Women’s Access to and Utilization of Sanitation and their Determinant Factors in Some Selected Rural Areas of East Gojjam Zone, North West Ethiopia

This study aimed to examine women’s sanitation access and utilization level and their determinants in some selected rural areas of East Gojjam Zone. The research employed cross sectional study design and data was collected from 380 women selected through multistage cluster sampling technique. Proportional odds model and partial proportional odds model were used to estimate the association between different factors and women’s sanitation access and utilization level. The result indicated that out of 380 sampled women, about 42.6% have high sanitation access compared with 34.7% medium and 22.6% low respectively. Despite this however; about 50.9% respondents have low sanitation utilization suggesting a mismatch between sanitation access at household level and women’s utilization status. Household size, access to sanitation facilities, and knowledge about the benefit of latrine utilization were found to be statistically significant determinants of women’s sanitation utilization while marital status, district, household income, participation in women health development team, and dependency ratio were found to be determinants of sanitation access. The study suggests that besides promotions to increase sanitation facility availability, monitoring on the utilization of the facilities need to be strengthened. Income creation capacity of women and their households should be strengthened as well

Nurses’ knowledge of the management of diabetic patients at Juba Teaching Hospital

Introduction: Diabetes mellitus (DM) is a group of metabolic diseases characterized by hyperglycaemia and is a major health problem. The International Diabetes Federation (IDF) estimated that there were 425 million people with diabetes in the world in 2017 with the number rising most rapidly in middle- and low-income countries. The prevalence of DM in Juba City in 2017 was reported to be 11.8%.Objective: To assess nurses’ knowledge of the management of diabetic patients and factors associated with it in Juba Teaching Hospital - the only referral hospital in South Sudan.Method: This was descriptive cross-sectional study, carried out in March 2018, in which 40 nurses were randomly selected. Data were collected using a pre-tested questionnaire and analysed using SPSS version 20 for Windows software.Results: Of the 40 participants 31(77.5%) were females. The mean age was 35.6±10.7 years and median work experience was 9 years and 10 months; overall 57.6% of the participants correctly answered the questions on diabetic care. The factors cited for poor management of diabetic patients included lack of hospital guidelines (47.5%), insufficient salary to motivate staff (77.5%), inadequate nurse to patient ratio for good patient care (60.0%), and no resources for special training (57.5%).Conclusion: Many nurses in JTH have inadequate knowledge for diabetic management and most are interested in receiving more training.Keywords: Nurse, knowledge, management of diabetes, South Suda

Prevalence of Wasting and Its Associated Factors of Children among 6-59 Months Age in Guto Gida District, Oromia Regional state, Ethiopia.

Background: Nutrition is central pillar of human life and its request differ with respect to age, gender and during physiological changes such as complimentary feeding and child age. Ethiopia has a high prevalence of Acute and Chronic Malnutrition, with almost half of Ethiopian children chronically malnourished and one-in-ten children wasted. About 47% of children under-five are stunted, 11% are wasted and 38% are underweight. Acute malnutrition also known as wasting, it is characterized by a rapid deterioration in nutritional status over a short period. For children, it can be measured using the weight-for-height nutritional index or mid-upper arm circumference. There are different levels of severity of acute malnutrition: moderate acute malnutrition (MAM) and severe acute malnutrition (SAM). The recommended a revision of cut-off points to determine wasting are the following: SAM: MUAC < 110 mm for Severe Acute Malnutrition (SAM), Moderate Acute Malnutrition (MAM): MUAC > 115 and < 125 mm Cut-Off Value Normal ?125 mm. A cross- sectional descriptive survey and measurements of MUAC was used to investigate Prevalence of wasting and Its Associated Factors among Children 6-59 Months of Age in Guto Gida District, Oromia, Ethiopia. Multistage random sampling technique was used and 359 children between 6-59 months aged were selected from 398 enrolled children to the study.  The quantitative data were analyzed using SPSS for windows version (17.0) and EPI-6. Both bivairate and multiple logistic regressions were run to assess factors that were associated with the dependent variable at p< 0.05 and to control the confounders. Objective: To determine the Prevalence of Wasting and Its Associated Factors Among 6-59 Months Age in Guto Gida District, Oromia, Ethiopia. Method: A cross-sectional survey design was used to assess the Prevalence of Wasting and Its Associated Factors Among 6-59 Months Age in Guto Gida District, Oromia, Ethiopia from March to June 2013. Results: During the study period, 398 children were enrolled and about 359 children were included in the final analysis. Associate factors taken to analyze wasting were Socio-economic status, Housing quality, Water quality, Children Healthy condition, Child characteristics, Maternal Caring and characteristics and Dietary history of child and mother. There was significant relationship between Socio-economic status, House and Water quality, Children Healthy condition, Child and caregivers characteristics, Maternal Care, dietary history of child and mother, household food intake, and public healthy practice and dependent one. Both biviarate and multivariate logistic analysis indicated that low birth weight, lack of balanced diet as of food pyramid and housing quality, water quality are some associate factors of wasting, stunting, and underweight. With respect to age categories the study result shows 11.14% wasting for among 24-59months age and children 6-23months were 12.53% were wasted .About 27.5 % of children were severe stunted, 41.78% less than 65% median for height meaning that stunted children, the proportions of severely underweight and underweight children in this study area were 28.7% and 39.6%  respectively. Conclusion: Depending on facts of the study, it can be concluded that; child wasting (acute   mal nutrition) problem is highly observed in Guto Gida District. When out puts of the result compare to that of standard the prevalence’s of wasting in the study area was the same but slightly excised EDHS, 2011 report. It can be concluded professional that most households in the study area were illiterate, had low income, consumed cereals and crops, had not get quality water, had low nutritional information, majority of children did not taken Rota viral vaccine(de-worming activities). Therefore, it is a time to tickle child undernourishment, which is a silent killer of the community. Keywords: Prevalence, Wasting, associated factors, MUAC and Guto Gida District

Reorienting livestock production to respond to the meat quality requirements of high-end domestic and export markets

The Agriculture Knowledge, Learning, Documentation and Policy Project (AKLDP) was requested by the then Ministry of Livestock and Fisheries (MoLF) to undertake this study. The study was conducted during the period March 30 to July 30, 2018. Following this request, desk reviews, tests, field visits, and consultations to assess the quality requirements of the export and high-end domestic (HED) red meat (beef, mutton, goat meat) and live animals (cattle, sheep, and goats) markets and the current supply situation were conducted. The prevailing livestock conditioning/fattening practices to meet these requirements were also assessed after identifying the current and potential sources of supply. Intervention models targeting the different production systems and livestock species were then developed based on the assessments. Financial and economic evaluation of the intervention models was conducted to assess the feasibilities of the proposed models. Recommendations to reorient the conditioning/fattening practices in the major livestock supply areas to meet the identified requirements were then made based on the findings of the series of activities conducted. This report presents the results of this exercise

Time to complementary feeding initiation and its predictors among children aged 9–23 months in Meket District, Northeast Ethiopia: a Cox Weibull regression

.Globally and nationally, only 64⋅5 and 49⋅2 % of infants received solid or semi-solid foods, respectively. The available evidence indicates that the time to initiate complementary feeding practices is still poor and varies by region. The aim of the present study was to assess the time to initiation of complementary feeding and its predictors among children aged 9–23 months in Meket District, Amhara Region, Ethiopia. A community-based retrospective cohort study was conducted from June to July 2022 among 459 systematically selected mothers/caregivers with their children from 9 to 23 months of age. The result of descriptive statistics was reported by table, frequency, Kaplan-Meier curve and percent. The proportional hazard model assumption was checked, and a Weibull regression model was used to see the predictors of timely initiation of complementary feeding. An adjusted hazard ratio with a 95 % confidence interval and a P-value of 0⋅05 were used to declare the significant predictors. The median time of complementary feeding initiation was 6 months. Attending primary education (adjusted hazard ration (AHR) 1⋅8; 95 % CI 1⋅16, 2⋅78), occupation of the mother (AHR 1⋅43; 95 % CI 1⋅04, 1⋅95), home delivery (AHR 1⋅61; 95 % CI 1⋅09, 2⋅37) and birth preparedness (AHR 1⋅37; 95 % CI 1⋅03, 1⋅81) were the predictors of time to complementary feeding initiation. The median time to complementary feeding initiation was consistent with the WHO recommendation. Maternal education, maternal employment, place of delivery and birth preparedness were the predictors of time to initiation of complementary feeding. Therefore, working with the education sector, increasing the delivery rate in health facilities, strengthening counselling on birth preparation, increasing maternity leave until 6 months of age and initiating corner feeding should be part of the complementary feeding practices promotion agenda

Cereals Availability Study in Ethiopia, 2008

Unusual changes in grain markets have been the source of major concerns for the Government of Ethiopia and its development partners. Increase in cereal price presented serious challenges to the implementation of country’s food security programs. Local procurement of food by the WFP declined also in the recent years. Being one of the largest donors of local procurement of food, the European Union was particularly concerned about these developments. Thus, as a General Directorate in charge of supporting EU policies, the Joint Research Centre (JRC) of the EU developed the technical specification of a project to extend the scope of the usual Cereal Availability Study (CAS) in order to account for the developments in the Ethiopian cereal markets. International Food Policy Research Institute (IFPRI) consortium with the Ethiopian Development Research Institute (EDRI) and the Ethiopian Institute of Agricultural Research (EIAR) was selected to carry out the study. A number of preliminary analyses, undertaken by the World Bank and IFPRI had put forward a number of hypotheses to explain unusual high cereal prices. While the different hypotheses were widely debated in the country, there is limited primary information to validate or refute them. It is in this context that the current study was undertaken. The focus has been mainly on achieving the following objectives: • To gather information regarding recent changes in cereal production, storage, and marketing patterns in order to test the hypotheses that have been proposed to explain the high price of cereals in Ethiopian markets. • To improve the general methodology of the past cereal availability studies. • To estimate the quantity of maize, sorghum, and wheat that can be procured from domestic markets in the 2008 for relief purposes without disturbing the local market. Implementation of the study was carried out in three broad stages. The first stage involved an overview of cereal availability methods and a consultation for determining the survey / sampling methods. Three surveys were conducted in the second stage, namely, a household survey, a traders’ survey, and a rapid assessment of cross border trade. At third stage, results from the surveys, and some secondary data, have been used to develop a spatial equilibrium multi-market model (ESGMM) to analyze policy impacts of various policy interventions. The results were presented in a final workshop held in the United Nations’ Economic Commission for Africa in Addis Ababa on December 5, 2008.JRC.H.4-Monitoring Agricultural Resource

Impact of the COVID-19 pandemic on mental health care and people with mental health conditions in Ethiopia:the MASC mixed-methods study

BACKGROUND: The COVID-19 pandemic has had far-reaching effects on the mental health of populations around the world, but there has been limited focus on the impact on people with existing mental health conditions in low-income countries. The aim of this study was to examine impact of the pandemic on mental health care and people with mental health conditions in Ethiopia.METHODS: A convergent mixed methods study was conducted. We systematically mapped information from publicly available reports on impacts of the pandemic on mental health care. Monthly service utilisation data were obtained from Amanuel Mental Specialised Hospital, the main psychiatric hospital, and analysed using segmented Poisson regression (2019 vs. 2020). In-depth interviews were conducted with 16 purposively selected key informants. Framework analysis was used for qualitative data. Findings from each data source were integrated.RESULTS: In the early stages of the pandemic, participants indicated a minimal response towards the mental health aspects of COVID-19. Mental health-related stigma and discrimination was evident. Scarce mental health service settings were diverted to become COVID-19 treatment centres. Mental health care became narrowly biomedical with poorer quality of care due to infrequent follow-up. Households of people with pre-existing mental health conditions in the community reported worsening poverty and decreased access to care due to restricted movement, decreased availability and fear. Lack of reliable medication supplies increased relapse and the chance of becoming chained at home, abandoned or homeless. Caregiver burden was exacerbated. Within mental health facilities, prisons and residential units, infection control procedures did not adequately safeguard those with mental health conditions. Meanwhile, the needs of people with mental health conditions in COVID-19 quarantine and treatment facilities were systematically neglected. Only late in the day were integrated services developed to address both physical and mental health needs.CONCLUSIONS: The COVID-19 pandemic had substantial negative impacts on the lives of people with mental health conditions in Ethiopia. Future emergency response should prioritise the human rights, health, social and economic needs of people with mental health conditions. Integration of mental and physical health care would both expand access to care and increase resilience of the mental health system

The Ethiopian Health Extension Program and Variation in Health Systems Performance: What Matters?

Background: Primary health care services are fundamental to improving health and health equity, particularly in the context of low and middle-income settings where resources are scarce. During the past decade, Ethiopia undertook an ambitious investment in primary health care known as the Ethiopian Health Extension Program that recorded impressive gains in several health outcomes. Despite this progress, substantial disparities in health outcomes persist across the country. The objective of this study was to understand how variation in the implementation of the primary health care efforts may explain differences in key health outcomes. Methods and Findings: We conducted a qualitative study of higher-performing and lower-performing woredas using site visits and in-depth interviews undertaken in 7 woredas. We classified woredas as higher-performing or lower-performing based on data on 5 indicators. We conducted a total of 94 open-ended interviews; 12–15 from each woreda. The data were analyzed using the constant comparative method of qualitative data analysis. Substantial contrasts were apparent between higher-performing and lower-performing woredas in use of data for problem solving and performance improvement; collaboration and respectful relationships among health extension workers, community members, and health center staff; and coordination between the woreda health office and higher-level regulatory and financing bodies at the zonal and regional levels. We found similarities in what was reported to motivate or demotivate health extension workers and other staff. Additionally, higher-performing and lower-performing woredas shared concerns about hospitals being isolated from health centers and health posts. Participants from both woredas also highlighted a mismatch between the urban health extension program design and the urban-dwelling communities’ expectations for primary health care. Conclusions: Data-informed problem solving, respectful and supportive relationships with the community, and strong support from zonal and regional health bureaus contributed to woreda performance, suggesting avenues for achieving higher performance in primary health care

Systematic review and meta-analysis: prevalence of alcohol use among young people in eastern Africa.

OBJECTIVE: Systematic review and meta-analysis of published studies of alcohol use among young people (age 15-24 years) in eastern Africa to estimate prevalence of alcohol use and determine the extent of use of standardised screening questionnaires in alcohol studies. METHODS: Five databases (MEDLINE, EMBASE, Global Health, Africa-wide, and PsycINFO) were searched for publications until 30th June 2013. Results were summarised using the guidelines on preferred reporting items for systematic reviews and meta-analyses (PRISMA) and on quality assessment using the modified quality assessment tool for systematic reviews of observational studies (QATSO). Heterogeneity was assessed using the I(2) statistic (DerSimonian-Laird). RESULTS: We identified 2785 potentially relevant studies, of which 56 were eligible for inclusion. Only two studies (4%) used the standardised Alcohol Use Disorder Identification Test (AUDIT) questionnaire, and six studies (13%) used the Cut down, Annoyed, Guilt, Eye opener (CAGE) questionnaire. The reported median prevalence of alcohol use was ever-use 52% [interquartile range (IQR): 20-58%], use in the last month 28% (IQR: 17-37%), use in the last year 26% (IQR: 22-32%), and problem drinking as defined by CAGE or AUDIT 15% (IQR: 3-36%). We observed high heterogeneity between studies, with the highest prevalence of ever use of alcohol among university students (82%; 95%CI: 79-85%) and female sex workers (66%; 95%CI: 58-74%). Current use was most prevalent among male sex workers (69%; 95%CI: 63-75%). CONCLUSIONS: Reported alcohol use and problem drinking were common among diverse groups of young people in eastern Africa, indicating the urgent need for alcohol-focused interventions in this population. Few studies have used standardised alcohol screening questionnaires. Epidemiological research to investigate alcohol-focused interventions in young people should aim to apply such questionnaires that should be validated for use in this population