SYMBOLIC VALUES AND IMPLICATIONS OF THE GRAND ETHIOPIAN RENAISSANCE DAM PROJECT IN ETHIOPIAN IDENTITY POLITICS

This paper attempts to show how the Grand Ethiopian Renaissance Dam (GERD) 's economic and political gains could help develop a shared outlook to regulate Ethiopia's opposing political trajectories, i.e., the ethnocentric and pan-Ethiopian nationalist camps. Presently, different ethnic-based "in-group and out-group" contrasting political discourses have dominated Ethiopian polity. The paper reviews and exposes relevant philosophical concepts, including "mirror identity," primordial and instrumental conception of ethnicity. Notably, following Anderson's (2006) line of thought, nationalism as a "cultural artefact" and expression of an "imagined community," the paper argues that GERD could serve as a shared symbolic and developmental language to reshape Ethiopian national consciousness and imagination by improving the political and economic domains of the country. Accordingly, the GERD covertly or overtly helps reform the polity's self-recognition mechanisms and circuitously re-approaches outstanding political differences by inspiring trust-based relations among major political actors. Ethnocentric motivations raise political questions such as secession, the right to linguistic and cultural recognition, economic equality, and political security and representation by using their respective ethnic lines as means of political mobilization. In current Ethiopia, political identities have been practically blended with ethnic identity. In this sense, as diverse ethnic groups exist, political borders sustain among the multiple ethnic-based nationalists and between pan-Ethiopian and ethnocentric actors. Thus, a comprehensive dialogue and constructive political cross-fertilization are required between various political actors, horizontally and vertically, among ethnocentric nationalists and the pan-Ethiopian advocates. In Ethiopia, the realization of internal political consensus requires an instantaneous remedial mechanism. Accordingly, the politically drawn antithetical ethnic demarcations and occasionally fabricated historical narratives have undeniably pushed politics into unfavourable conditions. That is why, as the paper maintains that developmental projects such as the GERD would have pertinent economic and political mechanisms to developing a national sentiment, which in turn symbolically facilitate national consensus among the major political actors. Hence, borrowing Fukuyama's (2018) notion of "creedal national identity", one could resonate that developmental projects can help realize symbolic worth by constructively enabling citizens to recognize their countries' foundational ideals and elevating common factors. The present paper does not examine the GERD project's external geopolitical and legal concerns concerning scope, although these topics are worth examining for further investigations

Soil fertility status and wheat nutrient content in Vertisol cropping systems of central highlands of Ethiopia

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Equity in long-lasting insecticidal nets and indoor residual spraying for malaria prevention in a rural South Central Ethiopia.

BACKGROUND: While recognizing the recent achievement in the global fight against malaria, the disease remains a challenge to health systems in low-income countries. Beyond widespread consensuses about prioritizing malaria prevention, little is known about the prevailing status of long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) across different levels of wealth strata. The aim of this study was to evaluate the socioeconomic related dimension of inequalities in malaria prevention interventions. METHODS: This study was conducted in July-August 2014 in Adami Tullu district in the South-central Ethiopia, among 6069 households. A cross-sectional data were collected on household characteristics, LLIN ownership and IRS coverage. Principal component analysis technique was used for ranking households based on socioeconomic position. The inequality was measured using concentration indices and concentration curve. Decomposition method was employed in order to quantify the percentage contribution of each socioeconomic related variable on the overall inequality. RESULTS: The proportion of households with at least one LLIN was 11.6 % and IRS coverage was 72.5 %. The Erreygers normalized concentration index was 0.0627 for LLIN and 0.0383 for IRS. Inequality in LLIN ownership was mainly associated with difference in housing situation, household size and access to mass-media and telecommunication service. CONCLUSION: Coverage of LLIN was low and significant more likely to be owned by the rich households, whereas houses were sprayed equitably. The current mass free distribution of LLINs should be followed by periodic refill based on continuous monitoring data

Drop Out Among Primary School Students: Reasons, Experience and Mitigating Mechanisms: In Case of BenchMaji Zone Shey-Bench Wereda

This study was conducted to assess the causes, experience and Mitigating mechanism of school dropout among primary school students in Benchi-Maji zone Shey Bench Wereda. The study mainly attempted to answer research questions like the major reason that leads students' to drop out, the experiences of dropouts while they were out of school and mitigating mechanism of school dropout. The study adopted a qualitative research approach, and non-probability sampling techniques were used to identify participants of the study. An in-depth interview and focus group discussions are utilized as the main tools of data collection. Interviews were conducted with key informants like homeroom teachers, principal's parents, and students. Thirty-three (33) participants were involved in an interview, and three focus group discussion is comprising 10 participants in each group were conducted accordingly. Generally, data were collected from 63 purposively sampled participants. The researcher transcribed the notes taken while having an interview and FGD with children's (students), teachers and parents. The transcription, which is written in the Amharic language was translated to English as accurately as possible and presented in a narrative way through thematic analysis. Poverty, the absence of motivation and interest, peer pressure and school-related difficulties were identified as the main cause of school dropout. With regard to the experience of dropouts, the majority of dropouts engaged in helping families, leave the area in search of jobs and create different work opportunities to deal with life. In addition working with financial aid organizations, GOs, NGOs, eliminating illiteracy of the society through awareness creation programs, developing a good interpersonal relationship with students, a participating community in educational programs are among major mechanisms identified by stakeholders as a mitigating mechanism of school dropout. Finally based on the findings, conclusions and recommendations were made

Anaemia among children in a drought affected community in south-central Ethiopia.

INTRODUCTION: As part of a field trial (PACTR201411000882128) to provide evidence on the combined use of long-lasting insecticidal nets and indoor residual spray for malaria prevention, we measured haemoglobin values among children aged 6 to 59 months. The aim of this study was to estimate the prevalence of anaemia, and to determine the risk factors of anaemia and change in haemoglobin value in Adami Tullu district in south-central Ethiopia. METHODS: Repeated cross-sectional surveys among 2984 children in 2014 and 3128 children in 2015; and a cohort study (malaria as exposure and anaemia as outcome variable) were conducted. The study area faced severe drought and food shortages in 2015. Anaemia was diagnosed using HemoCue Hb 301, and children with haemoglobin <11 g/dl were classified as anaemic. Multilevel and Cox regression models were applied to assess predictors of anaemia. RESULTS: The prevalence of anaemia was 28.2% [95% Confidence Interval (CI), 26.6-29.8] in 2014 and increased to 36.8% (95% CI, 35.1-38.5) in 2015 (P<0.001). The incidence of anaemia was 30; (95% CI, 28-32) cases per 100 children years of observation. The risk of anaemia was high (adjusted Hazard Ratio = 10) among children with malaria. Children from poor families [Adjusted Odds Ratio (AOR); 1.3; 95% CI, 1.1-1.6)], stunted children (AOR 1.5; 95% CI; 1.2-1.8), and children aged less than 36 months (AOR; 2.0; 95% CI, 1.6-2.4) were at risk of anaemia compared to their counterparts. There was no significant difference in risk of anaemia among the trial arms. CONCLUSIONS: Young age, stunting, malaria and poverty were the main predictors of anaemia. An increase in the prevalence of anaemia was observed over a year, despite malaria prevention effort, which could be related to the drought and food shortage. Therefore, conducting trials in settings prone to drought and famine may bring unexpected challenges

The Role of Environmental Factors in the Etiology of Nonsyndromic Orofacial Clefts

Background: Nonsyndromic orofacial clefts (NSOFCs) represent the most common congenital anomalies in the head and neck region. Multiple factors contribute to the occurrence of this anomaly. The etiology of NSOFCs in the Ethiopian population has not been investigated prior to this study.Aims of the Study: To assess the role of maternal environmental factors in the occurrence of NSOFCs in the Ethiopian Population.Methods: The authors used unmatched case control study design and evaluated the role of environmental factors to the occurrence of NSOFCs in the Ethiopian population. The participants were recruited from the same institution (Yekatit 12 Hospital Medical College). The authors studied 760 mothers (359 mothers of children born with NSOFCs and 401 mothers of children born without any congenital anomalies). Univariate and multivariate logistic regression analyses were used to calculate relative risk by odds ratio and 95% confidence interval.Results: Mothers who gave history of bronchial asthma and mothers who were admitted for threatened abortion had a higher risk of delivering a child with NSOFCS P value=0.013; AOR=0.194, 95% CI [0.053-0.712], P value &lt;0.001; AOR= 0.179, 95% CI [0.091-0.352] respectively. Higher number of children with NSOFCs were born to mothers who were exposed to diagnostic X-ray investigation during early pregnancy than those who were not exposed P value 0.048; AOR=0.375, 95% CI [0.142-0.990].Conclusion: Maternal exposure to diagnostic x-ray, maternal chronic illness like bronchial asthma and threatened abortion were found to be associated with the occurrence of NSOFCS in the studied population.</p

Cost-effectiveness of a combined intervention of long lasting insecticidal nets and indoor residual spraying compared with each intervention alone for malaria prevention in Ethiopia.

BACKGROUND: The effectiveness of long lasting insecticidal nets (LLINs) and indoor residual spraying (IRS), for malaria prevention, have been established in several studies. However, the available evidence about the additional resources required for a combined implementation (LLIN + IRS) with respect to the added protection afforded is limited. Therefore, the aim of this study was to compare the cost-effectiveness of combined implementation of LLINs and IRS, compared with LLINs alone, IRS alone, and routine practice in Ethiopia. METHODS: The study was performed alongside a cluster randomized controlled trial of malaria prevention conducted in Adami Tullu district, in Ethiopia, from 2014 to 2016. In addition, literature-based cost-effectiveness analysis-using effectiveness information from a systematic review of published articles was conducted. Costing of the interventions were done from the providers' perspective. The health-effect was measured using disability adjusted life years (DALYs) averted, and combined with cost information using a Markov life-cycle model. In the base-case analysis, health-effects were based on the current trial, and in addition, a scenario analysis was performed based on a literature survey. RESULTS: The current trial-based analysis showed that routine practice is not less effective and therefore dominates both the combined intervention and singleton intervention due to lower costs. The literature-based analysis had shown that combined intervention had an incremental cost-effectiveness ratio of USD 1403 per DALY averted, and USD 207 per DALY averted was estimated for LLIN alone. In order for the ICER for the combined intervention to be within a range of 1 GDP per capita per DALY averted, the annual malaria incidence in the area should be at least 13%, and the protective-effectiveness of combined implementation should be at least 53%. CONCLUSIONS: Based on the current trial-based analysis, LLINs and IRS are not cost-effective compared to routine practice. However, based on the literature-based analysis, LLIN alone is likely to be cost-effective compared to 3 times GDP per capita per DALY averted. The annual malaria probability and protective-effectiveness of combined intervention are key determinants of the cost-effectiveness of the interventions.Trial registration PACTR201411000882128 (Registered 8 September 2014). http://www.pactr.org/ATMWeb/appmanager/atm/atmregistry?dar=true&tNo=PACTR201411000882128

Oral Health-Related Quality of Life of Children Born With Orofacial Clefts in Ethiopia and Their Parents

Objective: To assess the oral health–related quality of life (OH-RQoL) using a translated standardized measure in an understudied population of Ethiopian children born with orofacial clefts (OFCs) and their parents. Methods: Using a descriptive study design, we assessed the OH-RQoL of 41 patients with OFCs between the ages of 8 and 17 years and their parents. Participants received multidisciplinary cleft care from 2008 to 2016. They completed an Amharic translation of the Child Oral Health Impact Profile (COHIP). Results: There was strong internal reliability with the translated COHIP for parents and patients. Parents’ COHIP scores ranged from 67 to 186, and patients’ scores were 78 to 190. The mean for patients and parents was 155, indicating good OH-RQoL. Conclusion: The Amharic translation of the COHIP appears appropriate for use with families in Ethiopia. Both parents and patients reported OH-RQoL at similar levels as other international populations. </jats:sec

Epidemiology of Mycobacterium tuberculosis lineages and strain clustering within urban and peri-urban settings in Ethiopia.

BackgroundPrevious work has shown differential predominance of certain Mycobacterium tuberculosis (M. tb) lineages and sub-lineages among different human populations in diverse geographic regions of Ethiopia. Nevertheless, how strain diversity is evolving under the ongoing rapid socio-economic and environmental changes is poorly understood. The present study investigated factors associated with M. tb lineage predominance and rate of strain clustering within urban and peri-urban settings in Ethiopia.MethodsPulmonary Tuberculosis (PTB) and Cervical tuberculous lymphadenitis (TBLN) patients who visited selected health facilities were recruited in the years of 2016 and 2017. A total of 258 M. tb isolates identified from 163 sputa and 95 fine-needle aspirates (FNA) were characterized by spoligotyping and compared with international M.tb spoligotyping patterns registered at the SITVIT2 databases. The molecular data were linked with clinical and demographic data of the patients for further statistical analysis.ResultsFrom a total of 258 M. tb isolates, 84 distinct spoligotype patterns that included 58 known Shared International Type (SIT) patterns and 26 new or orphan patterns were identified. The majority of strains belonged to two major M. tb lineages, L3 (35.7%) and L4 (61.6%). The observed high percentage of isolates with shared patterns (n = 200/258) suggested a substantial rate of overall clustering (77.5%). After adjusting for the effect of geographical variations, clustering rate was significantly lower among individuals co-infected with HIV and other concomitant chronic disease. Compared to L4, the adjusted odds ratio and 95% confidence interval (AOR; 95% CI) indicated that infections with L3 M. tb strains were more likely to be associated with TBLN [3.47 (1.45, 8.29)] and TB-HIV co-infection [2.84 (1.61, 5.55)].ConclusionDespite the observed difference in strain diversity and geographical distribution of M. tb lineages, compared to earlier studies in Ethiopia, the overall rate of strain clustering suggests higher transmission and warrant more detailed investigations into the molecular epidemiology of TB and related factors

Perioperative care capacity in East Africa : results of an Ethiopian national cross-sectional survey

Acknowledgments The authors thank all hospitals who participated in the survey, all anesthesia providers, surgeons, obstetricians, nurses, and hospi- tal management staff who provided data voluntarily, and those who helped coordinate the study in their area.Peer reviewedPublisher PD