Carbapenem-resistant Enterobacterales (CRE), particularly carbapenemase-producing CRE (CP-CRE) are a growing global threat in health care. Intestinal colonization increases infection risk and facilitates transmission in the hospital. We aimed to determine intestinal colonization of CRE and CP-CRE among hospitalized patients in Addis Ababa, Ethiopia. A longitudinal study was conducted on 165 patients from February 2023 to April 2024 at Tikur Anbessa Specialized Hospital. Microbial identification and antimicrobial susceptibility testing were done using VITEK 2. Carbapenemase production was confirmed using the modified carbapenem inactivation method, and Polymerase Chain Reaction (PCR) was used to detect carbapemase genes. CRE colonization was detected in 19.4% of patients at admission and 18.8% during follow-up, showing no significant change (p = 0.65). CP-CRE colonization was increased from 10.3% at admission to 16.4% (p = 0.03) during follow-up. The most frequently identified genes were blaNDM (71.0%) and blaOXA-48 (53.0%) at admission. These genes were detected in (74.1%) and (48.1%) during follow-up, respectively. A substantial burden of CRE and CP-CRE colonization was found, with a high persistence rate. Screening high-risk patients and strengthening infection prevention measures are urgently needed.

Obstructive jaundice has contributed a sizable burden of global mortality, morbidity, economic cost, and hospitalization worldwide cause by benign and malignant conditions. To assess the etiological pattern, predictors for postoperative complications, and short-term outcomes among patients undergoing surgical intervention for EHBO at Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia, 2024. A hospital-based retrospective cohort study was conducted to evaluate the etiological patterns, outcomes, and predictors of complications following surgical intervention for extrahepatic biliary obstruction (EHBO). The study included 122 EHBO patients who were consecutively enrolled during the study period. Normality of continuous variables was assessed using the Shapiro-Wilk test; normally distributed data were expressed as means with standard deviations, whereas skewed variables were reported as medians with interquartile ranges. Univariate and multivariate binary logistic regression analyses were performed to identify predictors of 30-day postoperative complications. Results are reported as adjusted odds ratios (AOR) with 95% confidence intervals (CI), and a p-value < 0.05 was considered statistically significant. Among 122 patients undergoing surgical intervention for EHBO, the mean age was 51.8 years (SD 13.2), with a slight male predominance (53.3%). Most patients had good performance status (ECOG 0-1 in 91.8%). Malignant biliary obstruction (MBO) was present in 67 (54.9%), predominantly due to pancreatic cancer (23.0%) and periampullary tumors (18.9%). In MBO patients, mean serum bilirubin decreased from 18.8mg/dL preoperatively to 1.7mg/dL at 4 weeks, representing a 90.1% reduction. Curative resection was achieved in 22 (32.8%) patients (Whipple procedure in 19, bile duct excision in 3); the remainder underwent palliative surgery. The 30-day postoperative complication rate was 25.4% (31/122), with mortality of 1.6% (2/122). Surgical site infection was the most frequent complication (19.7%), followed by anastomotic leakage (6.6%). Multivariable analysis identified poorer ECOG status (AOR 6.1, 95% CI 2.0-18.4; p = 0.001) and jaundice duration > 8 weeks (AOR 2.1, 95% CI 1.7-6.3; p = 0.003) as independent predictors of postoperative complications. Our findings demonstrate that favorable surgical outcomes for EHBO are achievable even in resource-constrained environments. However, further mitigating postoperative morbidity requires targeted perioperative optimization of high-risk patients, specifically those presenting with prolonged jaundice (> 8 weeks), preoperative cholangitis, poor ECOG performance status, hypoalbuminemia, and malignant biliary obstruction (MBO). Consequently, implementing systematic risk stratification and addressing these key clinical predictors are imperative to minimize complications and optimize patient outcomes. Not applicable.

Purpose Artificial intelligence (AI) and building information modelling (BIM) have transformed the architecture, engineering and construction (AEC) industry in developed countries, but their adoption in Ethiopia's road infrastructure management remains limited. Empirical evidence on adoption benefits, challenges and a context-specific strategic framework for developing countries is limited. This study addresses this gap by exploring the necessity of AI-BIM integration and identifying how it can be effectively implemented in Ethiopia. Specifically, it investigates: (1) professional perception on the benefits and challenges of AI-BIM adoption, (2) critical dimensions for adopting AI-BIM integration and (3) the development of a context-specific strategic framework to guide AI-BIM adoption. Design/methodology/approach This study employs a mixed-method exploratory design, combining a narrative literature review and structured questionnaire survey to investigate AI-BIM adoption in Ethiopian road infrastructure management. The literature review synthesises fragmented theoretical and empirical insights to identify six interrelated strategic dimensions, while the survey captures practitioner perceptions of adoption benefits and challenges. Data were collected from 33 professionals from the Ethiopian Road Administration (ERA) and the Addis Ababa City Road Authority (AACRA) using purposive and convenience sampling. Quantitative data were analysed using descriptive statistics to determine key patterns and priorities, and qualitative insights were thematically synthesised. The integration of findings follows a triangulation approach, enabling the development of a context-specific, empirically grounded, and practically applicable AI-BIM adoption framework. Findings Road infrastructure management practices in Ethiopia are conventional and fragmented. The findings highlighted the potential benefits and challenges of adopting AI-BIM integration. Six critical strategic dimensions were synthesised into a context-specific strategic framework tailored to Ethiopia's road sectors. Research limitations/implications This study provides timely, context-specific insights; however, it is limited by the sample size and focus on selected road sectors and technologies. The findings are primarily context-specific and may not be directly generalisable. Future research could expand the empirical scope, incorporate additional emerging technologies, and validate the framework in other sectors and geographical contexts. Practical implications The proposed framework offers structured and actionable guidance for policymakers and practitioners, emphasising phased implementation, capacity building and interdepartmental collaboration to enable successful AI-BIM adoption. Social implications The study promotes the adoption of AI-BIM integrations to support digital transformation, enhances transparency, improves service delivery, and contributes to sustainable road infrastructure development outcomes. Originality/value This study contributes evidence-based, context-specific insights and a strategic framework for AI-BIM adoption in Ethiopia, bridging the gap between global technological advancement and local implementation realities. It contributes practical guidance for policymakers and practitioners in developing countries rather than theoretical innovation.

IntroductionDespite the postpartum intrauterine device being highly effective, inexpensive, non-hormonal and reversible, its acceptance is very low in developing countries including Ethiopia. Considering the importance of the use of immediate postpartum intrauterine contraceptives is a valuable means to keep women and children healthy.ObjectivesThis study aimed to assess the acceptance of an immediate postpartum contraceptive device and associated factors among women who gave birth in selected public hospitals in Addis Ababa.MethodA health institution-based cross-sectional survey was conducted among 336 women who gave birth in selected public health facilities in Addis Ababa from the beginning of February to March 2021. Information was gathered by using interviewer-administered questionnaires. Data were double-entered in Epidata V.4.6 statistical package, cleaned and exported to IBM SPSS statistics V.25 for analysis. Logistic regression models were used to predict the association of outcome variables and adjusted for possible confounders.ResultA total of 42 (12.5%) of women accepted to use the immediate use of postpartum intrauterine devices. Woman’s employment status such as (private employees (adjusted OR, AOR=4.269, 95% CI (1.280 to 14.234) (p<0.018), daily labourer (AOR=7.373, 95% CI (1.534 to 35.433) (p<0.013), student (AOR=11.004, 95% CI (1.602 to 75.572) (p<0.015)), and monthly income of the mother Birr greater than 7901.00 (AOR=6.589, 95% CI (1.736 to 25.009) (p<0.006) were found to be associated with acceptance of the immediate postpartum contraceptive device.ConclusionsThe acceptance of immediate postpartum intrauterine contraceptive device was low, that is 12.5%, maternal education, occupation, monthly income and attitude of women were associated with acceptance. Addressing women’s awareness by using target-oriented health education and training of healthcare workers was recommended.

Childhood cancer represents a significant cause of morbidity and mortality among children under 15 years of age and is a growing public health concern, particularly in low- and middle-income countries, including Ethiopia. The purpose of this study was to assess factors Influencing delay to diagnosis and treatment initiation among pediatric cancer patients attending at Tikur Anbessa Specialized Hospital oncology unit in Addis Abeba, Ethiopia, in 2019. An institutional-based cross-sectional study involving 244 pediatric cancer patients was conducted between February and April of 2019. Data were collected from parents/caregivers using a structured questionnaire through face-to-face interviews and supported by review of medical records. Bivariate and multivariate analyses with adjusted odds ratios were employed to evaluate the association between dependent and independent factors. Statistical analysis was performed using STATA (Version 14) with a significance level of P < 0.05. A total of 244 children participated, with an average age of 6.4 (± SD 3.2 years). One hundred twenty-seven (52.0%) were reported as patient delays (> 30 days), while 179 (73%) were reported as health system delays. Children aged 5-9 years AOR:2.98; 95% CI,1.35, 6.57; three times delayed than children 0-4 years; where as children from rural areas AOR:2.28; 95% CI, 1.07, 4.88; were about 2.28 delayed as compared to children who come from urban. Furthermore, parents of children who visited traditional healers AOR: 7.85, 95% CI; 3.88,15.89 were more likely to be delayed as compared to their counter's parts. Health system-related factors, such as lack of medical insurance AOR: 5.52, 95%CI: 2.61, 11.69 and first visit to a health institution AOR: 16.13, 95%CI: 4.00, 65.03, were identified as the cause of delay. In conclusion, prolonged patient and health system delays were significantly associated with age AOR: 2.98; 95% CI: 1.35-6.57), rural residence AOR: 2.28; 95% CI: 1.07-4.88, use of traditional healers AOR: 7.85; 95% CI: 3.88-15.89), low disease awareness, and lack of health insurance at diagnosis (AOR = 5.52; 95% CI: 2.61-11.69). To reduce delays, targeted health education for parents and healthcare providers, improved early detection and referral systems, strengthened multisectoral collaboration, expansion and decentralization of pediatrics oncology care facilities and further qualitative research to explore underlying causes of delay are recommended.

Ethiopia remains a high-burden measles setting, yet the drivers of protracted transmission and regional susceptibility remain poorly understood. This study analyzes seven years of national surveillance data to characterize demographic shifts, disease severity, and the impact of system performance on outbreak dynamics. A longitudinal analysis of confirmed measles cases from 2018 to 2024 was conducted. Age-specific attack rates (AR) and case fatality rates (CFR) were calculated, and time-varying reproduction numbers (Rt) were estimated to assess transmission intensity. The relationship between surveillance latency (onset-to-confirmation) and outbreak characteristics, including duration and size, was evaluated. A total of 69,866 confirmed cases were analyzed, of which 12.5% were laboratory confirmed and 87.5% were epidemiologically linked. The highest burden was observed among children aged 1-4 years (AR: 195 per 100,000). Substantial regional variation was evident, with the median age of infection at 2.8 years in pastoralist regions (e.g., Somali) and 7.2 years in urban settings (e.g., Addis Ababa). The overall CFR was 0.8%, peaking at 1.12% among infants aged < 9 months. Transmission intensity remained elevated during epidemic peaks (Rt: 1.8-2.4). The median onset-to-confirmation delay was 18 days, exceeding the estimated measles serial interval. While longer outbreaks were associated with larger outbreak size, no significant association was observed between surveillance delay and outbreak duration. Persistent measles transmission in Ethiopia appears to be driven primarily by regional immunity gaps among susceptible pediatric populations, while prolonged surveillance delays remain an important operational concern for timely outbreak detection and response. Elimination efforts should prioritize strengthening routine immunization, closing regional immunity gaps, and improving surveillance timeliness. These findings also provide practical insights for other low- and middle-income countries seeking to strengthen measles control programs and surveillance systems in heterogeneous transmission settings.

Background:Burn injuries impose substantial burdens in low- and middle-income countries, where prolonged hospitalization occurs due to limited specialized centers, resources, and surgical delays. This study examines factors associated with prolonged length of stay (LOS) and treatment costs relative to catastrophic health expenditure (CHE) thresholds among burn patients treated at a tertiary center in Ethiopia.Methods:Burn patients treated at the Addis Ababa Burn, Emergency, and Trauma Center from January 2023 to 2025 were prospectively enrolled in this observational cohort study. Univariable and multivariable analyses were performed to evaluate factors associated with LOS for the overall cohort and by age subgroup and treatment costs were compared with CHE thresholds.Results:Among 196 patients (55.6% men; mean age 17.6 y), the mean LOS was 33.5 ± 28.8 days. Electrical (36.4%) and flame (35.2%) injuries predominated in adults versus scalds in children (73.1%). Total body surface area and sex distribution were similar across groups, but pediatric burns were more superficial and required fewer surgical procedures (0.6 versus 1.4). The number of procedures and systemic infections remained independently associated with log-transformed LOS in adjusted analyses for all groups (all P < 0.05). LOS independently predicted cost. Facility and out-of-pocket costs averaged 24,428 and 7283 Ethiopian birr, respectively, with out-of-pocket spending by subgroup approaching or exceeding CHE thresholds.Conclusions:Prolonged LOS after burn injury in Addis Ababa is driven by clinical severity and complications, escalating costs toward catastrophic levels. Prevention strategies and age-tailored clinical pathways may shorten LOS, reduce costs, and strengthen financial risk protection in low-resource settings.

ObjectiveThe aim of this study was to assess vaccination coverage and inequalities in childhood immunisation among children aged 12 months in Ethiopia.DesignPerformance monitoring for action Ethiopia implemented a nationally representative first-cohort longitudinal survey (2019–2021), collecting data at baseline, 6 weeks, 6 months and 1 year post partum to monitor reproductive, maternal, newborn and child health indicators.SettingsThe study was conducted from five Ethiopian regions: three predominantly agrarian (Amhara, Oromia and Southern Nations, Nationalities and Peoples), one pastoralist (Afar) and one urban (Addis Ababa).ParticipantsThe weighted sample comprised 1888 participants for full vaccine coverage (FVC) and 1677 for both incomplete vaccine coverage (IVC) and dropout rate (DOR) between pentavalent-1 and pentavalent-3 vaccines.Outcome measuresThe vaccine coverage and inequalities were assessed using three indicators: FVC, IVC and DOR (between the first and third doses of the pentavalent vaccine). Key dimensions of inequality included maternal age, economic status, education level, place of residence and subnational regions. The analysis was conducted using Health Equity Assessment Toolkit Plus software, employing seven summary measures of inequalities: Difference, Ratio, Population Attributable Risk, Population Attributable Fraction, Slope Index of Inequality, Relative Index of Inequality and the Theil Index.ResultThe study found that only 29.1% of 12-month-old children in Ethiopia had received full vaccination, whereas 67.2% had incomplete coverage and the DOR between the first and third doses of the pentavalent vaccine was 34.3%. Both simple and complex inequality measures revealed a high level of inequality in childhood immunisation indicators across wealth, education, place of residence and regions. FVC was higher among children of higher socioeconomic status and urban residence, whereas IVC and DOR were disproportionately higher among children from the poorest households, mothers with no education, rural residents and disadvantaged regions.ConclusionsChildhood immunisation coverage in Ethiopia remains low and marked by high inequality. Higher rates of incomplete vaccination and vaccine dropout are disproportionately concentrated among children from low socioeconomic backgrounds, rural residents and disadvantaged regions. These disparities reflect substantial health inequities in childhood vaccinations as they are unfair and avoidable with appropriate interventions. The study underscores that addressing socioeconomic and geographic inequalities could substantially improve the national immunisation coverage and accelerate progress towards universal health coverage targets.

ABSTRACTEthiopia has one of the highest rates of undernutrition among children under five (U5) and women of reproductive age (WRA) globally, alongside rising overweight/obesity, particularly in urban areas. Poor diet is a shared driver of multiple forms of malnutrition. We used a participatory photography (Photovoice) approach to explore the lived experiences of WRA and their children U5 in adopting healthy diets across lower‐ and higher‐ socio‐economic status (SES) groups in Addis Ababa. Women took photographs illustrating challenges to healthy diets, and five focus groups (n = 31 women) were conducted to discuss challenges and solutions, with separate sessions held for different SES groups. A hybrid thematic analysis, combining deductive and inductive approaches, identified themes/subthemes, with comparisons across SES groups. Financial and physical barriers to accessing healthy foods, time constraints and perceived poor food safety were major contributors to poor diets. In lower SES groups, women also reported limited knowledge about healthy diets, inadequate family support and poor home food environments. In higher SES groups, unhealthy food preferences coupled with easy access to and aggressive promotion of unhealthy foods were key challenges. Proposed government‐level solutions included job creation, nutrition education, affordable healthy food, investment in household infrastructure, expanded childcare and restrictions on unhealthy food availability and promotion. Societal‐level solutions included gender equality, strengthened community‐based loan schemes and support for urban agriculture. These findings highlight that women recognise their needs and who should support them, and emphasise the importance of including women's voices in decision‐making processes. Findings also underscore the need for integrated interventions targeting individual, food environment and socio‐economic drivers to improve diets among women and children in urban Ethiopia.

Schistosomiasis remains a significant public health burden in many developing countries. Plant‐based molluscicides have gained considerable attention as alternatives for snail control, owing to their relatively lower toxicity and favorable environmental profile. However, prior to large‐scale application, plant‐based molluscicides require rigorous small‐scale field trials and comprehensive toxicity assessments under natural conditions to confirm their efficacy and evaluate their potential impact on nontarget organisms, particularly fish. This study evaluated the molluscicidal activity of 70% ethanol and chloroform fractions of Hagenia abyssinica flowers against Biomphalaria species and assessed the acute toxicity of the 70% ethanol extract on Nile tilapia (Oreochromis niloticus) through a small‐scale trial. Female flowers of H. abyssinica were collected in Addis Ababa, Ethiopia. Adult Biomphalaria species were exposed to 70% ethanol and chloroform fractions of H. abyssinica for 24, 48, and 72 h. Fish toxicity was assessed following the Organisation for Economic Co‐operation and Development guidelines at the National Fish and Other Aquatic Lives Research Center in Sebeta. Lethal concentration values (LC50 and LC90) were calculated from mortality data using probit regression analysis in IBM SPSS software. In fish toxicity assessments, the LC50 and LC90 for the 70% ethanol extract were 38.71 and 57.14 mg/L, respectively. Fish fingerlings showed no significant difference in survival at concentrations up to 16 mg/L, establishing this level as the no observed adverse effect concentration (NOAEC). The study found that both the 70% ethanol extract and chloroform fraction of H. abyssinica flowers displayed significant molluscicidal activity against Biomphalaria species, with LC50 values of 78.77 and 36.49 mg/L, respectively, after 24 h. The LC50 of the 70% ethanol extract for molluscicidal activity was about twice that needed for fish, showing that fish were more sensitive than Biomphalaria snails. This differential toxicity raises important ecological concerns.

Balance is essential for daily activities, motor development, and overall well-being. The vestibular system plays a key role in balance control, and impairments associated with hearing loss may negatively affect balance in children. However, balance assessment is not routinely performed in children with hearing impairment. This study assessed static and dynamic balance performance and associated factors among children with and without hearing impairment in selected public schools in Addis Ababa, Ethiopia. A comparative cross-sectional study was conducted from September 2023 to June 2024 among 148 schoolchildren aged 7-18 years (74 with hearing impairment and 74 sex-matched peers with normal hearing). Balance performance was evaluated using the single-leg stance test (eyes open and closed), functional reach test, and Pediatric Balance Scale. Data were analyzed using independent t-tests, Pearson's correlation, and regression analyses in SPSS version 27. Statistical significance was set at p < 0.05. Children with hearing impairment scored significantly lower than their normal-hearing peers in the single-leg stance (eyes open and closed), functional reach test, and pediatric balance scale (all p < 0.001). When analyzed by sex, males with hearing impairments had significantly lower scores in single-leg stance (eyes open and closed, p < 0.001), functional reach test (p < 0.002), and pediatric balance scale (p < 0.001) compared to males with normal hearing. Similarly, females with hearing impairments demonstrated significantly lower scores in single-leg stance (eyes open and closed, p < 0.001), functional reach test (p < 0.003), and pediatric balance scale (p < 0.001) compared to females with normal hearing. Children with hearing impairment demonstrated significantly lower static and dynamic balance performance than age- and sex-matched peers with normal hearing. These findings highlight the importance of incorporating routine balance assessment in this population.

BackgroundChildren are particularly vulnerable to road traffic injuries (RTIs) leading to morbidity and mortality. Despite the high incidence of pediatric RTIs in Ethiopia, data on the patterns and consequences of pediatric RTIs are limited.ObjectiveTo assess the characteristics and ED disposition among pediatric patients (age ≤ 18 years old) with RTI admitted to emergency department of Addis Ababa Burn, Emergency, and Trauma (AaBET) Hospital, Addis Ababa, Ethiopia.MethodsA hospital‐based cross‐sectional study was conducted, focusing on pediatric patients with RTIs who presented it to the emergency department of AaBET Hospital from December 12, 2021, to December 30, 2023, retrospectively. Data were collected using a standardized structured data collection checklist from hospital data records and medical charts. A sample size of 279 pediatric RTI patients was included from registered hospital records. After data cleaning, data were analyzed using SPSS Version 21. Descriptive statistics were used to describe the dependent variables.ResultOut of 279 patients, the median age was thirteen (IQR: 9–17). A total of 54.1% of the patients were male. One hundred and fourteen (40.9%) of those were from age 15–18. Two hundred and eight (74.6%) patients were pedestrians. Forty‐eight percent of the patients sustained injury while in transit to work or school. Seventy six (27.2%) came to the hospital with private cars or trucks, while 63 (22.6%) came with an ambulance. One‐hundred thirty five (48.4%) of the patients sustained extremity and pelvis injuries, while 41.9% sustained head injuries. Two‐hundred fifty‐five (91.4%) patients were discharged home from the emergency department. The emergency department mortality was 0.7%.ConclusionIn this study, children from the ages of 15–18 were more affected by RTIs. Pedestrians and while in transit to school or work were more injured. Head and extremity injuries were the predominant injuries that happened to children. Children and schools should be prioritized in targeted road safety initiatives, supported by stricter enforcement of traffic laws near school zones.

Maternal depression is one of several multidimensional factors that influence children′s nutritional status. However, research in this area remains limited in urban poverty settings, where residents are often assumed to have better access to socioeconomic and health services. We estimated the prevalence of maternal depression and assessed its association with undernutrition among children aged 12–36 months of economically disadvantaged mothers in urban Ethiopia. A cross‐sectional survey was conducted to collect data from 627 mother‐child pairs in selected urban areas of Ethiopia: Adama, Addis Ababa, Debre Birhan. Maternal depression was measured using Patient Health Questionnaire–9 (PHQ–9) score, whereas child nutritional status was measured using anthropometric methods. Background characteristics of the study were summarized using percentages and averages. Binary logistic regression was used to assess the association between maternal depression and undernutrition, adjusting for confounders. The prevalence of maternal depression was 16.0% (95% CI: 13.3%–19.0%), while stunting among children aged 12–36 months was 52.7% (95% CI: 48.7%–56.7%). Maternal depression was significantly associated with child stunting after adjusting for covariates but showed no significant association with wasting or underweight. Children of mothers exhibiting depression symptoms had 2.21 times higher odds of being stunted (95% CI: 1.33–3.68) compared with those of nondepressed mothers. These findings underscore the critical need for integrated public health interventions that incorporate maternal mental health into child nutrition programs, alongside strengthened community advocacy and education on maternal mental health. Childcare support with income‐generating activities for women can boost women′s income, provide greater peace of mind, and support improved mental well‐being.

Expanding free maternal health services in Ethiopia advances gender justice. However, structural inequities, low satisfaction, and limited use of labour companionship remain. Lower self-efficacy in companions and views of labour wards as female-only spaces are major barriers. This study measured the effectiveness and cost-effectiveness of a structured Health Belief Model (HBM)-based education session for chosen labour companions in public facilities. This parallel-group cluster-randomized trial was conducted in 12 public health facilities in Addis Ababa from January 15 to June 5, 2025 implementation phase. Facilities were randomized 1:1, assigning six clusters (222 primigravidae dyads) to each arm. Primigravidae were screened at 12-14 weeks of gestation. The intervention group completed five HBM-based sessions for labour companions from 26 weeks to admission for labour and delivery. The control group received only standard antenatal care. The primary outcome was maternal satisfaction, measured by the 25-item Pregnancy and Childbirth Questionnaire (PCQ). Secondary outcomes included delivery mode, labour duration, and newborn complications. We used Generalized Estimating Equations (GEE) for estimation and validated the results using a 9,999-replication Wild Cluster Bootstrap (WCB). Economic assessment took a health system view, using micro-costing to calculate the Incremental Cost-Effectiveness Ratio (ICER) per newborn complication avoided. The intervention had a highly significant positive impact on enhancing maternal satisfaction (β = 21.14, WCB 95% CI: 14.14 to 28.50, p < 0.001) compared to the control group. A notable reduction in prolonged labour > 8h (aOR = 0.82 =, 95% CIWCB: [0.74, 0.91], PWCB < 0.001) was accompanied by a significant drop in newborn complications (4.5% vs. 11.26%; aOR = 0.93, 95% CIWCB: [0.90, 0.97], PWCB = 0.0041). Descriptively, higher spontaneous vaginal delivery rates were observed in the intervention group (77.0% vs. 66.2%), alongside reduced Cesarean pathways (14.9% vs. 23.0%), though these modal variations did not achieve formal statistical significance (p > 0.05). Economic modeling revealed that the intervention was highly cost-effective, demonstrating a > 90% probability of cost-effectiveness at Ethiopia's willingness-to-pay benchmark, driven by the avoidance of newborn complications and neonatal intensive care costs. Preparing labour companions through a socio-culturally adaptive, theory-based approach substantially improves subjective maternal satisfaction and optimizes key physiological parameters, including labour duration and immediate neonatal transition outcomes. While it does not significantly alter the mechanical mode of birth or maternal complications, it provides an exceptionally cost-effective strategy that optimizes low-resource health systems, offering high clinical value without escalating institutional overhead costs. It was registered with Pan African Clinical Trials Registry (PACTR) with Trial ID: PACTR202503666794479 on March 17, 2025, retrospectively registered due to a lack of awareness. URL: https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=33509.

Occupational injuries account for more than 395million cases and almost 3million deaths globally each year, with the highest burden occurring in low- and middle-income countries. In Ethiopia, occupational injuries contribute substantially to emergency department visits, yet evidence on the magnitude, characteristics, and determinants remain limited. This study aimed to describe the magnitude and characteristics of occupational injuries and identify factors associated with severe injuries among patients presenting to emergency departments. A prospective hospital-based observational study was conducted at three urban public hospitals in Ethiopia. A total of 868 participants aged 18-60 years who visited emergency departments with occupational injuries were consecutively enrolled. Data was collected from October 3, 2024, to March 14, 2025, using structured interviews and clinical chart reviews. Injury severity was classified based on the World Health Organization injury surveillance guideline. Descriptive statistics summarized patient characteristics, work, and injury patterns. Poisson regression with robust variance estimation was used to identify factors associated with severe injury, and adjusted prevalence ratios with 95% confidence intervals were reported. Among 5,038 injury patients, 918 (18.2%) had occupational injuries. Of these, 868 (94.6%) participated in the study. The median age was 27 years, and most participants were male (89.5%). The majority were employed in manufacturing (43.9%) and construction (24.0%). Craft and related trades (34.9%) and elementary workers (34.2%) were the most affected. Upper extremity injuries were the most common (57.0%), with lacerations (48.2%) as the leading nature of injury, followed by fractures (28.7%). The primary mechanism of injury was contact with sharp, pointed, or rough elements (43.9%), followed by falls or crashes into objects (16.6%). Among the patients, 175 (20.2%) had severe injuries. Low educational level, fall-related mechanisms, no fixed work area, and accidents due to peers and organizational causes were significantly associated with severe injury in a multivariable regression analysis. Occupational injuries are a burden on emergency departments, affecting a high proportion of young, male workers in the construction and manufacturing sectors. Severe injuries were related to education, type of work, and injury mechanism. This study underscores the need for targeted workplace safety interventions.

Prior Pregnancies Deplete Maternal Folate Status and Increase Risks of Neural Tube Defects in Addis Ababa, Ethiopia.

IntroductionPatient satisfaction and dissatisfaction are critical indicator of healthcare quality. This study assessed satisfaction levels and identified factors associated with outpatient dissatisfaction among adult outpatient attendees in public hospitals in Addis Ababa, Ethiopia.MethodsA multicenter, institution-based cross-sectional study was conducted in August 2023 among 421 outpatients. Data were collected using a standardized questionnaire, processed in EpiData, and analyzed via SPSS version 27. Multivariable logistic regression was used to identify factors associated with patient dissatisfaction.ResultsA total of 421 patients participated, with an overall satisfaction was 67% (95% CI [62.5, 71.5%]). Patients with repeated visits for the second (adjusted odds ratio (AOR): 0.023; 95% CI [0.003, 0.192]) and third visits (AOR: 0.098; 95% CI [0.016–0.603]) were significantly less likely to be dissatisfied compared to first-time visitors. Conversely, partial (AOR: 4.126; 95% CI [1.589, 10.72]) or complete non-availability (AOR: 6.668; 95% CI [2.14, 20.753]) of ordered procedures, unclean waiting areas (AOR: 12.48; 95% CI [3.96, 39.37]) or consultation rooms (AOR: 0.168; 95% CI [0.041, 0.68]), and poor patient-provider interactions, including not feeling comfortable asking questions (AOR: 30.28; 95% CI [13.52, 67.85]), and perceived impoliteness: (AOR: 7.204; 95% CI [1.305, 39.78]) were significantly associated with higher odds of dissatisfaction.ConclusionPatient satisfaction was sub-optimal. Outpatient dissatisfaction was strongly associated with first-time visits, structural limitations in procedure availability, unclean waiting environments, and poor interpersonal interactions. Strengthening nurses’ roles in patient communication and coordination represents a vital pathway to mitigate dissatisfaction and optimize healthcare quality.

ABSTRACT This article explores perceptions of gender norms change shaped by lived experiences of migration in Ethiopia. Drawing on interviews and focus group discussions with internal and transnational migrant youths living and working in Addis Ababa, this article links shifting attitudes around normative gender roles to spontaneous responses to marginalisation adopted by women, and reactionary disapproval proclaimed by men confronted with unemployment. Findings discussed show how women’s efforts in navigating everyday life through strategic income-generation and self-reliance are interpreted as transgressive by disenfranchised men when coupled with broadened claims to space and personal freedom. This article highlights the need for structural, gender-sensitive responses to shifting earning capabilities among migrant youth across the rural–urban divide in order to safeguard women’s rights as citizens across the Global South.

Postpartum depression (PPD) harms maternal and child health. Evidence showed elevated PPD during the COVID-19 pandemic, but post-pandemic data from low-resource urban settings are limited. We measured PPD prevalence and its correlates among mothers attending postnatal clinics in Bole sub-city, Addis Ababa, Ethiopia, during the post-COVID-19 period (data collection: 1 March–30 April 2024). An institution-based cross-sectional study enrolled 410 mothers who delivered 2 weeks–1 year prior, attending five primary health centres. Participants were selected using systematic random sampling, with proportional allocation based on client flow across five primary health centers. Depressive symptoms were screened with the Edinburgh Postnatal Depression Scale (EPDS); a cutoff ≥11 defined probable PPD. Data were entered in EpiData and analysed in SPSS. Bivariate analyses (p < 0.25) identified candidates for multivariable logistic regression; adjusted odds ratios (AOR) with 95% confidence intervals (CI) and p < 0.05 indicated statistical significance. A total of 410 mothers participated (mean age 28.8 ± 4.7 years). The prevalence of postpartum depression (PPD) was 20.0% (82/410; 95% CI: 16.4–24.1%). In multivariable logistic regression analysis, primiparity (AOR = 7.83; 95% CI: 1.29–47.71), unplanned pregnancy (AOR = 2.49; 95% CI: 1.25–4.95), poor partner support (AOR = 13.23; 95% CI: 3.08–56.94), low social support (AOR = 3.31; 95% CI: 1.13–9.74), and induction of labor (AOR = 2.73; 95% CI: 1.13–6.60) were independently associated with higher odds of postpartum depression. One in five mothers screened positive for PPD in this post-COVID-19 urban primary-care sample. First-time mothers and those with limited partner or social support, unplanned pregnancies, or induction of labour are at elevated risk. Integrating routine PPD screening into postnatal care, strengthening partner- and community-based support, and expanding family-planning and counselling services are priority measures to reduce PPD burden in Addis Ababa and similar settings.

African cities apply new planning tool to guide urban NbS action for climate resilience: insights from Addis Ababa and Kigali