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Abstract Background Contraception is a critical service for women to control their reproductive health, allowing them to determine the number and spacing of their children prevent unintended pregnancies, reduce the risk of morbidity and mortality from associated with childbirth, and reduce the likelihood of abortions. Despite its benefits, the utilization of modern contraceptive methods remains low in certain regions of Ethiopia, Particularly in Afar and Somali, which are also experiencing high fertility rates. However, there is a substantial gap in understanding the sociocultural barriers that hinder the adoption of modern contraception in these regions. This study aims to explore these barriers to contraceptive use among women of reproductive age in Afar and Somali regions, providing qualitative insights that are essential for designing effective strategies to improve contraceptive service utilization. Methods Asequential mixed method approach was employed, including scoping review and qualitative interviews. Scoping review focused on qualitative or mixed-methods studies conducted in Ethiopia and published between 2013 and 2023 in English, Selecting 14 articles Additionally, qualitative data were collected from Afar and Somali regions through In-depth interviews with women aged 15–49 who are married or in consensual union, and key informant interviews with health extension workers and contraception providers at health center. A total of 20 in-depth interviews and 07 key informants were conducted. Thematic analysis was used to analyze the data. Result The integrated findings from the scoping review and qualitative study reveal various barriers and determinants influencing contraceptive use among women in Ethiopia. Barriers includes religious or cultural beliefs, myths and misconceptions, fear of side effects, lack of knowledge and misinformation, negative attitude towards contraceptives, partner opposition, socio-cultural factors, fear of being judged by family and friends, and lack of communication between husband and wife, husband altitude, distance from health facility, availability of service and different contraceptive choice, separate room for family planning services, and cost of contraceptive method and transportation. The scoping review corroborates these findings, emphasizing on the role of socio-demographic, economic, cultural, religious, health service, and knowledge-related factors. Higher education, urban residence, higher income, mass media exposure, spousal communication, family size, and access to quality health services were associated with increased utilization, while lack of awareness, misconceptions, myths, side effects, fear of infertility, partner opposition, social stigma, and cultural norms decreased utilization. Conclusion The study recommended promoting contraceptive use, challenging socio-cultural norms through Social Behavioural Communication and Counselling (SBCC), engaging partners and community members, and improving the quality of care.

Ethiopia is experiencing considerable impact of climate change and variability in the last five decades. Analyzing climate trends and variability is essential to develop effective adaptation strategies, particularly for countries vulnerable to climate change. This study analyzed trends and variabilities of climate (rainfall, maximum temperature (Tmax), and minimum temperature (Tmin)) at local and regional scales in Ethiopia. The local analysis was carried out considering each meteorological station, while the regional analyses were based on agro-ecological zones (AEZs). This study used observations from 47 rainfall and 37 temperature stations obtained from the Ethiopian Meteorological Institute (EMI) for the period of 1986 to 2020. The Modified Mann-Kendall (MMK) trend test and Theil Sen's slope estimator were used to analyze the trends and magnitudes of change, respectively, in rainfall as well as temperature. The coefficient of variation (CV) and standardized anomaly index (SAI) were also employed to evaluate rainfall and temperature variabilities. The local level analysis revealed that Bega (dry season), Kiremt (main rainy season), and annual rainfall showed increasing trend, albeit no significant, in most stations, but the rainfall in Belg (small rainy) season showed a non-significant decreasing trend. The regional levels analysis also indicated an increasing trend of Bega, Kiremt, and annual rainfall in most AEZs, while Belg rainfall showed a decreasing trend in the greater number of AEZs. The result of both local and regional levels of analysis discerned a spatially and temporally more homogeneous warming trend. Both Tmax and Tmin revealed an increasing trend in annual and seasonal scales at most meteorological stations. Likewise, an increase was recorded for mean Tmax and Tmin in entire/most AEZs. The observed trends and variabilities of rainfall and temperature have several implications for climate change adaptations. For example, the decrease in Belg rainfall in most AEZs would have a negative impact on areas that heavily depend on Belg season's rainfall for crop production. Some climate adaptation options include identifying short maturing crop varieties, soil moisture conservation, and supplemental irrigation of crops using harvested water during the main rainy season. Conversely, since the first three months of Bega season (October to December) are crop harvest season in most parts of Ethiopia, the increase in Bega rainfall would increase crop harvest loss, and hence, early planting date and identifying short maturing crops during the main rainy season are some climate adaptation strategies. Because of the increase in temperature, water demand for irrigation during Bega season will increase due to increased evapotranspiration. On the other hand, the increase in Kiremt rainfall can be harvested and used for supplemental irrigation during Bega as well as the small rainy season, particularly for early planting. In view of these findings, it is imperative to develop and implement effective climate-smart agricultural strategies specific to each agro-ecological zone (AEZ) to adapt to rainfall and temperature changes and variabilities.

Article Highlights The annual precipitation of the sub-basin has shown an increasing trend. A considerable upward trend in the annual average temperature was found. The observed rainfall and temperature trends are associated with the hydro-climate trends.

Ethiopia, a densely populated country with abundant natural resources, is often hit by climate extreme disasters that cause severe damage to life and property every year in one or the other corner. The frequency and intensity of extreme events have increased in the recent decades due to climate change and variability. This study aimed to analyze the changes in observed rainfall and minimum and maximum temperature extremes in the Upper Blue Nile Basin (UBNB) of Ethiopia from 1980 to 2019 periods. The Mann-Kendall (MK) trend test and Theil-Sen's slope estimator were used to estimate annual and seasonal trends. The rainfall and temperature extremes were analyzed using RClimDex, which is a graphical user interface in R software, by selecting ten rainfall and eleven temperature indices. The results showed a positive trend in annual, dry (March–May) and small rain (October–February) seasons rainfall in more than 54% of the stations and a decreasing trend in the main rain (June–September) season rainfall in 65.4% of the stations. Several extreme rainfall indices showed insignificant positive trends in the basin. Although there is a positive trend in extreme rainfall, the number of consecutive wet days (CWD) and the simple daily intensity index (SDII) show insignificant negative trends in most stations. In addition, a warming trend of the annual and seasonal maximum and minimum temperature extreme indices was noted. Overall, the increase in extreme rainfall and a warming trend in the extreme temperature indices indicate signs of climate change in the UBNB. The findings of this study suggests the need for developing climate change adaptation and mitigation strategies in the UBNB.

Climate extreme events have been observed more frequently since the 1970s throughout Ethiopia, which adversely affects the socio-economic development of the country, as its economy depends on agriculture, which, in turn, relies heavily on annual and seasonal rainfall. Climate extremes studies conducted in Ethiopia are mainly limited to a specific location or watershed, making it difficult to have insights at the national level. The present study thus aims to examine the observed climate extreme events in Ethiopia at both station and agro-ecological zone (AEZ) levels. Daily rainfall and temperature data for 47 and 37 stations, respectively (1986 up to 2020), were obtained from the National Meteorology Agency (NMA). The Modified Mann–Kendall (MMK) trend test and the Theil–Sen slope estimator were employed to estimate the trends in rainfall and temperature extremes. This study examines trends of 13 temperature and 10 rainfall extreme indices using RClimDex in R software. The results revealed that most of the extreme rainfall indices showed a positive trend in the majority of the climate stations. For example, an increase in consecutive dry days (CDD), very heavy rainfall days (R20), number of heavy rainfall days (R10) and consecutive wet days (CWD) were exhibited in most climate stations. In relation to AEZs, the greater number of extreme rainfall indices illustrated an upward trend in cool and sub-humid, cool and humid, and cool and moist AEZs, a declining trend in hot arid AEZ, and equal proportions of increasing and decreasing trends in warm semi-arid AEZs. Concerning extreme temperature indices, the result indicated an increasing trend of warm temperature extreme indices and a downward trend of cold temperature extreme indices in most of the climate stations, indicating the overall warming and dryness trends in the country. With reference to AEZs, an overall warming was exhibited in all AEZs, except in the hot arid AEZ. The observed trends in the rainfall and temperature extremes will have tremendous direct and indirect impacts on agriculture, water resources, health, and other sectors in the country. Therefore, the findings suggest the need for identifying and developing climate change adaptation strategies to minimize the ill effects of these extreme climate events on the social, economic, and developmental sectors.

BackgroundThe COVID-19 pandemic is one of the most devastating public health emergencies of international concern to have occurred in the past century. To ensure a safe, scalable, and sustainable response, it is imperative to understand the burden of disease, epidemiological trends, and responses to activities that have already been implemented. We aimed to analyze how COVID-19 tests, cases, and deaths varied by time and region in the general population and healthcare workers (HCWs) in Ethiopia.MethodsCOVID-19 data were captured between October 01, 2021, and September 30, 2022, in 64 systematically selected health facilities throughout Ethiopia. The number of health facilities included in the study was proportionally allocated to the regional states of Ethiopia. Data were captured by standardized tools and formats. Analysis of COVID-19 testing performed, cases detected, and deaths registered by region and time was carried out.ResultsWe analyzed 215,024 individuals' data that were captured through COVID-19 surveillance in Ethiopia. Of the 215,024 total tests, 18,964 COVID-19 cases (8.8%, 95% CI: 8.7%- 9.0%) were identified and 534 (2.8%, 95% CI: 2.6%- 3.1%) were deceased. The positivity rate ranged from 1% in the Afar region to 15% in the Sidama region. Eight (1.2%, 95% CI: 0.4%- 2.0%) HCWs died out of 664 infected HCWs, of which 81.5% were from Addis Ababa. Three waves of outbreaks were detected during the analysis period, with the highest positivity rate of 35% during the Omicron period and the highest rate of ICU beds and mechanical ventilators (38%) occupied by COVID-19 patients during the Delta period.ConclusionsThe temporal and regional variations in COVID-19 cases and deaths in Ethiopia underscore the need for concerted efforts to address the disparities in the COVID-19 surveillance and response system. These lessons should be critically considered during the integration of the COVID-19 surveillance system into the routine surveillance system.

SARS-CoV-2 co-infection with the influenza virus or human respiratory syncytial virus (RSV) may complicate its progress and clinical outcomes. However, data on the co-detection of SARS-CoV-2 with other respiratory viruses are limited in Ethiopia and other parts of Africa to inform evidence-based response and decision-making. We analyzed 4,989 patients' data captured from the national severe acute respiratory illness (SARI) and influenza-like illness (ILI) sentinel surveillance sites over 18 months period from January 01, 2021, to June 30, 2022. Laboratory specimens were collected from the patients and tested for viral respiratory pathogens by real-time, reverse transcription polymerase chain reaction (RT-PCR) at the national influenza center. The median age of the patients was 14 years (IQR: 1-35 years), with a slight preponderance of them being at the age of 15 to less than 50 years. SARS-CoV-2 was detected among 459 (9.2%, 95% CI: 8.4-10.0) patients, and 64 (1.3%, 95% CI: 1.0-1.6) of SARS-CoV-2 were co-detected either with Influenza virus (54.7%) or RSV (32.8%) and 12.5% were detected with both of the viruses. A substantial proportion (54.7%) of SARS-CoV-2 co-detection with other respiratory viruses was identified among patients in the age group from 15 to less than 50 years. The multivariable analysis found that the odds of SARS-CoV-2 co-detection was higher among individuals with the age category of 20 to 39 years as compared to those less than 20 years old (AOR: 1.98, 95%CI:1.15-3.42) while the odds of SARS-CoV-2 co-detection was lower among cases from other regions of the country as compared to those from Addis Ababa (AOR:0.16 95%CI:0.07-0.34). Although the SARS-CoV-2 co-detection with other respiratory viral pathogens was minimal, the findings of this study underscore that it is critical to continuously monitor the co-infections to reduce transmission and improve patient outcomes, particularly among the youth and patients with ILI.

Abstract Background One of the strategies to promote child health and reduce child mortality is growth monitoring and promotion services. But, there is limited information on determinants of Growth Monitoring and Promotion service utilization. Objective To identify determinants of growth monitoring and promotion (GMP) service utilization among children 0–23 months of age in Legambo district, South Wollo zone, Northern Ethiopia, 2020. Methods Community based un-matched case-control study was conducted on 363 (91 cases and 272 controls) study participants from March 15 to April 15, 2020. A multi-stage sampling technique was employed to select the study participants. Bivariable and multivariable logistic regressions were performed and an adjusted odds ratio with 95% confidence intervals was estimated to identify determinants of GMP service utilization. Results A total of 358 mothers (89 cases and 269 controls) with 98.6% response rate were included in the study. The mean (±SD) age of child was 11.66(±6.29) months among controls and 15.02 (±6.06) months among cases. Good maternal knowledge (AOR) = 2.42; 95% CI: 1.23, 4.75), favorable attitude (AOR = 2.45; 95% CI; 1.20, 4.98), counseling on GMP (AOR = 2.34; 95% CI; 1.19, 4.56), attending ante natal care services (AOR = 2.46; 95% CI: 1.18, 5.16), index child age 12–17 months (AOR = 3.45; 95% CI: 1.26, 9.41) and 18–23 months (AOR = 4.38; 95% CI: 1.53, 12.49), and short distance to health facilities (AOR = 4.53; 95% CI; 1.99, 10.28) were determinants of GMP service utilization. Conclusion Index child age, good knowledge, favorable attitude, attending antenatal care services, receiving nutritional counseling, and a short distance to health facility were determinants of GMP service utilization. Nutritional interventions should emphasize nutritional counseling and accessibility of growth monitoring and promotion services.