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Dawit Wolde Daka,1 Mirkuzie Woldie,1,2 Meskerem Seboka Ergiba,1 Birhanu Kenate Sori,3 Dereje Abdena Bayisa,3 Asfaw Benti Amente,3 Firew Tekle Bobo4,5 1Faculty of Public Health, Department of Health Policy and Management, Jimma University, Jimma, Ethiopia; 2Fenot Project, Harvard T.H. Chan School of Public Health, Addis Ababa, Ethiopia; 3Policy, Planning, Monitoring and Evaluation Directorate, Oromia Region Health Bureau, Addis Ababa, Ethiopia; 4Institute of Health Science, Department of Public Health, Wollega University, Nekemte, Ethiopia; 5School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, AustraliaCorrespondence: Dawit Wolde DakaJimma University, P.O. Box=378, Jimma, EthiopiaTel +251-966763913Email dave86520@gmail.comBackground: Despite improvement in the coverage of most maternal, newborn, and child health services, inequality in the uptake of services still remains the challenge of health systems in most developing countries. This study was conducted to examine the degree of inequities and potential predictors of inequity in reproductive and maternal health services utilization in the Oromia region, Ethiopia.Methods: The 2016 Ethiopian demographic and health survey data set was used. Utilization rate of four maternal health service categories (family planning, antenatal care, facility based delivery and postnatal care) was considered in the analysis. Equity in each of these indicators was assessed by residence (urban/rural), wealth index, and educational status. Inequality in service utilization was estimated using rate ratios, concentration curve, and concentration indices.Results: Overall data of 5701 women were used in this analysis. The concentration index to all of the maternal health service utilization indicators showed significance. The concentration index of family planning, antenatal care, facility based delivery, and postnatal care was 0.136 (95% CI=0.099– 0.173), 0.106 (95% CI=0.035– 0.177), 0.348 (95% CI=0.279– 0.418), and 0.348 (95% CI=0.279– 0.418), respectively. Maternal age and all of the three socio-demographic factors (residence, education, and wealth) showed inequitable distribution of maternal health service utilization in the Oromia region. The majority of women who were in the favored groups utilized the key reproductive and maternal health services.Conclusion: The utilization of maternal health services in the study area is grossly skewed to those who are well off, educated, and live in urban areas. Any action intended to improve utilization of maternal and child health services should aim to reduce the unnecessary and avoidable disparity demonstrated in our analysis. This of course demands multisectoral intervention to impact on the determinants.Keywords: inequity, reproductive health, maternal health, utilization, Oromia, Ethiopia

Background Patient-safety culture is an important component of health-care quality and currentlyan issue of high concern globally. In Ethiopia, little is known about patient-safety culture in hospitals. We assessed the patient-safety culture and associated factors among health-care workers in public hospitals of East Wollega Zone, western Ethiopia. Methods This institution-based cross-sectional study was conducted among 421 health-care workers selected using simple random sampling from March 4 to March 29, 2019. A standardized measuring 12 patient safety–culture components was used for data collection. Data were cleaned and entered into EpiData version 3.1 and analysis done using SPSS version 25 (IBM). Bivariate and multivariate linear regression analyses were performed. Significance was set at 95% CI and p

Garumma Tolu Feyissa,1,2 Dina Balabanova,3 Mirkuzie Woldie2,4 1Department of Health, Behavior and Society, Jimma University, Jimma, Ethiopia; 2Ethiopian Evidence Based Healthcare: JBI Center of Excellence, Jimma University, Jimma, Ethiopia; 3Department of Health Policy and Management, London School of Hygiene and Tropical Medicine, London, UK; 4Department of Global Health and Population, T.H. Chan Harvard School of Public Health, Addis Ababa, EthiopiaCorrespondence: Garumma Tolu FeyissaDepartment of Health, Behavior and Society, Jimma University, P.o.box 378, Jimma, EthiopiaEmail garummatolu@yahoo.comIntroduction: Mentoring programs are frequently recommended as innovative and low-cost solutions, and these have been implemented in many healthcare institutions to tackle multiple human resource-related challenges. This review sought to locate, appraise and describe the literature reporting on mentorship programs that were designed to improve healthcare worker competence and institutional performance in Africa.Methods: This review searched and synthesized reports from studies that assessed the effectiveness of mentorship programs among healthcare workers in Africa. We searched for studies reported in the English language in EMBASE, CINAHL, COCHRANE and MEDLINE. Additional search was conducted in Google Scholar.Results: We included 30 papers reporting on 24 studies. Diverse approaches of mentorship were reported: a) placing a mentor in health facility for a period of time (embedded mentor), b) visits by a mobile mentor, c) a mentoring approach involving a team of mobile multidisciplinary mentors, d) facility twinning, and e) within-facility mentorship by a focal person or a manager.Implication for practice: Mentoring interventions were effective in improving the clinical management of infectious diseases, maternal, neonatal and childhood illnesses. Mentoring interventions were also found to improve managerial performance (accounting, human resources, monitoring and evaluation, and transportation management) of health institutions. Additionally, mentoring had improved laboratory accreditation scores. Mentoring interventions may be used to increase adherence of health professionals to guidelines, standards, and protocols. While different types of interventions (embedded mentoring, visits by mobile mentors, facility twinning and within-facility mentorship by a focal person) were reported to be effective, there is no evidence to recommend one model of mentoring over other types of mentoring.Implications for research: Further research—experimental methods measuring the impact of different mentoring formats and longitudinal studies establishing their long-term effectiveness—is required to compare the effectiveness and cost-effectiveness of different models of mentoring. Further studies are needed to explore why and how different mentoring programs succeed and the meaningfulness of mentoring programs for the different stakeholders are also required.Keywords: mentoring, Africa, institutional performance, health worker competence, systematic review

Garumma Tolu Feyissa,1–3 Craig Lockwood,3 Mirkuzie Woldie,1,2,4 Zachary Munn3 1Department of Health, Behavior and Society, Jimma University, Jimma, Ethiopia; 2Ethiopian Evidence Based Healthcare Centre, JBI Center of Excellence, Jimma University, Jimma, Ethiopia; 3School of Public Health, The Joanna Briggs Institute, The University of Adelaide, Adelaide, SA, Australia; 4Department of Health Economics, Management and Policy, Jimma University, Jimma, Ethiopia Introduction: Policy makers and health professionals prefer to use preappraised and summarized evidence. Stigma and discrimination (SAD) reduction activities and programs are needed to improve the quality of care delivered to people living with HIV and the success of HIV-related prevention, care and treatment programs. The objective of this review was to identify and describe systematic reviews, best practices, consensus statements, standards of practice and guidelines that addressed SAD among healthcare workers (HCWs). Methods: All documents in the form of systematic reviews, best practices, consensus statements, standards of practice and guidelines were considered for inclusion. The search strategy aimed to find both published and unpublished studies reported in English with unlimited date range in Excerpta Medica Database from Elsevier (EMBASE), Cumulative Index to Nursing and Allied Health (CINAHL), Psychological Information (PsycINFO) database and Medical Literature Analysis and Retrieval System Online (MEDLINE). Websites of organizations and guideline databases were also searched. Two individuals independently appraised the quality of the documents using the Appraisal of Guidelines for Research and Evaluation (AGREEII) checklist and the Joanna Briggs Institute critical appraisal checklist for systematic reviews. Data extraction was done using a customized tool that was developed to record the key information of the source that is relevant to the review question. Results: Twelve records (six guideline-related documents and six systematic reviews) were included in the review. Interventions and recommendations developed to reduce HIV-related SAD were categorized into information-based, structural, biomedical, counseling and support, skills building and contact interventions. Conclusion: Implications for practice: Interventions that reduce HIV-related SAD are broadly categorized into information-based, structural, biomedical, counseling and support, skills building and contact interventions. Because of limited methodological description of the included documents, it was difficult to draw recommendations for policy and practice. Implications for research: Future studies need to use up-to-date instruments to measure SAD. Further studies of greater methodological quality are needed. Guidelines, tools and best practice documents that aim to reduce HIV-related SAD should be developed with the considerations of research evidence on the specific setting and specific targeted populations. Keywords: HIV, stigma, guideline, systematic review