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High enteric bacterial contamination of drinking water in Jigjiga city, Eastern Ethiopia 埃塞俄比亚东部吉吉加市饮用水高度肠道细菌污染
IF 0.6 4区 医学 Q4 Medicine Pub Date : 2016-01-01 DOI: 10.4314/EJHD.V30I3
Henok Sileshi Asfaw, M. Reta, F. Yimer
Background: The high prevalence of diarrheal disease among children and infants can be traced due to the use of unsafe water and unhygienic practices. The overall concept adopted for microbiological quality is that no water intended for human consumption shall contain Escherichia coli per 100 ml sample. Objective: The aim of this study was to assess household water handling and hygienic practices and to determine bacteriological quality of drinking water from different sources in Jigjiga city. Methods: A cross-sectional study was conducted to assess bacteriological quality of drinking water in Jigjiga city from May-August, 2013. Both simple random and convenient sampling techniques were applied to select 238 households to assess water handling and hygienic practices, and 125 water samples to assess bacteriological quality of drinking water respectively. The water samples were collected from household water container, pipeline, water reservoir, ‘ Beyollie ’, and main sources. Easily isolated bacteria called coliforms were used as indicator organisms of human and other animals’ fecal contamination status of drinking water. Data were summarized using descriptive and analytical statistics. Chi-square (χ2) and logistic regression tests were used and p<0.05 was considered as cut off value for statistical significance. Results: Overall, 71.2%(n=89) of water samples were contaminated by one or more bacterial species of E.coli , Shigella Sp, Salmonella Sp, and Vibrio sp. Particularly, 65(52%), 10(8%), 9(7.2%), and 8(6.4%) were contaminated by E.coli , Shigella sp, Salmonella sp, and Vibrio sp, respectively. On the other hand, 20% of the households and pipeline water samples had a fecal coliform count of 150 and above. Placement of water drinking utensils had a statistically significant association with illiterate education (p=0.01, AOR=5.47, 95% CI: (1.31, 22.78)) and male household head (p=0.02, AOR=2.11, 95% CI: (1.10, 4.05)). Conclusions: The majorities of drinking water sources were highly contaminated by Enterobacteriaceae . Regular bacteriological water quality control mechanisms need to be in place to ensure bacteriological safety of drinking water. [ Ethiop. J. Health Dev . 2016;30(3):118-128] Keywords: Contamination, drinking water, households, enteric bacteria, Jigjiga
背景:儿童和婴儿腹泻病的高流行率可追溯到使用不安全的水和不卫生的做法。对微生物质量所采用的总体概念是,供人类饮用的水每100毫升样品中不得含有大肠杆菌。目的:本研究的目的是评估吉吉加市家庭用水处理和卫生习惯,并确定不同来源的饮用水的细菌质量。方法:采用横断面法对2013年5 - 8月吉吉加市饮用水细菌质量进行评价。采用简单随机抽样和方便抽样两种方法,分别选取238户家庭进行水处理和卫生习惯评价,选取125个水样进行饮用水细菌质量评价。从家庭用水容器、管道、水库、“Beyollie”和主要水源中采集水样。被称为大肠菌群的易分离细菌被用作人类和其他动物的饮用水粪便污染状况的指示生物。采用描述性统计和分析性统计对数据进行汇总。采用χ2检验和logistic回归检验,p<0.05为有统计学意义的截断值。结果:总体而言,71.2%(n=89)的水样被大肠杆菌、志贺氏菌、沙门氏菌和弧菌中的一种或多种细菌污染,其中65例(52%)、10例(8%)、9例(7.2%)、8例(6.4%)被大肠杆菌、志贺氏菌、沙门氏菌和弧菌污染。另一方面,20%的家庭和管道水样的粪便大肠菌群数量在150及以上。饮水器具的放置与文盲教育程度(p=0.01, AOR=5.47, 95% CI:(1.31, 22.78))和男性户主(p=0.02, AOR=2.11, 95% CI:(1.10, 4.05))有统计学显著相关。结论:大部分饮用水源受到肠杆菌科细菌的高度污染。需要建立定期的细菌水质控制机制,以确保饮用水的细菌安全。[阿比西尼亚人。J.卫生发展。[关键词]污染,饮用水,家庭,肠道细菌,叮叮咚
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引用次数: 7
Review of Climate Change and Health in Ethiopia: Status and Gap Analysis. 埃塞俄比亚气候变化与健康审查:现状和差距分析。
IF 0.6 4区 医学 Q4 Medicine Pub Date : 2016-01-01
Belay Simane, Hunachew Beyene, Wakgari Deressa, Abera Kumie, Kiros Berhane, Jonathan Samet

Background: This review assessed Ethiopia's existing situation on issues related to the environment, climate change and health, and identifies gaps and needs that can be addressed through research, training, and capacity building.

Methods: The research was conducted through a comprehensive review of available secondary data and interviewing key informants in various national organizations involved in climate change adaptation and mitigation activities.

Results: Climate change-related health problems, such as mortality and morbidity due to floods and heat waves, vector-borne diseases, water-borne diseases, meningitis, and air pollution-related respiratory diseases are increasing in Ethiopia. Sensitive systems such as agriculture, health, and water have been affected, and the effects of climate change will continue to magnify without the right adaptation and mitigation measures. Currently, research on climate change and health is not adequately developed in Ethiopia. Research and other activities appear to be fragmented and uncoordinated. As a result, very few spatially detailed and methodologically consistent studies have been made to assess the impact of climate in the country. There has often been a lack of sufficient collaboration among organizations on the planning and execution of climate change and health activities, and the lack of trained professionals who can perform climate change and health-related research activities at various levels.

Conclusion: Firstly, there is a lack of organized structure in the various organizations. Secondly, there is inadequate level of inter-sectoral collaboration and poor coordination and communication among different stakeholders. Thirdly, there are no reliable policy guidelines and programs among organizations, agencies and offices that target climate change and health. Fourth, the existing policies fail to consider the gender and community-related dimensions of climate change. Fifth, the monitoring and evaluation efforts exerted on climate change and health activities are not strong enough to address the climate change and health issues in the country.

背景:本次审查评估了埃塞俄比亚在与环境、气候变化和健康有关的问题上的现状,并确定了可通过研究、培训和能力建设解决的差距和需求。方法:通过对现有二手数据的全面审查和对参与气候变化适应和减缓活动的各个国家组织的关键线人的访谈,进行了这项研究。结果:在埃塞俄比亚,与气候变化有关的健康问题,如洪水和热浪造成的死亡率和发病率、媒介传播疾病、水传播疾病、脑膜炎和与空气污染有关的呼吸系统疾病正在增加。农业、卫生和水等敏感系统受到了影响,如果不采取适当的适应和减缓措施,气候变化的影响将继续扩大。目前,埃塞俄比亚没有充分开展关于气候变化和健康的研究。研究和其他活动似乎是支离破碎和不协调的。因此,很少进行空间上详细和方法上一致的研究来评估该国的气候影响。在规划和执行气候变化和卫生活动方面,各组织之间往往缺乏充分的合作,而且缺乏能够在各级开展气候变化和卫生相关研究活动的训练有素的专业人员。结论:第一,各组织缺乏组织结构。第二,部门间合作水平不足,不同利益相关者之间的协调和沟通不足。第三,在以气候变化和健康为目标的组织、机构和办公室之间没有可靠的政策指导方针和方案。第四,现有政策没有考虑到气候变化的性别和社区相关方面。第五,对气候变化和卫生活动的监测和评价力度不够,不足以解决该国的气候变化和卫生问题。
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引用次数: 0
Economic impact of surgery cancellation in a general hospital, Iran 伊朗一家综合医院取消手术的经济影响
IF 0.6 4区 医学 Q4 Medicine Pub Date : 2016-01-01 DOI: 10.4314/EJHD.V30I2
N. Maimaiti, A. Rahimi
Abstract Background: Cancellation of surgical procedures creates a financial burden to health providers and patients. It also causes a potential emotional stress and a negative impact on perception of quality of care. It should be a priority to identify risks of surgery cancellations in view of modification to assure timely and efficient delivery of care. Objective: To identify and estimate costs borne by cancelation of elective surgeries in a general hospital. Methods: Data were collected from a general hospital of social security organization of Iran. In-patient medical records were reviewed for all patients scheduled for elective surgeries in a period of 1 year, starting from 21stof March 2011 to 20th of March 2012. The costing data were collected in 2014. Patients undergoing out-patient surgery and emergency surgical procedures were excluded from the study. Results: During the study period, 14,687 cases were scheduled to undergo inpatient elective surgical procedures. Of those 274 cases were cancelled, among the cancelled cases, 242 were cancelled during the preparation in the surgery ward and 32 cases were cancelled in operation room. The total cost of surgery cancellation was US$ 92, 049.0. Out of this: US$ 42,668.0 (46.4%) was related to bed expense; 32,363.0$US (35.1%) for direct costs related to resources and supplies; and US$ 16,569 (18.5%) was related to physician visits. Conclusion: The study demonstrated that cost of surgery cancelation was considerably high in the studied general hospital. More than half of the cost (62.1%) of surgery cancelation was due to avoidable reasons. [Ethiop. J. Health Dev. 2016;30(2):92-95] Keyword: Cost of illness; Cost of Cancelation; Direct Cost; Surgery Cancelation Cost.
背景:外科手术的取消给医疗服务提供者和患者带来了经济负担。它还会造成潜在的情绪压力,并对护理质量的感知产生负面影响。鉴于修改,应优先确定手术取消的风险,以确保及时有效地提供护理。目的:确定和估算综合性医院取消选择性手术的费用。方法:资料来源于伊朗某社会保障机构总医院。从2011年3月21日至2012年3月20日,对所有计划进行择期手术的患者的住院医疗记录进行了审查。成本数据收集于2014年。接受门诊手术和紧急外科手术的患者被排除在研究之外。结果:在研究期间,14,687例患者计划接受住院选择性外科手术。取消274例,其中手术病房准备取消242例,手术室取消32例。取消手术的总费用为92 049.0美元。其中:42,668.0美元(46.4%)与床位费用有关;32,363.0美元(35.1%)用于与资源和用品相关的直接成本;16,569美元(18.5%)与看医生有关。结论:本研究表明,在所研究的综合医院,手术取消费用相当高。手术取消费用的一半以上(62.1%)是由于可避免的原因。[阿比西尼亚人。[j]卫生发展,2016,30(2):92-95]关键词:疾病成本;取消费用;直接成本;手术取消费用。
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引用次数: 19
Occupational Health and Safety in Ethiopia: A review of Situational Analysis and Needs Assessment. 埃塞俄比亚的职业健康和安全:对情况分析和需求评估的审查。
IF 0.6 4区 医学 Q4 Medicine Pub Date : 2016-01-01
Abera Kumie, Tadesse Amera, Kiros Berhane, Jonathan Samet, Nuvjote Hundal, Fitsum G/Michael, Frank Gilliland

Background: The current rapid economic development has brought changes in workplaces in developing countries, including Ethiopia. The organization of occupational health and safety services is not yet resilient enough to handle the growing demands for workers' health in the context of industrialization. There is limited information on the gaps and needs of occupational health services in workplaces in Ethiopia.

Objectives: The present review article describes the existing profile of occupational safety and health services in Ethiopia and identifies the current gaps and needs in the services.

Methods: Secondary data sources were reviewed using a structured checklist to explore the status of occupational safety, health services and related morbidity. Local literature was consulted in order to describe the type and prevalence of work related hazards, patterns of industries and of workforce. Published articles were searched in Google, Google scholar, PUBMED, and HINARI databases. Relevant heads of stakeholder organizations and experts were interviewed to verify the gaps that were synthesized using desk review.

Results: Ethiopia is an agrarian country that is industrializing rapidly with a focus on construction, manufacturing, mining, and road infrastructure. An estimated work force of about two million is currently engaged in the public and private sectors. Males constitute the majority of this workforce. Most of the workforce has basic primary education. Commonly observed hazards in the workplace include occupational noise and dust of various types in manufacturing sectors and chemical exposures in the flower industry. Injury in both the agriculture and the manufacturing sectors is another workplace hazard commonly observed in the country. A lack of information made assessing workplace exposures in detail difficult. The prevalence of noise exposure was found to be high with the potential to seriously impact hearing capacity. Exposure to dust in textile and cement factories greatly exceeded international permissible limits. There is a high level of workplace injuries that often leads to an extended loss of productive working days. Occupational safety and health services were found to be inadequately organized. There is limited practice in exposure assessment and monitoring. This happens to be true despite the existing favorable environment in areas of policies and regulations.

Conclusion and recommendation: There is a severe scarcity of peer-reviewed literature related to workplace exposures and their impact on workplace health and safety. Limited adequately skilled manpower is available. The internal infrastructural capacity is weak and cannot help to identify and assess hazards in the workplace. Monitoring system and laboratory investigation is limited despite the presence of favorable policy and regulatory frameworks. Addressing these ga

背景:当前经济的快速发展给包括埃塞俄比亚在内的发展中国家的工作场所带来了变化。职业健康和安全服务的组织还没有足够的弹性来处理工业化背景下对工人健康日益增长的需求。关于埃塞俄比亚工作场所职业卫生服务的差距和需求的信息有限。目的:本审查文章描述了埃塞俄比亚职业安全和健康服务的现有概况,并确定了目前服务方面的差距和需求。方法:采用结构化检查表对二手数据来源进行审查,以了解职业安全、卫生服务和相关发病率的状况。查阅了当地文献,以便描述与工作有关的危害的类型和普遍程度、工业和劳动力的模式。在Google、Google scholar、PUBMED和HINARI数据库中搜索已发表的文章。采访了利益相关者组织的相关负责人和专家,以验证使用案头审查合成的差距。结果:埃塞俄比亚是一个快速工业化的农业国,重点发展建筑业、制造业、采矿业和道路基础设施。目前估计约有200万劳动力在公共和私营部门工作。男性占劳动力的大多数。大多数劳动力都受过基本的初等教育。工作场所常见的危害包括制造部门的各种职业噪音和粉尘以及花卉行业的化学品接触。农业和制造业部门的伤害是该国常见的另一种工作场所危害。由于缺乏信息,很难详细评估工作场所的暴露情况。噪音暴露的普遍程度很高,有可能严重影响听力。在纺织厂和水泥厂接触粉尘大大超过了国际允许的限度。工作场所伤害的发生率很高,经常导致长时间失去有生产力的工作日。发现职业安全和卫生服务组织不足。在暴露评估和监测方面的做法有限。尽管在政策法规方面存在着有利的环境,但这恰好是事实。结论和建议:与工作场所暴露及其对工作场所健康和安全的影响有关的同行评议文献严重缺乏。技术熟练的人力有限。内部基础设施能力薄弱,无法帮助识别和评估工作场所的危害。尽管存在有利的政策和监管框架,监测系统和实验室调查仍然有限。解决这些差距是当务之急。
{"title":"Occupational Health and Safety in Ethiopia: A review of Situational Analysis and Needs Assessment.","authors":"Abera Kumie,&nbsp;Tadesse Amera,&nbsp;Kiros Berhane,&nbsp;Jonathan Samet,&nbsp;Nuvjote Hundal,&nbsp;Fitsum G/Michael,&nbsp;Frank Gilliland","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The current rapid economic development has brought changes in workplaces in developing countries, including Ethiopia. The organization of occupational health and safety services is not yet resilient enough to handle the growing demands for workers' health in the context of industrialization. There is limited information on the gaps and needs of occupational health services in workplaces in Ethiopia.</p><p><strong>Objectives: </strong>The present review article describes the existing profile of occupational safety and health services in Ethiopia and identifies the current gaps and needs in the services.</p><p><strong>Methods: </strong>Secondary data sources were reviewed using a structured checklist to explore the status of occupational safety, health services and related morbidity. Local literature was consulted in order to describe the type and prevalence of work related hazards, patterns of industries and of workforce. Published articles were searched in Google, Google scholar, PUBMED, and HINARI databases. Relevant heads of stakeholder organizations and experts were interviewed to verify the gaps that were synthesized using desk review.</p><p><strong>Results: </strong>Ethiopia is an agrarian country that is industrializing rapidly with a focus on construction, manufacturing, mining, and road infrastructure. An estimated work force of about two million is currently engaged in the public and private sectors. Males constitute the majority of this workforce. Most of the workforce has basic primary education. Commonly observed hazards in the workplace include occupational noise and dust of various types in manufacturing sectors and chemical exposures in the flower industry. Injury in both the agriculture and the manufacturing sectors is another workplace hazard commonly observed in the country. A lack of information made assessing workplace exposures in detail difficult. The prevalence of noise exposure was found to be high with the potential to seriously impact hearing capacity. Exposure to dust in textile and cement factories greatly exceeded international permissible limits. There is a high level of workplace injuries that often leads to an extended loss of productive working days. Occupational safety and health services were found to be inadequately organized. There is limited practice in exposure assessment and monitoring. This happens to be true despite the existing favorable environment in areas of policies and regulations.</p><p><strong>Conclusion and recommendation: </strong>There is a severe scarcity of peer-reviewed literature related to workplace exposures and their impact on workplace health and safety. Limited adequately skilled manpower is available. The internal infrastructural capacity is weak and cannot help to identify and assess hazards in the workplace. Monitoring system and laboratory investigation is limited despite the presence of favorable policy and regulatory frameworks. Addressing these ga","PeriodicalId":11852,"journal":{"name":"Ethiopian Journal of Health Development","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5578617/pdf/nihms899327.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35370770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Strengthening the Link between Economic Development, Environment and Public Health. 加强经济发展、环境和公共卫生之间的联系。
IF 0.6 4区 医学 Q4 Medicine Pub Date : 2016-01-01
Damen Hailemariam
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引用次数: 0
Review of Policy, Regulatory, and Organizational Frameworks of Environment and Health in Ethiopia. 审查埃塞俄比亚环境与卫生的政策、规章和组织框架。
IF 0.6 4区 医学 Q4 Medicine Pub Date : 2016-01-01
Getnet Mitike, Achenef Motbainor, Abera Kumie, Jonathan Samet, Heather Wipfli

Background: Ethiopia produced its Environmental Health Situational Analysis and Needs Assessment (SANA) report in 2010 as part of the global endeavor to characterize and underscore the importance of connecting health and environment. The assessment methods used in SANA 2010 were updated, replicated and used in this SABNA. with a focus on air pollution, occupational safety and health, and climate change.

Objectives: The purpose of the review was to examine national policies and identify gaps in regulations and organizational arrangements that determine Ethiopia's ability to mitigate and eventually prevent the health impacts of air pollution, occupational hazards, and climate change.

Methods: The national policy and regulatory documents were reviewed. Literature was identified through electronic searches. Hard copies of past reports and policies were reviewed whenever necessary. A semi-structured guideline was used to conduct in-depth interviews aimed at identifying gaps and needs.

Results: The Constitution of Ethiopia has policy provisions related to air pollution, occupational safety and health (OSH), and climate change and health. Proclamation No. 300/2002 on Environmental Pollution Control specifies ambient air quality standards and allowable emissions. However, there were no documents that outlined the national or regional strategies that the ministries and agencies could adopt to translate existing policies, legal provisions, or guidelines for air pollution into practical programs. In the same way, a national OSH policy was lacking at the time this review was made on how occupational safety and health should be handled nationally or at lower governing levels as required by the International Occupation Safety and Health and Working Environment Convention No. 155/1981. Ethiopia is a signatory of this Convention.

Conclusions and recommendations: The results of the situational analysis indicate that there are cross-cutting gaps in the various sectors. Among these, addressing the critical shortage of skilled personnel is an urgent priority. Most stakeholders face acute shortages of professionals and poor retention mechanisms. It is therefore important to design interventions that focus on capacity building in, for example, aligning curricula with specific needs of ministries, andequip professionals with the necessary technical skills.In addition, the results indicate that policies and regulations exist in theory, but in practice, there are inadequate implementation strategies to encourage adherence and enforcement of the regulations and policies.

背景:埃塞俄比亚于2010年编写了环境卫生状况分析和需求评估报告,作为全球努力的一部分,以确定和强调将卫生与环境联系起来的重要性。2010年SANA中使用的评估方法被更新、复制并在本次SABNA中使用。重点关注空气污染、职业安全和健康以及气候变化。目标:审查的目的是审查国家政策,查明决定埃塞俄比亚减轻并最终防止空气污染、职业危害和气候变化对健康影响的能力的法规和组织安排方面的差距。方法:查阅国家相关政策和规范性文件。文献是通过电子检索确定的。有需要时,检讨过去的报告和政策的硬拷贝。采用半结构化准则进行深入访谈,以确定差距和需求。结果:埃塞俄比亚《宪法》有与空气污染、职业安全与健康(OSH)以及气候变化与健康有关的政策规定。《环境污染管制公告》第300/2002号订明环境空气质素标准及容许排放量。然而,没有文件概述了国家或区域战略,以便各部委和机构将现有的空气污染政策、法律规定或指导方针转化为实际方案。同样,在审查应如何按照《第155/1981号国际职业安全与健康及工作环境公约》的要求在国家或较低管理级别处理职业安全与健康问题时,也缺乏一项国家职业安全与健康政策。埃塞俄比亚是该公约的签署国。结论和建议:情景分析的结果表明,各个部门存在着跨领域的差距。其中,解决技术人员严重短缺的问题是一个紧迫的优先事项。大多数利益攸关方面临专业人员严重短缺和留住机制不佳的问题。因此,重要的是设计注重能力建设的干预措施,例如,使课程符合各部的具体需要,并使专业人员具备必要的技术技能。此外,研究结果表明,政策法规在理论上是存在的,但在实践中,没有足够的实施策略来鼓励法规和政策的遵守和执行。
{"title":"Review of Policy, Regulatory, and Organizational Frameworks of Environment and Health in Ethiopia.","authors":"Getnet Mitike,&nbsp;Achenef Motbainor,&nbsp;Abera Kumie,&nbsp;Jonathan Samet,&nbsp;Heather Wipfli","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Ethiopia produced its Environmental Health Situational Analysis and Needs Assessment (SANA) report in 2010 as part of the global endeavor to characterize and underscore the importance of connecting health and environment. The assessment methods used in SANA 2010 were updated, replicated and used in this SABNA. with a focus on air pollution, occupational safety and health, and climate change.</p><p><strong>Objectives: </strong>The purpose of the review was to examine national policies and identify gaps in regulations and organizational arrangements that determine Ethiopia's ability to mitigate and eventually prevent the health impacts of air pollution, occupational hazards, and climate change.</p><p><strong>Methods: </strong>The national policy and regulatory documents were reviewed. Literature was identified through electronic searches. Hard copies of past reports and policies were reviewed whenever necessary. A semi-structured guideline was used to conduct in-depth interviews aimed at identifying gaps and needs.</p><p><strong>Results: </strong>The Constitution of Ethiopia has policy provisions related to air pollution, occupational safety and health (OSH), and climate change and health. Proclamation No. 300/2002 on Environmental Pollution Control specifies ambient air quality standards and allowable emissions. However, there were no documents that outlined the national or regional strategies that the ministries and agencies could adopt to translate existing policies, legal provisions, or guidelines for air pollution into practical programs. In the same way, a national OSH policy was lacking at the time this review was made on how occupational safety and health should be handled nationally or at lower governing levels as required by the International Occupation Safety and Health and Working Environment Convention No. 155/1981. Ethiopia is a signatory of this Convention.</p><p><strong>Conclusions and recommendations: </strong>The results of the situational analysis indicate that there are cross-cutting gaps in the various sectors. Among these, addressing the critical shortage of skilled personnel is an urgent priority. Most stakeholders face acute shortages of professionals and poor retention mechanisms. It is therefore important to design interventions that focus on capacity building in, for example, aligning curricula with specific needs of ministries, andequip professionals with the necessary technical skills.In addition, the results indicate that policies and regulations exist in theory, but in practice, there are inadequate implementation strategies to encourage adherence and enforcement of the regulations and policies.</p>","PeriodicalId":11852,"journal":{"name":"Ethiopian Journal of Health Development","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5589201/pdf/nihms899379.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35390468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Indoor and Outdoor Air Pollution- related Health Problem in Ethiopia: Review of Related Literature. 埃塞俄比亚与健康有关的室内外空气污染问题:相关文献综述。
IF 0.6 4区 医学 Q4 Medicine Pub Date : 2016-01-01
Worku Tefera, Araya Asfaw, Frank Gilliland, Alemayehu Worku, Mehari Wondimagegn, Abera Kumie, Jonathan Samet, Kiros Berhane

Background: The health effects of air pollution are generally global problems, but they have, since recently become issues of particular concern for developing countries. This review assessed the situation of air pollution and related health effects in the context of Ethiopia.

Methods: The materials reviewed in this publication are published scientific papers from online search engines, unpublished government reports and academic theses/dissertations. In addition, interview data obtained from authorities and experts involved in the management of air quality were analyzed, interpreted and reported in the article.

Results: Review of the few studies conducted in Ethiopia showed that average concentrations of PM2.5 reached as high as 280 µg/m3 for 24-hour measurements (range: 2,417-12,739 µg/m3). Indoor carbon monoxide (CO) levels were universally higher than regulatory limits for the United States and were found to be much higher among households using traditional stoves and solid biomass fuels. The use of traditional stoves and solid biomass fuels was reported in >95% of the households considered. High average levels of NO2 (97 ppb) were reported in a large longitudinal study. The ambient PM10 level was below the WHO guideline values in the majority of the samples. About 50% of the on-road CO samples taken from traffic roads in Addis Ababa were found to be less than the guideline values while the number of motor vehicles in Ethiopia is reported to be increasing by more than 9% per annum. There is a very limited air quality monitoring capacity in the country. The co-ordination between stakeholders in this regard is also inadequate. The limited evidence available on health effects of air pollution indicates that the prevalence of acute respiratory illness among children living in households using crude biomass fuels is significantly higher than the national average figures.

Conclusion: The limited evidence reviewed and reported in this article indicates high levels of indoor air pollution and trends of worsening outdoor air pollution. This tentative conclusion carries with it the urgent need for more evidence-based research and capacity building in the areas of indoor and outdoor air pollution.

背景:空气污染对健康的影响通常是全球性的问题,但近年来已成为发展中国家特别关注的问题。本综述评估了埃塞俄比亚的空气污染状况及相关健康影响:本出版物所查阅的资料包括在线搜索引擎中已发表的科学论文、未发表的政府报告和学术论文/论文。此外,文章还对从参与空气质量管理的当局和专家处获得的访谈数据进行了分析、解释和报告:对埃塞俄比亚进行的少数几项研究的审查表明,24 小时测量的 PM2.5 平均浓度高达 280 µg/m3(范围:2,417-12,739 µg/m3)。室内一氧化碳 (CO) 含量普遍高于美国的监管限值,使用传统炉灶和固体生物质燃料的家庭的一氧化碳含量更高。据报告,超过 95% 的家庭使用传统炉灶和固体生物质燃料。据一项大型纵向研究报告,二氧化氮的平均水平较高(97 ppb)。大多数样本的环境 PM10 水平低于世界卫生组织的指导值。在亚的斯亚贝巴的交通道路上采集的路面 CO 样本中,约 50% 低于指导值,而据报告,埃塞俄比亚的机动车数量每年增长超过 9%。该国的空气质量监测能力非常有限。利益相关者之间在这方面的协调也不足。有关空气污染对健康影响的有限证据表明,使用粗生物质燃料的家庭中儿童急性呼吸道疾病的发病率明显高于全国平均水平:本文审查和报告的有限证据表明,室内空气污染严重,室外空气污染呈恶化趋势。这一初步结论表明,迫切需要在室内和室外空气污染领域开展更多循证研究和能力建设。
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引用次数: 0
Cesarean delivery practices in teaching public and non-government/private MCH hospitals, Addis Ababa. 亚的斯亚贝巴公立和非政府/私营妇幼保健教学医院的剖宫产做法。
IF 0.6 4区 医学 Q4 Medicine Pub Date : 2014-01-01 DOI: 10.4314/EJHD.V28I1
H. Aman, S. Negash, L. Yusuf
Background: Cesarean section is one of the skilled delivery interventions that have proven to be a life-saving procedure. It should be done under appropriate indications owing to the inherent short and long term complications and high cost. In Ethiopia, a study comparing the practice of cesarean sections in government and non-government hospitals has not been undertaken before. Objective: To describe and compare the practices of cesarean delivery in the teaching public and non-governmental MCH hospitals in Addis Ababa, Ethiopia. Methods : Retrospective cross-sectional study using the cesarean section data of 2011 G.C. from three teaching government and three private-MCH hospitals. The data was analyzed and the mean with standard deviation for continuous variables and proportions for categorical variables were used as descriptive statistics. Chi-square test was used to measure the strength of associations where appropriate, with level of significance set at p-value <0.05. Results: The difference in the proportion of cesarean delivery between the two groups was statistically significant, 31.1% and 48.3% (P<0.05) in the teaching government hospitals and the non-governmental hospitals, respectively. Non-government MCH hospitals contributed to one-third of the total deliveries and 40% of the cesarean sections. Non-reassuring fetal heart rate pattern, previous cesarean section scar, and cephalo-pelvic disproportion account for 51.3% and 59.6% of the indications in the teaching hospitals and non-governmental hospitals, respectively. When individual indications were analyzed between the two groups, previous cesarean section was higher in the non-governmental hospitals, 29.3% vs. 14.6%, (P<0.05), and non-reassuring fetal heart rate pattern frequented more in the teaching hospitals 26.3% vs. 17.8%,(P<0.05), contributed significantly. Maternal request per se contributed to 7.5% of the indication in the non-governmental hospitals compared to none in the teaching hospitals. Of the repeat cesarean sections, 70.3% were done merely for reasons of first cesarean section in non-governmental hospitals compared to 16.8% in the teaching (P<0.05). The proportion of low birth weight, post-term pregnancy and unknown date were seen more in the teaching hospitals compared to non-governmental hospital, (P<0.05). Though three dosing was the most frequently practiced prophylaxis in both study groups, there is a great deal of variability in the choice of antibiotics. Conclusion: The higher proportion of maternal morbidities/mortalities and poor peri-natal outcomes in the setting of higher proportion of emergency cesarean delivery in teaching government hospitals need further study to explore for factors that have contributed so as to improve the quality of care. The high rate of repeat cesarean delivery for one previous cesarean section scar and other non medical indications like maternal request in the non-government MCH hospitals elucidates the need to monitor the appropria
背景:剖宫产是一种熟练的分娩干预措施,已被证明是一种挽救生命的手术。由于其固有的短期和长期并发症和高费用,应在适当的适应症下进行。在埃塞俄比亚,以前从未对政府医院和非政府医院的剖宫产做法进行过比较研究。目的:描述和比较埃塞俄比亚亚的斯亚贝巴公立和非政府妇幼保健教学医院剖宫产的做法。方法:回顾性横断面研究3家公立教学医院和3家民营妇产医院2011年剖宫产资料。对数据进行分析,连续变量采用均数加标准差,分类变量采用比例法进行描述性统计。在适当的情况下,使用卡方检验来测量关联强度,显著性水平设置为p值<0.05。结果:两组间剖宫产比例差异有统计学意义,公立教学医院和民办医院剖宫产比例分别为31.1%和48.3% (P<0.05)。非政府妇幼保健医院接生的产妇占分娩总数的三分之一,剖宫产占40%。胎心不稳型、既往剖宫产疤痕、头盆腔比例失调分别占教学医院和民间医院指征的51.3%和59.6%。两组个体指征比较,民间医院剖宫产率较高,分别为29.3%比14.6% (P<0.05),教学医院非安心型胎心率较高,分别为26.3%比17.8% (P<0.05),差异有统计学意义。在非政府医院,产妇请求本身占了7.5%的指征,而在教学医院,这一比例为零。单纯因第一次剖宫产原因而再次剖宫产在民办医院占70.3%,在教学医院占16.8% (P<0.05)。教学医院低出生体重、早产、出生日期不详的比例高于民办医院(P<0.05)。虽然在两个研究组中,三次给药是最常用的预防方法,但在抗生素的选择上存在很大的差异。结论:在公立教学医院急诊剖宫产比例较高的情况下,产妇发病率/死亡率较高,围产儿结局较差,需要进一步研究探讨其影响因素,以提高护理质量。在非政府妇幼保健医院,有一次剖宫产疤痕和产妇要求等其他非医学指征的重复剖宫产率很高,说明有必要监测这些指征的适当性。我们还建议规范预防性抗生素的使用,扩大剖宫产术区域麻醉的使用。
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引用次数: 11
Lessons from the evolution of human resources for health in Ethiopia: 1941-2010 埃塞俄比亚卫生人力资源演变的经验教训:1941-2010年
IF 0.6 4区 医学 Q4 Medicine Pub Date : 2013-01-01 DOI: 10.4314/EJHD.V27I1
Yayehyirad Kitaw, G. Teka, H. Meche
Human resources for health (HRH) policy and planning is highly challenging in any setting but the more so in underdeveloped countries. Ethiopia has relatively vast and distinctive experience in accelerated training, use of substitute categories/task-shifting… from which important lessons could be drawn. Based on thorough analysis of documents (official, unofficial, government and others) and 1st hand experience of the authors, the paper explores the major issues in HRH development between 1941 – end of the Italian Occupation - and 2010 – end of the Health Sector Development Program (HSDP) III. The socio-cultural and economic context; development in education, higher education in particular and the general human resources development policy, strategy and plans in the successive periods are assessed briefly. Major developments of • Reconstruction and Basic Health Services Period (1941-1974) : the successive five-year plans; the training of orderlies/dressers, the 1st nursing schools, training abroad…; the Gondar Public Health College and the Gondar Team; the beginnings of medical education … • Primary Health Care Period (1974-1991) the Ten Years Perspective Health Plan; the training of Community Health Workers - Community Health Agents and Trained Traditional Birth Attendants -, nurse practitioners, health assistants; discontinuation of the health officers (HO) training, the initiation of Jimma College of Health Sciences and of post-graduate training in medicine at the Faculty of Medicine Addis Ababa University… • Sector-Wide Approach Period (1991-2010) the Health Sector Development Programs I-III, the reintroduction of Health Officers training, the accelerated training/‘Flooding Strategy’, Health Extension Workers, retention/‘Brain-Drain’ of health workers… are explored in some depth and lessons drawn for future HRH development in the country. The conclusions underscore the laudable efforts in all periods but difficulties of learning from the past; the continued very low workforce density and the highly skewed distribution; the recurring challenges of sustained human resources development – quality, motivation, retention… - of the task-shifting and accelerated training attempts and the need to develop specific HRH policy and strategy.
卫生人力资源政策和规划在任何情况下都极具挑战性,但在不发达国家更是如此。埃塞俄比亚在加速培训、使用替代类别/任务转移等方面具有相对丰富和独特的经验,从中可以吸取重要的教训。基于对文件(官方、非官方、政府和其他)的深入分析和作者的第一手经验,本文探讨了1941年(意大利占领结束)至2010年(卫生部门发展计划(HSDP) III结束)期间卫生保健发展的主要问题。社会文化和经济背景;简要评价了教育的发展,特别是高等教育的发展以及其后各时期的一般人力资源发展政策、战略和计划。重建和基本保健服务时期(1941-1974年)的主要发展:连续的五年计划;护理员/化妆师的培训,第一所护理学校,出国培训……冈达尔公共卫生学院和冈达尔团队;初级保健期(1974-1991年)十年远景保健计划;培训社区保健工作者——社区保健代理人和训练有素的传统助产士——、执业护士、保健助理;停止卫生官员培训,开办吉马卫生科学学院,并在亚的斯亚贝巴大学医学院开展医学研究生培训。•全部门办法期(1991-2010年)卫生部门发展方案1- 3,重新开展卫生官员培训,加速培训/ "洪水战略",卫生推广工作者;深入探讨了卫生工作者的保留/ "人才流失"问题,并为该国今后的卫生保健发展吸取了经验教训。结论强调了所有时期值得赞扬的努力,但也强调了从过去吸取教训的困难;劳动力密度持续偏低,分布高度倾斜;持续人力资源开发的反复出现的挑战- -质量、动机、保留……- -任务转移和加速培训的尝试以及制定具体人力资源政策和战略的必要性。
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引用次数: 10
Risk factors of neonatal mortality in Ethiopia. 埃塞俄比亚新生儿死亡的危险因素。
IF 0.6 4区 医学 Q4 Medicine Pub Date : 2013-01-01 DOI: 10.4314/EJHD.V27I3
N. Wakgari, E. Wencheko
Abstract Background: An understanding of risk factors related to neonatal mortality is important to guide the development of focused and evidence-based health interventions to reduce neonatal deaths. Objective: This study aimed to identify risk factors of neonatal mortality in Ethiopia. Methods: The data source for the study was the 2011 Ethiopian Demographic and Health Survey. The survival information of a total of 8,651 live-born neonates born five years before the survey was examined. Stratified Cox-proportional hazards model was employed to identify risk factors associated with neonatal deaths. Results: About 71% of the neonatal deaths occurred within the first week after birth and, the cumulative death rate reached 79% in the second week. The estimated hazard ratios of mortality were higher for twins or multiple births (HR=3.73, 95% CI: 2.81-4.94), first order birth (HR=1.68, 95% CI: 1.25-2.24), male sex (HR=1.26, 95% CI: 1.06-1.50), birth interval shorter than 24 months (HR=1.63, 95% CI:1.31-2.03), very small and vary large size neonates born to mothers younger than 20 years of age and above 34 years (HR=1.38, 95% CI:1.05-1.82) and (HR=1.32, 95% CI 0.06-2.80), respectively, and neonates whose mothers had a history of pregnancy complications (HR=1.73, 95% CI: 1.27-2.24) compared to their respective counterparts. The risk of dying was lower for neonates whose mothers attended antenatal visits (HR=0.72, 95% CI: 0.59-0.89) and neonates put to breast immediately upon birth (HR=0.83, 95% CI: 0.59-0.99). Conclusion: Public health interventions directed at reducing neonatal death should address the demographic factors mentioned above and maternal health services. [Ethiop. J. Health Dev. 2013;27(3):192-199]
背景:了解与新生儿死亡率相关的危险因素对于指导有针对性和基于证据的卫生干预措施的发展以减少新生儿死亡具有重要意义。目的:本研究旨在确定埃塞俄比亚新生儿死亡的危险因素。方法:本研究的数据来源为2011年埃塞俄比亚人口与健康调查。对调查前5年出生的8651名活产新生儿的生存信息进行了检查。采用分层cox -比例风险模型确定与新生儿死亡相关的危险因素。结果:新生儿死亡约71%发生在出生后第1周,第2周累计死亡率达79%。双胞胎或多胞胎(HR=3.73, 95% CI: 2.81-4.94)、第一胎(HR=1.68, 95% CI: 1.25-2.24)、男性(HR=1.26, 95% CI:1.06-1.50),出生间隔小于24个月(HR=1.63, 95% CI:1.31-2.03),小于20岁和大于34岁的母亲所生的新生儿(HR=1.38, 95% CI:1.05-1.82)和(HR=1.32, 95% CI: 0.06-2.80),以及母亲有妊娠并发症史的新生儿(HR=1.73, 95% CI: 1.27-2.24)与各自的同行相比。母亲参加产前检查(HR=0.72, 95% CI: 0.59-0.89)和新生儿出生后立即母乳喂养(HR=0.83, 95% CI: 0.59-0.99)的新生儿死亡风险较低。结论:旨在降低新生儿死亡率的公共卫生干预措施应解决上述人口因素和孕产妇保健服务问题。[阿比西尼亚人。中华卫生杂志,2013;27(3):192-199 [j]
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引用次数: 31
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Ethiopian Journal of Health Development
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