Nursing Supervisors Perception on quality of Nursing Care in Ethiopia

Background: The problem of clarifying the nature of the core elements of the nursing profession and the limits of its scope of practice are found in many countries. Additional problem in Ethiopia which should be taken into consideration and thoroughly examined by policy-makers and nurses are the existing imbalances between the numbers, types, functions, istributions, and quality of nursing personnel, on the one hand, and on the other, the country's need for their services and ability to employ, support and maintain them. Guided by this perspective, the purpose of this study were to assess (a) any nursing imbalance and shortage and (b) the quality of nursing education and nursing care in Ethiopia. Methods: A cross-sectional approach was utilized. Health department supervisor nurse (or the equivalent) respondents (n= 70) were recruited from the 11 regional and 59 zonal and 7 special woredas'. Participants completed the Nursing Personnel Resources Survey Questionnaire (NPRSQ). The NPRSQ is a self-administered 51-items instrument for measuring the distribution of nursing personnel; the quality of nursing schools and the relevance of nursing education; the quality of nursing care (relative to a perceived standard); and the status and image of nursing in the country. Results: The most important findings shows a three dimensional nursing workforce imbalances: the numerical dimension involves under-supply compared to country needs and resources; the qualitative dimension represents a mismatch between educational preparation and requirements in the workplace; and the distributional dimension focuses on urban areas and hospitals compared to rural areas and community health care settings. Conclusion: This study does not try to address all the issues related to nursing personnel imbalance. However, regardless of the nature of the nursing situations, this study does show that nursing shortage is associated with quality of care, and quality of care with quality of education. The solution lies in a broad, country-based approach that addresses infrastructure, education, and human resources management. as an interrelated and complex aspects of human resources policy and planning.Ethiop J Health Sci Vol. 11, No. 2 July 200

Decision Modelling for the Integration of Woody Plants in Smallholder Farms in the Central Highlands of Ethiopia

Farmers’ perceptions of the utility and the constraints of locally available woody species are assumed to influence the decision-making and the behaviour of tree and shrub integration into current land-use types. Accordingly, the objectives of this study are (1) to analyse farmers’ decisions in making use of woody plants under perceived constraints and (2) to analyse influencing factors that determine the deliberate tree and shrub growing behaviour. The methodology bases on the approaches of the ’Farming Systems’ and the ’Behavioural Decision-Making’. Influence diagrams are constructed incorporating the perceived utility and decision determinants of deliberately grown woody plants. Modelling of the tree adoption behaviour of farmers employs the ’Discriminant Analytical Approach’ taking into account the identified external and internal influencing factors. Results from the decision modelling reveal that woody plants are grown on-farm in view of the perceived utility of the species, predominantly fuelwood and timber-based produce, followed by cash-generation. Service functions pertaining to the protection of land gain secondary importance to the tree produce. Major decision determinants comprise resource-based factors, e.g. the shortage of land and seedlings or competition with agricultural crops, over stochastic-environmental factors. Results of the ’Discriminant Analysis’ confirm that the adoption of trees is characterised by the available resource base, the access to infrastructure and support services as well as by personal characteristics of the farmers

Ethnobotany of Wild and Semi-Wild Edible Fruit Species used by Maale and Ari Ethnic Communities in Southern Ethiopia

Wild and semi-wild tree fruit species are important resources in combating food insecurity and providing supplementary diet to rural people. We studied wild and semi-wild fruit species used by the Maale and Ari communities in southern Ethiopia and the conservation status of these resources. We used focus group discussions (n = 18) and individual interviews (n = 144) in three rural kebeles. In total, the two communities used 52 species of wild and semi-wild fruit species which were especially important for their diet in times of food shortage. The most important species were, for the Maale community, Balanites rotundifolia (Tiegh.) Blatt. and Dobera glabra (Forssk.) Juss. ex Poir. and, for the Ari community, Carissa spinarum L. and Vitex doniana Sweet. No significant variation in ethnobotanical knowledge regarding fruit species existed among gender and age groups. The main traded fruit species were B. rotundifolia, Ximenia caffra Sond., and Vangueria madagascariensis J.F.Gmel. The major threats reported by informants to the availability of wild and semi-wild fruit species were tree felling and conversion of forest to agricultural land. In addition to preserving the local knowledge and implementing conservation strategies that protect the remaining fruit trees, maintenance and enrichment planting of the most important species are plausible management interventions

Ethnobotany of Wild and Semi-Wild Edible Fruit Species used by Maale and Ari Ethnic Communities in Southern Ethiopia

Wild and semi-wild tree fruit species are important resources in combating food insecurity and providing supplementary diet to rural people. We studied wild and semi-wild fruit species used by the Maale and Ari communities in southern Ethiopia and the conservation status of these resources. We used focus group discussions (n = 18) and individual interviews (n = 144) in three rural kebeles. In total, the two communities used 52 species of wild and semi-wild fruit species which were especially important for their diet in times of food shortage. The most important species were, for the Maale community, Balanites rotundifolia (Tiegh.) Blatt. and Dobera glabra (Forssk.) Juss. ex Poir. and, for the Ari community, Carissa spinarum L. and Vitex doniana Sweet. No significant variation in ethnobotanical knowledge regarding fruit species existed among gender and age groups. The main traded fruit species were B. rotundifolia, Ximenia caffra Sond., and Vangueria madagascariensis J.F.Gmel. The major threats reported by informants to the availability of wild and semi-wild fruit species were tree felling and conversion of forest to agricultural land. In addition to preserving the local knowledge and implementing conservation strategies that protect the remaining fruit trees, maintenance and enrichment planting of the most important species are plausible management interventions

Predictors of defaulting from completion of child immunization in south Ethiopia, May 2008 – A case control study

<p>Abstract</p> <p>Background</p> <p>Epidemiological investigations of recent outbreaks of vaccine preventable diseases have indicated that incomplete immunization was the major reason for the outbreaks. In Ethiopia, full immunization rate is low and reasons for defaulting from immunization are not studied well. The objective of the study was to identify the predictors of defaulting from completion of child immunization among children between ages 9–23 months in Wonago district, South Ethiopia.</p> <p>Methods</p> <p>Unmatched case control study was conducted in eight Kebeles (lowest administrative unit) of Wonago district in south Ethiopia. Census was done to identify all cases and controls. A total of 266 samples (133 cases and 133 controls) were selected by simple random sampling technique. Cases were children in the age group of 9 to 23 months who did not complete the recommended immunization schedule. Pre-tested structured questionnaire were used for data collection. Data was analyzed using SPSS 15.0 statistical software.</p> <p>Results</p> <p>Four hundred eighteen (41.7%) of the children were fully vaccinated and four hundred twelve (41.2%) of the children were partially vaccinated. The BCG: measles defaulter rate was 76.2%. Knowledge of the mothers about child immunization, monthly family income, postponing child immunization and perceived health institution support were the best predictors of defaulting from completion of child immunization.</p> <p>Conclusion</p> <p>Mothers should be educated about the benefits of vaccination and the timely administration of vaccines.</p

Effect of birthweight measurement quality improvement on low birthweight prevalence in rural Ethiopia.

BACKGROUND: Low birthweight (LBW) (< 2500 g) is a significant determinant of infant morbidity and mortality worldwide. In low-income settings, the quality of birthweight data suffers from measurement and recording errors, inconsistent data reporting systems, and missing data from non-facility births. This paper describes birthweight data quality and the prevalence of LBW before and after implementation of a birthweight quality improvement (QI) initiative in Amhara region, Ethiopia. METHODS: A comparative pre-post study was performed in selected rural health facilities located in West Gojjam and South Gondar zones. At baseline, a retrospective review of delivery records from February to May 2018 was performed in 14 health centers to collect birthweight data. A birthweight QI initiative was introduced in August 2019, which included provision of high-quality digital infant weight scales (precision 5 g), routine calibration, training in birth weighing and data recording, and routine field supervision. After the QI implementation, birthweight data were prospectively collected from late August to early September 2019, and December 2019 to June 2020. Data quality, as measured by heaping (weights at exact multiples of 500 g) and rounding to the nearest 100 g, and the prevalence of LBW were calculated before and after QI implementation. RESULTS: We retrospectively reviewed 1383 delivery records before the QI implementation and prospectively measured 1371 newborn weights after QI implementation. Heaping was most frequently observed at 3000 g and declined from 26% pre-initiative to 6.7% post-initiative. Heaping at 2500 g decreased from 5.4% pre-QI to 2.2% post-QI. The percentage of rounding to the nearest 100 g was reduced from 100% pre-initiative to 36.5% post-initiative. Before the QI initiative, the prevalence of recognized LBW was 2.2% (95% confidence interval [CI]: 1.5-3.1) and after the QI initiative increased to 11.7% (95% CI: 10.1-13.5). CONCLUSIONS: A QI intervention can improve the quality of birthweight measurements, and data measurement quality may substantially affect estimates of LBW prevalence

Enhancing Nutrition and Antenatal Infection Treatment (ENAT) study: protocol of a pragmatic clinical effectiveness study to improve birth outcomes in Ethiopia.

INTRODUCTION: The WHO Nutrition Target aims to reduce the global prevalence of low birth weight by 30% by the year 2025. The Enhancing Nutrition and Antenatal Infection Treatment (ENAT) study will test the impact of packages of pregnancy interventions to enhance maternal nutrition and infection management on birth outcomes in rural Ethiopia. METHODS AND ANALYSIS: ENAT is a pragmatic, open-label, 2×2 factorial, randomised clinical effectiveness study implemented in 12 rural health centres in Amhara, Ethiopia. Eligible pregnant women presenting at antenatal care (ANC) visits at &lt;24 weeks gestation are enrolled (n=2400). ANC quality is strengthened across all centres. Health centres are randomised to receive an enhanced nutrition package (ENP) or standard nutrition care, and within each health centre, individual women are randomised to receive an enhanced infection management package (EIMP) or standard infection care. At ENP centres, women receive a regular supply of adequately iodised salt and iron–folate (IFA), enhanced nutrition counselling and those with mid-upper arm circumference of &lt;23 cm receive a micronutrient fortified balanced energy protein supplement (corn soya blend) until delivery. In standard nutrition centres, women receive routine counselling and IFA. EIMP women have additional screening/treatment for urinary and sexual/reproductive tract infections and intensive deworming. Non-EIMP women are managed syndromically per Ministry of Health Guidelines. Participants are followed until 1-month post partum, and a subset until 6 months. The primary study outcomes are newborn weight and length measured at &lt;72 hours of age. Secondary outcomes include preterm birth, low birth weight and stillbirth rates; newborn head circumference; infant weight and length for age z-scores at birth; maternal anaemia; and weight gain during pregnancy. ETHICS AND DISSEMINATION: ENAT is approved by the Institutional Review Boards of Addis Continental Institute of Public Health (001-A1-2019) and Mass General Brigham (2018P002479). Results will be disseminated to local and international stakeholders. REGISTRATION NUMBER: ISRCTN15116516

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic

Low Power Wide Area Networks based on LoRA Technology

The demand for connected devices, according to the Internet of Things (IoT) paradigm, is expected to grow considerably in the immediate future. Various standards are currently contending to gain an edge over the competition and provide the massive connectivity that will be required by a world in which everyday objects are expected to communicate with each other. Among these standards, Low-Power Wide Area Networks (LPWANs) are continuously gaining momentum, mainly thanks to their ability to provide long-range coverage to devices, exploiting license-free frequency bands. The focus of this thesis is on one of the most prominent LPWAN technologies: LoRa™. First, this thesis establishes a series of models that cover various aspects of a LoRa network. Then, a new Network LoRaWAN Simulator is introduced to simulate a LoRa-based IoT network of four use cases. Finally, the performance of the LoRa system is evaluated and analyzed