Review of Climate Change and Health in Ethiopia: Status and Gap Analysis

Background: This review assessed Ethiopia’s existing situation on issues related to the environment, climate change and health, and identifies gaps and needs that can be addressed through research, training, and capacity building.Methods: The research was conducted through a comprehensive review of available secondary data and interviewing key informants in various national organizations involved in climate change adaptation and mitigation activities.Results: Climate change-related health problems, such as mortality and morbidity due to floods and heat waves, vector-borne diseases, water-borne diseases, meningitis, and air pollution-related respiratory diseases are increasing in Ethiopia. Sensitive systems such as agriculture, health, and water have been affected, and the effects of climate change will continue to magnify without the right adaptation and mitigation measures. Currently, research on climate change and health is not adequately developed in Ethiopia. Research and other activities appear to be fragmented and uncoordinated. As a result, very few spatially detailed and methodologically consistent studies have been made to assess the impact of climate in the country. There has often been a lack of sufficient collaboration among organizations on the planning and execution of climate change and health activities, and the lack of trained professionals who can perform climate change and health-related research activities at various levels.Conclusion: Firstly, there is a lack of organized structure in the various organizations. Secondly, there is inadequate level of inter-sectoral collaboration and poor coordination and communication among different stakeholders. Thirdly, there are no reliable policy guidelines and programs among organizations, agencies and offices that target climate change and health. Fourth, the existing policies fail to consider the gender and community-related dimensions of climate change. Fifth, the monitoring and evaluation efforts exerted on climate change and health activities are not strong enough to address the climate change and health issues in the country

A randomised controlled feasibility trial of a BabyWASH household playspace: the CAMPI study

Background Water, sanitation and hygiene (WASH) interventions should support infant growth but trial results are inconsistent. Frequently, interventions do not consider behaviours or transmission pathways specific to age. A household playspace (HPS) is one intervention component which may block faecal-oral transmission. This study was a two-armed, parallel-group, randomised, controlled feasibility trial of a HPS in rural Ethiopia. It aimed to recommend proceeding to a definitive trial. Secondary outcomes included effects on infant health, injury prevention and women’s time. Methods November 2019−January 2020 106 households were identified and assessed for eligibility. Recruited households (N = 100) were randomised (blinded prior to the trial start) to intervention or control (both n = 50). Outcomes included recruitment, attrition, adherence, and acceptability. Data were collected at baseline, two and four weeks. Findings Recruitment met a priori criteria (≥80%). There was no loss to follow-up, and no non-use, meeting adherence criteria (both ≤10%). Further, 48.0% (95% CI 33.7−62.6; n = 24) of households appropriately used and 56.0% (41.3−70.0; n = 28) cleaned the HPS over four weeks, partly meeting adherence criteria (≥50%). For acceptability, 41.0% (31.3−51.3; n = 41) of infants were in the HPS during random visits, failing criteria (≥50%). Further, the proportion of HPS use decreased during some activities, failing criteria (no decrease in use). A modified Barrier Analysis described good acceptability and multiple secondary benefits, including on women’s time burden and infant injury prevention. Interpretation Despite failing some a priori criteria, the trial demonstrated mixed adherence and good acceptability among intervention households. A definitive trial to determine efficacy is warranted if recommended adjustments are made

Determinants of diarrhoeal morbidity: The case of children under five years of age among agricultural and agro-pastoralist community of southern Ethiopia

Background: Diarrhoea is a leading cause of morbidity and mortality among the under-five children in low-income countries. Despite improvements in water and sanitation coverage, studies show that diarrhoea is still a major public health problem in Ethiopia. This study was designed to determine the magnitude and risk factors of diarrhoea in the agricultural and agro-pastoralist communities of the rural Sidama zone, Southern Ethiopia. Methods: a cross-sectional study was conducted in July 2013. Interview and questionnaire were the main data gathering instruments used in the study. Data for the study was collected from 1939 mothers/caregivers of the children. The children were under five years of age during the data collection period. Structured questions were used to collect data for the study. SPSS software V 19 was used to analyze the data based on a predefined conceptual model, including interrelated determinants. Bivariate and multivariable logistic regression was computed to assess independent factors of childhood diarrhoea. Results: Slightly over 95% of the participants were from Sidama ethnic background and about 88% of them were Participants. The number of male children in the study was slightly higher (53%) than that of the female participants. The mean and median ages of the children were 33.53 and 35 months, respectively. The prevalence of diarrhoea in the two weeks prior to the study was 25.6%. The occurrence of diarrhea was significantly associated with household heads following traditional religion (Odds Ratio (OR): 2.40; 95% Confidence Interval (CI) =1.49-3.88)), living in rented or shared houses (OR: 2.00; 95% CI=1.14 -3.51), living in agro-pastoralist (OR: 1.84; 95% CI=1.29-2.63), and Midland agriculturalists areas (OR: 1.50; 95% CI=1.04-2.14). In addition, storing drinking water for more than two days (OR: 1.74; 95% CI=1.27-2.37), the presence of diarrhoea in the family members other than the index child (OR: 1.35; 95% CI=1.05-1.74), children being in the age group of 6-12 months (OR: 2.459; 95% CI=1.676-3.608) and 13-24 months (OR: 1.619; 95% CI=1.103-2.377) were strongly associated with the under-five diarrhoeal morbidity (p.0.05). Conclusions: The study showed that diarrhoea was a major health problem of the under five among the agro-pastoralist communities. Socioeconomic, environmental, household and childcare related factors have influenced the transmission of diarrhoea in the study setting. Delivery of improved sanitation and hygiene suitable for agro-pastoralist communities may have a significant importance on the child health and survival in the study area

Altering of the sprayed wall after indoor residual spraying and associated factors among households in Boricha district, Sidama regional state, Ethiopia, 2019: community-based cross-sectional study

Abstract Background Indoor residual spraying (IRS) has been the main tool used to control malaria. Reducing the life span and the density of the vector mosquitoes are direct effects of IRS towards restricting malaria transmission. Residents must not wash or re-plaster walls after the spray application for at least 6 months to fight against malaria with IRS. This study sought to assess the alteration of the sprayed wall after the IRS operation and associated factors among households in the Boricha district. Methods Community-based cross-sectional study was conducted among 608 households selected using multi-stage sampling. A structured interviewer-administered questionnaire was used to collect data. Data were analysed by SPSS version 25. Both bivariable and multivariable logistic regression analysis was done. Finally, the strength of the association was measured based on AOR with 95% CI and statistical significance was declared at a p-value less than 0.05. Result From the total of 608 sprayed houses included in the study, 37.3% (95% CI: 33.41% – 41.15%) were found to have altered sprayed walls. The highest class of wealth index category (AOR = 2.50; 95% CI: 1.19, 5.16), low level of comprehensive knowledge about IRS (AOR = 6.08; 95% CI: 3.37, 10.94), did not get information within 2 weeks before spray (AOR = 2.09; 95% CI: 1.43, 3.05), absence of supervision after the spray operation (AOR = 1.77; 95% CI: 1.27, 2.73) and walking distance to nearest health facility (AOR = 2.39; 95% CI: 1.63, 3.35) remained significant factors of altering of the sprayed wall after IRS. Conclusion The prevalence of alteration was relatively high. The highest socio-economic status, poor knowledge about indoor residual spraying, lack of information about IRS within two weeks before spray, absence of supervision after IRS, and walking distance of more than 30 min to reach the nearest health post were the factors affecting the alteration status of the sprayed wall. Future efforts to focus on successive awareness creation activities should be done before and after IRS operation to the community by concerned bodies