Drought Risk Assessment using Remote Sensing and GIS: The Case of Southern Zone, Tigray Region, Ethiopia

This study used satellite sensor data which are consistently available, cost effective and can be used to detect the onset of drought, its duration and magnitude. Moreover, an effort has been made to derive drought risk areas facing agricultural as well as meteorological drought using eight-year time series rainfall data and dekadal satellite SPOT NDVI (Normalized Difference Vegetation Index). A deviation of the current NDVI with the long-term mean NDVI, and the Vegetation Condition Index (VCI) derived from the SPOT were used in this study for drought detection and monitoring. The results revealed that large proportion of the area, i.e. 31.45% (3009km2) is at moderate drought risk level, whereas 17% (1568km2) of the area accounted for high drought risk.  It is also shown that Enderta, HintaloWajirat, Eastern part of Raya Azebo and southern part of Alamata distric that more susceptible to drought. Moreover, it has been indicated that the two remote-sensing indices used, DEVNDVI, and VCI are complementary and were found to be sensitive indicators of drought conditions. SPOT NDVI at 1km by 1km resolution, which incorporates the long-term NDVI, is also found to be one of the best data for drought risk assessment. Keywords: Drought, Normalized Difference Vegetation Index, Vegetation Condition Index, Risk assessmen

Human resources for public health supply chain management in Ethiopia: Competency mapping and training needs

Background: A health care system is judged to be functioning well, among others, when seen in light of the access it provides to affordable and quality medicines and supplies. This largely depends on the availability of competent health supply workforce.Health supply workers can become competent if and when they get the education and training needed to develop the skills required to work effectively in health supply chain in the country.Objective: The objective of this needs assessment was to identify the need for health supply chain management trainingand map competencies of personnel working at different levels of the health supply chain in Ethiopia.Methods: Initially, national sensitization and consensus building workshop on human resources for public health supply chain management was held in Addis Ababa.At the workshop, gaps were identified and required competencies suggested. This was followed by qualitative and quantitative surveys.Findings: The sensitive nature ofpublic health supply seems to be increasingly recognized by policy makers and other stakeholders. This is encouraging. However, the situation of the supply chain in the countryis not as effective as desired. Issues related to human resourcewereamong themajor factors that have contributed tothe problem of the supply chain. Scarcity and lack of expertise in supply chain management were noted in the finding as the challenges often talked about. In addition, there are issues related to poor commitment and lack of motivationon the part of the personnel currently involved in the management of the supply chain.Overall, shortages in some aspects and gaps in others characterize the supply chain management. Evidence of emergency purchases has also been observed.Largely, participants had either entry level or midlevel competencies in the five major supply chain domains. The majority (i.e., 89.5%) of the participants of the study showed interest to advance their career in health supply chain management. MSc level training was one way they said this could be achieved.Conclusion: Despite various efforts made to implement initiatives that increase the supply chain efficiencyover the past years, marked inadequacies still characterize the system. For example, stocks are observed to run out of essential medicines and supplies. Lack of timelinessin delivery of itemsis also reported. Multiple factors were identified to be held responsible for the reported deficiencies of theperformances of the supply chain system. Human resources related challenges are identified as key contributing factors to the problems.Examples reported include workers’ lack of competencies required for the work. One reason claimed to have underlined this lack of competencies is the inadequate level of the training given to the workers. Ethiop. J. Health Dev. 2017; 31(4):266-275]Keywords: Human resources for health supply chain, training need, competency, Ethiopi

Health seeking behavior and use of medicinal plants among the Hamer ethnic group, South Omo zone, southwestern Ethiopia

Appendix I Glossary of local names of illnesses and some traditional medical practices and their equivalent meanings in English. Appendix II Questionnaire to be used to collect ethnopharmacological information at house hold level among Hamer ethnic group, Hamer Woreda, South Omo Zone, SNNPR. Appendix III Questionnaire to be used to collect ethnopharmacological information for key informants among Hamer ethnic group, Hamer Woreda, South Omo Zone, SNNPR. Appendix IV Questions for Focused Group Discussions. (DOCX 24 kb

Popular Healing and Primary Health Care: A Socio-Cultural Study in Rural North-Eastern Ethiopia

Introduction: Studies have shown that popular healing practices at home could play a major role in solving the problem of overcrowding in primary care services. This study explored the indigenous popular healing practices used by communities in North Eastern Ethiopia.Methodology: A qualitative ethnographic method was used for this study. Using Kleinman’s Cultural Systems Model, we conducted participatory observation (5 months during the span of one year) supplemented by ten focus group discussions (n=96) and 20 key informant interviews with purposefully selected knowledgeable community members. The focus group and key informant interviews included questions about the popular healing as a health care option and popular modes of healing practices. The process of analysis and interpretation was informed by thematically and the analysis of narratives strategies.Findings: The study found that home remedies are applied for both prevention and remedial purposes. Common ailments that are managed at home include Nedad (malaria) and Mich (acute febrile illness). Home remedies are prepared in the household by the patient, his/her parent or a family member. However, in cases where home remedies and/or home-based treatment did not cure a patient, other alternatives are looked for such as visiting a bio-medical care facility following a similar model developed by Kleinman in early 1980’s.Conclusion: Since people in the study communities believe that popular healing is a health care option among multiple health-care resources, successful rural primary health care strategy would give due attention to such local resources. This will help to ensure the optimal utilization of Ethiopia’s limited resources. ]Key Words: Popular healing, home remedies, ailments, primary health care, Ethiopi

Use of medicinal plants among Ethiopian patients with diabetes: A qualitative exploration

Background: Most studies on the use of medicinal plants reported from Africa (including Ethiopia) have focused on the clinical actions of medicinal plants with little attention given to patient experiences in using these plants and factors impacting patients’ decisions about using them.Objectives: The main objective of this study is to explore the experiences of patients with diabetes attending treatment in the biomedical setting regarding their use of medicinal plants.Methods: Qualitative interviews were held with 39 purposively selected participants attending their treatment in 3 public hospitals in urban centers of central Ethiopia. Interviews continued until key themes were saturated.Results: Medicinal plants were used alongside prescribed medicines with a range of factors impacting study participants decisions to trying out and continuing to use medicinal plants and also in recommending against their use or discontinuing them. Some of the main factors that encouraged use of medicinal plants include perceptions that bitter things were thought to be good for diabetes, their claimed and experienced benefits as well as the influence of others and the media while those that discouraged the use of medicinal plants primarily include safety concerns in relation to using the plants.Conclusions: The findings highlight the use of medicinal plants by patients with diabetes in the context of limited information. This is suggestive of the need for the healthcare practitioners in the conventional healthcare system to give more attention to patients’ interest in medicinal plants and for providing more evidence-based information about the plants used by these patients so as to improve health outcomes. Key words: medicinal plants, type 2 diabetes, Ethiopia, qualitative researc

Ethnomedicinal uses of plants among the Somali ethnic group, Jigjiga Woreda, Somali Regional State, Eastern Ethiopia

Introduction: In Ethiopia, most people are dependent on traditional medicine (TM), mainly of plant origin for human and animal health problems. The practice of herbal medicine varies widely, in keeping with the societal and cultural heritage of different countries. The heritage has not been well documented in the developing countries including Ethiopia and this is even more so in the emerging regions of the country. The objective of this study was to document medicinal plant knowledge of the people and identifying factors determining the use of medicinal plants in Jigjiga Woreda, Somali Regional State, eastern Ethiopia.Methods: A cross-sectional study was conducted in five kebeles from where ethno-medicinal information was collected using semi-structured questionnaire. The questionnaire was administered to 800 heads of households. Data were entered and analyzed using Statistical Packages for Social Sciences version 20. Multivariable logistic regression was performed to show possible associations between the dependent and independent variable and statistical significance was set at p < 0.05.Results: The study documented an overall prevalence of 40% to use of herbal medicine during one month recall period. A total of 45 medicinal plant species were collected and botanically identified. The study found that leaves are the most frequently utilized plant part (30.5%), followed by roots (23.0%). The reasons for preference of herbal drugs were related to lower price, efficacy and geographic accessibility as compared to modern medicine. Age, gender, educational status and occupation were identified as important determinants for the use of herbal medicine.Conclusion: This ethno-medicinal study showed that community in Jigjiga Woreda relies on traditional medicinal plant species to treat a wide spectrum of human ailments. It is therefore suggested that more in depth studies be condicted to explore the potential of traditional medicine in the region to preserve this indigenous knowledge. [Ethiop. J. Health Dev. 2017;31(3):188-199]Keywords: Ethnomedicine, Jigjiga Woreda, Medicinal plants, Somali ethnic grou

Concomitant use of medicinal plants and conventional medicines among hypertensive patients in five hospitals in Ethiopia

Background: Even if the use of medicinal plants has a long tradition in Ethiopia, little is known about which medicinal plants are concomitantly used with which conventional medicines, since patients’ disclosure to their treating physicians is low. The concomitant use of medicinal plants and conventional medicines may increase the risk of unwanted interactions, unexpected toxicities and possible under-treatment. The aim of this study was to identify plants concomitantly used with conventional medicines by hypertensive patients. Methods: A total of 365 patients and 17 healers were surveyed to identify medicinal plants commonly used by hypertensive patients. In addition, patients’ charts were reviewed to identify if they had any co-morbid conditions or history of taking medicinal plants. Descriptive statistics were used for the analysis. Results: Of 365 hypertensive patients, 171(46.8%) reported having co-morbidities, mainly hypercholesterolemia(28, 7.7%), diabetes mellitus(38, 4.9%) and asthma (12, 3.3%). While the majority (319, 87.4%) of patients preferred modern medicines for the management of their hypertension, some preferred taking holy water (24, 6.69%) and using medicinal plants (20,5.5%). The concomitant use of medicinal plants and conventional medicines was practiced by just under half of the patients (171, 46.8%). Hydrochlorothiazide, enalapril, nifedipine, amlodipine, atenolol and aspirin were the most commonly used conventional medicines. Moringa (Moringa stenopetala), damakase (OcimumlamiifoliumHochst.), haregresa (ZehneriascabraSond.) and thyme(Thymus serrulatus)were the most commonly used plants. However, none of these medicinal plants were standardized in terms of the dose, frequency, duration or method of preparation. Conclusions: Conventional medicine was the initial primary treatment choice for hypertensive patients. However, a high tendency of using medicinal plants concomitantly was observed due to the side-effects of conventional medicines, patients’ curiosity to try medicinal plants and the desire to achieve better blood pressure control. [Ethiop. J. Health Dev. 2019; 33(4):239-249] Key words: Hypertension, herb-drug interaction, medicinal plants, conventional medicine, Ethiopi

PREVALENCE OF EXTENDED-SPECTRUM BETA-LACTAMASE PRODUCING ENTEROBACTERIACEAE MEMBERS ISOLATED FROM CLINICALLY SUSPECTED PATIENTS

 Objective: Emergence of extended-spectrum beta-lactamases (ESBLs) production poses another clinical problem with Gram-negative bacterial infections. The present study was aimed to evaluate the ESBL producers among various clinical samples of clinically suspected patients.Methods: A total of 1279 samples (urine [918], pus [207] and stool [154]) were collected and 465 isolates (Escherichia coli [320], Enterobacter aerogenes [119] and Klebsiella pneumoniae [26]) were isolated and screened for the presence of ESBL producers using combination disc method and double disc synergy test.Results: Of the 465 culture positive isolates, 130 (E. coli 93 [29.06%], E. aerogenes 35 [29.41%] and K. pneumoniae 2 [7.69%]) were identified as ESBL producers. Among the three Enterobacteriaceae members, E. coli 93 (29.06%) was found to be predominant ESBL producer next in order E. aerogenes 35 (29.41%) and K. pneumoniae 2 (7.69%). Maximum number of ESBL producers were recovered from urine (n=111) followed by pus (n=14) and stool (n=5). All the ESBL-producing isolates were subjected to antibiotic sensitivity test using 10 different antibiotics. ESBL producers were chiefly resistance to ceftriaxone followed by ceftazidime and cefotaxime. Of 130 ESBL producers, 15 (E. coli (8), E. aerogenes (6) and K. pneumoniae (1)] strains were selected for genotypic identification. Among, only two strains of E. aerogenes were positive isolates for CTX-M type ESBL in polymerase chain reaction.Conclusion: This study concluded that among Enterobacteriaceae members, E. coli was the predominant ESBL producers and urine was noted as the prime source for the ESBL positive isolates when compared to other source. Genotypic identification was the best method to differentiate ESBL types which were essential to provide proper treatment