37 research outputs found
The Burden of Internal Conflict on Expanded Programs on Immunization in Northwest Ethiopia: Implementation Science Study
AbstractBackground: Despite the rapid progress in immunization service delivery systems worldwide, populations in areas of conflict often have limited or no access to lifesaving vaccines. Hence, evidence generation and translation for context-specific strategies and tailored action would be important, before, during and after an acute humanitarian emergency.Aim: To explore factors affecting immunization service delivery during and after conflict among internally displaced communities in Northwest Ethiopia.Methods: Qualitative and quantitative (record review) methods were applied, phenomenological study design and in-depth interviews were applied to collect the lived experiences of participants in the affected areas. Transcribed and translated data were analyzed and thematized using open code software. A Twenty-four-month record review of quantitative data was analyzed descriptively using an excel sheet to develop immunization coverage trends for tracer antigens.Results: We found that the immunization program had seriously deteriorated during and after the conflict in the study area. The monthly EPI service report in the affected areas showed a decline with the lowest records in December and January when the internal conflict was peak. Security problems, displacement of health workers, destruction of health infrastructures, mixing of the displaced community in the host community and poor coordination among stakeholders and partners, clients having other emergent needs and shortages of resources were important factors for immunization services.Conclusion: Vaccination service delivery was found to have significantly declined in the study area. Security problems affected not only the service utilizers but also the service providersâ wing as well. Coordination of stakeholders and strong leadership systems are crucial in maintaining optimum vaccination service delivery even at the time of conflict. [Ethiop. J. Health Dev. 2021; 35(SI-3):39-48]Key words: Conflict, internally displaced, Immunization service
Implementation fidelity and challenges of optimal cold chain management in Assossa district health system, Benshangul-Gumuz region, Western Ethiopia
AbstractIntroduction: Preventive programs which have proven to be effective in clinical trials may not necessarily impact the health and wellbeing of the community unless they are implemented with fidelity. While cold chain is the backbone of immunization programs, limited studies exist to explain fidelity implementation which likely contributes to a lack of evidence-based instructional practices of cold chain management.Aim: This study aimed to explore the fidelity implementation and challenges of optimal cold chain management in the Benshangul-gumuz region.Methods: A qualitative approach was utilized to explore the underlying challenges to optimum implementation of cold chain management in Benshangul-gumuz region. Observational techniques and key informant interviews with 12 key-informants were conducted. Data was collected at all levels of the health system including, the regional health bureau, Ethiopian Pharmaceuticals Supply Agency hub, district health offices, Health centers, and health posts. Data analysis and interpretation was performed using the framework analysis approach. Open Code 4.02 software was used for analysis.Findings: This study identified three main themes including adherence to intervention, human resource development, and availability and use of resources. The findings also revealed that a significant number of the employees were not adhering to the optimal cold chain management guidelines. Staff development, availability and utilization of equipment and related finances were major fidelity implementation challenges of cold chain management.Conclusions: Across the health facilities under study, implementation fidelity of cold chain management was considered poor. Human resource development, proper allocation and effective management of logistics and related finance could facilitate optimal cold chain management practices, and efforts to save lives through delivery of safe and quality vaccines. [Ethiop. J. Health Dev. 2021; 35(SI-3):03-08]Keywords: Cold chain management, Implementation fidelity, Challenges, Ethiopi
How to optimize health facilities and community linkage in order to enhance immunization service? The case of West Amhara Region, Ethiopia
AbstractBackground: Health facility-community linkages are important in designing community-level interventions, appropriate immunization service provision modalities, and changing unhealthy behaviors. However, there is limited evidence on the influence of community and facility linkage on vaccination services in Ethiopia.Aim: This study aimed to explore how the linkage between health facilitiesa and the community could be optimized in order to enhance immunization services.Methods: A Phenomenological study design, using an explanatory approach was applied in the two districts (Shebele Berenta & South Achefer district) of the Amhara region for the month of June , 2020. Forty-six key informants were interviewed using an interview guide and data was analyzed using open code version 4.02. The data was coded, and thematic analysis was applied.Results: The finding revealed that there were community platforms to facilitate community and health facility linkage. Respondents also perceived that the community to health facility linkage was an effective strategy for the Expanded Program on Immunization (EPI) service provision. The study revealed that perception of health care providers, health care providers attitude and practices, shortages of stock (medication and supplies), distance from main road and transportation, irregularity in the implementation of rules and regulations, lack of incentives, inadequate counseling and support, lack of awareness, shortages of human resources and lack of training support for health care workers were barriers for effective community-health facility linkage.Conclusion: The linkage of community and facilities were not approached in the same manner within districts and facilities. Therefore, strengthening a common system for community-health facility linkage and community engagement is critical during immunization services. Establishing a strong strategy of incentivizing mechanisms is vital for the effective implementation of immunization services. An advocacy strategy to mobilize engagement among policy and decision-makers, and other key stakeholders was an important strategy for improving the program. [Ethiop. J. Health Dev. 2021; 35(SI-3):75-85]Keywords: Community, Facility linkage, EPI, Amhara Region, Ethiopi
Assessment of barriers to the implementation of community-based data verification and immunization data discrepancies between health facilities and the community in Tach Gayint district, Northwest Ethiopia.
AbstractIntroduction: While community-based data verification (CBDV) is critical for effective implementation of immunization programs, limited evidence exists detailing its implementation at the local levels thereby threatening data quality which is used to guide decision making.Aim: To explore the barriers to proper implementation of CBDV and determine the level of immunization data discrepancy between the health facilities and community levels in Tach Gayint district of Northwest Ethiopia.Methods: A Mixed methods approach was used. Interviews with twenty-six key informantsâ (health experts) in immunization data, and an additional a sample of 324 infants were recruited. All health centers in the district (6) and 2 health posts from each health center (12 in total) were selected using Simple Random Sampling. Key informant interviewees were purposely included from all health facilities. For quantitative data, samples of infants were proportionally allocated for each health facility as per their DPT/Pentavalent-1 vaccine report. Thematic analysis of the qualitative data and descriptive quantitative analysis were performed using statistical software open-code v-4.02 and STATA v14.1 respectively.Results: Only few health facilities implemented CBDV and consider it to be their routine task. Also, barriers to effective implementation of CBDV such as lack of prioritization, poor capacity among health staff, and conflicting job roles were identified. The highest immunization data discrepancy among community and health facilities was observed for the measles-one vaccine (35.4%), and the minimum was for DPT/Pentavalent-1 (25.6%).Conclusion: This study revealed a poor level of CBDV implementation and barriers to its effective implementation which include lack of prioritizing CBDV, limited capacity among health staff in performing CBDV, and conflicting job roles among health staff. There was a high level of immunization data discrepancy for measles-1 and DTP/Pentalent-3 vaccines. Based on our finding, we make the following recommendations: building skills among health workers to perform CBDV, enhancing availability and use of standard CBDV tools, ensuring monitoring, and control mechanism, and setting clear definition of roles regarding CBDV, as well as closing the gap in level of immunization data discrepancy could help foster effective implementation of CBDV. [Ethiop. J. Health Dev. 2021; 35(SI-3):09-15]Key words: Immunization, CBDV, Data discrepancy, Data qualit
A systems and partnership approach to agricultural research for development: Lessons from Ethiopia
In spite of the availability of several improved agricultural technologies
generated by the research system in Ethiopia over the last four decades, adoption of
these innovations by smallholder farmers has been very low. This has led to
stagnation of agricultural productivity and low crop yields, exposing the country to
recurrent food shortfalls and national food insecurity. The old approach to
agricultural research emphasized developing new technologies mainly through onstation
research that were then supposed to reach farmers through the public-sector
extension system. The Ethiopian Institute of Agricultural Research (EIAR) has in
recent years introduced a shift in agricultural research for development, which is
based on the innovation systems approach that involved cultivating partnerships
with several actors along the value chain, especially farmers, farmersâ cooperatives
and input suppliers. This paper presents the methodology used to facilitate
agricultural innovations and the diffusion of new technologies and illustrates the
outcomes of this initiative with regard to technology adoption, productivity growth
and the market orientation of production. The authors use examples from
experiences in scaling up three grain legumes. Compared to the three-year baseline
average (2003â05), crop output increased nationally by 89%, 85% and 97% in
2008 for common bean, chickpea and lentil respectively. Nationally, 53â59% of the
output growth is attributable to yield growth due to technological change, while the
balance is due to area expansion. These results affirm that the new approach has led
to accelerated adoption of new and high-yielding or low-risk varieties
Balanced fertilization increases wheat yield response on different soils and agroecological zones in Ethiopia
The response of wheat to the application of different rates of nitrogen (N), phosphorus (P), potassium (K), and sulfur (S) under balanced fertilization on different soil types and agroecologies has not been well studied in Ethiopia. Therefore, the objectives of this study were to (1) determine soil-specific responses of wheat to N, P, K, and S under balanced fertilization; (2) quantify agroecology-specific N, P, K, and S response of wheat under balanced fertilization; and (3) determine nutrient use efficiency of wheat on different soil types under balanced fertilization. Trials were conducted on farmersâ fields across 24 locations covering 4 soil types and 5 agroecological zones (AEZs) from 2013 to 2017. The mean grain yields of wheat significantly varied with applied N and P fertilizer rates with soil types and AEZs. With balanced application of other nutrients, the optimum N rates for wheat were 138 kg N haâ1 on Cambisols and Luvisols, 92 kg N haâ1 on Vertisols, and 176 kg N haâ1 on Nitisols, while the optimum P rate was 20 kg P haâ1 on Cambisols and Vertisols. The nutrient doseâresponse curve did not reveal consistent pattern for K and S applications on all soil types. The agronomic efficiency of wheat decreased with increasing rates N and P on all soil types. The highest agronomic efficiency of N (15.8 kg grain kgâ1 applied N) was recorded with application of 92 kg N haâ1 on Vertisols, while the highest agronomic efficiency of P (49 kg grain kgâ1 applied P) was achieved with application of 10 kg P haâ1 on Cambisols. We conclude that applications of 92â138 kg N haâ1, 20 kg P haâ1, 18 kg K haâ1, and 10 kg S haâ1 under balanced application of zinc and boron could be recommended depending on soil type for wheat production in the study areas
Patterns of help-seeking behavior among people with mental illness in Ethiopia: a systematic review and meta-analysis
BackgroundDespite the availability of evidence-based and effective treatments, significant numbers of people living with mental illness do not receive treatment or do not seek help from providers of formal modern treatment. Although numerous primary studies have been conducted on patterns of help-seeking behavior among individuals with mental illness with respect to modern therapy, the evidence has not been aggregated nationwide. Therefore, the aim of this review was to investigate pooled data on patterns of help-seeking behavior among individuals with mental illness in Ethiopia.MethodsAll available primary studies were searched via the Google Scholar, HINARI, and PubMed databases from June 22 to December 20, 2023; 912 articles were identified. Sixteen articles were included in the final review; data from them were extracted to an Excel spreadsheet and exported to Stata version 17 for analysis. The search terms used were: âPattern of help-seeking behaviorââ OR âPattern of treatment-seeking behaviorâ OR âHealth care-seeking behaviorâ OR âHelp-seeking intentionâ OR âHelp-seeking preferencesâ OR âPerceived needâ OR âPathways to psychiatric careâ, AND âCommon mental disordersâ OR âMental illnessâ OR âMental health problemsâ OR âDepressionâ, AND âPredictorsâ OR âDeterminate factorsâ OR âAssociated factorsâ, AND âEthiopiaâ. The quality of the studies included was critically appraised using the modified The Joanna Briggs Institute (JBI) Joanna Briggs Institute quality assessment tool, adapted for observational studies. During critical appraisal, disagreements between the two authors conducting the assessment were resolved by the involvement of a third author. Effect sizes were pooled using the random effects model, and the presence of publication bias was detected based on asymmetry of the funnel plot and a statistically significant result of Eggerâs test (p<0.05).ResultsThe pooled rate of positive help-seeking behavior with respect to modern treatment among people living with mental illness was 42.21% (95% CI: 29.29, 55.12; I2 = 99.37%, P=0.00). Factors significantly associated with a positive pattern of help-seeking behavior were: having a secondary education or above (AOR=5.47, 95% CI: 2.33, 12.86); believing that mental illness requires treatment (AOR=2.76, 95% CI: 2.02, 3.78); having strong social support (AOR=2.00, 95% CI: 1.64, 2.44); having a family history of mental illness (AOR=2.68, 95% CI: 1.38, 3.97); having awareness of the availability of treatment (AOR=2.92, 95% CI: 1.56, 5.46); having previously engaged in positive help-seeking behavior (AOR=3.28, 95% CI: 1.63, 6.60); having comorbid disorders (AOR=4.25, 95% CI: 1.69, 10.66); not using alcohol (AOR=3.29, 95% CI: 1.73, 6.27); and the perceived severity of mental illness (AOR=2.54, 95% CI: 1.490, 4.33).ConclusionsThe majority of people with mental illness in Ethiopia exhibited a poor pattern of help-seeking behavior with respect to modern treatment. Therefore, mobilization of the community should be encouraged via regular public awareness campaigns regarding mental illness and the availability of evidence-based and effective modern treatment in Ethiopia. Moreover, the design of effective community-based mental health interventions is recommended in order to improve public attitudes and rates of help-seeking behavior in relation to mental health problems
institutional framework of in action against land degradation
While econometric and spatial data are increasingly helpful to quantify and locate the extent and costs of land degradation, there is still little understanding of the contextual factors that determine or influence the land users' practices that aggravate or counteract land degradation. In this chapter, we take an institutional economic approach to analyse the persistence of degrading practices, the low adoption of sustainable land management (SLM), or the eventual organisational reaction to land degradation. The chapter reviews four examples of land degradation in different contexts to reveal the multiple driving forces and contextual factors. We then propose a conceptual framework to better understand the incentive structure and factors determining the land users' decision making. A layered analysis of the social phenomena is applied, following Williamson (2000). The chapter shows how actions at different layers can help improve land management. The chapter concludes with practical recommendations for the institutional economic analysis of land degradation
Adsorption of methylene blue dye onto acid-treated tej residue: Kinetic, equilibrium and thermodynamic study
94-102Dye-containing wastewater is a very toxic and a major threat to the deterioration of water quality and makes it unsuitable
for domestic purposes. This drives low cost and eco-friendly adsorbents from environmental waste have been investigated to
treat dye-containing wastewater. In the present study, tej residues (TR) have been successfully employed as a natural and
non-conventional low-cost adsorbent for the removal of methylene blue (MB) dye from an aqueous solution. Optimization
of maximum operating condition has been carried out by batch mode experiment and the result shows maximum removal
efficiency of 82.1821 % at pH 8.0, adsorbent dosage 0.4g, initial dye concentration 20 ppm, contact time 60 min, and
temperature 25°C on the acid-treated surface of tej residue. Adsorption kinetics of the adsorbent has been evaluated by
pseudo-first-order, pseudo-second-order and intra-particle diffusion, and it is observed that the pseudo-first-order kinetic
model is better fitted with a good correlation coefficient, and the equilibrium data fitted well with the Freundlich isotherm
model. The Langmuir isotherm model estimates that the maximum adsorption capacity of the monolayer is found to be
215.053 mg/g. Thermodynamics parameters such as ÎG0, ÎH0 and ÎS0 indicate that the sorption process is feasible and
exothermic