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Background: Alcohol consumption during the pregnancy period is high despite the well-established evidence of its harmful effects on pregnancy and infant development. Early identification and behavioral modification are of great significance. This study aimed to assess the prevalence and associated factors of alcohol consumption among pregnant women attending antenatal care at governmental hospitals in the Harari regional state, Eastern Ethiopia. Method: From April 1/2022-May 1/2022, an institutional-based cross-sectional survey was conducted among 589 pregnant women attending antenatal care governmental hospitals in Harari regional state. A systematic random sampling technique was used to select study participants during the study period. Data were collected through face-to-face interview methods using AUDIT-C. The collected data were coded, entered into Epi-data data version 3.1, and analyzed by SPSS Version 26. Binary logistic regression was carried out to identify independent predictors of alcohol consumption at a 95% confidence level. Results: From a total of 617 eligible participants, 589 participated in the study with a response rate of 95.46%. The overall prevalence of alcohol consumption among pregnant women in Harari regional state governmental hospitals was 21.2% (95% CI:17.8, 24.4). In multivariate analysis, single marital status (AOR = 5.18;95% CI (2.66,10.11), previous history of abortion(AOR = 4.07;95% CI(2.06,8.04), family history of mental illness (AOR = 4.79;95% CI (1.94,11.83), depression (AOR 2.79; 95%CI(1.35,5.76), and anxiety(AOR = 2.51; 95% CI (1.23, 5.12) were variables found to have a statistically significant association with alcohol consumption during pregnancy in Harari regional state governmental hospitals. Conclusion: In comparison to the majority of other research, the prevalence of alcohol usage during pregnancy was high in this study. This study observed that single marital status, previous history of abortion, family history of mental illness, depression, and anxiety were highly associated with alcohol consumption during pregnancy. Hence, responsible bodies working on mother and child health should try to mitigate or remove the above-mentioned risks when developing interventions. [ABSTRACT FROM AUTHOR]

Background: Depression during pregnancy has a significant impact on public health as it can adversely affect both the mother's and the child's health. These can have devastating effects on the mother, the unborn child, and the entire family. Objective: This study aimed to determine the prevalence of depressive symptoms and associated factors among pregnant women in Ethiopia. Method: An institutional-based cross-sectional study was conducted among pregnant women attending antenatal care services at comprehensive specialized hospitals in Northwest Ethiopia from May to June 2022. Measurement: The desired data were collected through face-to-face interview techniques by using validated questionnaires such as the Edinburgh Postnatal Depression Scale, the Oslo-3 social support scale, and the Abuse Assessment Screen tools. The data were analyzed by using SPSS Version 25. Logistic regression analysis was used to identify factors associated with antenatal depressive symptoms. Variables having a p-value of<0.2 in the bivariate analysis were entered into the multivariable logistic regression. A p-value of <0.05 was considered statistically significant, at 95% CI. Results: This study revealed that 91 (19.2%) pregnant women screened positive for depressive symptoms. According to multivariable logistic regression, living in rural areas (adjusted odds ratio (AOR) = 2.58, 95% CI: 1.267, 5.256), being in the second or third trimesters of gestational phase (AOR = 4.40, 95% CI: 1.949, 9.966 and AOR = 5.42, 95% CI: 2.438, 12.028, respectively), having a history of alcohol use (AOR = 2.41, 95% CI: 1.099, 5.260), having moderate or poor social support (AOR = 2.55, 95% CI: 1.220, 5.338 and AOR = 2.41, 95% CI: 1.106, 5.268), and having a history of intimate partner violence (AOR = 2.67, 95% CI: 1.416, 5.016) were the factors significantly associated with depressive symptoms at a p-value of ≤ 0.05. Conclusion and recommendation: The prevalence of depressive symptoms among pregnant women was high. Living in rural areas, second and third trimesters, use of alcohol, having moderate to poor social support, and having a history of intimate partner violence were variables significantly associated with depressive symptoms during pregnancy. [ABSTRACT FROM AUTHOR]

Background Anemia is a worldwide problem with serious effects for mothers and their babies. Although efforts have been made to lessen the burden of anemia, it has remained a problem. Moreover, there is a paucity of information regarding the perinatal outcomes of anemia in the study area. Thus this study aimed to assess the perinatal outcomes in anemic pregnant women in eastern Ethiopia. Methods A facility-based cross-sectional study was conducted among 407 systematically selected pregnant women. Data were collected by interview and entered into EpiData version 3.1 and then exported into SPSS for Windows version 20 for analysis. Bivariate and multivariate analyses were employed to determine the association between independent variables and the outcome variable. Results Among pregnant women, 61.9% had an adverse perinatal outcome. The most common reported adverse perinatal outcomes were preterm birth, congenital anomalies and stillbirths. Furthermore, variables such as educational status (adjusted odds ratio [AOR] 2.11 [95% confidence interval {CI} 1.245 to 3.58]), antenatal care follow-up (AOR 2.75 [95% CI 1.47 to 5.18]) and hemoglobin level (AOR 4.1 [95% CI 2.609 to 6.405]) were significantly associated with perinatal outcomes. Conclusions Nearly three-fourths of anemic pregnant women experienced adverse perinatal outcomes. In general, this study identified that educational status, antenatal follow-up and hemoglobin level were associated with perinatal outcomes among anemic pregnant women. To prevent adverse perinatal outcomes, efforts must be made to ensure that all pregnant women receive antenatal care and have adequate maternal nutritional status. [ABSTRACT FROM AUTHOR]

BACKGROUND: Woman-friendly care plays a crucial role to enhance maternal health service utilization particularly in settings wherever maternal health service utilization is low. However, it doesn't get appropriate attention in our country with low maternal health service utilization. Therefore, this aimed to assess the provision of women-friendly care and its associated factors among mothers attending antenatal care at Jimma public health institutions. METHODS: An institution-based cross-sectional study was conducted among 303 pregnant women who attended antenatal care at Jimma public health institutions from December 1 to December 30, 2020. The sample size was calculated using the single population proportion formula and samples were taken after proportional allocation was done for the hospital and health centers using the proportion allocation formula. Data were entered into EpiData version 3.1.1 and exported into statistical packages for Social Sciences version 21.0 for cleaning and further analysis. Binary logistic regression was used to analyze the association between women-friendly care and explanatory variables. The strength of association was evaluated using an odds ratio at a 95% confidence interval and a p -value less than (<) 0.05 was considered to declare significant associations. RESULTS: A total of 322 pregnant women were involved in this study and 19 questionnaires were incomplete giving a response rate of 94.1%. The proportion of women-friendly care was 60.1%[(95% CI); (55.1–66.1)]. Women-friendly care was significantly associated with marital status AOR = 2.7[(95%CI); (1.32–5.63)], residence AOR = 4.1[(95%CI); (1.97–8.6)], mode of delivery AOR = 0.18[(95%CI); (0.05–0.6)], and choice of the health care provider AOR = 16.5[(95%CI); (6.9–37.6)]. CONCLUSION AND RECOMMENDATION: The provision of women-friendly care in this study was lower than the World Health Organization focused antenatal care recommendation. Therefore, the provision of women-friendly care that reflects factors associated with it during the provision is recommended. Health professionals and other stakeholders should consider that women may refuse to seek care from a provider who "abuses" them or does not treat them well, even if the provider is skilled in preventing and managing complications. [ABSTRACT FROM AUTHOR]

Background: Physiological changes during pregnancy cause alterations in concentration of biochemical analytes. Thus, locally established pregnancy-specific reference intervals are important for accurate diagnosis, treatment, and prognosis of diseases. The objective of the study was to establish reference interval for the common renal and liver function clinical chemistry parameters among pregnant and non-pregnant women of South Wollo zone, Ethiopia. Methods: A community-based cross-sectional study was conducted on a total of 323 apparently healthy study participants randomly selected from South Wollo zone, Ethiopia, from April to June 2019. Medical history, physical examination and sociodemography were collected by using questionnaire. Liver and renal function clinical chemistry tests were done using A25 Biosystems, clinical chemistry analyzer. After the exclusion of outliers, Kolmogorov–Smirnov test was used to check its normality. The 95% RI with 95% confidence interval was established using the nonparametric method. The significance of differences was evaluated using Mann–Whitney U test. Result: There was statistically significant variation between pregnant and non-pregnant women in values of albumin, T. protein, ALP, urea and creatinine, but not for AST, ALT, bilirubin (direct) and bilirubin (total). Reference intervals established for pregnant women includes albumin 26.14– 42.87g/L, total protein 48.52– 74.71 g/L, AST 2.4– 43.6 U/L, ALT 0.94– 28.35 U/L, ALP 21.2– 337 U/L, bilirubin (direct) 0.03– 0.32 mg/dL, bilirubin (total) 0.26– 0.94 mg/dL, creatinine 0.29– 0.87 mg/dL, urea 7.17– 20.82 mg/dL. Albumin: 32.81– 47.87, total protein: 56.71– 83.9 U/L, AST: 4.2– 37.1 U/L, ALT: 2.69– 41.18 U/L, ALP: 3.22– 278.7 U/L, bilirubin (direct) 0.1– 0.51 mg/dL, bilirubin (total) 0.24– 1.06 mg/dL, creatinine 0.44– 1.00 mg/dL, urea 8.07– 27.87 mg/dL for non-pregnant women. Conclusion: The study showed marked difference in albumin, total protein, alkaline phosphatase, urea and creatinine. Therefore, physiological adaptations of pregnancy should be considered when interpreting liver and renal function tests in a pregnant woman. [ABSTRACT FROM AUTHOR]

Background: Current data suggest that far more women around the world are exposed to abuse by health care providers while receiving maternity care. This predisposes them to psychological distress; abstain from accessing health facilities for care and end up with avoidable death and disability. Objective: To assess the level of respectful care during delivery among mothers giving birth in public health facilities in Ilu AbaBor, Southwest Ethiopia, 2019. Materials and methods: An institution-based cross-sectional study was conducted among 285 randomly selected mothers in the post-natal ward from 17 health facilities in 2019. Data were collected through interviewer-administered pre-tested questionnaires. The collected data were entered into Epi-data version 3.1 statistical and analyzed by SPSS version 21. Both bivariable and multivariable logistic regression models were employed. Results: The proportion of respectful care during maternity care in health care institutions of Ilu Ababor zone was 47.3%. In the multivariable logistic regression; age (AOR 0.25, 95% CI 0.08, 0.81), occupation (AOR 4.16: (1.34, 12.9)), planned pregnancy (AOR 0.28: (0.12, 0.67)), mode of delivery (AOR 0.05: (0.01, 0.33)), and receiving care from providers who had a compassionate and respectful care training (AOR 0.13: (0.06, 0.25)) were independent predictors of respectful care. Conclusions: The proportion of respectful care of the health institution in the Ilu Ababor zone was low compared to the other studies. Variables like; age, occupational status, pregnancy plan, mode of delivery, facing complications during labor and delivery, and taking compassionate and respectful care training were independent predictors of respectful maternity care. This study recommended that the responsible stakeholders should strengthen monitoring and evaluation of the practice and mainstreaming of respectful maternity care, give training for health professionals, and develop guidelines used to monitor, report, and track barriers to the practice of maternity care. Plain English Summary: Respect during maternity care advocates that females' experiences of delivering are a crucial part of service standard: autonomy, dignity, feelings, choices, and preferences must be valued. If a facility is not providing care properly, it affects utilization of maternity services and their satisfaction is also affected by the way they are treated. Two hundred eighty-one (281) post-natal women participated in this research, giving a 98.5% response rate. Most (34.2%) of mothers were in the age category of 25 to 29 years, attained at least primary education (40.9%) while most (87.2%) of them are married, housewives (32%) in occupation, Oromo (66.9%) in ethnicity with a monthly income of less than 1200 ETB (52.3%) and urban (51.2%) residents. In conclusion, the proportion of respectful care at the health institution of Ilu Ababor zone is 47.3%, which is low. Age, occupational status, pregnancy plan, mode of delivery, facing complications during labor and delivery, and taking respectful care training were independent predictors of respectful care at the health facilities. This study recommended that the responsible stakeholders should strengthen monitoring and evaluation of the practice and mainstreaming of respectful maternity care, give training for health professionals, and develop guidelines used to monitor, report, and track barriers to the practice of maternity care. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to assess the timely initiation of Antenatal Care and associated factors among pregnant women attending antenatal care clinics at Bahir Dar city, North West Ethiopia. Design: Institutional based cross‐sectional study was conducted. Methods: Data were collected on 804 pregnant women from 20 February to 27 March 2017. Face‐to‐face interview through systematic sampling technique was applied. Binary logistic regression was performed using SPSS software version 21, and the level of significance of association was determined at p‐value <0.05 with a 95%confidence interval. Results: This study identified 44.2% of pregnant women started their first antenatal care timely. Maternal secondary and above level of education AOR = 7.07 (95% CI: 4.41, 11.35)), age at first pregnancy >18 years AOR = 2.77 (95% CI: 1.39, 5.57) and having information about the correct time of ANC booking AOR = 3.14 (95% CI: 1.67, 5.92) were significantly associated with timely commencement to first antenatal care. [ABSTRACT FROM AUTHOR]

Background: Balantidium coli is a ciliated protozoan parasite, which causes intestinal and extraintestinal infections in humans. It is transmitted feco-orally by ingesting infective cysts with food and water. Urinary balantidiasis may occur through contamination (direct spread from the anal area), secondarily to rectovaginal fistula and following immune suppression. Data about cases of urinary balantidiasis are rare in the world. Currently, there are no documented reports of urinary balantidiasis in Ethiopia. As our understanding, there are only eleven documented reports of urinary balantidiasis globally. However, cases of urinary balantidiasis among pregnant women have not been documented yet. The aim of this report is to alarm health professionals for considering the occurrence of such rare cases and conduct diagnosis. Case Presentation: A 24-year old pregnant woman was admitted due to severe preeclampsia and preterm delivery at Debre Tabor Comprehensive Specialized Hospital, gynecology ward. Her urine was presented to inpatient laboratory for routine urinalysis. We detected unusual and ciliated parasite from her urine sediment characterized by its active and rotary motility through its cilia and possessing macro- and micro-nuclei, several food vacuoles and ingested red blood cells inside the cytoplasm. Hematuria, many white blood cells and epithelial cells were also detected from the urine sediment, which suggests genito-urinary tract infection due to this parasite. This rare parasite finding was confirmed to be B. coli. Conclusion: The route of transmission and extraintestinal existence from this woman's urine was unclear. It might be due to feco-oral transmission and spread to the genitourinary tract through direct anal contact. Moreover, it might be associated with immune suppression as she is pregnant woman. [ABSTRACT FROM AUTHOR]

Introduction: early commencement of antenatal care by pregnant women as well as regular visits has the potential to affect maternal and fetal outcomes positively. Even with antenatal care, the intervention requires fewer resources; however, most pregnant women in sub-Saharan Africa have begun late for antenatal care services. This study aimed to assess the magnitude and contributors of late antenatal care initiation among pregnant women at selected public health institutions of the Bench-Sheko Zone in southwest Ethiopia. Methods: a cross-sectional study was conducted among 509 pregnant women attending the Antenatal Care (ANC) service at selected public health institutions. The data were collected using a structured and pre-tested questionnaire. The data were entered using Epi-data version 3.1 and analyzed using SPSS version 22. A binary logistic regression analysis was computed to determine the association using crude and adjusted odds ratios at 95% confidence intervals. Independent variables with a p-value of less than 0.05 in the multivariable logistic regression model were considered significant. Results: of the 509 respondents interviewed, 337 (66%) reported late antenatal care initiation. The factors associated with late antenatal care initiation were mothers aged 25 years and above (AOR = 1.59, 95% CI [1.02, 2.48]), attended below secondary school (AOR =2.33, 95% CI [1.05, 5.19]), unplanned pregnancy (AOR=2.25, 95%CI [1.34, 3.77]), pregnancy recognition by missing period (AOR=0.61, 95%CI [0.39, 0.93]), perceived right time of ANC after 4 months (AOR=2.29, 95% CI [1.36, 3.85]), and did not get advice to have ANC (AOR=1.64, 95% CI [1.10, 2.45]). Conclusion: the majority of pregnant women initiate their first antenatal care lately. We can conclude that late antenatal care initiation is a major problem in the study area. Therefore, providing continuous health education on the importance of initiating antenatal care visits early to prevent unwanted pregnancy outcomes is an important segment of intervention that can be done through health extension workers. [ABSTRACT FROM AUTHOR]

Background: Bed net utilization is one of the important methods of malaria prevention. Malaria during pregnancy is one of the fatal diseases which mostly leads to the death of the mother and the fetus. Some of the complications of malaria during pregnancy are: intrauterine growth restrictions, intrauterine fetal death, and stillbirth. The main challenge of malaria treatment is that most of the anti-malarial drugs are not safe to use during pregnancy. The use of bed net is the most effective method of prevention of malaria during pregnancy. There is a paucity of information on bed net utilization among pregnant women in the study setting. Hence, this study aims to assess the trends of bed net utilization among pregnant women in Arba Minch Health and Demography Surveillance Site (HDSS), Southern Ethiopia. Methods: The study was conducted in the Arba Minch HDSS. The observation started in 2010 till 2016, using a repeated cross-sectional study design. The data was collected using interviewer administered questionnaire biannually with a total of 14 rounds of data collection from 2010 to 2016. A total of 2657 pregnant women were included in the study. Descriptive statistics such as frequency and proportion were used to present the findings of each variable. Results: Out of 2657 mothers included in the study, more than half, 1521 (63.6%), of the study participants were in the age group between 20 and 29 years. About one-third of the study population 793 (29.8) were having no schooling. The trend of bed net utilization decreased from 83.6% in 2010 to 36.5% in 2016. Conclusion: The trends of bed net utilization decreased from 2010 to 2016 in Arba Minch HDSS. Utilization of bed net by pregnant women in the area need to be increased as it is malaria endemic. The government should strengthen the existing bed net distribution strategy. Further research is needed to investigate the cause of decreasing bed net utilization. [ABSTRACT FROM AUTHOR]

Background: Though antenatal depression (AND) has a risk of maternal and fetal morbidity and mortality, it is a neglected component of pregnancy care in Ethiopia. Research evidence is compulsory in different parts of the country to alleviate this problem. Thus, this study was needed to assess antenatal depression and its associated factors, which can help antenatal care (ANC) providers and program coordinators focus on the mental health of pregnant mothers., Objectives: This study aimed to assess antenatal depression and associated factors among pregnant women attending ANC at public health facilities in the Gida Ayana district, Oromia Region, West Ethiopia, in 2022., Methods: A facility-based cross-sectional study was conducted among 370 pregnant women attending ANC at public health facilities. Systematic random sampling techniques were used to select study participants. A standard (validated) tool, the Edinburgh Postnatal Depression Scale, was also used to assess antenatal depression. The collected data were coded, entered into Epi-data software version 4.6, and analyzed by SPSS version 23. Multivariable logistic regression analyses were used to identify associated factors with a p -value <0.05., Results: In this study, the prevalence of antenatal depression was 62 (16.8%; 95% CI: 13, 20.5). Being single in marital status (AOR = 3, 95% CI: 1.5, 6.2), having an unplanned pregnancy (AOR = 2.7, 95% CI: 1.45, 5.1), and having partner conflict (AOR = 3.49, 95% CI: 1.79, 6.8) were the factors associated with antenatal depression., Conclusion: About one in five pregnant women has antenatal depression. Being single, having an unplanned pregnancy, and having a dissatisfied relationship with a sexual partner were the factors associated with antenatal depression. Therefore, women or partners are expected to plan pregnancy, and the dissemination of health information related to an unplanned pregnancy needs to be intensified by health providers. The partner ought to avoid conflict during the pregnancy, and healthcare providers or families are needed to support the single or widowed pregnant women. Further prospective cohort studies are needed to ascertain the effect of antenatal depression on fetal-maternal outcomes., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Oljira, Abdissa, Lema, Merdassa, Wakoya Feyisa and Desalegn.)

Background: Antenatal care is a care given for pregnant women and is taken as a key maternal care service in improving and keeping health of both life outcomes for mothers and newborns. Countries with low antenatal care coverage are the countries with very high maternal mortality ratios., Objective: Hence, The aim of this study was to determine the level of late initiation of antenatal care visit and associated factors amongst antenatal care follow up in Antenatal care (ANC) services at Gedo General Hospital, Western Oromia Region, Ethiopia, 2021., Methodology: A health facility based cross-sectional study design was conducted from July 10-30, 2021 using primary data review and face-to-face interviews among clients receiving ANC. A total of 347 mothers was selected by simple random sampling and were interviewed while they come to antenatal care follow-up in Gedo general hospital. Data were entered into Epi-data version 4.6 and then changed to SPSS version 23 for the analysis purpose. Those Variables which are P < 0.25 in binary logistic regression were selected as a candidate for multiple logistic regressions to determine independently associated factors. The adjusted odds ratio was employed with 95% CI to illustrate the strength of association and P < 0.05 was used to state a statistical significance., Result: Among 330 women, about 58.5% of women came for their first ANC visit initiation lately. Being a housewife, having a family size >4, and having a distance from the health facility >1 h were higher odds of late first ANC visit initiation as compared to vice versa . Besides, women aged 20-24 years had 0.18 times and 25-29 years had lower odds of late first ANC visit initiation., Conclusion: Majority of women began their first antenatal care initiation lately. Therefore, the provision of awareness on the significance of attending the first antenatal care early via health extension workers is recommended., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Debelo and Danusa.)

Background: Patients with depressed mental disorders may experience a lack of interest or pleasure, a poor mood, feelings of guilt or unworthiness, sleep and appetite disturbances, and easy fatigability. Based on the degree of the condition, depression is classed as mild, moderate, or severe. Maternal depression is the most common psychiatric condition during pregnancy, and its harmful effects have serious ramifications for both the mother and the fetus. Almost one in every four women will experience depression at some point in her life, the majority of which will occur during her childbearing years. Studies reports showed that antenatal depression is a common maternal problem in Ethiopia and as reported antenatal depression ranges in Ethiopia from 19.04 to 29.92%., Objective: To assess the prevalence of maternal depression and associated factors among antenatal care attendants at Wolayta Sodo Teaching and Referral hospital, Southern Ethiopia., Methods: Health facility based cross-sectional study was conducted at Wolayta Sodo Teaching and Referral Hospital from May 01 to 30, 2018. Data were collected from through face to face interview at exit from antenatal care unit using structured questionnaire and checklist adopted from patient Health Questionnaire (PHQ-9). Data were collected from 309 antenatal attendant mothers using systematic random sampling from each either mother. Binary and multivariable logistic regression model was employed to identify factors associated with maternal depression at P -value <0.05 level of significant., Result: Depression among pregnant mother was found to be 27.2% (95% Cl: 22, 32%). Women's level of education; being elementary school (AOR = 6.35 95%CL (2.32, 17.38), completing high school and above (AOR = 3.35, 95%CL 1.33, 8.47) were associated with maternal depression whereas having good husband support was protective for maternal depression (AOR = 0.4, 95%CL: 0.19, 0.83) and also not using substance during pregnancy period was protective for maternal depression (AOR = 0.39, 95%CI, 0.19, 0.77)., Conclusion: The frequency of mother depression in this community was greater than in previous Ethiopian studies reported. Maternal depression was linked to a woman's level of education, husband support, and substance usage. This suggested that health care providers regarding pregnant women should emphasize the importance of husband support, substance usage and women level of education., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer TF declared a shared affiliation with the authors to the handling editor at time of review., (Copyright © 2022 Borie, Siyoum, Tsega and Anbese.)

Background: Pregnancy can aggravate nutritional deficiencies, especially micronutrient deficiencies, which can have major health impact for the fetus and mother. Women in low-income countries are frequently malnourished when they become pregnant. Identifying the magnitude of dietary diversity and its influencing factors among pregnant women in the pastoral region of Afar, where no study has been conducted, is critical for establishing an intervention program in the region., Method: A mixed study comprising 241 pregnant women and six focus group discussions was conducted from October 1 to November 10, 2018. Participants in the quantitative study were selected by a systematic sampling method, whereas those in the focus group discussions were selected by a purposive sampling method. The data were collected using pretested questionnaires administered via face-to-face interviews. Logistic regression determines the association between the dietary diversity practice and its influencing factors. The results were presented by the odds ratio with a 95% confidence interval. A P-value of < 0.05 is used to declare a statistically significant. A thematic framework was used to analyze the qualitative data., Results: Seventy-three percent of pregnant women had poor dietary diversity. Dietary diversity was higher in younger pregnant women who were under the age of 20 years (AOR = 5.8; at 95% CI: 1.6-13.5) and aged between 21 and 25 years (AOR = 3.9; at 95% CI: 1.1-12.2) than those pregnant women over the age of 30 years. Those participants with a high average family income (above 4500 birr) had good dietary diversity compared to those with an average family income of less than 1500 birr (AOR = 0.1: 95% CI; 0.02-0.7) and 1500-3000 birr (AOR = 0.05: 95% CI; 0.01-0.2). Pregnant women who had one antenatal care visit had less dietary diversity practice than those who had four or more antenatal care visits (AOR = 0.18: 95% CI; 0.04-0.8). Protein-rich foods (meat and eggs), cereal-based semi-solid foods (porridge and soup), milk, bananas and cabbage, were the most commonly tabooed foods during pregnancy. Protein-rich foods were thought to increase the size of the fetus. Semi-solid foods (porridge and soup), bananas, and cabbage, on the other hand, were thought to stick to the fetus's body., Conclusion: Most of the study participants had poor dietary diversity. Older women have lower dietary diversity practices than younger women. Pregnant women with a low family income and only one prenatal care visit were less likely to practice dietary diversity than pregnant women with a high family income and those with four or more antenatal care visits. Pregnant women practiced food taboos due to misconceptions that were producing large babies and attached to the babies' bodies. A public health campaign emphasizing the necessity of antenatal care follow-ups should be launched. Community nutrition education should be provided to reduce the traditional beliefs about certain foods, especially for older women., (© 2022. The Author(s).)

Background: Effectiveness of prenatal iron supplementation program depends on utilization of the supplement by pregnant women. Nevertheless, in Ethiopia, regardless of increasing efforts, lower proportion of pregnant women use the supplementation for recommended 3 months and above but, the reason is not clear. This study aimed to identify the level and factors associated with utilization of prenatal iron supplementation., Methods: A community based cross-sectional quantitative study complemented with qualitative component was carried out in January, 2016. A total of 411 pregnant women who gave birth 6 months preceding data collection were selected using multi-stage cluster sampling technique. Qualitative data were collected by conducting four focus group discussions (FGDs) of local pregnant mothers and interviewing district maternal and child health (MCH) focal, 3MCH heads of health centers and four health extension workers. Factors associated with appropriate utilization of supplementation were assessed using multivariate logistic regression. The outputs of analyses were presented using Adjusted Odds Ratio (AOR) with 95% confidence intervals (CI)., Result: From the study participants, 11.5% (95% CI = 9.9-13.1%) took the supplement for the recommended duration of 3 months or above. Pregnant women who could not read and write had 77% reduced odds of using iron supplementation than their counterparts (AOR = 0.23(95% CI: 0.07-0.75)). As compared to women who had four or more antenatal care (ANC), women with 2 and 3 ANC visits had 78% (AOR = 0.22(0.07-0.63)) and 66% (AOR = 0.34(0.14-0.81)) reduced odds of using the supplementation, respectively. As compared to women who were aware of benefits of taking the supplement for maternal and child health, the counterparts had 90% (AOR = 0.10 (0.10-0.63)) reduced odds of using the supplement. Women who were not knowledgeable of anemia had 85% (AOR = 0.15(0.04-0.62) reduced odds of using the supplement than those who were knowledgeable. The qualitative study indicated that there was no problem in the supply and logistic system of iron supplement and leading reasons for not taking the supplement were late initiation of Antenatal Care, lack of awareness and occurrence of side effects; unpleasant taste, nausea, vomiting., Conclusion: In the study area utilization of prenatal iron supplementation is very low. Improving maternal education, ensuring early and frequent ANC, educating pregnant women about the benefits of service and ensuring comprehensive knowledge of anemia expected to improve the utilization of prenatal iron supplementation.