Amhara Region Research Articles

Development and Validation of an Empirical Model to Forecast Malaria Outbreaks at Amhara Region, Ethiopia: A Retrospective Follow-Up Study

Development and Validation of an Empirical Model to Forecast Malaria Outbreaks at Amhara Region, Ethiopia: A Retrospective Follow-Up Study

Multilevel and geographically weighted regression analysis of factors associated with full immunization among children aged 12–23 months in Ethiopia

Immunization is the process of building immunity or resistance to an infectious disease, typically through administering a vaccine. It is one of the most effective strategies for lowering child morbidity and death. It protects against more than 20 potentially fatal diseases, increasing longevity and health. Despite progress, Ethiopia failed to meet its vaccination coverage target. The magnitude of full immunization is different across areas. Therefore, conducting geographically weighted regression to identify the local factors and multilevel analysis to investigate and identify factors associated with full immunization coverage among children aged 12–23 months is necessary. The study was conducted using the 2019 Ethiopian Mini Demographic Health Survey dataset. A sample of 1028 weighted children aged 12–23 months were included in the analysis. Descriptive statistics were used to describe variables. For the spatial analysis, Arc-GIS version 10.8 statistical software was used. Spatial regression (geographically weighted regression) was done to identify factors associated with the proportion of full immunization, and model comparison was based on adjusted R2 and Akaike Information Criteria (AICc). Multilevel mixed-effect binary logistic regression models were fitted to identify factors associated with full immunization. The fitted models were compared based on log-likelihood, deviance, median odds ratio, and Proportional Change in Variance. Finally, statistically significant factors were reported using an adjusted odd ratio (AOR) with a 95% Confidence Interval for fixed effect. All variables with a p-value less than 0.05 in the final model were considered statistically significant factors. In Ethiopia, the overall full immunization coverage among children aged 12–23 months was 40.58%, with spatial variation across regions in Ethiopia. The significant spatial distribution of full immunization coverage among children aged 12–23 months was detected in northern Tigray, Addis Ababa, central Oromia, and southeastern Amhara regions. The proportion of rural residents,the proportion of women aged 35–44 years, the proportion of women who had ANC 4 and above andthe proportion of women who had PNC were local factors associated with the proportion of full immunization among children aged 12–23 months. Rural residence [AOR 0.27 (95% CI 0.10, 0.70)], family size 4 and above[AOR 0.41 (95% CI 0.17, 0.96)], never breastfeed [AOR 0.026(95% CI 0.003, 0.21)], 1–3 times ANC visit [AOR 0.45 (95% CI 0.23, 0.86)], being from Oromia region [AOR 0.23 (95% CI 0.05, 0.97)], Eastern pastoralist region [AOR 0.09 (95% CI 0.023, 0.35)], age 35–44 years [(AOR 6 (95% CI 1.57, 22.9)], and PNC [AOR 2.40 (95% CI 1.24, 4.8)] were significant factors associated with fully immunization in multilevel mixed effect analysis. Full immunization coverage in Ethiopia is below the global target with significant geographical variation. The high proportion of rural residents, the high proportion of women who had ANC 4 and above, mothers who had a high proportion of PNC, and the high proportion women age 35-44 years were local geographical factors for the proportion of full immunization among children age 12–23 months in Ethiopia. Women who had PNC, ANC visits four or more times, and increased maternal age were positively associated, whereas larger family size, no breastfeeding, rural residence, and being from Oromia and eastern pastoralist region were negatively associated with full immunization. Strengthening maternal and child health services, focusing on rural areas and low-coverage regions, is essential to increase immunization coverage in Ethiopia.

Influence of Nitrogen and Phosphorus Fertilizers Applications for Tomato (<i>Solanum lycopersicum </i>L.) Production Under Irrigation in the Fogera District, Northwest Ethiopia

Small-scale tomato production under irrigation is a common practice in the Fogera area of the Amhara Region in Northwest Ethiopia. However, there were no location-specific economic optimum N and P fertilizer recommendations for tomato production in the area. Therefore, a field study was conducted in 2020 and 2021 to investigate the response of tomato to N and P fertilizer applications and determine the economic return of N and P fertilizers applications. Four levels of N (0, 46, 92, and 138 kg N ha<sup>-1</sup>) and three levels of P (0, 46, and 92 kg P<sub>2</sub>O<sub>5</sub> ha<sup>-1</sup>) were factorially combined and laid in a randomized complete block design with three replications. The results revealed that tomato yield and yield-related attributes were significantly (p<0.01) affected by the main effects of N. However, the main effect of P and its interaction with N did not considerably influence the yield and yield-related parameters. The highest marketable (39.3 t ha<sup>-1</sup>) and total fruit yields (46.2 t ha<sup>-1</sup>) of tomato were recorded from the application of 138 kg N ha<sup>-1</sup>. The highest net economic return of Ethiopian birr 185,538.50 with a marginal rate return of 1326.1% was recorded from the application of 138 kg N ha<sup>-1</sup>. Therefore, 138 kg ha<sup>-1</sup> N can be recommended to increase the yield and economic return of tomato production in Fogera area. However, as the yield response to N followed a linear response curve, further study with higher rates of N than those considered in the present study is recommended.

Impacts of Irrigated Water Use on Household’s Income in South Wollo Zone, Amhara Regional State, Ethiopia

Agriculture is the backbone of the Sub-Saharan African economy. Ethiopia's GDP is also shared by 45 from the agriculture sectors. However, it is confronted and challenged by variable rainfall and climate changes. Particularly, in South Wollo zone, agriculture is not exceptional in facing such daunting challenges and effects of variable rainfall and climate change despite there are abundant alternative irrigated water resources. River and groundwater sources have not yet been used as alternative uses for agricultural production. As a result, rural households' income couldn’t meet their minimum food and nonfood requirements. This study, thus, attempted to evaluate the impact of irrigated water use on rural household's income in South Wollo Zone, Amhara regional state, Ethiopia. In pursuit of this, it employed a descriptive type of research design and triangulated research approach that consists of both quantitative and qualitative techniques. Primary and secondary data were collected from small scale irrigated households and secondary sources. Binary logistic regression was used to determine major significant factors that affect households' irrigated water use for agricultural production. A propensity core matching model was employed to evaluate irrigated water use and agriculture on household’s income. This study result (binary logistic regression result) showed that the household’s family size, land size and willingness were significant factors that determined irrigated water use for agricultural production at 95 percent level of significance. The propensity score matching model result also shows that irrigated water use significantly created significant impact on household’s income. It is, thus, keenly important to change and improve the smallholder farmer’s land size, extension services, rural credit, technology, education level, awareness about family size, and willingness to use irrigated water sources, such as, ground and river water for agriculture agricultural production that increase their level of income.

Burden of chemical poisoning and contributing factors in the case of the Amhara Region, Ethiopia

BackgroundThis study aimed to evaluate the burden of chemical poisoning and its associated factors at the Chemical, Biological, Radiological, and Nuclear (CBRN) pilot surveillance sites in the Amhara region, Northwest Ethiopia. The analysis of burdens and contributing factors is intended to inform targeted interventions and enhance public health strategies.MethodsA cross-sectional study was conducted at TibebeGhionComprehensive Specialized Hospital(TGCSH) and FelegeHiwot Comprehensive Specialized Hospital(FHCSH) in the Amhara region of Ethiopia from June to November 2021. Data were collected using structured tools and analyzed with SPSS version 26. Descriptive statistics assessed the burden of chemical poisoning, while Chi-square analysis identified significant factors associated with the burden of chemical poisoning.ResultsThe study reported a total of 184 chemical poisoning cases at TGCSH and FHCSH in the Amhara region, with a case fatality rate of 17%. The most affected age group was 16 to 25 years, and females accounted for 60% of the cases. Geographic distribution showed that Bahir Dar had the highest incidence, contributing to 64.7% of the cases, while the South Gondar zone, particularly the Fogera district, accounted for 30.88%. Organophosphates emerged as the most prevalent toxic agents, responsible for 53% of the cases. Chi-square analysis highlighted several significant associations with a higher burden of chemical poisoning, including being female (X² = 4.463, p = 0.035), being 35 years or younger (X² = 4.629, p = 0.031), ingestion of rodent poison (X² = 4.154, p = 0.042), intentional poisoning (X² = 7.488, p = 0.006), and inhalation exposure (X² = 4.154, p = 0.042) and educational level (X² = 5.764, p = 0.016).Conclusions and recommendationsThe study reveals a significant burden of chemical poisoning in the Amhara Region, Ethiopia, with a 17% fatality rate, predominantly impacting young adults and females, particularly in areas with high pesticide use, such as Bahir Dar and South Gondar. Key issues include cases with no antidotes, inhalation exposure, and intentional poisoning. Recommendations: Implement stricter chemical regulations, limit pesticide sales, enhance community education on safe handling, and improve mental health support for high-risk groups. Develop sustained CBRN surveillance systems and conduct further research on regional disparities and chemical agent assessments.

Determinants of farmers’ willingness to pay for crop insurance in Ankober Woreda, North Shewa Zone, Amhara Region, Ethiopia

Determinants of farmers’ willingness to pay for crop insurance in Ankober Woreda, North Shewa Zone, Amhara Region, Ethiopia

Beyond babysitting: an analysis of the quality of childcare service in Ethiopia

ABSTRACT Empirical evidence underscores the importance of investing in early childhood care to ensure its quality. This study examined the quality of child care in day-care centers in Bahir Dar and Gondar cities, Amhara region, Ethiopia, employing an embedded mixed-methods approach. Utilizing descriptive and inferential statistics, including t-tests, regression analysis, and thematic analysis, the research assessed both distal quality – encompassing environmental and staffing conditions – and proximal quality – focusing on caregiver–child interactions. The findings revealed significant deficiencies in distal quality, including inadequate space, activities, and staff qualifications. Proximal quality was also found to be lacking, with government centers exhibiting higher levels of harshness in caregiver interactions compared to private centers. Key factors influencing interaction quality were staff education, experience, and child-to-worker ratios. Despite existing regulatory standards, their enforcement was found to be inadequate. The study recommends that policymakers enhance and enforce regulations, improve staff training and invest in professional development. Further research should explore regulatory enforcement challenges and assess the long-term impacts of training improvements on care quality.

Impact of urban productive safety net program on urban households' asset accumulation and food consumption rate in Dessie City, South Wollo Zone, Amhara Region, Ethiopia.

Agriculture is the driver of economic growth in many developing countries like Ethiopia, where it often represents at least 25% of gross domestic product. But the quality and productivity of the land depends on the way agriculture is practiced. Better agricultural techniques are necessarily including Productive Safety net Program. Urban Productive Safety Net Program is designed to support the poor households and establish urban safety net mechanisms. While several studies have examined the effects of rural productive safety net programs, the outcomes of similar programs in urban areas are not well documented. This knowledge gap hinders the ability to effectively design and implement urban productive safety net programs. The main objective of this study was to assess the impact of urban productive safety net program on asset accumulation and consumption rate in Dessie city. Both primary and secondary data sources were used. A total of 112 households were selected randomly among the public work Urban Productive Safety Net Program beneficiary and non-beneficiary households. Descriptive analysis, inferential statistics and econometric models were used for analysis. Based on the econometric estimation results the demographic and socio-economic variables such as education, access to credit, access to extension services and adult male labor force revealed positive relation to public work urban productive safety net program beneficiary and non-beneficiary household's asset accumulation and consumption. The impact of program participation was also found to be positive and significant for both home asset and community asset. While food and non-food consumption even the total consumption and food security status are also positive. Generally, the result indicated that, due to program participation beneficiary households have higher home asset and community asset and better consumption and food security status.

Evaluation of the prevalence and risk factors of perinatal depression among women living with HIV in the Amhara Region, Northwest Ethiopia

IntroductionDepressive disorder is a common mental health issue among perinatal mothers living with HIV, potentially leading to significant despair and anxiety. This condition can hinder maternal-infant bonding and undermine efforts to prevent mother-to-child transmission of HIV. Despite its importance, little is known about the factors associated with depression in this population. Main objectiveThis study aimed to evaluate the prevalence and risk factors of perinatal depression among women living with HIV in the Amhara region, Northwest Ethiopia, in 2022. MethodsAn institutional-based cross-sectional study was conducted among 399 HIV-positive pregnant and postpartum women, both with follow-up and newly diagnosed cases, who attended PMTCT services in the East Gojjam Zone Public Hospitals from May 28 to July 12, 2022. Participants were selected using a simple random sampling technique. Data were collected through direct interviews and document reviews. The Edinburgh Perinatal Depression Scale was used to assess perinatal depression which demonstrated high internal reliability (Cronbach's alpha of 0.93). Data were cleaned and analyzed using Epi-data version 3.1 and SPSS version 25. Binary logistic regression models were used to identify variables associated with perinatal depression, with statistical significance set at p < 0.05. ResultsOut of 399 eligible women, 394 participated, yielding a response rate of 98.7 %. The prevalence of perinatal depression among these women was 34.3 % (95 % CI: 29.6–39.4). Factors significantly associated with perinatal depression included intimate partner violence (AOR = 4.24, 95 % CI: 2.507–7.168), internalized stigma (AOR = 4.93, 95 % CI: 2.912–9.560), poor social support (AOR = 4.0, 95 % CI: 1.693–9.560), and poor adherence to antiretroviral therapy (AOR = 3.65, 95 % CI: 1.774–7.519). ConclusionApproximately one-third of perinatal women living with HIV experienced depression. Key factors contributing to this included intimate partner violence, internalized stigma, low social support, and poor adherence to antiretroviral therapy. Interventions should focus on enhancing social support, empowering women, counseling on drug adherence, and screening for depression among perinatal women living with HIV.

Spatial distribution and clustering of contagious caprine pleuropneumonia in goats of Amhara region, Ethiopia

A cross-sectional study with a multistage cluster sampling technique was undertaken from January to July 2019 in Amhara region to identify spatial clusters and distributions of contagious caprine pleuropneumonia (CCPP) hotspots. In the study, a total of 2080 goats from 258 flocks across 60 villages in 12 districts were tested for CCPP serostatus using Competitive Enzyme-Linked Immunosorbent Assay (C-ELISA). Villages were taken as an aggregate unit to detect spatial distribution and clustering. Spatial autocorrelation, interpolation, and spatial scan statistics analyses were employed to analyze the spatial patterns and clusters of CCPP serostatus. The overall seroprevalence of CCPP at the animal level was 5.1 % (95 % CI: 3.8–6.6). The spatial distribution of CCPP seropositivity was non-random at the village level (Moran's I: 0.400791, P-value <0.01). Two statistically significant spatial clusters of CCPP seropositive were found: one in West Gojjam and the other encompassing parts of North Wollo, Oromiya Liyu zone, and South Wollo zones. The CCPP seropositivity showed spatial variation across the Amhara region. High CCPP seropositive spots were found in the southwestern and northeastern parts of the Amhara region. Generally, the findings of this study provide valuable insights in developing disease control strategies, prioritizing target intervention areas and measures, and designating CCPP disease-free zones. Applying movement restrictions and vaccinating goats will be important intervention measures to prevent and control CCPP in the region.

Efficacy of albendazole against soil-transmitted helminth infections in Ethiopia: a systematic review and meta-analysis

Soil-transmitted helminths (STH) are neglected parasites more prevalent in the tropics. Periodic mass distribution of albendazole, is one key strategy to control STHI in endemic areas. However, benzimidazoles have low efficacy against STHI, and there is a lack of information on the magnitude of the problem in Ethiopia. Articles were searched from PubMed using MeSH words, Google Scholar, Web of science, EMBASE and Scopus database to retrieve the data published and available until December 30, 2022. Totally, 107 published articles were retrieved. Only studies conducted in English that reported the efficacy of albendazole against STHI in any year and studies with more than fifty positive cases were included in the present study. The efficacy of albendazole was estimated by its cure rate and egg reduction rate. Excel software was used to extract the name of the authors, the total sample size, number of cured participants, treatment assessment time, STH parasite involved, the study area, and the year of publication. The pooled efficacy of albendazole against STHs was analyzed using comprehensive meta-analysis version 2.2 software. A total of 14 studies (13 for hookworm, 12 for Ascaris lumbricoides, and 12 for Trichuris trichiura) fulfilled the inclusion criteria for the present systematic review and meta-analysis. The total positives for hookworm, A. lumbricoides, and T. trichiura were 1253 (24.9%), 1570 (29.5%), and 1647 (30.6%), respectively. The overall pooled efficacy of albendazole was 92.2% (95% CI 86.2–98.9%) against hookworm, 97.7% (95% CI 96.3–98.6%) against A. lumbricoides, and 38.6% (95% CI 31.0–46.9%) against T. trichiura. In subgroup analysis, the efficacy of albendazole against hookworm was 93.4% (95% CI 85.1–97.2%) in Oromia, 96.7% (95% CI 93.8–98.2%) in Sidama, and 77.2% (95% CI 64.4–86.4%) in Amhara region. Its heterogeneity was high (I2 = 89.418). The efficacy of albendazole against A. lumbricoides was 98.3% (95% CI 97.0–99.0%) in Oromia and 96.63% (95% CI 93.2–98.3%) in Sidama region. Its heterogeneity was moderate (I2 = 41.5%). Albendazole efficacy against T. trichiura was 39.0% (95% CI 30.4–48.5%) in Oromia and 37.8% (95% CI 21.8–56.9%) in Sidama region with high heterogeneity (I2 = 90.6%). In the present review, albendazole is effective against hookworm and A. lumbricoides but less effective against T. trichiura. Albendazole should therefore be used as a treatment option in hookworm and A. lumbricoides endemic areas. However, alternative drugs should be sought for T. trichiura.

Adoption of the recommended rate of chemical fertilizers in Dangila District, Amhara Region, Ethiopia

Adoption of the recommended rate of chemical fertilizers in Dangila District, Amhara Region, Ethiopia

Willingness to pay for sheep traits and their heterogeneous effects on prices: Evidence from primary livestock markets in Ethiopia

We test the hypothesis whether levels of key traits of sheep heterogeneously affect market prices of sheep in a rural setting. Feasible generalized least squares and (un)conditional quantile regression estimations were made on a dataset of 1153 sheep transactions in two primary small ruminant markets in the Amhara region of Ethiopia. The empirical results show that animal traits affect the observed prices of sheep differently, but only partly explain the sheep price differences. Our results also reveal that in addition to animal traits, the type of buyers and seasonality of sheep marketing cause heterogeneity in the observed prices. These findings imply that targeting the animal traits demanded by the market and access to price information that enables farmers to respond to the seasonal changes in livestock markets are essential to increase the income of sheep keepers.

Prevalence and epidemiological distribution of indicators of pathogenic bacteria in households drinking water in Ethiopia: a systematic review and meta-analysis

BackgroundEnsuring the availability of safe drinking water remains a critical challenge in developing countries, including Ethiopia. Therefore, this paper aimed to investigate the prevalence of fecal coliform and E. coli bacteria and, geographical, children availability, and seasonal exposure assessment through a meta-analysis.MethodsTwo independent review groups extensively searched internet databases for English-language research articles published between 2013 and 2023. This systematic review and meta-analysis followed PRISMA guidelines. The methodological quality of each included study was evaluated using the STROBE guidelines. Publication bias was assessed by visual inspection of a funnel plot and then tested by the Egger regression test, and meta-analysis was performed using DerSimonian and Laird random-effects models with inverse variance weighting. Subgroup analyses were also conducted to explore heterogeneity.ResultsOut of 48 potentially relevant studies, only 21 fulfilled the inclusion criteria and were considered for meta-analysis. The pooled prevalence of fecal coliform and E. coli was 64% (95% CI: 56.0–71.0%, I2 = 95.8%) and 54% (95% CI: 45.7–62.3%, I2 = 94.2%), respectively. Subgroup analysis revealed that the prevalence of fecal coliform bacteria increased during the wet season (70%) compared to the dry season (60%), particularly in households with under-five children (74%) compared to all households (61%), in rural (68%) versus urban (66%) areas, and in regions with high prevalence such as Amhara (71%), Gambela (71%), and Oromia (70%). Similarly, the prevalence of E. coli was higher in households with under-five children (66%) than in all households (46%).ConclusionsThe analysis highlights the higher prevalence of fecal coliform and E. coli within households drinking water, indicating that these bacteria are a significant public health concern. Moreover, these findings emphasize the critical need for targeted interventions aimed at improving drinking water quality to reduce the risk of fecal contamination and enhance public health outcomes for susceptible groups, including households with under-five children, in particular geographical areas such as the Amhara, Gambela, and Oromia regions, as well as rural areas, at point-of-use, and during the rainy season.RegistrationThis review was registered on PROSPERO (registration ID - CRD42023448812).

Spatial distribution and associated factors of cesarean section in Ethiopia using mini EDHS 2019 data: a community based cross-sectional study

Maternal health is a major public health tricky globally. Cesarean section delivery reduces morbidity and mortality when certain complications occur throughout pregnancy and labor. Cesarean section subjected to the availability and use of essential obstetric services in regional factors in Ethiopia. There was a scarcity of studies that assess the spatial distribution and associated factors of cesarean section. Consequently, this study aimed to assess the spatial variation of cesarean section and associated factors using mini EDHS 2019 national representative data. A community based cross-sectional study was conducted in Ethiopia from March to June 2019. A two-stage stratified sampling design was used to select participants. A Global Moran’s I and Getis-Ord Gi* statistic hotspot analysis was used to assess the spatial distribution. Kuldorff’s SaTScan was employed to determine the purely statistically significant spatial clusters. A multilevel binary logistic regression model fitted to identify factors. A total of 5753 mothers were included. More than one-fourth of mothers delivered through cesarean section at private health institutions and 54.74% were not educated. The proportion of cesarean section clustered geographically in Ethiopia and hotspot areas were observed in Addis Ababa, Oromia, Tigray, Derie Dewa, Amhara, and SNNR regions. Mothers’ age (AOR = 1.07, 95% CI 1.02–1.12), mother’s had secondary education (AOR = 2.113, 95% CI 1.414, 3.157), mother’s higher education (2.646, 95% CI 1.724, 4.063), Muslim religion followers (AOR = 0.632, 95% CI 0.469, 0.852), poorer (AOR = 1.719, 95% CI 1.057, 2.795), middle wealth index (AOR = 1.769, 95% CI 1.073, 2.918), richer (AOR = 2.041, 95% CI 1.246, 3.344), richest (AOR = 3.510, 95% CI 2.197, 5.607), parity (AOR = 0.825, 95% CI 0.739, 0.921), and multiple pregnancies (AOR = 4.032, 95% CI 2.418, 6.723) were significant factors. Therefore, geographically targeted interventions are essential to reduce maternal and infant mortality with WHO recommendations for those Muslim, poorest and not educated mothers.

Barriers and facilitators of visceral leishmaniasis case management in the Amhara Region, Northwest Ethiopia: an exploratory qualitative study

BackgroundVisceral leishmaniasis (VL) is among the world’s most serious public health threats, causing immense human suffering and death. In Ethiopia, little is known about the barriers and facilitators of visceral leishmaniasis case management. This study aimed to explore such barriers and facilitators in the Amhara Regional State, Northwest Ethiopia.MethodsAn exploratory qualitative study was conducted on 16 purposively selected patients and key informants from May 8 to June 2, 2023. The study participants were recruited using the maximum variation technique. The interviews were audio recorded, transcribed verbatim, and translated into English. Thematic analysis was employed using Atlas.ti 9 software with a blended approach of both deductive and inductive coding.ResultsThe study identified a variety of issues that hinder the success of visceral leishmaniasis case management. Treatment centers face frequent interruptions of medicinal supplies, a lack of funding, and a lack of trained healthcare providers. A lack of support from health authorities, including weak supervision and feedback systems, is also a source of concern. Most patients receive treatments after significant delays, which is primarily due to low awareness, poor surveillance, and misdiagnosis by healthcare workers. The case management is further constrained by malnutrition, VL-HIV co-infection, and other comorbidities. Despite these issues, we found that effective collaboration between hospital units and VL treatment centers, acceptance by hospitals, and the caring attitude of healthcare workers play a positive role in facilitating the program’s effectiveness.ConclusionsDespite the existence of certain efforts that facilitate the program’s effectiveness, VL remains largely neglected, with little government attention or intervention. Such inattention is the root cause of most of the issues. Despite limited resources, most issues could be resolved with cost-effective strategies if health authorities at all levels have the will and commitment to do so.

The Nature of Community Empowerment in Local Governance: The Case of Selected Amhara Regional State Zones

Abstract The study sought to explore the nature of community empowerment in holding local councils accountable. The study adopted both quantitative and qualitative data collection methods. Three Zones, namely Central Gondar, Wag Hemra, and South Wollo, were selected as study areas. From these three Zones, five woredas were selected. Two kebeles were selected purposively from each sample Woreda. Accordingly, 10 study kebeles were selected. A total of 269 samples from the community have been incorporated into the survey. Primary data were collected through survey, key informant interview, fgd, and in-depth interview techniques. The study used thematic analysis technique for the qualitative data and descriptive analysis for the quantitative data. The results show that the level of community empowerment in holding council members accountable for their needs and priorities is low. Local people have little say in their local affairs. Currently, the council members are serving their second term without local elections. Hence, Some Kebeles and Woredas do not have representatives in the local councils.

Prevalence, spatial distribution and determinants of complete childhood pneumococcal conjugate vaccination in Ethiopia: spatial and multilevel analyses

IntroductionPneumococcal disease is a serious global public health concern. The primary causative agent of severe illnesses such as pneumonia, meningitis, acute otitis media, and bacteremia is the pneumococcus bacterium. The pneumococcal conjugate vaccine is a key strategy to reduce the burden of pneumococcal disease. Understanding the spatial distribution of complete childhood pneumococcal conjugate vaccine utilization and its associated factors is crucial for designing strategies to improve vaccination implementation. Therefore, this study aimed to determine the spatial distribution of complete childhood pneumococcal conjugate vaccination coverage and identify its determinants in Ethiopia.MethodA spatial and multilevel analysis was conducted using data from the 2019 Ethiopian Mini Demographic and Health Survey. The analysis included a total of 2,055 weighted children. The association between the outcome variable and the explanatory variables was determined by calculating adjusted odds ratios at a 95% confidence interval. Explanatory variables were considered significantly associated with the outcome if the p-value was less than 0.05.ResultThe prevalence of complete childhood pneumococcal conjugate vaccination in Ethiopia was 53.94% (95% CI: 51.77, 56.08). Higher complete childhood pneumococcal vaccination coverage was observed in the Addis Ababa, Tigray, Amhara, Benishangul-Gumuz, and Oromia regions, while lower coverage was seen in the Afar, Somali, and SNNPR regions of Ethiopia. Factors significantly associated with complete childhood pneumococcal conjugate vaccination included maternal age, antenatal care visits, place of delivery, region, community women’s literacy level, community poverty level, and community antenatal care utilization.ConclusionThe distribution of complete childhood pneumococcal conjugate vaccination exhibited spatial variability across Ethiopia. Approximately half of children aged twelve to thirty-five months received the full dose of the childhood pneumococcal conjugate vaccine in the country. Several factors were identified as statistically significant determinants of complete childhood pneumococcal conjugate vaccination, including maternal age, antenatal care visits, place of delivery, region, community women’s literacy level, community poverty level, and community ANC utilization. Therefore, policies and strategies aimed at combating pneumococcal disease should consider these determinants and address areas with low vaccination coverage.

Evaluating Rural Land Administration Institutional Efficiency from Modern Land Administration Systems Perspective: In Case of Awi Zone, North-Western Ethiopia

This study is aimed to evaluate the institutional efficiency of rural land administration from the perspective of modern land administration systems in Awi zone Amhara region Ethiopia. The study employed a mixed research approach to evaluate the efficiency of rural land administration. Moreover, the study used various data collection tools such as questionnaires, interviews, focus group discussion, observation, and document review to acquire relevant data. The study pursued the influence of explanatory variables namely legal framework, digitalization, valuation and compensation, good governance, data quality, capacity building, and customer satisfaction on the efficiency of rural land administration. Furthermore, descriptive and inferential statistics were used to analyze quantitative data. Consequently, the study found that the legal framework and customer satisfaction are the most significant factors that affect the efficiency of rural land administration. However, the study finding revealed that lack of clear and uniform legislations and service delivery negatively affected the success of rural land administration. Thus, the prospects to assure efficient rural land administration are provision of unambiguous laws, delivering services impartially, and providing capacity-building training for experts are suggested as a vital to implement modern land administration systems to modern society.

Micronutrient intake inadequacies in Northwest Ethiopian children aged 6–23 months

The early stages of childhood are a crucial period of life for health, with inadequate nutrition impacting physical growth, cognitive development, and the immune system. A considerable proportion of children are affected by micronutrient intake inadequacy and deficiency across the globe. Evidence on micronutrient intake among children aged 6–23 months is limited in Northwest Ethiopia, where there is a divergence between production and dietary consumption practices compared to other regions of the country. This study aimed to determine micronutrient inadequacy and associated factors among children aged 6–23 months. From February 1 to February 18, 2023, 435 children aged 6–23 months participated in a community-based cross-sectional study in the North Mecha District of the Amhara Region, Northwest Ethiopia. The study participants were selected using a multistage sampling technique. A multiphasic interactive 24-h dietary recall was used to collect dietary intake data via an interviewer-administered questionnaire. The interviews were conducted with the mothers of the selected children. Nutrient values for the selected 12 micronutrients were calculated using the NutriSurvey 2007 software and food composition tables from Ethiopia, Tanzania, and Kenya. SPSS version 25 was used for the remaining parts of the analysis. The Nutrient Adequacy Ratio and Mean Adequacy Ratio were calculated to evaluate the nutrient intakes. To identify the factors associated with overall micronutrient intake inadequacy, a binary logistic regression analysis was performed, with statistical significance determined at a p-value < 0.05. The overall prevalence of micronutrient intake inadequacy was 64.7% (95% CI 59.9, 69.2). The odds of inadequacy of micronutrient intake were 2.8 times higher among children aged 6–8 months than children aged 9–23 months (AOR = 2.80, 95% CI 1.71, 4.59). Children with paternal education unable to read and write and primary school incomplete were 3.1 (AOR = 3.12, 95% CI 1.26, 7.70) and 2.4 (AOR = 2.40, 95% CI 1.01, 5.73) times more likely to have micronutrient intake inadequacy, respectively, compared to children with paternal education of primary school completed and above. The likelihood of micronutrient intake inadequacy was 1.8 times higher among children from mothers who had an unfavorable nutrition-related attitude than those from mothers who had a favorable attitude (AOR = 1.76, 95% CI 1.02, 3.05). Inadequate intake of micronutrients was shown to be highly prevalent among children aged 6–23 months. Child age, paternal education, and maternal nutrition-related attitude were significantly associated with micronutrient intake inadequacy. Integrating community-guided nutrition interventions targeting nutrition-related knowledge and attitudes of parents is critical in addressing the inadequate micronutrient intake of children in the study community, where production is not a major problem.