Perceived Impacts of Climate Change and Disaster Risk Management by Rural Communities in Ethiopia

In developing countries including Ethiopia changing pattern of rainfall, increasing temperature, recurrent drought, massive land degradation, and poor performance of agricultural sector contribute for failure to meet the growing demands for food for the rural communities and left dependent on foreign food aid and seasonal migration. This study aims at examining the perceived impacts of climate change and disaster risk management by rural communities in Ethiopia. Cross-sectional socio-economic data were used. Dejen district was purposively selected as it is highly susceptible to climate related problems. Stratified and snowball sampling techniques were employed to select a sample of 398 households. Household survey was employed to collect data on climate change impacts perceived by local communities. Focus group discussions were carried out using guiding questions and seasonal calendar. Key informant interviews were used to triangulate households\u27 perceived climate change impacts. Field observations were used to observe biophysical, economic, social, and institutional features of the district. The results indicate that crop pests, soil erosion, crop disease, frost, drought, flood, hailstorm, and erratic rainfall were the major contributing factor for the loss of 50,555 quintals of agricultural cops over the period 2009-2016. The community seasonal calendar indicate that erratic rainfall, hailstorm, dry period, flood, landslide, livestock disease, crop disease and pests, and human diseases were the major climatic events in the study areas of rural communities. The lowland households were more susceptible to climate change impacts. Policy priority should be given based on the agro-ecology and households livelihood assets vulnerability level

Institutions for irrigation water management in Ethiopia: Assessing diversity and service delivery

Irrigation systems cannot en sure the equitable distribution of water among users and sustainable operation and maintenance of the schemes without capable irrigation institutions. In Ethiopia, traditional institutions have emerged with the expansion of traditional irrigation schemes and most of them were established and operated on the initiative of the farmers. These often have very limited financial and technical capacities. Current trends show that developing infrastructure is the major concern in irrigation development efforts. However, managing the schemes is largely overlooked, particularly for externally initiated irrigation schemes. Operation and maintenance of the irrigation schemes, particularly those at tertiary levels, are commonly not well set and often neglected or left to farmers without building their capacities. The overarching objectives of the study were to: i) assess the nature and diversity of irrigation institutions in the study schemes; ii) evaluate existing institutions service delivery with respect to selected attributes and draw useful lessons; and iii) identify appropriate interventions. This study focused on 10 irrigation schemes located in four regional states of Ethiopia (Tigray, Amhara, Oromia and SNNP). Various approaches were used to generate data required for this study, such as household interview, transect walk and systematic observation, focus group discussion, key informant interviews and the review of existing literature. We clustered the study schemes as modern, semi-modern and traditional, using selected criteria (operation and maintenance service delivery, managing financial service delivery, level of inequity) to generate empirical evidence for evaluation of their performances. The results found two forms of irrigation institutions: irrigation water users associations (IWUA) and irrigation cooperatives or water committee. More than 30% of the irrigation schemes considered in the study, regardless of their typology, had no institution. Membership in the irrigation institution for traditional schemes was 100%, while the average membership both in modern and semi-modern schemes was about 70% of the respondents. This contrasts with the new proclamation in Ethiopia on IWUA which suggest mandatory membership for any water user in a scheme. Without exception bylaws were either not detailed enough to address scheme specific problems or not recorded at all. Ambiguity associated with these, and probably presence of non-member water users, deterred the decision-making processes and the enforcement of rules and regulations for water use, thus create opportunities for free riders. This also explains the reason for occasional conflict between irrigators and the inequity of water distribution within scheme. In many cases, irrigation institutions service delivery limited to operational management and other services, such as financial management, were not common even at those schemes where irrigation fee exists. Problems associated with a lack of empirical evidence as to what to pay for and how much to pay and the application of flat rate—regardless of the amount of irrigation water used, which is not measured—and crop types grown as currently practised will not act as an incentive for prudent water use. Establishing the amount and types of irrigation water fees will be an important step to finance irrigation schemes. Understanding this diversity and these gaps and tailoring actions to local conditions is vital efforts to improve the service delivery of irrigation institutions in Ethiopia. Secondly, the service required for the sustainable management of irrigation schemes and mechanisms to operate them needs to be standardized

Analysis of water delivery performance of smallholder irrigation schemes in Ethiopia: Diversity and lessons across schemes, typologies and reaches

Irrigation systems consist of three interdependent components involving: the irrigation scheme, the on-farm management and the organizations. The irrigation scheme refers to the infrastructure for water acquisition and distribution (water delivery). This study focused on water delivery performance of 10 smallholders irrigation schemes in four regions of Ethiopia, representing diverse water sources, distribution systems, command areas (50–6000 ha) and number of beneficiary farmers (233–500 farm households) and across agro-ecologies as represented by elevation ranges (1500–2725 masl). Relative irrigation supply (RIS), irrigation intensity (Ii), cropping intensity (CI), farm level adequacy (FLA), sustainability of irrigated land (SIL), and equity and field application efficiency were employed as performance indicators. The study involved focus group discussions, household surveys and measurements of water flow across selected points of water delivery systems during 2014/2015 cropping season. More than 300 sample farmers were selected randomly from different reaches (head, mid and tail) of the schemes and before the analysis the 10 irrigation schemes were clustered into three typologies (modern, semi-modern and traditional schemes) using seven comprehensive and weighted indicators. The result showed that irrigation typology developed in this study enabled to identify three relatively homogeneous irrigation schemes typologies: modern, semi-modern and traditional. There was apparent diversity of the study schemes in terms of indicators used. At typology level, as illustrated by the RIS, the highest amount of water was diverted for semi-modern schemes (RIS of 3.84); while the highest water delivery at farm relative delivery (FRD) was recorded for the modern schemes (FRD 2.21). Traditional schemes consistently showed lower value for both RIS and FRD. Regardless of their typologies, all study schemes suffer from mismatch of water demand and supply. The lower the RIS and FRD values, the stronger was the water supply disparities between irrigation reaches. Assessment of farmers’ perception on fairness of irrigation water delivery substantiate these arguments. Implicitly, it is important to track the fate of diverted excess water. Field observation and empirical evidences show divergent points of losses of excess water indicating focus areas of improved water conservation on smallholder irrigation schemes. For example the largest proportion of over supplied water (~100%) in the semimodern schemes and in traditional schemes was lost in the conveyance and distribution systems. For modern schemes water losses in the processes of conveyance was low (26%), while the significant proportion of water (76%) was lost on farm. In view of this evidence, we concluded that irrigation schemes in Ethiopia, regardless of their typology, have low water delivery performance. As every scheme has shown its own strength and weakness, concluding sustainability in terms of typology is misleading and this suggests that policy directions should be based on composite sustainability indices

'People have started to deliver in the facility these days': a qualitative exploration of factors affecting facility delivery in Ethiopia

Objectives To understand the recent rise in facility deliveries in Ethiopia. Design A qualitative study. Setting Four rural communities in two regions of Ethiopia. Participants 12 narrative, 12 in-depth interviews and four focus group discussions with recently delivered women; and four focus group discussions with each of grandmothers, fathers and community health workers. Results We found that several interwoven factors led to the increase in facility deliveries, and that respondents reported that the importance of these factors varied over time. The initial catalysts were a saturation of messages around facility delivery, improved accessibility of facilities, the prohibition of traditional birth attendants, and elders having less influence on deciding the place of delivery. Once women started to deliver in facilities, the drivers of the behaviour changed as women had positive experiences. As more women began delivering in facilities, families shared positive experiences of the facilities, leading to others deciding to deliver in a facility. Conclusion Our findings highlight the need to employ strategies that act at multiple levels, and that both push and pull families to health facilities

Early postnatal home visits: a qualitative study of barriers and facilitators to achieving high coverage

BACKGROUND: Timely interventions in the postnatal period are important for reducing newborn mortality, and early home visits to provide postnatal care are recommended. There has been limited success in achieving timely visits, and a better understanding of the realities of programmes is needed if improvements are to be made. METHODS: We explored barriers and facilitators to timely postnatal visits through 20 qualitative interviews and 16 focus group discussions with families and Health Extension Workers in four Ethiopian sites. RESULTS: All sites reported some inaccessible areas that did not receive visits, but, Health Extension Workers in the sites with more difficult terrain were reported to make more visits that those in the more accessible areas. This suggests that information and work issues can be more important than moderate physical issues. The sites where visits were common had functioning mechanisms for alerting workers to a birth; these were not related to postnatal visits but to families informing Health Extension Workers of labour so they could call an ambulance. In the other sites, families did not know they should alert workers about a delivery, and other alert mechanisms were not functioning well. Competing activities reducing Health Extension Worker availability for visits, but in some areas workers were more organized in their division of their work and this facilitated visits. The main difference between the areas where visits were reported as common or uncommon was the general activity level of the Health Extension Worker. In the sites where workers were active and connected to the community visits occurred more often. CONCLUSIONS: If timely postnatal home visits are to occur, CHWs need realistic catchment areas that reflect their workload. Inaccessible areas may need their own CHW. Good notification systems are essential, families will notify CHWs if they have a clear reasons to do so, and more work is needed on how to ensure notification systems function. Work ethic was a clear influencer on whether home visits occur, studies to date have focused on understanding the motivation of CHWs as a group, more studies on understanding motivation at an individual level are needed

Roles and Responsibilities in Newborn Care in four African Sites.

To explore roles and responsibilities in newborn care in the intra- and postpartum period in Nigeria, Tanzania and Ethiopia. Qualitative data were collected using in-depth interviews with mothers, grandmothers, fathers, health workers and birth attendants and were analysed through content and framework analyses. We found that birth attendants were the main decision-makers and care takers in the intrapartum period. Birth attendants varied across sites and included female relatives (Ethiopia and Nigeria), traditional birth attendants (Tanzania and Nigeria), spiritual birth attendants (Nigeria) and health workers (Tanzania and Nigeria). In the early newborn period, when the mother is deemed to be resting, female family members assumed this role. The mothers themselves only took full responsibility for newborn care after a few days or weeks. The early newborn period was protracted for first-time mothers, who were perceived as needing training on caring for the baby. Clear gender roles were described, with newborn care being considered a woman's domain. Fathers had little physical contact with the newborn, but played an important role in financing newborn care, and were considered the ultimate decision-maker in the family. Interventions should move beyond a focus on the mother-child dyad, to include other carers who perform and decide on newborn care practices. Given this power dynamic, interventions that involve men have the potential to result in behaviour change

Direct WIMP identification: Physics performance of a segmented noble-liquid target immersed in a Gd-doped water veto

We evaluate background rejection capabilities and physics performance of a detector composed of two diverse elements: a sensitive target (filled with one or two species of liquefied noble gasses) and an active veto (made of Gd-doped ultra-pure water). A GEANT4 simulation shows that for a direct WIMP search, this device can reduce the neutron background to O(1) event per year per tonne of material. Our calculation shows that an exposure of one tonne $\times$ year will suffice to exclude spin-independent WIMP-nucleon cross sections ranging from $10^{-9}$ pb to $10^{-10}$ pb.Comment: 17 pages, 5 figures. Version accepted for publication in JCA

Mortality and Disability-adjusted Life-years (DALYs) for common neglected tropical Diseases in Ethiopia, 1990 to 2015: evidence from the Global Burden of Disease Study 2015

Introduction: Neglected tropical diseases (NTDs) are important public health problems in Ethiopia. In 2013, the Federal Ministry of Health (FMOH) has launched a national NTD master plan to eliminate major NTDs of public health importance by 2020. Benchmarking the current status of NTDs in the country is important to monitor and evaluate the progress in the implementation of interventions and their impacts. Therefore, this study aims to assess the trends of mortality and Disability-adjusted Life-Years (DALY) for the priority NTDs over the last 25 years. Methods: We used the Global Burden of Disease (GBD) 2015 estimates for this study. The GBD 2015 data source for cause of death and DALY estimation included verbal autopsy (VA), Demographic and Health Surveys (DHS), malaria indicator surveys (MICS) and other disease specific surveys, Ministry of Health reports submitted to United Nations (UN) agencies and published scientific articles. Cause of Death Ensemble modeling (CODEm) and/or natural history models were used to estimate malaria and NTDs mortality rates. DALY were estimated as the sum of Years of Life Lost (YLL) due to premature mortality and Years Lived with Disability (YLD). Results: All NTDs caused an estimated of 6,293 deaths (95% uncertainty interval (UI): 3699 – 10,080) in 1990 and 3,593 deaths (95% UI: 2051 – 6178) in 2015, a 70% reduction over the 25 years. Age-standardised mortality rates due to schistosomiasis, STH and leshmaniasis have declined by 91.3%, 73.5% and 21.6% respectively between 1990 to 2015. The number of DALYs due to all NTDs has declined from 814.4 thousand (95% UI: 548 thousand–1.2 million) in 1990 to 579.5 thousand (95%UI: 309.4 thousand – 1.3 million) in 2015. Age-standardised DALY rates due to all NTDs declined by 30.4%, from 17.6 per 1000(95%UI: 12.5-26.5) in 1990 to 12.2 per 1000(95%UI: 6.5 – 27.4) in 2015. Age-standardised DALY rate for trachoma declined from 92.7 per 100,000(95% UI: 63.2 – 128.4) in 1990 to 41.2 per 100,000(95%UI: 27.4 – 59.2) in 2015, a 55.6% reduction between 1990 and 2015. Age-standardised DALY rates for onchocerciasis, schistosomiasis and lymphiatic filariasis decreased by 66.2%, 29.4% and 12.5% respectively between 1990 and 2015. DALY rate for ascariasis fell by 56.8% over the past 25 years. Conclusions: Ethiopia has made a remarkable progress in reducing the DALY rates for most of the NTDs over the last 25 years. The rapid scale of interventions and broader system strengthening may have a lasting impact on achieving the 2020 goal of elimination of most of NTDs. Ethiopia should strengthen the coverage of integrated interventions of NTD through proper coordination with other health programs and sectors and community participation to eliminate NTDs by 2020

Electroencephalographic Findings, Antiepileptic Drugs and Risk Factors of 433 Individuals Referred to a Tertiary Care Hospital in Ethiopia

Background: Little is known about the characteristics of electroencephalogram (EEG) findings in epileptic patients in Ethiopia. The objective of this  study was to characterize the EEG patterns, indications, antiepileptic drugs (AEDs), and epilepsy risk factors.Methods: A retrospective observational review of EEG test records of 433 patients referred to our electrophysiology unit between July 01, 2020 and  December 31, 2021.Results: The age distribution in the study participants was right skewed unipolar age distribution for both sexes and the mean age of 33.8 (SD=15.7) years. Male accounted for 51.7%. Generalized tonic clonic seizure was the most common seizure type. The commonest indication for EEG was  abnormal body movement with loss of consciousness (35.2%). Abnormal EEG findings were observed in 55.2%; more than half of them were Interictal epileptiform discharges, followed by focal/or generalized slowing. Phenobarbitone was the commonest AEDs. A quarter (20.1%) of the  patients were getting a combination of two AEDs and 5.2% were on 3 different AEDs. Individuals taking the older AEDs and those on 2 or more AEDs  tended to have abnormal EEG findings. A cerebrovascular disorder (27.4%) is the prevalent risk factor identified followed by brain tumor, HIV  infection, and traumatic head injury respectively.Conclusion: High burden of abnormal EEG findings among epileptic patients referred to our unit. The proportion of abnormal EEG patterns was  higher in patients taking older generation AEDs and in those on 2 or more AEDs. Stroke, brain tumor, HIV infection and traumatic head injury were  the commonest identified epilepsy risk factors