Background: There is little empirical evidence on the effect of childhood malnutrition on children's cognitive achievements in low income countries like Ethiopia. A longitudinal data is thus vital to understand the factors that influence cognitive development of children over time, particularly how early childhood stunting affects cognitive achievement of children up to the age of 8 years.
Objective: To examine the effect of early childhood stunting on cognitive achievements of children using longitudinal data that incorporate anthropometric measurements and results of cognitive achievement tests such as Peabody Picture Vocabulary Test and Cognitive Development Assessment quantitative tests.
Method: Defining stunted children as those having a standardized height for age z-score less than -2; we used a Propensity Score Matching (PSM) to examine the effect of early childhood stunting on measures of cognitive performance of children. The balance of the propensity score matching techniques was checked and found to be satisfied (P<0.01).
Results: Early childhood stunting is significantly negatively associated with cognitive performance of children. Controlled for confounding variables such as length of breastfeeding, relative size of the child at birth, health problems of early childhood such as acute respiratory illness and malaria, baseline household wealth, child gender, household size and parental education, estimates from PSM show that stunted children scored 16.1% less in the Peabody Picture Vocabulary Test and 48.8% less in the Quantitative Assessment test at the age of eight, both statistically significant at P<0.01.
Conclusions: It is important to realize the importance of early investment in terms of child health and nutrition until five years for the cognitive performance of children. As household wealth and parental education are particularly found to play an important role in children's nutritional achievements, policy measures that are directed in improving household's livelihood may have a spill-over impact in improving child nutritional status, and consequently cognitive development and schooling.
{"title":"The effect of early childhood stunting on children's cognitive achievements: Evidence from young lives Ethiopia.","authors":"Tassew Woldehanna, Jere R Behrman, Mesele W Araya","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>There is little empirical evidence on the effect of childhood malnutrition on children's cognitive achievements in low income countries like Ethiopia. A longitudinal data is thus vital to understand the factors that influence cognitive development of children over time, particularly how early childhood stunting affects cognitive achievement of children up to the age of 8 years.</p><p><strong>Objective: </strong>To examine the effect of early childhood stunting on cognitive achievements of children using longitudinal data that incorporate anthropometric measurements and results of cognitive achievement tests such as Peabody Picture Vocabulary Test and Cognitive Development Assessment quantitative tests.</p><p><strong>Method: </strong>Defining stunted children as those having a standardized height for age z-score less than -2; we used a Propensity Score Matching (PSM) to examine the effect of early childhood stunting on measures of cognitive performance of children. The balance of the propensity score matching techniques was checked and found to be satisfied (P<0.01).</p><p><strong>Results: </strong>Early childhood stunting is significantly negatively associated with cognitive performance of children. Controlled for confounding variables such as length of breastfeeding, relative size of the child at birth, health problems of early childhood such as acute respiratory illness and malaria, baseline household wealth, child gender, household size and parental education, estimates from PSM show that stunted children scored 16.1% less in the Peabody Picture Vocabulary Test and 48.8% less in the Quantitative Assessment test at the age of eight, both statistically significant at P<0.01.</p><p><strong>Conclusions: </strong>It is important to realize the importance of early investment in terms of child health and nutrition until five years for the cognitive performance of children. As household wealth and parental education are particularly found to play an important role in children's nutritional achievements, policy measures that are directed in improving household's livelihood may have a spill-over impact in improving child nutritional status, and consequently cognitive development and schooling.</p>","PeriodicalId":11852,"journal":{"name":"Ethiopian Journal of Health Development","volume":"31 2","pages":"75-84"},"PeriodicalIF":0.6,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5726774/pdf/nihms895341.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35663880","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}
Background : Globally, trends of medical admission have been changing. This study was carried out to assess the current trend of medical admissions and outcomes in Ethiopia. Methods : Retrospective review of 840 records of patients admitted to medical ward of Saint Paul hospital during April 1, 2012-March 31, 2013 was done. Ethical approval was obtained from the IRB of the hospital. Data on demographic profiles, reasons for admission, final diagnosis, length of hospital stay and treatment outcomes were recorded by physicians on structured format developed for this purpose. The data were entered & analysed using SPSS software version 20. Results : Most of the patients were from Addis Ababa. The mean age of patients was 40.9±17.7 years, 470 (56%) of the patients were females and 71% were married. Non-communicable diseases (NCDs) contributed to 51.1% of admissions. Communicable diseases were dominant diagnosis for those groups in 35-44 years of age while noncommunicable diseases were dominant diagnosis for those 45-54 years of age and above. The three most common reasons for immediate admission to the hospital were pneumonia 188 (22.4%), tuberculosis 177 (21.1%) and heart failure 134 (16.0%). And the major diagnoses for underlying illnesses during admissions were found to be AIDS 177 (21.1%), hypertension 102 (12.1%), diabetes mellitus 102 (12.1%), atherosclerotic cardio vascular disorders 86 (10.2%), gastrointestinal disorders 56 (6.7%), valvular heart diseases 51 (6.1%), and renal failure 46 (5.5%). Mean duration of stay in medical wards was 12.3 (+/-10) days and it is comparable for communicable diseases and non-communicable diseases. Two third of the medical admissions (66.4%) were discharged improved while mortality was close to one fourth (24.2%). Communicable diseases contributed to two thirds of the mortality (15.6%). Conclusion : Non-communicable diseases were the major cause of admission to the hospital while communicable diseases contributed to two thirds of the overall mortality predominantly among the younger patients. Health professionals, policy-makers and health planners should recognize the higher morbidity and hospital burden from non-communicable diseases and the higher mortality from communicable diseases. Key words : Medical admission, communicable and non-communicable, morbidity, mortality, Ethiopia
{"title":"Medical Admissions and Outcomes at Saint Paul’s Hospital, Addis Ababa, Ethiopia: a retrospective study","authors":"A. Bane, Tola Bayisa, F. Adamu, S. Abdissa","doi":"10.4314/EJHD.V30I1","DOIUrl":"https://doi.org/10.4314/EJHD.V30I1","url":null,"abstract":"Background : Globally, trends of medical admission have been changing. This study was carried out to assess the current trend of medical admissions and outcomes in Ethiopia. Methods : Retrospective review of 840 records of patients admitted to medical ward of Saint Paul hospital during April 1, 2012-March 31, 2013 was done. Ethical approval was obtained from the IRB of the hospital. Data on demographic profiles, reasons for admission, final diagnosis, length of hospital stay and treatment outcomes were recorded by physicians on structured format developed for this purpose. The data were entered & analysed using SPSS software version 20. Results : Most of the patients were from Addis Ababa. The mean age of patients was 40.9±17.7 years, 470 (56%) of the patients were females and 71% were married. Non-communicable diseases (NCDs) contributed to 51.1% of admissions. Communicable diseases were dominant diagnosis for those groups in 35-44 years of age while noncommunicable diseases were dominant diagnosis for those 45-54 years of age and above. The three most common reasons for immediate admission to the hospital were pneumonia 188 (22.4%), tuberculosis 177 (21.1%) and heart failure 134 (16.0%). And the major diagnoses for underlying illnesses during admissions were found to be AIDS 177 (21.1%), hypertension 102 (12.1%), diabetes mellitus 102 (12.1%), atherosclerotic cardio vascular disorders 86 (10.2%), gastrointestinal disorders 56 (6.7%), valvular heart diseases 51 (6.1%), and renal failure 46 (5.5%). Mean duration of stay in medical wards was 12.3 (+/-10) days and it is comparable for communicable diseases and non-communicable diseases. Two third of the medical admissions (66.4%) were discharged improved while mortality was close to one fourth (24.2%). Communicable diseases contributed to two thirds of the mortality (15.6%). Conclusion : Non-communicable diseases were the major cause of admission to the hospital while communicable diseases contributed to two thirds of the overall mortality predominantly among the younger patients. Health professionals, policy-makers and health planners should recognize the higher morbidity and hospital burden from non-communicable diseases and the higher mortality from communicable diseases. Key words : Medical admission, communicable and non-communicable, morbidity, mortality, Ethiopia","PeriodicalId":11852,"journal":{"name":"Ethiopian Journal of Health Development","volume":"30 1","pages":"50-56"},"PeriodicalIF":0.6,"publicationDate":"2016-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4314/EJHD.V30I1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70534222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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
{"title":"High enteric bacterial contamination of drinking water in Jigjiga city, Eastern Ethiopia","authors":"Henok Sileshi Asfaw, M. Reta, F. Yimer","doi":"10.4314/EJHD.V30I3","DOIUrl":"https://doi.org/10.4314/EJHD.V30I3","url":null,"abstract":"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","PeriodicalId":11852,"journal":{"name":"Ethiopian Journal of Health Development","volume":"30 1","pages":"118-128"},"PeriodicalIF":0.6,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4314/EJHD.V30I3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70534510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abera Kumie, Tadesse Amera, Kiros Berhane, Jonathan Samet, Nuvjote Hundal, Fitsum G/Michael, Frank Gilliland
<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
{"title":"Occupational Health and Safety in Ethiopia: A review of Situational Analysis and Needs Assessment.","authors":"Abera Kumie, Tadesse Amera, Kiros Berhane, Jonathan Samet, Nuvjote Hundal, Fitsum G/Michael, 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":"30 1 Spec Iss","pages":"17-27"},"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}
{"title":"Strengthening the Link between Economic Development, Environment and Public Health.","authors":"Damen Hailemariam","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":11852,"journal":{"name":"Ethiopian Journal of Health Development","volume":"30 1 Spec Iss","pages":"1-4"},"PeriodicalIF":0.6,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5589140/pdf/nihms899508.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35390467","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}
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.
{"title":"Review of Policy, Regulatory, and Organizational Frameworks of Environment and Health in Ethiopia.","authors":"Getnet Mitike, Achenef Motbainor, Abera Kumie, Jonathan Samet, 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":"30 1 Spec Iss","pages":"42-49"},"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}
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.
{"title":"Indoor and Outdoor Air Pollution- related Health Problem in Ethiopia: Review of Related Literature.","authors":"Worku Tefera, Araya Asfaw, Frank Gilliland, Alemayehu Worku, Mehari Wondimagegn, Abera Kumie, Jonathan Samet, Kiros Berhane","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>Review of the few studies conducted in Ethiopia showed that average concentrations of PM<sub>2.5</sub> reached as high as 280 µg/m<sup>3</sup> for 24-hour measurements (range: 2,417-12,739 µg/m<sup>3</sup>). 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 NO<sub>2</sub> (97 ppb) were reported in a large longitudinal study. The ambient PM<sub>10</sub> 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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":11852,"journal":{"name":"Ethiopian Journal of Health Development","volume":"30 1","pages":"5-16"},"PeriodicalIF":0.6,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5588149/pdf/nihms899372.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35390470","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}
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
{"title":"Cesarean delivery practices in teaching public and non-government/private MCH hospitals, Addis Ababa.","authors":"H. Aman, S. Negash, L. Yusuf","doi":"10.4314/EJHD.V28I1","DOIUrl":"https://doi.org/10.4314/EJHD.V28I1","url":null,"abstract":"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","PeriodicalId":11852,"journal":{"name":"Ethiopian Journal of Health Development","volume":"28 1","pages":"22-28"},"PeriodicalIF":0.6,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4314/EJHD.V28I1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70534165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"Lessons from the evolution of human resources for health in Ethiopia: 1941-2010","authors":"Yayehyirad Kitaw, G. Teka, H. Meche","doi":"10.4314/EJHD.V27I1","DOIUrl":"https://doi.org/10.4314/EJHD.V27I1","url":null,"abstract":"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.","PeriodicalId":11852,"journal":{"name":"Ethiopian Journal of Health Development","volume":"27 1","pages":"6-28"},"PeriodicalIF":0.6,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4314/EJHD.V27I1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70533656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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]
{"title":"Risk factors of neonatal mortality in Ethiopia.","authors":"N. Wakgari, E. Wencheko","doi":"10.4314/EJHD.V27I3","DOIUrl":"https://doi.org/10.4314/EJHD.V27I3","url":null,"abstract":"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]","PeriodicalId":11852,"journal":{"name":"Ethiopian Journal of Health Development","volume":"27 1","pages":"192-199"},"PeriodicalIF":0.6,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70534135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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