Groups In Ethiopia Research Articles

Determinants of the use of modern contraceptives among women of reproductive age group in Ethiopia: A multi-level mixed effects analysis.

Modern contraceptive methods are a scientifically effective method to control the fertility of reproductive-aged groups of people. The women's use of contraceptive methods creates a birth gap and limits the number of their children. The main objective of this study is to identify the significant determinant of modern contraceptive use of reproductive-aged women in Ethiopia. We used data from 2019 Ethiopian Mini Demographic and Health Survey. This data was multi-level, taking into account factors at the individual and community levels. In order to capture the multi-level structure of this data and make more reliable and broadly applicable conclusions about the variables influencing the use of modern contraceptives at the individual and community levels, we employed a two-level mixed-effects logistic regression model. In addition, we used cross-tabulation analysis to know the percentage of modern contraception users (reproductive-aged women) across their socio-economic, demographic, and health characteristics. A total of 8196 reproductive aged (15-49) women were included in this study. From a total of 8196 reproductive-aged women, 2495(30.4%) were using modern contraceptive method and the rest 5701(69.6%) did not use any modern contraceptive methods. Among 2495 contraceptive users, 1657 (67.3%) used injections and 533 (21.7%) used implants/Norplant. At a 5% level of significance, the result from the two-level binary logistic regression model revealed that the predictors; Age of women, education level, religion, wealth index, knowledge of modern contraception method, number of died children, number of living children, family size, total children ever born and contextual region have significant effect on the use of modern contraception method. Reproductive-aged women in Ethiopia with more living children, residing in urban/agrarian region, younger, wealthier, married, and more educated, were more likely to be modern contraceptive users. The concerned bodies in Ethiopia should bring forward the intervention strategy and should expand the existed programs to improve the use of modern contraception methods among reproductive-aged women in Ethiopia. Especially, they should give special attention to reproductive-aged women of less income, resident in pastoralist region, less educated, unmarried, and haven't living child.

The Food and Nutrition Policy Environment and Drivers of Changes in Key Food System Outcomes in Ethiopia

Background: There seems to be huge gap in our understanding of the changes over time in food system outcomes and their drivers in Ethiopia. The main aim of this study is to examine the food and nutrition programs and policies and their corresponding key food system outcomes in Ethiopia. Methods: The bulk of the information was generated using scooping review of relevant articles and policy documents. About 67 full text records were used for the review. In addition, data were collected using Key Informant Interview (KIIs) purposefully selected from sectoral offices from two major cities (Hawassa and Dire Dawa), of two regions. The analytical framework used in this paper was adopted from previous studies on related subjects and addressed three key components of food system: review of food and nutrition policy environment, key food system outcomes and key drivers. Results: Despite improvement in some food system outcomes (such as child nutrition and survival), food security crises in Ethiopia are still becoming more frequent and more acute, affecting the poor disproportionately. Most food and nutrition policies are constrained by lack of implementation capacities. Indicating the presence of various barriers (socioeconomic, demographic, and environmental). Poor human capital (such as knowledge and attitude), food taboos and tradition, cultural practices such as gender-based norms, poor education, poor delivery/supply chain, demographic pressure and other environmental drivers play critical role in food and nutrition security of most vulnerable population groups in Ethiopia. Conclusion and implications: Given the challenges confronting Ethiopia today, it is imperative to assume that meeting Sustainable Development Goal (SDG) 2 (i.e., attaining zero hunger by 2030) becomes challenging. This calls for continuous capacity building to help implement, learn, and adapt a systems approach; and access to education and skill training on food production and consumption and narrowing down the gender differential in food access and consumption.

The Food and Nutrition Policy Environment and Drivers of Changes in Key Food System Outcomes in Ethiopia

Background: There seems to be huge gap in our understanding of the changes over time in food system outcomes and their drivers in Ethiopia. The main aim of this study is to examine the food and nutrition programs and policies and their corresponding key food system outcomes in Ethiopia. Methods: The bulk of the information was generated using scooping review of relevant articles and policy documents. About 67 full text records were used for the review. In addition, data were collected using Key Informant Interview (KIIs) purposefully selected from sectoral offices from two major cities (Hawassa and Dire Dawa), of two regions. The analytical framework used in this paper was adopted from previous studies on related subjects and addressed three key components of food system: review of food and nutrition policy environment, key food system outcomes and key drivers. Results: Despite improvement in some food system outcomes (such as child nutrition and survival), food security crises in Ethiopia are still becoming more frequent and more acute, affecting the poor disproportionately. Most food and nutrition policies are constrained by lack of implementation capacities. Indicating the presence of various barriers (socioeconomic, demographic, and environmental). Poor human capital (such as knowledge and attitude), food taboos and tradition, cultural practices such as gender-based norms, poor education, poor delivery/supply chain, demographic pressure and other environmental drivers play critical role in food and nutrition security of most vulnerable population groups in Ethiopia. Conclusion and implications: Given the challenges confronting Ethiopia today, it is imperative to assume that meeting Sustainable Development Goal (SDG) 2 (i.e., attaining zero hunger by 2030) becomes challenging. This calls for continuous capacity building to help implement, learn, and adapt a systems approach; and access to education and skill training on food production and consumption and narrowing down the gender differential in food access and consumption.

Anomalous Political Discursive Narratives on Indigeneity: In Ethiopia's Regional States

AbstractThe major purpose of this article is to critically probe the competing political narratives on indigeneity‐ in the form of autochthony‐ the sons of the soil, and its instrumentalization for discrimination against non‐indigenous groups in Ethiopia's regional states. To this end, the article argues that the political discourses (narratives) determine Ethiopia's ethnic‐based state structure and politics that dichotomize citizens as indigenes and non‐indigenes, which, in reality, is not viable. Each ethnic group, which forms the region, has a warranty of sovereign political power and territorial autonomy. Inside the regions, except for the Amhara and the South Nations, Nationalities, and Peoples Regions, the privileged ethnic group (the indigenous) has been empowered to hold prominent political positions. Non‐indigenous ethnic groups, on the other hand, are discriminated against in politics, economy, and social affairs. Thus, these political narratives have created a system of inequality and discrimination that has persisted even after the end of EPRDF era. To address these intractable problems, Ethiopians seek to balance diversity and unity in order to create an inclusive and all‐empowering environment in society through multiculturalism.

Monitoring and management of common property resources: empirical evidence from forest user groups in Ethiopia

AbstractThe presence of monitoring institutions affects quality and effort of leaders. We investigate the effect of intensified monitoring on the ability and effort of leaders for a sample of forest user groups in Ethiopia, and find experimental and non-experimental evidence of an important trade-off: monitoring increases leaders' effort but lowers their quality in terms of education and experience. This effort–ability trade-off only occurs in the presence of alternative income opportunities (affecting the opportunity cost of time) and only among a subsample of leaders with low prosocial motivation. For our context, we document that the net effect of monitoring on economic outcomes is positive.

Facilitators and barriers to implementing chest radiography in tuberculosis systematic screening of clinically high-risk groups in Ethiopia: A qualitative study.

Chest X-ray has been included in national tuberculosis screening algorithms as a sensitive tuberculosis screening tool among high-risk groups. However, the implementation was influenced by multiple factors. We aimed to explore facilitators and barriers to implementing chest X-ray in systematic tuberculosis screening of clinically high-risk groups in Addis Ababa, Ethiopia. We conducted face-to-face, in-depth interviews with purposively selected participants at tertiary-level hospitals and a tuberculosis program coordinator at the Ethiopian Ministry of Health, who coordinates chest X-ray-guided systematic tuberculosis screening. A framework analysis was conducted using the consolidated framework for implementation research. We identified 11 constructs that influenced the implementation of the chest X-ray intervention. Facilitators included the relative sensitivity of chest X-ray over symptom-based screening, its potential integration into existing systems, technological advancements in the area, policies and laws supporting the screening intervention, and the quality of the evidence of the screening intervention. Barriers included implementation complexity, high costs of the intervention, knowledge gaps among healthcare providers, training gaps, low priority for chest X-ray screening at the healthcare facility level, and a lack of external support from the Ministry of Health and stakeholders. This study identified contextual factors that influence the implementation of chest X-ray guided systematic tuberculosis screening among clinically high-risk groups that healthcare facilities and health ministries may use for decision-making. Addressing the barriers identified by the study would help to improve the implementation of chest X-rays for improved tuberculosis case detection and prompt treatment in clinically high-risk groups.

The Art, Microbial Quality, Safety, and Physicochemical Characteristics of Jikita: A Traditional Ethiopian Fermented Beverage.

Jikita is a traditional fermented beverage popular among the Oromo ethnic groups in Ethiopia. It is made from cereal and has a high alcohol content and thick texture. Jikita is widely consumed in the Western Oromia region of Ethiopia and holds significant socioeconomic and cultural importance. However, there is limited knowledge regarding the microbial quality and safety of Jikita, as well as its physicochemical and proximate composition. This study is aimed at assessing the current state of Jikita production and consumption. Samples were collected from two districts in the West Shewa Zone, where Jikita is most prevalent. A survey was conducted to gather information on production methods, sanitary conditions, ingredient composition, and the socioeconomic importance of Jikita. The samples were then analyzed for microbial counts, identification, and dynamics, as well as for pH, titratable acidity (TA), moisture, total solid, alcohol, carbohydrate, fat, and protein contents. The results showed that the majority of producers and sellers were middle-aged women who did not use protective clothing. Microbial counts revealed that the levels of aerobic mesophilic bacteria, yeasts, and lactic acid bacteria (LAB) were below the WHO/FDA standards, and no Salmonella spp. were detected. The samples exhibited varying pH, TA, moisture, total solid, alcohol, carbohydrate, fat, and protein contents. The microbial dynamics during fermentation showed that different groups of bacteria and yeasts dominated different stages. The overall microbial quality of Jikita was indicative of spoilage microorganisms. However, the duration of fermentation inhibited the growth of pathogenic microorganisms and extended the shelf life of the product to more than 2 months. This study provides valuable insights into traditional fermented beverages and their implications for public health. It also suggests the need for improved hygiene practices and quality control measures in Jikita production and consumption.

Effectiveness and impact of community-based health insurance on health service utilization in northwest Ethiopia: a quasi-experimental evaluation.

Addressing the health challenges of lower socioeconomic groups in Ethiopia is still a huge problem. In that regard, the government piloted the community-based health insurance (CBHI) in 2011 in a few districts and subsequently scaled up. However, the effectiveness of the program on the utilization of health services and its impact was not well explored. Thus, we aimed to evaluate the effectiveness of CBHI toward health services' utilization and its impact in northwest Ethiopia. A quasi-experimental matched comparison group evaluation design with sequential explanatory mixed methods was employed. To evaluate the CBHI program, the effectiveness and impact dimensions from the Organization for Economic Cooperation and Development framework were used. A multistage sampling technique was used to select a total of 332 households enrolled in the CBHI program; 341 comparison households who did not enroll in the program were also randomly selected. A structured interviewer-administrated questionnaire was used to evaluate the effectiveness and impact of CBHI on health service utilization. The Propensity score matching model was employed for the estimation of the effect of the CBHI program on health service utilization. Challenges for program achievement toward health service utilization were explained through qualitative data and these were then analyzed thematically. The evaluation showed 1.3 visits per capita per year of health service utilization among CBHI members. Households enrolled in CBHI increased health service utilization by 6.9 percentage points (ATT = 0.069; 95% CI: 0.034, 0.114). There was an improvement in health service utilization after the introduction of CBHI, however, there are challenges: (i) shortage of human resources, (ii) out-of-stock of drugs and medical supplies, and (iii) long waiting times for service and reimbursement claims. These issues limit the success of the program toward health service utilization. The CBHI program contributed to health service utilization improvement among CBHI members. However, the utilization rate of health services among CBHI members is still less than the target stated for the program and also the WHO recommendation. Therefore, the findings of this evaluation can be used by program implementers, policy makers, and other stakeholders to overcome the identified challenges and to increase the success of the program.

The Burden of Epstein-Barr Virus (EBV) and Its Determinants among Adult HIV-Positive Individuals in Ethiopia.

Epstein-Barr virus (EBV) is a well-known risk factor for the development of nasopharyngeal carcinoma, Hodgkin's lymphoma (HL), and Non-Hodgkin's lymphoma (NHL). People with HIV infection (PWH) are at increased risk for EBV-associated malignancies such as HL and NHL. Nevertheless, there are limited data on the burden of EBV among this population group in Ethiopia. Hence, this study aimed to determine the burden of EBV infection among adult HIV-positive individuals in Ethiopia and assess the determinants of EBV DNA positivity. We conducted a cross-sectional study at the Tikur Anbessa Specialised Hospital from March 2020 to March 2021. Two hundred and sixty individuals were enrolled in this study, including 179 HIV-positive and 81 HIV-negative individuals. A structured questionnaire was used to capture demographic and individual attributes. In addition, the clinical data of patients were also retrieved from clinical records. EBV viral capsid antigen (VCA) IgG antibody was measured by multiplex flow immunoassay, and EBV DNA levels were tested by quantitative real-time polymerase chain reaction (q-PCR) assays targeting the EBNA-1 open reading frame (ORF). Descriptive statistics were conducted to assess each study variable. A multivariable logistic regression model was applied to evaluate the determinants of EBV infection. Statistical significance was determined at a p-value < 0.05. Two hundred and fifty-three (97.7%) study participants were seropositive for the EBV VCA IgG antibody. Disaggregated by HIV status, 99.4% of HIV-positive and 93.8% of HIV-negative participants were EBV seropositive. In this study, 49.7% of HIV-positive and 24.7% of HIV-negative individuals were EBV DNA positive. PWH had a higher risk of EBV DNA positivity at 3.05 times (AOR: 3.05, 95% CI: 1.40-6.67). Moreover, among PWH, those with an HIV viral load greater than 1000 RNA copies/mL (AOR = 5.81, 95% CI = 1.40, 24.13) had a higher likelihood of EBV DNA positivity. The prevalence of EBV among PWH was significantly higher than among HIV-negative individuals. Higher HIV viral loads in PWH were associated with an increased risk of EBV DNA positivity. Since the increases in the viral load of EBV DNA among PWH could be related to the risk of developing EBV-associated cancers, it is necessary for more research on the role of EBV in EBV-associated cancer in this population group to be carried out.

Hematological Abnormalities Among Malaria Infected Adult Patients in Association with ABO Blood Groups at Jinella Health Center, Harar, Eastern Ethiopia.

Hematological abnormalities are a common complication of malaria infection. However, there is a paucity of evidence regarding it among malaria-infected adult patients in association with the ABO blood group in Ethiopia, particularly in the Harari Region. Therefore, this study aimed to assess the hematological abnormalities among malaria-infected adult patients in association with ABO blood groups at Jinella Health Center, Harar, Eastern Ethiopia. An institutional-based cross-sectional study was conducted from July 10, 2022, to January 10, 2023. Four milliliters of venous blood were collected from each study participant. Drops of blood were used for blood film preparation. ABO blood group was determined by agglutination test using monoclonal anti-sera (Agape Diagnostics Ltd., India). A complete blood count was done using the DxH 800 (Beckman Coulter, Inc, Miami, FL) hematology analyzer. The data were analyzed using SPSS version 26. Bivariable and multivariable logistic regression models were fitted. The level of significance was declared at a p-value of <0.05. The study revealed that 47.2% (95% CI: 41.0 53.6) of the participants were anemic. Being female (AOR = 3.18, 95% CI = 1.67, 6.04), having the A blood group (AOR = 2.75, CI = 1.20, 6.31), and being infected with P. falciparum (AOR = 2.64, CI = 1.26, 5.53) were all significantly associated with malaria anemia. The overall prevalence of thrombocytopenia was also 67.7% (95% CI: 61.7-73.4%). It was significantly associated with P. falciparum infection (AOR = 8.03, CI = 3.53, 18.25) and high parasitemia levels (AOR = 4.40, CI = 1.57, 12.32). Patients with malaria who belonged to the "A" blood group in the study area had anemia as a serious health problem. Hence, frequently checking for anemia in patients with malaria who have blood group "A" can help with early detection and better management of anemia.

National and subnational burden of under-5, infant, and neonatal mortality in Ethiopia, 1990-2019: Findings from the Global Burden of Disease Study 2019.

The under-5 mortality rate is a commonly used indicator of population health and socioeconomic status worldwide. However, as in most low- and middle-income countries settings, deaths among children under-5 and in any age group in Ethiopia remain underreported and fragmented. We aimed to systematically estimate neonatal, infant, and under-5 mortality trends, identify underlying causes, and make subnational (regional and chartered cities) comparisons between 1990 and 2019. We used the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD 2019) to estimate three key under-5 mortality indicators-the probability of death between the date of birth and 28 days (neonatal mortality rate, NMR), the date of birth and 1 year (infant mortality rate, IMR), and the date of birth and 5 years (under-5 mortality rate, U5MR). The causes of death by age groups, sex, and year were estimated using Cause of Death Ensemble modelling (CODEm). Specifically, this involved a multi-stage process that includes a non-linear mixed-effects model, source bias correction, spatiotemporal smoothing, and a Gaussian process regression to synthesise mortality estimates by age, sex, location, and year. In 2019, an estimated 190,173 (95% uncertainty interval 149,789-242,575) under-5 deaths occurred in Ethiopia. Nearly three-quarters (74%) of under-5 deaths in 2019 were within the first year of life, and over half (52%) in the first 28 days. The overall U5MR, IMR, and NMR in the country were estimated to be 52.4 (44.7-62.4), 41.5 (35.2-50.0), and 26.6 (22.6-31.5) deaths per 1000 livebirths, respectively, with substantial variations between administrative regions. Over three-quarters of under-5 deaths in 2019 were due to five leading causes, namely neonatal disorders (40.7%), diarrhoeal diseases (13.2%), lower respiratory infections (10.3%), congenital birth defects (7.0%), and malaria (6.0%). During the same period, neonatal disorders alone accounted for about 76.4% (70.2-79.6) of neonatal and 54.7% (51.9-57.2) of infant deaths in Ethiopia. While all regional states in Ethiopia have experienced a decline in under-5, infant, and neonatal mortality rates in the past three decades, the rate of change was not large enough to meet the targets of the Sustainable Development Goals (SDGs). Inter-regional disparities in under 5 mortality also remain significant, with the biggest differences being in the neonatal period. A concerted effort is required to improve neonatal survival and lessen regional disparity, which may require strengthening essential obstetric and neonatal care services, among others. Our study also highlights the urgent need for primary studies to improve the accuracy of regional estimates in Ethiopia, particularly in pastoralist regions.

Dietary diversity and associated factors among adolescent girls in Nifas Silk Laphto sub city, Addis Ababa, Ethiopia, 2021

BackgroundAddressing the nutritional problems of adolescent girls is important as their nutritional status has a negative effect on the future generation. However, the evidence revealed the variation and unrelated data on the prevalence of dietary diversity and lack of including all adolescent age and community groups in Ethiopia. Hence, this study assessed dietary diversity and associated factors among adolescent girls in Nifas Silk Laphto Sub-city, Addis Ababa Ethiopia, 2021.MethodsA community-based cross-sectional study was conducted among 475 adolescent girls at Nifas Silk Laphto sub-city, Addis Ababa Ethiopia from July 1 to 30, 2021. Multistage cluster sampling was employed to select adolescent girls. Pretested questionnaires were used to collect the data. The data were checked for completeness and entered by Epidata version 3.1 and cleaned and analyzed by SPSS version 21.0. A multivariable binary logistic regression model was fitted to identify factors associated with dietary diversity scores. The degree of association was assessed using an odds ratio with a 95% confidence interval and variables with p-value ≤ 0.05 were considered significant.ResultThe mean and the standard deviation of dietary diversity scores were 4.70 and 1.21 respectively. The proportion of low dietary diversity scores among adolescent girls was 77.2%. Adolescent girls’ age, meal frequency, wealth index of household, and food insecurity were significant determinants of dietary diversity score.ConclusionThe magnitude of low dietary diversity scores was significantly higher in the study area. Adolescent girls’, meal frequency, wealth index, and food security status were predictors of dietary diversity score. School-based nutrition education and counseling and designing strategies for improving household food security programs are crucial.

Integrating Traditional and State Institutions for Conflict Prevention: Institutional, Legal and Policy Frameworks in Ethiopia

Despite the prevalence of traditional institutions and the growing official and academic need to ‘recognize,’ ‘empower’ and incorporate them in the state system, competition and harmony between the two persists. There are seventy-six officially listed ethnic groups in Ethiopia, and there exists a great plurality of livelihoods, social organizations, belief systems, and political and legal systems in the country. Notwithstanding the human right issues, traditional institutions operating outside the state are the dominant form of conflict prevention and resolution in Ethiopia. However, the relationship between traditional institutions and state institutions remains unclear. Previous researches either focus on the constitutional set-up and legal framework of states, or their scope is too specific relating to local case studies and their relationship with the state local institutions. This relationship does not, however, only involve legal issues or concerns at the bottom, but it is also an issue of governance and political structure. This article is based on content and document analysis and examines the harmony and competition between the state and traditional institutions in Ethiopia. I argue that despite their practical prevalence, the policy, legal and institutional frameworks in Ethiopia do not plainly address the relationship between the state and traditional institutions. Although de facto recognition seems to exist, the practice shows that the state that envisages the importance of traditional institutions undermines their role in case of conflict with state institutions.

Ethnobotanical study of medicinal plants used in Artuma Fursi district, Amhara Regional State, Ethiopia

IntroductionIndigenous people of different ethnic groups in Ethiopia are noticeably reliant on traditional medicinal plants for their healthcare due to their effective medicinal values. The study was aimed to document different herbal medicinal plants used and the associated knowledge of herbal medicine in the communities of the Artuma Fursi district.MethodologyEthnobotanical data were collected through semi-structured interviews, field observations, focused group discussions with the informants selected from the study area. Key informants were selected by purposive sampling technique, while the rest, were selected by random sampling techniques. The collected data were analyzed using descriptive statistics; paired comparison, preference ranking, and informant consensus factor.ResultsA total of 86 informants participated in the collection of the ethnobotanical data. A total of 92 medicinal plants were collected and identified. Fabaceae was the highest family cited (11.9%). The study revealed that leaves (31.1%), seeds (19.8%), and roots (12.26%) were the most cited plant parts used for the preparation of herbal medicine by the respondents. The most common method of preparation of herbal medicines was pounding (21.6%) and the most common route of administration was oral route (53.7%). The majority of the medications (60.3%) were prepared without the additive. Charcoal production was the major threat to medicinal plants in the study area.ConclusionArtuma Fursi district is rich in medicinal plant and the associated indigenous knowledge. The documented knowledge will be helpful for further research in the drug development process.

Multilevel analysis of undernutrition and associated factors among adolescent girls and young women in Ethiopia

BackgroundThe consequences of undernutrition have serious implication for the health and future reproductive periods of adolescent girls and young women aged 15–24 years. Inspite of this, they are neglected age groups and there is limited information about the nutritional status of this age group in Ethiopia. Therefore, estimating the extent and associated factors of undernutrition among adolescent girls and young women in a national context using multilevel analysis is essential.MethodsSecondary data analysis was conducted from the Ethiopian Demographic and Health Survey 2016. A total sample weight of 5362 adolescent girls and young women was included in this study. A multilevel mixed-effect binary logistic regression model with cluster-level random effects was fitted to determine the associated factors of undernutrition among adolescent girls and young women in Ethiopia. Finally, the odds ratios along with the 95% confidence interval was generated to determine the individual and community level factors of undernutrition. A p-value less than 0.05 was declared as the level of statistical significance.ResultsOverall, 25.6% (95%CI: 24.5–26.9) of adolescent girls and young women were undernourished. Statistically significant individual level factors includes adolescent girls and young women aged 15–19 years (AOR: 1.53, 95%CI: 1.32–1.77), individual media exposure (AOR: 0.82, 95%CI: 0.69–0.97), and unprotected drinking water source (AOR: 1.24, 95%CI: 1.04–1.48). Whereas, Southern Nations, Nationalities, and Peoples' Region (AOR: 0.33, 95%CI: 0.13–0.83) and rural residence (AOR: 1.69, 95%CI: 1.24–2.32), were community level factors for adolescent girls and young women undernutrition.ConclusionOne quarter of the Ethiopian adolescent girls and young women were undernourished. Therefore, the Ethiopian government should better engage this age group in different aspects of the food system. To improve nutritional status, public health interventions such as increased media exposure for rural residents and interventions that improve access to protected water sources will be critical.

Interventions for Inclusion in TVET through Private-Public Development Partnership in Ethiopia and Zambia

The study is about reconfiguring Technical and Vocational Education and Training (TVET) through Private-Public Development Partnership (PPDP) for the inclusion of disadvantaged groups in Ethiopia and Zambia. A PPDP is a cooperation between national and foreign actors targeted at development activities and is a governmental strategy to increase the standard of TVET, including strategies to include disadvantaged learners. This article focuses on two PPDPs, one comprising a TVET college in Ethiopia and another in Zambia. The aim is to analyse and compare the curricular strategies of these two PPDPs to revamp TVET for the inclusion of disadvantaged learners. Data was generated through document analysis, interviews and focus groups. The findings indicate that both PPDPs served as an intervention to the TVET institutions, thereby including disadvantaged learners in contexts of huge inequality of opportunities. The article points to tensions relating to inclusion, particularly about how global educational policy trends contend with the realities in local labour markets and the needs of TVET graduates who will work therein.

Incentivizing and nudging farmers to spread information: Experimental evidence from Ethiopia

AbstractInformation does not flow freely through social networks. We use an experiment to study knowledge diffusion about an innovation (integrated pest management, IPM) in farmer groups in Ethiopia. Group leaders are incentivized to share knowledge with members through the conditional provision of material or social prestige rewards. We combine incentives with loss‐framed messaging to leverage loss aversion. Incentives increase diffusion effort, and combining incentives with loss‐framed messaging increases effort further. However, the treatments failed to induce follower farmers to experiment with IPM. We also document that reclaiming material rewards is difficult after a long delay, attenuating the effectiveness of the loss frame.

Spatial distribution and determinant factors of unmet need for family planning among all reproductive-age women in Ethiopia: a multi-level logistic regression modelling approach

BackgroundUnmet need for family planning has been remaining high in developing countries than developed countries, notably in sub-Saharan Africa. Data on unmet needs can help countries set service priorities. This study aimed to explore the geographical disparities of unmet need among reproductive-age women in Ethiopia using a 2016 national population-based survey.MethodsThis study was based on the nationally representative 2016 Ethiopian Demographic and Health Survey data. We used a total weighted sample of 15,683 reproductive-aged women. A multi-level logistic regression analysis was used to account for the Demographic Health Survey data’s hierarchal nature. In the multivariable multi-level analysis, those variables with a p-value < 0.05 were significantly associated with unmet needs. Spatial autocorrelation techniques were used to explore the clustering tendencies of unmet needss using Getis-Ord Gi* statistics.ResultsOverall, 15.2% (95% Confidence Interval (CI): 14.63, 15.76) of women of the reproductive age group in Ethiopia had an unmet need for family planning in 2016. In multivariable multilevel logistic regression analysis; individual-level variables such as being married (Adjusted odds ratio (AOR) = 25.7,95% CI: 11.50,60.42), lowest wealth status (AOR = 1.43,95% CI:1.14,1.79), having five or more children (AOR = 1.98, 95% CI:1.62,2.41), being a follower of Muslim religion (AOR = 1.35,95% CI:1.03,1.76) and protestant religion (AOR = 0.73,95% CI: 0.53,0.99) than orthodox Christian followers were statistically associated factors with unmet need. Among community-level variables; being in rural residency (AOR = 1.37, 95% CI: 1.01, 1.93), belong to the Oromia region (AOR = 1.53, 95%CI: 1.10, 2.11) and Somali region (AOR = 0.37, 95% CI: 0.22, 0.61) were significantly associated unmet need. The spatial analysis of unmet need among all women revealed that Oromia, Southern Nations, and Nationality of People and Gambela regions had high hotspots than other parts of the country.ConclusionsIn this study, the prevalence of unmet needs was high. Significant regional unmet need variation was indicated among reproductive-age women in Ethiopia, specifically in western parts of the country. Wealth status, number of children, marital status, residence, and religion were the most important associated factors with unmet needs. Addressing unmet needs targeted rural residents with low socioeconomic status, and western regions should be given top priority.

Lessons Learnt From the First Year of a First-of-Its-Kind Breast Cancer Patient Psychosocial Support Group in Ethiopia and Promising Practices for Initiation and Implementation of Survivor Support Programs in Low-Resource Settings

PURPOSE Psychosocial support helps cancer patients adjust to diagnosis and treatment and improve their overall well-being. With few resources committed to cancer prevention and treatment in Ethiopia, patients’ and survivors’ mental health needs are frequently disregarded, resulting in low quality of life. In October 2020, a support group for breast cancer (BC) patients was formed at Adama Hospital Medical College (AHMC), the first of its kind in Ethiopia. Here, we reflect on lessons learnt from the first year of implementation and share promising practices for establishing such groups in low-resource settings. METHODS The founder and facilitators of the AHMC BC patient and survivor support group describe the program and critically reflect on its impact, challenges to implementation, lessons learned, and ideas for further improvement. Ng and Colombani’s framework for selecting best practices in public health (2015) is used to organize key themes. RESULTS One Saturday each month, 20-30 patients and survivors gather with a traditional Ethiopian coffee ceremony. Participants report feelings of empowerment, hope, and confidence, a stronger sense of interconnectedness with others, and increased engagement in social activities. One notable success was the advocacy opportunity for the women to speak with hospital administrators and Ministry of Health officials at a BC Awareness Month celebration this year. Implementation challenges include a lack of funding, lack of a trained psychologist, and ethical uncertainty about distress caused when members die (not uncommon as patients typically present with advanced stage disease). Clinicians have learned important lessons about patients’ lay beliefs and consequently, patient counseling has been improved to incorporate topics of diet, sexuality, and pregnancy. CONCLUSION A first-of-its-kind BC patient and survivor support group improves perceived psychosocial well-being and quality of life for women in Ethiopia. The low-cost program shares promising practices for survivor support groups and patient-centered cancer treatment in low-resource contexts.

Are strangers just enemies you have not yet met? Group homogeneity, not intergroup relations, shapes ingroup bias in three natural groups.

Humans often favour ingroup members over others, a bias that drives discrimination and intergroup conflicts. Hostile relations between groups and homogeneity within groups may affect such ingroup bias. In an experiment with members of three natural groups in Ethiopia, we vary intergroup relations (neutral versus enmity) and exploit the natural variation in the homogeneity of groups (homogeneous versus heterogeneous) to identify their effect on in- and outgroup concerns. We find that ingroup bias largely manifests as positive concern for ingroup members combined with no concern for outgroup members. Enmity has no effect on ingroup bias, whereas ingroup concern is amplified in homogeneous groups. Group homogeneity, thus, is the primary driver of concerns for others in our study's context. Our results are relevant to understanding the consequences of exclusionary group identities. This article is part of the theme issue 'Intergroup conflict across taxa'.