Valuing Water Supply Service Improvements In Addis Ababa

In many cities of developing countries, such as Addis Ababa, water supply service is poor. At the moment, Addis Ababa city which accounts for over a quarter of the nations urban population is facing unreliable and inadequate supply of water and sanitation services. The paper raises crucial issues regarding the necessity to better understand the demand for improved water supply service in the absence of market and tries to link in relation to customers’ participation in the provision of improved water supply service. In an attempt to examine the determinants of the value of improved water service and to establish how much consumers are willing to pay, we use a contingent valuation method (CVM). The tobit model shows socio-economic and demographic variables such as Income of the household, sex of the respondent dummy (female = 1), Family size, education (both secondary and tertiary level), households' year of stay, households not using tank as a storage, wealth of a household, employment status of the respondent dummy (employed = 1) , households satisfaction with the existing service dummy (unsatisfied=1), and location of the study site (Addis Ketema) are significant variables that explain the willingness to pay. The mean willingness to pay (WTP) values are 15.34 and 20.20 cents per bucket (a 20 liter container) above the exiting average tariff of 7.14 cents per bucket as calculated from the tobit and probit model, respectively. The empirical evidence is an important input for strategic planning to ensure that improvements proposed potentially improve cost recovery initiative and increase the level of customer satisfaction

Assessment of an integrated TB/HIV programme at health facilities in Hawassa town administration of Ethiopia

Magister Public Health - MPHEvaluation of health programmes is essential to assist programme managers in decision-making and accountability to the population they serve. Additionally, regular monitoring and evaluation of TB/HIV collaborative activities are used as a means to assess quality, effectiveness and coverage of services; yet little attention has been given to this in most developing countries. In the southern region of Ethiopia, since the inception of the TB/HIV collaborative activities in 2005, there has not been any formal evaluation pertaining to the implementation status of integrated TB/HIV services at routine program level. However, a series of TB/HIV reviews underlined many challenges that have adversely affected the implementation nationally. However, studies conducted on the quality of TB and HIV/AIDS services tend to be broad and not targeted to the integrated TB/HIV program and therefore, it was necessary to assess the implementation status in a more focused way with a vision to determine its adequacy or otherwise and make appropriate recommendations to improve integrated TB/HIV services in the town. Aim: To assess the implementation of integrated TB/HIV activities in the health facilities of Hawassa town administration Study design: Cross sectional study Study population: All health facilities, health managers, and records of TB and HIV patients in Hawassa town administration Sample population: The study population encompassed TB and HIV clinics, managers of each health facility, and sampled records of individual clients/patients enrolled in the HIV/AIDS/TB treatment and care program, from each health facility in the year 2009/10. Data collection: Face-to-face interviews with facility managers, observation of the rooms in which TB/HIV services are rendered and a review of patient records, were undertaken. Analysis: Descriptive statistics with frequencies and percentages were used for analysis of facility based resource inputs, TB case finding and management, and HIV case finding and management practices. Indicator variables extracted from the record review were transformed into scales (0 or 1) and weighted to reflect the levels of TB/HIV service quality, integration and resources input. After weighting, experts' opinion was used to set a cut off level (75%) to categorize the relative service quality received by individuals and the level of integrated care provided by facilities into "adequate" or "inadequate". Bivariate analysis was done to assess the effect of independent predictor variables on outcome variables. We used a– P value of 0.1 on bivariate analysis as the cut off point for inclusion of variables into the multivariate analysis. Prevalence ratios, adjusted prevalence odds ratios, and 95% confidence intervals were used to present outcomes. Results: Availability of resource inputs for HIV/AIDS care was inadequate in half of the facilities in Hawassa town whereas, laboratory infrastructure for TB/HIV care was adequate in all facilities. Most (91%) HIV/AIDS patients had their CD4 count and weight (96%) measured at baseline. However, the trend declined over time and the practice was better in hospitals than in health centres. HAART status was a strong predictor of CD4 count improvement and improvement in CD4 count was found to be a strong predictor of body weight gain. TB case finding and management practices in HIV/AIDS clinics were found to be adequate in the health facilities in Hawassa town. Ninety five percent and 86% of HIV positive patients were screened for TB at baseline and at the last clinical visit respectively, of which 98%, 93% and 81% of patients co infected with TB and HIV were provided with DOTS, CPT and ART respectively. However, only 11% of HIV positive patients without active TB were provided with IPT. Only HAART status was found to be a strong predictor of TB case finding. Quality of HIV/AIDS care in health facilities in Hawassa town was adequate. Availability of at least a minimum number of staff and being on HAART were found to be strong negative and positive predictors of quality respectively. Overall, 91% of patients on HAART were retained in care at the end of the year (alive and on treatment), 6% were retained and 3% died. Resources for the TB program were deficient in our study area. Three out of four facilities had inadequate overall input resources required for good quality TB care and the fourth barely managed to achieve adequate status. However, laboratory infrastructure and availability of forms and registers were adequate in all the facilities. There was a high degree of HIV case finding and a high prevalence (17%) of HIV among TB patients. Despite this, the overall HIV care provided was inadequate, with only 64% and 73% of TB/HIV co-infected patients being provided with HAART and co-trimoxazole respectively and 22% of TB/HIV co-infected patients not enrolled in HIV care. Among sputum positive TB patients good quality TB care was found to be a strong predictor of successful treatment outcome Our study also showed consistently very high quality TB service provision in the town despite the lack of required resources. Conclusion and Recommendations: The study showed that there was relatively good quality provision of TB and HIV services despite inadequate input resources and that quality of care was positively associated with good outcomes. The study also indicated that HAART benefited patients substantially and hence earlier initiation could be the way forward. We recommend that to further improve quality of care one stop shopping services (availing both anti-TB and HIV care at the same service point within a clinic) be established. In addition, we recommend improved patient monitoring, especially for Pre-ART patients, be established

Villagization and access to water resources in the Middle Awash Valley of Ethiopia: Implications for climate change adaptation

Since the 1970s, the Government of Ethiopia has implemented villagization, whereby nomadic pastoralist groups are supported to develop (more) sedentary lifestyles and livelihoods. Villagization has been officially promoted to encourage diversification from livestock herding to agricultural cultivation, and to fulfil basic needs through infrastructure and services. From the late 2000s, villagization was reintroduced for arid and semi-arid regions as a strategy for adaptation to climate change, as part of the country's green growth agenda. The aim of this paper is to evaluate to what extent this phase of villagization has contributed to adaptation strategies among pastoral and agro-pastoral communities, based on an empirical analysis of four villagised sites in the Middle Awash Valley using qualitative data collected between 2014 and 2018. Perceptions and experiences of villagization varied across individuals, households, villages, and districts. While villagization has generally delivered infrastructure and services, and offered income diversification to those able to access irrigated agriculture, its implementation has been partial and uneven, and it has reproduced previous problems of resource scarcity while creating new risks and vulnerabilities. We argue that villagization may play a role in some aspects of adaptation, if programmes address the drivers of livelihood change, and embed equity and rights

Views of women about accessibility of safe abortion care services in Addis Ababa, Ethiopia

Background: In many developing countries, maternal deaths occur mainly as a result of unsafe abortions, a situation reflecting the inaccessibility of safe abortion services in such countries. In Ethiopia, unsafe abortion accounts for 32% of maternal deaths and almost 60% of gynaecological admissions, and is one of the top ten causes of general hospital admissions. Purpose: The purpose of this study was to assess the views of women about the accessibility of safe abortion services in governmental health centres. Methods: A quantitative cross-sectional descriptive and non-experimental study using structured questionnaires was conducted. 342 women who had received abortion care services in governmental health centres participated. Findings: 46.8% of the participants do not know about the penal code regarding safe abortion care. 52.9% of the participants viewed safe abortion care as inaccessible because there are various and competing factors which make abortion service to be viewed as accessible or inaccessible and these include distance to nearest health centre, the time it takes to receive the service, the cost of the service, and the lack of appropriate skills in the service providers. Conclusion: An improvement in the accessibility of abortion services will prevent deaths resulting from unsafe abortionsHealth StudiesM.A. (Public Health

The inclusion of students with visual impairment at Addis Ababa University, Ethiopia : challenges and prospects

The inclusion of students with impairment in higher education needs enabling legal frameworks to lay the foundation for equal opportunities for those learners in all aspects of university life (Shepherd, 2001:17). To this effect, in the past two decades several countries have revised their legal documents in order to promote inclusive education at all levels of schooling. Accordingly, in 2006 the Ethiopian government also developed a new legislative document, namely Special Needs Education Program Strategy, in order to apply inclusive education in regular schools and in higher education institutions. Following the introduction of this policy document, all regular schools and higher education institutions in Ethiopia have been required to implement inclusive education as a mandatory approach when educating students with impairment, including those who are visually impaired. However, the actual implementation of an inclusive approach is being challenged by the social, political and physical circumstances of higher education institutions. Therefore, this study aimed at examining the existing challenges and prospects towards the inclusion of students with Visual Impairment (VI) in the particular context of Addis Ababa University (AAU). The study adopted an interpretive paradigm for better understanding and in-depth interpretation of the inclusion of students with VI at AAU. An interpretive paradigm also informs the detailed judgements made by experts of a suggested action plan for progressively providing support for students with VI at AAU. The study also applied the critical disability paradigm as a complementary philosophical base in order to examine critically the challenges that students with VI face and to suggest ways to transform the inclusive policies and practices of AAU in favour of the students. The researcher undertook a Delphi investigation to address the main aim of this research (i.e. to determine how best to implement an action plan that progressively increases support for students with VI at AAU over a period of time). The action plan that comprises various support measures and the necessary resources was developed using the empirical results of this study as well as the existing findings and best practices found in the literature study. It was scrutinized and approved by a number of experts. The researcher recommends that the plan should be implemented over the next five years at AAU in order to improve the support provided to students with VI.Inclusive EducationD. Ed. (Inclusive Education

Exploring the potential of Δ¹⁷O in CO₂ for determining mesophyll conductance

Mesophyll conductance to CO2 from the intercellular air space to the CO2–H2O exchange site has been estimated using δ18O measurements (gm18). However, the gm18 estimates are affected by the uncertainties in the δ18O of leaf water where the CO2–H2O exchange takes place and the degree of equilibration between CO2 and H2O. We show that measurements of Δ17O (i.e. Δ17O = δ17O − 0.528 × δ18O) can provide independent constraints on gm (gmΔ17) and that these gm estimates are less affected by fractionation processes during gas exchange. The gm calculations are applied to combined measurements of δ18O and Δ17O, and gas exchange in two C3 species, sunflower (Helianthus annuus L. cv. ‘sunny’) and ivy (Hedera hibernica L.), and the C4 species maize (Zea mays). The gm18 and gmΔ17 estimates agree within the combined errors (P-value, 0.876). Both approaches are associated with large errors when the isotopic composition in the intercellular air space becomes close to the CO2–H2O exchange site. Although variations in Δ17O are low, it can be measured with much higher precision compared with δ18O. Measuring gmΔ17 has a few advantages compared with gm18: (i) it is less sensitive to uncertainty in the isotopic composition of leaf water at the isotope exchange site and (ii) the relative change in the gm due to an assumed error in the equilibration fraction θeq is lower for gmΔ17 compared with gm18. Thus, using Δ17O can complement and improve the gm estimates in settings where the δ18O of leaf water varies strongly, affecting the δ18O (CO2) difference between the intercellular air space and the CO2–H2O exchange site.</p

Exploring the potential of Δ17O in CO2 for determining mesophyll conductance

Mesophyll conductance to CO2 from the intercellular air space to the CO2–H2O exchange site has been estimated using δ18O measurements (gm18). However, the gm18 estimates are affected by the uncertainties in the δ18O of leaf water where the CO2–H2O exchange takes place and the degree of equilibration between CO2 and H2O. We show that measurements of Δ17O (i.e. Δ17O = δ17O − 0.528 × δ18O) can provide independent constraints on gm (gmΔ17) and that these gm estimates are less affected by fractionation processes during gas exchange. The gm calculations are applied to combined measurements of δ18O and Δ17O, and gas exchange in two C3 species, sunflower (Helianthus annuus L. cv. ‘sunny’) and ivy (Hedera hibernica L.), and the C4 species maize (Zea mays). The gm18 and gmΔ17 estimates agree within the combined errors (P-value, 0.876). Both approaches are associated with large errors when the isotopic composition in the intercellular air space becomes close to the CO2–H2O exchange site. Although variations in Δ17O are low, it can be measured with much higher precision compared with δ18O. Measuring gmΔ17 has a few advantages compared with gm18: (i) it is less sensitive to uncertainty in the isotopic composition of leaf water at the isotope exchange site and (ii) the relative change in the gm due to an assumed error in the equilibration fraction θeq is lower for gmΔ17 compared with gm18. Thus, using Δ17O can complement and improve the gm estimates in settings where the δ18O of leaf water varies strongly, affecting the δ18O (CO2) difference between the intercellular air space and the CO2–H2O exchange site

Leaf-scale quantification of the effect of photosynthetic gas exchange on δ ¹⁷O of atmospheric CO ₂

Understanding the processes that affect the triple oxygen isotope composition of atmospheric CO2during gas exchange can help constrain the interaction and fluxes between the atmosphere and the biosphere. We conducted leaf cuvette experiments under controlled conditions using three plant species. The experiments were conducted at two different light intensities and using CO2with different δ17O. We directly quantify the effect of photosynthesis on δ17O of atmospheric CO2for the first time. Our results demonstrate the established theory for δ18O is applicable to δ17O.CO2/at leaf level, and we confirm that the following two key factors determine the effect of photosynthetic gas exchange on the δ17O of atmospheric CO2. The relative difference between δ17O of the CO2entering the leaf and the CO2in equilibrium with leaf water and the back-diffusion flux of CO2from the leaf to the atmosphere, which can be quantified by the cm=ca ratio, where ca is the CO2mole fraction in the surrounding air and cm is the one at the site of oxygen isotope exchange between CO2and H2O. At low cm=ca ratios the discrimination is governed mainly by diffusion into the leaf, and at high cm=ca ratios it is governed by back-diffusion of CO2that has equilibrated with the leaf water. Plants with a higher cm=ca ratio modify the 117O of atmospheric CO2more strongly than plants with a lower cm=ca ratio. Based on the leaf cuvette experiments, the global value for discrimination against δ17O of atmospheric CO2during photosynthetic gas exchange is estimated to be-0:57±0:14% using cm=ca values of 0.3 and 0.7 for C4and C3plants, respectively. The main uncertainties in this global estimate arise from variation in cm=ca ratios among plants and growth conditions.</p

Climate variability and impact in ASSAR's east African region

This working paper reviews available information and literature on climate variability, risks and vulnerabilities across East Africa, and reflects on implications for climate adaptation planning and intervention. It assessed climate variability risks with emphasis on rainfall, drought and flooding events, as well as environmental and socioeconomic vulnerability. Working in seven countries in semi-arid regions, Adaptation at Scale in Semi-Arid Regions (ASSAR) seeks to understand the factors that have prevented climate change adaptation from being more widespread and successful, including governance factors that can facilitate a shift from ad hoc adaptation to planning for large-scale adaptation measures.International Development Research Centre (IDRC)UK’s Department for International Development (DFID

Exploration on professional family mediation practice in courts of Addis Ababa, Ethiopia

Abstract: The literature recognizes that professional family mediation studies are generally scarce in Africa compared to the developed countries. Despite the overall dearth of mediation studies in Ethiopia, most of the research conducted on issues of mediation until now excluded professional family mediation practices. Qualitative research design was used to explore and describe the practice of professional family mediation in three courts of Addis Ababa, Ethiopia. Observation, interview, and document reviews were used to collect data. The child friendly space for the children and spouses counseling rooms were observed and mediated case files were reviewed. The generated data were analyzed by using thematic analysis. Four professional family mediators, three lawyers, three family bench judges and a mediation coordinator were participants of the study. The article explores benefits of mediation and the roles and challenges of the mediators. The mediation process promotes a win-win solution and helps spouses to build a stronger relationship. Mediators facilitate conversation through negotiation. The study found out facilitating conversation, educating, encouraging, confronting, bringing scenarios, and referral as the roles of the mediators. Lack of cooperation, limited source of referral, short appointments from judges were challenges mediators face. This article sheds light on the practice of family mediation in courts in Ethiopia. The research has social work implications on how to enhance the quality of mediation services