Strengthening Primary Health Care Through Community Health Workers: Investment Case And Financing Recommendations

A report released this week at the Third International Conference on Financing for Development found that there is a strong case for investing in Community Health Worker (CHW) programs as part of integrated health systems. The report was released by leaders from the Federal Democratic Republic of Ethiopia, the Republic of Liberia, the U.N. Secretary General's Special Envoy for Financing the Health MDGs and for Malaria, Partners in Health, the Clinton Foundation, the African Leaders Malaria Alliance, and the MDG Health Alliance. The authors encourage domestic governments, international financers, bilateral and multilateral donors, and the broader global health community to finance and support the scale up of CHW programs as part of community-based primary health care through a set of specific recommendations. The authors participated in the crafting of the report and its recommendations as part of a distinguished panel chaired by Ray Chambers, the UN Secretary General's Special Envoy for Financing the Health MDGs and for Malaria, and Prime Minister Hailemariam Dessalegn, President of the Federal Democratic Republic of Ethiopia

Tuberculosis and HIV co-infection: its impact on quality of life

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Incidence of Opportunistic Infections Among Adult HIV Positive People Receiving Co-trimoxazole Prophylaxis

In Ethiopia, Co-trimoxazole prophylaxis therapy (CPT) used to prevent opportunistic infections among people living with HIV is the standard of practice; however incidence of opportunistic infection and their predictors are rarely documented in the country. This was a retrospective follow up study to describe the incidence and predictors of opportunistic infections among 244 adults receiving CPT. Participants were followed for a median time of 72 weeks. During a study period a total of 53opportunistic infections were recorded; making the overall incidence rate 23.9/100 person-years. High incidence of opportunistic infections is likely to occur if: the clients were married (adjusted hazard ratio (AHR) 1.965;(95% CI: 1.109, 3.451), had history of tuberculosis treatment (AHR: 2.34(95% CI:1.05, 5.24)), patients who are indicated for CPT because of both clinical and WHO clinical staging criteria(AHR 2.418 (95% CI:1.02, 5.72 ),and had poor adherence to CPT (AHR, 2.11 (95% CI: 1.19-3.72)). Eventhough adherence is non-substitutable strategy to prevent opportunistic infection, the cohort of HIV patients failed to adhere to CPT, which in turn resulthigh incidence of opportunistic infections among them, therefore improving adherence as guideline should be a priority to prevent OIs among people living with HIV in the study region

Sewing Slits of the Laws: A Critics on Criminalizing Negligent Acts of Transmitting HIV and Constitutionality of Compulsory Testing for HIV/AIDS in Criminal Proceeding of Ethiopia

It is obvious in criminal cases proofing beyond reasonable doubt is expected from public prosecutors. In addition, the judge cannot create the crime by analogy. In my experience as a public prosecutor on North Shoa and also Special Zone around Finfine of Oromia, Ethiopia, for almost three years (2008-2011), I have seen that where there is legitimate criminal investigation, there is a legitimate fruits of investigation for framing the criminal charge. Thus, I realized that the issues of criminalizing the negligent of HIV and the existences of divergent views among the criminal procedure of 1961, the 1998 Policy on HIV/AIDS and 2007 Guidelines for HIV Counseling and Testing in Ethiopia. Therefore, this Article examines why proofing the criminal case beyond reasonable doubt is difficult when negligent acts of transmitting HIV has been criminalized. It also explore slits of the laws which in turn create legal black hole with regarding to the order of compulsory testing for HIV or other communicable human diseases in the criminal proceeding of Ethiopia. It also checks over the constitutionality of compulsory testing for HIV and the organ of government which is trustworthy and impartial to give such order in the criminal cases. Throughout these critics I will examine all the problems as to the Constitutional standards and some international policy concerns with regarding compulsory testing for HIV/AIDS. Keywords: HIV/AIDS, the Policy, Epidemic, a Venereal disease, Communicable human disease, Federal Democratic Republic of Ethiopia (FDRE)

Assessment of utilization of provider-initiated HIV testing and counseling as an intervention for prevention of mother to child transmission of HIV and associated factors among pregnant women in Gondar town, North West Ethiopia

<p>Abstract</p> <p>Background</p> <p>Detection of maternal HIV infection early in pregnancy is critical for prevention of mother to child transmission of HIV/AIDS. Most efforts have focused on VCT as the primary means of encouraging people to become aware of their HIV status. However, its uptake is low in many parts of sub-Saharan Africa including Ethiopia. Provider-initiated HIV testing and counseling provides a critical opportunity to diagnose HIV infection, to begin chronic care, and to prevent mother to child transmission. However, little is known about its acceptance and associated factors among pregnant women in the country and particularly in the present study area.</p> <p>Methods</p> <p>Health institution based cross-sectional quantitative study was conducted in Gondar town from July 22-August 18, 2010. A total of 400 pregnant women were involved in the study using stratified sampling technique and multiple logistic regression analysis was employed using SPSS version 16.</p> <p>Results</p> <p>A total of 400 pregnant women actively participated in this study and 330 (82.5%) of them accepted provider-initiated HIV testing and counseling to be tested for HIV and 70(17.5%) of them refused. Acceptance of provider-initiated HIV testing and counseling was positively associated with greater number of antenatal care visits [Adj. OR (95%CI)=2.64(1.17, 5.95)], residing in the urban areas[Adj. OR (95%CI)=2.85(1.10, 7.41)], having comprehensive knowledge on HIV [Adj. OR (95%CI)=4.30(1.72, 10.73)], positive partners reaction for HIV positive result [Adj. OR (95%CI)=8.19(3.57, 18.80)] and having knowledge on prevention of mother to child transmission of HIV[Adj. OR (95%CI)=3.27(1.34, 7.94)], but negatively associated with increased maternal age and education level.</p> <p>Conclusion</p> <p>Utilization of provider-initiated HIV testing and counseling during antenatal care was relatively high among pregnant women in Gondar town. Couple counseling and HIV testing should be strengthened to promote provider-initiated HIV testing and counseling among male partners and to reduce HIV related violence of women from their partner and access to and consistent use of antenatal care should be improved to increase the uptake of provider-initiated HIV testing and counseling service.</p

Challenges of Containing New HIV Infections in Ethiopia: Unacknowledged Transmission Route

As the main goal of the Partnership Framework (PF) between the Government of Ethiopia (GoE) and the U.S. Government (USG), Ethiopia has set a national target of reducing new HIV infections by 50% by the end of 2014 (National Target). Funded by the USG, the PF provides a five-year joint strategic plan (2010-2014) for cooperation to support Ethiopia’s national HIV/AIDS response (PEPFAR, 2010). Ethiopia has an estimated adult prevalence of 1.5% and about a million people living with HIV/AIDS (PLWHA) (ECSA & IFC, 2012), among countries most affected by the epidemic. The International Labor Organization (ILO) projection for 2015 indicates that as much as 8.5% of the Ethiopian labor force loss will be due to HIV/AIDS deaths (World Learning, 2012). On the other hand, since the PF took effect, USG funding to the program has been in constant decline. Moreover, the PF does not fully take into account context and development barriers due to the prevailing social, political, economic and development policies in the country. Participation of the private sector, independent civil societies and media in the development process has been severely curtailed. Contextual factors have been seriously challenging the prevention of mother-to-child transmissions (PMTCT) efforts. Furthermore, the country lacks a comprehensive strategy to fully address the issue of most-at-risk population (MARP) as drivers of the HIV epidemic; and the HIV/AIDS response excludes Men who have sex with Men (MSM), a “significant unacknowledged” but fast growing transmission route of HIV (Tadele, 2008). Drawing from literature review and practicum experience in Ethiopia, this paper examines the feasibility of Ethiopia’s National Target. The main problem in the HIV/AIDS discourse in Ethiopia appears to be behavioral change, but not lack of knowledge. In addition, contrary to the widespread public belief that homosexuality is not Ethiopian, there exists a flourishing underground male-sex trade in Addis Ababa

International Violence Against Women: U.S. Response and Policy Issues

[Excerpt] In recent years, the international community has increasingly recognized international violence against women (VAW) as a significant human rights and global health issue. VAW, which can include both random acts of violence as well as sustained abuse over time, can be physical, psychological, or sexual in nature. Studies have found that VAW occurs in all geographic regions, countries, cultures, and economic classes, with some research showing that women in developing countries experience higher rates of violence than those in developed countries. Many experts view VAW as a symptom of the historically unequal power relationship between men and women,and argue that over time this imbalance has led to pervasive cultural stereotypes and attitudes that perpetuate a cycle of violence. This report addresses causes, prevalence, and consequences of violence against women. It provides examples of completed and ongoing U.S. activities that address VAW directly or include anti-VAW components, and it outlines possible policy issues for the 112th Congress, including • the scope and effectiveness of U.S. programs in addressing international VAW; • further integrating anti-VAW programs into U.S. assistance and foreign policy mechanisms; • U.S. funding for anti-VAW activities worldwide, particularly in light of the global financial crisis, economic recession, and subsequent calls to reduce the U.S. budget deficit; and • strengthening U.S. government coordination of anti-VAW activities

BOOSHTEE! Survival and Resilience in Ethiopia

Although homosexuality is illegal in Ethiopia, same-sex behaviour is not prosecuted because the government of the Federal Democratic Republic of Ethiopia views homosexuality as a low law enforcement priority. While this may suggest at first glance that the situation for same-sex attracted men is better in Ethiopia than in other countries that retain laws against homosexuality, in reality the illegality of same-sex relations functions throughout Ethiopian society to drive and justify social and economic exclusion and human rights abuses of samesex attracted people. There is a powerful synergy between church and state and sections of the church are occupied with promulgating extreme homophobia by associating homosexuality with taboo superstition, undesirable foreign influence, child abuse and prostitution. Moreover, Ethiopia’s strong economic growth and geopolitical situation has limited the influence of other countries, donors and agencies in respect of human rights and economic or social policy in the country.UK Department for International Developmen

Government’s Response to the Challenge of HIV/AIDS in Ethiopia

Ethiopia is facing a huge threat to the survival of its people and the socio-economic development of the country from a generalized HIV/AIDS epidemic. Ethiopia with an estimated 1.3 million HIV/AIDS infected people as of December 2006, is one of the worst-affected countries where HIV infection is concentrating among productive age group, thereby affecting productivity. The objective of this study is to examine the ways in which the government of Ethiopia has been dealing with the spread of HIV/AIDS in Ethiopia and suggests the ways in which it can improve its strategies. More specifically, the study tried to investigate the major cause of the spread of HIV/AIDS in Ethiopia, the government’s strategies against the spread of HIV/AIDS in the country and to what extent have they been effective and in what ways they could be improved. The data were collected in eastern part of Ethiopia and also key informants in Addis Ababa were interviewed. The data indicated that HIV related stigma is one of the major causes of the spread of the disease and suggests the need for the further research