Despite the well-documented teratogenic effects of alcohol use, pregnant women’s alcohol exposure continues to be a worldwide public health concern. Alcohol consumption during pregnancy is associated with a number of adverse obstetric, fetal and child outcomes including stillbirth, spontaneous abortion, intrauterine growth retardation, low birth weight, preterm birth, congenital malformations and foetal alcohol spectrum disorder. Global, the prevalence of alcohol use during pregnancy was found to be 9-8% (95% CI 8-9–11-1).
In Ethiopia, although evidence from the 2011 Ethiopia Demographic and Health Survey (EDHS), and other community and institution-based study revealed high burden of alcohol, which ranged from x to y among the general population and pregnant mothers respectively. 31.3% and 34% (29,30). Despite the major burden caused by alcohol use, it remain neglected, with treatment gap of up to x% of the general population and there is no [10–16] data about pregnant women’s help seeking behaviours. During pregnancy, there is no safe level of alcohol consumption  and therefore many professional organizations recommended universal screening, including ACOG,5 AAP,23American Medical Association (AMA),24 and CDC.6.
Moreover, screening based on risk factors such as late entry to PNC or prior poor birth outcome potentially leads to missed cases and can exacerbate stigma and stereotyping.10 Efforts to reduce alcohol consumption during pregnancy in antenatal settings is also acceptable to women, with 97% of women indicating that they wanted information about alcohol use during pregnancy and would be willing to change their alcohol consumption if advised to do so .
Furthermore, antenatal care is an opportune setting/period to address maternal alcohol consumption. Although a considerable amount of work has been carried out on the burden, treatment gap and the effectiveness of brief intervention to address the burden of alcohol consumption during pregnancy, barriers including a lack of systems and/or tools, stigmatization, lack of time, need for staff training, culture, and [33–36], commitment of the organization, perceived value/need and readiness to change, skills, ability and confidence, and an absence of systems and tools to support/prompt care delivery) commonly impede changes in professional practice . In Ethiopia, there is dearth of information about the prevalence, treatment gap and determinants of alcohol use.
Moreover, there little information about the effectiveness of brief interventional studies to address the burden of the problem. Therefore, the main focus of this proposal is to implement a pilot intervention for alcohol use disorder among pregnant women in rural Ethiopia.