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Objective: To assess community practices related to COVID-19 prevention and its associated factors during the early introduction of the disease to the study area., Setting and Participants: A community-based cross-sectional study was conducted in Southern Nations, Nationalities and People's Region, Ethiopia. Ten zonal towns with high population density and mobility and 1239 participants were included in the study., Outcome Measure: A semistructured questionnaire was uploaded to SurveyCTO data collection system with security patterns. Mask usage was assessed by observation, while social distancing and handwashing were assessed by interview. Data were collected by health professionals who have Bachelor of Science degree and above and analysed using SPSS V.25. Descriptive statistics and binary logistic regression were performed., Results: From 1239 individuals, about half, 657 (53%), of respondents were women and about two-thirds, 795 (64.2%), were married. Nearly 9 out of 10 (90.3%) and about 8 out of 10 (82.0%) respondents reported that they frequently wash hands with soap and/or use sanitiser and keep social distancing as means to prevent COVID-19, respectively. Less than three-fifths (57.8%) of respondents wore masks during the interview. In summary, about half (48.9%) of respondents were practising the three recommended methods (social distancing, handwashing and wearing masks). Sex, educational status, family size and overall knowledge about COVID-19 were associated with practising COVID-19 prevention measures., Conclusion: COVID-19 prevention practice was low as only about half of participants were practising social distancing, handwashing and wearing masks. Although awareness creation has been implemented through different forms of media, it should be strengthened in different local languages. Concerned government bodies should strictly follow using masks in public gatherings., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objectives: Uptake of maternal health services remains suboptimal in Ethiopia. Significant proportions of antenatal care attendees give birth at home. This study was conducted to identify the predictors of non-institutional delivery among women who received antenatal care in the Southern Nations Nationalities and Peoples Region, Ethiopia., Design: A community-based cross-sectional survey was conducted among women who delivered in the year preceding the survey and who had at least one antenatal visit. Multistage cluster sampling was deployed to select 2390 women from all administrative zones of the region. A mixed-effects multivariable logistic regression analysis was performed to assess the predictors of non-institutional delivery; adjusted ORs (AOR) with 95% CIs are reported., Results: The proportion of non-institutional deliveries among participants was 62.2% (95% CI 60.2% to 64.2%). Previous experience of short and simple labour (46.9%) and uncomplicated home birth (42.9%), night-time labour (29.7%), absence of pregnancy-related problem (18.8%) and perceived providers poor reception of women (17.8%) were the main reasons to have non-institutional delivery. Attending secondary school and above (AOR=0.51; 95% CI 0.30 to 0.85), being a government employee (AOR=0.27; 95% CI 0.10 to 0.78) and woman's autonomy in healthcare utilisation decision making (AOR=0.51; 95% CI 0.33 to 0.79) were among the independent predictors negatively associated with non-institutional delivery. On the other hand, unplanned pregnancy (AOR=1.67; 95% CI 1.16 to 2.42), not experiencing any health problem during pregnancy (AOR=8.1; 95% CI 3.12 to 24.62), not perceiving the risks associated with home delivery (AOR=6.64; 95% CI 4.35 to 10.14) were the independent predictors positively associated with non-institutional delivery., Conclusions: There is a missed opportunity among women attending antenatal care in southern Ethiopia. Further health system innovations that help to bridge the gap between antenatal care attendance and institutional delivery are highly recommended., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)