{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T17:55:48Z","timestamp":1782496548580,"version":"3.54.5"},"reference-count":50,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"content-version":"unspecified","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,1,26]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess malaria service readiness and its associated factors among health facilities that provide antenatal care (ANC) services in Ethiopia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Nationally representative cross-sectional facility-based study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 1156 public and private health facilities that reported providing ANC services at the time of the survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Health facilities across nine regions and two city administrations of Ethiopia based on data from the 2021\/2022 Ethiopia Service Provision Assessment survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Only 15.7% (95% CI 13.8 to 18.0) of facilities demonstrated full malaria service readiness, while 14.3% had none of the key components. Substantial regional variation was observed: facilities in Somali region were more likely to be ready (adjusted OR (AOR)=1.53; 95%\u2009CI 1.19 to 1.95), whereas readiness was significantly lower in several regions, including Amhara, Oromia, Gambella, Harari, Addis Ababa, Dire Dawa and Sidama, compared with Southern Nations, Nationalities and Peoples\u2019 Region. Governance-related factors were strong predictors of readiness\u2014the presence of a client suggestion box (AOR=1.60; 95%\u2009CI 1.12 to 2.29), recent report submission (AOR=2.79; 95%\u2009CI 1.15 to 6.76) and monthly staff meetings (AOR=1.64; 95%\u2009CI 1.26 to 2.14) were associated with higher readiness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Malaria service readiness in Ethiopian health facilities providing ANC services is low and unevenly distributed across regions. Strengthening supply chains, staff training and governance systems may improve facility preparedness and support more effective malaria service delivery for pregnant women.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-109109","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T13:51:16Z","timestamp":1770299476000},"page":"e109109","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Malaria service readiness and associated factors among health facilities that provide antenatal care services in Ethiopia: a cross-sectional study using generalised estimating equation analysis"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1945-8981","authenticated-orcid":false,"given":"Kassawmar Angaw","family":"Bogale","sequence":"first","affiliation":[{"name":"College of Medicine and Health Sciences, School of Public Health, Department of Epidemiology and Biostatistics, Bahir Dar University, Bahir Dar, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0345-9437","authenticated-orcid":false,"given":"Mulusew Andualem","family":"Asemahagn","sequence":"additional","affiliation":[{"name":"School of Public Health, Bahir Dar University College of Medical and Health Sciences, Bahir Dar, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kassahun Alemu","family":"Gelaye","sequence":"additional","affiliation":[{"name":"Epidemiology, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9975-7948","authenticated-orcid":false,"given":"Kindie Fentahun","family":"Muchie","sequence":"additional","affiliation":[{"name":"School of Public Health, Department of Epidemiology and Biostatistics, Bahir Dar University College of Medical and Health Sciences, Bahir Dar, Ethiopia"},{"name":"Department of Infectious Diseases, University Hospital Heidelberg, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hailemariam Awoke","family":"Engedaw","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Bahir Dar University, College of Medical and Health Sciences, Bahir Dar, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muluken","family":"Azage","sequence":"additional","affiliation":[{"name":"Department of Environmental Health, School of Public Health, Bahir Dar University, College of Medical and Health Sciences, Bahir Dar, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,2,5]]},"reference":[{"key":"2026062610405849000_16.2.e109109.1","unstructured":"World Health Organization . 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