Challenges of Retaining Skilled Employees, The Case of Eritrean Public Sector

This article uses the public sector in the sub-Saharan nation of Eritrea to illustrate how the problem of brain drain poses severe challenges to developing countries. Following its analysis of the views of 313 Eritrean public servants, the article comes to the conclusion that deteriorating economic conditions, lack of good governance and political instability are the major causes of the brain drain in developing countries. On that basis, the article suggests some policy implications as well as frontiers for possible future research

Calcium, Magnesium, Iron, Zinc and Copper, Compositions of Human Milk from Populations with Cereal and ‘Enset’ Based Diets

Backround: As breast milk is normally the only source of food in the early stages of life, the dietary levels of the essential elements in the milk of lactating mothers are significantly important. Ethiopia is a country of many nations and nationalities with distinct dietary habits. This variation in food habit may result in the variation of the nutritional quality of milk of lactating mothers who live in different part of the country, which in turn may affect the intake of nutrients by breast-fed infants. Therefore, a cross-sectional study of the levels of Ca, Mg, Fe, Zn and Cu in milk of mothers from societies with cereal and ‘enset’ based dietary habits was carried out to assess the influence of maternal diet on the levels of the elements in human milk.Methods: Milk samples were collected from 27 voluntary mothers in Jimma and in 18 rural areas of Welkite. Breast milk samples were collected within four days postpartum and the concentrations of the elements were determined by using FAAS.Results: Average concentrations (mg/L) of the elements determined in the milk of mothers from Jimma and rural Welkite respectively were: Ca (758 ± 107, 579 ± 168); Mg (22.6 ± 7.87, 30.5 ± 13.4); Fe (0.50 ± 0.08, 0.41 ± 0.17); Zn (2.3 ± 1.2, 2.49 ± 0.88) and Cu (0.28 ± 0.14, 0.16 ± 0.08).Conclusions: Milk samples from Jimma were found to have significantly higher levels of Ca and Cu than those of rural Welkite (P < 0.05). Breast milk Ca and Cu levels were thus found to be influenced by dietary intake.Keywords: Human milk, Ethiopia, Welkite, Jimma, Essential elements, ‘Teff’, ‘Enset’

Client and facility level determinants of quality of care in family planning services in Ethiopia: multilevel modelling

Over the last two decades, while contraceptive use has improved in Ethiopia, the contraceptive prevalence rate remains low. In addition to socio-demographic and cultural factors, the quality of care in Family Planning (FP) services is an important determining factor of FP utilization. However, little research exists on the determinants of quality of care in FP services in Ethiopia. This study aims to identify the client and facility level determinants of quality of care in FP services in Ethiopia.This study was based on the first Ethiopian Services Provision Assessment Plus (ESPA+) survey conducted in 2014. A total of 1247 clients nested in 374 health facilities were included in the analysis. Multilevel mixed-effects logistic regression modelling was conducted. The outcome variable, client satisfaction, was created using polychoric principal component analysis using eleven facets that reflect client satisfaction.The results showed that both client-level and facility-level factors were associated with quality of care in FP services in Ethiopia. At the client-level; provision of information on potential side effects of contraceptive method (AOR = 5.22, 95% CI: 2.13-12.80), and number of history and physical assessments (AOR = 1.19, 95% CI: 1.03-1.34) were positively associated with client satisfaction, whereas waiting times of 30 minutes to two hours (AOR = 0.11, 95% CI: 0.03-0.33) was negatively associated with client satisfaction. At the facility-level; urban location (AOR = 4.61, 95% CI: 1.04-20.58), and availability of FP guidelines/protocols for providers (AOR = 4.90, 95% CI: 1.19-20.19) had positive significant effect on client satisfaction.Quality improvement programs in FP services in Ethiopia should focus on shortening waiting times and provision of information about the potential side effects of contraceptive methods. It is also important to improve health providers' skills in thorough client history taking and physical assessment. Further distribution and implementation of best practice guidelines for providers working in the FP services must be a priority.Gizachew Assefa Tessema, Mohammad Afzal Mahmood, Judith Streak Gomersall, Yibeltal Assefa, Theodros Getachew Zemedu, Mengistu Kifle, Caroline O. Laurenc

Progress in Water, Sanitation and Hygiene (WASH) coverage and potential contribution to the decline in diarrhea and stunting in Ethiopia

Inadequate safe water supply and poor sanitation and hygiene continue to be important risk factors for diarrhoea and stunting globally. We used data from the four rounds of the Ethiopian Demographic and Health Survey and applied the new World Health Organization (WHO)/UNICEF Joint Monitoring Program (JMP) service standards to assess progress in water, sanitation and hygiene (WASH) coverage between 2000 and 2016. We also performed an age-disaggregated pooled linear probability regression analysis followed by a decomposition analysis to determine whether changes in WASH practices have contributed to the changing prevalence of diarrhoea and stunting in children under 5 years of age. We observed a significant increase in the coverage of safe drinking water and adequate sanitation facilities over the period. At the national level, the use of a basic water source increased from 18% in 2000 to 50% in 2016. Open defecation declined from 82% to 32% over the same period. However, in 2016, only 6% of households had access to a basic sanitation facility, and 40% of households had no handwashing facilities. The reduction in surface water use between 2000 and 2016 explained 6% of the decline in diarrhoea observed among children aged 0–5 months. In children aged 6–59 months, between 7% and 9% of the reduction in stunting were attributable to the reduction in open defecation over this period. Despite progress, improvements are still needed to increase basic WASH coverage in Ethiopia. Our findings showed that improvements in water and sanitation only modestly explained reductions in diarrhoea and stunting

Parthenium weed (Parthenium hysterophorus L.) research in Ethiopia: Investigation of pathogens as biocontrol agents

Parthenium is an exotic invasive weed that now occurs widely in Ethiopia. Surveys to determine the presence and distribution of pathogens associated with parthenium and further evaluation of the pathogens found as potential biocontrol agents were carried out in Ethiopia since 1998. Several fungal isolates of the genus Helminthosporium, Phoma, Curvularia, Chaetomium, Alternaria, and Eurotium were obtained from the seeds and other plant parts. However, all of the isolates tested were non-pathogenic except Helminthosporium isolates. The two most important diseases were the rust, Puccinia abrupta var. partheniicola and the phyllody, caused by a phytoplasma belonging to the species “Candidatus Phytoplasma aurantifolia”. Host specificity tests revealed that the rust, P. abrupta, only sporulates on parthenium while the phyllody infected parthenium, groundnut, sesame, grass pea, lentil, and chickpea. Suspected insect vectors were examined for phytoplasma infection by means of Polymerase Chain Reaction (PCR). The successful acquisition of phytoplasma’s by the leafhopper, Orosius cellulosus Lindberg (Cicadellidae), was determined by molecular detection of phytoplasma. Phytoplasma was also detected from a single bait plant after feeding by the leafhopper. Sequencing data from phytoplasma obtained from parthenium and the above mentioned crops was identical with sequence identities > 98%. The rust was commonly found at 1400 – 2500 m.a.s.l. with disease incidence up to 100% in some locations while phyllody was observed at 900 – 2300 m.a.s.l. with incidence up to 75%. Individual effects of the rust and phyllody diseases on Parthenium in different locations under field condition showed significant reduction on seed and morphological parameters. Seed production was reduced by 42 and 85% due to rust and phyllody, respectively

Differential Epigenetic Regulation of TOX Subfamily High Mobility Group Box Genes in Lung and Breast Cancers

Aberrant cytosine methylation affects regulation of hundreds of genes during cancer development. In this study, a novel aberrantly hypermethylated CpG island in cancer was discovered within the TOX2 promoter. TOX2 was unmethylated in normal cells but 28% lung (n = 190) and 23% breast (n = 80) tumors were methylated. Expression of two novel TOX2 transcripts identified was significantly reduced in primary lung tumors than distant normal lung (p<0.05). These transcripts were silenced in methylated lung and breast cancer cells and 5-Aza-2-deoxycytidine treatment re-expressed both. Extension of these assays to TOX, TOX3, and TOX4 genes that share similar genomic structure and protein homology with TOX2 revealed distinct methylation profiles by smoking status, histology, and cancer type. TOX was almost exclusively methylated in breast (43%) than lung (5%) cancer, whereas TOX3 was frequently methylated in lung (58%) than breast (30%) tumors. TOX4 was unmethylated in all samples and showed the highest expression in normal lung. Compared to TOX4, expression of TOX, TOX2 and TOX3 in normal lung was 25, 44, and 88% lower, respectively, supporting the premise that reduced promoter activity confers increased susceptibility to methylation during lung carcinogenesis. Genome-wide assays revealed that siRNA-mediated TOX2 knockdown modulated multiple pathways while TOX3 inactivation targeted neuronal development and function. Although these knockdowns did not result in further phenotypic changes of lung cancer cells in vitro, the impact on tissue remodeling, inflammatory response, and cell differentiation pathways suggest a potential role for TOX2 in modulating tumor microenvironment