Study settings and study periods

The study was conducted at Hawela Tula sub-city of Hawassa City Administration, Sidama Regional State, Southern Ethiopia. The study was conducted from October 15 to December 2, 2021. Hawassa city was located 275 km from Addis Ababa. According to the population census, of 2007, the population of Hawassa City in 2021 was 374,034 out of which 190,757 were males and 183,277 were females (28). The total population of the sub-city is estimated to be 135,793 out of this about 4,698 (3.46%) pregnant women are expected to live in the city. In Hawassa city, there are eight sub-cities and 83 public and private health institutions among them, one public referral and teaching hospital, one General Hospital, two primary hospitals, four private hospitals, six public HC, 17 Health posts, and 51 private clinics given the service.