COVID-19 Pandemic In Ethiopia Research Articles

COVID-19 related barriers to institutional childbirth during the early phase of the pandemic in rural Arsi zone, Ethiopia, 2022: A qualitative study

IntroductionGlobal, national, and local studies revealed that the COVID-19 pandemic has significantly reduced institutional childbirth. However, it is not well understood how the COVID-19 epidemic affected institutional childbirth service utilization. Therefore, this study aimed to evaluate COVID-19 related impediments to institutional childbirth service uptake during the early phase of the COVID-19 pandemic (March 20/2020–June 20/2020) in the rural Arsi zone of Ethiopia. MethodsA community-based Phenomenological study was conducted from January 10–25/2022, among mothers who gave birth in the Arsi zone during the early phase of the COVID-19 epidemic (March 20/2020–June 20/2020) in Ethiopia. Data was collected by the primary author and a university graduated Midwives with experience in qualitative data collection. Eight focus group discussions and six in-depth interviews were conducted among mothers who gave birth in selected rural areas of the Arsi zone during the early phase of the COVID-19 pandemic. Nine key informant interviews were also conducted among Midwives, Maternity Ward Heads, and Community Health Extension Workers. Data was transcribed, translated, and analyzed thematically using Atlas Ti.7 version. ResultsFour major themes and eleven sub-themes emerged regarding the barriers to institutional childbirth during the early phase of COVID-19 pandemic. The COVID-19 related fear was a reason for avoiding institutional childbirth for almost all participants. COVID-19 restrictions such as transportation bans, market bans and public transport price doubling were also critical concerns to seeking institutional childbirth. Perceived Poor quality of institutional childbirth care during the curfew was also an impeding factor. Poor communication, incomplete care components and absenteeism were mentioned under this theme. Unbalanced mass media tragedies and rumors of unknown sources were COVID -19 related infodemics found affecting the practice of institutional childbirth. ConclusionsCOVID-19 related fears, COVID-19 restrictions, Perceived Poor quality of care during the COVID-19 pandemic and the COVID-19 Infodemic were the main reasons for reduced institutional childbirth service utilization during the early phase of the COVID-19 pandemic in Ethiopia. Therefore, strategies must be designed proactively to maintain essential maternal health services, particularly institutional childbirth, during pandemics like COVID-19 and similar future epidemics.

In-service teacher trainees experience with and preference for online learning environments during Covid-19 pandemic

The Covid-19 pandemic has forced the educational sector to quickly adapt to the crisis and shift to online learning environments (OLEs). Therefore, a critical area for research is assessing the readiness of teachers in terms of their familiarity and preference for OLEs. In this study, we aimed to improve the experience and preference of in-service teacher trainees with OLEs during the Covid-19 pandemic in Ethiopia. To achieve this goal, questionnaires were used to gather data from in-service teacher trainees. Descriptive and inferential statistical methods, including exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), Pearson correlation, and one-way ANOVA, were used to analyze the data and determine the participants' opinions and experiences with OLEs. The results showed that while in-service teacher trainees had less experience in knowledge and skills compared to cooperation and interaction, they preferred online learning platforms over online learning strategies. Additionally, correlations were found between cooperation and interaction, knowledge and skills; cooperation and interaction, online learning platforms; cooperation and interaction, online learning strategies; and online learning platforms and online learning strategies. Interestingly, no statistically significant correlation was found between knowledge and skills and online learning platforms. In conclusion, Ethiopian in-service teacher trainees favored online learning platforms over traditional online learning strategies, despite having less experience in knowledge and skills. Further research is needed to explore the experiences and preferences of in-service teacher trainees in various ecological aspects.

Women's experiences of receiving antenatal and intrapartum care during COVID-19 at public hospitals in the Sidama region, Ethiopia: A qualitative study using the combination of three delay and social-ecological framework (hybrid framework).

The COVID-19 pandemic, drought and internal conflict have worsened Ethiopia's already weak healthcare system. Antenatal and intrapartum care are especially prone to interruption under these circumstances. To explore women's experiences receiving antenatal and intrapartum care during the pandemic. A descriptive qualitative approach was utilised. We conducted in-depth interviews with 17 women and held 4 focus group discussions with women who gave birth at 4 public hospitals during the pandemic. A study was conducted at four public hospitals in the Sidama region of Ethiopia, during which data were collected from 14 February to 10 May 2022. Thematic analysis was performed to generate themes. The peak of the COVID-19 pandemic in Ethiopia presented several barriers to access and uptake of antenatal and intrapartum care at public hospitals. Four themes and 10 subthemes emerged from the thematic analysis. The themes were 'Barriers to maternity care uptake during COVID-19', 'Shortage of resources during COVID-19', 'Delays in maternity care uptake during COVID-19' and 'Mistreatment of women during maternity care during COVID-19'. The subthemes included 'Fear of contracting COVID-19', 'People in the hospital neglecting COVID-19 prevention', 'Women losing their job during COVID-19', 'Shortage of beds in the labour ward', 'Shortage of medical supplies', 'Delays in seeking care', 'Delays in receiving care', 'Complications during childbirth', 'disrespectful' and 'suboptimal care'. The findings of this study underscore the impact of COVID-19 on antenatal and intrapartum care, leading to delays in seeking and receiving care due to reduced rapport, resource shortages, companion restrictions, disrespectful care and suboptimal care. These factors contribute to increased obstetric complications during COVID-19. It is imperative for policymakers to prioritise essential resources for antenatal and intrapartum care in the present and future pandemics. Moreover, healthcare providers should maintain respectful and optimal care even amid challenges.

Psychological problems and associated factors during COVID-19 pandemic in Ethiopia

Objective: Psychological problems like depression, anxiety, and stress are common in the general population and they have a negative impact on the well-being of the community as well as the country. Pandemic diseases like COVID-19 increase the prevalence of psychological problems in the community. Studying psychological problems and associated factors in the community is very crucial for community mental health management. However, evidence is scarce in Ethiopia. Therefore, this study aimed to assess the prevalence of psychological problems and factors in the community during the COVID-19 pandemic in Shashemene Town, Oromia, Ethiopia.
 
 Methods: A community-based cross-sectional study was conducted from February 01,2012 to February 28, 2021. A structured, pretested, and interviewer-administered questionnaire was used to collect data from 889 study participants selected through a simple random sampling technique. The data was collected using the depression, anxiety, and stress scale (DASS-21) questionnaire and analyzed using SPSS version 25.0. Bivariable and multivariable logistic regression was done to determine factors associated with DAS. Adjusted odds ratio with their 95% confidence intervals were calculated to identify the presence and strength of an association, while statistical significance was reported at P<0.05.
 
 Results: The prevalence of psychological problems was 96.6% [95% Cl: 95.9,98.1]. The overall prevalence of depression and anxiety were 30% and 43.5% respectively. Having COVID-19 symptoms in the past two weeks before the survey (AOR=0.34; 95% Cl: 0.15,0.77) and having known medical problems (AOR=0.28; 95% Cl: 0.13,0.59) were factors significantly associated with a psychological problem in response to COVID-19 pandemic.
 
 Conclusion: The prevalence of psychological problems in response to the COVID-19 pandemic infection was very high in the study area. It needs immediate action to alleviate this psychological problem crisis in the community.

Violence against housemaids in an Ethiopian town during the early phase of the COVID-19 pandemic: a cross-sectional study

BackgroundViolence against women is a global public health problem that has numerous adverse effects. However, published literature regarding violence against housemaids during the COVID-19 pandemic in Ethiopia is lacking. The current study aims to explore the experiences of violence and associated factors among housemaids in Ethiopia. The findings may be useful to the design appropriate policies, programs and strategies to reduce the problem.MethodsA community-based cross-sectional study was conducted from January to March, 2021 in Kombolcha Town, Ethiopia. A total of 215 housemaids aged 14 years and older were included in the study using a simple random sampling technique. A multivariable logistic regression model with 95% CI (confidence interval) was applied to identify significant factors of physical and sexual violence. Variables with a P-value < 0.05 were declared as factors significantly associated with violence.ResultsAmong 215 housemaids, 33.49% (95% CI: 27.13–39.85%) reported physical violence and 21.4% (95% CI: 15.87–26.92) reported sexual violence during the COVID-19 pandemic. Thus, housemaids aged 19–23 years (AOR = 2.64, 95% CI: 1.01–6.89), who had a male employer (AOR = 2.39, 95% CI: 1.05–5.45), whose employers chewed chat (Catha edulis) (AOR = 3.78, 95% CI: 1.73–8.29), or drank alcohol (AOR = 2.90, 95% CI: 1.17–7.17) experienced more physical violence. Sexual violence was also associated with employers’ alcohol consumption (AOR = 9.72, 95% CI: 3.12–20.31), employers’ chat chewing (AOR = 7.40, 95% CI: 2.26–14.21) and male employers (AOR = 3.23, 95% CI: 1.22–8.52).ConclusionThe findings indicate that one in five housemaids and one in three housemaids experienced sexual violence and physical violence, respectively. Housemaids aged 19–23 years, having a male employer, having an employer who chewed chat (Catha edulis) or who drank alcohol were factors associated with physical violence, whereas employers’ alcohol consumption, employers’ chat chewing and male employers were factors associated with sexual violence.

Care-seeking behaviours of mothers and associated factors for possible serious bacterial infection in young infants during COVID-19 pandemic in Ethiopia: mixed-methods formative research

ObjectivesImplementation research was employed to examine rates and contextual factors associated with mothers’ care-seeking for their sick neonates and identify challenges for community-based possible serious bacterial infection (PSBI) services access...

Quality of routine health data at the onset of the COVID-19 pandemic in Ethiopia, Haiti, Laos, Nepal, and South Africa

BackgroundDuring the COVID-19 pandemic, governments and researchers have used routine health data to estimate potential declines in the delivery and uptake of essential health services. This research relies on the data being high quality and, crucially, on the data quality not changing because of the pandemic. In this paper, we investigated those assumptions and assessed data quality before and during COVID-19.MethodsWe obtained routine health data from the DHIS2 platforms in Ethiopia, Haiti, Lao People’s Democratic Republic, Nepal, and South Africa (KwaZulu-Natal province) for a range of 40 indicators on essential health services and institutional deaths. We extracted data over 24 months (January 2019–December 2020) including pre-pandemic data and the first 9 months of the pandemic. We assessed four dimensions of data quality: reporting completeness, presence of outliers, internal consistency, and external consistency.ResultsWe found high reporting completeness across countries and services and few declines in reporting at the onset of the pandemic. Positive outliers represented fewer than 1% of facility-month observations across services. Assessment of internal consistency across vaccine indicators found similar reporting of vaccines in all countries. Comparing cesarean section rates in the HMIS to those from population-representative surveys, we found high external consistency in all countries analyzed.ConclusionsWhile efforts remain to improve the quality of these data, our results show that several indicators in the HMIS can be reliably used to monitor service provision over time in these five countries.

COVID-19 Disruptions of Food Systems and Nutrition Services in Ethiopia: Evidence of the Impacts and Policy Responses.

Since its first case of COVID-19 on March 13, 2020, Ethiopia has exerted efforts to curb the spread of SARS-CoV-2 (COVID-19) without imposing a nationwide lockdown. Globally, COVID-19 related disruptions and mitigation measures have impacted livelihoods and food systems, nutrition, as well as access and use of health services. To develop a comprehensive understanding of the impacts of the COVID-19 pandemic on food systems, health services, and maternal and child nutrition and to synthesize lessons from policy responses to the COVID-19 pandemic in Ethiopia. We conducted a review of literature and 8 key informant interviews across government agencies, donors, and non-governmental organizations (NGOs), to map the impacts of the COVID-19 pandemic on the food and health systems in Ethiopia. We summarized policy responses and identified recommendations for future actions related to the COVID-19 pandemic and other future emergencies. The impacts of the COVID-19 pandemic were felt across the food system and include limited agriculture inputs due to travel restrictions and closed borders restricting trade, reduced in-person support by agriculture extension workers, income losses, increases in food prices, and the reduction in food security and dietary diversity. Maternal and child health services were disrupted due to fear of contacting COVID-19, diversion of resources, and lack of personal protective equipment. Disruptions eased over time due to the expansion of social protection through the Productive Safety Net Program, and the increased outreach and home service provision by the health extension workers. Ethiopia experienced disruptions to food systems and maternal and child nutrition services due to the COVID-19 pandemic. However, by expanding existing social protection programs and public health infrastructure and leveraging partnerships with non-state actors, the extent of the impact of the pandemic was largely minimized. Nevertheless, vulnerabilities and gaps remain and there is a need for a long-term strategy that considers the potential for future pandemics and other shocks.

Essential Health Services Delivery Status During COVID-19 Pandemic in Ethiopia: A National Mixed-Methods Survey of Primary Healthcare Units.

Essential health services are a package of services critical to improve health outcomes. COVID-19 pandemic disrupts essential health services. However, the level of essential health service disruption due to COVID-19 in Ethiopia is not clear. This study aimed at measuring the status of delivery of essential health services in Ethiopia during COVID-19. A national mixed-methods cross-sectional survey was conducted. It was undertaken in Amhara (10 districts), Oromia (eight districts), Sidama (six districts), Southern Nations, Nationalities, and People's Region (16 districts), and Dire Dawa City Administration. A total of 452 health facilities were surveyed. Data were collected using face-to-face interview. Descriptive analysis was undertaken. Qualitative data was analyzed thematically. The woredas (districts) and health facilities which adopted essential health services before the COVID-19 pandemic were 81.4% and 51.2%, respectively. Nearly all health centers provided antenatal care services. Blood pressure measuring apparatus and delivery set were available in all health centers. However, only 50% of health centers had radiant warmer. Malnutrition services were provided by 47% of rural health centers. Moreover, a functional incinerator was available in only 41% of health centers. The provision of cardiovascular disease management was at 27.2%. Furthermore, HIV/AIDS treatment was provided by 43.5% of health facilities. The adoption of lists of essential health services was optimal. The status of delivery of essential health services was high for maternal healthcare. Neonatal care at birth, malnutrition treatment, and cardiovascular disease management were low. The district health system should strive more to maintain essential health services.

Depression and insomnia among healthcare professionals during COVID-19 pandemic in Ethiopia: a systematic review and meta-analysis.

Healthcare professionals play a great role in the struggle against COVID-19. They are highly susceptible to COVID-19 due to their responsibilities. This susceptibility directly affects their mental health status. Comprehensive evidence on prevalence of depression and insomnia during this pandemic is vital. Thus, this study aims to provide the pooled prevalence of depression and insomnia, and their associated factors during the COVID-19 pandemic. This systematic review and meta-analysis follow the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Studies were searched from PubMed, Cochrane Library, CrossRef, African Journals Online and Google Scholar databases from the occurence of the pandemic to June 2022. Study selection, data extraction and methodological quality assessment were done by two authors independently. The I 2 statistics was used for testing heterogeneity. A random effect model was used. Stata version 16.0 was used for statistical analysis. Eight studies were incorporated for this systematic review and meta-analysis. From seven studies the pooled prevalence of depression was 40% (95% CI [0.23-0.57]; I 2=99.00%; P=0.00). From three studies the pooled prevalence of insomnia was 35% (95% CI [0.13-0.58]; I 2=98.20; P=0.00). Associated factors of depression on healthcare workers (HCWs) were being female pooled AOR: 2.09; 95% CI [1.41-2.76], been married (pooled AOR = 2.95; 95% CI [1.83-4.07]). Due to limited studies available on the factors associated with insomnia, it is impossible to pool and associated factors were presented in narrative synthesis. COVID-19 is highly associated with the prevalence of depression and insomnia among healthcare professionals in Ethiopia. The pooled prevalence of depression and insomnia were significantly higher among healthcare professionals. Appropriate psychological counseling package should be realized for healthcare workers (HCWs) in order to recover the general mental health problems. Trial registration. This review was registered PROSPERO with registration number CRD42022314865.

Magnitude of Medicine Wastage and Perceived Contributing Factors Among Public Health Facilities in Dire-Dawa City Administration, in Mid COVID-19 Pandemic in Ethiopia: Retrospective, Cross-Sectional Study.

World Health Organization refers medication waste as expired, unused, spilled, and contaminated pharmaceutical items, medications, vaccines, and sera. Budget constraints in financing the health care system together with huge amount of wastage and disposal costs of unused medications at LMIC create a serious risk to the economy, health care system and environment. Thus, the aim of this study was to assess the rate of medication waste and to identify contributing factors in public health facilities in Dire-Dawa city. An institution-based retrospective, cross-sectional study was supplemented by a qualitative study design from May 10 to June 10, 2021, at 2 public hospitals and 14 health centers. Qualitative data were collected by self-administered questionnaires and 2 years record review. In-depth interviews were used to obtain qualitative data. Excel sheets and SPSS version 20 and thematic analysis were used to analyze quantitative and qualitative data. An average medicine wastage rate was 3.07% between 2010 and 2012 EFY, in Dire-Dawa public health facilities that worth 4,048,594.0 ETB. The most wasted class of medication was anti-infectives, accounting for 2,360,330 ETB (58.3%), while tablets 2,615,391 ETB (64.6%). Medical waste has been linked to several issues, including pushing nearly expired medications to healthcare institutions, lack of clinician involvement in medication selection and quantification, rapid changes in treatment regimens, and the existence of overstocked medication shelves. The average rate of medication waste was higher than the allowed level of 2%. The only medications that should be accepted by medical facilities are those that can be used before they expire. All prescribers should receive lists of the drugs that are readily available from the pharmacy department, and clinicians should be involved in the quantification and drug selection processes to increase the effectiveness of the use of medications.

Adherence to iron and folate supplementation and associated factors among women attending antenatal care in public health facilities at Covid-19 pandemic in Ethiopia.

Adhesion is the degree to which a patient complies with treatment recommendations made by a health care professional. The majority of pregnant women worldwide don't get the recommended amounts of iron and folic acid (30 to 60 mg of iron and 400 g of folic acid/day for 6 months) pregnant women are more likely to develop iron- and folic acid deficiency anemia. For iron and folate supplementation programs to be effective in Ethiopia, adherence is a significant issue. So, this study aimed to evaluate the level and barriers preventing women receiving antenatal care from taking iron and folate supplements. A phenomenological qualitative study design was added to a facility-based cross-sectional study. The sample was established using a double population proportion formula. For the quantitative and qualitative study, 308 pregnant women and the focal points for the health facilities were chosen at random, using systematic random sampling and purposive sampling techniques. For the quantitative study, a face-to-face interviewer-guided, pre-tested structured questionnaire was used; for the qualitative study, a semi-structured questionnaire was used. Data was entered twice, cross-checked by comparing the two separate entries in Epi Data version 7.2.2.6, and exported to SPSS version 25 for analysis. COR and AOR with 95% CI are used to evaluate the relationship between variables and control for confounding factors. Statistical significance was declared at a p-value < 0.05. All, 308 (100%) participants were involved. 56.5% of pregnant women attending an ANC clinic (95% CI: 51%-62.2%) adhered to Iron and folate supplementation. Mothers with primary education], Urban residents mothers, Mother who had four or more ANC visits, mothers who had registered for their first ANC at early gestational age, mothers who had good awareness about birth defects were independent predictors of adherence to Iron and folate supplementation. In our study, adherence to iron and folate supplementation was low relative to previous research findings. Promoting early and frequent ANC visits and improving pregnant women's awareness of anemia and birth defects through education is necessary to increase the adherence status.

Using the Implementation Research Logic Model to design and implement community-based management of possible serious bacterial infection during COVID-19 pandemic in Ethiopia

BackgroundCommunity-based treatment of possible serious bacterial infection (PSBI) in young infants, when referral to a hospital is not possible, can result in high treatment coverage and low case fatality. However, in Ethiopia, the coverage of PSBI treatment remains low, worsened by COVID-19. To understand the challenges of delivery of PSBI treatment and design and test adaptative strategies to mitigate the impact of COVID-19 on neonatal mortality, we did implementation research (IR) employing Implementation Research Logic Model (IRLM). In this paper, we describe IRLM application experiences in designing, implementing, and evaluating strategies to improve community-based treatment of PSBI during the COVID-19 pandemic in Ethiopia.MethodsThis IR was conducted between November 2020-April 2022 at Dembecha and Lume woredas of Amhara and Oromia regions, respectively. We employed narrative reviews, formative assessment and facilitated stakeholder engagement to develop the PSBI treatment IRLM to identify barriers, understand the conceptual linkages among determinants, choose implementation strategies, elicit mechanisms, and link to implementation outcomes. In addition, we used the IRLM to structure the capture of emerging implementation challenges and resulting strategy adaptations throughout implementation.ResultsThis IR identified COVID-19 and multiple pre-existing contextual factors. We designed and implemented implementation strategies to address these challenges. These adaptive strategies were implemented with sufficient strength to maintain the delivery of PSBI services and improve mothers’ care-seeking behavior for their sick young infants.The IRLM offers us a clear process and path to prioritize implementation challenges, choose strategies informed by mechanisms of action, and where the adaptive implementation of community-based management of PSBI would lead to high-implementation fidelity and change in mother behavior to seek care for their sick young infants. The IRLM was also an effective tool for stakeholder engagement, easily explained and used to structure discussion and decision-making during co-design meetings.ConclusionsThe use of the IRLM helps us to specify the conceptual links between the implementation challenges, strategies, mechanisms of action, and outcomes to explore the complex community-based management of PSBI during complex contexts to improve high-fidelity implementation and integration of PSBI treatment in the primary healthcare delivery systems through active engagement of stakeholders.

Lost to follow up from chronic care services during COVID-19 from health facilities, in Northwest Ethiopia.

The COVID-19 pandemic and the responses to it have greatly altered individual lives, particularly those with chronic illnesses. The pandemic affected the processes of routine comprehensive care for patients. Because chronic illnesses depress the immune system, they make individuals more susceptible to infection as well as more sickly and less likely to recover from the COVID-19 pandemic. Because of this, the rate of loss to follow-up (LTFU) from chronic illness care is accelerated by the COVID-19 pandemic, and the number of patients receiving new treatments is decreased. Therefore this study aimed to assess the mean difference of loss to follow-up among HIV/AIDS, diabetes mellitus (DM), and hypertension patients during the COVID-19 period as compared to pre-COVID-19 at health facilities in Northwest Ethiopia. An institution-based secondary data analysis of the Gondar city health report from October 2019 to Jun 2021 was done. Excel data were transformed to STATA 14 for analysis. An independent t-test was used to compare the mean difference of loss to follow-up and new initiation of treatment among HIV/AIDS, DM, and hypertension patients during the pre-COVID-19 and COVID-19 periods at facilities in Northwest Ethiopia. Variables with a mean difference of p < 0.005 with a 95% confidence interval were used to declare the significant level. There was a significantly higher mean difference in the number of patients with LTFU from Anti-Retroviral Therapy (ART) and antihypertensive treatment during COVID-19 as compared to the pre-COVID-19 period [μd =17.85, 95%CI: 3.25, 32.95] and [μd =17.31, 95%CI: 8.35, 26.97] respectively. The mean number of patients who were newly started anti-hypertensive treatment during the COVID-19 season was significantly decreased as compared to those who were before the COVID-19 period [μd = -32.94, 95%CI: -63.76, -2.12]. There was a significantly higher mean difference in the number of patients with LTFU from Anti-Retroviral Therapy (ART) and antihypertensive treatment during COVID-19 as compared to the pre-COVID-19 period. The mean number of patients who were newly started anti-hypertensive treatment during the COVID-19 season was significantly decreased as compared to the pre-COVID-19 period. Therefore the Ministry of Health Ethiopia (MOH) should update and prepare convenient care and follow-up such as remote chronic illness management methods during the ongoing COVID-19 pandemic in Ethiopia.

Risk factors for the prevalence of poor sleep quality in lecturers during COVID-19 pandemic in Ethiopia: an institution-based cross-sectional study

ObjectiveThis study was conducted to assess the prevalence and risk factors of poor sleep quality (SQ) among the academic staff at the University of Gondar, Northwestern Ethiopia.DesignAn institution-based cross-sectional study...

A Review of COVID-19 Response Challenges in Ethiopia.

Background: The COVID-19 pandemic has positioned fragile healthcare systems in low-income countries under pressure, leading to critical gaps in service delivery. The pandemic response demands the healthcare system to be resilient and continue provision of healthcare services. This review is aimed at describing the healthcare response challenges during the pandemic in Ethiopia. Methodology: Eligible studies dealing with challenges of the healthcare system in response to the COVID-19 pandemic in Ethiopia were included. The six World Health Organization (WHO) healthcare system building blocks were used to categorize healthcare challenges. PubMed ProQuest, databases were searched, and results were summarized using systematic review synthesis. Results: Financial constraints led to a shortage of mechanical ventilators. Furthermore, the pandemic hindered the capacity to avail full packages of personal protective equipment in health facilities and intensive care capacity. The pandemic also affected the delivery of maternal, child and new-born services, prevention, and treatment of childhood illness, including immunization services. Conclusions: The COVID-19 pandemic posed various challenges to the performance of the healthcare system in Ethiopia. It is recommended that policy makers and stakeholders enhance pandemic preparedness and strengthen response capacity by considering the six WHO healthcare system building blocks.

Access to and challenges in water, sanitation, and hygiene in healthcare facilities during the early phase of the COVID-19 pandemic in Ethiopia: A mixed-methods evaluation.

Inadequate water, sanitation, and hygiene (WASH) in healthcare facilities (HCFs) have an impact on the transmission of infectious diseases, including COVID-19 pandemic. But, there is limited data on the status of WASH facilities in the healthcare settings of Ethiopia. Therefore, this study aimed to assess WASH facilities and related challenges in the HCFs of Northeastern Ethiopia during the early phase of COVID-19 pandemic. An institution-based cross-sectional study was conducted from July to August 2020. About 70 HCFs were selected using a simple random sampling technique. We used a mixed approach of qualitative and quantitative study. The quantitative data were collected by an interviewer-administered structured questionnaire and observational checklist, whereas the qualitative data were collected using a key-informant interview from the head of HCFs, janitors, and WASH coordinator of the HCFs. The quantitative data were entered in EpiData version 4.6 and exported to Statistical Package for Social Sciences (SPSS) version 25.0 for data cleaning and analysis. The quantitative data on access to WASH facilities was reported using WHO ladder guidelines, which include no access, limited access, and basic access, whereas the qualitative data on challenges to WASH facilities were triangulated with the quantitative result. From the survey of 70 HCFs, three-fourths 53 (75.7%) were clinics, 12 (17.2%) were health centers, and 5 (7.1%) were hospitals. Most (88.6%) of the HCFs had basic access to water supply. The absence of a specific budget for WASH facilities, non-functional water pipes, the absence of water-quality monitoring systems, and frequent water interruptions were the major problems with water supply, which occurred primarily in clinics and health centers. Due to the absence of separate latrine designated for disabled people, none of the HCFs possessed basic sanitary facilities. Half (51.5%) of the HCFs had limited access to sanitation facilities. The major problems were the absence of separate latrines for healthcare workers and clients, as well as female and male staffs, an unbalanced number of functional latrines for the number of clients, non-functional latrines, poor cleanliness and misuse of the latrine. Less than a quarter of the HCFs 15 (21.4%) had basic access to handwashing facilities, while half 35 (50%) of the HCFs did not. The lack of functional handwashing facilities at expected sites and misuse of the facilities around the latrine, including theft of supplies by visitors, were the two most serious problems with hygiene facilities. Despite the fact that the majority of HCFs had basic access to water, there were problems in their sanitation and handwashing facilities. The lack of physical infrastructure, poor quality of facilities, lack of separate budget to maintain WASH facilities, and inappropriate utilization of WASH facilities were the main problems in HCFs. Further investigation should be done to assess the enabling factors and constraints for the provision, use, and maintenance of WASH infrastructure at HCFs.

Prevalence of household food insecurity in Ethiopia during the COVID-19 pandemic: Evidence from panel data

The COVID-19 pandemic is a global problem that confronted the economy and household food security of many countries. This study aimed to analyze the determinants of a household's food insecurity status in the era of the COVID-19 pandemic in Ethiopia. A panel data of 2,410 households in a six-round High-Frequency Phone Survey were retrieved from the World Bank database. The product of the corresponding pairwise severity weight and household responses to each coping strategy was summed up to get the individual's Coping Strategy Index. The Random Effect Model (REM) for panel data analysis was used to identify factors associated with household-related food insecurity during the COVID-19 pandemic. The descriptive statistics result shows that 18.63% and 11.08% of rural households and 56.55% and 38.13% of urban residents were food secure in the first and sixth rounds, respectively. On the contrary, 3.65% and 3.2% of rural households and 6.8% and 7.18% of urban households experienced severe food insecurity from the first to the sixth round, respectively. Most households have maintained their food security in urban areas than rural residents. However, the number of food secure households was gradually reduced from Round-1 to Round-6. Besides, REM output indicates that access to financial services, farm income, wage employment, income from property, investment, and savings, and NGO assistance negatively affected household's food insecurity. Whereas government support showed a positive association with households' food insecurity. Based on the findings, we recommend that households should adopt the behavior of enhancing and diversifying their sources of income, and the government also emphasize the establishment of national social security services by taking experience from NGOs’ emergency response mechanisms.

Employment Status during the COVID-19 Pandemic: Evidence from Ethiopia.

Since the beginning of the year 2020, the world has been suffering from an unprecedented situation due to the Corona Virus Disease (COVID-19). The negative impact of COVID-19 is one of the worrisome issues across the globe. Among others, employment is one area affected during the COVID-19, which requires considerable scientific studies to identify factors affecting employment status throughout the disease crisis. Therefore, this study has mainly aimed to investigate the factors affecting the employment status during the COVID-19 pandemic in Ethiopia, taking a total of 2,396 respondents who had jobs before the COVID-19 outbreak. To achieve the stated objectives, the study has employed a binary logit regression model considering the employment status of respondents who lost their job (unemployed) and who secured their job (employed) during the pandemic. The model result indicates that females were more likely to be unemployed than males, persons living in a rural area were more likely to be unemployed than persons living in an urban area, and persons engaged in industry, service, and trade were more likely to be unemployed than people engaged in agriculture during the pandemic. Furthermore, during the pandemic, people living in the capital city of Ethiopia (Addis Ababa) were more likely to be unemployed compared to people living in the other regions of the country. Finally, based on these findings, critical recommendations were forwarded to the government and policymakers for their intervention.

Impact of COVID-19 pandemic on TB prevention and care in Addis Ababa, Ethiopia: a retrospective database study

ObjectiveThe current COVID-19 pandemic in Ethiopia could cause severe dysfunction in tuberculosis (TB) treatment, diagnostic services, and prevention and control efforts. In this study, we evaluated the effect of COVID-19...