Background Despite a remarkable progress in the reduction of global rate of maternal mortality, cervical cancer has been identified as the leading cause of maternal morbidity and mortality, particularly in sub-Saharan African countries. The uptake of cervical cancer screening service has been consistently shown to be effective in reducing the incidence rate and mortality from cervical cancer. Despite this, there are limited studies in Ethiopia that were conducted to assess the uptake of cervical cancer screening and its predictors, and these studies showed inconsistent and inconclusive findings. Therefore, this systematic review and meta-analysis was conducted to estimate the pooled cervical cancer screening utilization and its predictors among eligible women in Ethiopia. Methods and findings Databases like PubMed, Web of Science, SCOPUS, CINAHL, Psychinfo, Google Scholar, Science Direct, and the Cochrane Library were systematically searched. All observational studies reporting cervical cancer screening utilization and/ or its predictors in Ethiopia were included. Two authors independently extracted all necessary data using a standardized data extraction format. Quality assessment criteria for prevalence studies were adapted from the Newcastle Ottawa quality assessment scale. The Cochrane Q test statistics and I2 test were used to assess the heterogeneity of studies. A random effects model of analysis was used to estimate the pooled prevalence of cervical cancer screening utilization and factors associated with it with the 95% confidence intervals (CIs). From 850 potentially relevant articles, twenty-five studies with a total of 18,067 eligible women were included in this study. The pooled national cervical cancer screening utilization was 14.79% (95% CI: 11.75, 17.83). The highest utilization of cervical cancer screening (18.59%) was observed in Southern Nations Nationalities and Peoples’ region (SNNPR), and lowest was in Amhara region (13.62%). The sub-group analysis showed that the pooled cervical cancer screening was highest among HIV positive women (20.71%). This meta-analysis also showed that absence of women’s formal education reduces cervical cancer screening utilization by 67% [POR = 0.33, 95% CI: 0.23, 0.46]. Women who had good knowledge towards cervical screening [POR = 3.01, 95%CI: 2.2.6, 4.00], perceived susceptibility to cervical cancer [POR = 4.9, 95% CI: 3.67, 6.54], severity to cervical cancer [POR = 6.57, 95% CI: 3.99, 10.8] and those with a history of sexually transmitted infections (STIs) [POR = 5.39, 95% CI: 1.41, 20.58] were more likely to utilize cervical cancer screening. Additionally, the major barriers of cervical cancer screening utilization were considering oneself as healthy (48.97%) and lack of information on cervical cancer screening (34.34%). Conclusions This meta-analysis found that the percentage of cervical cancer screening among eligible women was much lower than the WHO recommendations. Only one in every seven women utilized cervical cancer screening in Ethiopia. There were significant variations in the cervical cancer screening based on geographical regions and characteristics of women. Educational status, knowledge towards cervical cancer screening, perceived susceptibility and severity to cervical cancer and history of STIs significantly increased the uptake of screening practice. Therefore, women empowerment, improving knowledge towards cervical cancer screening, enhancing perceived susceptibility and severity to cancer and identifying previous history of women are essential strategies to improve cervical cancer screening practice.

Background: Heart failure is the cumulative and progressive result of conditions that cause structural defects and functional abnormalities in the heart. It is affects at least 26 million people worldwide and is increasing in prevalence especially among hemodialysis patients with severe renal failure. Objective: To assess the incidence and predictors of congestive heart failure among hemodialysis patients at Felege Hiote Referral Hospital, Northwest Ethiopia. Methods: This institutionally based retrospective cohort study was undertaken among 205 hemodialysis patients of Felege Hiote Referral Hospital from January 1, 2016 to February 29, 2020. All eligible hemodialysis patients who fulfilled the inclusion criteria were included in the study. Data were entered using Epi-data Version 4.1 and analyzed using STATA Version 14. The survival time of hemodialysis patients was estimated using the Kaplan-Meier survival curve, and the survival time between different categorical variables was compared using the log rank test. Both bivariable and multivariable Cox-proportional hazard regression models were fitted to identify independent predictors of congestive heart failure among hemodialysis patients. Results: Among a cohort of 205 hemodialysis patients at Felege Hiote Referral Hospital, 12 (5.9%) developed congestive heart failure during the follow-up time. The overall congestive heart failure incidence rate was 2.9 per 100 person-years (PY) with 95% CI. The total time allotted to follow up the study participants was 4968 PY. Using multivariable Cox-regression analysis, we found that male sex, rural residence, no formal education, low body mass index (<18.5), presence of comorbidity, and anemia during dialysis initiation significantly increased the risk of heart failure. Conclusion: In this study, we found a high rate of congestive heart failure among hemodialysis patients. Factors significantly linked with increased risk of heart failure included male sex, rural residence, no education, low body mass index (<18.5), presence of comorbidity, and anemia during dialysis initiation. Early screening and treatment for heart failure are highly recommended at hemodialysis follow-up for patients with the above risk factors.

Background Labor Pain is “unpleasant sensory and emotional experience associated with actual or potential tissue damage, affects parturient and fetuses’. Developed countries regularly use obstetric analgesia but in developing countries, including Ethiopia pain is neglected and most women go through painful labor. The study was conducted in public health institutions of East Gojjam Zone; Amhara region, Ethiopia. The aim of this study was to assess utilization of labor pain management methods and associated factors among obstetric care givers in the study setting. Method Facility-based cross sectional study design was carried out in public health institutions of East Gojjam Zone from April 15 to May 15, 2020. Semi Structured questionnaires were used and 305 obstetric care givers were participated. Stratified sampling technique was used. Data was entered by Epi- data version 3.1 and exported to SPSS version 20. Descriptive analysis was done and Bivariate and multivariate logistic regression with 95% CI was used to saw the association of dependent and independent variables at p < 0.05. Result Utilization of labor pain management methods in this study was 48.9%. In Multivariate logistic regression; Professional knowledge [AOR = 2.006, 95% CI = ((1.032–3.898)], availability of drug and equipment [AOR = 2.937, 95% CI= (1.311–6.578)] and allow companionship [AOR = 2.587, 95% CI= (1.322–5.063)] were significantly associated with utilization of labor pain management methods. Conclusion and recommendation This study showed low utilization of labor pain management methods. Adequate knowledge, allow accompany and availability of drug & equipment were factors associated with use of labor pain relief options .so it is important to build knowledge of obstetric care givers, availing drugs and materials and make safe the environment for accompany ship to improving use of labor pain management.

Background Labor Pain is “unpleasant sensory and emotional experience associated with actual or potential tissue damage, affects parturient and fetuses’. Developed countries regularly use obstetric analgesia but in developing countries, including Ethiopia pain is neglected and most women go through painful labor. The study was conducted in public health institutions of East Gojjam Zone; Amhara region, Ethiopia. The aim of this study was to assess utilization of labor pain management methods and associated factors among obstetric care givers in the study setting. Method Facility-based cross sectional study design was carried out in public health institutions of East Gojjam Zone from April 15 to May 15, 2020. Semi Structured questionnaires were used and 305 obstetric care givers were participated. Stratified sampling technique was used. Data was entered by Epi- data version 3.1 and exported to SPSS version 20. Descriptive analysis was done and Bivariate and multivariate logistic regression with 95% CI was used to saw the association of dependent and independent variables at p < 0.05. Result Utilization of labor pain management methods in this study was 48.9%. In Multivariate logistic regression; Professional knowledge [AOR = 2.006, 95% CI = ((1.032–3.898)], availability of drug and equipment [AOR = 2.937, 95% CI= (1.311–6.578)] and allow companionship [AOR = 2.587, 95% CI= (1.322–5.063)] were significantly associated with utilization of labor pain management methods. Conclusion and recommendation : This study showed low utilization of labor pain management methods. Adequate knowledge, allow accompany and availability of drug & equipment were factors associated with use of labor pain relief options .so it is important to build knowledge of obstetric care givers, availing drugs and materials and make safe the environment for accompany ship to improving use of labor pain management.