Prevalence and associated factors of neonatal mortality in North Gondar Zone, Northwest Ethiopia

Background: Childhood mortality is often used as a broad indicator of the social development and health conditions of a country. Updated information on neonatal mortality does thus influence policy, improve services and lead to better health for newborns.Objective: To assess the prevalence of neonatal mortality and associated factors in North Gondar Zone, Ethiopia.Methods: Community based cross-sectional study was carried out from November 2009 to January 2010 in North Gondar Zone. Multi-stage sampling was adopted to get respondents and data was collected using structured questionnaires from 3600 mothers who gave live birth during the year 2005 to 2009.Results: Neonatal mortality was found to be 214 out of 4888 live births with the rate of 43.8 per 1000 live births. The number of pregnancies the women, had (AOR =3.76: 95% CI, 2.73- 5.20), maternal morbidity (AOR =5.43: 95% CI, 2.90-10.17) and neonatal illness (AOR = 3.68: 95% CI, 2.41-5.62) were strongly associated with neonatal mortality. Small size neonates at birth were 2 times more likely to die compared with medium sized ones. Compared with illiterate mothers, secondary and above secondary educated mothers reduced the risk of neonatal deaths by 85% (0.04, 0.51) and 90% (0.01, 0.94), respectively.Conclusion: Neonatal mortality was very high when compared with the national data of Ethiopia. Strategies to improve female education, reducing maternal morbidity, limiting the number of pregnancies, early intervention for neonatal illness, prevention and intervention in low birth weight neonates are recommended to reduce neonatal mortality

Husbandry practices and phenotypic characteristics of indigenous goat populations in Ethiopia.

Abstract: The present study was conducted with the objective to characterize the husbandry practices and phenotypic characteristics of mature Bati, Borana and Short-eared Somali goats kept under traditional management systems so that the information generated can be used in designing breeding programs. The study was covered five districts in four administrative zones of Ethiopia representing Bati (in Oromia Zone) and Kalu (in South Wollo Zone) for Bati goats; Yabello (in Borana Zone) for Borana goats and Shinille and Erer (in Siti Zone) for Short-Eared Somali goats. A total of 345 households interview was made and phenotypic measurements were taken on 601(468 females and 133 males) heads of adult goats with 4 pair of permanent incisors (PPI). However, because of difficulty of finding adequate number of 4PPI sample males, measurements were taken from 2PPI and above males. In this study, in number, goats accounted for 72.01, 50.93 and 47.38% of other livestock species in Siti, around Bati and Borana, respectively. The least square mean (±SE) of goat flock size (44.02±3.33) per household in Siti was significantly (p0.05),whereas Short-eared Somali goats remained significantly (p<0.05) lower for most of the body measurement characteristics. The canonical analysis done on phenotypic measurements also put Bati and Borana goats closer by discriminating Short-eared Somali goat populations. The similarities between Bati and Borena goats and significance divergence of Short-eared Somali goats in phenotypic measurements suggested that the need of further molecular characterization study to validate information from phenotypic characterization. Correlation coefficient was consistently highest between live weight and chest girth in both sexes across the goat populations. Hence, linear measurements could be valuable to estimate live body weight for those farm communities where sensitive weighing scales are not readily available

Challenges and opportunities for implementing integrated mental health care: a district level situation analysis from five low- and middle-income countries.

BACKGROUND: Little is known about how to tailor implementation of mental health services in low- and middle-income countries (LMICs) to the diverse settings encountered within and between countries. In this paper we compare the baseline context, challenges and opportunities in districts in five LMICs (Ethiopia, India, Nepal, South Africa and Uganda) participating in the PRogramme for Improving Mental health carE (PRIME). The purpose was to inform development and implementation of a comprehensive district plan to integrate mental health into primary care. METHODS: A situation analysis tool was developed for the study, drawing on existing tools and expert consensus. Cross-sectional information obtained was largely in the public domain in all five districts. RESULTS: The PRIME study districts face substantial contextual and health system challenges many of which are common across sites. Reliable information on existing treatment coverage for mental disorders was unavailable. Particularly in the low-income countries, many health service organisational requirements for mental health care were absent, including specialist mental health professionals to support the service and reliable supplies of medication. Across all sites, community mental health literacy was low and there were no models of multi-sectoral working or collaborations with traditional or religious healers. Nonetheless health system opportunities were apparent. In each district there was potential to apply existing models of care for tuberculosis and HIV or non-communicable disorders, which have established mechanisms for detection of drop-out from care, outreach and adherence support. The extensive networks of community-based health workers and volunteers in most districts provide further opportunities to expand mental health care. CONCLUSIONS: The low level of baseline health system preparedness across sites underlines that interventions at the levels of health care organisation, health facility and community will all be essential for sustainable delivery of quality mental health care integrated into primary care

Groundwater and resilience to drought in the Ethiopian Highlands

During drought, groundwater is often relied on to provide secure drinking water, particularly in rural Africa where other options are limited. However, the technology chosen to access groundwater significantly affects local water security. Here we examine the performance of springs, hand-dug- wells and boreholes in northern Ethiopia through direct high frequency monitoring of water-levels (n=19) and water quality (n=48) over an 18-month period and gathering information on community impacts of declining water access during the El Niño 2015/2016 drought. We found that shallow boreholes equipped with handpumps were the most reliable water supply, recovering within hours to daily abstraction throughout all conditions. Recovery and performance of most hand-dug-wells and springs declined significantly throughout the extended dry season, although in specific aquifer conditions they were reliable. All sources types had negligible measured contamination from Thermo-tolerant Coliforms through the extended dry season, but were contaminated during the rains marking drought cessation. Boreholes were least affected, median 10 cfu/100ml, compared to 190 and 59 cfu/100ml for hand-dug-wells and springs respectively. Many communities who relied solely on springs, wells or rivers experienced severe water shortage in the El Niño drought with mean daily collection times up to 12 hours and volumes collected reducing to 3-5 litre- per-capita- per-day. This led to reports of violent conflict, missed meals, reduction in school attendance and farm activity and increased health impacts. From this study there is a clear case for improving resilience to drought by installing boreholes equipped with handpumps where feasible even if collection times are >30 minutes

Future challenges of coastal landfills exacerbated by sea level rise

In England and Wales, there are at least 1700 coastal landfills in the coastal flood plain and at least 60 threatened by erosion, illustrating a global problem. These landfills are a major issue in shoreline management planning (SMP) which aims to manage the risks associated with flooding and coastal erosion. Where landfills exist, "hold the line" (requiring the building or upgrading of artificial defences to maintain the current shoreline) is often selected as the preferred SMP option, although government funding is not available at present. To investigate these issues in detail, three case-study landfills are used to examine the risks of future flooding and erosion together with potential mitigation options. These cases represent a contrasting range of coastal landfill settings. The study includes consideration of sea-level rise and climate change which exacerbates risks of erosion and flooding of landfills. It is fundamental to recognise that the release of solid waste in coastal zones is a problem with a geological timescale and these problems will not go away if ignored. Future erosion and release of solid waste is found to be more of a threat than flooding and leachate release from landfills. However, while leachate release can be assessed, there is presently a lack of methods to assess the risks from the release of solid waste. Hence, a lack of science constrains the design of remediation options

Groundwater quality: global challenges, emerging threats and novel approaches

Improving our understanding of groundwater quality threats to human health and the environment is essential to protect and manage groundwater resources effectively. This essay highlights some global groundwater quality challenges, describes key contaminant groups and threats of emerging concern, including antimicrobial resistance, and discusses novel approaches to assessing groundwater quality. Groundwater quality monitoring needs to improve significantly in order to effectively identify and mitigate threats to groundwater from historical, current and future pollution

The Value of Literacy Practices

The concepts of literacy events and practices have received considerable attention in educational research and policy. In comparison, the question of value, that is, ‘which literacy practices do people most value?’ has been neglected. With the current trend of cross-cultural adult literacy assessment, it is increasingly important to recognise locally valued literacy practices. In this paper we argue that measuring preferences and weighting of literacy practices provides an empirical and democratic basis for decisions in literacy assessment and curriculum development and could inform rapid educational adaptation to changes in the literacy environment. The paper examines the methodological basis for investigating literacy values and its potential to inform cross-cultural literacy assessments. The argument is illustrated with primary data from Mozambique. The correlation between individual values and respondents’ socio-economic and demographic characteristics is explored

Khat and alcohol use and risky sex behaviour among in-school and out-of-school youth in Ethiopia

BACKGROUND: Khat (an evergreen plant with amphetamine-like properties) and alcohol are widely consumed among the youth of Ethiopia. However, their relationship to risky sexual behaviour is not well described. This study was conducted to describe the magnitude of risky sexual behaviour (unprotected sex and early initiation of sexual activity) and its association with Khat and alcohol consumption in Ethiopian youths. METHODS: A probabilistic national sample of 20,434 in-school and out-of-school youths aged between 15 and 24 years of age was selected and interviewed regarding their sexual behavior and substance use. RESULTS: Over 20% of out-of-school youth had unprotected sex during the 12-month period prior to interview compared to 1.4% of in-school youth. Daily Khat intake was also associated with unprotected sex: adjusted OR (95% CI) = 2.26 (1.92, 2.67). There was a significant and linear association between alcohol intake and unprotected sex, with those using alcohol daily having a three fold increased odds compared to those not using it: adj. OR (95% CI) = 3.05 (2.38, 3.91). Use of substances other than Khat was not associated with unprotected sex, but was associated with initiation of sexual activity: adj. OR (95% CI) = 2.54 (1.84, 3.51). CONCLUSION: A substantial proportion of out-of-school youth engage in risky sex. The use of Khat and alcohol and other substances is significantly and independently associated with risky sexual behaviour among Ethiopian youths

Predicting Distribution of Aedes Aegypti and Culex Pipiens Complex, Potential Vectors of Rift Valley Fever Virus in Relation to Disease Epidemics in East Africa.

The East African region has experienced several Rift Valley fever (RVF) outbreaks since the 1930s. The objective of this study was to identify distributions of potential disease vectors in relation to disease epidemics. Understanding disease vector potential distributions is a major concern for disease transmission dynamics. DIVERSE ECOLOGICAL NICHE MODELLING TECHNIQUES HAVE BEEN DEVELOPED FOR THIS PURPOSE: we present a maximum entropy (Maxent) approach for estimating distributions of potential RVF vectors in un-sampled areas in East Africa. We modelled the distribution of two species of mosquitoes (Aedes aegypti and Culex pipiens complex) responsible for potential maintenance and amplification of the virus, respectively. Predicted distributions of environmentally suitable areas in East Africa were based on the presence-only occurrence data derived from our entomological study in Ngorongoro District in northern Tanzania. Our model predicted potential suitable areas with high success rates of 90.9% for A. aegypti and 91.6% for C. pipiens complex. Model performance was statistically significantly better than random for both species. Most suitable sites for the two vectors were predicted in central and northwestern Tanzania with previous disease epidemics. Other important risk areas include western Lake Victoria, northern parts of Lake Malawi, and the Rift Valley region of Kenya. Findings from this study show distributions of vectors had biological and epidemiological significance in relation to disease outbreak hotspots, and hence provide guidance for the selection of sampling areas for RVF vectors during inter-epidemic periods

Magnitude and Correlates of Intimate Partner Violence against Women and Its Outcome in Southwest Ethiopia

BACKGROUND: Intimate Partner Violence (IPV) is a major public health problem with serious consequences. This study was conducted to assess the magnitude of IPV in Southwest Ethiopia in predominantly rural community. METHODS: This community based cross-sectional study was conducted in May, 2009 in Southwest Ethiopia using the World Health Organization core questionnaire to measure violence against women. Trained data collectors interviewed 851 ever-married women. Stata version 10.1 software and SPSS version 12.0.1 for windows were used for data analysis. RESULT: In this study the life time prevalence of sexual or physical partner violence, or both was 64.7% (95%CI: 61.4%-67.9%). The lifetime sexual violence [50.1% (95% CI: 46.7%-53.4%)] was considerably more prevalent than physical violence [41.1% (95%:37.8-44.5)]. A sizable proportion [41.5%(95%CI: 38.2%-44.8%)] of women reported physical or sexual violence, or both, in the past year. Men who were controlling were more likely to be violent against their partner. CONCLUSION: Physical and sexual violence is common among ever-married women in Southwest Ethiopia. Interventions targeting controlling men might help in reducing IPV. Further prospective longitudinal studies among ever-married women are important to identify predictors and to study the dynamics of violence over time