Trends of modern contraceptive use among young married women based on the 2000, 2005, and 2011 Ethiopian Demographic and Health Surveys: a multivariate decomposition analysis

Published: January 30, 2015Introduction: Accessing family planning can reduce a significant proportion of maternal, infant, and childhood deaths. In Ethiopia, use of modern contraceptive methods is low but it is increasing. This study aimed to analyze the trends and determinants of changes in modern contraceptive use over time among young married women in Ethiopia. Methods: The study used data from the three Demographic Health Surveys conducted in Ethiopia, in 2000, 2005, and 2011. Young married women age 15–24 years with sample sizes of 2,157 in 2000, 1,904 in 2005, and 2,146 in 2011 were included. Logit-based decomposition analysis technique was used for analysis of factors contributing to the recent changes. STATA 12 was employed for data management and analyses. All calculations presented in this paper were weighted for the sampling probabilities and non-response. Complex sampling procedures were also considered during testing of statistical significance. Results: Among young married women, modern contraceptive prevalence increased from 6% in 2000 to 16% in 2005 and to 36% in 2011. The decomposition analysis indicated that 34% of the overall change in modern contraceptive use was due to difference in women’s characteristics. Changes in the composition of young women’s characteristics according to age, educational status, religion, couple concordance on family size, and fertility preference were the major sources of this increase. Two-thirds of the increase in modern contraceptive use was due to difference in coefficients. Most importantly, the increase was due to change in contraceptive use behavior among the rural population (33%) and among Orthodox Christians (16%) and Protestants (4%). Conclusions: Modern contraceptive use among young married women has showed a remarkable increase over the last decade in Ethiopia. Programmatic interventions targeting poor, younger (adolescent), illiterate, and Muslim women would help to maintain the increasing trend in modern contraceptive use.Abebaw Gebeyehu Worku, Gizachew Assefa Tessema, Atinkut Alamirrew Zelek

Yam breeding at IITA: achievements, challenges, and prospects

African food system Yam (Dioscorea spp.) is a multispecies, clonally propagated crop cultivated for its starchy tubers. About 10 species are widely cultivated around the world, but only D. rotundata, D. alata, and D. cayenensis are the most widely cultivated species in West Africa, accounting for 93% of the global yam production. Since inception, IITA R4D efforts have focused on developing new varieties of yam with desired agronomic and quality traits and to improve yam-based cropping systems

Improvement of accession distinctiveness as an added value to the global worth of the yam (Dioscorea spp) genebank

Open Access JournalMisidentification of accessions is a common problem in genebanks. Along the years, mistakes accumulate and this is particularly true when dealing with a large number of accessions requiring annual regeneration. Human errors such as mislabeling or misreading and material mix up during planting or storage are the main causes for misidentification of accessions. The international collection of yam, maintained at IITA, has accumulated ‘non true to type’ accessions along the years. In the present study, 53 morphological descriptors were used to detect uniformity of individuals within accessions of the yam gene bank collection i.e. agro morphological mismatch between individual plants of the same accession. Based on a similarity matrix, individual pairs with less than 0.90 similarity coefficients, which varies in six descriptors and more, were considered as distinct and mismatched, whereas those that had similarity coefficients greater than or equal to 0.90 were considered as clones from the same parent. Overall, 20.60% of the total 3156 accessions were found not true to type i.e., misidentified individuals. The descriptive analysis shows that morphological traits like distance between lobes, upward folding of leaf along main vein, young stem color, old stem color, leaf shape, leaf density and plant vigor are the most discriminative descriptors for individual identification within accession. Some other traits were also found species specific and they may aid in distinguishing misidentifications between species

Effect Of High Strength Concrete On the Bondability of Prestressing

Abstract Recent research in bond suggested that concrete strength can affect the bond strength between prestressing strand and concrete.However, earlier research from the 1960's through the 1980's suggested that concrete strength does not affect the bond between prestressing strand and concrete. Neither the ACI Building code nor AASHTO Bridge code makes provision for concrete strength, though its been suggested that concrete strength parameter is needed in the equations. Codes based on early research therefore do not account for variations in concrete strength. The purpose of the research is to investigate what effects, if any; concrete strength has on the bond of prestressing strand to concrete. To investigate these effects, NASP Bond tests on strands are performed at various concrete strengths. The tests demonstrated that bond improve with increasing concrete strengths. The thesis also reports on the development of HPC for use in precast/ prestressed concrete products. This thesis project includes the development of concrete mix proportions for four types of concrete with varying compressive strengths from 4,000 to 15,000 psi. Beams were made in a precast concrete plant with strength ranging from 6,000 psi to about 15,000 psi.Engineering and Technology Managemen

Sensitive electrochemical determination of ethambutol in pharmaceutical formulation and human urine at nickel nanoparticles/electrochemically reduced graphene oxide modified electrode

This paper describes the application of nickel nanoparticles decorated electrochemically reduced graphene oxide modified glassy carbon electrode (NiNPs/ERGO/GCE) for the determination of ethambutol (ETB), an anti-Mycobacterium tuberculosis drug. The modified electrode showed remarkable electrocatalytic properties accompanied with a significant enhancement in the peak current response towards ETB compared to the bare electrode. The results showed that the composite modified electrode played a significant catalytic role due to the synergetic effect of NiNPs and ERGO. The NiNPs/ERGO modified electrode demonstrated excellent square wave voltammetric response towards ETB determination at the NiNPs/ERGO/GCE in the range 0.05‒100 µM. The sensor demonstrated outstanding sensitivity towards ETB determination with limit of detection (LOD) and limit of quantification (LOQ) of 0.023 and 0.075 µM, respectively. The developed sensor was effectively validated for real sample study using drug formulation and urine samples which showed an acceptable recovery (99.6‒109%). The electrode also exhibited good precision (RSD < 1%, n = 20), reproducibility (RSD < 1.9%, n = 3), long-term stability (92% of its initial response after two weeks) and selectivity towards interfering substances in the determination of ethambutol.               KEY WORDS: Ethambutol, Glassy carbon electrode, Square wave voltammetry, Electrochemically reduced graphene oxide, Nickel nanoparticles Bull. Chem. Soc. Ethiop. 2019, 33(2), 215-228.DOI: https://dx.doi.org/10.4314/bcse.v33i2.

Applying the Transdisciplinary Adaptive Systemic Approach to Securing the Long-Term Future of Grassland Ecosystems

Contemporary grasslands all exist as complex adaptive systems, specifically complex social-ecological systems – whether these are in protected areas or are part of private or communal agricultural landscapes. These systems are subject to the current planetary condition that includes rapidly growing human populations and demand for natural resources, the widespread use of pollutants, and climate change consequences. All complex adaptive systems have characteristics in common - they comprise multiple elements, which interact, and the multiple interactions cause intersecting feedback loops. As a result, a current system condition reflects its history, future condition is difficult to predict, and interventions have unpredictable outcomes – some positive others negative. The system itself produces emergent properties – new characteristics - through time, out of the multiple element interactions. As complex social-ecological systems, grasslands have all the interactive complexity of both society and ecosystems. This paper uses place-based landscape restoration interventions in the grasslands of the Tsitsa River Catchment, South Africa, and the Lake Tana basin, Ethiopia, to showcase the development and application of the Adaptive Systemic Approach – which we present as an advance in participatory sustainability science

Client and facility level determinants of quality of care in family planning services in Ethiopia: multilevel modelling

Over the last two decades, while contraceptive use has improved in Ethiopia, the contraceptive prevalence rate remains low. In addition to socio-demographic and cultural factors, the quality of care in Family Planning (FP) services is an important determining factor of FP utilization. However, little research exists on the determinants of quality of care in FP services in Ethiopia. This study aims to identify the client and facility level determinants of quality of care in FP services in Ethiopia.This study was based on the first Ethiopian Services Provision Assessment Plus (ESPA+) survey conducted in 2014. A total of 1247 clients nested in 374 health facilities were included in the analysis. Multilevel mixed-effects logistic regression modelling was conducted. The outcome variable, client satisfaction, was created using polychoric principal component analysis using eleven facets that reflect client satisfaction.The results showed that both client-level and facility-level factors were associated with quality of care in FP services in Ethiopia. At the client-level; provision of information on potential side effects of contraceptive method (AOR = 5.22, 95% CI: 2.13-12.80), and number of history and physical assessments (AOR = 1.19, 95% CI: 1.03-1.34) were positively associated with client satisfaction, whereas waiting times of 30 minutes to two hours (AOR = 0.11, 95% CI: 0.03-0.33) was negatively associated with client satisfaction. At the facility-level; urban location (AOR = 4.61, 95% CI: 1.04-20.58), and availability of FP guidelines/protocols for providers (AOR = 4.90, 95% CI: 1.19-20.19) had positive significant effect on client satisfaction.Quality improvement programs in FP services in Ethiopia should focus on shortening waiting times and provision of information about the potential side effects of contraceptive methods. It is also important to improve health providers' skills in thorough client history taking and physical assessment. Further distribution and implementation of best practice guidelines for providers working in the FP services must be a priority.Gizachew Assefa Tessema, Mohammad Afzal Mahmood, Judith Streak Gomersall, Yibeltal Assefa, Theodros Getachew Zemedu, Mengistu Kifle, Caroline O. Laurenc

Prevalence, Reasons, and Perceived Effects of Khat Chewing Among Students of a College in Gondar Town, Northwestern Ethiopia: A Cross‑sectional Study

Background: The estimate of the number of people chewing Khat globally ranges from 5 to 10 million people. Its use may result in a variety of effects due to the different compounds in it with effects on the gastro‑intestinal system and nervous system being the principal ones. Aim: To assess the prevalence, factors, and effects of Khat chewing among students of a college in Gondar town, northwestern Ethiopia. Subjects and Methods: An institution‑based cross‑sectional study was conducted from 15th to 20th of April 2009 on a total sample of 424 students who were selected using stratified random sampling technique. Data were collected by three of the principal investigators using a structured pretested data collection instrument and analyzed by Epi Info version 3.5.2. Results: The lifetime and current prevalence of Khat chewing among the respondents were 42% (168/400) and 32.5% (130/400), respectively. Sex (P < 0.01), religion (P < 0.001), and income (P < 0.01) showed statistically significant variation in Khat chewing. The commonest frequency of Khat chewing was once a day 33.1% (43/130) while alcohol (40.8% [53/130]) and cigarette (40.0% [52/130]) were the mostly used substances with Khat. More than half of the chewers (53.85% [70/130]) reported spending 1–4 h for one Khat chewing ceremony. Financially majority of the chewers reported spending up to 10 Ethiopian Birr (ETB) (1.13 United States Dollar) on Khat ( 54.6% [71/130]) and other substances (64.6% [84/130]). Nearly two‑thirds (62.3% [81/130]) of the chewers mentioned seeking concentration during study as their main reason for chewing. Among chewers, 83.1% (108/130) reported they faced problem associated to sleep disturbance, 82.3% (107/130) loss of appetite, and 80.8% (105/130) constipation. Conclusion: The prevalence of Khat chewing was fairly high among the students and the majority among them used other substances together with Khat. Spending of a significant amount of money and facing health problems were reported to be consequences of the habit. The college should take steps to make students aware of the ills of Khat chewing and associated habits.Keywords: College, Effects, Gondar, Khat, Prevalence, Reason

Re-evaluation of gestational age as a predictor for subsequent preterm birth

Background: To evaluate gestational age as a predictor of subsequent preterm birth. Materials and methods: This was a retrospective birth cohort study to evaluate gestational age as a predictor of subsequent preterm birth. Participants were mothers who gave birth to their first two children in Western Australia, 1980–2015 (N = 255,151 mothers). For each week of final gestational age of the first birth, we calculated relative risks (RR) and absolute risks (AR) of subsequent preterm birth defined as final gestational age before 28, 32, 34 and <37 weeks. Risks were unadjusted to preserve risk factor profiles at each week of gestation. Results: The relative risks of second birth before 28, 32, and 34 weeks’ gestation were all approximately twenty times higher for mothers whose first birth had a gestational age of 22 to 30 weeks compared to those whose first birth was at 40 weeks’ gestation. The absolute risks of second birth before 28, 32, and 34 weeks’ gestation for these mothers had upper confidence limits that were all less than 16.74%. The absolute risk of second birth before 37 weeks was highest at 32.11% (95% CI: 30.27, 34.02) for mothers whose first birth was 22 to 30 weeks’ gestation. For all gestational ages of the first child, the lowest quartile and median gestational age of the second birth were at least 36 weeks and at least 38 weeks, respectively. Sensitivity and positive predictive values were all below 35%. Conclusion: Relative risks of early subsequent birth increased markedly with decreasing gestational age of the first birth. However, absolute risks of clinically significant preterm birth (<28 weeks, <32 weeks, <34 weeks), sensitivity and positive predictive values remained low. Early gestational age is a strong risk factor but a poor predictor of subsequent preterm birth.Elizabeth Pereira, Gizachew Tessema, Mika Gissler, Annette K. Regan, Gavin Pereir

Global, regional, and national levels of maternal mortality, 1990–2015 : a systematic analysis for the Global Burden of Disease Study 2015

Background In transitioning from the Millennium Development Goal to the Sustainable Development Goal era, it is imperative to comprehensively assess progress toward reducing maternal mortality to identify areas of success, remaining challenges, and frame policy discussions. We aimed to quantify maternal mortality throughout the world by underlying cause and age from 1990 to 2015. Methods We estimated maternal mortality at the global, regional, and national levels from 1990 to 2015 for ages 10–54 years by systematically compiling and processing all available data sources from 186 of 195 countries and territories, 11 of which were analysed at the subnational level. We quantifi ed eight underlying causes of maternal death and four timing categories, improving estimation methods since GBD 2013 for adult all-cause mortality, HIVrelated maternal mortality, and late maternal death. Secondary analyses then allowed systematic examination of drivers of trends, including the relation between maternal mortality and coverage of specifi c reproductive health-care services as well as assessment of observed versus expected maternal mortality as a function of Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Findings Only ten countries achieved MDG 5, but 122 of 195 countries have already met SDG 3.1. Geographical disparities widened between 1990 and 2015 and, in 2015, 24 countries still had a maternal mortality ratio greater than 400. The proportion of all maternal deaths occurring in the bottom two SDI quintiles, where haemorrhage is the dominant cause of maternal death, increased from roughly 68% in 1990 to more than 80% in 2015. The middle SDI quintile improved the most from 1990 to 2015, but also has the most complicated causal profi le. Maternal mortality in the highest SDI quintile is mostly due to other direct maternal disorders, indirect maternal disorders, and abortion, ectopic pregnancy, and/or miscarriage. Historical patterns suggest achievement of SDG 3.1 will require 91% coverage of one antenatal care visit, 78% of four antenatal care visits, 81% of in-facility delivery, and 87% of skilled birth attendance. Interpretation Several challenges to improving reproductive health lie ahead in the SDG era. Countries should establish or renew systems for collection and timely dissemination of health data; expand coverage and improve quality of family planning services, including access to contraception and safe abortion to address high adolescent fertility; invest in improving health system capacity, including coverage of routine reproductive health care and of more advanced obstetric care—including EmOC; adapt health systems and data collection systems to monitor and reverse the increase in indirect, other direct, and late maternal deaths, especially in high SDI locations; and examine their own performance with respect to their SDI level, using that information to formulate strategies to improve performance and ensure optimum reproductive health of their population.GBD 2015 Maternal Mortality Collaborators ...Nicholas J Kassebaum ... Azmeraw T Amare ... Liliana G Ciobanu ... James Hancock ... Ratilal Lalloo ... Yohannes Adama Melaku ... John Nelson Opio ... G A Tessema ... et.al