Trade facilitation in Ethiopia: the role of WTO accession in domestic reform

Ethiopia is one of the countries with excessive challenges in cross border trade. The high cost of doing business across borders in Ethiopia has become a major constraint. The focus of this article is trade facilitation which requires the examination of the dynamic gains associated with lowering trade transaction costs and identifying the relative importance of related trade policy reform measures in Ethiopia. In particular, the current state of the law and practice in trade facilitation and the international trading environment in Ethiopia are examined. The article focuses on customs law, border institutions, transport and logistics services and various issues related with investment and trade policy. In so doing, it attempts to examine how Ethiopia’s WTO Accession and trade facilitation instruments can be streamlined with domestic reform

Rethinking Ethiopia’s bilateral investment treaties in light of recent developments in international investment arbitration

International investment law is dynamic. As treaty practice and jurisprudence in the area constantly develop, global standards are always in the making. Rethinking Ethiopia’s Bilateral Investment Treaties (BITs) is thus a natural response to evaluate the status of the country’s obligations under the regime of global investment standards. This article briefly evaluates the concept of Most Favored Nation (MFN) treatment, in relation to the nature or purpose of MFN clauses and its interaction with dispute resolution provisions contained in BITs. In doing so, the article evaluates the different scenarios of ‘treaty shopping’ whereby an investor can possibly use BITs signed by Ethiopia and a state other than the investor’s home state, to benefit from treaty obligations entered by Ethiopia with other partners. A review of Ethiopian BITs indicate that in almost all of the BITs, the MFN clause is phrased in general terms and leaves leverage to raise competing interpretations and creating a matrix of obligations thereby stretching the country’s obligations under the respective agreements. This calls for revising the broad and incoherent application of the MFN standard contained in various BITs signed by Ethiopia with the aim to laying down a coherent investment treaty framework

Revisiting money and labor for valuing environmental goods and services in developing countries

Many Stated Preference studies conducted in developing countries provide a low willingness to pay (WTP) for a wide range of goods and services. However, recent studies in these countries indicate that this may partly be a result of the choice of payment vehicle, not the preference for the good. Thus, low WTP may not indicate a low welfare effect for public projects in developing countries. We argue that in a setting where 1) there is imperfect substitutability between money and other measures of wealth (e.g. labor), and 2) institutions are perceived to be corrupt, including payment vehicles that are currently available to the individual and less pron to corruption may be needed to obtain valid welfare estimates. Otherwise, we risk underestimating the welfare benefit of projects. We demonstrate this through a rural household contingent valuation (CV) survey designed to elicit the value of access to reliable irrigation water in Ethiopia. Of the total average annual WTP for access to reliable irrigation service, cash contribution comprises only 24.41 %. The implication is that socially desirable projects might be rejected based on cost-benefit analysis as a result of welfare gain underestimation due to mismatch of payment vehicles choice in valuation study.Comment: There is no difference between the previous version and the current version. This version is to link with the published version DO

A semi-parametric mixed models for longitudinally measured fasting blood sugar level of adult diabetic patients

Abstract Background At the diabetic clinic of Jimma University Specialized Hospital, health professionals provide regular follow-up to help people with diabetes live long and relatively healthy lives. Based on patient condition, they also provide interventions in the form of counselling to promote a healthy diet and physical activity and prescribing medicines. The main purpose of this study is to estimate the rate of change of fasting blood sugar (FBS) profile experienced by patients over time. The change may help to assess the effectiveness of interventions taken by the clinic to regulate FBS level, where rates of change close to zero over time may indicate the interventions are good regulating the level. Methods In the analysis of longitudinal data, the mean profile is often estimated by parametric linear mixed effects model. However, the individual and mean profile plots of FBS level for diabetic patients are nonlinear and imposing parametric models may be too restrictive and yield unsatisfactory results. We propose a semi-parametric mixed model, in particular using spline smoothing to efficiently analyze a longitudinal measured fasting blood sugar level of adult diabetic patients accounting for correlation between observations through random effects. Results The semi-parametric mixed models had better fit than the linear mixed models for various variance structures of subject-specific random effects. The study revealed that the rate of change in FBS level in diabetic patients, due to the clinic interventions, does not continue as a steady pace but changes with time and weight of patients. Conclusions The proposed method can help a physician in clinical monitoring of diabetic patients and to assess the effect of intervention packages, such as healthy diet, physical activity and prescribed medicines, because individualized curve may be obtained to follow patient-specific FBS level trends

Attitude and perceptions of local communities towards the conservation value of gibe Sheleko national park, Southwestern Ethiopia

The study assessed the attitude and perceptions of the local communities towards Gibe Sheleko National Park. The data was collected from three districts of Gurage Zone. Ten sample kebeles of the selected districts were selected by purposive sampling method based on the level interaction, distance from the park, and dependency on the park. The sample size of the respondents was 5% of the total households from each selected kebeles. Household survey, key informant interview, field observation, and focus group discussion were employed to collect the data. Data was analyzed by SPSS version 23 software. Descriptive statistics and Chi-square test were used to analysis major determinant factors for perception and attitude of the local communities. The perception and attitude of the local communities towards the conservation values of Gibe Sheleko National Park showed a significant difference in education level, sex of respondents, distance from the park, and land owning inside or adjoin the park. Therefore, it can be concluded that sex, distance of settlement from the park, academic level and land owning inside or adjoining the park were the major determinant factors that influence perception and attitude of the local communities. Attending high level of education, far proximity from the park and male communities better understood the importance of wildlife and park. Therefore, to encourage partnership with adjacent community and implement conservation measure and awareness creation for local communities by considering these factors that affect on the attitude and perception of local communities towards Gibe Sheleko National Park

Family Planning Knowledge, Attitude and Practice among Married Couples in Jimma Zone, Ethiopia

Background: Understanding why people do not use family planning is critical to address unmet needs and to increase contraceptive use. According to the Ethiopian Demographic and Health Survey 2011, most women and men had knowledge on some family planning methods but only about 29% of married women were using contraceptives. 20% women had an unmet need for family planning. We examined knowledge, attitudes and contraceptive practice as well as factors related to contraceptive use in Jimma zone, Ethiopia. Methods: Data were collected from March to May 2010 among 854 married couples using a multi-stage sampling design. Quantitative data based on semi-structured questionnaires was triangulated with qualitative data collected during focus group discussions. We compared proportions and performed logistic regression analysis. Result: The concept of family planning was well known in the studied population. Sex-stratified analysis showed pills and injectables were commonly known by both sexes, while long-term contraceptive methods were better known by women, and traditional methods as well as emergency contraception by men. Formal education was the most important factor associated with better knowledge about contraceptive methods (aOR = 2.07, p\u3c0.001), in particular among women (aOR(women )= 2.77 vs. aOR(men) = 1.49; p\u3c0.001). In general only 4 out of 811 men ever used contraception, while 64% and 43% females ever used and were currently using contraception respectively. Conclusion: The high knowledge on contraceptives did not match with the high contraceptive practice in the study area. The study demonstrates that mere physical access (proximity to clinics for family planning) and awareness of contraceptives are not sufficient to ensure that contraceptive needs are met. Thus, projects aiming at increasing contraceptive use should contemplate and establish better counseling about contraceptive side effects and method switch. Furthermore in all family planning activities both wives\u27 and husbands\u27 participation should be considered

The Burden of Internal Conflict on Expanded Programs on Immunization in Northwest Ethiopia: Implementation Science Study

AbstractBackground: Despite the rapid progress in immunization service delivery systems worldwide, populations in areas of conflict often have limited or no access to lifesaving vaccines. Hence, evidence generation and translation for context-specific strategies and tailored action would be important, before, during and after an acute humanitarian emergency.Aim: To explore factors affecting immunization service delivery during and after conflict among internally displaced communities in Northwest Ethiopia.Methods: Qualitative and quantitative (record review) methods were applied, phenomenological study design and in-depth interviews were applied to collect the lived experiences of participants in the affected areas. Transcribed and translated data were analyzed and thematized using open code software. A Twenty-four-month record review of quantitative data was analyzed descriptively using an excel sheet to develop immunization coverage trends for tracer antigens.Results: We found that the immunization program had seriously deteriorated during and after the conflict in the study area. The monthly EPI service report in the affected areas showed a decline with the lowest records in December and January when the internal conflict was peak. Security problems, displacement of health workers, destruction of health infrastructures, mixing of the displaced community in the host community and poor coordination among stakeholders and partners, clients having other emergent needs and shortages of resources were important factors for immunization services.Conclusion: Vaccination service delivery was found to have significantly declined in the study area. Security problems affected not only the service utilizers but also the service providers’ wing as well. Coordination of stakeholders and strong leadership systems are crucial in maintaining optimum vaccination service delivery even at the time of conflict. [Ethiop. J. Health Dev. 2021; 35(SI-3):39-48]Key words: Conflict, internally displaced, Immunization service

Implementation fidelity and challenges of optimal cold chain management in Assossa district health system, Benshangul-Gumuz region, Western Ethiopia

AbstractIntroduction: Preventive programs which have proven to be effective in clinical trials may not necessarily impact the health and wellbeing of the community unless they are implemented with fidelity. While cold chain is the backbone of immunization programs, limited studies exist to explain fidelity implementation which likely contributes to a lack of evidence-based instructional practices of cold chain management.Aim: This study aimed to explore the fidelity implementation and challenges of optimal cold chain management in the Benshangul-gumuz region.Methods: A qualitative approach was utilized to explore the underlying challenges to optimum implementation of cold chain management in Benshangul-gumuz region. Observational techniques and key informant interviews with 12 key-informants were conducted. Data was collected at all levels of the health system including, the regional health bureau, Ethiopian Pharmaceuticals Supply Agency hub, district health offices, Health centers, and health posts. Data analysis and interpretation was performed using the framework analysis approach. Open Code 4.02 software was used for analysis.Findings: This study identified three main themes including adherence to intervention, human resource development, and availability and use of resources. The findings also revealed that a significant number of the employees were not adhering to the optimal cold chain management guidelines. Staff development, availability and utilization of equipment and related finances were major fidelity implementation challenges of cold chain management.Conclusions: Across the health facilities under study, implementation fidelity of cold chain management was considered poor. Human resource development, proper allocation and effective management of logistics and related finance could facilitate optimal cold chain management practices, and efforts to save lives through delivery of safe and quality vaccines. [Ethiop. J. Health Dev. 2021; 35(SI-3):03-08]Keywords: Cold chain management, Implementation fidelity, Challenges, Ethiopi

Depression, anxiety and stress, during COVID-19 pandemic among midwives in ethiopia: A nationwide cross-sectional survey

IntroductionCOVID-19 has rapidly crossed borders, infecting people throughout the whole world, and has led to a wide range of psychological sequelae. Midwives who come close in contact with women while providing care are often left stricken with inadequate protection from contamination with COVID-19. Therefore, this study aimed to assess the level of depression, anxiety, and stress (DASS) among midwives in Ethiopia.MethodsA cross-sectional study was conducted from 20 June to 20 August 2020, among 1,691 practicing midwives in Ethiopia. A simple random sampling technique was used to select study participants. Data were collected through a structured telephone interview. A 21-item depression, anxiety, and stress scale (DASS-21) was used. Data were entered using the Google forms platform and were analyzed with SPSS version 24. Both bivariate and multivariable logistic regression analyses were employed. Variables with a p-value < 0.05 in the final model were declared statistically significant. Adjusted odds ratio (AOR) with the corresponding 95% confidence interval (95% CI) was used to determine independent predictors.ResultsThe prevalence of DASS among midwives in Ethiopia was 41.1, 29.6, and 19.0%, respectively. Being female [AOR = 1.35; 95% CI: 1.08, 1.69], working in rural areas [AOR = 1.39; 95% CI: 1.06, 1.82], having poor knowledge of COVID-19 [AOR = 1.40; 95% CI: 1.12, 1.75], having poor preventive practice [AOR = 1.83; 95% CI: 1.47, 2.28], and substance use [AOR = 0.31; 95% CI: 0.17, 0.56] were significantly associated with depression; while, working in the governmental health facility [AOR = 2.44; 95% CI: 1.24, 4.78], having poor preventive practice [AOR = 1,47; 95% CI: 1.16, 1.85], and having poor attitude [AOR = 2.22; 95% CI: 1.04, 1.66] were significantly associated with anxiety. Furthermore, working in rural areas [AOR = 0.57; 95% CI: 0.39, 0.83], substance use [AOR = 2.06; 95% CI: 1.51, 2.81], having poor knowledge [AOR = 1.44; 95% CI: 1.20, 1.90], and having poor preventive practice [AOR = 1.60; 95% CI: 1.23, 2.10] were associated with stress.ConclusionIn this study, the overall magnitude of depression, anxiety, and stress were high. Addressing knowledge gaps through information, training, and safety protocols on COVID-19 and the provision of adequate personal protective equipment (PPE) is essential to preserve the mental health of Midwives during COVID-19