Review of Policy, Regulatory, and Organizational Frameworks of Environment and Health in Ethiopia

Background: Ethiopia produced its Environmental Health Situational Analysis and Needs Assessment (SANA) report in 2010 as part of the global endeavor to characterize and underscore the importance of connecting health and environment. The assessment methods used in SANA 2010 were updated, replicated and used in this SABNA. with a focus on air pollution, occupational safety and health, and climate change.Objectives: The purpose of the review was to examine national policies and identify gaps in regulations and organizational arrangements that determine Ethiopia’s ability to mitigate and eventually prevent the health impacts of air pollution, occupational hazards, and climate change.Methods: The national policy and regulatory documents were reviewed. Literature was identified through electronic searches. Hard copies of past reports and policies were reviewed whenever necessary. A semi-structured guideline was used to conduct in-depth interviews aimed at identifying gaps and needs.Results: The Constitution of Ethiopia has policy provisions related to air pollution, occupational safety and health (OSH), and climate change and health. Proclamation No. 300/2002 on Environmental Pollution Control specifies ambient air quality standards and allowable emissions. However, there were no documents that outlined the national or regional strategies that the ministries and agencies could adopt to translate existing policies, legal provisions, or guidelines for air pollution into practical programs. In the same way, a national OSH policy was lacking at the time this review was made on how occupational safety and health should be handled nationally or at lower governing levels as required by the International Occupation Safety and Health and Working Environment Convention No. 155/1981. Ethiopia is a signatory of this Convention.Conclusions and Recommendations: The results of the situational analysis indicate that there are cross-cutting gaps in the various sectors. Among these, addressing the critical shortage of skilled personnel is an urgent priority. Most stakeholders face acute shortages of professionals and poor retention mechanisms. It is therefore important toa) design interventions that focus on capacity building in, for example, aligning curricula with specific needs of ministries, andb) equip professionals with the necessary technical skills.In addition, the results indicate that policies and regulations exist in theory, but in practice, there are inadequate implementation strategies to encourage adherence and enforcement of the regulations and policies

Food security outcomes in agricultural systems models: Current status and recommended improvements

Improvement of food security is a common objective for many agricultural systems analyses, but how food security has been conceptualized and evaluated within agricultural systems has not been systematically evaluated. We reviewed the literature on agricultural systems analyses of food security at the household- and regionallevels, finding that the primary focus is on only one dimension of food security-agricultural output as a proxy for food availability. Given that food security comprises availability, access, utilization and stability dimensions, improved practice would involve more effort to incorporate food access and stability indicators into agricultural systems models. The empirical evidence base for including food access indicators and their determinants within agricultural systems models requires further development through appropriate short and longterm investments in data collection and analysis. Assessment of the stability dimension of food security (through time) is also particularly under-represented in previous work and requires the development and application of appropriate dynamic models of agricultural systems that include food security indicators, coupled with more formalized treatment of robustness and adaptability at both the regional and household levels. We find that agricultural systems models often conflate analysis of food security covariates that have the potential to improve food security (like agricultural yields) with an assessment of food security itself. Agricultural systems modelers should exercise greater caution in referring to analyses of agricultural output and food availability as representing food security more generally

Household food insecurity is associated with both body mass index and middle upper-arm circumference of mothers in northwest Ethiopia: a comparative study

Achenef Motbainor, Alemayehu Worku, Abera Kumie School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia Background: Food insecurity and associated malnutrition result in serious health problems in developing countries. This study determined levels of maternal undernutrition and its association with food insecurity in northwest Ethiopia. Materials and methods: This was a community-based comparative cross-sectional study conducted May 24–July 20, 2013. Multistage random sampling was used to select 4,110 samples. Availability of Ethiopia’s Productive Safety Net Programme was used for grouping the study areas. A food-security access scale developed by the Food and Nutrition Technical Assistant project was used to measure food security. Sociodemographic data were collected using a structured questionnaire. A binary logistic regression model was used to assess the association of food insecurity and maternal undernutrition. Results: From the total participants, 12.6% (95% confidence interval [CI] 11.6%–13.6%) had a body mass index (BMI) <18.5 kg/m2. Comparison of maternal undernutrition in the two study areas revealed 8.8% (95% CI 7.6%–10.2%) in the program area and 16.4% (95% CI 14.8%–18.1%) in nonprogram areas were undernourished. Severe food insecurity was ­significantly associated with BMI of mothers (adjusted odds ratios [AORs] 3.6 and 2.31, 95% CI 2.32–5.57 and 1.52–3.5, respectively) in both program and nonprogram areas. Mild (AOR 1.77, 95% CI 1.21–2.6) and moderate (AOR 1.6, 95% CI 1.18–2.16) food insecurity significantly associated with maternal undernutrition in nonprogram areas. In the same way, all forms of food insecurity significantly associated with maternal middle upper-arm circumference in both program and nonprogram areas. The odds of mothers who did not exercise decision-making practice on the household income was also 4.13 times higher than those who did (AOR 4.13, 95% CI 2.2–7.77) in the program area.Conclusion: Food insecurity significantly associated with both maternal BMI and middle upper-arm circumference in both study areas. Female authority also significantly associated with BMI of the mothers in the program area. Maternal nutrition-intervention programs should focus on women-empowerment strategies that enable them to decide on the income for household-nutrition provision. Keywords: food insecurity, undernutrition, BMI, MUAC, Ethiopia, food-security, maternal nutrition&nbsp

Effect of exclusive breastfeeding cessation time on childhood morbidity and adverse nutritional outcomes in Ethiopia: Analysis of the demographic and health surveys.

BackgroundThough exclusive breastfeeding (EBF) for the first six months is recommended, it remains a debatable issue in both developed and developing countries. Thus, this study investigated the effect of EBF cessation time on childhood morbidity and adverse nutritional outcome in Ethiopia.MethodsWe used the 2011 and 2016 Ethiopian Demographic and Health Surveys. The study involved 2,433 children under six months of age. Logistic regression model was applied to determine the effect of EBF cessation time on outcome variables. Population Attributable Fraction was calculated to evaluate the public health impacts of EBF termination in the population.ResultsDiscontinuing EBF at 0-3 months (adjusted odds ratio (AOR): 1.95, 95% confidence interval (CI): 1.08, 3.53)) and 4-6 months (AOR: 3.57, 95% CI: 2.19, 5.83) increased diarrhea occurrence compared to children who continued EBF up to 6 months. Children who had terminated EBF at 4-6 months had increased odds of fever (AOR: 1.73, 95% CI: 1.11, 2.68) and acute respiratory illnesses (ARIs) (AOR: 2.74, 95% CI: 1.61, 4.65). Cessation of EBF earlier than 4 months or between 4-6 months was associated with increased odds of having at least one childhood morbidity. Termination of EBF at 0-3 months and at 4-6 months were associated with increased occurrence of wasting (AOR: 2.32, 95% CI: 1.45, 3.74) and underweight (AOR: 2.30, 95% CI: 1.36, 3.91), respectively. Exclusive breastfeeding can avert 42% of diarrhea, 27% of ARI, 21% of fever, 26% of wasting and 23% of underweight burden among children under six months of age.ConclusionsTermination of EBF before six months was associated with increased occurrence of diarrhea, fever and ARIs. It was also linked with increased occurrence of childhood wasting and underweight. The finding emphasized EBF for the first six months to reduce childhood morbidity and adverse nutritional outcomes

Stunting Is Associated with Food Diversity while Wasting with Food Insecurity among Underfive Children in East and West Gojjam Zones of Amhara Region, Ethiopia.

Food insecurity has detrimental effects in protecting child undernutrition.This study sought to determine the level of child undernutrition and its association with food insecurity.A community based comparative cross-sectional study design involving multistage sampling technique was implemented from 24th of May to 20th of July 2013. Using two population proportion formula, a total of 4110 randomly selected households were included in the study. Availability of the productive safety net programme was used for grouping the study areas. A multiple linear regression model was used to assess the association between food insecurity and child malnutrition. Clustering effects of localities were controlled during analysis.Stunting (37.5%), underweight (22.0%) and wasting (17.1%) were observed in East Gojjam zone, while 38.3% stunting, 22.5% underweight, and 18.6% wasting for the West Gojjam zone. Food insecurity was significantly associated with wasting (β = - 0.108, P < 0.05).Food diversity and number of meals the child ate per day significantly associated with stunting (β = 0.039, P < 0.01) and underweight (β = 0.035, P < 0.05) respectively. Residential area was the significant predictor of all indices.The magnitude of child undernutrition was found to be very high in the study areas. Food insecurity was the significant determinant of wasting. Food diversity and number of meals the child ate per day were the significant determinants of stunting and underweight respectively. Child nutrition intervention strategies should take into account food security, dietary diversity, and carefully specified with regard to residential locations. Addressing food insecurity is of paramount importance

Level and determinants of food insecurity in East and West Gojjam zones of Amhara Region, Ethiopia: a community based comparative cross-sectional study

Abstract Background Food insecurity remains highly prevalent in developing countries and over the past two decades it has increasingly been recognized as a serious public health problem, including in Ethiopia. An emerging body of literature links food insecurity to a range of negative health outcomes and causes of a decline in productivity. The objectives of the present study were to determine the level of food insecurity in East Gojjam zone where the productive safety net program is available, and in West Gojjam zone where there is no program, and to identify the determinants of food insecurity in both East and West Gojjam zones of Amhara Region, Ethiopia. Methods Community based comparative cross-sectional study design was used from 24 May 2013- 20 July 2013. Multistage sampling technique was implemented. A total of 4110 randomly selected households in two distinct populations were approached to be included in the study. Availability and absence of the productive safety net program between the two study areas was used to categorize them as comparative groups; otherwise the two communities are comparable in many socio-cultural characteristics. The household food security access scale questionnaire, developed by the Food and Nutrition Technical Assistant Project, was used to measure food security level. Socio-demographic and other household level information were collected by using a structured questionnaire. The binary logistic regression model was used to assess factors associated with food insecurity. Results From the total 4110 households, 3964 (96.45 %) gave complete responses. The total prevalence of food insecurity was 55.3 % (95 % CI: 53.8, 56.8). To compare food insecurity levels between the two zones, nearly sixty percent, 59.2 % (95 % CI: 57 %, 61.4 %) of the East Gojjam and 51.3 % (95 % CI: 49.1 %, 53.5) of West Gojjam households were food insecure. Family size (2–4) (AOR = 0.641, 95 % CI: 0.513, 0.801), non-merchant women (AOR = 1.638, 95 % CI: 1.015, 2.643), household monthly income quartiles, 1st (AOR = 2.756, 95 % CI: 1.902, 3.993), and 2nd (AOR =1.897, 95 % CI: 1.299, 2.775) were the significant socio-demographic determinants in east Gojjam zone. Illiterate mothers (AOR = 1.388, 95 % CI: 1.011, 1.905), household monthly income quartiles, 1st (AOR = 3.110232, 95 % CI: 2.366, 4.415), 2nd (AOR =2.618, 95 % CI: 1.892, 3.622) and 3rd (AOR = 2.177, 95 % CI: 1.6911, 2.803) were the significant socio-demographic predictors in west Gojjam zone. Rural residential area (AOR = 3.201, 95 % CI: 1.832, 5.594) and (AOR = 2.425, 95 % CI: 1.79, 3.272), highland agro-ecology (AOR = 2.193, 95 % CI: 1.348, 3.569 and AOR = 3.669, 95 % CI: 2.442, 5.513) and lack of livestock (AOR = 1.553, 95 % CI: 1.160, 2.078 and AOR = 1.568 95 % CI: 1.183, 2.080) were significant environmental predictors in east and west Gojjam zones respectively. Conclusion Food insecurity is highly prevalent in both study areas; however, there are different predictor factors. Intervention strategies should give emphasis to women’s education, diversified income generating opportunities, and for each agro-ecological zone, mixed agriculture strategy

Comparing level of food insecurity between households with and without home gardening practices in Zege, Amhara region, North West Ethiopia: Community based study.

BackgroundGlobally, close to 1 billion people suffer from hunger and food insecurity. Evidence showed that prevalence of household food insecurity in Ethiopia is ranged from 25.5%-75.8%. Home gardening is one way to alleviate food insecurity. Hence, the study aimed to determine level of food insecurity and its associated factors between home gardening and non-home gardening household in Zegie, North west Ethiopia.MethodsCommunity-based study was conducted from February 10th-March 10th/2020. A total of 648 samples were included. First, 2142 total households who have 6-59 months of age children in the area identified and registered. Then, households categorized in to home garden practicing (1433) and non-home garden practicing (709). The calculated sample size, 324 for each group were selected using simple random sampling technique.ResultsThe overall prevalence of food insecurity was 38.1% (95% CI: 34.29-42.11%). Food insecurity was significantly higher in non-home gardening groups than their counter parts 45.5% (95% CI: 39.80-51.20%). Having primary education and above (AO = 1.89, 95% CI: 1.25-2.86%), wealth index; 2nd quantile (AOR = 0.44, 95% CI: 0.25-0.85%), 3rd quantile (AOR = 0.32, 95% CI: 0.17-0.62%) and 4th quantile (AOR = 0.27, 95% CI: 0.15-0.54%), dietary diversity (AOR = 1.83, 95% CI: 1.15-2.92%) and home garden practices (AOR = 1.57, 95% CI: 1.06-2.32%) were variables significantly associated with food insecurity.ConclusionFood insecurity in non-home garden practicing households is higher than practicing households. The local agriculture sector needs to emphasis and empowered households on home gardening practices to realize food security

Socio-demographic characteristics of the study participants (n = 3964) in East and West Gojjam zones of Amhara region, 2013.

<p>Socio-demographic characteristics of the study participants (n = 3964) in East and West Gojjam zones of Amhara region, 2013.</p