Knowledge, Attitude, Practice and Associated Factors of Kangaroo Mother Care for Neonatal Survival Among Care Takers of Preterm and Low Birth Weight Infants in Health Care Settings, Hawassa, Southern Ethiopia, 2018

Background: In Ethiopia, preterm and low-birth weight is the leading cause of neonatal morbidity and Mortality. Many of these deaths can be prevented using Kangaroo Mother Care (KMC) which has been proven and cost-effective intervention especially in low- and middle-income countries. However, there is presently a lack of KMC data in the region on the barriers causing a low record for KMC, is it attitude or knowledge. Hence, the purpose of this study was to explore the knowledge, attitude, practices and associated factors of KMC among caretakers of preterm and LBW infants. Methods: A facility-based cross-sectional study was done in KMC centers on 93 care takers in Hawassa health care settings from March 2018 to April 2018. Study participants were selected using a convenient random sampling technique. Data were collected through questionnaire interviews and extract information during review of records and observation. These data were cleaned, coded and entered using EpiData Version 3.1 statistical software then transferred to SPSS software package version 22 for analyses and explained with texts, figures and tables. Pearson chi-square was computed to test the association between independent and outcome variables.  P-value of chi-square (X2) <0.05 with 95% CI was confirmed as statistically significant. Results: Fifty nine (68.6 %) study participants were knowledgeable on Kangaroo mother care and 61.6 % had the good practice of KMC. Three variables (having delivery in KMC health care setting (p=0.018), being skilled birth attendant (p=0.0001) and getting KMC counseling (p=0.001)) had statically significant association with knowledge of caregivers regarding to KMC, whereas two variables (being knowledgeable on KMC (p=0.001) and being skilled birth attendant (p=0.006)) had statically significant association with caregivers’ practice of Kangaroo mother care. Conclusion: Our study shows that overall knowledge and practice of care takers of premature and low birth weight infants regarding KMC was low. Some factors of care takers affect the knowledge and practice of KMC for caring in premature and LBW infants. Recommendation: KMC counseling and education should be conducted during ANC follow up and delivery should be assisted by skilled birth attendant in KMC health care settings to improve their knowledge. Besides, knowledge of KMC should be generated to increase the practice of KMC. Keywords: KMC, knowledge, attitude, practice care takers, associated factors, Ethiopia DOI: 10.7176/JHMN/58-0

CORRELATION STUDIES AND PATH COEFFICIENT ANALYSIS FOR SEED YIELD AND YIELD COMPONENTS IN ETHIOPIAN CORIANDER ACCESSIONS

Coriander ( Coriandrum sativum L.) is an annual spice herb that belongs to the family Umbelliferae. Even though Ethiopia is a centre of primary diversity for the crop, the current knowledge about its biology, variety development and agronomy is neither complete nor conclusive under Ethiopian conditions. To contribute to filling some of the existing gaps, a field experiment was conducted during the main rainy season of 2007-2008 at Wondo Genet and Kokate, southern Ethiopia. Data for 15 agronomic and quality traits were measured and statistically tested. More of the traits were found having high correlation coefficients at genotypic level than the phenotypic level, demonstrating intrinsic associations among the traits. Seeds plant-1 and thousand seeds weight were associated significantly and positively with seed yield plant-1 at phenotypic and genotypic levels. Essential oil and fatty oil contents were negatively associated with most of the trait studied. Path analysis revealed that days to end 50% flowering, longest basal leaf length, plant height, days to 50% maturity and seeds umbellet-1 exerted positive direct effect on seed yield plant-1, indicating that selection using these traits would be effective in improving seed yield in coriander.Le Coriander ( Coriandrum sativum L.) est une herbe d\u2019\ue9pice annuelle qui appartient \ue0 la famille Umbelliferae. M\ueame si l\u2019Ethiope est un centre de sa diversit\ue9 primaire, la connaissance actuelle de sa biologie, son d\ue9veloppement vari\ue9tal et son agronomie ne sont jamais exhaustif ni conclusive en conditions ethiopiennes. Pour contribuer \ue0 combler cette br\ue8che, un essai en champ \ue9tait effectu\ue9 durant la principale saison de pluie 2007-2008 \ue0 Wondo Genet et Kokate, Sud Ethiopie. Les donn\ue9es de 15 traits agronomiques et traits de qualit\ue9 \ue9taient mesur\ue9es et statistiquement test\ue9es. Laplupart des traits ont manifest\ue9 des coefficients de corr\ue9lation \ue9lev\ue9e au niveau g\ue9notypique qu\u2019 au niveau ph\ue9notypique, t\ue9moignant des associations intrins\ue8ques parmi les traits. Le nombre de grains par plante et le poids de mille grains \ue9taient significativement associ\ue9s et positivement avec le rendement en grains par plante aux niveaux ph\ue9notypiques et g\ue9notypiques. Les teneurs en huile essentielle et mati\ue8re grasse \ue9taient n\ue9gativement associ\ue9es \ue0 laplupart des traits \ue9tudi\ue9s. L\u2019analyse du passage a r\ue9v\ue9l\ue9 que les jours \ue0 50% de la floraison, la plus longue base de la longueur des fueilles, la hauteur de plants, les jours \ue0 50% de la maturit\ue9 et le nombre de grains par umbellet ont excerc\ue9 un effet positif direct sur le rendement en grains par plant, indicant que cette s\ue9lection par l\u2019utilisation de ces traits pourrait \ueatre efficace en amelioration du rendement en grains coriander

Efficacy of Bilateral Transversus Abdominis Plane and Ilioinguinal-Iliohypogastric Nerve Blocks for Postcaesarean Delivery Pain Relief under Spinal Anesthesia

Background. Caesarean delivery can be associated with considerable postoperative pain. While the benefits of transversus abdominis plane (TAP) and ilioinguinal-iliohypogastric (II-IH) nerve blocks on pain after caesarean delivery via Pfannenstiel incision have been demonstrated, no enough investigations on the comparison of these blocks on pain after caesarean delivery have been conducted in our setup. Method. An institutional-based prospective observational cohort study was conducted to compare the analgesic efficacy of those blocks. We observed 102 postoperative parturients. The outcome measure was the severity of pain measured using a numeric rating scale. Result. Twenty-four hours after surgery, the NRS score at rest was (0.90 ± 0.80) versus (0.67 ± 0.58) and at movement (1.2 ± 1.07) versus (0.88 ± 0.76) for the TAP and II-IH groups, respectively. Twenty-four hours after surgery, the mean tramadol consumption was (55.45 ± 30.51) versus (37.27 ± 27.09) mg in TAP and II-IH groups, respectively (p = 0.009). The mean first analgesic requirement time was also prolonged in the II-IH group. Conclusion and Recommendations. There was no statically significant difference between TAP and II-IH blocks regarding postoperative pain score, but the II-IH block significantly reduced the total tramadol consumption and prolonged the time to first analgesic request than TAP. Thus, we recommend the II-IH nerve block

Variations in mitochondrial cytochrome b region among Ethiopian indigenous cattle populations assert Bos taurus maternal origin and historical dynamics

Objective This study was carried out to assess the haplotype diversity and population dynamics in cattle populations of Ethiopia. Methods We sequenced the complete mitochondrial cytochrome b gene of 76 animals from five indigenous and one Holstein Friesian×Barka cross bred cattle populations. Results In the sequence analysis, 18 haplotypes were generated from 18 segregating sites and the average haplotype and nucleotide diversities were 0.7540±0.043 and 0.0010±0.000, respectively. The population differentiation analysis shows a weak population structure (4.55%) among the populations studied. Majority of the variation (95.45%) is observed by within populations. The overall average pair-wise distance (F ST) was 0.049539 with the highest (F ST = 0.1245) and the lowest (F ST = 0.011) F ST distances observed between Boran and Abigar, and Sheko and Abigar from the indigenous cattle, respectively. The phylogenetic network analysis revealed that all the haplotypes detected clustered together with the Bos taurus cattle and converged to a haplogroup. No haplotype in Ethiopian cattle was observed clustered with the reference Bos indicus group. The mismatch distribution analysis indicates a single population expansion event among the cattle populations. Conclusion Overall, high haplotype variability was observed among Ethiopian cattle populations and they share a common ancestor with Bos taurus

“ANALISIS PENGARUH THEORY OF PLANNED BEHAVIOR, NILAI YANG DIRASAKAN, DAN KESEDIAAN UNTUK MEMBAYAR TERHADAP PERILAKU PEMBELIAN KONSUMEN MELALUI MINAT BELI KONSUMEN SEBAGAI VARIABEL INTERVENING” (STUDI PADA KONSUMEN THE BODY SHOP di CITRALAND SEMARANG)

Green consumption by the community can be an effective way to minimize negative impacts on the environment. Research related to consumer behavior in consuming environmentally friendly products in developing countries such as Indonesia is very little and rarely. Considering this, researchers in this study have tried to understand consumer behavior to buy environmentally friendly products in the context of developing countries such as Indonesia. Based on the gaps phenomenon above, this study aims to analyze what factors influence consumer purchasing behavior on environmentally friendly products. And in this study using the Theory of Planned Behavior (TPB) variable and then expanding the Theory of Planned Behavior using additional variables, namely perceived value and willingness to pay and consumer buying intention as intervening variables. The population used in this study were female consumers of The Body Shop who are domiciled in Semarang aged 20-60 years and purchased The Body Shop products at the Citraland Semarang for more than 3 months. The number of samples used in this study were 150 respondents. The method of data collection is done through a questionnaire. This research uses Structural Equation Modeling (SEM) analysis technique using AMOS 24.0 analysis tool. The test results using Structural Equation Modeling (SEM) analysis techniques indicate that the model is not in accordance with population data. While the hypothesis testing shows that four hypotheses from six hypotheses can be accepted and proven in this study, namely attitudes, subjective norms, and willingness to pay affect consumer buying intention and consumer buying intention influence consumer buying behavior. And the two hypotheses rejected in this study are subjective norms and values that are assessed do not have an influence on consumer buying interest

Subnational mapping of HIV incidence and mortality among individuals aged 15–49 years in sub-Saharan Africa, 2000–18 : a modelling study

Background: High-resolution estimates of HIV burden across space and time provide an important tool for tracking and monitoring the progress of prevention and control efforts and assist with improving the precision and efficiency of targeting efforts. We aimed to assess HIV incidence and HIV mortality for all second-level administrative units across sub-Saharan Africa. Methods: In this modelling study, we developed a framework that used the geographically specific HIV prevalence data collected in seroprevalence surveys and antenatal care clinics to train a model that estimates HIV incidence and mortality among individuals aged 15–49 years. We used a model-based geostatistical framework to estimate HIV prevalence at the second administrative level in 44 countries in sub-Saharan Africa for 2000–18 and sought data on the number of individuals on antiretroviral therapy (ART) by second-level administrative unit. We then modified the Estimation and Projection Package (EPP) to use these HIV prevalence and treatment estimates to estimate HIV incidence and mortality by second-level administrative unit. Findings: The estimates suggest substantial variation in HIV incidence and mortality rates both between and within countries in sub-Saharan Africa, with 15 countries having a ten-times or greater difference in estimated HIV incidence between the second-level administrative units with the lowest and highest estimated incidence levels. Across all 44 countries in 2018, HIV incidence ranged from 2 ·8 (95% uncertainty interval 2·1–3·8) in Mauritania to 1585·9 (1369·4–1824·8) cases per 100 000 people in Lesotho and HIV mortality ranged from 0·8 (0·7–0·9) in Mauritania to 676· 5 (513· 6–888·0) deaths per 100 000 people in Lesotho. Variation in both incidence and mortality was substantially greater at the subnational level than at the national level and the highest estimated rates were accordingly higher. Among second-level administrative units, Guijá District, Gaza Province, Mozambique, had the highest estimated HIV incidence (4661·7 [2544·8–8120·3]) cases per 100000 people in 2018 and Inhassunge District, Zambezia Province, Mozambique, had the highest estimated HIV mortality rate (1163·0 [679·0–1866·8]) deaths per 100 000 people. Further, the rate of reduction in HIV incidence and mortality from 2000 to 2018, as well as the ratio of new infections to the number of people living with HIV was highly variable. Although most second-level administrative units had declines in the number of new cases (3316 [81· 1%] of 4087 units) and number of deaths (3325 [81·4%]), nearly all appeared well short of the targeted 75% reduction in new cases and deaths between 2010 and 2020. Interpretation: Our estimates suggest that most second-level administrative units in sub-Saharan Africa are falling short of the targeted 75% reduction in new cases and deaths by 2020, which is further compounded by substantial within-country variability. These estimates will help decision makers and programme implementers expand access to ART and better target health resources to higher burden subnational areas

Global, regional, and national sex-specific burden and control of the HIV epidemic, 1990-2019, for 204 countries and territories: the Global Burden of Diseases Study 2019

Background: The sustainable development goals (SDGs) aim to end HIV/AIDS as a public health threat by 2030. Understanding the current state of the HIV epidemic and its change over time is essential to this effort. This study assesses the current sex-specific HIV burden in 204 countries and territories and measures progress in the control of the epidemic. Methods: To estimate age-specific and sex-specific trends in 48 of 204 countries, we extended the Estimation and Projection Package Age-Sex Model to also implement the spectrum paediatric model. We used this model in cases where age and sex specific HIV-seroprevalence surveys and antenatal care-clinic sentinel surveillance data were available. For the remaining 156 of 204 locations, we developed a cohort-incidence bias adjustment to derive incidence as a function of cause-of-death data from vital registration systems. The incidence was input to a custom Spectrum model. To assess progress, we measured the percentage change in incident cases and deaths between 2010 and 2019 (threshold >75% decline), the ratio of incident cases to number of people living with HIV (incidence-to-prevalence ratio threshold <0·03), and the ratio of incident cases to deaths (incidence-to-mortality ratio threshold <1·0). Findings: In 2019, there were 36·8 million (95% uncertainty interval [UI] 35·1–38·9) people living with HIV worldwide. There were 0·84 males (95% UI 0·78–0·91) per female living with HIV in 2019, 0·99 male infections (0·91–1·10) for every female infection, and 1·02 male deaths (0·95–1·10) per female death. Global progress in incident cases and deaths between 2010 and 2019 was driven by sub-Saharan Africa (with a 28·52% decrease in incident cases, 95% UI 19·58–35·43, and a 39·66% decrease in deaths, 36·49–42·36). Elsewhere, the incidence remained stable or increased, whereas deaths generally decreased. In 2019, the global incidence-to-prevalence ratio was 0·05 (95% UI 0·05–0·06) and the global incidence-to-mortality ratio was 1·94 (1·76–2·12). No regions met suggested thresholds for progress. Interpretation: Sub-Saharan Africa had both the highest HIV burden and the greatest progress between 1990 and 2019. The number of incident cases and deaths in males and females approached parity in 2019, although there remained more females with HIV than males with HIV. Globally, the HIV epidemic is far from the UNAIDS benchmarks on progress metrics. Funding: The Bill & Melinda Gates Foundation, the National Institute of Mental Health of the US National Institutes of Health (NIH), and the National Institute on Aging of the NIH

Measuring routine childhood vaccination coverage in 204 countries and territories, 1980-2019 : a systematic analysis for the Global Burden of Disease Study 2020, Release 1

Background Measuring routine childhood vaccination is crucial to inform global vaccine policies and programme implementation, and to track progress towards targets set by the Global Vaccine Action Plan (GVAP) and Immunization Agenda 2030. Robust estimates of routine vaccine coverage are needed to identify past successes and persistent vulnerabilities. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020, Release 1, we did a systematic analysis of global, regional, and national vaccine coverage trends using a statistical framework, by vaccine and over time. Methods For this analysis we collated 55 326 country-specific, cohort-specific, year-specific, vaccine-specific, and dosespecific observations of routine childhood vaccination coverage between 1980 and 2019. Using spatiotemporal Gaussian process regression, we produced location-specific and year-specific estimates of 11 routine childhood vaccine coverage indicators for 204 countries and territories from 1980 to 2019, adjusting for biases in countryreported data and reflecting reported stockouts and supply disruptions. We analysed global and regional trends in coverage and numbers of zero-dose children (defined as those who never received a diphtheria-tetanus-pertussis [DTP] vaccine dose), progress towards GVAP targets, and the relationship between vaccine coverage and sociodemographic development. Findings By 2019, global coverage of third-dose DTP (DTP3; 81.6% [95% uncertainty interval 80.4-82 .7]) more than doubled from levels estimated in 1980 (39.9% [37.5-42.1]), as did global coverage of the first-dose measles-containing vaccine (MCV1; from 38.5% [35.4-41.3] in 1980 to 83.6% [82.3-84.8] in 2019). Third- dose polio vaccine (Pol3) coverage also increased, from 42.6% (41.4-44.1) in 1980 to 79.8% (78.4-81.1) in 2019, and global coverage of newer vaccines increased rapidly between 2000 and 2019. The global number of zero-dose children fell by nearly 75% between 1980 and 2019, from 56.8 million (52.6-60. 9) to 14.5 million (13.4-15.9). However, over the past decade, global vaccine coverage broadly plateaued; 94 countries and territories recorded decreasing DTP3 coverage since 2010. Only 11 countries and territories were estimated to have reached the national GVAP target of at least 90% coverage for all assessed vaccines in 2019. Interpretation After achieving large gains in childhood vaccine coverage worldwide, in much of the world this progress was stalled or reversed from 2010 to 2019. These findings underscore the importance of revisiting routine immunisation strategies and programmatic approaches, recentring service delivery around equity and underserved populations. Strengthening vaccine data and monitoring systems is crucial to these pursuits, now and through to 2030, to ensure that all children have access to, and can benefit from, lifesaving vaccines. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

Tracking development assistance for health and for COVID-19: a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990-2050

Background The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020. Methods We estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US$, 2020 US$ per capita, purchasing-power parity-adjusted US$per capita, and as a proportion of gross domestic product. We used various models to generate future health spending to 2050. Findings In 2019, health spending globally reached$8. 8 trillion (95% uncertainty interval UI] 8.7-8.8) or $1132 (1119-1143) per person. Spending on health varied within and across income groups and geographical regions. Of this total,$40.4 billion (0.5%, 95% UI 0.5-0.5) was development assistance for health provided to low-income and middle-income countries, which made up 24.6% (UI 24.0-25.1) of total spending in low-income countries. We estimate that $54.8 billion in development assistance for health was disbursed in 2020. Of this,$13.7 billion was targeted toward the COVID-19 health response. $12.3 billion was newly committed and$1.4 billion was repurposed from existing health projects. $3.1 billion (22.4$2.4 billion (17.9%) was for supply chain and logistics. Only $714.4 million (7.7$1519 (1448-1591) per person in 2050, although spending across countries is expected to remain varied. Interpretation Global health spending is expected to continue to grow, but remain unequally distributed between countries. We estimate that development organisations substantially increased the amount of development assistance for health provided in 2020. Continued efforts are needed to raise sufficient resources to mitigate the pandemic for the most vulnerable, and to help curtail the pandemic for all. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd

Global, regional, and national progress towards Sustainable Development Goal 3.2 for neonatal and child health: all-cause and cause-specific mortality findings from the Global Burden of Disease Study 2019

Background Sustainable Development Goal 3.2 has targeted elimination of preventable child mortality, reduction of neonatal death to less than 12 per 1000 livebirths, and reduction of death of children younger than 5 years to less than 25 per 1000 livebirths, for each country by 2030. To understand current rates, recent trends, and potential trajectories of child mortality for the next decade, we present the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 findings for all-cause mortality and cause-specific mortality in children younger than 5 years of age, with multiple scenarios for child mortality in 2030 that include the consideration of potential effects of COVID-19, and a novel framework for quantifying optimal child survival. Methods We completed all-cause mortality and cause-specific mortality analyses from 204 countries and territories for detailed age groups separately, with aggregated mortality probabilities per 1000 livebirths computed for neonatal mortality rate (NMR) and under-5 mortality rate (USMR). Scenarios for 2030 represent different potential trajectories, notably including potential effects of the COVID-19 pandemic and the potential impact of improvements preferentially targeting neonatal survival. Optimal child survival metrics were developed by age, sex, and cause of death across all GBD location-years. The first metric is a global optimum and is based on the lowest observed mortality, and the second is a survival potential frontier that is based on stochastic frontier analysis of observed mortality and Healthcare Access and Quality Index. Findings Global U5MR decreased from 71.2 deaths per 1000 livebirths (95% uncertainty interval WI] 68.3-74-0) in 2000 to 37.1 (33.2-41.7) in 2019 while global NMR correspondingly declined more slowly from 28.0 deaths per 1000 live births (26.8-29-5) in 2000 to 17.9 (16.3-19-8) in 2019. In 2019,136 (67%) of 204 countries had a USMR at or below the SDG 3.2 threshold and 133 (65%) had an NMR at or below the SDG 3.2 threshold, and the reference scenario suggests that by 2030,154 (75%) of all countries could meet the U5MR targets, and 139 (68%) could meet the NMR targets. Deaths of children younger than 5 years totalled 9.65 million (95% UI 9.05-10.30) in 2000 and 5.05 million (4.27-6.02) in 2019, with the neonatal fraction of these deaths increasing from 39% (3.76 million 95% UI 3.53-4.021) in 2000 to 48% (2.42 million; 2.06-2.86) in 2019. NMR and U5MR were generally higher in males than in females, although there was no statistically significant difference at the global level. Neonatal disorders remained the leading cause of death in children younger than 5 years in 2019, followed by lower respiratory infections, diarrhoeal diseases, congenital birth defects, and malaria. The global optimum analysis suggests NMR could be reduced to as low as 0.80 (95% UI 0.71-0.86) deaths per 1000 livebirths and U5MR to 1.44 (95% UI 1-27-1.58) deaths per 1000 livebirths, and in 2019, there were as many as 1.87 million (95% UI 1-35-2.58; 37% 95% UI 32-43]) of 5.05 million more deaths of children younger than 5 years than the survival potential frontier. Interpretation Global child mortality declined by almost half between 2000 and 2019, but progress remains slower in neonates and 65 (32%) of 204 countries, mostly in sub-Saharan Africa and south Asia, are not on track to meet either SDG 3.2 target by 2030. Focused improvements in perinatal and newborn care, continued and expanded delivery of essential interventions such as vaccination and infection prevention, an enhanced focus on equity, continued focus on poverty reduction and education, and investment in strengthening health systems across the development spectrum have the potential to substantially improve USMR. Given the widespread effects of COVID-19, considerable effort will be required to maintain and accelerate progress. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd