Previous utilization of service does not improve timely booking in antenatal care: Cross sectional study on timing of antenatal care booking at public health facilities in Addis Ababa

Background: Antenatal care is more beneficial in preventing adverse pregnancy outcomes when it is sought early in pregnancy. However, existing evidence from developing countries including Ethiopia indicate that few women seek antenatal care at early stage of their pregnancy.Objective: The objective of this study was to assess the timing of ANC booking and impact of previous antenatal care utilization on timing of first antenatal care booking in Addis Ababa governmental health institutions.Methods: A cross sectional study was conducted to collect data from 630 pregnant women who were attending antenatal care service at 10 governmental health centers in Addis Ababa from March 1 to 30, 2008.Results: Past experience on antenatal care service utilization did not come out as a predictor for timely booking of antenatal care (OR=1.40, 95%CI: 0.91, 2.15). Multivariate analysis revealed that respondents who received advice on recommended time of booking, their pregnancy was planned and first pregnancy, were more likely to book timely compared to others (AOR=10.10, 95% CI: 4.54, 22.40; AOR=1.87, 95% CI:1.11, 3.23; (AOR= 1.86, 95% CI: 1.01, 3.44) respectively.Conclusions: Past utilization of antenatal care service did not come as a predictor for timely booking of the service, provided that advice on timely booking is the main factor. In order to improve the situation, strengthening of focused antenatal care, availing of clear service delivery guidelines and training of service providers are important

A Dynamic Sorghum (Sorghum Bicolor (L.) Moench) diversity Management in Situ and Livelihood Resilience in South and Central Tigray Region, Ethiopia

Sorghum is an important crop for the south and central parts of Tigray Region of Ethiopia. To assess the level of sorghum diversity, two zones, namely South and Central Tigray were selected and eighteen villages in three woredas, Alamata, Raya-Azebo and Tanqua-Abergelle, were surveyed. A total of 93 randomly selected farmers were interviewed using a structured questionnaire that elicited information on socioeconomic aspects of households, sorghum plots, the number and types of farmers’ local varieties grown in the area, variety characteristics, seed exchange systems and seed flow together with selection criteria’s as well as seed selection process and management. A total of 165 collections belonging to 31 locally named sorghum varieties were retrieved and stored at Mekelle University. High diversity in terms of landrace richness were found the Alamata area (Margalef = 2.92; Menhinick = 1.66) followed by Raya-Azebo (Margalef = 2.61; Menhinick = 1.46) and Tanqua-Abergelle was found to be less diverse in terms of number of named varieties (Margalef = 1.40; Menhinick = 1.0). Diversity estimated based on evenness indices showed that Tanqua-Abergelle has the highest diversity (Shannon =0.86; Brillouin index = 0.86) followed by Raya-Azebo (Shannon =0.85; Brillouin index = 0.85). The lowest evenness was found in Alamata woreda (Shannon =0.77; Brillouin index = 0.77). Based on the varietal richness and use values, four sites (villages) that could serve as seed repositories were identified. The result of the econometric analysis indicated that a combination of factors, such as year of schooling, labour equivalence, tropical livestock unit, and number of parcels were the most important determinants that affect significantly the intra-specific diversity. The regression analysis indicates the positive linkage between land fragmentation and landrace richness. The increase in diversity over temporal scale of ten years found in this study revealed that the level of genetic erosion needs numerical evidence to substantiate. The socioeconomic factors that affect varietal diversity and possible conservation and incentive strategies are discussed. Key words: Sorghum, Diversity, Seed flow, Genetic erosion, Resilienc

Introduction to decoloniality and anti-racism in global health : Student Toolkit

Like every initiative of Black Lives Matter-LSHTM (now the FAIR Network), this student toolkit is a response to a continually expressed need - ‘I wish we’d had something like an anti-racism toolkit during our year’ is something we heard repeatedly since October 2020. As with BLM-LSHTM, the FAIR Network is a movement created to address the gaps in knowledge about anti-racism and decoloniality, highlighted by the LSHTM community. Our goal is to create an environment of shared learning where information is readily available and accessible. Your questions and comments continue to help us learn and grow. This document reflects our vision and is not meant to be prescriptive but to inspire conversations. Challenging conversations are an imperative, and we hope that you continue to challenge us, yourselves and each other to seek truth and create change

Physical factors contributing to rural water supply functionality performance in Ethiopia

This report communicates the findings generated from one of the project surveys – deconstruction and forensic analysis of 50 individual water points in Ethiopia. The report presents the new data generated to Ethiopia’s groundwater resource potential; the nature and condition of hand-pump borehole installations; and the significance of both of these factors to service performance. Based on the evidence collected, the survey results indicate the main physical factors most likely to affect functionality performance within the Ethiopian Highlands are the relatively deep depth to groundwater and the poor condition of handpump components. The impact of these factors to functionality performance can be mitigated through appropriate pump technology choice (e.g. use of deeper handpump boreholes (HPB) lift design), handpump construction, and adequate accessibility to repairs and maintenance capacity with breakdowns. These factors should not, however, be considered to be the only driving forces of functionality outcomes in these regions of Ethiopia, and the results of this survey need to be examined alongside the wider project findings. Wider institutional arrangements, resources and dynamics, are likely to play a significant role in the implementation of appropriate borehole construction, siting and design; procurement processes; and the management capacity available for water points at national to local levels

Mortality and Disability-adjusted Life-years (DALYs) for common neglected tropical Diseases in Ethiopia, 1990 to 2015: evidence from the Global Burden of Disease Study 2015

Introduction: Neglected tropical diseases (NTDs) are important public health problems in Ethiopia. In 2013, the Federal Ministry of Health (FMOH) has launched a national NTD master plan to eliminate major NTDs of public health importance by 2020. Benchmarking the current status of NTDs in the country is important to monitor and evaluate the progress in the implementation of interventions and their impacts. Therefore, this study aims to assess the trends of mortality and Disability-adjusted Life-Years (DALY) for the priority NTDs over the last 25 years. Methods: We used the Global Burden of Disease (GBD) 2015 estimates for this study. The GBD 2015 data source for cause of death and DALY estimation included verbal autopsy (VA), Demographic and Health Surveys (DHS), malaria indicator surveys (MICS) and other disease specific surveys, Ministry of Health reports submitted to United Nations (UN) agencies and published scientific articles. Cause of Death Ensemble modeling (CODEm) and/or natural history models were used to estimate malaria and NTDs mortality rates. DALY were estimated as the sum of Years of Life Lost (YLL) due to premature mortality and Years Lived with Disability (YLD). Results: All NTDs caused an estimated of 6,293 deaths (95% uncertainty interval (UI): 3699 – 10,080) in 1990 and 3,593 deaths (95% UI: 2051 – 6178) in 2015, a 70% reduction over the 25 years. Age-standardised mortality rates due to schistosomiasis, STH and leshmaniasis have declined by 91.3%, 73.5% and 21.6% respectively between 1990 to 2015. The number of DALYs due to all NTDs has declined from 814.4 thousand (95% UI: 548 thousand–1.2 million) in 1990 to 579.5 thousand (95%UI: 309.4 thousand – 1.3 million) in 2015. Age-standardised DALY rates due to all NTDs declined by 30.4%, from 17.6 per 1000(95%UI: 12.5-26.5) in 1990 to 12.2 per 1000(95%UI: 6.5 – 27.4) in 2015. Age-standardised DALY rate for trachoma declined from 92.7 per 100,000(95% UI: 63.2 – 128.4) in 1990 to 41.2 per 100,000(95%UI: 27.4 – 59.2) in 2015, a 55.6% reduction between 1990 and 2015. Age-standardised DALY rates for onchocerciasis, schistosomiasis and lymphiatic filariasis decreased by 66.2%, 29.4% and 12.5% respectively between 1990 and 2015. DALY rate for ascariasis fell by 56.8% over the past 25 years. Conclusions: Ethiopia has made a remarkable progress in reducing the DALY rates for most of the NTDs over the last 25 years. The rapid scale of interventions and broader system strengthening may have a lasting impact on achieving the 2020 goal of elimination of most of NTDs. Ethiopia should strengthen the coverage of integrated interventions of NTD through proper coordination with other health programs and sectors and community participation to eliminate NTDs by 2020

Adherence to Tuberculosis Therapy among Patients Receiving Home-Based Directly Observed Treatment: Evidence from the United Republic of Tanzania.

\ud \ud Non-adherence to tuberculosis (TB) treatment is the leading contributor to the selection of drug-resistant strains of Mycobacterium tuberculosis and subsequent treatment failure. Tanzania introduced a TB Patient Centred Treatment (PCT) approach which gives new TB patients the choice between home-based treatment supervised by a treatment supporter of their own choice, and health facility-based treatment observed by a medical professional. The aim of this study was to assess the extent and determinants of adherence to anti-TB therapy in patients opting for home-based treatment under the novel PCT approach. In this cross-sectional study, the primary outcome was the percentage of patients adherent to TB therapy as detected by the presence of isoniazid in urine (IsoScreen assay). The primary analysis followed a non-inferiority approach in which adherence could not be lower than 75%. Logistic regression was used to examine the influence of potentially predictive factors. A total of 651 new TB patients were included. Of these, 645 (99.1%) provided urine for testing and 617 patients (95.7%; 90%CI 94.3-96.9) showed a positive result. This result was statistically non-inferior to the postulated adherence level of 75% (p<0.001). Adherence to TB therapy under home-based Directly Observed Treatment can be ensured in programmatic settings. A reliable supply of medication and the careful selection of treatment supporters, who preferably live very close to the patient, are crucial success factors. Finally, we recommend a cohort study to assess the rate of adherence throughout the full course of TB treatment

Planar 17O NMR study of Pr_yY_{1-y}Ba_2Cu_3O_{6+x}

We report the planar ^{17}O NMR shift in Pr substituted YBa_{2}Cu_{3}O_{6+x}, which at x=1 exhibits a characteristic pseudogap temperature dependence, confirming that Pr reduces the concentration of mobile holes in the CuO_{2} planes. Our estimate of the rate of this counterdoping effect, obtained by comparison with the shift in pure samples with reduced oxygen content, is found insufficient to explain the observed reduction of T_c. From the temperature dependent magnetic broadening of the ^{17}O NMR we conclude that the Pr moment and the local magnetic defect induced in the CuO_2 planes produce a long range spin polarization in the planes, which is likely associated with the extra reduction of T_c. We find a qualitatively different behaviour in the oxygen depleted Pr_yY_{1-y}Ba_2Cu_3O_{6.6}, i.e. the suppression of T$_c$ is nearly the same, but the magnetic broadening of the ^{17}O NMR appears weaker. This difference may signal a weaker coupling of the Pr to the planes in the underdoped compound, which might be linked with the larger Pr to CuO_2 plane distance, and correspondingly weaker hybridization.Comment: 8 pages, 9 figures, accepted in Phys Rev