A preliminary survey of Erythrocebus patas in Anbesa Chaka, Bambesi Woreda of Benishangul-Gumuz Region, western Ethiopia

A preliminary survey conducted in Benishangul-Gumuz Region, Bambesi Woreda from late January to early February, 2010 resulted in finding two groups of the same taxon of patas monkeys. Each of the two groups had one adult male, and one of them consisted of 33 individuals, where as the other had a total of 23 individuals including the adult males, adult and sub-adult females and infants. The survey was conducted on foot and by a vehicle and behavioural data were collected using adlibtum method. From the structure of the two groups and the season during which they probably had their newborns, they belong to the species Erythrocebus patas which are also found elsewhere. However, the long black fur coloration along the shoulder, back and upper fore limbs of the males is different from any of the four different subspecies, namely, E. patas patas, E. patas villiersi, E. patas pyrrhonotus and E. patas baumstarki, and others found in Athi plains, southeast of Nairobi and east of the rift valley, which have pink faces and a blue nasal spot and not given subspecific names. Thus, it is reasonable to think of the Benishangul patas as subspecies, as they are distinct from the other subspecies

Assessing the quality of care in sick child services at health facilities in Ethiopia.

BACKGROUND: Quality of care depends on system, facility, provider, and client-level factors. We aimed at examining structural and process quality of services for sick children and its association with client satisfaction at health facilities in Ethiopia. METHODS: Data from the Ethiopia Service Provision Assessment Plus (SPA+) survey 2014 were used. Measures of quality were assessed based on the Donabedian framework: structure, process, and outcome. A total of 1908 mothers or caretakers were interviewed and their child consultations were observed. Principal component analysis was used to construct quality of care indices including a structural composite score, a process composite score, and a client satisfaction score. Multilevel mixed linear regression was used to analyze the association between structural and process factors with client satisfaction. RESULT: Among children diagnosed with suspected pneumonia, respiratory rate was counted in 56% and temperature was checked in 77% of the cases. A majority of children (92%) diagnosed with fever had their temperature taken. Only 3% of children with fever were either referred or admitted, and 60% received antibiotics. Among children diagnosed with malaria, 51% were assessed for all three Integrated Management of Childhood Illnesses (IMCI) main symptoms, and 4% were assessed for all three general danger signs. Providers assessed dehydration in 54% of children with diarrhea with dehydration, 17% of these children were admitted or referred to another facility, and Oral Rehydration Solution was prescribed for 67% while none received intravenous fluids. The number of basic amenities in the facility was negatively associated with the clients' satisfaction. Private facilities, when the providers had got training for care of sick children in the past 2 years, had higher client satisfaction. There was no statistical association between structure, process composite indicators and client satisfaction. CONCLUSION: The assessment of sick children was of low quality, with many missing procedures when comparing with IMCI guidelines. In spite of this, most clients were satisfied with the services they received. Structural and process composite indicators were not associated with client's satisfaction. These findings highlight the need to assess other dimensions of quality of care besides structure and process that may influence client satisfaction

Association between a complex community intervention and quality of health extension workers' performance to correctly classify common childhood illnesses in four regions of Ethiopia.

BACKGROUND: Due to low care utilization, a complex intervention was done for two years to optimize the Ethiopian Health Extension Program. Improved quality of the integrated community case management services was an intermediate outcome of this intervention through community education and mobilization, capacity building of health workers, and strengthening of district ownership and accountability of sick child services. We evaluated the association between the intervention and the health extension workers' ability to correctly classify common childhood illnesses in four regions of Ethiopia. METHODS: Baseline and endline assessments were done in 2016 and 2018 in intervention and comparison areas in four regions of Ethiopia. Ill children aged 2 to 59 months were mobilized to visit health posts for an assessment that was followed by re-examination. We analyzed sensitivity, specificity, and difference-in-difference of correct classification with multilevel mixed logistic regression in intervention and comparison areas at baseline and endline. RESULTS: Health extensions workers' consultations with ill children were observed in intervention (n = 710) and comparison areas (n = 615). At baseline, re-examination of the children showed that in intervention areas, health extension workers' sensitivity for fever or malaria was 54%, 68% for respiratory infections, 90% for diarrheal diseases, and 34% for malnutrition. At endline, it was 40% for fever or malaria, 49% for respiratory infections, 85% for diarrheal diseases, and 48% for malnutrition. Specificity was higher (89-100%) for all childhood illnesses. Difference-in-differences was 6% for correct classification of fever or malaria [aOR = 1.45 95% CI: 0.81-2.60], 4% for respiratory tract infection [aOR = 1.49 95% CI: 0.81-2.74], and 5% for diarrheal diseases [aOR = 1.74 95% CI: 0.77-3.92]. CONCLUSION: This study revealed that the Optimization of Health Extension Program intervention, which included training, supportive supervision, and performance reviews of health extension workers, was not associated with an improved classification of childhood illnesses by these Ethiopian primary health care workers. TRIAL REGISTRATION: ISRCTN12040912, http://www.isrctn.com/ISRCTN12040912

COVID 19 Epidemic Trajectory Modeling Results for Ethiopia

AbstractBackground: An outbreak of “pneumonia of unknown etiology" later renamed as Novel Corona Virus (COVID 19) was first reported from Hubei Province, China on 31 December 2019. The cases have increased exponentially; the pandemic has reached all countries in the world with 81.2 million confirmed cases and over 1.8 million by December 28, 2020. Ethiopia reported its first case on March 13, 2020, and as of December 28, 2020, the country had 122864 confirmed COVID-19 cases and 1909 deaths. Being a new pandemic its epidemiologic trajectories across regions and populations remains unknown. Mathematical models are widely used to understand and predict the possible courses of an outbreak, given a set of underlying assumptions. Objective: This study intends to model COVID 19 epidemic trajectory under different assumptions and to predict the likely timing of peak of the epidemic in Ethiopia. Methods: Standard Susceptible Exposed, Infected and Recovery (SEIR) compartmental epidemiological deterministic model was employed to estimate and predict COVID 19 in progression in Ethiopia and Addis Ababa at different points of time. Exhaustive literature reviews were carried out to contextualize COVID 19 pandemic epidemiological. Efficacy and coverage of face mask and social distancing were considered in the best and worst situation to run the model and estimate the number of infections after sustained local transmissions. Result. Without any intervention, the COVID 19 viruses spread will peak at 150 days from the first report, infecting 8.01million people given local/community transmission. As the compliance with face mask coverage increases by 25%, 50%, and 75%, the infection will be reduced by about 20%, 40%, and 60% respectively social distancing compliance by le 25% of the population alone will reduce above 60% of infections. Compliance of 40% face mask use and social distance combined effect will reduce 97% of the estimated number of cases. Conclusion: This predication indicated that compliance with combination of non-pharmaceutical intervention such as use of face mask use with physical distance averted significant number of COVID infection. For a county like Ethiopia with poor health systems resilience, mitigating the pandemic at an early stage through strong preventive measures is necessary. [Ethiop. J. Health Dev. 2021; 35(SI-1):25-32] Key word: COVID 19, Modelling, Non-Pharmaceutica intervention, Ethiopi

Health extension workers' perceived health system context and health post preparedness to provide services: a cross-sectional study in four Ethiopian regions.

OBJECTIVE: The health system context influences the implementation of evidence-based practices and quality of healthcare services. Ethiopia aims at reaching universal health coverage but faces low primary care utilisation and substandard quality of care. We assessed the health extension workers' perceived context and the preparedness of health posts to provide services. SETTING: This study was part of evaluating a complex intervention in 52 districts of four regions of Ethiopia. This paper used the endline data collected from December 2018 to February 2019. PARTICIPANTS: A total of 152 health posts and health extension workers serving selected enumeration areas were included. OUTCOME MEASURES: We used the Context Assessment for Community Health (COACH) tool and the Service Availability and Readiness Assessment tool. RESULTS: Internal reliability of COACH was satisfactory. The dimensions community engagement, work culture, commitment to work and leadership all scored high (mean 3.75-4.01 on a 1-5 scale), while organisational resources, sources of knowledge and informal payments scored low (1.78-2.71). The general service readiness index was 59%. On average, 67% of the health posts had basic amenities to provide services, 81% had basic equipment, 42% had standard precautions for infection prevention, 47% had test capacity for malaria and 58% had essential medicines. CONCLUSION: The health extension workers had a good relationship with the local community, used data for planning, were highly committed to their work with positive perceptions of their work culture, a relatively positive attitude regarding their leaders, and reported no corruption or informal payments. In contrast, they had insufficient sources of information and a severe lack of resources. The health post preparedness confirmed the low level of resources and preparedness for services. These findings suggest a significant potential contribution by health extension workers to Ethiopia's primary healthcare, provided that they receive improved support, including new information and essential resources

Implementing a Multi-Component School-based Obesity Prevention Intervention: A Qualitative Study

Objective: To explore barriers and facilitators to implementing and sustaining Healthy Choices, a three-year multi-component obesity prevention intervention implemented in middle schools in Massachusetts. Methods: Using purposive sampling, 56 in-depth interviews were conducted with middleschool employees representing different positions (administrators, teachers, food service personnel, and employees serving as intervention coordinators). Interviews were recorded and transcribed. Emergent themes were identified using thematic analyses. Results: State-mandated testing, budget limitations, and time constraints were viewed as implementation barriers while staff buy-in and technical assistance were seen as facilitating implementation. Respondents felt that intervention sustainability was dependent on external funding and expert assistance. Conclusions and Implications: Results confirm the importance of gaining faculty and staff support. Schools implementing large scale interventions should consider developing sustainable partnerships with organizations that can provide resources and ongoing training. Sustainability of complex interventions may depend on state-level strategies that provide resources for implementation and technical assistance

Effect of the planet health intervention on eating disorder symptoms in Massachusetts middle schools, 2005-2008

INTRODUCTION: The Planet Health obesity prevention curriculum has prevented purging and abuse of diet pills (disordered weight control behavior [DWCB]) in middle-school girls in randomized trials, but the effects of Planet Health on DWCB when implemented by schools under dissemination conditions are not known. METHODS: Massachusetts Department of Public Health and Blue Cross Blue Shield of Massachusetts disseminated Planet Health as part of the 3-year, Healthy Choices obesity prevention program in middle schools. We conducted an evaluation in 45 schools from fall 2005 to spring 2008. We gathered data from school staff to quantify intervention activities, and we gathered anonymous cross-sectional survey data from students on DWCB at baseline and Year 3 follow-up (n = 16,369). Multivariate logistic analyses with generalized estimating equations examined the effect of intervention activities on odds of students reporting DWCB at follow-up. RESULTS: Students in schools reaching a high number of youth with Planet Health lessons on reducing television viewing had lower odds of DWCB at follow-up (odds ratio [OR], 0.80 per 100 lesson-exposures; 95% confidence interval [CI], 0.74-0.85). In addition, reduced odds of DWCB at follow-up were found in schools with active staff teamwork (OR, 0.76; 95% CI, 0.66-0.86) and the presence of programs addressing television viewing goals with staff (OR, 0.38; 95% CI, 0.28-0.53). CONCLUSION: Combined evidence from efficacy and effectiveness trials and now from dissemination research indicates that appropriately designed obesity prevention programs can achieve DWCB prevention on a large scale

Effect of the Planet Health Intervention on Eating Disorder Symptoms in Massachusetts Middle Schools, 2005–2008

Introduction: The Planet Health obesity prevention curriculum has prevented purging and abuse of diet pills (disordered weight control behavior [DWCB]) in middle-school girls in randomized trials, but the effects of Planet Health on DWCB when implemented by schools under dissemination conditions are not known. Methods: Massachusetts Department of Public Health and Blue Cross Blue Shield of Massachusetts disseminated Planet Health as part of the 3-year, Healthy Choices obesity prevention program in middle schools. We conducted an evaluation in 45 schools from fall 2005 to spring 2008. We gathered data from school staff to quantify intervention activities, and we gathered anonymous cross-sectional survey data from students on DWCB at baseline and Year 3 follow-up (n = 16,369). Multivariate logistic analyses with generalized estimating equations examined the effect of intervention activities on odds of students reporting DWCB at follow-up. Results: Students in schools reaching a high number of youth with Planet Health lessons on reducing television viewing had lower odds of DWCB at follow-up (odds ratio [OR], 0.80 per 100 lesson-exposures; 95% confidence interval [CI], 0.74–0.85). In addition, reduced odds of DWCB at follow-up were found in schools with active staff teamwork (OR, 0.76; 95% CI, 0.66–0.86) and the presence of programs addressing television viewing goals with staff (OR, 0.38; 95% CI, 0.28–0.53). Conclusion: Combined evidence from efficacy and effectiveness trials and now from dissemination research indicates that appropriately designed obesity prevention programs can achieve DWCB prevention on a large scale

Dietary and Physical Activity Factors Related to Eating Disorder Symptoms Among Middle School Youth

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/95371/1/j.1746-1561.2012.00742.x.pd