Improving the Sustainability of Agriculture: Challenges and Opportunities

The agricultural practice is a foundation for all global development. Increasing its production and productivity may affect the land capacity in the future if not managed sustainably. Sustainable agriculture could be one way to preserve land use potential. However, several obstacles impede its implementation, such as high reliance on external inputs to boost short-term output, lack of innovative technology in developing countries, and climate change impacts. Despite these obstacles, a variety of tackling options have been proposed, like decreasing the excessive usage of artificial fertilizer and relying on locally available organic materials as sources of plant nutrients. Improving small-scale irrigation practices by managing their negative environmental effects in small-scale agriculture could also enhance sustainable agriculture. This chapter briefly overviews sustainable agriculture, its components, and the potential and obstacles to achieving overall sustainability in both developed and developing countries

Cost-effectiveness of facility-based, stand-alone and mobile-based voluntary counseling and testing for HIV in Addis Ababa, Ethiopia

Background: Globally, there is a consensus to end the HIV/AIDS epidemic by 2030, and one of the strategies to achieve this target is that 90% of people living with HIV should know their HIV status. Even if there is strong evidence of clients’ preference for testing in the community, HIV voluntary counseling and testing (VCT) continue to be undertaken predominantly in health facilities. Hence, empirical cost-effectiveness evidence about different HIV counseling and testing models is essential to inform whether such community-based testing are justifiable compared with additional resources required. Therefore, the purpose of this study was to compare the cost-effectiveness of facility-based, stand-alone and mobile-based HIV voluntary counseling and testing methods in Addis Ababa, Ethiopia. Methods: Annual economic costs of counseling and testing methods were collected from the providers’ perspective from July 2016 to June 2017. Ingredients based bottom-up costing approach was applied. The effectiveness of the interventions was measured in terms of the number of HIV seropositive clients identified. Decision tree modeling was built using TreeAge Pro 2018 software, and one-way and probabilistic sensitivity analyses were conducted by varying HIV positivity rate, costs, and probabilities. Results: The cost of test per client for facility-based, stand-alone and mobile-based VCT was USD 5.06, USD 6.55 and USD 3.35, respectively. The unit costs of test per HIV seropositive client for the corresponding models were USD 158.82, USD 150.97 and USD 135.82, respectively. Of the three models, stand-alone-based VCT was extendedly dominated. Mobile-based VCT costs, an additional cost of USD 239 for every HIV positive client identified when compared to facility-based VCT. Conclusion: Using a mobile-based VCT approach costs less than both the facility-based and stand-alone approaches, in terms of both unit cost per tested individual and unit cost per HIV seropositive cases identified. The stand-alone VCT approach was not cost-effective compared to facility-based and mobile-based VCT. The incremental cost-effectiveness ratio for mobile-based VCT compared with facility-based VCT was USD 239 per HIV positive case.publishedVersio

Proceeding Report of the 40th Anniversary of National Meteorological Agency, Official endorsement of the National Framework for Climate Services an International Scientific Conference

Ethiopia is located in the Horn of Africa within 3–15° N and 33–48° E, bordered by Eritrea to the north and northeast, Djibouti to the east, Sudan to the west, Kenya to the south, and Somalia to the south and east. It covers an area of about 1.14 million square kilometers. The country's topography consists of high and rugged plateaus and peripheral lowlands. Elevations in the country range from 160 meters below sea level (northern exit of the Rift Valley) to over 4600 meters above sea level (of northern mountainous regions). The highest mountains are concentrated on the northern and southern plateaus of the country. A large percentage of the country consists of high plateaus and mountain ranges, dissected by major rivers such as Blue Nile, Tekeze, Awash, Omo, Wabi Shebelle, etc. Overall, Ethiopia consists of 9 major rivers and 19 lakes. The Blue Nile, the chief headstream of the Nile, rises in Lake Tana in northwest Ethiopia. The meteorological observation started in the 1890s with few meteorological stations. In 1951, meteorological services were established as a small unit in the then Civil Aviation Department to render aeronautical services. Since then, meteorological observation has been expanding over Ethiopia. As the importance of meteorology was realized by other economic sectors, National Meteorological Services Agency (NMSA) was established by the Government Proclamation Number 201/1980. Besides, NMA started seasonal forecasting and advisory service in 1987 for three seasons, namely Belg (February - May), Kiremt (June-September), and Bega (October-January). The primary duty of NMA is to support all country's socio-economic developments by delivering climate services. Moreover, NMA has more than one thousand three hundred conventional Meteorological stations, three hundred automatic weather stations, five AWOS, three air pollution monitoring stations, three upper air stations, one radar, and eleven satellite receiver stations. The government of Ethiopia is determined to eradicate poverty and become a prosperous country by 2030. In this regard, addressing climate variability and change play a pivotal role in achieving this goal. To this effect, NMA is equipping with modern weather observing and monitoring capabilities and improving processing, analyzing, interpreting, and forecasting weather and climate capabilities at a high resolution and accuracy to meet the end-user's demands and effectively support all socio-economic developments of the country. NMA collaborates with all key stakeholders and partners through continuous engagement on climate services. The NFCS, endorsed during the NMA 40th Anniversary, is envisaged to strengthen collaborative co-production between climate services provider (NMA) and climate service beneficiaries institutions (MoWIE, EFCCC, MoA, MoH, and NDRMC). To commemorate its 40th anniversary, NMA has organized a conference with a theme of "Forty Years of Climate and Weather Services in Ethiopia" on May 25-26, 2021, at Skylight Hotel, Addis Ababa, Ethiopia. Generally, three main sessions were held during the conference. These include; Session one: panel discussion and opening ceremony; session two: presentations on the history of NMA and NFCS Ethiopia, official endorsement of NFSC Ethiopia, and certificate wards; and session three: parallel session of four groups and paper presentations on different thematic areas were made. The 40th anniversary was attended by ministers, commissioners, heads of organizations, and representatives from the WMO Africa regional office, international institutes representatives, experts from different organizations, lecturers, researchers, and NMA officials and staff. This document is proceedings of the 40th anniversary, including summaries of the opening session and the presentations

Epidemiology of rubella virus cases in the pre-vaccination era of Ethiopia, 2009–2015

Abstract Background Rubella is a common mild rash illness caused by rubella virus. The majority of infections occur in children and young adults. The infection is the cause of a serious birth defect known as Congenital Rubella Syndrome (CRS) when a woman acquires infection early in pregnancy. Ethiopia has not yet established rubella virus surveillance and has not yet introduced rubella vaccine into the routine immunization program. We characterize the epidemiology of laboratory confirmed rubella virus cases collected through measles surveillance from 2009 to 2015 to better understand the burden of the disease in the country. Methods A descriptive analysis was made to characterize rubella cases reported through the national measles case based surveillance system. The measles case definition was used to capture potential rubella cases. A suspected measles case was a person with generalized rash and fever with cough, or coryza or conjunctivitis. Those cases whose sera were negative for measles IgM antibodies were tested for rubella IgM antibody. A confirmed rubella case was a person who tested positive for rubella IgM. Only laboratory confirmed rubella cases were analyzed in this article. Results Between 2009 and 2015, a total of 28,284 serum/plasma samples were collected and tested for measles IgM antibody and 11,151 (39.4%) were found positive. A total of 17,066 measles IgM negative or indeterminate samples were tested for rubella virus IgM and 2615 (15.3%) were found positive during the same period. Of 2615 confirmed rubella cases, 52.2% were females. The age of confirmed cases ranged from one month to 42 years with a mean age of 7.3 years. Three-fourth of all confirmed rubella cases were aged less than 10 years. The number of laboratory confirmed rubella cases linearly increased from 83 in 2009 to 856 in 2013 but dropped to 222 and 319 in 2014 and 2015 respectively. Higher number of cases occurred in the hot dry season (January through June) and in the central and western part of Ethiopia with 127 lab-confirmed outbreaks in the study period. Conclusions Based on our analysis, rubella was found to be endemic throughout Ethiopia. Children below the age of 10 years were the most affected. The burden of rubella cases varied from year to year but had a seasonal peak in March. To better understand the magnitude of rubella prior to vaccine introduction, establishing rubella surveillance system, conducting sero-prevalence studies among child bearing age females and establishing CRS sentinel surveillance among young infants are critical

The psychosis treatment gap and its consequences in rural Ethiopia

Abstract Background The “treatment gap” (TG) for mental disorders, widely advocated by the WHO in low-and middle-income countries, is an important indicator of the extent to which a health system fails to meet the care needs of people with mental disorder at the population level. While there is limited research on the TG in these countries, there is even a greater paucity of studies looking at TG beyond a unidimensional understanding. This study explores several dimensions of the TG construct for people with psychosis in Sodo, a rural district in Ethiopia, and its implications for building a more holistic capacity for mental health services. Method The study was a cross-sectional survey of 300 adult participants with psychosis identified through community-based case detection and confirmed through subsequent structured clinical evaluations. The Butajira Treatment Gap Questionnaire (TGQ), a new customised tool with 83 items developed by the Ethiopia research team, was administered to evaluate several TG dimensions (access, adequacy and effectiveness of treatment, and impact/consequence of the treatment gap) across a range of provider types corresponding with the WHO pyramid service framework. Results Lifetime and current access gap for biomedical care were 41.8 and 59.9% respectively while the corresponding figures for faith and traditional healing (FTH) were 15.1 and 45.2%. Of those who had received biomedical care for their current episode, 71.7% did not receive minimally adequate care. Support from the community and non-governmental organisations (NGOs) were negligible. Those with education (Adj. OR: 2.1; 95% CI: 1.2, 3.8) and history of use of FTH (Adj. OR: 3.2; 95% CI: 1.9–5.4) were more likely to use biomedical care. Inadequate biomedical care was associated with increased lifetime risk of adverse experiences, such as history of restraint, homelessness, accidents and assaults. Conclusion This is the first study of its kind. Viewing TG not as a unidimensional, but as a complex, multi-dimensional construct, offers a more realistic and holistic understanding of health beliefs, help-seeking behaviors, and need for care. The reconceptualized multidimensional TG construct could assist mental health services capacity building advocacy and policy efforts and allow community and NGOs play a larger role in supporting mental healthcare

Antenatal care utilization and nutrition counseling are strongly associated with infant and young child feeding knowledge among rural/semi-urban women in Harari region, Eastern Ethiopia

There is a gap in evidence linking antenatal care (ANC) utilization, nutrition counseling, and knowledge of pregnant women about infant and young child feeding (IYCF), particularly in low-income settings. Therefore, this study aimed to identify the association between ANC follow-up and nutrition counseling with IYCF knowledge. A cross-sectional study was conducted among 390 pregnant women in the rural kebeles of the Harari region from January to June 2019. Data were collected using face-to-face interviews on tablet computers. Bivariate and multivariate logistic regression were employed. An adjusted odds ratio (with 95% CI) was used to determine the strength of association between IYCF knowledge with ANC follow-up and nutrition counseling by adjusting for educational status, occupation, gravida, and distance to the nearest health center. Overall, 54.4% [95% CI 49.2, 59.2] of currently pregnant women were knowledgeable about IYCF of which only 20% started ANC follow-up and 24.4% received nutrition counseling. Out of 288 multigravida women, only 51.4% had ANC follow-up during their last pregnancy. In the adjusted model, ANC follow-up during the current pregnancy (AOR 1.85, 95% CI 1.07–3.22), those who received nutrition counseling (AOR 1.92, 95% CI 1.09–3.38), literate in education (AOR 1.71, 95% CI 1.07–2.73), multigravida (AOR 1.96, 95% CI 1.12–3.43), and far from the nearest health center (AOR 0.95, 95% CI 0.93–0.97) were significantly associated with the mothers IYCF knowledge. Thus, health care providers should encourage mothers to attend ANC during pregnancy and provide nutrition counseling about the IYCF

Global, regional, and national burden of chronic kidney disease, 1990–2017 : a systematic analysis for the Global Burden of Disease Study 2017

Background Health system planning requires careful assessment of chronic kidney disease (CKD) epidemiology, but data for morbidity and mortality of this disease are scarce or non-existent in many countries. We estimated the global, regional, and national burden of CKD, as well as the burden of cardiovascular disease and gout attributable to impaired kidney function, for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. We use the term CKD to refer to the morbidity and mortality that can be directly attributed to all stages of CKD, and we use the term impaired kidney function to refer to the additional risk of CKD from cardiovascular disease and gout. Methods The main data sources we used were published literature, vital registration systems, end-stage kidney disease registries, and household surveys. Estimates of CKD burden were produced using a Cause of Death Ensemble model and a Bayesian meta-regression analytical tool, and included incidence, prevalence, years lived with disability, mortality, years of life lost, and disability-adjusted life-years (DALYs). A comparative risk assessment approach was used to estimate the proportion of cardiovascular diseases and gout burden attributable to impaired kidney function. Findings Globally, in 2017, 1·2 million (95% uncertainty interval [UI] 1·2 to 1·3) people died from CKD. The global all-age mortality rate from CKD increased 41·5% (95% UI 35·2 to 46·5) between 1990 and 2017, although there was no significant change in the age-standardised mortality rate (2·8%, −1·5 to 6·3). In 2017, 697·5 million (95% UI 649·2 to 752·0) cases of all-stage CKD were recorded, for a global prevalence of 9·1% (8·5 to 9·8). The global all-age prevalence of CKD increased 29·3% (95% UI 26·4 to 32·6) since 1990, whereas the age-standardised prevalence remained stable (1·2%, −1·1 to 3·5). CKD resulted in 35·8 million (95% UI 33·7 to 38·0) DALYs in 2017, with diabetic nephropathy accounting for almost a third of DALYs. Most of the burden of CKD was concentrated in the three lowest quintiles of Socio-demographic Index (SDI). In several regions, particularly Oceania, sub-Saharan Africa, and Latin America, the burden of CKD was much higher than expected for the level of development, whereas the disease burden in western, eastern, and central sub-Saharan Africa, east Asia, south Asia, central and eastern Europe, Australasia, and western Europe was lower than expected. 1·4 million (95% UI 1·2 to 1·6) cardiovascular disease-related deaths and 25·3 million (22·2 to 28·9) cardiovascular disease DALYs were attributable to impaired kidney function. Interpretation Kidney disease has a major effect on global health, both as a direct cause of global morbidity and mortality and as an important risk factor for cardiovascular disease. CKD is largely preventable and treatable and deserves greater attention in global health policy decision making, particularly in locations with low and middle SDI

Mapping inequalities in exclusive breastfeeding in low- and middle-income countries, 2000–2018

Exclusive breastfeeding (EBF)—giving infants only breast-milk for the first 6 months of life—is a component of optimal breastfeeding practices effective in preventing child morbidity and mortality. EBF practices are known to vary by population and comparable subnational estimates of prevalence and progress across low- and middle-income countries (LMICs) are required for planning policy and interventions. Here we present a geospatial analysis of EBF prevalence estimates from 2000 to 2018 across 94 LMICs mapped to policy-relevant administrative units (for example, districts), quantify subnational inequalities and their changes over time, and estimate probabilities of meeting the World Health Organization’s Global Nutrition Target (WHO GNT) of ≥70% EBF prevalence by 2030. While six LMICs are projected to meet the WHO GNT of ≥70% EBF prevalence at a national scale, only three are predicted to meet the target in all their district-level units by 2030

Land Use and Land Cover Change in the Bale Mountain Eco-Region of Ethiopia during 1985 to 2015

Anthropogenic factors are responsible for major land use and land cover changes (LULCC). Bale Mountain Eco-Region in Ethiopia is a biodiversity-rich ecosystem where such LULCC have occurred. The specific objectives of this study were to: (i) determine which LULC types gained or lost most as a result of the observed LULCC; (ii) identify the major drivers of the LULCC/deforestation; and (iii) assess the approximate amount of carbon stock removed as a result of deforestation during the study period. Remote sensing and GIS were used to analyze LULCC. Landsat images acquired in 1985, 1995, 2005, and 2015 were used. Additionally, data from the Central Statistics Agency on cropland expansion, and human and livestock population growth were analyzed and correlations were made. The results showed that forest lost 123,751 ha while farmland gained 292,294 ha. Farmland and urban settlement expansion were found to be major drivers of LULCC. Aboveground carbon stock removed from forest and shrubland was more than 24 million tons. In the future, allocation of land to different uses must be based on appropriate land use policies. Integrating biodiversity and ecosystem values for each land cover as per the UN Sustainable Development Goal (UN-SDG) 15.9 may be one of the mechanisms to limit unplanned expansion or invasion of one sector at the expense of another