Gender power relations in reproductive decision-making: The case of Gamo migrants in Addis Ababa, Ethiopia

In many developing countries most of reproductive decisions are made by men although it is, as well, the concern of women. This study was undertaken with the objective of assessing gender power relations in reproductive decision-making (DM). Data collected from random sample of 317 married couples using structured questionnaire. Multinomial logistic regression was used to find the determinants of reproductive DM. Accordingly, 33% of women reported joint contraceptive use DM; 36% of women and 38% of men reported joint maternal health service utilization (MHSU) DM. Women who are older, literate, have fewer children, media access, have job, and not victim of harassment/abuse participate in reproductive DM, while men who are literate, have fewer children, media access, older, and did not harass/abuse their wives let wives participate in MHSU DM. Thus, empowering the study community in general and women in particular is recommended to improve their participation in reproductive DM

Correlates of Unmet Need for Contraception in Ethiopia: Evidence from 2011 Ethiopian Demographic and Health Survey

The highest proportion of unmet need for contraception is found in sub-Saharan Africa. Although unmet need for contraception declined from 36% in 2000 to 25% in 2011 in Ethiopia, it is still far from satisfying the demand. The data for this study is obtained from the 2011 Ethiopian Demographic and Health Survey (EDHS). Multinomial logistic regression was used to identify correlates of unmet need for contraception. Accordingly, 18% of women have unmet need for spacing and 9.6% for limiting. Age, educational level, number of children and religion were significant correlates of unmet needs for spacing and limiting. In addition, place of residence was significant correlate for spacing while age at marriage and knowledge of contraceptives were significant correlates for limiting. Expanding contraceptive accessibility and methods mix in rural areas; empowering women; and engaging religious and community leaders in educating the community about family planning (FP) are recommendations to satisfy the demand of contraception

Factors Associated with Stunting among Pre-school Children in Southern Highlands of Tanzania

Stunting is a major public health problem in Africa and is associated with poor child survival and development. We investigate factors associated to child stunting in three Tanzanian regions. A cross-sectional two-stage cluster sampling survey was conducted among children aged 6-59 months. The sample included 1360 children aged 6-23 months and 1904 children aged 24-59 months. Descriptive statistics and binary and multivariate logistic regression analyses were used. Our main results are: in the younger group, stunting was associated with male sex (adjusted odds ratio [AOR]: 2.17; confidence interval [CI]: 1.52-3.09), maternal absence (AOR: 1.93; CI: 1.21-3.07) and household diet diversity (AOR: 0.61; CI: 0.41-0.92). Among older children, stunting was associated with male sex (AOR: 1.28; CI: 1.00-1.64), age of 4 and 5 (AOR: 0.71; CI: 0.54-0.95; AOR: 0.60; CI: 0.44-0.83), access to improved water source (AOR: 0.70; CI: 0.52-0.93) and to a functioning water station (AOR: 0.63; CI: 0.40–0.98) and mother breastfeeding (AOR: 1.97; CI: 1.18-3.29). Interventions that increase household wealth and improve water and sanitation conditions should be implemented to reduce stunting. Family planning activities and programmes supporting mothers during pregnancy and lactation can positively affect both newborns and older siblings

The burden of malnutrition and mortality in humanitarian emergencies : efficient use of health surveys from Ethiopia

Comprehensive analysis of the impact of humanitarian emergencies on nutrition and mortality is limited in Ethiopia. This is mainly due to either the lack of nationally representative data or non-generalizability of subnational health surveys in such settings. Consequently, humanitarian decisions and advocacy are often based on anecdotal information or non-representative data with limited geographical coverage. The aims of this study are therefore to investigate the burden of malnutrition and mortality, and to identify its causes in humanitarian settings. Given the data challenges, we apply advanced epidemiological methods in existing population-based health surveys. The key findings are: i) the burden of child undernutrition is declining, but are persistent and higher in moderate drought areas; ii) the burden of child mortality falls below both the emergency and baseline thresholds for sub-Saharan Africa; iii) the burden of women’s undernutrition is higher near the borders. On the basis of these findings, we provide propositions to guide effective humanitarian interventions.(SP - Sciences de la santé publique) -- UCL, 201

Child Wasting in Emergency Pockets: A Meta-Analysis of Small-Scale Surveys from Ethiopia

Child undernutrition is a major public health concern in Ethiopia (stunting national prevalence: 44%; wasting: 10%), despite the overall improvement in child health status during the last decade. Hundreds of small-scale surveys are conducted in Ethiopia’s emergency pockets under ENCU’s supervision. We reviewed the evidence from small-scale surveys conducted between 2008 and 2013 with two objectives: to provide a summary estimate of wasting prevalence from emergency pockets and to examine reasons for variation in prevalence estimates. We created a dataset by combining data from the Complex Emergency Database, the Famine Early Warning System Network and the Armed Conflict Location Event Data. We conducted a meta-analysis of small-scale surveys using a random effects model with known within-study heterogeneity. The influence of survey covariates on estimated prevalence was investigated with meta-regression techniques. We included 158 surveys in the analysis. A high degree of heterogeneity among surveys was observed. The overall estimate of wasting prevalence was 10.6% (95% CI 9.8–11.4), with differences among regions and between residents and refugees. Meta-regression results showed that vaccination coverage, child mortality, diarrhea prevalence and food insecurity are significantly associated with wasting prevalence. Child care and displacement status were not. Aggregated analysis of small-scale surveys provides insights into the prevalence of wasting and factors explaining its variation. It can also guide survey planning towards areas with limited data availability

Impact of disasters on child stunting in Nepal

BACKGROUND: Stunting is a major public health problem that results from inadequate nutritional intake over a long period of time. Disasters have major implications in poor and vulnerable children. The aim of this study was, therefore, to assess the impact of disasters on child stunting in Nepal. METHOD: A sample consisting of 2,111 children aged 6-59 months was obtained from the 2011 Nepal Demographic and Health Survey. We used bivariate and multivariate analyses to examine moderate and severe stunting against disaster, controlling for all possible confounders. RESULT: Out of the total study sample, 43% were stunted (17.1% severely and 25.9% moderately). The final model, after adjusting for confounders, showed that epidemics have no impact on child stunting (adjusted odds ratio [OR] =1.14, 95% confidence interval [CI]: 0.66, 1.97 and adjusted OR =1.04, 95% CI: 0.66, 1.65 for severe and moderate stunting, respectively). Floods have impact on child stunting (adjusted OR =0.57, 95% CI: 0.31, 0.96 and adjusted OR =0.66, 95% CI: 0.41, 0.94 for severe and moderate stunting, respectively). However, children aged 6-11 months, nonvaccinated children, children of working women, children who live in mountainous areas, and children from the poorest households were more likely to be moderately stunted. Similarly, children aged 36-47 months, Dalit and other ethnic groups, children from rural settings, and children from the poorest households were more likely to be severely stunted. CONCLUSION: This article illustrates the need to rethink about child stunting in Nepal. This study suggests need for further research, integration of disaster data in the Nepal Demography Health Survey, educational interventions, public awareness, promotion of vaccination, and equity in health service delivery

Food insecurity among low-income households in Addis Ababa, Ethiopia

With the rapid urbanization in developing countries, poverty and food insecurity are becoming increasing prevalent, posing a major challenge to urban areas. The COVID-19 pandemic induced job losses and reduced income combined with inflation have further exacerbated the household food insecurity situation, particularly in cities of low-income countries. Our study aims to assess the extent of food insecurity and its determinants among low-income household in Addis Ababa, Ethiopia. We conducted a community-based cross-sectional study among a sample of 578 households in Addis Ababa. We estimated the household food insecurity status using the Household Food Insecurity Access Scale (HFIAS). An ordinal logistic regression model was used to assess the relationship between household food insecurity status and the socioeconomic and demographic covariates. The STATA 14 software package was used for data analysis. We found that household food insecurity was prevalent among low-income households in Addis Ababa, with a prevalence rate of 92.4 % (95 % CI: 90.2–94.6 %). Of these households, 33.6 % (95 % CI: 29.7–37.4 %) were severely food insecure. To cope with the food shortage, households were forced to reduce their food quantity and quality. We also found that respondent's education, engagement in income generating activities, and household wealth were independently associated with household food insecurity. We conclude that although supporting people living below the poverty line (pro-poor) remains the top priority for social protection programs, adapting the program to accommodate the working poor (informal sector employees and casual workers) is crucial, especially during shocks

The humanitarian situation in syria: a snapshot in the third year of the crisis

Between April and June 2014, International Orthodox Christian Charities (IOCC), an International NGO, and the Greek Orthodox Patriarchate of Antioch and All the East (GOPA) conducted a needs assessment of Syrians affected by the crisis with the objective of gaining a better understanding of humanitarian needs and assistance priorities. Findings suggest that interventions that increase access to non-food items, food, medication and education should be prioritized where cost was the primary barrier to accessing goods and services. Cash transfer programs and direct provision of material assistance should be considered, though the most appropriate assistance modality is likely to vary by sector, location and the preferences and prior experience of donors and implementing organizations. Renewed international commitment to funding humanitarian assistance efforts in Syria and neighboring countries where the burden of refugees is greatest is essential from both a human rights perspective and in terms of maintaining stability in the region

Drought and child mortality: a meta-analysis of small-scale surveys from Ethiopia

Despite the intuitive connection between drought and mortality, we still lack a sound quantitative synthesis of evidence drawn from the available data. In this study, we estimate the pooled under-five death rates (U5DR) and assess the effect of drought on child death in Ethiopia. Small-scale mortality surveys were searched from the Complex Emergency Database and then aggregated spatially and temporally with drought exposure data from the Global Drought Monitor and food insecurity data from the Famine Early Warning Systems Network. A Bayesian Poisson meta-analysis was performed on 88 surveys conducted in Ethiopia between 2009 and 2014, consisting of 55,219 under-five children. The pooled U5DR was estimated at 0.323/10,000/day (95% credible interval, CrI: 0.254-0.397), which is below both the emergency and the baseline death rate thresholds of sub-Saharan Africa. We failed to find a plausible association between drought and U5DR. However, minimal food insecure areas showed elevated U5DR compared to stressed food insecure areas. Furthermore, the U5DR increases as the prevalence of acute malnutrition increases. Targeted interventions to improve the underlying causes of child malnutrition are crucial. Further, revising and updating the existing mortality thresholds, both the baseline and the emergency, is recommended.JRC.D.5-Food Securit