Unlocking the potential of farmer-led irrigation development in central and northern Nigeria: What does it take?

The potential for profitable groundwater irrigated area development in Nigeria is 5.04 million hectares (ha), almost all of it located in the country’s central and northern states. To develop this vast area, granular water budgets, financial service provision and support to grow sustainability of production will be needed. Increasing temperature, erratic rainfall, and other extreme events, such as floods and droughts, pose severe threats to development in Nigeria, and particularly in central and northern Nigeria where rainfall is limited, natural resources are threatened by degradation and agriculture, including livestock production, is the major economic driver. Climate change has significant adverse impacts on agricultural production and livelihoods, making the regions’ poor and disadvantaged people even more vulnerable. Agricultural productivity is already affected by climate extreme events and further land expansion would increase degradation and deforestation. At the same time, the central and northern regions of the country are blessed with substantial underground water resources that have been barely tapped. At this point, the potential of farmer-led irrigation, a system where farmers acquire the irrigation technology and access to a water source themselves, is barely exploited. What role could farmer-led, small-scale irrigation play in growing agricultural productivity, rural employment and incomes, and reducing climate stress? And what mechanisms are needed to make this happen

Quality assessment of health management information system (HMIS) data for maternal and child health in Jimma zone, Ethiopia

Health management information system (HMIS) data underpin attainment of health targets in low- and middle-income countries. However, the quality of HMIS data is often poor. The study appraised the completeness, timeliness, and internal consistency of eight key maternal and child health (MCH) indicators collected for all the primary health care units (PHCUs) located within three districts of Jimma Zone, Ethiopia. Results show that the HMIS may over-report the coverage of key MCH services, namely, antenatal care, skilled birth attendance and postnatal care. The quality of data at the zonal level could be improved to inform MCH research and programmatic efforts.Global Affairs Canada (GAC)Canadian institutes of Health Research (CIHR

Pragmatic cluster-randomized trial of home-based preventive treatment for TB in Ethiopia and South Africa (CHIP-TB)

Background Each year, 1 million children develop TB resulting in over 200,000 child deaths. TB preventive treatment (TPT) is highly effective in preventing TB but remains poorly implemented for household child contacts. Home-based child contact management and TPT services may improve access to care. In this study, we aim to evaluate the effectiveness and cost-effectiveness of home-based contact management with TPT initiation in two TB high-burden African countries, Ethiopia and South Africa. Methods This pragmatic cluster randomized trial compares home-based versus facility-based care delivery models for contact management. Thirty-six clinics with decentralized TB services (18 in Ethiopia and 18 in South Africa) were randomized in a 1:1 ratio to conduct either home-based or facility-based contact management. The study will attempt to enroll all eligible close child contacts of infectious drug-sensitive TB index patients diagnosed and treated for TB by one of the study clinics. Child TB contact management, including contact tracing, child evaluation, and TPT initiation and follow-up, will take place in the childs home for the intervention arm and at the clinic for the control arm. The primary outcome is the cluster-level ratio of the number of household child contacts less than 15 years of age in Ethiopia and less than 5 years of age in South Africa initiated on TPT per index patient, comparing the intervention to the control arm. Secondary outcomes include child contact identification and the TB prevention continuum of care. Other implementation outcomes include acceptability, feasibility, fidelity, cost, and cost-effectiveness of the intervention. Discussion This implementation research trial will determine whether home-based contact management identifies and initiates more household child contacts on TPT than facility-based contact management.This project is funded by UNITAID and IMPAACT4TB. NSA salary is supported by the National Institutes of Health (K23HD096973). The Aurum Institute, 29 Queens Rd, Parktown, Johannesburg, 2194, South Africa is the sponsor of the trial. The funder had no role in the writing of this manuscript after concept approva

Risky sexual practices and related factors among ART attendees in Addis Ababa Public Hospitals, Ethiopia: A cross-sectional study

Background Many HIV-positive persons avoid risky sexual practices after testing HIV sero-positive. However, a substantial number continue to engage in risky sexual practices that may further transmit the virus, put them at risk of contracting secondary sexually transmitted infections and lead to problems with drug resistance. Thus, this study was intended to assess risky sexual practices and related factors among HIV- positive ART attendees in public hospitals of Addis Ababa. Methods A cross-sectional study was conducted among ART attendees from February to March, 2009. Questionnaire-based face-to-face interviews were used to gather data. SPSS software was used to perform descriptive and logistic regression analyses. Results Six hundred and one ART attendees who fulfilled the inclusion criteria was included in the study and interviewed. More than one-third (36.9%) had a history of risky sexual practices in the three months prior to the study. The major reasons given for not using condoms were: partner's dislike of them, both partners being positive for HIV and the desire to have a child. Factors associated with risky sexual practices included: lack of discussion about condom use (Adjusted Odds Ratio (AOR = 7.23, 95% CI: 4.14, 12.63); lack of self-efficacy in using condoms (AOR = 3.29, 95% CI: 2.07, 5.23); lack of sexual pleasure when using a condom (AOR = 2.39, 95% CI: 1.52, 3.76); and multiple sexual partners (AOR = 2.67, 95% CI: 1.09, 6.57). Being with a negative sero-status partner (AOR = 0.33, 95% CI: 0.14, 0.80), or partners of unknown sero-status (AOR = 0.19, 95% CI: 0.09, 0.39) were associated with less risky practice. Conclusions A considerable proportion (36.9%) of respondents engaged in unprotected sexual intercourse, potentially resulting in re-infection by a new virus strain, other sexually transmitted infections and onward transmission of the HIV virus. Health education and counseling which focuses on the identified factors has to be provided. The health education and counseling can be provided to these people at ART appointments on follow- up care. It can be provided in a one-on-one basis or through patient group educational discussions at the clinics

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

Modeling smallholder farmers' preferences for soil management measures: a case study from South Ethiopia

Land degradation is a major environmental problem in Ethiopia posing serious threats to agricultural productivity and livelihoods. The interactions of numerous socio-economic, demographic, natural, and institutional factors constitute the underlying causes of soil degradation in Ethiopia. However, there exist evidence gaps on the contextual factors that hinder investments on soil conservation among smallholders. Using primary data generated through a stated preference survey among 359 sample smallholder farm households in Southern Ethiopia, this study investigates investment constraints on soil management technologies among smallholders. A random parameter logit model was implemented to estimate the model. Results indicate that smallholders are willing to invest in soil management technologies if appropriate incentive mechanisms, primarily, secured land tenure rights and access to nance are in place. Unfortunately, the prevailing land tenure regime in the country does not allow private property rights on land and smallholders have very limited access to credit. Thus, instituting secure land rights and improving credit access to smallholders should be considered as key interventions to enhance adoption of soil management technologies. The study highlights that policy interventions that incentivize adoption of soil management measures provide not only on-site private bene ts but wider societal o -site bene ts through the provision of multiple ecosystem services

Trees, soils, and warthogs - distribution of services and disservices from reforestation areas in southern Ethiopia

Conservation projects have often been criticised for creating global benefits while causing negative impacts on local livelihoods. Ecosystem services approaches have been seen as one way to change this by focussing explicitly on maintaining ecosystems for human well-being of stakeholders at various scales. However, ecosystem services approaches have often ignored trade-offs between groups of people and issues of power and do not automatically lead to better outcomes in terms of human well-being. Here we report on a study on the impacts of reforestation projects with an explicit focus on human well-being in three communities in southern Ethiopia. We investigated the distribution of services and disservices from reforestation using qualitative methods. Results showed that the services and disservices from reforestation were distributed unequally across space and wealth groups resulting in widespread dissatisfaction with existing reforestation projects despite the explicit focus on human benefits. To improve outcomes of reforestation it is necessary to acknowledge and manage disservices adaptively, include issues of power and make trade-offs transparent