Análise das políticas de partilha de custos no ensino superior etíope

Mestrado em Ensino Superior - Erasmus MundusOne major problem governments of the world and particularly governments of the developing countries have faced is the issue of how to reform the finance of higher education in response to the interconnected pressures of rising higher education enrollment (massification) and the incompatible public budget. The last three or four decades have witnessed major changes in the way both developed and developing countries‘ higher education is financed. Governments and higher education institutions have grappled with the problem of financing massified higher education system while public expenditure for education has failed to keep pace or in some cases declined. Backed by such objectives and economic arguments as higher education rates of return, equity, and efficiency, higher education massification has caused far-reaching, country and institution specific, turbulent reform processes and one of these is the higher education financial reform. Massification has exerted financial pressure on the public revenue and caused the inescapable higher education financial austerity, which is more pronounced and exhibited in the developing countries. The perception and the subsequent introduction of cost sharing, in the form of tuition fee, other fees and user charges where higher education was previously offered for free and the substantial increase in tuition fees in several countries where they did previously exist, is partly the result of the higher education financial pressure. This has been the product of escalating higher education enrollment, less revenue, and the rising of unit cost. Arguably, cost sharing has been adhered and favored for its role in promoting higher education efficiency and equity as well. Four parties are in the frontline in sharing the cost of higher education. These are students, parents, governments and donors. Private investors also share the burden of the growing higher education demand. The tendency of introducing payments for higher education, significant increases in tuition fees, and the change of student aid systems from grants to loans has been the source of controversy and debates, which have become negative dowries for the implementation of the policy of cost sharing, in many countries. Moreover, the effort of cost sharing policy implementation, in many developing countries has been frustrated by many other national and international factors. This study is trying to analyze, benchmarking developing countries and with specific reference to Ethiopia, the concept of cost sharing, the rationales of cost sharing and highlights the major features of cost sharing policy implementations.Um grande problema dos governos dos governos do mundo e particularmente dos países em desenvolvimento têm enfrentado é a questão de como a reforma do financiamento do ensino superior em resposta às pressões crescentes interligada de inscrição do ensino superior (massificação) e do orçamento incompatível público. Os últimos três ou quatro décadas testemunharam grandes mudanças na maneira como a educação tanto nos países desenvolvidos e em desenvolvimento maior é financiado. Os governos e as instituições de ensino superior têm se confrontado com o problema do financiamento massificada sistema de ensino superior, enquanto a despesa pública para a educação não conseguiu manter o ritmo ou, em alguns casos diminuiu. Apoiado por esses objectivos e argumentos econômicos como as taxas de retorno do ensino superior, equidade e eficiência, a massificação do ensino superior tem provocado profundas, o país ea instituição específica, os processos de reforma turbulento e uma delas é a reforma do ensino superior financeiros. Massificação exerceu pressão financeira sobre a receita pública e causou a austeridade de ensino superior inescapável financeira, que é mais pronunciado e exibido em países em desenvolvimento. A percepção ea subsequente introdução da partilha de custos, na forma de propinas, taxas e outros encargos do usuário onde o ensino superior foi anteriormente oferecido gratuitamente eo aumento substancial das propinas em vários países onde existiam anteriormente, é em parte resultado da maior pressão de educação financeira. Este tem sido o produto de uma escalada de matrícula do ensino superior, menos receitas, bem como a subida do custo unitário. Indiscutivelmente, a partilha dos custos tem sido respeitado e favorecido por seu papel na promoção da eficiência e equidade do ensino superior também. Quatro partidos estão na linha da frente na distribuição dos custos do ensino superior. Estes são os alunos, pais, governos e doadores. Os investidores privados também partilhar os encargos da demanda crescente de educação superior. A tendência de introdução de pagamentos para o ensino superior, um aumento significativo das propinas ea alteração dos regimes de auxílio estudantil de subvenções ao crédito tem sido fonte de controvérsias e debates, que tornaram-se os dotes negativos para a execução da política de partilha dos custos, em muitos países. Além disso, o esforço de implementação da política de partilha de custos, em muitos países em desenvolvimento tem sido frustrados por muitos outros factores nacionais e internacionais. Este estudo é tentar analisar, a análise comparativa dos países em desenvolvimento e com referência específica à Etiópia, o conceito de partilha de custos, as lógicas de partilha de custos e destaca as principais características de implementações de políticas de partilha de custos

Explaining technical inefficiency and the variation in income from apple adoption in highland Ethiopia: The role of unequal endowments and knowledge asymmetries

This paper considers the performance and quality of apple fruits and seedlings production in Chencha district of southern Ethiopia. The estimated, three-factor (labour, land and capital) production frontier reveals that the technical inefficiency is 60% and 48% for fruits and seedlings production, respectively. Endowments in land, apple plantation and manure are important production factors for both fruits and seedlings, while labour is significant only for seedlings production. We could not reject constant returns to scale, neither for apple fruits nor for seedlings. Apart from capital and labour endowments, producer knowledge on apple cultivation is a positive and significant determinant of the level of output, product quality, and income generated from apples. The insignificance of the education variable for fruits and seedlings production suggests that what matters in the apple business is specific knowledge of apple-growing technology rather than formal education, at least beyond primary education

Medication counselling practices amid COVID -19 pandemic and associated factors in drug retail outlets of Jimma town, Southwest Ethiopia: cross-sectional study

Background: Patients’ good understanding and awareness of drug information received at the drug retail outlet is paramount to gaining expected outcomes. In the COVID-19 pandemic, the routine counselling practice faced multifactorial challenges.Objectives: The study aimed to assess medication counseling practice and associated factors in drug retail outlets of Jimma town, southwest Ethiopia.Methods: A facility-based cross-sectional study was conducted using an interviewer administered questionnaire. The data were analysed by using SPSS version 23. A multivariable logistic regression model was used to identify factors associated with medicationcounselling practice.Results: A total of 180 pharmacy professionals were enrolled in the study, about half (51.1%) of the participants reported good medication counselling provision for their patients. In A multivariable logistic regression analysis, reduced pharmacist’s level of communication (AOR=0.008; CI: 0.001-0.292; p= 0.009) and shortage of personal protective equipment (AOR=0.021; CI: 0.002-0.226; p=0.002) due Covid-19 were factors associated with poor medication counselling practice.  Conclusion: Reduced level of communication and shortage of personal protective equipment due to Covid-19 were factors associated with poor medication counselling practice. In general, Jimma town health offices and Oromia Region Health bureau should struggle in association with other stakeholders to improve the identified bottleneck of pharmacist’s counselling practice. Keywords: Counseling practice; COVID -19; drug retail outlet; Jimma

Explaining technical inefficiency and the variation in income from apple adoption in highland Ethiopia : The role of unequal endowments and knowledge asymmetries

This paper considers the performance and quality of apple fruits and seedlings production in Chencha district of southern Ethiopia. The estimated, three-factor (labour, land and capital) production frontier reveals that the technical inefficiency is 60% and 48% for fruits and seedlings production, respectively. Endowments in land, apple plantation and manure are important production factors for both fruits and seedlings, while labour is significant only for seedlings production. We could not reject constant returns to scale, neither for apple fruits nor for seedlings. Apart from capital and labour endowments, producer knowledge on apple cultivation is a positive and significant determinant of the level of output, product quality, and income generated from apples. The insignificance of the education variable for fruits and seedlings production suggests that what matters in the apple business is specific knowledge of apple-growing technology rather than formal education, at least beyond primary education.</p

Re-considering internationalisation from the periphery : Introduction to the two linked articles

Peer reviewe

Baseline assessment of pharmacovigilance activities in four sub-Saharan African countries: a perspective on tuberculosis.

BACKGROUND: New medicines have become available for the treatment of drug-resistant tuberculosis (DR-TB) and are introduced in sub-Saharan Africa (SSA) by the national TB programs (NTPs) through special access schemes. Pharmacovigilance is typically the task of national medicines regulatory agencies (NMRAs), but the active drug safety monitoring and management (aDSM) recommended for the new TB medicines and regimens was introduced through the NTPs. We assessed the strengths and challenges of pharmacovigilance systems in Eswatini, Ethiopia, Nigeria and Tanzania, focusing on their capacity to monitor safety of medicines registered and not registered by the NMRAs for the treatment of DR-TB. METHODS: Assessment visits were conducted to all four countries by a multidisciplinary team. We used a pharmacovigilance indicator tool derived from existing tools, interviewed key stakeholders, and visited health facilities where DR-TB patients were treated with new medicines. Assessment results were verified with the local NMRAs and NTPs. RESULTS: Most countries have enabling laws, regulations and guidelines for the conduct of pharmacovigilance by the NMRAs. The relative success of NTP-NMRA collaboration is much influenced by interpersonal relationships between staff. Division of roles and responsibilities is not always clear and leads to duplication and unfulfilled tasks (e.g. causality assessment). The introduction of aDSM has increased awareness among DR-TB healthcare providers. CONCLUSION: aDSM has created awareness about the importance of pharmacovigilance among NTPs. In the future, a push for conducting pharmacovigilance through public health programs seems useful, but this needs to coincide with increased collaboration with between public health programs and NMRAs with clear formulation of roles and responsibilities

The variable prevalence of bovine tuberculosis among dairy herds in Central Ethiopia provides opportunities for targeted intervention.

Bovine tuberculosis (bTB) is an important disease for dairy productivity, as well as having the potential for zoonotic transmission. Previous prevalence studies of bTB in the dairy sector in central Ethiopia have suggested high prevalence, however, they have been limited to relatively small scale surveys, raising concerns about their representativeness. Here we carried out a cross sectional one-stage cluster sampling survey taking the dairy herd as a cluster to estimate the prevalence of bTB in dairy farms in six areas of central Ethiopia. The survey, which to date is by far the largest in the area in terms of the number of dairy farms, study areas and risk factors explored, took place from March 2016 to May 2017. This study combined tuberculin skin testing and the collection of additional herd and animal level data by questionnaire to identify potential risk factors contributing to bTB transmission. We applied the single intradermal cervical comparative tuberculin (SICCT) test using >4mm cut-off for considering an individual animal as positive for bTB; at least one reactor animal was required for a herd to be considered bTB positive. Two hundred ninety-nine dairy herds in the six study areas were randomly selected, from which 5,675 cattle were tested. The overall prevalence of bTB after standardisation for herd-size in the population was 54.4% (95% CI 48.7-60%) at the herd level, and it was 24.5% (95% CI 23.3-25.8) at the individual animal level. A Generalized Linear Mixed Model (GLMM) with herd and area as random effect was used to explore risk factors association with bTB status. We found that herd size, age, bTB history at farm, and breed were significant risk factors for animals to be SICCT positive. Animals from large herds had 8.3 times the odds of being tuberculin reactor (OR: 8.3, p-value:0.008) as compared to animals from small herds. The effect of age was strongest for animals 8-10 years of age (the oldest category) having 8.9 times the odds of being tuberculin reactors (OR: 8.9, p-value:<0.001) compared to the youngest category. The other identified significant risk factors were bTB history at farm (OR: 5.2, p-value:0.003) and cattle breed (OR: 2.5, p-value: 0.032). Our study demonstrates a high prevalence of bTB in central Ethiopia but with a large variation in within-herd prevalence between herds, findings that lays an important foundation for the future development of control strategies

Prevalence of bovine tuberculosis and its associated risk factors in the emerging dairy belts of regional cities in Ethiopia.

Bovine tuberculosis (BTB) has become an economically important disease in dairy herds found in and around Addis Ababa City and is emerging in regional cities like Gondar, Hawassa and Mekelle because of the establishment of dairy farms in the milk sheds of these cities. A cross-sectional study to estimate the prevalence of BTB and identify associated risk factors was conducted between February 2016 and March 2017. A total of 174 herds comprising of 2,754 dairy cattle in the cities of Gondar, Hawassa and Mekelle were tested using the Single Intradermal Comparative Cervical Tuberculin (SICCT) test. Data on herd structure, animal origin, body condition, housing condition, farm hygiene, management and biosecurity practices were collected using a pre-tested structured questionnaire. Generalized Linear Models (GLM) and Generalized Linear Mixed Models (GLMM) were used to analyze the herd and animal level risk factors, respectively. The herd prevalence was 22.4% (95% CI: 17-29%) while the animal prevalence was 5.2% (95% CI: 4-6%) at the cut-off >4 mm. The herd prevalence rose to 65.5% (95% CI: 58-72%) and the animal prevalence rose to 9% (95% CI: 8-10%) when the severe interpretation of >2 mm cut-off was applied. The mean within-herd prevalence in positive farms at the cut-off >4 mm was 22.7% (95% CI: 15-31%). At the herd level, the analysis showed that herd size, farm hygiene, feeding condition and biosecurity were significantly associated with BTB status, while new cattle introductions showed only borderline significance and that age of farm, housing condition, farmers' educational status and animal health care practice were not significant. At the animal level, the results showed that age and animal origin were identified as significant predictors for BTB positivity but sex and body condition score were not related to BTB status. Descriptive analysis revealed that herds having 'BTB history' showed slightly higher likelihood of being BTB positive compared to farms having no previous BTB exposure. In conclusion, this study showed relatively lower average prevalence in the emerging dairy regions as compared to the prevalence observed in and around Addis Ababa City, warranting for implementation of control program at this stage to reduce or possibly stop further transmission of BTB.This work was funded by the Biotechnology and Biological Sciences Research Council, the Department for International Development, the Economic & Social Research Council, the Medical Research Council, the Natural Environment Research Council and the Defence Science & Technology Laboratory, under the Zoonoses and Emerging Livestock Systems (ZELS) programme, ref: BB/L018977/1

Prevalence of bovine tuberculosis and its associated risk factors in the emerging dairy belts of regional cities in Ethiopia

Bovine tuberculosis (BTB) has become an economically important disease in dairy herds found in and around Addis Ababa City and is emerging in regional cities like Gondar, Hawassa and Mekelle because of the establishment of dairy farms in the milk sheds of these cities. A cross-sectional study to estimate the prevalence of BTB and identify associated risk factors was conducted between February 2016 and March 2017. A total of 174 herds comprising of 2,754 dairy cattle in the cities of Gondar, Hawassa and Mekelle were tested using the Single Intradermal Comparative Cervical Tuberculin (SICCT) test. Data on herd structure, animal origin, body condition, housing condition, farm hygiene, management and biosecurity practices were collected using a pre-tested structured questionnaire. Generalized Linear Models (GLM) and Generalized Linear Mixed Models (GLMM) were used to analyze the herd and animal level risk factors, respectively. The herd prevalence was 22.4% (95% CI: 17-29%) while the animal prevalence was 5.2% (95% CI: 4-6%) at the cut-off &gt;4 mm. The herd prevalence rose to 65.5% (95% CI: 58-72%) and the animal prevalence rose to 9% (95% CI: 8-10%) when the severe interpretation of &gt;2 mm cut-off was applied. The mean within-herd prevalence in positive farms at the cut-off &gt;4 mm was 22.7% (95% CI: 15-31%). At the herd level, the analysis showed that herd size, farm hygiene, feeding condition and biosecurity were significantly associated with BTB status, while new cattle introductions showed only borderline significance and that age of farm, housing condition, farmers' educational status and animal health care practice were not significant. At the animal level, the results showed that age and animal origin were identified as significant predictors for BTB positivity but sex and body condition score were not related to BTB status. Descriptive analysis revealed that herds having 'BTB history' showed slightly higher likelihood of being BTB positive compared to farms having no previous BTB exposure. In conclusion, this study showed relatively lower average prevalence in the emerging dairy regions as compared to the prevalence observed in and around Addis Ababa City, warranting for implementation of control program at this stage to reduce or possibly stop further transmission of BTB

Mapping inequalities in exclusive breastfeeding in low- and middle-income countries, 2000–2018

Abstract: Exclusive breastfeeding (EBF)—giving infants only breast-milk for the first 6 months of life—is a component of optimal breastfeeding practices effective in preventing child morbidity and mortality. EBF practices are known to vary by population and comparable subnational estimates of prevalence and progress across low- and middle-income countries (LMICs) are required for planning policy and interventions. Here we present a geospatial analysis of EBF prevalence estimates from 2000 to 2018 across 94 LMICs mapped to policy-relevant administrative units (for example, districts), quantify subnational inequalities and their changes over time, and estimate probabilities of meeting the World Health Organization’s Global Nutrition Target (WHO GNT) of ≥70% EBF prevalence by 2030. While six LMICs are projected to meet the WHO GNT of ≥70% EBF prevalence at a national scale, only three are predicted to meet the target in all their district-level units by 2030