Food security outcomes in agricultural systems models: Current status and recommended improvements

Improvement of food security is a common objective for many agricultural systems analyses, but how food security has been conceptualized and evaluated within agricultural systems has not been systematically evaluated. We reviewed the literature on agricultural systems analyses of food security at the household- and regionallevels, finding that the primary focus is on only one dimension of food security-agricultural output as a proxy for food availability. Given that food security comprises availability, access, utilization and stability dimensions, improved practice would involve more effort to incorporate food access and stability indicators into agricultural systems models. The empirical evidence base for including food access indicators and their determinants within agricultural systems models requires further development through appropriate short and longterm investments in data collection and analysis. Assessment of the stability dimension of food security (through time) is also particularly under-represented in previous work and requires the development and application of appropriate dynamic models of agricultural systems that include food security indicators, coupled with more formalized treatment of robustness and adaptability at both the regional and household levels. We find that agricultural systems models often conflate analysis of food security covariates that have the potential to improve food security (like agricultural yields) with an assessment of food security itself. Agricultural systems modelers should exercise greater caution in referring to analyses of agricultural output and food availability as representing food security more generally

Global injury morbidity and mortality from 1990 to 2017 : results from the Global Burden of Disease Study 2017

Correction:Background Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. Methods We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs). Findings In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505). Interpretation Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.Peer reviewe

Estimating global injuries morbidity and mortality : methods and data used in the Global Burden of Disease 2017 study

Background While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria. Methods In this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation. In summary, these methods included estimating cause-specific mortality for every cause of injury, and then estimating incidence for every cause of injury. Non-fatal disability for each cause is then calculated based on the probabilities of suffering from different types of bodily injury experienced. Results GBD 2017 produced morbidity and mortality estimates for 38 causes of injury. Estimates were produced in terms of incidence, prevalence, years lived with disability, cause-specific mortality, years of life lost and disability-adjusted life-years for a 28-year period for 22 age groups, 195 countries and both sexes. Conclusions GBD 2017 demonstrated a complex and sophisticated series of analytical steps using the largest known database of morbidity and mortality data on injuries. GBD 2017 results should be used to help inform injury prevention policy making and resource allocation. We also identify important avenues for improving injury burden estimation in the future.Peer reviewe

Intention to donate blood and its predictors among adults of Gondar city: Using theory of planned behavior.

BACKGROUND:Blood transfusion is a lifesaving procedure when someone encounters severe anemia, accident or injury, surgery, heavy bleeding during childbirth and cancer chemotherapy. The average blood donation rate of Africa is 4.7/1000 inhabitants and Ethiopia is among one of the countries with the lowest annual donation rate which is 0.8/1000 population. This study assessed intention to donate blood on adults of Gondar city administration using the theory of planned behavior. METHODS:A community-based cross-sectional study was conducted. The study was conducted on two randomly selected Gondar sub-cities using systematic sampling on a sample size of 524 adults. Epi Data version 3.0 and STATA version 14 were used for entry and analysis of data respectively. Multiple linear regression was carried out to see the association between intention and sociodemographic variables, past donation experience, attitude, subjective norm and perceived behavioral control and with 95% confidence interval and a p-value of less than 0.05 was used to detect statistical significance. RESULTS:A total of 515 respondents participated in the study giving a response rate of 98%. Most of the participants were females (66.4%) and the participants' age ranges from 18 to 65 years. The variance explained by the model was 49%. The mean intention to donate blood was 3.02±1.13. Direct perceived behavioural control (β = 0.14, CI (0.04, 0.23)), direct subjective norm (β = 0.11: CI (0.04, 0.17), direct attitude (β = 0.03; CI (0.01, 0.06)) and past behaviour of blood donation (β = 0.3; CI (0.07, 0.51) were significant predictor of intention. CONCLUSION:Theory of planned behavior could be successfully applied in determining adult's blood donation intention. Predictors of intention to donate blood were past experience of blood donation, direct subjective norm, direct perceived behavioural control and direct attitude. None of the external variables predict blood donation intention

Determinants of COVID-19-related knowledge and preventive behaviours among students in reopened secondary schools: cross-sectional study

Purpose In Ethiopia, more than 26 million students have been out of the classroom for nearly 9 months. On 18 September, the Ethiopian Minister of Health advised the Parliament the possibility of reopening schools provided certain conditions were met. Schools are currently reopening in the country for the first time since March 2020.Objective This study assessed the knowledge and preventive health behaviours toward COVID-19 and associated factors among secondary school students.Design, setting, participants and outcome measures An institution-based cross-sectional study was conducted from October to December 2020 in Gondar city, Northwest Ethiopia. A total of 370 secondary school students were included. Bivariable and multivariable ordinal logistic regression model were fitted to identify the predictors of knowledge about COVID-19. Simple and multiple linear regression analysis were done to identify factors associated with preventive behaviour. A p<0.05 was used to declare statistical significance.Results Only one-fourth (23.5%, 95% CI 19.5% to 28.1%) of the participants had a good knowledge about COVID-19. The mean score of preventive behaviour was 22.8±SD 6.2. Marital status, religion, father education, living arrangement and sources of information were significantly associated with knowledge about COVID-19. Being female and using health professionals as source of information increased the engagement in preventive behaviours. On the other hand, student whose father employed in non-governmental organisation and other jobs had decreased engagement in preventive health behaviours.Conclusion Significant number of the students had inadequate knowledge about COVID-19 and poorly engaged in COVID-19 preventive behaviour. Thus, it is suggested to include and disseminate about COVID-19 in related academic sessions, using school clubs and minimedias. The sources of COVID-19-related information need to strengthen the dissemination of tailored, credible and timely message to enhance the knowledge and engagement of the students in preventive behaviours

Exploring spatiotemporal distribution of under-five mortality in Ethiopia: further analysis of Ethiopian Demographic and Health Surveys 2000, 2005, 2011 and 2016

Objective The aim of this study was to explore spatiotemporal distribution of under-five mortality in Ethiopia using data from four (2000, 2005, 2011 and 2016) consecutive demographic and health surveys.Methods A total of 41 498 children were included from four consecutive Ethiopian Demographic and Health Surveys. The geospatial analysis was conducted by using ArcGIS V.10.7 and saTScan V.9.6. Thus, spatial autocorrelation, hotspot analysis, spatial interpolation and spatial scan statistics were carried out for each survey separately to show the temporal pattern of geographically risk areas of under-five mortality in Ethiopia. Finally, the most under-five mortality rate (U5MR) risk areas in each survey period were mapped.Results Under-five mortality was spatially clustered in Ethiopia (Moran’s Index: 0.046–0.096, p<0.01). The Benishangul-Gumuz region was consistently at a higher risk in the last two decades. Additional hotspot areas were detected at Afar and Amhara (in 2000, 2005, 2016), at Gambala (in 2011) and the South Nation Nationality and People’s (SNNP) Region (in 2016). Moreover, 160 primary clusters were identified. Of these, 85 clusters (log-likelihood ratio (LLR)=13.10, p<0.01) were from Benishangul-Gumuz and Amhara regions (in 2000); 67 clusters (LLR=12.93, p<0.01) were from Afar and Amhara regions (in 2005); 4 clusters (LLR=10.54, p<0.01) were from Benishangul-Gumuz region (in 2011); and another 4 clusters (LLR=11.85, p<0.01) were from Afar region (in 2016).Conclusion High-risk areas were detected mainly in the Benishangul-Gumuz and Afar regions. As a result, designing under-five population targeted intervention programmes in those high-risk geographical regions was vital to reduce under-five mortality in Ethiopia

Smoking Intensity and Associated Factors among Male Smokers in Ethiopia: Further Analysis of 2016 Ethiopian Demographic and Health Survey

Background. Smoking invariably has health, social, economic, and environmental consequences in Ethiopia. Reducing and quitting cigarette smoking improves individual health and increases available household funds for food, education, and better economic productivity. Therefore, this study is aimed at assessing cigarette smoking intensity and associated factors among male smokers in Ethiopia. Methods. The data were extracted from the 2016 national cross-sectional Ethiopian Demographic and Health Survey. Our study used data from the standardized and adapted men’s questionnaire. The study included a total of 391 (weighted) smokers who at least smoked one manufactured cigarette per day. The data were collected using a two-stage cluster design which includes selection of enumeration areas and then selection of households. The number of manufactured cigarettes smokers smoked per day was used to measure smoking intensity. Descriptive statistics were used to summarize the study findings. Bivariable and multivariable truncated negative binomial Poisson regression models were employed to determine smoking intensity. Results. The finding showed that on average men smoked weighted nine cigarettes per day. One in every five of the smokers (21.2%) smoked 10 cigarettes per day. Smokers living in rural areas (IRR=0.43, 95% CI: 0.244, 0.756), currently married (IRR=0.64, 95% CI: 0.46, 0.91), formerly married (IRR=0.54, 95% CI: 0.30, 0.96), richer men (IRR=0.63, 95% CI: 0.43, 0.90), and richest men (IRR=0.49, 95% CI: 0.28, 0.87) were associated with lower smoking intensity. Smokers in the Somali (IRR=2.80, 95% CI: 1.29, 6.11), Harari (IRR=3.46, 95% CI: 1.14, 10.51), and Dire Dawa (IRR=3.09, 95% CI: 1.23, 7.80) regions; older age (IRR=1.77, 95% CI: 1.31, 2.40); affiliated with Protestant religion (IRR=1.81, 95% CI: 1.12, 2.92); poorer men (IRR=1.64, 95% CI: 1.19, 2.27); watched television (IRR=1.18, 95% CI: 1.04, 1.35); drunk alcohol (IRR=1.37, 95% CI: 1.03, 1.82); and completed primary (IRR=1.15, 95% CI: 1.01, 0.317) and higher education (IRR=2.96, 95% CI: 1.88, 4.67) were positively associated with smoking intensity. Conclusion. Male smokers in Ethiopia smoked intensively with an average of nine manufactured cigarettes per day. Tobacco control interventions should target the following: Eastern Ethiopia regions, older aged, affiliated with Protestant religion, poorer men, watched television, drunk alcohol, and primary and higher educational level

COVID-19-related disruptions to routine vaccination services in India: a survey of paediatric providers

The COVID-19 pandemic has led to disruptions in essential health services globally. We surveyed Indian paediatric providers on their perceptions of the impact of the pandemic on routine vaccination. Among 424 (survey 1) and 141 (survey 2) respondents representing 26 of 36 Indian states and union territories, complete suspension of vaccination services was reported by 33.4% and 7.8%, respectively. In April–June 2020, 83.1% perceived that vaccination services dropped by half, followed by 32.6% in September 2020, indicating slow resumption of services. Concerns that vaccine coverage gaps can lead to mortality were expressed by 76.6%. Concerted multipronged efforts are needed to sustain gains in vaccination coverage

Medical documentation practice and its association with knowledge, attitude, training, and availability of documentation guidelines in Ethiopia, 2022. A systematic review and meta-analysis

Objective: Documentation practice plays a great role in decreasing medication error, continuity of patient care, effective communication between professionals, and evidence-based decision-making. Even though documentation practices in Ethiopia were undone. So the aim of this systematic review and meta-analysis was to estimate the pooled level of documentation practices in Ethiopia among healthcare professionals. Method: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed to review either published or unpublished studies in Ethiopia regarding medical or clinical documentation practices. All studies in Google Scholar, PubMed, Cochrane Library, Hinari, CINAHL, and Global Health databases were searched. Meta-analysis was performed using STATA 14 software. The heterogeneity and publication bias was assessed using the I2statistics and Egger regression test, respectively. Forest plots were used to present the pooled prevalence with a 95% confidence interval (CI). Result: A total of 12 articles with 4362 participants were included in this systematic review and meta-analysis. The pooled level of documentation practice was 50.11% (95%CI: 46.27, 55.89) among healthcare professionals in Ethiopia. Knowledge [AOR = 2.62 (95% CI: 1.92, 3.59)], attitude [AOR = 2.67 (95% CI: 1.70, 4.19)], receiving training [AOR = 2.89 (95% CI: 2.18, 3.83)], and availability of documentation guidelines [AOR = 2.67 (95% CI: 1.61, 4.44)] were found to be significant factors. Conclusion: The pooled level of documentation practice in Ethiopia was relatively low. Good knowledge, a favorable attitude towards documentation, receiving training, and availability of documentation guidelines in the organization were factors affecting documentation practices. Providing documentation training, and increasing their knowledge, attitude, and availability of documentation guidelines will increase documentation practices among healthcare professionals