Newborn care seeking practices in Central and Southern Ethiopia and implications for community based programming

Background: In Ethiopia, close to 120,000 newborns die annually and newborn mortality now constitutes 42% of under-five deaths. The use of health care for newborn illnesses is very limited.Objective: To investigate local perspectives and practices related to newborn care-seeking and the factors affecting them.Methods: Key informant interviews with grandmothers and in-depth interviews with mothers, TBAs and fathers were used to collect data in four communities in Sidama Zone, Southern Nations, Nationalities and Peoples Region and East Shewa Zone and West Arsi Zone in Oromia Region. Analysis consisted of manual thematic coding of the data and synthesis for write-up.Results: Locally recognized signs and types of illness only partially conform to medically recognized danger signs. Households apply home therapies, traditional healers or health facilities to get treatment for sick newborns. Lack of resources, transportation and appropriate treatment are barriers to making use of health facilities.Conclusion: Local conceptions of newborn illnesses, inadequate recognition of danger signs, using traditional treatment, and lack of financial resources, transportation and appropriate treatment constrain or delay resorting to health facilities for newborn illnesses

Community case management improves use of treatment for childhood diarrhea, malaria and pneumonia in a remote district of Ethiopia

Background: Ethiopia’s Health Extension Workers (HEW) deliver preventive interventions and treat childhood diarrhea and malaria, but not pneumonia. Most of Ethiopia’s annual estimated 4 million childhood pneumonia cases go untreated. Objective: Evaluate the performance of volunteers in providing Community Case Management (CCM) for diarrhea,fever and pneumonia – in a pre-HEW setting in Liben Woreda, Oromiya Regional State. Methods: Save the Children supported Ministry of Health and communities to deliver child survival interventions from 1997-2006. We obtained permission in 2005 to train 45 volunteers from remote kebeles in CCM. We evaluated the strategy through reviewing registers and supervision records; examining CCM workers; focus group discussions;and three household surveys. Results: The CCM workers treated 4787 cases, mainly: malaria (36%), pneumonia (26%), conjunctivitis (14%), and watery diarrhea with some dehydration (12%). They saw 2.5 times more cases of childhood fever, pneumonia, and diarrhea than all the woreda’s health facility staff combined. Quality of care was good. Conclusion: The availability, quality, demand, and use of CCM were high. These CCM workers were less educated and less trained than HEWs who perform complicated tasks (Rapid Diagnostic Tests) and dispense expensive antimalarial drugs like Coartem®. They should also treat pneumonia with inexpensive drugs like cotrimoxazole to help achieve Millennium Development Goal 4.

The influence of grazing and cultivation on runoff, soil erosion, and soil nutrient export in the central highlands of Ethiopia

Background: Grazing by livestock and cultivation have been considered as two important causes of soil erosion and nutrient export. However, there has been limited evidence that grazing or cultivation matters to soil erosion and nutrient export in Ethiopia. Hence, this study was conducted in the Galesa watershed in Ethiopia to examine the effects of grazing and cultivation on runoff, soil loss, and nutrient export. Daily values of runoff, soil erosion, and nutrient outflow were measured for three consecutive years following standard procedures. Independent t test was performed to check if the means of runoff, soil loss, and nutrient loss from grazing and cultivated lands were significantly different. Moreover, repeated analysis of variance (ANOVA) was used to test if mean values of runoff, soil loss, and nutrient export varied significantly over the study years. Results: Although the average annual runoff depth was 7.8% higher in grazing land (GL), soil erosion was significantly lower (39%) in GL as compared to cultivated land (CL). Similarly, sediment and runoff-associated annual losses of total nitrogen (N), available phosphorus (P), exchangeable potassium (K), and organic carbon (OC) were low in the GL treatments. Lowest losses of total N (9.30 kg ha-1 year-1 ), available P (0.83 kg ha-1 year-1 ), and exchangeable K (1.84 kg ha-1 year-1 ) were recorded in GL treatment. Likewise, lowest losses of sediment-associated total N (32.8 kg ha-1 year-1 ), available P (0.39 kg ha-1 year-1 ), exchangeable K (0.23 kg ha-1 year-1 ), and soil organic carbon (630 kg ha-1 year-1 ) were recorded from GL over the 3 years of experimentation. Conclusion: Our results indicate that cultivation increased soil erosion as compared to grazing. Although there were significant reductions in soil erosion and nutrient export from grazing lands compared with cultivated lands, the absolute losses were still high. This implies the need for grazing land management using appropriate physical and biological erosion control measures to increase productivity and reduce soil erosion as well as nutrient export

National survey of the health and nutrition of schoolchildren in Ethiopia

OBJECTIVE To estimate the prevalence of chronic health and nutritional conditions of schoolchildren in Ethiopia. METHODS A cross-sectional survey in schools in each region randomly selected in proportion to size, then a random sample of 50–68 children in grades 3 and 4 in each school. Children were examined for signs of micronutrient deficiencies and chronic infections; weighed and measured; provided a faecal sample to diagnose intestinal parasitic infections; and were interviewed about their recent diet and hygiene practices. RESULTS A total of 7,572 children were studied in 142 schools in all 11 regions of Ethiopia. Nearly 17% of children were orphans. The prevalence of stunting was 22.3% and 23.1% of children were thin for age, but these may be underestimates as there was evidence that age may have been estimated based on stature when children enrol in school. Just under 10% of children were anaemic when altitude was accounted for. The overall prevalence of trachoma was 13% and children who washed their face before school were at lower risk of trachoma than children who had not. Children who reported that they had eaten fruit or vegetables the day before also had a lower risk of xerophthalmia than children who had not. Only 30% of children were infected with intestinal worms. CONCLUSIONS Trachoma is a problem but anaemia and intestinal worms are relatively uncommon in Ethiopian schoolchildren. These data provide a basis for developing a school health policy and programmes

Canopy-atmosphere interactions under foggy condition—Size-resolved fog droplet fluxes and their implications

Microphysical processes of fog and their spatial and temporal pattern are a challenge to study under natural conditions. This work focuses on the development of bi-directional fluxes of fog droplets above a forest canopy in north-eastern Taiwan. Bi-directional fluxes occurred regularly, start from the smallest droplet class (< 2.66 μm diameter), and subsequently extend to larger droplets up to 7.41 μm diameter. The development of the bi-directional fluxes with positive (upward) fluxes of smaller droplets and downward fluxes of larger fluxes is associated with a temperature gradient and with the activation of fog droplets according to the Köhler-Theory. Small fog droplets develop close to the canopy as result of evapotranspiration and subsequent condensation. The rapid growth of small fog droplets and the accelerated growth of activated droplets, a process which is more likely to occur at higher levels of the fog layer, lead to a sink of small droplets and a source of larger droplets within the fog. This is in accordance with the observation that positive droplet number fluxes of small fog droplets outnumber the negative fluxes from the larger fog droplets. For liquid water, the net flux is negative