Ethiopian Community Research Articles

Solidarity and Social Networks: The Invisible Backbone That Ethiopians and Eritreans in Washington D.C. used to Transform Adams Morgan and U Street

This research depicts the social networks that the Ethiopian and Eritrean communities use to establish and support ethnic and non-cultural businesses in Washington D.C. It also showcases the solidarity expressions that, behind-the-scenes, sustain and help strengthen these migrant-led businesses in the area. Furthermore, it describes the opportunity structure found in Washington D.C. that has allowed Ethiopians and Eritreans to open businesses and progress in neighborhoods such as Adams Morgan and U Street. The study uses ethnographic research comprised of participant observation and in-depth interviews to analyze 20 case studies of successful Ethiopian and Eritrean entrepreneurs in D.C. This paper describes the characteristics of an immigrant community that is underrepresented in the literature, especially regarding its entrepreneurship; it underscores the special role that family and kin play in supporting their entrepreneurship; and it makes visible the impact that Ethiopians and Eritreans have had in some areas of Washington D.C.

Predictors of employment status: A study of former refugee communities in Australia

ObjectiveThere is substantial evidence that refugees' employment experiences are marred by a range of hurdles as they settle in their host country. This study investigated the relationship between a range of independent variables such as, demographic factors, acculturation, acculturative stress, and resilience and the dependent variable that is the employment status of former refugees.MethodQuestionnaire data were gathered from 169 participants from the Ethiopian, Congolese, and Myanmar communities settled in Brisbane, Australia. Hierarchical logistic regression was used to investigate the factors that predicted employment status.ResultsResilience and demographic variables such as age, education, gender, and country of origin were not associated with being employed. Length of stay and English proficiency increased the likelihood of being employed. Surprisingly, an increase in acculturation was associated with the likelihood of being unemployed, while an increase in acculturative stress was associated with the likelihood of being employed.ConclusionsThese findings indicate that unemployed participants perceived themselves to be acculturated and integrated, while those who were employed reported more acculturative stress. Furthermore, employment despite its positive impact can also be stressful. The study has practical and theoretical implications for stakeholders involved in the employment of refugees.

Benefits and challenges of pastoralism system in Ethiopia

Pastoralism is an important livelihood system practice in most of the dryland areas of the globe.It is a source of income and way of livelihood for hundreds of millions of world population.This research aimed at explaining the benefits of pastoral system, identifying the main challenges the sector faced based on secondary data obtained from different official records such as FAO, CSA (Central Statistical Authority of Ethiopia) and published research article and government reports. Besides this, this research also tried to indicate the possible way outs. Economically it contributes about 10%-40% of national GDP of countries and over 1.3 billion people benefited from the livestock value chain. Ethiopia has the largest livestock population in Africa (first in Africa, and 5th in the world) and 20 % of the national export and 90% of live animal export of the Ethiopian trade, and 80% of annual milk supply to the Ethiopian community resulted directly from the pastoralists. Yet the sectorial contribution has many bottlenecks and the most important one is lack of appropriate policy due to the misconception that the system is economically not feasible and environmentally unfriendly. In addition to this, unexpected, but short period drought and weak market chain, limited access to feed, equipment and information, market chain, animal health (veterinary) are contributing factors to the low contribution of the livestock sector. Ethiopia, with its huge livestock population and the increasing demand of global meat and milk demand, should give attention towards the sectorial development including provision of infrastructure such as milk and milk processing industries, leather and leather processing industries, and focus on Diversification of economic activities inthe pastoral areas. Besides, the government of Ethiopia should give an emphasis on developing policies and strategies to increase productivity of livestock and maintain the development of the sector. Furthermore, the government should devise mechanisms to control the illegal inter-boarder live animal export and way of measuring unaccounted (nonmarketable) values of livestock pastoral contributions.

Genital self-sampling for HPV-based cervical cancer screening: a qualitative study of preferences and barriers in rural Ethiopia

BackgroundIn the context of WHO’s “task shifting” project and growing global consensus on primary HPV-based cervical cancer screening, self-sampling is a promising new tool to expand screening access, uptake and coverage for women worldwide. We aimed to explore perceptions and acceptability of HPV self-sampling-based cervical cancer screening among community members and health professionals in rural northwest Ethiopia and to identify preferences and socio-cultural barriers regarding self-sampling in order to design a suitable high-coverage screening intervention for a rural African setting.MethodsFour community-based focus group discussions (FGD) were conducted in the rural district of Dabat, Northwest Ethiopia, each comprising 8 to 14 female participants, counting a total of 41 participants. The groups were homogenously composed in terms of their socio-economic status in the community. They included health centre attendees, community members, nurses and health development army leaders (HDAL). Two qualitative data collection experts conducted the interviews in the local language, using a FGD guide with several thematic areas. All participants granted written informed consent prior to the conduct of the interviews. As a concrete example of an existing self-sampling approach for cervical cancer screening we used the Evalyn® Brush.ResultsEmerging themes included (i) misconceptions and low awareness about cervical cancer among community residents and primary health care providers in rural northwest Ethiopia, (ii) stigmatization and social exclusion of affected women, (iii) delay in seeking of health care due to poor access and availability of services, and lacking of a concept of early cancer prevention, (iv) need of spousal permission, (v) fear of financial burden and (vi) fear of social marginalization. The self-sampling device was regarded to be acceptable and was judged to be easy to use for most women. The existing Ethiopian health care structure could facilitate a community approach.ConclusionHome-based self-sampling for cervical cancer screening is a socially acceptable and feasible “task shifting” method that will increase cervical cancer screening access and coverage in the Ethiopian study community. Education, awareness creation, community mobilization and family inclusion are identified as key activities to promote, implement and facilitate “task shifting” approaches like self-sampling.

A Community-Based Participatory Approach to Understanding HIV/AIDS in the Ethiopian Community

ABSTRACTThe rate of HIV/AIDS in Washington, D.C remains at epidemic levels and is most prevalent in the black community, with foreign-born blacks accounting for an increasing proportion of HIV infections in the Washington DC area. The Ethiopian community is among the subgroups that are especially impacted by HIV/AIDS. Yet, seldom does research on the epidemiology of HIV/AIDS break data into diverse subgroups, accounting for the distinct needs based on cultural or ethnic differences. This paper reports on the qualitative findings from a community participatory action research study that involved interviewing 60 Ethiopian-immigrants and nine community-based providers about their attitudes toward HIV/AIDS, and to elicit their ideas about how to improve HIV/AIDS prevention, promotion, and treatment approaches targeting the Ethiopian community. Findings show that stigma remains the largest barrier to accessing HIV/AIDS treatment among Ethiopians in the Washington, D.C. area. Therefore, strategies to reduce HIV/AIDS must address stigmatizing beliefs and be met with cultural sensitivity when developing community prevention and treatment outreach programs designed to reduce HIV/AIDS among Ethiopians.

Linear growth in preschool children treated with mass azithromycin distributions for trachoma: A cluster-randomized trial.

BackgroundMass azithromycin distributions have been shown to reduce mortality among pre-school children in sub-Saharan Africa. It is unclear what mediates this mortality reduction, but one possibility is that antibiotics function as growth promoters for young children.Methods and findings24 rural Ethiopian communities that had received biannual mass azithromycin distributions over the previous four years were enrolled in a parallel-group, cluster-randomized trial. Communities were randomized in a 1:1 ratio to either continuation of biannual oral azithromycin (20mg/kg for children, 1 g for adults) or to no programmatic antibiotics over the 36 months of the study period. All community members 6 months and older were eligible for the intervention. The primary outcome was ocular chlamydia; height and weight were measured as secondary outcomes on children less than 60 months of age at months 12 and 36. Study participants were not masked; anthropometrists were not informed of the treatment allocation. Anthropometric measurements were collected for 282 children aged 0–36 months at the month 12 assessment and 455 children aged 0–59 months at the month 36 assessment, including 207 children who had measurements at both time points. After adjusting for age and sex, children were slightly but not significantly taller in the biannually treated communities (84.0 cm, 95%CI 83.2–84.8, in the azithromycin-treated communities vs. 83.7 cm, 95%CI 82.9–84.5, in the untreated communities; mean difference 0.31 cm, 95%CI -0.85 to 1.47, P = 0.60). No adverse events were reported.ConclusionsPeriodic mass azithromycin distributions for trachoma did not demonstrate a strong impact on childhood growth.Trial registrationThe TANA II trial was registered on clinicaltrials.gov #NCT01202331.

A Journey between Identities: A Story of Education Students’ Journey to Ethiopia

ABSTRACTThe qualitative case study presented in this article describes and analyzes the experiences of Israeli education students, who joined a delegation to Ethiopia last year. This journey opened the doors of Ethiopia to the Ethiopian community’s younger generation, most of whom were born in Israel, and to the non-Ethiopian Israelis. During the journey, the participants coped with many challenges and a variety of experiences. They returned home having broken the stereotypes regarding the perception of Ethiopian Jewry, as well as racism, pluralism and relations between the majority and minority groups in Israel. In addition, the Ethiopian participants returned with the renewed identity and the new discourse that had been formed within the group as equal members of Israeli society.

Higher Maternal and Child Undernutrition in Pulse than Cereal Growing Rural Communities of Ethiopia: A comparative Cross-sectional Study

Background: Whether growing pulses (low fat legumes rich in protein and micronutrients) translates to nutritional health benefits has not been well documented in Ethiopia. In pulse- and cereal-based agricultural communities, we compared the nutrition of mothers and children (<5y) through anthropometric and dietary assessment to document evidence of pulse agriculture translating to nutritional health benefits. We also explored contextual factors influencing nutritional status. 
 
 Methods: Comparative study was conducted in purposively selected pulse- and cereal-growing Ethiopian communities, from rural Halaba and Zeway, with randomly selected individual participants of 413 and 217 mother-child dyads, respectively. Dietary diversity scores (DDS) and consumption indexes for selected food groups were assessed; median intakes of energy, protein, Fe, Zn, Ca were determined from a single-day weighed food records (in a subsample). Mother-child undernutrition was estimated using anthropometric assessments of weight, length/height and mid-upper-arm-circumference, MUAC.
 
 Results: Median energy and nutrient intakes for pulse-mothers, but not children, were significantly higher than cereal-mothers (p<0.01); Median DDS for mothers-children were three, out of nine food groups, in both communities; consumption index of pulses, although higher in the pulse-community (p<0.001), was generally low amounting to consumption of only 1-2/week; consumption from animal sources was minimal. Undernutrition in mothers was 22% in pulse and 14% in cereal. Child stunting, wasting and underweight were 53.5%, 10.4% and 36.5% in pulse and 41.8%, 4.1% and 21.6% in the cereal group, respectively. Gender-sensitive factors, such as access to own-land and work-burden predicted maternal-MUAC. Stunting, household size, land size, antenatal-clinic visits and frequency of dairy consumption also predicted maternal-MUAC. Child age, community (i.e., pulse- or cereal-growing), household size and land size predicted chid height-for-age z-score (HAZ). Pulses were mostly sold and women had limited control; mothers’ knowledge of the nutrition benefits of pulses was lower in pulse community (p<0.01).
 
 Conclusions: Poor DDS, pulse or animal-source food consumption and high levels of maternal and child undernutrition were found in both communities. The unexpected finding of greater undernutrition in the pulse-growing Halaba communities was of concern needing further investigation. The pulse-community could benefit from educational nutrition-intervention focusing on nutrition and other benefits of pulses.

Antenatal predictors of incident and persistent postnatal depressive symptoms in rural Ethiopia: a population-based prospective study

BackgroundThere have been few studies to examine antenatal predictors of incident postnatal depression, particularly in low- and middle-income countries (LMICs). The aim of this study was to investigate antenatal predictors of incident and persistent maternal depression in a rural Ethiopian community in order to inform development of antenatal interventions.MethodA population-based prospective study was conducted in Sodo district, south central Ethiopia. A locally validated version of the Patient Health Questionnaire (PHQ-9) was used to assess antenatal (second and third trimesters) and postnatal (4–12 weeks after childbirth) depressive symptoms, with a PHQ-9 cut-off of five or more indicating high depressive symptoms. Poisson regression with robust standard errors was used to identify independent predictors of persistence and incidence of postnatal depressive symptoms from a range of antenatal, clinical and psychosocial risk factors.ResultOut of 1311 women recruited antenatally, 1240 (356 with and 884 without antenatal depressive symptoms) were followed up in the postnatal period. Among 356 women with antenatal depressive symptoms, the elevated symptoms persisted into postnatal period in 138 women (38.8%). Out of 884 women without antenatal depressive symptoms, 136 (15.4%) experienced incident elevated depressive symptoms postnatally. The prevalence of high postnatal depressive symptoms in the follow-up sample was 274 (22.1%). Higher intimate partner violence scores in pregnancy were significantly associated with greater risk of incident depressive symptoms [adjusted Risk Ratio (aRR) = 1.06, 95% CI: 1.00, 1.12]. Each 1-point increment in baseline PHQ-9 score predicted an increased risk of incidence of postnatal depressive symptoms (aRR = 1.29, 95% CI: 1.15, 1.45). There was no association between self-reported pregnancy complications, medical conditions or experience of threatening life events with either incidence or persistence of depressive symptoms.ConclusionPsychological and social interventions to address intimate partner violence during pregnancy may be the most important priorities, able to address both incident and persistent depression.

Ethiopian Community Attitude Towards the O-Words (Overweight and Obesity); As A Symbol Of Wealth, Health, Beauty, Comfort, Honesty, Dignity, Respect And Confidence Which Should Be A Turning Point For Their Detrimental Effects

Ethiopian Community Attitude Towards the O-Words (Overweight and Obesity); As A Symbol Of Wealth, Health, Beauty, Comfort, Honesty, Dignity, Respect And Confidence Which Should Be A Turning Point For Their Detrimental Effects

Use of Natural Dietary Spices for Reclamation of Food Quality Impairment by Aflatoxin

Certain natural dietary spices, in addition to their use in food flavoring and preservation, have the ability to detoxify or degrade a wide range of chemical carcinogens. In the present study, aqueous extracts of judiciously selected natural dietary spices were evaluated for their ability to degrade aflatoxin B1 (AFB1). A total of 9 spices including garlic (Allium sativum), ginger (Zingiber officinale), black cumin (Nigella sativum), clove (Syzygium aromaticum), sacred basil (Ocimum basilicum), lemon grass (Cymbopogon citratusL. (DC)Stapf)), thyme (Thymus schimperi), fenugreek (Trigonella foenum-graecum), and lemon traditionally used by the Ethiopian Community for food flavoring and preservation were considered. Aflatoxin degradation efficacy of the spice extracts was studied through determination of the toxin in extract-treated and nontreated samples using LC-MS/MS. The degradation was characterized by electrochemical methods based on the characteristic oxidation peak of phenolic hydroxyl resulting from the degradation of the toxin after treatment with the extracts. Of the various spices, garlic showed the highest 35.8% (30 min) to 61.7% (1 hr) in spiked and 46.7% (30 min) to 68.3% (1 hr) and real-sample (contaminated maize) treatment reduction followed by lemon 34.2% (30 min) to 56.0% (1 hr) in spiked and 41.1% (30 min) to 60.6% (1 hr) in real-sample treatment at 25°C. The level of reduction was higher in real-sample treatment than that in spiked. This suggests adsorptive contribution by the matrix in addition to the chemical degradation. The current findings revealed nonobvious benefits of the use of natural dietary spices as effective solution for AFB1 degradation and decontamination of food.

Treatment gap, help-seeking, stigma and magnitude of alcohol use disorder in rural Ethiopia

BackgroundAlthough alcohol use disorders contribute a high proportion of population disease burden, the treatment gap is large, especially in low- and middle-income countries. To narrow this gap, contextually relevant evidence is needed to inform service development in low- and middle-income country settings. The aim of this study was to assess the magnitude of the treatment gap for alcohol use disorder, help-seeking behavior, stigma and barriers to care among people with alcohol use disorder in rural Ethiopia.MethodsA cross-sectional, house-to-house survey was conducted in Sodo district, south Ethiopia. A sample of 1500 adults was selected using simple random sampling from a census of households and screened for alcohol use disorder using the alcohol use disorders identification tool (AUDIT). Help-seeking, barriers to care and internalized stigma were investigated among people with moderately severe alcohol use disorder (AUDIT score ≥ 16). Poisson regression with robust variance was used to examine factors associated with alcohol use disorder.ResultsThe prevalence of alcohol use disorder (AUDIT ≥8) in the past 12 months was 13.9% (25.8% in men and 2.4% in women, p-value < 0.001). People with alcohol use disorder had increased disability (adjusted prevalence ratio (aPR) 1.03, 95% confidence interval (CI) 1.01, 1.03) and higher depressive symptom scores (aPR 1.02, 95% CI 1.01, 1.04). The treatment gap was very wide, about 87.0% (only 13% sought help) of participants with an AUDIT score ≥ 16 had never sought help for their alcohol problems and 70.0% reported high internalized stigma. Major barriers to seeking help were wanted to handle the problem on their own, believing that it would get better by itself and being unsure about where to go.ConclusionsAlthough alcohol use disorders are common problems in Ethiopian community, the unmet need for treatment is substantial. An integrated care approach has the potential to address this need, but stigma and low awareness may be major barriers to help-seeking. Interventions to reduce stigma and enhance community awareness are recommended.

Who Is a Jew (in Africa)? Definitional and Ethical Considerations in the Study of Sub-Saharan Jewry and Judaism

ABSTRACTIn recent decades, the fulcrum of African Jewry has shifted from long-established Ethiopian communities to emerging ones in West and Central Africa. This transition from “old” to “new” expressions of Judaism in Africa reanimates the question, “Who is a Jew?” The matter is problematized by the existence of multiple and diverse communities who purport Israelite lineage but eschew normative Judaism. This article offers a “concentric circles” model to bring conceptual and theological clarity to this issue. The outer circle or ring includes African “tribes” (as the term is used by African themselves) that claim ancient Hebrew lineage but still subscribe to institutionalized Christianity (Protestant or Catholic) or indigenous belief systems (animist or ancestral), or a combination of these. A middle circle or ring encompasses groups that have modified their practices and beliefs to resemble Jewish or Israelite religion but in fundamentally non-normative ways (e.g., practicing priestly sacrifice or retaining Jesus Christ as a Messianic touchstone). The core ring represents those African communities that do adopt normative Judaism, albeit with Africanized accretions. Some scholarly consensus regarding the legitimacy of wide-ranging claims to Jewish identity in Black Africa is critical to the analytical and ethical integrity of the study of African Judaism.

Planned social network change and modern contraceptive use in a rural Ethiopian community

# Background Over the last decade, Ethiopia has substantially increased uptake of modern contraception and experienced a decline in total fertility, coinciding with implementation of the national Health Extension Programme (HEP), involving an extensive deployment of health extension workers (HEWs), and a health development army (HDA) of volunteer families. The dynamics of such change are important. This multi-method qualitative study was conducted in a rural community in Oromia, Ethiopia, as part of a larger effort to understand the influence of social networks on modern contraceptive use. # Methods Data were collected in five focus groups and twelve individual interviews (n = 59) with men, women, adolescents and key informants in a rural area in Oromia, Ethiopia, together with participant observation. Analysis was conducted using NVivo qualitative research software. # Results We found two types of decision-making social networks for family planning: (i) one pertaining to basic decisions about having children *per se*, which remains the prerogative of traditional, patriarchal social structures; and (ii) a second network, which included HEWs, that applies after initial childbirth, concerning family size and spacing decisions for additional children. # Conclusions While this study supports other research on the effectiveness of the HEP, the study also identified limitations, and raised questions about the replicability of the Ethiopian model for reducing fertility. The level of government commitment and resources required for the HEP are linked to Ethiopia's key position among recipients of development assistance, likely connected to its history and geopolitical role. These circumstances may not be widely applicable.

Planned social network change and modern contraceptive use in a rural Ethiopian community

Planned social network change and modern contraceptive use in a rural Ethiopian community

English

This study was conducted to characterize flock size, composition, productivity, motivational drivers, and breed selection criteria in village chicken production systems of lowlands, midlands, and highlands of Ethiopia. Data were collected at 360 rural households of which 120 were from lowland, 160 midland, and 80 highlands. A standardized questionnaire was used to collect the data using person to person interview method. Data were analyzed using the various statistical procedures of statistical analysis system (SAS) version 9.2. Higher flock size and productivity of chicken were obtained for midlands than the other agro-ecologies. The average flock size per household was 16.6. The average age at sexual maturity of hens was 7 months. Average number of egg production was 43 eggs per hen per year. Average hatching rate was in the range of 76 to 82%. Mortality occurred in the range of 27 to 39%. Although, village chicken has diverse use in Ethiopian rural community, the main motivations to keep village chicken were egg production followed by income generation. Eggs were mainly used for hatching, home consumption, and to generate a daily disposable income. The three most important breed selection criteria were egg production, morphometric characteristics, and mothering ability. Findings from this study can support the design of agro-ecology based breeding strategies aiming to improve native chicken production, productivity, and enhance their economic contributions to the farmers. Key words: Ethiopian native chicken, breed selection criteria, flock productivity, motivational drivers.

Understanding modern contraception uptake in one Ethiopian community: a case study

BackgroundIn the last decade, the proportion of Ethiopian women using contraceptive methods has increased substantially (from 14% in 2005 to 35% in 2016 among married women). Numerous factors have contributed to the increased uptake. An important one is the implementation of the Health Extension Program, a government-led health service delivery strategy that has deployed more than 38,000 health extension workers (HEWs) throughout the country. Key mechanisms underlying the success of this program are not well understood. Using a case study approach, the goal of this study is to describe how key features of local contexts, community perceptions, and messaging by HEWs have contributed to the increased use of modern contraception in one community in Ethiopia.MethodsWe conducted focus groups and individual interviews with men, women, adolescents, and key informants, including (HEWs), in Oromia, Ethiopia. We used a random sampling protocol to recruit all participants except key informants, with whom purposive sampling was used to ensure participants were knowledgeable on family planning in the village. Interviews were audio recorded, translated, transcribed, and then analyzed using applied thematic analysis and NVivo v.11 qualitative research software.ResultsWe identified four themes that may explain uptake of contraception: (1) HEWs are seen as trusted and valued community members who raised awareness about family planning; (2) the HEW messaging that contraception is useful to space pregnancies among married women was effective; (3) the message that spacing is healthy for mother and child was also effective; and (4) communicating to the entire community (including men, women, adolescents, and religious leaders), contributed to changing attitudes around contraception.ConclusionThe four aspects of the Health Extension Program approach increased uptake of contraception in our sample. In contexts where community health workers are valued by the health systems and local communities they serve, this type of approach to widening modern contraception use could help increase uptake and address unmet need. Understanding these granular aspects of the program in one local context may help explain how use of contraception increased in the country as a whole.

Prevalence and Associated Factors of Perinatal Depression in Ethiopia: A Systematic Review and Meta-Analysis.

Background There is no pooled evidence regarding the prevalence and potential associated factors of perinatal depression in Ethiopian community. Hence, the current review aimed to examine the prevalence and associated factors of perinatal depression in Ethiopia. Method A computerized systematic literature search was made in MEDLINE, Scopus, PubMed, ScienceDirect, and Google Scholar. Each database was searched from its start date to January 2018. All included articles were published in English, which evaluated prevalence and associated factors of perinatal depression in Ethiopia. Pooled estimations with 95% confidence interval (CI) were calculated with DerSimonian-Laird (DL) random-effects model. Publication bias was evaluated by using inspection of funnel plots and statistical tests. Result Eight observational studies with an overall sample size of 4624 mothers were included in the review. The pooled prevalence of perinatal depression from these studies reported that the prevalence of perinatal depression in Ethiopia is 25.8% [95% CI, 24.6%-27.1%]. A pervious history of depression [RR: 3.78 (95% CI, 2.18-6.57), I2 = 41.6%], poor socioeconomic status [RR: 4.67 (95% CI, 2.89-7.53), I2 = 0%], not living with spouse [RR: 3.76 (95% CI, 1.96-7.38), I2 = 36.4%], having obstetric complications in previous and/or this pregnancy [RR: 2.74 (95% CI, 1.48-5.06), I2 = 67.7%], and having unplanned pregnancy [RR: 2.73 (95% CI, 2.11-3.53), I2 = 0%] were the major factors associated with perinatal depression. Conclusion The pooled prevalence of perinatal depression in Ethiopia is far above most developed as well as developing countries. Hence, to realize the sustainable development goals (SDGs) outlined by united nation, much attention should be given to improve maternal mental health through reduction of identified modifiable factors. Maternal health programs, polices, and activities should incorporate maternal mental health as a core component.

Household Food Insecurity and Hunger in Selected Ethiopian Agricultural Communities: Examination of Supply and Demand Factors

Food insecurity and hunger are major challenges in many Ethiopian communities with repercussions on health and nutrition outcomes in vulnerable household members. The level and contextual risk factors of household food insecurity and hunger were assessed in households (n=630) from three rural communities of Ethiopia (Halaba or Zeway) using the Household Food Insecurity Access Scale and Household Hunger Scale. Multiple classification analysis was employed to explore the effects of key demand (e.g. household size, livestock) and supply (e.g. land size, frequency of production) factors and community (geographic location) as well as institutional (participation in food security programs) factors on food insecurity and hunger. Household food insecurity was unacceptably high in both districts (95% in Halaba &amp;amp; 67% in Zeway). Household hunger was 38% in Halaba and 18% in Zeway. Both food insecurity and hunger were significantly greater in Halaba (p&amp;lt;0.001), indicating an effect of geographic location. Both supply and demand factors were significant in determining household food insecurity and hunger (p&amp;lt;0.01); however, supply factors such as women’s access to land, land size and wealth had greater influence than the demand factors. Levels of food insecurity and hunger in both communities were very high and of serious concern. We recommend increasing the food supply, and its subsequent accessibility, for households through enhancing women’s access to land, improving income through savings and wealth accumulation, introducing more inclusive programs for women’s participation and reducing household work-burden by significantly enhancing productivity of cultivable land.

Indirect questioning method reveals hidden support for female genital cutting in South Central Ethiopia.

Female genital cutting (FGC) has major implications for women’s physical, sexual and psychological health, and eliminating the practice is a key target for public health policy-makers. To date one of the main barriers to achieving this has been an inability to infer privately-held views on FGC within communities where it is prevalent. As a sensitive (and often illegal) topic, people are anticipated to hide their true support for the practice when questioned directly. Here we use an indirect questioning method (unmatched count technique) to identify hidden support for FGC in a rural South Central Ethiopian community where the practice is common, but thought to be in decline. Employing a socio-demographic household survey of 1620 Arsi Oromo adults, which incorporated both direct and indirect direct response (unmatched count) techniques we compare directly-stated versus privately-held views in support of FGC, and individual variation in responses by age, gender and education and target female (daughters versus daughters-in-law). Both genders express low support for FGC when questioned directly, while indirect methods reveal substantially higher acceptance (of cutting both daughters and daughters-in-law). Educated adults (those who have attended school) are privately more supportive of the practice than they are prepared to admit openly to an interviewer, indicating that education may heighten secrecy rather than decrease support for FGC. Older individuals hold the strongest views in favour of FGC (particularly educated older males), but they are also more inclined to conceal their support for FGC when questioned directly. As these elders represent the most influential members of society, their hidden support for FGC may constitute a pivotal barrier to eliminating the practice in this community. Our results demonstrate the great potential for indirect questioning methods to advance knowledge and inform policy on culturally-sensitive topics like FGC; providing more reliable data and improving understanding of the “true” drivers of FGC.