Patterns of Fractures and Their Current Hospital Management in Eastern Ethiopia: A Six-Years Prospective review

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Preventable amputations in Ethiopia

Objective: To determine how many amputations might be avoidable in Ethiopia.Patients and methods: A retrospective study was made of 110 amputations (Male 83, Female 27) performed at the Tikur Anbessa Hospital during the 12 months between May 1 - April 3 1,200 1- 02.Results: Upper limb amputations (ULA) were performed for 27 (25 %) of the patients and lower limb amputations (LLA) for 83(75%). Amputation was performed for Trauma (40%), Gangrene of various causes (32 %), Tumour (17 %), and Infections (1 1%). The majority 64 (58 %) of the amputations were for conditions, which are preventable; these included all of the 27 upper limbs (loo%), and 37 of the lower limbs (45 %). Further identification of preventable causes and the implementation of effective preventive measures are recommended

Socioeconomic Assessment of a Tsetse and Trypanosomosis Control Program in Southwest Ethiopia

A socioeconomic study was made to assess the outcome of a tsetse and trypanosomosis control operation conducted in Chewaka settlement station, Southwest Ethiopia, during 2005-2007 through comparisons of data before and after the control program within Chewaka, and between Chewaka and a non-controlled adjacent site, Bikiltu Didessa peasant Association. Retrospective and crossectional questionnaire survey methods were used to generate data for the study. Results showed that the total livestock and cattle population in chewaka increased by 116% and 1039 %, respectively, and the total cereal production increased by 63.2 %. During this period the overall livestock and cattle population in Bikiltu decreased by 45.7% and 47.5%, respectively, and the total cereal production declined by 35.6%. The average number of cattle bought per house hold per year in Chewaka, 1.15 head, was significantly higher (P=0.000) than the average number of 0.55 head in Bikiltu. The chances of cattle and oxen mortality in Bikiltu were 10 and 6 times (OR= 6.5 and 10.2) more likely than in Chewaka and the chance of abortion in cows in Bikiltu was more than 10 times as compared to Chewaka (OR=10.79). The control operation in chewaka settlement station resulted in rapid growth of livestock and crop production, fast expansion of farmland, improved income from animal sell and increased animal purchasing power

Economic Significance of Fasciolosis at Mettu Municipal Abattoir, Southwest Ethiopia

A study was conducted to determine the prevalence and economic significance of fasciolosis in cattle slaughtered at Mettu town municipal abattoir, Southwest Ethiopia. A total of 663 animals were randomly selected from the indigenous zebu cattle brought to the abattoir during October 2008-May 2009. Retrospective assessment, Ante-mortem examinations, body condition scoring and Post-mortem inspections were performed to collect data. Out of the total examined animals 47.1% (312/663) were found positive for Fasciola parasites. Two species of Fasciola: Fasciola hepatica and Fasciola gigantica were detected with prevalences of 26.9% (178/663) and 11.8% (78/663), respectively, mixed infections by both species were 4.8% (32/663) and immature (unidentified) flukes were 3.5% (24/663) of the total infections. The difference in prevalence of Fasciola hepatica and Fasciola gigantica was found to be significant (P=0.000). Prevalence of the disease was also determined in relation to body condition score of the sample animals whereby 319 and 344 animals were categorized under Good and Medium body condition score sub-groups, respectively. It was found that 41.7% (133/319) of the Good score animals and 52% (179/344) of the medium score animals were positive for Fasciola parasites, and the difference in prevalence between the two sub-groups was statistically significant (P=0.008). The annual direct economic loss due to liver condemnation and the annual indirect economic loss due to carcass weight reduction were estimated to be 4,757.00 USD (47,570.00 birr) and 46,615.00 USD (466,150.00 birr), respectively; hence, the total economic loss due to fasciolosis in cattle slaughtered at Mettu municipal abattoir was estimated to be 51,372.00 USD (513,720.00 birr). In conclusion, bovine fasciolosis due to Fasciola hepatica and Fasciola gigantica was observed to be an economically important disease in Mettu and its surrounding districts. Further studies on small ruminant species and local epidemiology of the disease are suggested to enable control of the infection in the area

An analysis of the implementation of business process reengineering health care reform initiative in Ethiopia

The purpose of this research was to explore and describe the effectiveness of the health care reform implemented in Ethiopia in the form of Business Process Reengineering (BPR) and develop strategies to strengthen its implementation. The research was conducted in two phases. In phase I, the effectiveness of the BPR health care reform was explored and described through gathering quantitative information from health care providers (n=406) using a structured questionnaire. All public hospitals of Addis Ababa, Ethiopia which have been implementing the reform from its inception (n=5) were included. In Phase II, in-depth strategies aimed at strengthening implementation of the reform were developed. Two-rounds of Delphi study were conducted to seek the opinions of senior health policy experts (n=10) and arrive at consensus on the developed strategies. Cronbach's alpha, descriptive statistics, Chi-square, logistic regression analysis, principal component analysis, weighted median score, adjusted and standard satisfaction scores, Mann-Whitney U test, and Kruskal-Wallis test were conducted for data analysis. The BPR health care reform was able to restructure the hospitals’ departments into case teams, with the goal of adopting a “one-stop shopping” approach. However, 50% of the health care providers reported that the reform was not effective to satisfy the perceived health service needs. Limited effects were reported in favour of health care quality (48%), access (50%), efficiency (51%), sustainability (53%), and equity (61%). While poor effects were reported in patient-provider (41%) and provider-management (32%) interactions. The most important predictors that influenced implementation of the reform were financial resources (AOR=3.54, 95%CI: 1.97, 6.33), top management commitment and support (AOR=2.27, 95%CI: 1.15, 4.47), collaborative working environment (AOR=1.77, 95%CI: 1.00, 3.11), and information technology (AOR=3.15, 95%CI: 1.57, 6.32). The overall job satisfaction in the public health sectors remained poor, with only 25% job-satisfied providers engaged. Moral satisfaction (AOR=177.654, 95%CI: 59.539, 530.08), management style (AOR=4.017, 95%CI: 1.490, 10.828), workload (AOR=2.422, 95%CI: 0.925, 6.342), and task (AOR=5.491, 95%CI: 2.307, 13.069) were the most significant factors. Job satisfaction results were significantly different among the study hospitals (2 = 30.557, p < 0.001). The current health care delivery performance of the public hospitals was 60% when weighed against the World Health Organization’s health system framework which required a minimum of 80% score. However, there existed a significant difference in performance at least between two hospitals (2 = 571.902, p < 0.001). Five strategies that could disrupt the status quo and strengthen the BPR health care reform are proposed based on their strategic priority, which were: reinforce patient-centred quality of care services; foster a healthy and respectful workforce environment; efficient and accountable leadership and governance; efficient use of hospital financing; and maximize innovations and the use of health technologies. The strategies could be used to enrich the quality of health care interventions through continuous review, refinement and adjustment of the reform as required. Key words: Health care reform; Business Process Reengineering; quality; access; equity; efficiency; sustainability; job satisfaction; health system; patient-centred care; workforce; leadership and governance; hospital financing; health technologies; Ethiopia.Health StudiesD. Litt. et Phil. (Health Studies

Epidemiology of Fasciolosis in Southwest Ethiopia

The design of strategic deworming programs is one of the control options for fasciolosis, and needs to be supported by local epidemiology knowledge. To address this issue in Southwest Ethiopia, a study using tracer calf and crossectional study methods was made at an endemic area for the disease during 2006–2007. Coprology and necropsy examinations were used to collect information. Results showed that both Fasciola hepatica and Fasciola gigantica were abundant in the area with almost equal prevalence rates, and infections of animals occur during the wet season from May to October. The mean number of flukes recovered in the positive tracer calves ranged from 3.0 to 42.5 per animal, and the maximum worm count observed in an individual animal was 66 flukes. The overall prevalence of Fasciolosis in the extensively managed local breeds of cattle, yearling calves, sheep and goats was 74.8%, 55.3%, 35%, and 27.1%, respectively. A significant difference was observed in the prevalence of fasciolosis among cattle, yearling calves and sheep population, while no difference was observed among the goat populations of the five provinces. Based on the regional epidemiology of the disease, a twice yearly strategic deworming program has been devised to control the infection in the region

Load classification and appliance fingerprinting for residential load monitoring system

Previous work on residential load monitoring has attempted to address different requirements including the systematic collection of information about electric power consumption for load research purpose, the provision of a detailed consumption report to facilitate energy conservation practices and the monitoring of critical loads for fault diagnostics. This work focuses on developing methods for appliance fingerprinting that is foreseen to be an integral part of an automatic residential load monitoring system. Various approaches outlined in previous research form the basis for the concepts developed in this thesis. In addition, an extensive series of measurement work was performed on several household appliances in order to acquire the necessary operation data for building the technique and also to explore the extent up to which residential loads can be categorized into distinct groups. The fingerprinting process proposed in this work employs three main phases: feature extraction of electrical attributes, event detection and pattern recognition. Test results obtained at different stages of the work using the measurement data are also discussed in detail. Such studies are necessary to enable utilities to manage their networks reliably and efficiently, and also to encourage the active participation of consumers in energy conservation programs

Cryptosporidium Infection in Dairy Cattle Calves and its Public Health Significance in Central Ethiopia

Cryptosporidium spp. are common intestinal protozoan parasites that causes diarrhoea in neonates and young calves. This longitudinal study was conducted at two large dairy cattle farms in central Ethiopia during February/2014 to June/2015 to determine the age-related distribution of Cryptosporidium species, to identify risk factors of the disease and to assess the public health significance of the parasite. Thirty calves born to these dairy farms were followed-up from birth to three months of age, and 270 faecal samples were collected and examined by the Modified Ziehl-Neelsen, PCR-RFLP and Sequencing. Cryptosporidium was detected from week 1 to 3 months of age with an overall prevalence of 14.8%, Peak of the infection was at two weeks of age when 12 of the 30 calves (40%) shedded oocysts. Cryptosporidium parvum and C. andersoni were identified in pre-weaned and post-weaned calves, respectively. Phylogenetic analysis showed clustering of the C. parvum isolates from this study with GenBank sequences for C. parvum bovine genotype IIa and IId subtypes. This study showed the predominance of the zoonotic C. parvum species in pre-weaned calves and demonstrated that this age group of calves pose the greatest risk for human infection. Due attention on the management of pre-weaned calves is recommended to prevent transmission of the infection to humans and lessen contamination of the environment by oocysts

Bioethical Implications of Vulnerability and Politics for Healthcare in Ethiopia and The Ways Forward

Vulnerability and politics are among the relevant and key topics of discussion in the Ethiopian healthcare context. Attempts by the formal bioethics structure in Ethiopia to deliberate on ethical issues relating to vulnerability and politics in healthcare have been limited, even though the informal analysis of bioethical issues has been present in traditional Ethiopian communities. This is reflected in religion, social values, and local moral underpinnings. Thus, the aim of this paper is to discuss the bioethical implications of vulnerability and politics for healthcare in Ethiopia and to suggest possible ways forward. First, we will briefly introduce what has been done to develop bioethics as a field in Ethiopia and what gaps remain concerning its implementation in healthcare practice. This will give a context for our second and main task - analyzing the healthcare challenges in relation to vulnerability and politics and discussing their bioethical implications. In doing so, and since these two concepts are intrinsically broad, we demarcate their scope by focusing on specific issues such as poverty, gender, health governance, and armed conflicts. Lastly, we provide suggestions for the ways forward

Towards effective and sustainable global academic partnerships through a maturity model informed by the capability approach

BackgroundShortage of skilled workforce is a global concern but represents a critical bottleneck to Africa’s development. While global academic partnerships have the potential to help tackle this development bottleneck, they are criticised for inadequate attention to equity, impact, and sustainability. We propose a new values-driven partnership model for sustainable and equitable global partnerships that achieve impact.MethodThe model was based on the authors’ experiences of participation in over 30 partnerships and used insights from the Capability Approach.ResultsWe developed an Academic Partnership Maturity Model, with five levels of maturity, extending from pre-contemplative to mature partnerships. The level of maturity increases depending on the level of freedom, equity, diversity, and agency afforded to the partners. The approach offers a framework for establishing a forward-looking partnership anchored in mutual learning, empowerment, and autonomy.ConclusionThis is a pragmatic model limited by the biases of experiential knowledge. Further development of the concept, including metrics and an evaluation tool kit are needed to assist partners and funders