Product Development Using CFD Simulation of Energy Efficient Institutional Bio-char Rocket Stove

Globally, biomass accounts for ten percent of energy production, two-thirds of which is used for cooking and heating purposes in developing countries. Environmental degradation and natural resource depletion are also serious issues as a result of cutting trees to serve as fuel wood; biomass will govern household energy of the countries in the near future and increased afforestation, reforestation, and forest management to increase carbon sequestration in forests and woodlands. This study was product development using CFD simulation, of modified rocket stove that is energy efficient for institutional cooking. The stove design was selected for both the computational fluid dynamic (CFD) simulation and prototype production. ANSYS fluent work bench was used for CFD simulation the wood combustion and pyrolysis of woodchip to form multi-face exhaust holes syngas flow to stove combustion chamber. Gasses start to come out from the pyrolysis chamber through the exhaust outlet after 8 minutes of pyrolysis, and pressurized gasses come out at this time, and start burn in combustion chamber. At 60 minutes pressurized Syngas stops and gives low combustion. Keywords: stove, CFD, combustion, pyrolysis, Syngas, biochar rocket stov

Development and evaluation of Indirect Hemagglutination Antibody Test (IHAT) for serological diagnosis and screening of bovine cysticercosis in Ethiopia

The study was conducted to develop and evaluate an Indirect Hemagglutination Antibody Test (IHAT) for the serological diagnosis of Cysticercus bovis in live animals. IHAT was set-up in-house and used to test serum samples of cattle against sheep red blood cell (SRBC) coated with crude extracts of C. bovis cyst. Serum samples for screening were collected from Addis Ababa abattoir (n=522), a dairy farm from the suburbs of Addis Ababa (n=101), and a traditional extensive farm (n=109). Postmortem inspection was conducted on a total of 522 animals slaughtered in Addis Ababa Abattoir, out of which 39 (7.5%) were positive for C. bovis.  Thirty-seven of these had viable C. bovis cysts. IHAT titres were determined from serially diluted sera, with a cut-off value set at a titre of 1:64. Cross reaction with other helminths was either absent or very low.  Sensitivity and specificity of the IHAT were 100% and at least 90%, respectively. Based on this test, 149 cattle (28.5%) from the Abattoir, 33 cattle (30.3%) from the extensive farm and 8 cattle (7.9%) from the dairy farm were positive for C. bovis. The difference in prevalence between the dairy farm and extensive farm was significant (

Assessment of internal control over cash: the case of National Alcohol and Liquor Factory

Internal control over cash is of major importance in any business enterprise since cash is a vital factor in the operation of business and many business transactions involve cash. In addition, controlling of cash is important since it is the most liquid of all assets that is vulnerable to theft or misappropriation. Due to the execution and involvement of cash and its flow in different institutions, there might have been problems life mishandling and misusage unreliable and unreal formats and documents as well as effectiveness with lack of proper timing and authority are among the problems. This study will mainly focus on some of the controlling mechanisms that might have been over looked on the internal control policies over cash in the case of National Alcohol and Liquor Factory and to give some valuable feed back to the management. To execute, our study use primary data by interviewing the factory’s stakeholders who are responsible members and review theirs cash operation manual guidelines and reports as well as different resources from company’s website

Prevalence and Associated Factors of Thyroid Incidentaloma among Adult People Attending Gondar University Hospital, Northwest Ethiopia Temesgen Tadesse1

BACKGROUND: Incidentally discovered thyroid lesions have become highly common in the development and more frequent utilization of highly sensitive imaging modalities, like ultrasound. However, little is known about its prevalence and associated factors in Ethiopia. The aim of this study was to determine the prevalence of thyroid incidentalomas and associated factors through ultrasound (US) among adults attending Gondar University Hospital.METHODS: A hospital-based cross-sectional study was carried out on 290 adults aged 15 years and above. Out of the adults who visited the hospital during the study, those who neither had history of thyroid disease, thyroid surgery, nor clinically palpable thyroid nodules were involved in the investigation. The participants were examined using a high frequency linear-array transducer (7MHz). For comparing men and women, the unpaired t-test wasused. Binary logistic analysis was used to identify the associated factors, and a P-value < 0.05 was considered statistically significant.RESULT: The frequency of thyroid incidentaloma was found to be 33.4% (95% CI: 27.9, 38.9). Thyroid incidentaloma was detected in 42.4% of the females and 22.7% of the males (P<0.001). About 63% had single and 37% multiple thyroid nodules. About 25.8% had thyroid nodules greater than 1cm. In the multivariable logistic regression analysis, increasing age (AOR=5.96; 2.34, 15.15) and female sex (AOR=3.01; 1.73, 5.26) were significantly associated with thyroid incidentalomas.CONCLUSION: The frequency of thyroid incidentaloma (TI) was found to be high in this study and much higher among older women. Solitary and small sized thyroid nodules were commonly seen in the study.

Is universal health coverage affordable? Estimated costs and fiscal space analysis for the Ethiopian Essential Health Services Package

Estimating the required resources for implementing an essential health services package (EHSP) is vital to examine its feasibility and affordability. This study aimed to estimate the financial resources required to implement the Ethiopian EHSP from 2020 to 2030. Furthermore, we explored potential alternatives to increase the fiscal space for health in Ethiopia. We used the OneHealth Tool (OHT) to estimate the costs of expanding the EHSP service provision in the public sector in Ethiopia. Combinations of ingredient-based bottom-up and program-based summary costing approaches were applied. We predicted the fiscal space using assumptions for economic growth, government resource allocations to health, external aid for health, the magnitude of out-of-pocket expenditure, and other private health expenditures as critical factors affecting available resources devoted to health. All costs were valued using 2020 US dollars (USD). To implement the EHSP, 13.0 billion USD (per capita: 94 USD) would be required in 2030. The largest (50–70%) share of estimated costs was for medicines, commodities, and supplies, followed by human resources costs (10–17%). However, the expected available resources based on a business-as-usual fiscal space estimate would be 63 USD per capita for the same year. Therefore, the gap as a percentage of the required resources would be 33% in 2030. The resources needed to implement the EHSP would increase steadily over the projection period due mainly to increases in service coverage targets over time. Allocating gains from economic growth to increase the total government health expenditure could partly address the gap.publishedVersio

Measuring progress towards universal health coverage: National and subnational analysis in Ethiopia

Introduction: Aiming for universal health coverage (UHC) as a country-level goal requires that progress is measured and tracked over time. However, few national and subnational studies monitor UHC in low-income countries and there is none for Ethiopia. This study aimed to estimate the 2015 national and subnational UHC service coverage status for Ethiopia. Methods: The UHC service coverage index was constructed from the geometric means of component indicators: first, within each of four major categories and then across all components to obtain the final summary index. Also, we estimated the subnational level UHC service coverage. We used a variety of surveys data and routinely collected administrative data. Results: Nationally, the overall Ethiopian UHC service coverage for the year 2015 was 34.3%, ranging from 52.2% in the Addis Ababa city administration to 10% in the Afar region. The coverage for non-communicable diseases, reproductive, maternal, neonatal and child health and infectious diseases were 35%, 37.5% and 52.8%, respectively. The national UHC service capacity and access coverage was only 20% with large variations across regions, ranging from 3.7% in the Somali region to 41.1% in the Harari region. Conclusion: The 2015 overall UHC service coverage for Ethiopia was low compared with most of the other countries in the region. Also, there was a substantial variation among regions. Therefore, Ethiopia should rapidly scale up promotive, preventive and curative health services through increasing investment in primary healthcare if Ethiopia aims to reach the UHC service coverage goals. Also, policymakers at the regional and federal levels should take corrective measures to narrow the gap across regions, such as redistribution of the health workforce, increase resources allocated to health and provide focused technical and financial support to low-performing regions.publishedVersio

Cost-effectiveness of facility-based, stand-alone and mobile-based voluntary counseling and testing for HIV in Addis Ababa, Ethiopia

Background: Globally, there is a consensus to end the HIV/AIDS epidemic by 2030, and one of the strategies to achieve this target is that 90% of people living with HIV should know their HIV status. Even if there is strong evidence of clients’ preference for testing in the community, HIV voluntary counseling and testing (VCT) continue to be undertaken predominantly in health facilities. Hence, empirical cost-effectiveness evidence about different HIV counseling and testing models is essential to inform whether such community-based testing are justifiable compared with additional resources required. Therefore, the purpose of this study was to compare the cost-effectiveness of facility-based, stand-alone and mobile-based HIV voluntary counseling and testing methods in Addis Ababa, Ethiopia. Methods: Annual economic costs of counseling and testing methods were collected from the providers’ perspective from July 2016 to June 2017. Ingredients based bottom-up costing approach was applied. The effectiveness of the interventions was measured in terms of the number of HIV seropositive clients identified. Decision tree modeling was built using TreeAge Pro 2018 software, and one-way and probabilistic sensitivity analyses were conducted by varying HIV positivity rate, costs, and probabilities. Results: The cost of test per client for facility-based, stand-alone and mobile-based VCT was USD 5.06, USD 6.55 and USD 3.35, respectively. The unit costs of test per HIV seropositive client for the corresponding models were USD 158.82, USD 150.97 and USD 135.82, respectively. Of the three models, stand-alone-based VCT was extendedly dominated. Mobile-based VCT costs, an additional cost of USD 239 for every HIV positive client identified when compared to facility-based VCT. Conclusion: Using a mobile-based VCT approach costs less than both the facility-based and stand-alone approaches, in terms of both unit cost per tested individual and unit cost per HIV seropositive cases identified. The stand-alone VCT approach was not cost-effective compared to facility-based and mobile-based VCT. The incremental cost-effectiveness ratio for mobile-based VCT compared with facility-based VCT was USD 239 per HIV positive case.publishedVersio

Critical success factors model developing for sustainable Kaizen implementation in manufactur-ing industry in Ethiopia

The purpose of the research is to identify critical success factors and model developing for sustaining kaizen implementation. Peacock shoe is one of the manufacturing industries in Ethiopia facing challenges on sustaining. The methodology followed is factor analysis and empirically testing hypothesis. A database was designed using SPSS version 20. The survey was validated using statistical validation using the Cronbach alpha index; the result is 0.908. The KMO index value was obtained for the 32 items and had a value of 0.642 with Bartlett's Test of Sphericity Approx. Chi-Square 4503.007, degree of freedom 496 and significance value 0.000. A factor analysis by principal components and varimax rotation was applied for finding the critical success factors. Finding designates that 32 items were merged into eight critical success factors. All the eight factors together explain for 76.941 % of the variance. Multiple regression model analysis has indicated that some of the critical success factors had relationship with success indicators. Due to constraint of time, the researcher focused only at peacock shoe manufacturing industry. Other limitation also includes the absence of any local research that shows the critical success factors at the moment

Contextualization of cost-efectiveness evidence from literature for 382 health interventions for the Ethiopian essential health services package revision

Background Cost-effectiveness of interventions was a criterion decided to guide priority setting in the latest revision of Ethiopia’s essential health services package (EHSP) in 2019. However, conducting an economic evaluation study for a broad set of health interventions simultaneously is challenging in terms of cost, timeliness, input data demanded, and analytic competency. Therefore, this study aimed to synthesize and contextualize cost-effectiveness evidence for the Ethiopian EHSP interventions from the literature. Methods The evidence synthesis was conducted in five key steps: search, screen, evaluate, extract, and contextualize. We searched MEDLINE and EMBASE research databases for peer-reviewed published articles to identify average cost-effectiveness ratios (ACERs). Only studies reporting cost per disability-adjusted life year (DALY), quality-adjusted life year (QALY), or life years gained (LYG) were included. All the articles were evaluated using the Drummond checklist for quality, and those with a score of at least 7 out of 10 were included. Information on cost, effectiveness, and ACER was extracted. All the ACERs were converted into 2019 US dollars using appropriate exchange rates and the GDP deflator. Results In this study, we synthesized ACERs for 382 interventions from seven major program areas, ranging from US$3 per DALY averted (for the provision of hepatitis B vaccination at birth) to US$242,880 per DALY averted (for late-stage liver cancer treatment). Overall, 56% of the interventions have an ACER of less than US$1000 per DALY, and 80$10,000 per DALY. Conclusion We conclude that it is possible to identify relevant economic evaluations using evidence from the literature, even if transferability remains a challenge. The present study identified several cost-effective candidate interventions that could, if scaled up, substantially reduce Ethiopia’s disease burden.publishedVersio

Revision of the Ethiopian Essential Health Service Package: An Explication of the Process and Methods Used

To make progress toward universal health coverage, countries should define the type and mix of health services that respond to their populations’ needs. Ethiopia revised its essential health services package (EHSP) in 2019. This paper describes the process, methodology and key features of the new EHSP. A total of 35 consultative workshops were convened with experts and the public to define the scope of the revision, develop a list of health interventions, agree on the prioritization criteria, gather evidence and compare health interventions. Seven prioritization criteria were employed: disease burden, cost effectiveness, equity, financial risk protection, budget impact, public acceptability and political acceptability. In the first phase, 1,749 interventions were identified, including existing and new interventions, which were regrouped and reorganized to identify 1,442 interventions as relevant. The second phase removed interventions that did not match the burden of disease or were not relevant in the Ethiopian setting, reducing the number of interventions to 1,018. These were evaluated further and ranked by the other criteria. Finally, 594 interventions were classified as high priority (58%), 213 as medium priorities (21%) and 211 as low priority interventions (21%). The current policy is to provide 570 interventions (56%) free of charge while guaranteeing the availability of the remaining services with cost-sharing (38%) and cost-recovery (6%) mechanisms in place. In conclusion, the revision of Ethiopia’s EHSP followed a participatory, inclusive and evidence-based prioritization process. The interventions included in the EHSP were comprehensive and were assigned to health care delivery platforms and linked to financing mechanisms.publishedVersio