Data Informed Platform for Health Feasibility Study Report, Amhara and Oromia Regions, Ethiopia

IDEAS has published a report on the feasibility of implementing the Data Informed Platform for Health in Amhara and Oromia Regions, Ethiopia. The Data Informed Platform for Health is a framework to guide coordination, bringing together key data from public and private health sectors on inputs and processes that could influence maternal and newborn health. The key data will be synthesised to create a measure of programme implementation strength for each local area, which in turn can be used in the evaluation of the effects of large-scale programmes on health outcomes

Community Based Newborn Care in Ethiopia: Executive Summary for the Quality of CBNC programme assessment Midline Evaluation Report

Report from IDEA

Outcomes of TB/HIV co-infected patients presenting with antituberculosis drug-induced liver injury

Background. South Africa has a significant burden of tuberculosis (TB). Anti-TB drug-induced liver injury (TB DILI) is one of the most serious adverse events that can arise from TB treatment (TBT). There are  limited data on TB DILI among HIV-infected patients and those on antiretroviral therapy (ART).Objective. To describe characteristics of HIV-infected patients presenting with TB DILI and the  proportion reintroduced on standard or modified TBT after DILI.Methods. This was a retrospective study of TB/HIV co-infected patients with DILI between 1 July 2009  and 30 September 2012. The primary focus of interest was HIV-infected patients with TB DILI on ART (ART/TB DILI) v. not on ART (TB DILI).Results. A total of 94 patients were included, 41 with TB DILI and 53 with ART/TB DILI. Compared with  patients with TB DILI, patients with ART/TB DILI were more likely to present with symptomatic DILI  (71.2% v. 51.2%; p=0.03) and had a lower median alanine aminotransferase level at diagnosis (89 IU/L v. 118 IU/L; p=0.008), a lower rate of ALT decline (–23 IU/L v. –76 IU/L; p=0.047) and longer duration of TBT at DILI diagnosis (53 days v. 11 days; p<0.001). In 71.8% of patients, standard TBT was reintroduced. More patients with ART/TB DILI than TB DILI required modified TBT (37.2% v.17.1%; p=0.05; crude odds ratio 2.17; 95% confidence interval 0.95 - 4.96). The rate of death/loss to follow-up was higher in the ART/TB DILI group (18.9% v. 14.5%).Conclusion. A significant number of TB/HIV co-infected patients were not able to tolerate standard TBT. Furthermore, ART appears to complicate TBT, with relatively fewer patients reintroduced on standard TBT

Community Based Newborn Care in Ethiopia: Quality of CBNC programme assessment Midline Evaluation Report March 2017

Report from IDEA

Outcomes of TB/HIV co-infected patients presenting with antituberculosis drug-induced liver injury

Background. South Africa has a significant burden of tuberculosis (TB). Anti-TB drug-induced liver injury (TB DILI) is one of the most serious adverse events that can arise from TB treatment (TBT). There are limited data on TB DILI among HIV-infected patients and those on antiretroviral therapy (ART).Objective. To describe characteristics of HIV-infected patients presenting with TB DILI and the proportion reintroduced on standard or modified TBT after DILI.Methods. This was a retrospective study of TB/HIV co-infected patients with DILI between 1 July 2009 and 30 September 2012. The primary focus of interest was HIV-infected patients with TB DILI on ART (ART/TB DILI) v. not on ART (TB DILI).Results. A total of 94 patients were included, 41 with TB DILI and 53 with ART/TB DILI. Compared with patients with TB DILI, patients with ART/TB DILI were more likely to present with symptomatic DILI (71.2% v. 51.2%; p=0.03) and had a lower median alanine aminotransferase level at diagnosis (89 IU/L v. 118 IU/L; p=0.008), a lower rate of ALT decline (–23 IU/L v. –76 IU/L; p=0.047) and longer duration of TBT at DILI diagnosis (53 days v. 11 days; p<0.001). In 71.8% of patients, standard TBT was reintroduced. More patients with ART/TB DILI than TB DILI required modified TBT (37.2% v.17.1%; p=0.05; crude odds ratio 2.17; 95% confidence interval 0.95 - 4.96). The rate of death/loss to follow-up was higher in the ART/TB DILI group (18.9% v. 14.5%).Conclusion. A significant number of TB/HIV co-infected patients were not able to tolerate standard TBT. Furthermore, ART appears to complicate TBT, with relatively fewer patients reintroduced on standard TBT

Market-oriented beekeeping development to improve smallholder income: Results of development experiences in Atsbi-Womberta District, northern Ethiopia

Beekeeping is an important income-generating activity in the Atsbi-Womberta district of Tigray. Beekeeping can also be easily integrated into the on-going natural resources conservation developments in the district. However, beekeeping has traditionally been considered as a supplementary enterprise and its potential as a source of smallholder income has never been fully utilized. The Improving Productivity and Market Success (IPMS) of Ethiopian Farmers Project, in collaboration with the district Office of Agriculture and Rural Development (OoARD), the regional Bureau of ARD and other partners have introduced, tested and promoted improved beekeeping development practices based on the value chains framework. This paper presents results of this experience. The core of the experience is the transformation of a largely traditional system towards a more knowledge based and market-oriented beekeeping. Major interventions include introduction, testing and promotion of learning platforms on improved use of hive equipment, improved apiary and colony management, bee forages, harvesting and postharvest handling practices, and facilitation of access to market information and linkages. Qualitative and quantitative studies were conducted to assess developmental changes made due to the interventions. Results show that the honey productivity of adopters increased by about threefold (32 kg honey/hive per year) compared to the non-adopters (10 kg honey/hive per year) in 2008 despite the variation in rainfall distribution and amount. Interestingly, the honey productivity of adopters increased by 52% in 2008 (32 kg honey/hive per year) compared to those adopters in 2004 (21 kg honey/hive per year). Market-oriented improved beekeeping adopters had a threefold higher income from the sale of honey (Ethiopian birr, ETB1 1820/household per year) than non-adopters (ETB 614/household per year). Moreover, the gross annual income of smallholder beekeepers in the district increased from about ETB 2.7 million in 2004 to ETB 19.5 million in 2008. Similarly, the number of honeybee colonies has increased by about fourfold and that of beneficiaries increased by about threefold. About 36% of the beekeepers adopted improved beekeeping management which contributed to about 75% of the district gross annual income of smallholder beekeepers in 2008. The basis of transformation towards market-oriented beekeeping has been capacity building of beekeepers to acquire, share and use improved skills. Results show that marketoriented improved beekeeping appears to be a more resilient income generating business under the uncertain and variable rainfall conditions

A Farmer-based fruit seedling supply system in Dale Pilot Learning Woreda (PLW): experiences from IPMS

Dale Woreda is well known for its avocado (Persia americana) and to a lesser extent mango (Mangifera indica) production. These fruit trees are planted along with coffee (Coffee arabica), enset (Enset ventricosum) and other crops. They are important sources of income and food, playing a considerable role in the livelihood of thousands of smallholder farmers of Dale. However, the varieties found in the area have large canopies that reduce land availability for other crops. They are also tall (10-15 m) thus harvesting becomes a challenge, particularly for women. Market prices for these varieties are low and during collection, there is considerable fruit loss when they fall, causing cracks and bruises and hence their rejection. The trees also take 7- 10 years to bear fruit and farmers mention that the land can be used more productively and therefore want to replace fruit trees with other more profitable crops. The diagnostic survey carried out by Improving Productivity and Marketing Success (IPMS) of Ethiopian farmers’ project identified some of the above production constraints as the major area of intervention. Further study was conducted by the International Centre for Research on Agro Forestry (ICRAF) which confirmed the above problems and suggested introduction of improved variety through grafting as one of the best solution to improve the quality of seed, reduce size and height as well as improve productivity and marketability of these varieties. Taking the experience of Dale for coffee seedling production where farmer’s nurseries have taken over 95% of seedling production, the Dale partners decided to use farmers’ nurseries as the base to start production of grafted seedlings. Using participatory extension methods with the help of various partners, the number of private nursery operators increased from the initial six (3 females) to 20 (7 female) in 2009. The number of seedlings produced has now reached 12,000 annually and this can be easily expanded since scions can now be obtained from mother trees established earlier in each of the nursery sites. Currently, seedlings are sold at around Birr 15/seedling to neighboring farmers, some on credit provided by the nursery operators. Linkages with the Productive Safety Net program are made to facilitate the scaling out of the sale of seedlings to emerging commercial farmers. Nursery operators earned between Birr 4,000–7,000 per year from these operations. Further skills development can still be made to improve survival rates of grafted seedlings. Attention will also need to be paid to the marketing of these improved varieties as well as the development of a responsive support system providing fresh knowledge, building capacity and new technologies

Dynamo Transition in Low-dimensional Models

Two low-dimensional magnetohydrodynamic models containing three velocity and three magnetic modes are described. One of them (nonhelical model) has zero kinetic and current helicity, while the other model (helical) has nonzero kinetic and current helicity. The velocity modes are forced in both these models. These low-dimensional models exhibit a dynamo transition at a critical forcing amplitude that depends on the Prandtl number. In the nonhelical model, dynamo exists only for magnetic Prandtl number beyond 1, while the helical model exhibits dynamo for all magnetic Prandtl number. Although the model is far from reproducing all the possible features of dynamo mechanisms, its simplicity allows a very detailed study and the observed dynamo transition is shown to bear similarities with recent numerical and experimental results.Comment: 7 page