who had a compassionate and respectful care training (AOR 0.13: (0.06, 0.25)) were independent predictors of respectful care. Conclusions The proportion of respectful care of the health institution in the Ilu Ababor zone was low compared to the other studies. Variables like; age, occupational status, pregnancy plan, mode of delivery, facing complications during labor and delivery, and taking compassionate and respectful care training were independent predictors of respectful maternity care. This study recommended that the responsible stakeholders should strengthen monitoring and evaluation of the practice and mainstreaming of respectful maternity care, give training for health professionals, and develop guidelines used to monitor, report, and track barriers to the practice of maternity care.

Background Unintended pregnancy reflects the existence of unprotected sex. Understanding factors associated with unintended pregnancy among HIV-positive women is very important to design strategies for the prevention of further transmission and infection with the virus. However, there is scarce information in this regard. Given the degree of HIV prevalence among women and the current antiretroviral therapy scale up in Ethiopia, it is important to understand factors associated with un-intended pregnancy in order to prevent mother to child HIV transmission (MTCT). Methods An institution-based cross-sectional study design was employed. The sample size was 353; all HIV/AIDS sero-positive reproductive age group (15–49) women having any pregnancy history after their diagnosis and having started HAART were included and simple random sampling was used to select study participants. Data collection period was from March 9 to April 13, 2019. Results The prevalence of unintended pregnancy among the participants was 40.9%. In the multivariate logistic regression, unemployment (AOR, 3.36; 95% CI: 1.55–7.26), not being knowledgeable on MTCT and prevention of MTCT (PMTCT) (AOR, 3.18; 95% CI: 1.92–5.24), and having had no discussion on reproductive health issues (AOR, 1.83; 95% CI: 1.09–3.07) are factors significantly associated with unintended pregnancy occurrence among HIV-positive women on antiretroviral therapy. Conclusion and Recommendation The prevalence of unintended pregnancy among the women in the study is high. To avoid unintended pregnancies, HIV-infected women need access to effective family planning services and risk reduction discussions during routine care visits.

Background: Maternity Waiting Homes are houses built in the healthcare settings that lodge pregnant women in their term state of pregnancy to  prevent labor and delivery-related complication. This study aimed to estimate the extent of pregnant women’s intention to use Maternal Waiting  Homes and identify its associated factors in Metu Woreda, Western Ethiopia. Methods: A community-based cross-sectional study was conducted from March 1-30, 2018. We used a systematic sampling method to select the  study participants and Binary logistic regression analysis was used to identify factors associated with the intention of the women to use Maternal  Waiting Homes. Results: A total of (97%) of respondents’ questionnaires were found complete and analyzed for this study. Almost half (48.8%) of  the pregnant women who participated in the study were planned to use Maternal Waiting Homes in their prospective delivery. Based on  multivariate logistic regression analysis; being illiterate and/or less educated in their educational status, having a history of using Maternal Waiting  homes, and receiving a number of times antenatal care services were found statistically significantly associated with intention of the women to use Maternal Waiting Homes. Conclusion: It is trivial that more than half of the pregnant women who participated in the study were unintended to use Maternal Waiting  Homes. Educational status, a number of times attending antenatal care services and experience of using Maternal Waiting Homes were found  statistically significantly associated with women’s intention to use Maternal Waiting Homes.