Gender Inequity in Higher Education in Ethiopia

Despite their recognizable role in the political arena and resultant gender mainstreamed policies, women in Ethiopia face day-to-day obstacles to ensure gender equity, and academia is no exception. In the past few decades, higher education in Ethiopia has rapidly expanded, resulting in increased enrollment of female students and faculty employment in various academic fields. Although the progress in the sector is highly promising, ensuring gender equality has still been a significant challenge. Several studies have revealed different barriers to women's academic, leadership, and research participation in higher educational institutions in Ethiopia

Women’s Health Research Working Group: A Mentorship Model to Increase Women’s Participation in Research

AbstractBackground: Female academia makes up only a fifth of all faculty at Addis Ababa University, where only a few are actively engaged in research. With a belief that dedicated mentorship could bring positive change in research participation, a female-to-female mentorship group was established at the College of Health Sciences. Objective: This study aimed to assess the effectiveness of mentorship in improving the research participation of young female academia from August 2016-April 2019. Methods: The implementation was instituted by establishing a female-only research working group to enhance the participation of young female faculty members who were newly employed in a relatively large number. The main interventions were the coupling of mentors and mentees based on their respective research areas for two hours’ weekly lunchtime and providing need-based training and life skill talks by exemplary women. We used a desk review and written testimonies of the Group to evaluate the effectiveness of the intervention. Results: Young academics of the Group started to author scientific articles while the mentors had increased their publication track. The Group won a competitive three-year research grant. from Addis Ababa University. Its visibility due to its research output has helped to attract more members and encouraged the establishment of other sister groups in the University. The Group has also received the best female research group award from the Ministry of Science and Higher Education. Conclusion: Female-to-female mentorship had helped researchers in their early careers to publish and won grants. This could be an exemplary intervention which only requires a commitment of staff time. [Ethiop. J. Health Dev. 2021; 35(SI-2):08-14]Keywords: Female faculty, Implementation research, Mentorship, Research working grou

Disrespect and abuse during pregnancy, labour and childbirth: a qualitative study from four primary healthcare centres of Amhara and Southern Nations Nationalities and People's Regional States, Ethiopia

Background: In Ethiopia, only 28% of all births occur at health facilities. Disrespect and abuse of women by health providers during pregnancy, labour and immediate postpartum is one of the main reasons that affect health care seeking from health facilities. This study explored disrespect and abuse of women using seven categories (Bowser D. and Hill K) including physical abuse, non-dignified care, non-consented care, non-confidential care, discrimination, abandonment care and detention at health facilities.Methods: We conducted a qualitative research in four health centres of Amhara and Southern Nations Nationalities and Peoples’ regional states between March and April 2014. Data were generated using in-depth interviews involving four midwives, 42 women (22 who delivered at the health facilities and another 20 who delivered at home) and eight focus group discussions involving 63 family members who accompanied labouring women to the health centres in the past three months before the study. The interview guides explored potentially abusive and disrespectful care and the perspectives of the participants towards such occurrences. Key themes were identified using phenomenological approach.Results: This study found that most women faced disrespectful care while few were abused during labour, delivery and immediate postpartum. Women who faced disrespect and abusive care during antenatal care reported to have avoided giving birth at health facilities. However, most women and their accompanying family members were found to have normalized non-dignified care (disrespect) and abuse as indicated by a participant "It is ok if a woman is mistreated, insulted, her consent is not asked or her privacy is violated as far as it is for the wellbeing of the delivering women and the newborn".Conclusion: These findings showed that disrespect and abuse at health facilities have negatively affected women’s care-seeking from health facilities for delivery. Normalization of disrespect and abuse by labouring women could be one reason for the continuation of the practice by providers. Facilitating community dialogue on respectful and compassionate care, improving client-professional relationships and ensuring functional grievance handling systems in health facilities should be given high priority to change the situation. [Ethiop. J. Health Dev. 2017; 31(3):129-137]Keywords: Disrespect and abuse, maternal health, pregnancy, labour, delivery, normalization, women and Ethiopi

‘I wanted to go, but they said wait’: Mothers’ bargaining power and strategies in careseeking for ill newborns in Ethiopia

Introduction To prevent the 2.6 million newborn deaths occurring worldwide every year, health system improvements and changes in care-taker behaviour are necessary. Mothers are commonly assumed to be of particular importance in care-seeking for ill babies; however, few studies have investigated their participation in these processes. This study explores mothers’ roles in decision making and strategies in care-seeking for newborns falling ill in Ethiopia. Methods A qualitative study was conducted in Butajira, Ethiopia. Data were collected during the autumn of 2015 and comprised 41 interviews and seven focus group discussions. Participants included primary care-takers who had experienced recent newborn illness or death, health care workers and community members. Data were analysed using thematic analysis. Results Choices about whether, where and how to seek care for ill newborns were made through cooperation and negotiation among household members. Mothers were considered the ones that initially identified or recognised illness, but their actual opportunities to seek care were bounded by structural and cultural constraints. Mothers’ limited bargaining power, contained by financial resources and gendered decision making, shaped their roles in care-seeking. We identified three strategies mothers took on in decision making for newborn illness: (a) acceptance and adaptation (to the lack of options), (b) negotiation and avoidance of advice from others, and (c) active care-seeking and opposition against the husband’s or community’s advice. Conclusion While the literature on newborn health and parenting emphasizes the key role of mothers in care-seeking, their actual opportunities to seek care are shaped by factors commonly beyond their control. Efforts to promote care-seeking for ill children should recognise that mothers’ capabilities to make decisions are embedded in gendered social processes and financial power structures. Thus, policies should not only target individual mothers, but the wider decision making group, including the head of households and extended family.publishedVersio

Transactional sex and HIV risk among adolescent schoolgirls in Ethiopia: Mixed method study

Background. Young people in Sub-Saharan Africa are affected by HIV pandemic to a greater extent than elsewhere. Transactional sex among adolescent school girls with older men commonly called “sugar daddies” is one of the major factors fueling the spread of the infection due to the extended sexual network. Thus, this study aimed to assess the magnitude and factors associated with transactional sex among adolescent girls and “sugar daddies” in relation to HIV/AIDS. Methods. Mixed method cross-sectional study was done among 620 female students in Hawassa town, South Ethiopia, from September 2010 to May 2011. A structured questionnaire and in-depth interview check list were used to collect the quantitative and qualitative data, respectively. Survey participants were selected randomly from five preparatory schools whereas ten in-depth interview participants were recruited by a snowball sampling technique from the same schools. Data were entered using Epi-Info and analyzed by SPSS. A descriptive statistics followed by multivariable logistic regression analyses were conducted to identify factors associated with transactional sex with “sugar daddy’’. Both crude and adjusted odds ratios with 95% confidence interval were reported. We used OpenCode software for coding and categorizing the in-depth interviews and quotes that represent the informants opinion were used to support the quantitative findings. Results. A substantial number of female students, 71(11.5%), reported to have had transactional sex with older men. Most of the respondents who dated “sugar daddies” (93%) had multiple sexual partners concurrently and sequentially, and among them, only 22.7% had consistent condom use. Girls who were in older age group [OR (CI) 6.87 (3.48-13.58)], who had lost both parents [OR (CI) 2.99 (1.14-7.84)], had perceived less economic status [OR: 25.41; 95% CI: 7.80-82.76] and engaged in substance abuse [OR (CO) 5.8 (2.1-15.77)] had higher odds of practicing transactional sex with “sugar daddies”. In-depth interviewed participants also revealed that they were involved in transactional sex for monetary while having concurrent and subsequent sexual network with their schoolmates and other young partners. Conclusion. Transactional sex among female students was high, and the sexual network they had with the young men put young people in the network at risk of HIV and other sexually transmitted infections. Therefore, HIV prevention programs shall focus on transactional sex among adolescent school girls to halt transmission of HIV among the generation

Selling my sheep to pay for medicines – household priorities and coping strategies in a setting without universal health coverage

Background: The first month of life is the period with the highest risk of dying. Despite knowledge of effective interventions, newborn mortality is high and utilization of health care services remains low in Ethiopia. In settings without universal health coverage, the economy of a household is vulnerable to illness, and out-of-pocket payments may limit families’ opportunities to seek health care for newborns. In this paper we explore intra-household resource allocation, focusing on how families prioritize newborn health versus other household needs and their coping strategies for managing these priorities. Methods: A qualitative study was conducted in 2015 in Butajira, Ethiopia, comprising observation, semi-structured interviews, and focus group discussions with household members, health workers, and community members. Household members with hospitalized newborns or who had experienced neonatal death were primary informants. Results: In this predominantly rural and poor district, households struggled to pay out-of-pocket for services such as admission, diagnostics, drugs, and transportation. When newborns fell ill, families made hard choices balancing concerns for newborn health and other household needs. The ability to seek care, obtain services, and follow medical advice depended on the social and economic assets of the household. It was common to borrow money from friends and family, or even to sell a sheep or the harvest, if necessary. In managing household priorities and high costs, families waited before seeking health care, or used cheaper traditional medicines. For poor families with no money or opportunity to borrow, it became impossible to follow medical advice or even seek care in the first place. This had fatal health consequences for the sick newborns. Conclusions: While improving neonatal health is prioritized at policy level in Ethiopia, poor households with sick neonates may prioritize differently. With limited money at hand and high direct health care costs, families balanced conflicting concerns to newborn health and family welfare. We argue that families should not be left in situations where they have to choose between survival of the newborn and economic ruin. Protection against out-of-pocket spending is key as Ethiopia moves towards universal health coverage. A necessary step is to provide prioritized newborn health care services free of charge.publishedVersio

The impact of introducing new vaccines on the health system: case studies from six low- and middle-income countries.

OBJECTIVE: We aimed to explore the impacts of new vaccine introductions on immunization programmes and health systems in low- and middle-income countries. METHODS: We conducted case studies of seven vaccine introductions in six countries (Cameroon, PCV;Ethiopia, PCV; Guatemala, rotavirus; Kenya, PCV; Mali, Meningitis A; Mali, PCV; Rwanda, HPV). Inter-views were conducted with 261 national, regional and district key informants and questionnaires were completed with staff from 196 health facilities. Routine data from districts and health facilities were gathered on vaccination and antenatal service use. Data collection and analysis were structured around the World Health Organisation health system building blocks. FINDINGS: The new vaccines were viewed positively and seemed to integrate well into existing health systems. The introductions were found to have had no impact on many elements within the building blocks framework. Despite many key informants and facility respondents perceiving that the new vaccine introductions had increased coverage of other vaccines, the routine data showed no change. Positive effects perceived included enhanced credibility of the immunisation programme and strengthened health workers' skills through training. Negative effects reported included an increase in workload and stock outs of the new vaccine, which created a perception in the community that all vaccines were out of stock in a facility. Most effects were found within the vaccination programmes; very few were reported on the broader health systems. Effects were primarily reported to be temporary, around the time of introduction only. CONCLUSION: Although the new vaccine introductions were viewed as intrinsically positive, on the whole there was no evidence that they had any major impact, positive or negative, on the broader health systems

Gender Difference in Research Productivity and its Associated factors in Addis Ababa University: a Cross-Sectional study

AbstractBackground: Gender equity movements have increased the number of women going to higher institutions. However, the number of women participating in research is limited in creating a critical mass. Objective: To assess the gender gap in research and its associated factors determinants among faculty at Addis Ababa University. Method: We conducted a cross-sectional study from October 2018 to March 2019 using a structured self-administered questionnaire. University faculty who was lecturers and above level who served the University for more than a year were invited to participate in the study. Faculty were approached by data collection facilitators with graduate degrees and the secretory of the respective departments. We used descriptive and multivariate statistical methods to analyse the data. Result: Of the 888 study participants, 161 (18.1%) females faculty participated in the study. It was found that three hundred ninety-seven male academics (54.6%) and 50 female academics (31.1%) had ever published articles in peer-reviewed journals (p<0.001). Male faculty were more likely to publish in peer-reviewed journals than their female counterparts [AOR and (95% CI) [2.55 (1.68, 3.86)]. Faculty with a rank of assistant professors and above [AOR (95% CI) 3.47(2.31, 5.21)], those who have a Ph.D. as highest degree [AOR (95% CI) 2.98 (2.11, 4.19) and those who have affiliation with other institutions [AOR (95% CI) 2.59 (1.98, 3.56)], were more likely to publish in peer-reviewed journals than their counterparts. Conclusion: Female faculty were less likely to be involved in research than men counterparts. The University needs to narrow the gender gap in research by designing and implementing an appropriate intervention strategy. [Ethiop. J. Health Dev. 2021; 35(SI-2):15-21]Keywords: Addis Ababa University, female faculty, gender difference, publication, researc

Experience of Research Undertaking among Women Academia at Addis Ababa University: a Qualitative Study

AbstractBackground: As a pioneer University in the Country, Addis Ababa University engages itself in collaborative and local research undertakings along with teaching, community engagements and technology transfer. Despite its long engagement in research, the participation of women academia in research is limited as manifested by their low research productivity in terms of publication in peer-reviewed scientific journals. However, the reasons for their low research participation are less known and needs further exploration. Objective: To explore the experience of research undertakings among women academia at Addis Ababa University. Method: We conducted an exploratory qualitative study using a phenomenological approach among women academia. Eight women who have been working in the University with a rank of a lecturer having at least two years participated in in-depth interviews. We used NVivo10 software to code and categorize the transcripts. Result: Our study revealed that only a few senior informants with more than 10 years of stay at the University had a better experience in applying for national and international research grants. Although all the participants said they had ever undertaken research, their publication track in peer-reviewed journals is limited. Social and economic factors, lack of networking, low salary and family responsibility, limited internet and library access, and lack of research skill among young faculty were raised as impediments to undertake research. Conclusion: This study has indicated that women in academia had limited research engagement in terms of grant application and publication in peer reviewed scientific journals. Balancing work and family life, low salary, lack of access to common University facilities were some of the challenges. While structural change ensures gender equality at a long time, addressing the gender gap in research is the responsibility of AAU. [Ethiop. J. Health Dev. 2021; 35(SI-2):22-29]Keywords: Addis Ababa University, experience of research, women in academi

Female Academic Career Development and Administrative Positions at Addis Ababa University: a Mixed-Method Study

AbstractBackground: In Ethiopia, the number of female in academia in general and in administrative positions and higher university ranks in specific is very small as compared to men. A slight change has been seen in recent years, where a few women have come to male-dominated administrative positions as university presidents, vice presidents, deans and directors with still insignificant increase in the number of full professors. Objective: This study assessed female faculty member's career development and involvement in administrative positions and explored challenges. Method: We used a sequential mixed-method study starting with a cross-sectional quantitative study among 888 faculty members. The quantitate data were analysed using descriptive statistics and regression models to identify independent predictors of administrative involvement using SPSS version 25 software. An exploratory qualitative study was done among eight purposively selected female faculty. NVivo10 data management software was used to code and categorize the transcripts. Result: We found that male faculty members were more likely to involve in administrative positions than their female counterparts [AOR (95%CI) 1.6(1.1, 2.4)]. Those who were provided housing facility by AAU [AOR (95%CI) 2.29 (1.61, 3.23)] and assistant professors and above [AOR (95%CI) 1.495 (1.01, 2.220)] were more likely to involve in an administrative position than their counterparts. The qualitative findings indicated that the low salary faculty earns, lack of networks and family responsibility have deterred females from taking administrative positions. Conclusion: Female faculty involvement in the university administrative position and career development is very low. Both structural and personal factors such as gender roles affected their professional enhancement in academic ranks and hence positions. Creating a conducive platform for female faculty development is recommended to increase their involvement in administrative positions. [Ethiop. J. Health Dev. 2021; 35(SI-2):30-39]Keywords: Addis Ababa University, administrative positions, career development, female academician, female facult