Mainstreaming Children into National Poverty Strategies : a child-focused analysis of the Ethiopian Sustainable Development and Poverty Reduction Programme (2002-05)

The purpose of this paper is to assess how the needs of children are incorporated into Ethiopia¿s Poverty Reduction Strategy Paper (PRSP)¿known as the Ethiopian Sustainable Development and Poverty Reduction Programme 2002-2005 (SDRDP) ¿and to develop policy recommendations for the second PRSP based on a comparative content analysis with other countries¿ PRSPs. The paper begins by identifying the key ingredients of a child-centred PRSP, including: consideration of childhood poverty in the document¿s poverty analysis; spaces for consultation with children; childspecific policies and programmes as well as child-sensitive macro-development policies; institutionalized mechanisms to coordinate these policy approaches and the inclusion of child-related progress indicators. The second section uses a content analysis methodology to consider the extent to which the Ethiopian PRSP is pro-poor and pro-child and contrasts this to more child-sensitive approaches in other PRSPs. The paper then analyses the SDPRP¿s policies, programmes and indicators using a rights-based framework. It assesses the extent to which both the direct (child-specific policy commitments) and indirect (macro-development) policies are in keeping with the United Nations Convention on the Rights of the Child (UNCRC) principles of child survival, development, protection, equal treatment and participation. The paper concludes by drawing on the best practices of PRSPs in other countries and outlining how a child-focused PRSP could more effectively address the multi-dimensionality of childhood poverty in Ethiopia

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Prevalence of prelacteal feeding and its associated factors among mothers of under-24-month-old children at Arba Minch Zuria District, Ethiopia : a cross-sectional study

Background. Introduction of prelacteal feeds to newborn babies negates the recommendation of the World Health Organization that breastfeeding should be initiated within an hour after childbirth. As a result, many known health benefits of breastfeeding for infants, children and mothers are precluded. Therefore, to obviate the harmful effects of prelacteal feeding, it remains of paramount concern to identify the current status of prelacteal feeding and its contributing factors. Objective. To assess the prevalence of prelacteal feeding and associated factors among mothers of under-24-month-old children in Arba Minch Zuria District, Ethiopia. Methods. A community-based cross-sectional study was conducted among 400 mother/caregiver-child pairs. A structured and pretested questionnaire uploaded on mobile devices pre-installed with open data kit software was used for data collection. Factors associated with prelacteal feeding practices were explored using multivariable logistic regression analysis. The Hosmer-Lemeshow goodness-of-fit test was used to determine whether the model adequately described the data or not. Results. A total of 400 mothers/caregivers participated in the study, of whom 67 (16.8%) practised prelacteal feeding. Mothers who had poor knowledge of breastfeeding were nearly four times more likely to practise prelacteal feeding than those who had good knowledge (adjusted odds ratio (aOR) 3.95; 95% confidence interval (CI) 1.82 - 8.54). Mothers who did not receive counselling on breastfeeding during antenatal care (ANC) follow-up were 4.1 times more likely to provide prelacteal feeds than those who received counselling (aOR 4.1; 95% CI 1.70 - 9.76). Furthermore, mothers who did not receive immediate postnatal care were 6.46 times more likely to give prelacteal feeding than those who received immediate postnatal care (aOR 6.46; 95% CI 2.85 - 14.63). Conclusions. One out of six neonates was given prelacteal feeds in the study area. Poor knowledge among mothers about breastfeeding, lack of counselling on optimal breastfeeding during ANC visits, and lack of immediate postnatal care mainly led to prelacteal feeding. Therefore, attention should be given to improving maternal knowledge of breastfeeding through the refining of skilled counseling during ANC and immediate postnatal care