Integration of Family Planning Services within Post Abortion Care at Health Facilities in Dessie –North East Ethiopia

The aim of this study is to investigate the integration of family planning services within post abortion care that plays a vital role in reducing maternal morbidity and mortality resulting from abortion and its  complications. Facility based cross - sectional study design was used including both quantitative and qualitative data collection method. The sample size was 291. The number of study units to be sampled from each facility was determined using proportional allocation to size and systematic random sampling was employed to select and approach each study  subjects. A validated semi structured questionnaire was used to collect thedata. Bi-variate analysis and multivariate logistic regression analysis was carried out to identify the most important predictors of integrating family planning services within post abortion care. A total of 282 post abortion women were included in the exit interview. Among these 158 (56.0%) reported that they have got family planning (FP) counselling and 134 (47.5%) left the health facility with modern contraceptive method. Lack of trained provider, being over loaded by other routine activities, absence of separate post abortion room, lack of commodities and supplies were major identified barriers of integrating family planning services within post  abortion care. Family planning services were partially integrated within post abortion care. Attention should be given in service providers training,  availing post abortion family planning supplies and equipments in the post abortion recovery room

Study of the Ethiopian live cattle and beef value chain

Rats achieve remarkable texture discriminations by sweeping their facialwhiskers along surfaces. This work explores how neurons at two levels of the sensory pathway, trigeminal ganglion and barrel cortex, carry information about such stimuli. We identified two biologically plausible coding mechanisms, spike counts and patterns, and used “mutual information” to quantify how reliably neurons in anesthetized rats reported texture when “decoded” according to these candidate mechanisms. For discriminations between surfaces of different coarseness, spike counts could be decoded reliably and rapidly (within 30 ms after stimulus onset in cortex). Information increased as responseswere considered as spike patterns with progressively finer temporal precision. At highest temporal resolution (spike sequences across six bins of 4ms), the quantity of “information” in patterns rose 150% for ganglion neurons and 110% for cortical neurons above that in spike counts. In some cases, patterns permitted discriminations not supported by spike counts alone

Isovector part of nuclear energy density functional from chiral two- and three-nucleon forces

A recent calculation of the nuclear energy density functional from chiral two- and three-nucleon forces is extended to the isovector terms pertaining to different proton and neutron densities. An improved density-matrix expansion is adapted to the situation of small isospin-asymmetries and used to calculate in the Hartree-Fock approximation the density-dependent strength functions associated with the isovector terms. The two-body interaction comprises of long-range multi-pion exchange contributions and a set of contact terms contributing up to fourth power in momenta. In addition, the leading order chiral three-nucleon interaction is employed with its parameters fixed in computations of nuclear few-body systems. With this input one finds for the asymmetry energy of nuclear matter the value $A(\rho_0) \simeq 26.5\,$MeV, compatible with existing semi-empirical determinations. The strength functions of the isovector surface and spin-orbit coupling terms come out much smaller than those of the analogous isoscalar coupling terms and in the relevant density range one finds agreement with phenomenological Skyrme forces. The specific isospin- and density-dependences arising from the chiral two- and three-nucleon interactions can be explored and tested in neutron-rich systems.Comment: 14 pages, 7 figures, to be published in European Physical Journal

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.

Selection of optimum replacement option for amine pump in a gas processing plant using fuzzy analytical hierarchy process

In order to excel in the competitive market, it is essential to make a flawless decision which is difficult without considering different factors that affect it. These factors can be qualitative or quantitative which are full of uncertainties. Fuzzy analytical hierarch process (FAHP) is a very useful tool to model such a decision making process. In this study FAHP is used to select the optimum replacement option of amine pump in a gas processing plant. The gas processing plant has 10 unit of amine circulation pumps. These pumps have been installed since 1996. After installation, various problems occurred which lead to low reliability and availability of the amine pump system and a lot of design modification has been done since then. In this study three different replacement options are investigated to solve the problem. These options are a) To continue with the existing pump system through repair, b) To modify the existing system by changing one or two of the old pumps which has low performance by `a new one and c) To add a new pump. These options were assessed with four criteria; Ease of operation, Flexibility, Maintainability and environment. Data was collected from 25 employees and a pairwise comparison was conducted. It is found that the weight of the first option which is continuing with the existing system is higher with 0.47 values which show this option is preferable for the selected case. A sensitivity analysis is conducted to explore how the ranking of the analysis varies when the input data were changed

Cost analysis of violence-related medical imaging in a Free State tertiary trauma unit

Background: Violence is a leading public health problem worldwide. Beyond the pain and suffering, violence has a significant economic impact on a country’s health, policing and judicial services. Because of the lack of current and comprehensive data in South Africa, local violence-related economic impact studies are largely estimations. Violence-related imaging expenditure, as a component of a public hospital’s expenditure, is yet to be determined. Objectives: The goals of this study were to measure the violence-related patient burden on Pelonomi Tertiary Hospital’s (PTH) trauma and radiology services, determine the imaging-component cost of violence-related injuries and calculate the financial burden violence has on the hospital’s expenditures. Method: From the PTH’s trauma unit patient registry, 1380 patients with violence-related injuries were consecutively sampled for 6 months ending 31 December 2017. Imaging investigations were documented and categorised according to the South African National Department of Health’s 2017 Uniform Patient Fee Schedule (UPFS). Descriptive analysis and cost calculations were performed using the 2017 UPFS tariff schedule and hospital-specific health efficiency indicators – patient-day equivalent and expenditure per patient-day equivalent. Results: Violence-related injuries accounted for 50.64% of all trauma department visits and received a total of 5475 imaging investigations. Violence-related imaging investigations represented 14.81% of all investigations performed by the radiology department in the study period. Overall violence-related admission costs amounted to R35 410 241.85 (8.33% of the hospital’s total expenditure), of which 20.08% (R7 108 845.00) was attributed to imaging investigations. Conclusion: Violence-related admissions had a high patient and financial burden on PTH. The pinnacle of healthcare cost saving is violence prevention; however, the cost-conscious radiologist could assist with cost saving if responsible and ethical imaging practices are followed