Explaining migration intention from selected psycho-social variables in South Wollo, Ethiopia

Migration has become one of the challenging global issues of the twenty-first century. Therefore, analyzing the intention to migrate is essential to develop clear strategies to manage actual migration. This research aimed to investigate emigration intention predictors (namely place attachment, attitude, national pride, subjective social norm, and perceived behavioral control) and the interaction effect of social networks between those predictors and migration intention. A sample of 701 high school students participated in the research. Exploratory Factor Analysis and Confirmatory Factor Analysis were employed to explore the dimension and loading of items respectively. To test the moderation effect of social networks on migration intention and the predictor variables, structural equation modeling was employed using Amos version 27. The findings indicated that Attitude, National pride, subjective social norm, and perceived behavioral control predict youths' emigration intention. The result also revealed that social network strengthens the negative correlation between place attachment and intention to migrate only if the individuals have a high social network. The social network also moderates the relationship between attitude and emigration intention

Under detection of depression in primary care settings in low and middle-income countries:a systematic review and meta-analysis

Background: Depression is one of the commonest mental disorders in primary care but is poorly identified. The objective of this review was to determine the level of detection of depression by primary care clinicians and its determinants in studies from low- to middle-income countries (LMICs). Methods: A systematic review and meta-analysis was conducted using PubMed, PsycINFO, MEDLINE, EMBASE, LILAC, and AJOL with no restriction of year of publication. Risk of bias within studies was evaluated with the Effective Public Health Practice Project (EPHPP). “Gold standard” diagnosis for the purposes of this review was based on the 9-item Patient Health Questionnaire (PHQ-9; cutoff scores of 5 and 10), other standard questionnaires and interview scales or expert diagnosis. Meta-analysis was conducted excluding studies on special populations. Analyses of pooled data were stratified by diagnostic approaches. Results: A total of 3159 non-duplicate publications were screened. Nine publications, 2 multi-country studies, and 7 single-country studies, making 12 country-level reports, were included. Overall methodological quality of the studies was good. Depression detection was 0.0% in four of the twelve reports and < 12% in another five. PHQ-9 was the main tool used: the pooled detection in two reports that used PHQ-9 at a cutoff point of 5 (combined sample size = 1426) was 3.9% (95% CI = 2.3%, 5.5%); in four reports that used PHQ-9 cutoff score of 10 (combined sample size = 5481), the pooled detection was 7.0% (95% CI = 3.9%, 10.2%). Severity of depression and suicidality were significantly associated with detection. Conclusions: While the use of screening tools is an important limitation, the extremely low detection of depression by primary care clinicians poses a serious threat to scaling up mental healthcare in LMICs. Interventions to improve detection should be prioritized. Systematic review registration: PROSPERO CRD42016039704

Knowledge, perception and practice towards oxytocin stability and quality: A qualitative study of stakeholders in three resource-limited countries

Background: Oxytocin is the gold standard drug for the prevention of postpartum haemorrhage, but limitations in cold chain systems in resource-constrained settings can severely compromise the quality of oxytocin product available in these environments. This study investigated the perspectives and practices of stakeholders in low and lower-middle income countries towards oxytocin, its storage requirements and associated barriers, and the quality of product available. Methods: Qualitative inquiries were undertaken in Ethiopia, India and Myanmar, where data was collected through Focus Group Discussions (FGDs) and In-Depth Interviews (IDIs). A total of 12 FGDs and 106 IDIs were conducted with 158 healthcare providers (pharmacists, midwives, nurses, doctors and obstetricians) and 40 key informants (supply chain experts, program managers and policy-makers). Direct observations of oxytocin storage practices and cold chain resources were conducted at 51 healthcare facilities. Verbatim transcripts of FGDs and IDIs were translated to English and analysed according to a thematic content analysis framework. Findings: Stakeholder awareness of oxytocin heat sensitivity and the requirement for cold storage of the drug was widespread in Ethiopia but more limited in Myanmar and India. A consistent finding across all study regions was the significant barriers to maintaining a consistent cold chain, with the lack of refrigeration facilities and unreliability of electricity cited as major challenges. Perceptions of compromised oxytocin quality were expressed by some stakeholders in each country. Conclusion: Knowledge of the heat sensitivity of oxytocin and the potential impacts of inconsistent cold storage on product quality is not widespread amongst healthcare providers, policy makers and supply chain experts in Myanmar, Ethiopia and India. Targeted training and advocacy messages are warranted to emphasise the importance of cold storage to maintain oxytocin quality

Impact of Parental Migration on Education and Behavioural Outcomes of Children Left Behind in Southern Wollo

The migration of parents is believed to be for the sake of children and families left behind. However, its impact on children left behind has been overlooked in Southern Wollo, Ethioipia. The impact of parental migration on the education and behavioral outcomes of children left behind has to be investigated in the migration-prone area. The objective of this study was to examine the impact of the migration of parent(s) on the education and behavioral outcomes of children left behind. A total of 622 children of migrating parents and children living with both parents were selected for this study. Data were gathered by using a strength and difficulty questionnaire (SDQ) from children of non-migrating parents and children whose either one or both parents migrated abroad in two weredas of southern Wollo, Ethiopia through the use of a stratified sampling method. Morover18 teachers were selected for an interview and focus group discussion to explore their perception of the influence of migration on the education and literacy of children. The results found that the mean score of LBC with parental migration was 15.86 (SD= 3.18) as compared to children living with intact families with a mean score of 12.06 (SD=3.20). The results of the study demonstrated that a significant mean difference was found between children of migrating parents and children living with both parents (F(1,620)= 219.25, p.01). Interview and FGD results also demonstrated that children experienced isolation, longing, sadness, and lack of motivation in schooling following their parents’ migration. To mitigate the problem families, government, and non-government organizations that have a stake in children's well-being and education that can be affected by migration should discharge their responsibilities accordingly. It is necessary to look at the hidden costs of parental migration on children left behind

Prevalence and associated factors of common mental disorders among Ethiopian migrant returnees from the Middle East and South Africa

Abstract Background Ethiopian migrants to the Middle East and South Africa experience a range of problems at various stages of their migration including overwork, sleep deprivation, denial of food, emotional abuse, difficulty adapting to the host culture, salary denial, sexual abuse, labor exploitation, confiscation of their travel documents, confinement, denial of medication, lack of access to legal service and degrading attitude by employers, traffickers and smugglers. These experiences can be associated with different types of mental disorders. This study sought to determine the prevalence of common mental disorders (CMD) and socio-demographic and other migration related associated factors among Ethiopian migrant returnees from the Middle East and South Africa. Method A cross-sectional study was conducted using non-probability (i.e. purposive, availability and snowball) sampling techniques. Migrant returnees (n = 1036) were contacted individually at their homes in eight high prevalent immigrant returnee locations in Ethiopia. Common mental disorders were assessed using the self-reporting questionnaire (SRQ-20) and a structured questionnaire was employed to collect data on socio-demographic and migration related characteristics. Data were analyzed using descriptive statistics, univariate logistic regression, and multivariable logistic regression. Results The prevalence of CMD among migrant returnees was found to be 27.6%. Highly prevalent specific CMD symptoms included headaches, poor appetite, being tired, sleeping problems, and feeling unhappy or nervous. Being originally from Amhara and Oromia regions, being Christian, being divorced, not receiving salary on time, not being able to contact family, unable to prepare for domestic labor abroad, lack of cross- cultural awareness, and lack of knowledge and skills for work were all important risk factors for CMD. Migrants experienced adversities at different stages of their migration which are associated with psychological distress and even to long term mental illnesses. Conclusions CMD symptoms were found to be prevalent among Ethiopian migrant returnees. As pre-migration factors are associated with CMD symptoms, pre-departure training could be useful to mitigate the risk factors. Creating and routinely arranging mental health interventions and rehabilitation services are advisable for returnees who are screened for, or diagnosed with, mental health problems

Additional file 1: of Prevalence and associated factors of common mental disorders among Ethiopian migrant returnees from the Middle East and South Africa

English version of the questionnaire developed to assess socio-demographic and migration related characteristics. (DOCX 29 kb

Shows the characteristics of selected articles on rk-39 test.

Shows the characteristics of selected articles on rk-39 test.</p

Developing interventions to improve detection of depression in primary healthcare settings in rural Ethiopia

Background The poor detection of depression in primary healthcare (PHC) in low- and middle-income countries continues to threaten the plan to scale up mental healthcare coverage. Aims To describe the process followed to develop an intervention package to improve detection of depression in PHC settings in rural Ethiopia. Method The study was conducted in Sodo, a rural district in south Ethiopia. The Medical Research Council's framework for the development of complex interventions was followed. Qualitative interviews, observations of provider–patient communication, intervention development workshops and pre-testing of the screening component of the intervention were conducted to develop the intervention. Results A multicomponent intervention package was developed, which included (a) manual-based training of PHC workers for 10 days, adapted from the World Health Organization's Mental Health Gap Action Programme Intervention Guide, with emphasis on depression, locally identified depressive symptoms, communication skills, training by people with lived experience and active learning methods; (b) screening for culturally salient manifestations of depression, using a four-item tool; (c) raising awareness among people attending out-patient clinics about depression, using information leaflets and health education; and (d) system-level interventions, such as supportive supervision, use of posters at health facilities and a decision support mobile app. Conclusions This contextualised, multicomponent intervention package may lead to meaningful impact on the detection of depression in PHC in rural Ethiopia and similar settings. The intervention will be pilot tested for feasibility, acceptability and effectiveness before its wider implementation

Schematic diagram showing a summary of the best estimates.

Schematic diagram showing a summary of the best estimates.</p