The Ethiopian Journal of Health Development: Retrospective Synopsis

No Abstrac

Public Health Optimism in the New Millennium

No AbstractsThe Ethiopian Journal of Health Development Vol. 21 (2) 2007: pp. 109-11

Cold chain status at immunisation centres in Ethiopia

Background: Child immunisation is among the most cost-effective ways of preventing premature child deaths, and the potency of vaccines, crucial for vaccine efficacy, is dependent on effective management of the cold chain at all levels of vaccine handling.Objective: To assess the status of the cold chain at peripheral vaccine stores in Ethiopia.Design: Institution based cross-sectional survey in two rural and one urban administrative areas were included in the study. Sixty seven health institutions providing static vaccination services were included in the study but cold chain system was assessed fully in only sixty four.Data were collected by interviewing health workers and by directly observing the cold chain equipment and records using structured forms.Results: Conditions of the cold chain system were described based on 64 of the 67 centres visited, three were excluded because of non-functioning cold chain. Complete temperature record was observed in 37(57.8%) of the centres. Thermometer was not available in four(6.3%) and thermometer reading was found to be outside the optimal range in another seven (10.9%) centres. Vaccine storage in the refrigerator was not proper in 47 (73.4%) centres. Majority of the centres had neither trained personnel nor budget for maintenance of the cold chain.Conclusion: There is a real danger of vaccines losing their potency at these centres even if they were potent on arrival. Relevant training for those handling the cold chain, improving the maintenance conditions of refrigerators and introduction of cold chain monitoring devises are recommended

Assessment of alcohol advertising practices in Ethiopia

Background: Alcohol advertising should be prepared with an appropriate sense of responsibility to the consumer public. In Ethiopia, some aspects of alcohol advertising practices contravene with standards.Objectives: To document alcohol advertising practices and explore perceptions about them in Ethiopia.Methods: A qualitative study was carried out in 2010, in the relevant institutions selected purposively from Addis Ababa: private media/advertising agencies, the Federal Ministry of Health (FMOH)/ Food, Medicine and Health Care Administration and Control Authority, Ethiopian Public Health Association (EPHA), Ethiopian Medical Association (EMA), the Ethiopian Youth and Sports Ministry (MYS), Addis Ababa University (AAU), Addis Continental Institute of Public Health (ACIPH), the Ethiopian Broadcast Authority (EBA) and a brewery. Data were generated using indepth, face-to-face interviews with 18 professionals from the nine institutions. Slightly differing interview guides were used according to nature of institutions; thematic analysis of the data on transcribed interviews was performed.Results: Alcohol advertising practices in Ethiopia contravene with fundamental principles of marketing for alcoholic beverages. Advertisers use misleading information about alcoholic drinks, employ people with questionable legal age and use imagery that could be particularly appealing to young audiences. Lack of audience segmenting mechanisms in the media coupled with other forms of promotion such as sponsorships expose, even the very young, to alcohol advertisements.Conclusions: The existing practice of alcohol advertising in the country is against the interest of the public. All concerned stakeholders should be considered in alcohol related policy formulation, implementation and monitoring

Impact of child mortality and fertility preferences on fertility status in rural Ethiopia

Objectives: To determine the effects of child mortality and fertility preference on fertility status in rural Ethiopia. Design: Case-referent where the cases were women with number of children ever born alive was less than five and controls were women with number of children ever born alive greater or equal to five. Setting: Butajira rural health project study base which is a field epidemiologic laboratory found 35 Kms south of the capital city of Ethiopia, Addis Ababa run by the Department of Community Health of Tikur Anbessa Medical Faculty. Main outcome measures: Fertility status measured by number of children ever born alive; death of a child or an infant is a predictor. Subjects: A total of 219 women with number of children ever born alive less than five and 899 women with number of children ever born alive greater or equal to five were included in the study. Results: Child mortality affected number of children ever born alive significantly (OR= 7.39, 95% CI: 4.62, 9.08). As the number of children died increased proportionally, there is a proportional increase in the risk of higher fertility (X2 for trend 4.92, d.f =4, p-value 0.02). Number of children desired before marriage, desire for more children and sex preference were not associated with increased fertility in this study. Of all the socio-demographic and reproductive variables, later age at first marriage and first birth showed lower number of children ever born alive with (OR= 1.82, 95 % CI: 1.24, 2.83) and (OR= 3.08, 95 % Cl: 2.03, 4.68) respectively. Breast-feeding duration of more than six months showed association with less number of children ever born alive (OR= 1.92, 95% CI: 1.30,2.80). Conclusion: The study finding implies high fertility status is strongly associated with child death and hence measures that curb child mortality are believed to decrease fertility status besides promoting child survival. East African Medical Journal Vol.81(6) 2004: 300-30

Health facility-based maternal death audit in Tigray, Ethiopia

Background: Maternal deaths are often unrecognized and improperly documented in the health system. Objective: To identify causes of maternal death occurring in hospitals and determine avoidability of maternal death. Methods: The study assessed each death for the cause and surrounding circumstances as well as avoidable factors, by reviewing two years patient and facility records and interviewing individuals who were involved in caring for the deceased. Data were collected between December 2005 and May 2006. Result: A total of 34 maternal deaths were identified in five public hospitals in Tigray over a period of two years, of which 12 (35.2%) were reported to have been avoidable. The leading causes of death were infection, haemorrhage and hypertensive disorders. Avoidable factors were mainly related to hospital service or medical factors such as lack of blood for transfusion, delay in transfusion, and inappropriate treatment. Lack of transportation and delayed careseeking also contributed to avoidable maternal deaths. The quality of medical records was very poor. Nearly 73.5% of maternal deaths were of rural residents and 20.5% of those who died were under the age of 18, which shows that young girls and rural residents carry significant maternal death risk. Conclusions: Maternal deaths are not properly documented in health facilities. Improper care led to avoidable maternal death. Improving care and information systems is crucial to making pregnancy safer and reducing maternal death.

Photodetachment of cold OH- in a multipole ion trap

The absolute photodetachment cross section of OH- anions at a rotational and translational temperature of 170K is determined by measuring the detachment-induced decay rate of the anions in a multipole radio-frequency ion trap. In comparison with previous results, the obtained cross section shows the importance of the initial rotational state distribution. Using a tomography scan of the photodetachment laser through the trapped ion cloud, the derived cross section is model-independent and thus features a small systematic uncertainty. The tomography also yields the column density of the OH- anions in the 22-pole ion trap in good agreement with the expected trapping potential of a large field free region bound by steep potential walls.Comment: Phys. Rev. Lett., in pres

Perceptions and attitude towards violence against women by their spouses: A qualitative study in Northwest Ethiopia.

Introduction: To stop violence against women by their spouses we need to understand how the specific society perceives and views such violence. Then and only then can we institute effective and acceptable strategy to tackle the problem.Objective: To assess community perceptions and attitude towards violence against women by their spouses Methods: We conducted a qualitative study using focus group discussions and in-depth interviews with women,family arbitrators, healthcare workers, psychosocial experts, victims and perpetrator of violence, and law enforcement bodies in Gondar town, Northwest Ethiopia. Data were analyzed thematically using the Open Code Software. Results: The normative expectation that conflicts are inevitable in marriage makes it difficult for society to reject violence. Acts of violence against women represent unacceptable behavior according to existing social and gender norms when there is no justification for the act and the act causes severe harm. There is considerable permissiveness of violent acts when the act is not regarded as wrong, there is socially acceptable premise, and the consequences are deemed mild. Marital rape is not understood well and there is less willingness to condemn it. Conclusions: We conclude that there is insufficient understanding of violence against women in its contemporary use and many people hold a non-disapproving stance regarding violence against women by their spouses calling for a culturally sensitive information, education and communication intervention. [Ethiop. J. Health Dev. 2010(1):39-45

Social Stratification, Diet Diversity and Malnutrition among Preschoolers: A Survey of Addis Ababa, Ethiopia

In Sub-Saharan Africa, being overweight in childhood is rapidly rising while stunting is still remaining at unacceptable levels. A key contributor to this double burden of malnutrition is dietary changes associated with nutrition transition. Although the importance of socio-economic drivers is known, there is limited knowledge about their stratification and relative importance to diet and to different forms of malnutrition. The aim of this study was to assess diet diversity and malnutrition in preschoolers and evaluate the relative importance of socioeconomic resources. Households with children under five (5467) were enrolled using a multi-stage sampling procedure. Standardized tools and procedures were used to collect data on diet, anthropometry and socio-economic factors. Multivariable analysis with cluster adjustment was performed. The prevalence of stunting was 19.6% (18.5–20.6), wasting 3.2% (2.8–3.7), and overweight/obesity 11.4% (10.6–12.2). Stunting, overweight, wasting and limited diet diversity was present in all social strata. Low maternal education was associated with an increased risk of stunting (Adjusted odds ratio (AOR): 1.8; 1.4–2.2), limited diet diversity (AOR: 0.33; 0.26–0.42) and reduced odds of being overweight (AOR: 0.61; 0.44–0.84). Preschoolers in Addis Ababa have limited quality diets and suffer from both under- and over-nutrition. Maternal education was an important explanatory factor for stunting and being overweight. Interventions that promote diet quality for the undernourished whilst also addressing the burgeoning problem of being overweight are needed

Age at first dose of measles vaccination in Ethiopia

Background: Although measles vaccination is recommended to be given at nine months of age in Ethiopia and in most of sub-Saharan Africa, no information is available about the age at which children actually receive their first dose of measles vaccine. This has important implications in terms of preventing infection and averting epidemics of measles. Objective: To determine the age at which Ethiopian children actually receive their first dose of measles vaccine. Design: Cross sectional study. Setting: All major vaccination facilities including private and non-governmental health facilities that were registered with the Addis Ababa city Administration Health Bureau. Subjects: A total of 17,674 records of children who received measles vaccination in health facilities were reviewed and in rural areas 615 children were surveyed over one year period September 2004 to August 2005. Results: In both the urban and the rural settings the median age of children at first dose of measles vaccination was nine months. In the rural areas only 19.8% of children had vaccination cards. Measles coverage by card and history in rural areas was 84.4%. Many children from the rural site received measles vaccination during supplemental immunisation activities (SIAs) rather than from routine vaccination programmes. Measles coverage significantly varies among sub-cities in Addis Ababa. Conclusion: Vaccination practices and measles coverage levels do not support delaying the first measles vaccine dose. Strengthening the routine vaccination programmes must receive priority before changing recommended age for the first dose of measles vaccine