Addis Ababa City Administration Health Bureau

Exclusive breastfeeding is defined as feeding infants only breast milk for the first six months of life, with no additional liquids or solids except prescribed medicines, vitamins, or mineral supplements. This study aimed to compare the prevalence of exclusive breastfeeding and identify factors associated with its practice among employed and unemployed mothers in Arada Subcity, Addis Ababa, Ethiopia, in 2024. A community-based comparative cross-sectional study was conducted from July–August 2024 in four randomly selected woredas of Arada Subcity, Addis Ababa. Using proportional stratified sampling, 808 mother–infant dyads (404 employed, 404 unemployed) with infants aged 0–6 months were enrolled. Exclusive breastfeeding status was determined using a 24-hour recall method, using a pretested interviewer-administered questionnaire adapted from the WHO Infant and Young Child Feeding indicators and the 2016 Ethiopian Demographic and Health Survey. multilevel logistic regression identified factors associated with EBF, reported as adjusted odds ratios (AORs) with 95% CIs. Exclusive breastfeeding during the first six months was reported by 440 mothers (54.7%): 69.0% (95% CI 64.3, 73.4) of nonemployed mothers and 40.3% (95% CI 35.6, 45.1) of employed mothers. Nonemployed mothers had 3.3 times greater odds of practicing EBF (AOR 3.3, 95% CI 2.47, 4.4). Among unemployed mothers, EBF was positively associated with being married, having ≥ 3 years of birth spacing, lacking religious barriers, being comfortable discussing breastfeeding, and receiving counseling. Among employed mothers, higher odds of EBF were linked to working < 20 h/week, being married, having a lower income, the absence of religious barriers, perceived workplace support, and high confidence in breastfeeding while employed. The prevalence of exclusive breastfeeding in Arada was low and more common among nonemployed mothers. EBF practices are significantly influenced by multiple factors. Strengthening workplace support; enhancing family and social support; addressing religious barriers; improving maternal confidence; ensuring effective counseling; and creating supportive environments at home, workplaces, and health facilities are recommended to improve EBF practices in cities. Not applicable.

Background: Antimicrobial resistance, fueled in part by antibiotic non-adherence, is a critical global public health threat. Understanding the scale and drivers of non-adherence at the community level is essential for crafting effective interventions, particularly in low-and middle-income countries like Ethiopia. Objective: This study aimed to assess the prevalence of antibiotic non-adherence and identify its associated factors among household members in Kolfe Keraniyo and Nifas Silk Lafto subcities of Addis Ababa, Ethiopia. Methods: A community-based cross-sectional study was conducted from July to August 2025. A total of 507 households were selected using a multi-stage sampling technique. Data were collected through face-to-face interviews using a structured questionnaire that included the 8-item Morisky Medication Adherence Scale (MMAS-8). Bivariate and multivariable logistic regression analyses were employed to identify factors associated with antibiotic non-adherence. Results: The prevalence of antibiotic non-adherence was 79.5% (95% CI: 75.7-82.9). The most common reason for non-adherence was forgetting to take the medication (39.6%). In the multivariable analysis, lower educational status (AOR=0.003, 95% CI: 0.00-0.023 for college and above vs. illiterate), poor knowledge about antibiotics (AOR=2.43, 95% CI: 1.12-5.30), poor attitude towards antibiotic use (AOR=2.38, 95% CI: 1.20-4.72), experiencing medication discomfort (AOR=2.50, 95% CI: 1.27-4.92), and not receiving prescription information from a drug dispenser (AOR=2.59, 95% CI: 1.29-5.23) were statistically significant factors associated with antibiotic non-adherence. Conclusion and Recommendations: The study revealed an alarmingly high prevalence of antibiotic non-adherence in the community. Public health interventions should prioritize patient education, improve healthcare provider-patient communication, and strengthen antibiotic stewardship programs, with a special focus on individuals with lower educational attainment.

BackgroundImmunization is the safest way to protect against disease. Currently, vaccination saves more than 4 million lives annually. By 2030, 90% of people worldwide are expected to have received the basic immunizations, according to the Immunization Agenda 2030 (IA2030). However, in sub-Saharan Africa (SSA), only 54.1% of children receive the complete set of basic childhood vaccinations. Therefore, this study aims to assess the spatial variation of incomplete basic childhood vaccination and its determinants in SSA by using DHS data from 2019–2024.MethodFor our study, we utilized a total of 28,045 weighted children from 16 selected SSA countries. The vaccination status was determined through both maternal recall and the use of vaccination cards. Spatial autocorrelations, hotspot analysis, spatial interpolation, and SaTScan analysis were conducted to explore the spatial distribution. Ordinary Least Squares (OLS) and Geographical Weighted Regression (GWR) were performed to identify the associated factors of partial immunization.ResultsThe pooled prevalence of partial immunization in SSA was 35.5% [95% CI: 28.49%, 42.51%]. Mauritania, Gabon, Côte d’Ivoire, central Tanzania, Liberia, and northeast Mozambique are among the hotspot regions that have been identified. Higher maternal education, female-headed households, maternal age between 15 and 24 years, absence of antenatal care, and urban residency were all found to be significant predictors with GWR analysis.ConclusionIn SSA, partial immunization shows a clustered spatial pattern with different hotspot areas. The use of maternal health services and socio-demographic factors has an impact on incomplete immunization. Improving vaccination coverage requires focused programs that address awareness creation and service utilization.

Objectives To summarise the best available evidence on tertiary prevention interventions for patients with stroke conducted in African countries, identify the gaps in stroke prevention research and augment efforts to establish stroke rehabilitation guidelines in African countries.DesignWe performed a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement on the basis of a published protocol.Data sourcesWe conducted a systematic search of nine electronic databases, including PubMed, the Cochrane Library and African Index Medicus, published until August 2023 and additionally contacted authors and screened reference lists.Eligibility criteriaWe included randomised controlled trials (RCTs) and prospective cohort studies on African adult patients with a clinical diagnosis of stroke. The primary outcome was global disability, and secondary outcomes were neurologic function scales.Data extraction and synthesisTwo authors independently screened the search results, with data extracted by one author and verified by a second author. The data were narratively synthesised. A meta-analysis was done using a random-effects model for metric data using standardised mean differences. Risk of bias was assessed using the Cochrane Risk of Bias tool.ResultsOf 3305 publications, 25 studies met the inclusion criteria involving cumulatively 973 patients with subacute and chronic stroke. Two-thirds of the trials were conducted in Nigeria and Egypt. The interventions covered physiotherapeutic, electrophysiologic, psychotherapeutic and transitional care domains with mostly beneficial outcomes. All included studies were RCTs with some concerns about methodologic quality.ConclusionThis systematic review comprises heterogeneous effective interventions for tertiary stroke prevention mostly conducted in small productive research clusters. There is a growing body of research from African countries covering important fields of stroke rehabilitation, including local adaptations of the rehabilitation process and new knowledge concerning transcranial magnetic stimulation. There remains an urgent need to implement interventions aimed at overcoming barriers to stroke rehabilitation.PROSPERO registration numberCRD42020159125.

Abstract BackgroundLymphedema is a chronic condition characterized by fluid accumulation and tissue swelling, often complicated by recurrent acute attacks. Nodules, a common feature of chronic lymphedema, may contribute to the frequency and severity of these episodes. However, nodules as a risk factor for acute attacks remains poorly understood. This study aimed to assess the prevalence of nodules, the frequency of acute attacks, and nodule as risk factor for acute attacks among individuals with lymphedema in Addis Ababa city Administration, Ethiopia.MethodsA cross-sectional study was conducted among individuals with lymphedema in Addis Ababa city Administration. Data were collected using structured interviews and clinical examinations. The prevalence of nodules and acute attacks was determined, and logistic regression was used to assess their association.ResultsAmong the participants, 57.5% reported the presence of nodules affecting multiple areas of the lower limbs. Additionally, 41.2% experienced acute attacks, with an average of 5.89 episodes in the past six months. Logistic regression analysis revealed that individuals with nodules were 3.2 times more likely to experience acute attacks compared to those without nodules (p = 0.001). Other demographic and clinical factors, including sex and lymphedema severity, also showed trends associated with acute attack occurrence. Stigma was a significant concern, with 42.6% of participants reporting stigma from their communities (60.9%) and families (36.8%). Additionally, 34.8% of participants faced workplace challenges due to their condition.ConclusionsThe occurrence of nodules was associated with an increased risk of acute attacks. Both nodules and acute attacks were commonly observed. Many patients faced stigma from close family members and the surrounding community.Author SummaryLymphedema is a long-term condition that leads to swelling in the limbs due to fluid accumulation and impaired lymphatic function. People with lymphedema often experience recurrent acute attacks, which cause pain, inflammation, and disability. This study investigated the relationship between nodules—hardened tissue formations commonly found in chronic lymphedema—and the occurrence of acute attacks among individuals with lymphedema in Addis Ababa City Administration, Ethiopia.Our findings revealed that more than half of the participants had nodules, and over 40% experienced acute attacks, with an average of nearly six episodes in the past six months. We found that individuals with nodules were significantly more likely to suffer from acute attacks, suggesting that nodules may serve as reservoirs for bacteria or contribute to lymphatic obstruction. Additionally, many participants reported experiencing stigma from their communities and families, as well as difficulties in the workplace due to their condition.These findings highlight the need for early detection and management of nodules to prevent acute attacks, improve patient quality of life, and reduce the psychosocial and economic burden of lymphedema. Public health interventions should focus on improving self-care practices, providing accessible treatment options, and addressing stigma through education and community awareness programs. Future research should explore long-term strategies for preventing and managing nodules to reduce complications associated with lymphedema.

Background Medical devices (MDs) are critical components of healthcare systems, used for diagnosing and managing diseases. However, MDs have the potential for adverse events and hazards for patients that could be assessed through post market surveillance (PMS). Objective This study was designed to assess the PMS systems, regulatory challenges, and future perspectives of MDs in Ethiopia. Methods A mixed-methods study was conducted involving MDs importers in Addis Ababa and the Ethiopian Food and Drug Authority (EFDA). Data were collected using checklists and interview guides. Quantitative data were analyzed with Excel, while thematic analysis was applied to qualitative data. Results are presented as frequencies, percentages, and qualitative themes supported by verbatim quotes. Results The survey checklist was completed by engaging one focal person from each importer, resulting in a total of 52 respondents. Additionally, 12 key informants (10 male and 2 women) participated in the qualitative interviews. Although 71% of importers had Standard Operating Procedures (SOPs) for PMS, only 13% implemented their PMS plans. Additionally, 54% and 19% of companies reported having dedicated experts and budgets for PMS, respectively. Challenges include mixed regulation of MDs and medicines, resource constraints, low awareness, and poor stakeholder collaboration. Suggested strategies include independent MD regulatory structures and enhanced stakeholder engagement. Conclusions The study results revealed that MD PMS system is inconsistent among importers, and the EFDA has taken steps to improve the MDs PMS system. Strengthening regulatory frameworks and promoting collaboration among stakeholders are essential to mitigate current challenges.

This study examines the factors affecting strategic plan implementation in case of commercial bank of Ethiopia. The research design was an explanatory, quantitative study that examined the factors associated with the successful implementation of strategic plans within Commercial Bank of Ethiopia. Using a judgmental sampling technique, the analysis was conducted on a sample size of 196. The findings revealed that several organizational enablers had a significant positive relationship with strategic plan implementation (SPI). The strongest predictor of SPI was effective communication, underscoring the critical role of clear, consistent, and transparent communication from leadership in driving strategy execution. Stakeholder engagement, leadership support, and the alignment of human resources practices with strategic priorities also emerged as key drivers of successful SPI. Interestingly, the study did not find a significant relationship between resource availability and SPI, challenging the common assumption that a lack of resources is a primary barrier to strategy implementation. These findings emphasize the importance of developing organizational capabilities, such as communication, stakeholder management, and HR-strategy alignment, to enhance the effective translation of strategic plans into tangible outcomes. The study provides valuable insights for organizations seeking to bridge the strategy-to-execution gap and improve the implementation of their strategic initiatives. By focusing on cultivating these organizational enablers, particularly effective leadership communication, organizations can more successfully drive the execution of their strategic plans and achieve their desired outcomes.

BackgroundPatient safety culture is the result of individual and group values, attitudes, perceptions, competencies, and patterns of behavior that determine the commitment, style, and proficiency of health providers’ safety management. Globally, millions of adverse events occur annually, with a significant burden on low- and middle-income countries. The burden of injuries and other harm to patients from adverse events is likely one of the top 10 causes of death and disability worldwide. This study aimed to assess patient safety culture and its associated factors in regional public hospitals in Addis Ababa.MethodsAn institution-based cross-sectional study was conducted among 494 healthcare professionals working at regional public hospitals in Addis Ababa. The data were collected using a pretested structured self-administered questionnaire from June 3 to July 30, 2023. The data were entered into Epi info version 7.2 and exported to SPSS version 26.0 for analysis. Binary logistic regression analysis was used to determine the associations between the patient safety culture (dependent variables) and socio-demographic factors, health care providers and system’s. Multicollinearity was checked using VIF, and the adequacy of the final model was assessed using the Hosmer and Lemeshow goodness-of-fit test.ResultOverall, 48.8% (95% CI: 44.3–53.1) of participants had a good patient safety culture, for a response rate of 93.3%. Factors significantly associated with patient safety culture, as identified through factor analysis, included having 6–10 years of experience (AOR = 1.81, 95% CI = 1.13–2.88), having more than 11 years of experience (AOR = 3.49, 95% CI = 1.27–9.56), reporting adverse events (AOR = 2.47, 95% CI = 1.37–4.45), participating in patient safety programs (AOR = 3.64, 95% CI = 1.91–6.92), and working in obstetrics and pediatric wards (AOR = 0.47, 95% CI = 0.23–0.94) and (AOR = 0.21, 95% CI = 0.097–0.44), respectively.ConclusionThe overall level of patient safety culture in regional public hospitals was low (< 75%). Factors such as having 6 or more years of experience, reporting adverse events, participating in patient safety programs, and working in obstetrics and pediatric wards were significantly associated with patient safety culture.

BackgroundWHO reported that neonatal hypothermia accounts for about 27% of newborn deaths worldwide. It is a serious concern in Ethiopia and other parts of sub-Saharan Africa; it poses a serious threat to global health, increasing morbidity and mortality. Hypothermic neonates are more likely to experience respiratory distress, infections and other issues that could result in longer hospital stays and delayed development. The objective of this quality improvement project was to minimise intensive medical treatments, maximise resource usage and enhance overall health outcomes for newborns at Gandhi Memorial Hospital by reducing neonatal hypothermia.MethodsOver 10 months (from 1 March 2021 to 30 January 2022), neonatal hypothermia incidence was assessed using Quality Supervision Mentoring Team and Health Management Information System data. Root cause analysis and literature review led to evidence-based interventions in a change bundle. After team training and neonatal intensive care unit (NICU) relocation, Plan-Do-Study-Act cycles tested the bundle. Close temperature monitoring and data collection occurred. Run charts evaluated intervention success against baseline data, informing conclusions about effectiveness.ResultThe quality improvement project reduced neonatal hypothermia in NICU admissions from a baseline median of 80.6% to a performance median of 30%.Conclusion and recommendationThe quality improvement project at Gandhi Memorial Hospital effectively reduced neonatal hypothermia through interventions such as the temperature management bundle and NICU relocation, leading to improved patient care, fewer hypothermic neonates and enhanced body temperature management. Continuous monitoring, adherence to best practices, sharing success and outcome assessment are crucial for enhancing the project’s effectiveness and sustaining positive impacts on neonatal hypothermia reduction and patient outcomes.