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Objective: This study seeks to examine the impact of war on maternal mortality following an exacerbation in the dynamics of inequality in maternal health caused by the continuing conflict. Design: Community‐based cross‐sectional study. Setting: Tigray region of Northern Ethiopia, between November 2020 and May 2022. Population: This study surveyed a total of 189 087 households from six of the seven zones of Tigray in 121 tabiyas from 31 districts selected. A multistage cluster sampling technique was used to select the districts and tabiyas. Methods: The study was conducted in two phases. In the first phase, reproductive‐age deaths that occurred during the study period were screened. In the second phase, verbal autopsies were conducted at the screened households. Main Outcome Measures: Maternal mortality ratio level and cause‐specific mortality. Results: The results of the study showed that the maternal mortality ratio was 840 (95% CI 739–914) per 100 000 live births. Haemorrhage, 107 (42.8%), pregnancy‐induced hypertension, 21 (8.4%), and accidents, 14 (5.6%), were the main causes of mortality. Additionally, 203 (81.2%) of the mothers died outside of a health facility. Conclusions: This study has shown a higher maternal mortality ratio following the dynamics of the Tigray war, as compared with the pre‐war level of 186/100 000. Furthermore, potentially many of the pregnancy‐related deaths could have been prevented with access to preventive and emergency services. Given the destruction and looting of many facilities, the restoration and improvement of the Tigray health system must take precedence. [ABSTRACT FROM AUTHOR]

Background: Pneumonia is a major reason for hospital admission among children, particularly in resource-poor areas. A hospital stay (length of stay) alone is found to contribute for 46.8% of a household cost for single episode of severe pneumonia. The aim of this study was to determine the incidence of recovery from severe pneumonia and predictors among children 2–59 months of age admitted to pediatric ward of Ayder Comprehensive Specialized Hospital (ACSH). Methods: A retrospective facility-based cohort study was conducted among under-five-year-old children admitted in ACSH. Three years medical records from July 7, 2015 to July 6, 2018 were reviewed. A total of 285 children with severe pneumonia admitted to pediatric ward of ACSH were included. Kaplan-Meier Survival Curve was used to estimate recovery time. The independent effects of covariates on recovery time are analyzed using multivariate Cox-proportional adjusted model. Result: The median survival time was four days (95% CI = 3.732 – 4.268). The incidence of recovery was 92.3%. Co-morbidity (AOR: 3.47, 95%CI, 2.21, 5.4), malnutrition (AOR = 1.9, 95%CI, 1.2, 3.1), duration of chief complaint (AOR = 0.72, 95%CI: 0.54, 0.94), and vaccination (AOR = 0.32, 95% CI, 0.13, 0.81) were significant predictors of time to recovery from severe pneumonia. Conclusion: High recovery rate and short length of hospital stay was observed in this study. Increased duration of chief complaint, presence of co-morbidity, being malnourished, and vaccination were factors that associated with time to recovery. Therefore focuses have to be given in increasing the community's health seeking behavior to visit health facility early and especial attention should be given for children with co-morbidity, malnutrition, and unvaccinated children. [ABSTRACT FROM AUTHOR]

Background: Measles is a viral disease and a leading vaccine-preventable childhood killer. More than 95% of measles deaths occur in countries with low incomes and weak health infrastructures. In response to this, Ethiopia prepared a measles elimination strategic plan to achieve by 2020. However, based on the Mini-Ethiopian demographic health survey 2019 the full coverage of immunization is 43% at the country level and it is lowest (20%) in the Afar region where this study was conducted. Therefore, this study aimed to identify the determinants of the measles vaccine dropout rate in Afar regional state which is one of the pastoralist communities in Ethiopia.Methods: Community based unmatched case-control study design was used. The study was conducted in Awash district of Afar regional state, Ethiopia from June 1st -30th 2018. Data were collected from a study unit of 12-23 months old children. For this study, a sample of 166 cases and 331controls were selected by simple random sampling methods and the total sample size was 497. Data were collected using a pretested structured questionnaire by health workers using the local language. Data were entered into Epi-info - 7 and analyzed by SPSS version 20 software and logistic regression was used to assess the determinants measles dropout rate.Results: A total of 487 children participated in this study with a response rate of 97.9%. More than half of the children were female (53.3%) and 113 (35.2%) children mothers' were not attended formal education. Mother who had antenatal care ≤ 2 visits [AOR:=5.7(3.2-10.14)], being in the birth order of 1 - 3 [AOR = 4.47(1.63-12.29)], long waiting time > 60 min at nearby health facility for vaccine [AOR = 2.37(1.36-4.15)], households visit by health extension workers [AOR = 2.03(1.12-3.66)], pregnant women not participating with women development army [AOR = 3.5(1.94-6.18)], and poor maternal knowledge on vaccination [AOR = 3.30(1.9-5.73)] were significant determinants with measles vaccination dropout rate.Conclusions: Health facility and mother characteristics were the determinants of the measles vaccine dropout rate. Therefore, tracing and strict follow up by the health extension works using home visits and women development army at the pastoralist community is necessary to reach them. [ABSTRACT FROM AUTHOR]

Objective: This study seeks to examine the impact of war on maternal mortality following an exacerbation in the dynamics of inequality in maternal health caused by the continuing conflict., Design: Community-based cross-sectional study., Setting: Tigray region of Northern Ethiopia, between November 2020 and May 2022., Population: This study surveyed a total of 189 087 households from six of the seven zones of Tigray in 121 tabiyas from 31 districts selected. A multistage cluster sampling technique was used to select the districts and tabiyas., Methods: The study was conducted in two phases. In the first phase, reproductive-age deaths that occurred during the study period were screened. In the second phase, verbal autopsies were conducted at the screened households., Main Outcome Measures: Maternal mortality ratio level and cause-specific mortality., Results: The results of the study showed that the maternal mortality ratio was 840 (95% CI 739-914) per 100 000 live births. Haemorrhage, 107 (42.8%), pregnancy-induced hypertension, 21 (8.4%), and accidents, 14 (5.6%), were the main causes of mortality. Additionally, 203 (81.2%) of the mothers died outside of a health facility., Conclusions: This study has shown a higher maternal mortality ratio following the dynamics of the Tigray war, as compared with the pre-war level of 186/100 000. Furthermore, potentially many of the pregnancy-related deaths could have been prevented with access to preventive and emergency services. Given the destruction and looting of many facilities, the restoration and improvement of the Tigray health system must take precedence., (© 2023 John Wiley & Sons Ltd.)