SNNP Region Research Articles

Spatial distribution and determinants of unskilled birth attendance in Ethiopia: spatial and multilevel analysis

Deliveries performed by unskilled birth attendants is a concern in low-and middle-income countries such as Ethiopia. Unskilled birth attendants may lack the necessary medical knowledge and skills to handle potential complications during child birth. Hence, this study was aimed to assess spatial variation and associated factors of unskilled birth attendance in Ethiopia. This study used a total weighted sample of 7579 women who had a live birth in the five years preceding the survey obtained from EDHS 2016 data. ArcGIS 10.7 software was used to detect areas with a high prevalence of unskilled birth attendance in Ethiopia. Besides, a multilevel logistic regression analysis was done to identify associated factors of unskilled birth attendance. The spatial distribution analysis of unskilled birth attendants was significantly varied across the regions in the country with the significant hotspot areas in the eastern Somali, western Gambela, central and eastern Amhara, southwestern Oromia, eastern border of SNNP regions were detected. In the multilevel multivariable logistic regression model; women in age group (25–34), women attained primary and above educational level, women in the middle and richest household wealth status, mass media exposure, ANC visits, region, place of residence and health insurance coverage were significantly associated with unskilled birth attendance. The geospatial distribution of UBAs was varied across the regions of the country. Maternal age group, education level, rural residence, ANC visits, mass media exposure, wealth status, health insurance coverage and barriers in accessing healthcare service were determinant factors of unskilled birth attendance. Therefore, mothers who had no educational level, not covered by health insurance, women from poor households’ economic status, women from rural areas, and women who had no ANC visit should be given priority in terms of resource allocation including skilled personnel and access to healthcare facilities.

Optimal planning and sizing of microgrid cluster for performance enhancement

Access to electricity is a key indicator of a country’s development. In developing nations like Ethiopia, this metric is particularly crucial for assessing progress. Currently, about 45.8% of Ethiopia’s population lacks access to electricity, with rural areas experiencing even higher rates, reaching 57.2%. The Southern Nations, Nationalities, and People’s (SNNP) region faces the greatest challenge, with 62.1% of its population lacking electricity. Ethiopia aims to achieve universal electricity access by 2030, and microgrid (MG) development is expected to play a pivotal role in meeting this goal. This study employs a multi-tier framework (MTF) to categorize village households based on electricity access, considering factors like income level and willingness to pay, to support the MG development process. Three villages—Toba, Koza, and Womba—in the SNNP region were selected for optimal MG sizing. Sensitivity variables such as global horizontal irradiance (GHI) variation, photovoltaic (PV) and battery prices, battery usage limits, and capacity shortage levels were analyzed for their impact on net present cost (NPC), initial capital cost, and cost of energy (COE) using HOMER Pro software. For example, in the Toba MG, increasing the capacity shortage from 0 to 10% reduced the COE from 0.1195 $/kWh to 0.09104 $/kWh, a 23.82% decrease. Additionally, fluctuations in PV and battery prices had a direct impact on the system’s NPC. The study also explored the impact of clustering the microgrids by interconnecting the three individual systems and conducting a techno-economic analysis. The comparison between standalone MG operation and clustered microgrids revealed that, despite the added cost of interconnection, the benefits in terms of technological, economic, and reliable operation of the clustered system were comparable to standalone microgrids. Finally, a feasibility study was conducted for the potential grid extension of the Toba MG, which is located 130 km from the nearest substation in Sawla.

Modelling Time to Recovery from Multidrug Resistant Tuberculosis in Southern Ethiopia

Introduction: Multidrug resistant tuberculosis (MDR-TB) is a global heath threat, resistant to key anti-TB drugs. It is ranked among the top 10 causes of death worldwide. Therefore, the current study investigated time to recovery from MDR-TB in southern Ethiopia. Data, Materials and Methods: Restrospective data from selected hospitals in SNNPR (January 2016 to December 2021) were analyzed. A cluster sample of 301 MDR-TB patients (131 NEMMCH, 121 BH, 49 AGH) was considered. Results: Among the 301 cases, 116 (38.5%) were censored. While 185 (61.5%) were recovered. Parametric shared frailty models were employed to account unobserved heterogeneity among the Hospitals and patients and AFT models were employed. the median recovery time of MDR-TB is 22 months. The clustering effect of frailty model was hospitals. Weibull-gamma shared frailty model was appropriate for this data. Conclusion: The final model showed that males have higher recovery rates than females. Extra pulmonary MDR-TB and Urban residency correleted with longer recovery times. The recovery rate increases with increasing baseline weight, education level, and occupation. But, the recovery rate decreases with smoking, co-morbidities, previous drug history, history of TB, and alcohol use Recommendation: All concerned bodies should be cognizant on the risk factors of MDR-TB in SNNP region By providing on early case detection and appropriate treatment of drug-susceptible MDR-TB, since it is essential to shorten the recovery time of MDR-TB patients in line with WHO guidelines

Advancing minigrid clusters in Ethiopia: A Multi-Tier Framework for optimal planning and sizing

This paper introduces an innovative approach to promote sustainable electrification in Ethiopia through the strategic development of minigrid clusters. In collaboration with Ethiopian authorities, technical and economic barriers obstructing the large-scale deployment of minigrid clusters are systematically identified. A novel Multi-Tier Framework (MTF)-based energy access matrix is presented, facilitating the creation of hybrid load profiles prioritizing affordability and reliability. The most suitable multi-criteria optimization strategy tailored to the Ethiopian context is explored, emphasizing the need for scalable and adaptable solutions. The proposed approach is rigorously validated through case studies in three villages within the Southern Nations, Nationalities, and Peoples' Region (SNNP). The research findings reveal the remarkable techno-economic advantages of minigrid clusters when compared to single minigrids, establishing the practicality and significance of the methodology. Sensitivity analysis is conducted to assess the impact of varying techno-economic scenarios on optimal sizing, providing essential insights for decision-makers. As a result, this paper significantly contributes to the upcoming deployment of four planned large-scale minigrids in the SNNP region, funded by the African Development Bank. Valuable guidance for stakeholders and decision-makers involved in minigrid cluster development in Ethiopia is offered, underscoring the critical role of such systems in achieving sustainable energy access and fostering socioeconomic progress.

The characteristics of bio-digester owners and effects of biogas utilization on woodfuel and emission reduction in Gambella, Oromia, southern nations and Somalia regions of Ethiopia

<p>Biogas is an environmentally friendly energy source produced from the anaerobic digestion of biodegradable biomass. In response to Sustainable Development Goal 7 (SDG7), biogas programme and a biogas scale-up project were implemented in Ethiopia. In this study, a multi-stage sampling procedure was employed to select well-functioning bio-digesters that supply cooking energy and bio-slurry from bio-digesters constructed in April 2017 to April 2020 in the National Biogas Scale-Up Project (NBPE+) of Ethiopia. Then qualitative and quantitative data were collected through interviews with 59 households, 10 focus groups, and 20 key informants in 22 woredas in Gambella, Oromia, SNNP, and Somalia regions. The type of digester was fixed a dome type constructed underground. Qualitative data were narrated and summarized and quantitative data were analysed for means of variance. Utilization of biogas energy reduced the wood fuel collection and consumption time by 38% in Gambella, by 50% in Oromia, and in SNNP and 55% in Somalia region. The use of biogas reduced the amount of carbon emissions from woodfuel combustion by 7.28 tCO<sub>2</sub><sup>e</sup> in Oromia to 2.78 tCO<sub>2</sub><sup>e</sup> in Gambella. Although the households were highly interested in biogas technology, the cost for bio-digester construction became unaffordable and only 15% of the households requested credit. About 69.49% of the households constructed 6 m<sup>3</sup> bio-digester. Overall, 16.95% of the households had four cattle and 10.17% of them had nine cattle. In Gambella, the available feedstock was sufficient to feed only 3.7 m<sup>3</sup> bio-digester size, while the mean size of the installed bio-digester was 6 m<sup>3</sup> and as a result, only 61.7% of the size of the bio-digesters was filled by the available feedstock. The dung’s total solids and volatile solids were different among the regions that affected the amount of biogas production. The biogas production ranged from 0.01 to 1.75 m<sup>3</sup>, which was sufficient for cooking for 0.03 to 4.38 h. The highest mean amount of biogas and corresponding cooking hours were obtained in Somalia, about 0.51 ± 0.11 m<sup>3</sup> and 1.27 ± 0.27 h based on the number of available cattle; however, there was a lack of water. Therefore, zero grazing, home feeding, and watering of cattle should be practiced for the sustainability of biogas production.</p>

The Link between Overweight/Obesity and Noncommunicable Diseases in Ethiopia: Evidences from Nationwide WHO STEPS Survey 2015.

Noncommunicable diseases (NCDs) are the leading cause of death worldwide. Each year, 15 million adults die from NCDs; more than 85% of these premature deaths occur in low- and middle-income nations. Evidence indicates that overweight and obesity are the main risk factors for NCDs. Although the literature indicates that the burden of NCDs is increasing in Ethiopia, no research has been conducted to demonstrate a link between overweight/obesity and NCDs. Therefore, the aim of this study is to examine the association between overweight/obesity and the common NCDs while adjusting for other important factors. We analysed data from the 2015 Ethiopia WHO STEPS survey, which was conducted in 2015. A total weighted sample of 9,800 participants (15-69 years) was included. The relationship between nutritional status and NCDs was assessed using bivariate and multivariable logistic regression models while adjusting for covariates. Among the 9,800 participants, 2053 (21% with (95% CI: 19.8-22.1) had hypertension and 1368 (14% with (95% CI: 13.1-15.0) had high cholesterol levels. According to the multivariable logistic regression analysis, being overweight/obese (AOR = 2.0; 95% CI: 1.7-2.3), alcohol consumption, received lifestyle advice, being female, living in urban areas, increased age, having government occupation, and living in SNNP region were positively associated with hypertension. While being underweight (AOR = 0.6; 95% CI: 0.5-0.7), living in the Afar, Somali, and Tigray regions were negatively associated with hypertension. Being overweight/obese (AOR = 1.4; 95% CI: 1.1-1.7), being female, having older age, and living in Somali region were positively associated with a high cholesterol level. Whereas being underweight (AOR = 0.7; 95% CI: 0.6-0.9), received lifestyle advice, reside in rural areas, being farmer, student, and housewife, and living in Gambela region were negatively associated with a high cholesterol level. This study found a statistically positive association between the common NCDs, namely, overweight/obesity, hypertension, and high cholesterol levels. Our findings imply that there is a need for effective interventions to prevent overweight/obesity by encouraging people to increase physical activity, minimize sedentary behavior, and maintain a healthy dietary pattern in order to reduce the risk of hypertension and high cholesterol levels.

The Effectiveness of Radio Talk Shows by UNICEF Ethiopia in Increasing Knowledge and Changing Attitudes and Behaviors Around Child Marriage, Female Genital Mutilation, and Gender Equality

Female genital mutilation (FGM), child marriage (CM), and gender inequality are some practices that are discriminatory and abusive to women and deny them the potential to live better and more inclusive lives. UNICEF in collaboration with other partners have initiated radio talk shows (RTS)in SNNP, Oromia, Somali, and Afar regions with the aim of addressing these issues. This evaluation study assessed the effectiveness of these shows on these matters. The study used a cross-sectional survey approach blended with key informant interviews to interrogate the issue at hand. A stratified cluster sampling method was used to identify 458 subjects to participate in the study. The study found that not many people have been reached by the radio talk shows. Those reached had acquired knowledge/enlightenment and attitude change that is positive towards lowering cases of FGM, CM, and gender inequality. The study thus found radio talk shows to be effective in increasing knowledge and attitude that could bring about social behavior change. It was recommended that UNICEF to scale up RTS into unreached areas to expand the reach hence the impact of the shows on FGM, CM, and gender equality.

Major maternal related determinants of non-breastfeeding among mothers in Ethiopia: A multilevel analysis from DHS Ethiopia 2016.

In Ethiopia, the burden of non-breastfeeding is still high despite substantial improvements in breastfeeding. However, the determinants of non-breastfeeding were poorly understood. Therefore, the aim of this study was to identify the maternal -related factors associated with non-breastfeeding. An in-depth analysis of data from the Ethiopian Demographic and Health Survey 2016 (EDHS 2016) was used. A total weighted sample of 11,007 children was included in the analysis. Multilevel logistic regression models were fitted to identify factors associated with non-breastfeeding. A p-value < of 0.05 was used to identify factors significantly associated with non-breastfeeding. The prevalence of non-breastfeeding in Ethiopia was 5.28%. The odds of not breastfeeding were 1.5 times higher among women aged 35to 49 years (AOR = 1.5 CI: 1.034, 2.267) than among women aged 15to 24 years. The odds of not breastfeeding were higher among children whose mothers had BMIs of 18.5-24.9 (AOR = 1.6 CI: 1.097, 2.368) and 25-29.9 (AOR = 2.445 CI: 1.36, 4.394) than among women with BMIs of < 18.5. In addition, not breastfeeding was also significantly associated with ANC follow-up, where mothers who had 1-3 ANC follow-up had a 54% decreased odds (AOR = 0.651 CI: 0.46,0.921) compared to mothers who had no ANC follow-up. Demographically, mothers from Somalia region were five times (AOR = 5.485 CI: 1.654, 18.183) and mothers from SNNP region were almost four times (AOR = 3.997 CI: 1.352, 11.809) more likely to not breastfeed than mothers residing in Addis Ababa. Although breastfeeding practices are gradually improving in Ethiopia, the number of children not breastfed remains high. Individual-level characteristics (women's age, body mass index, and ANC follow-up) and community-level characteristics (geographic region) were statistically significant determinants of non-breastfeeding. Therefore, it is good for the federal minister of Health, planners, policy and decision- makers, and other concerned child health programmers to prioritize both individual and community factors.

Species-Site Suitability Matching Study of Introduced Bamboos in Ethiopia

In view of broadening the genetic base of bamboo resources and looking for alternative bamboo species that can grow in mid altitude areas where indigenous species are not growing in Ethiopia, different introduced bamboo species were tested for their adaptability and growth performance in different areas across the country. Data on ecological and climatic conditions of testing sites and corresponding growth in terms of diameter, height and density of the species were assessed; growth in Ethiopia was compared with growth of the species in their place of origin, i.e. South, Southeast and Tropical Asia. Accordingly, Dendrocalamus asper, Dendrocalamus hamiltonii, Bambusa vulgaris and Dendrocalamus giganteus were found to have similar diameter and height growth while Dendrocalamus membranaceus showed lower values in Ethiopia when compared to growth in its origin. The species-site matching effort of the species within Ethiopia in this regard, is conducted based on similarity in altitude and climatic conditions (rainfall, temperature) of experimental sites to other sites across the country. All the species, except B. bambos, perform well in Oromia, Amhara, SNNP and Tigray regions. All species, except D. gigantues. B. balcoa and B.bambos performed well in Benishangul-Gumuz region. Research on adaptability study needs to be extended in other regions of Ethiopia.

One health insights into pastoralists’ perceptions on zoonotic diseases in Ethiopia: perspectives from South Omo Zone of SNNP Region

Zoonotic diseases negatively impact pastoral communities in Ethiopia. In addition to impacts on human health, the interaction between people, livestock and environment which is so fundamental to the pastoralist way of life, means zoonoses pose additional challenges to social bonds and protection networks. These challenges are compounded by adverse impacts from climate change, poor health care services, market problems and cultural practices that increase pastoralists’ vulnerability to zoonotic diseases. This research adopted a grounded theory approach and attempted to capture the perception of Hamer and Dassenetch pastoralists on zoonotic diseases and rangeland health through focus group discussions and key informant interviews. Involved in the research were human and animal health experts, and woreda (Woreda is a third level of administrative unit in Ethiopia following region and zone) level government officials. Thematic framework analysis was used to analyse the data. Zoonotic diseases are a significant public health concern and have a substantial economic burden on local livelihoods. Poor access to human and livestock health services contributed towards the widespread transmission of zoonotic pathogens. In most cases, pastoralists were aware of the possibility of zoonotic disease transmission from livestock to humans and were cognizant of infections contracted from animals. However, the level of risk perception from zoonotic diseases and the subsequent measures of protection was poor. In almost all cases, despite pastoralists’ awareness of zoonotic diseases, they did not consider zoonoses as harmful to human health as they are to animals. It was evident that the burden of zoonotic diseases was high in livestock camps away from settlements in Hamer while for Dassenetch the resettlement clusters created a conducive environment for transmission. This research underscored the importance of engaging with local communities on the risk implications of zoonotic diseases including those related to their food habits and practices.

Prevalence of urinary tract infections and risk factors among diabetic patients in Ethiopia, a systematic review and meta-analysis.

Urinary tract infection (UTI) is a common clinical problem that comprises 1-6% of medical referrals and includes urinary tract, bladder, and kidney infections. UTI is the most commonly occurring infectious disease in diabetic patients. Therefore, this systematic review and meta-analysis aimed to estimate the prevalence of urinary tract infection and its associated factors in Ethiopia. The online libraries of PubMed, Google Scholar, Scopus, and Science Direct, were searched. Data were extracted using Microsoft Excel and analyzed using STATA statistical software (v. 16). Forest plots, Begg's rank test, and Egger's regression test were all used to check for publication bias. To look for heterogeneity, I2 was computed, and an overall estimated analysis was carried out. Subgroup analysis was done by region, and publication year. Meta-regression analysis using study-level covariates as predictors of study-level estimates to explore the determinants of potential heterogeneity in our pooled estimates. The pooled odds ratio for related covariates was also calculated. Out of 1128 studies assessed, 14 met our criteria and were included in the study. A total of 3773 people were included in the study. The prevalence of urinary tract infection was estimated to be 15.97% (95% CI: 12.72-19.23). According to subgroup analysis, the highest prevalence was observed in the SNNP region (19.21%) and studies conducted in and after 2018 (17.98%). Being female (AOR = 3.77; 95% CI: 1.88, 5.65), being illiterate (AOR = 5.29; 95% CI: 1.98, 8.61), prior urinary tract infection history (AOR = 3.04; 95% CI: 2.16-3.92) were the predictor of urinary tract infection. The prevalence of urinary tract infections was high in Ethiopia. Female gender, illiteracy, and prior UTI history were associated with urinary tract infections. Since UTIs in diabetic patients has serious medical and public health consequence, screening of UTIs in diabetic patients and early initiation of treatment should become a public health priority.

Spatial variation of overweight/obesity and associated factor among reproductive age group women in Ethiopia, evidence from EDHS 2016.

Globally, at least 4.7 million people die from being overweight or obese. In Ethiopia, the level of overweight and obesity among women grew from 3% to 8%. However, as far as my literature searching, studies concerning the spatial variation of overweight/obesity and factors associated are not researched in Ethiopia using geospatial techniques. Therefore, this study aimed to explore the spatial variation of overweight/obesity and factor associated among reproductive age group women in Ethiopia using geospatial techniques. A total weighted sample of 10,928 reproductive age women were included in the study. ArcGIS version10.7 was used to explore the spatial variation of overweight/obesity. Bernoulli based model was used to analyze the purely spatial cluster detection of overweight/obesity through SaTScan version 9.6.1 software. Ordinary Least Square analysis and geographically weighted regression analysis was employed to assess the association between an outcome variable and explanatory variables by using ArcGIS 10.7 software. P value of less than 0.05 was used to declare statically significant. The spatial distribution of overweight/obesity in Ethiopia was clustered. Statistically, a significant-high hot spot overweight/obesity was identified at Addis Ababa, harrari, Dire Dawa. SaTScan identified 66 primary spatial clusters (RR = 4.17, P < 0.001) located at Addis Ababa, southeast amhara, central part of oromia region and northern part of SNNP region. In geographically weighted regression, rich wealth index, women's age (35-39 and 40-44 years), watching TV, internet use and not working were statistically significant that affecting spatial variation of overweight/obesity. In Ethiopia, overweight/obesity varies across the region. Statistically, significant-high hot spots of overweight/obesity were detected in Addis Ababa, Harari, Dire Dawa, some parts of Amhara and afar region, most of the Oromia and Somalia region, and the South Nation Nationality and People region of Ethiopia. Therefore, the ministry of health and the Ethiopian public health institute, try to initiate policies and practices that could include providing funding for physical education as well as recreational centers in communities most in need. In addition, public and private mass media create awareness of healthy lifestyles is promoted by health education regarding increased physical activity and reduced sedentary behavior through various media platforms.

Geographical weighted regression analysis of delayed antenatal care initiation and its factors among all reproductive-aged women in Ethiopia, 2016

BackgroundDelayed antenatal care is when the first visit is carried out after 12 gestational weeks. Despite the fact that many studies have been conducted on antenatal care initiation, little attention has been paid to its spatial pattern. Therefore, this study examine geographical weighted regression analysis of delayed antenatal care initiation and its factors among all reproductive-aged women in Ethiopia.ObjectiveTo assess geographical weighted regression analysis of delayed antenatal care initiation and its factors among all reproductive-aged women in Ethiopia, 2016.MethodsThis study was grounded on the 2016 Ethiopian Demographic Health Survey. It incorporated extracted sample size of 4740 (weighted) reproductive-aged women. ArcGIS version 10.8 and SaTScan™ version 9.7 software were employed to investigate geographic information. To distinguish factors associated with hotspot areas, local and global models were fitted.Resultthe geographic pattern of Delayed antenatal care initiation was clustered (Moran’s I = 0.38, p < 0.001). Kuldorff’s spatial scan statistics discovered three significant clusters. The most likely cluster (LLR = 66.13, p < 0.001) was situated at the zones of SNNP and Oromia regions. In the local model, being uneducated, being poor wealth, having an unwanted pregnancy, and having higher birth order were factors associated with spatial variation of delayed antenatal care.ConclusionThe spatial pattern of delayed antenatal care in Ethiopia is clustered. Maternal education, wealth status, pregnancy desirability, and birth order were predictor variables of spatial variation of delayed antenatal care. Therefore, designing a hotspot area-based interventional plan could help to improve early ANC initiation.

Spatial variation and factors associated with home delivery after ANC visit in Ethiopia; spatial and multilevel analysis.

Institutional delivery is crucial to reduce maternal and neonatal mortality as well as serious morbidities. However, in Ethiopia, home delivery (attended by an unskilled birth attendant) after antenatal care (ANC) visit is highly in practice. Therefore, this study aimed to assess the spatial variation and determinants of home delivery after antenatal care visits in Ethiopia. A secondary data analysis was conducted using the 2019 mini Ethiopian demographic and health survey. A total of 2,923 women who had ANC visits were included. Spatial analysis was done by using GIS 10.7 and SaTscan 9.6. The risk areas for home delivery from GIS and spatial scan statistics results were reported. A multi-level logistic regression model was fitted using Stata14 to identify individual and community-level factors associated with home delivery after ANC visit. Finally, AOR with 95% CI and random effects were reported. Home delivery after ANC visit was spatially clustered in Ethiopia(Moran's index = 0.52, p-value <0.01). The primary clusters were detected in Oromia and SNNP region (LLR = 37.48, p < 0.001 and RR = 2.30) and secondary clusters were located in Benishangul Gumuz, Amhara, Tigray and Afar (LLR = 29.45, p<0.001 and RR = 1.54). Being rural resident (AOR = 2.52; 95%CI 1.09-5.78), having no formal education (AOR = 3.19;95% CI 1.11-9.16), being in the poor (AOR = 2.20;95%CI 1.51-3.22) and middle wealth index (AOR = 2.07;95% CI 1.44-2.98), having one ANC visit (AOR = 2.64; 95% CI 1.41-4.94), and living in the agrarian region (AOR = 3.63; 95%CI 1.03-12.77) had increased the odds of home delivery after ANC visit. Home delivery after ANC visit was spatially clustered in Ethiopia. Factors like maternal education, wealth index, number of ANC visits, residency and region were significantly associated with home delivery after ANC visit. Therefore, it is better to increase the number of ANC contact by giving health education, especially for women with low levels of education and better to improve the wealth status of women. A special strategy is also vital to reduce home delivery after ANC visit in those high-risk regions.

Factors associated with post-neonatal mortality in Ethiopia: Using the 2019 Ethiopia mini demographic and health survey.

Post-neonatal mortality is the number of deaths of infants aged 28 days through 11 months and is expressed as post-neonatal deaths per 1000 live births per year. This study aimed to identify the factors that influence post-neonatal death using the 2019 Ethiopia mini demographic and health survey (EMDHS2019). The study included 2126 post neonates born from mothers who had been interviewed about births in the five years before the survey. The survey gathering period was carried out from March 21, 2019, to June 28, 2019. The data were first analyzed with a chi-square test of association, and then relevant factors were evaluated with binary logistic regression models and the results were interpreted using adjusted odds ratio (AOR) and confidence interval(CI) of parameters. The prevalence of post neonatal death was 16% (95% CI: 15.46, 17.78). The study also showed that not vaccinated post-neonates (AOR = 2.325, 95% CI: 1.784, 3.029), mothers who were not receiving any tetanus injection (AOR = 2.891, 95% CI: 2.254, 3.708), mothers age group 15-24(AOR = 1.836, 95% CI: 1.168, 2.886), Afar (AOR = 2.868, 95% CI: 1.264, 6.506), Somali(AOR = 2.273, 95% CI: 1.029, 5.020), Southern Nations, Nationalities, and People's Region(SNNP) (AOR = 2.619, 95% CI: 1.096, 6.257), 2-4 birth orders (AOR = 1.936, 95% CI: 1.225, 3.060), not attend antenatal care(ANC) visit (AOR = 6.491, 95% CI: 3.928, 10.726), and preceding birth interval less than 24 months (AOR = 1.755, 95% CI: 1.363,2.261) statistically associated with a higher risk of post neonatal death. Although not given anything other than breast milk (AOR = 0.604, 95% CI 0.462, 0.789), urban residents (AOR = 0.545, 95% CI: 0.338, 0.877), single births (AOR = 0.150, 95% CI: 0.096, 0.234), less than 3 children in a family (AOR = 0.665, 95% CI 0.470, 0.939) and the head of the male household (AOR = 0.442, 95% CI: 0.270, 0.724) were statistically associated with a lower risk of post-neonatal mortality. It is highly suggested that maternal and child health care services (including antenatal care visits, postnatal care visits, and immunization) be strengthened and monitored during the early stages of infancy. Mothers from Somali, Afar, and SNNP regions, as well as multiple births, rural residents, and those giving birth to a child with a birth gap of fewer than 24 months, demand special care.

Prevalence Rate and Associated Risk Factors of Anaemia among under Five Years Children in Ethiopia.

Background: Anaemia is a condition characterised by a decrease in the concentration of haemoglobin (Hb) in the blood. Anaemia suffers under five years children about 47.4% and 67.6% worldwide and developing countries including Ethiopia, respectively. The aim of this study was to assess the prevalence rate and the associated socio-economic, geographic and demographic factors of anaemia status of under five years children in Ethiopia. Methods: The data for this study were obtained from the 2011 Ethiopia National Malaria Indicator Survey (EMIS 2011). A sample of 4356 under five years age children was obtained from three regional states of Ethiopia. Based on haemoglobin level, child anaemia status was ordered and takes an ordinal value as no anaemia, mild anaemia, moderate anaemia and severe anaemia, respectively. Ordinal logistic regression model, specifically the proportional odds model was used by considering with and without survey design features. Results: Of the 4356 complete cases, 2190 (50.28%) were male and 1966 (49.72%) were female children under five years old. The children overall mean (SD) age was 2.68 (1.21) years. It was observed that both the mean ages and their variabilities in the regions are approximately equal to the overall mean and variability. It was also observed that in Amhara, Oromiya and SNNP regions 72.28%, 67.99% and 73.63% of the children, respectively had no anaemia; 15.93%, 13.47% and 13.56% of the children, respectively had mild anaemia; 10.99%, 15.61% and 11.33% of the children, respectively had moderate anaemia; and only 0.81%, 2.93% and 1.49% had severe anaemia, respectively. The prevalence of severe child anaemia status was higher in Oromiya region compared to Amhara and SNNP regions, respectively. Our result indicates that age, use of mosquito net, malaria RDT outcome, type of toilet facility, household wealth index, region and median altitude were significantly related to child anaemia status. However, it was observed that some covariates were model dependent, for example household wealth index and type of toilet facility were not significant when considering survey features. Conclusions: Anaemia burden remains high particularly in developing countries. Controlling the burden of anaemia necessitates the formulation of integrated interventions which prioritise the highest risk groups including children under five years. The statistical model used in this paper identified individual, household and cluster level risk factors of child anaemia. The identified risk factors for example not having improved toilet facility in the dwelling where a child lived as well as poorest household wealth index suggest the policymakers should target to focus more on children from poor community. Further, the strong association between malaria infection and anaemia suggests that malaria preventative methods such as vector control methods namely, long-lasting insecticidal nets (LLINs) and indoor residual spraying of households with insecticides and including case diagnostic testing and treatment may be the most effective ways to reduce infections associated with anaemia. Such collective assessment approach may lead to more effective public health strategies and could have important policy implications for health promotion and for the reduction of health disparities.

The contribution of climate change on the production and distributions of tef (Eragrostis tef (Zucc.) Trotter) Associated with its breeding enhancement phases in Ethiopia

Agriculture is the leading sector in Ethiopia and its economy highly depend on it. Hence it accounts about 50% GDP with 85% employment and more than 85% export revenue. Tef has the leading share of cereals in production area and vital in nutritional aspect more than 15% of all calories spent via 90 million people and exporting injera for foreign currency returns. Therefore, this review targeted with the objectives of delivering information on the role of Tef production in food security with global market value and the impact of climate change and challenge on production and productivity over its breeding enhancement. Currently agriculture highly exposed to climate changes and strongly distresses the productivity altering areas crops grown. Climate change supposed via alterations in variability of properties in temperature, rainfall, increased atmospheric CO2 levels and relative humidity. It is evidently known and highly vulnerable caused food insecurity. For instance, 20% of Ethiopian economy production deficit and 25% of poverty level is caused by rain fall variability. Tef is seasonal crop on rainfall all over Ethiopia, so its production distributions and productivity still very limited only at Amhara, Oromia, SNNP, Tigray and Benishangul Gumuz Regions while Afar, Somali, Harare and Gambela regions are not still included in its production profiles. There is also research gap with the relation and consequence of climate change. Hence filling the gaps will be critical in the future for improving the production efficiency via characterizing agro-ecologies and designing breeding strategies for stress environment variety development.

School-Based Nutrition Interventions Had Impacts on Dietary Diversity and Meal Frequency of Adolescent Girls in Ethiopia

ObjectivesAdolescence is a critical period of physical and psychological development, especially for girls as poor nutrition can affect their well-being as well as the well-being of their children. In Ethiopia, where the population is very young, evidence on the nutrition of adolescent girls and their determinants is scant. We tested the impact of a package of nutrition interventions delivered primarily through schools and implemented by Alive & Thrive (A&T) on the diet of adolescent girls. MethodsA cluster-randomized trial design compared 27 primary school clusters in A&T areas to 27 clusters in non-A&T areas in the SNNP and Somali regions. We surveyed adolescent girls (n = 536) aged 10–14 years and enrolled in primary school grades 4–8, following at least one school semester (approximately 4 months) of implementation in March-April 2021. Using linear regression models, we tested for differences between program groups on dietary diversity, meal frequency, and consumption of unhealthy foods. In adjusted models, we controlled for age, household food security and wealth, and region. ResultsWe observed significant impacts on dietary diversity score (1.4 food groups) and minimum dietary diversity (OR: 5.2). Among the food groups, there was significantly higher consumption of 5 groups in A&T areas: pulses, meats, eggs, vitamin A-rich fruits and vegetables, and other fruits. There was also a significant impact on meal frequency of 0.9 meals/snacks in the previous 24 hours, with girls in A&T areas consuming 4.0 meals/snacks out of 6 eating times compared to 3.2 in control areas. There was no significant impact on consumption sweets, baked sweets, sweetened beverages, and fried and salty foods among girls, but there was lower consumption of sweets in the previous 24 hours in A&T (14%) versus control areas (23%). ConclusionsIntegrating nutrition interventions into primary schools in Ethiopia was feasible and achieved a significant impact on girls’ dietary diversity and meal frequency. Reinforcing messages about eating better and more often resulted in incremental behavior change related to dietary diversity and meal frequency; however, telling adolescents not to eat junk foods that they crave or enjoy without changing their food environments may be less successful in curbing consumption. Funding SourcesBill & Melinda Gates Foundation, through A&T, managed by FHI Solutions.

The ISSUES, CHALLENGES AND MANAGEMENT OF URBAN HOUSEHOLD WATER SUPPLY: AN OVERVIEW IN CASE OF DURAME CITY, KAMBATA TEMBARO ZONE, SNNP REGION, ETHIOPIA JANUARY, 2019

The provision of urban infrastructure like water service has become a major concern in many developed and developing countries. Access to safe water and sanitary means of waste disposal is universal needs and indeed basic human rights. Besides, they are essential elements of human development and poverty alleviation and constitute an obligatory component of primary health care. The main objective of this study is to assess issues, challenges and management of urban household water supply: in case of Durame city, Kambata Tembaro Zone, SNNP Region. The study is descriptive in its nature and both qualitative and quantitative research Approach with a sample size of 120 which selected through systematic random sampling method used. Interview questionnaires were employed for data collection. Lastly the data were analyzed using descriptive statistical tools like frequency and percentage. The study findings revealed that factors like, shortage of water at the sources; rapid population growth, electric power failure, and rapid urbanization were classified to be main causes of water supply shortage to the city communities. The gap between demand and output is increasing from year to year as a result of the aforementioned primary factors. Water source for the city entirely relying only on groundwater is not enough. The study therefore recommends that the groundwater source has to be enlarged by surface water through water conservation techniques. Therefore, as a long- run solution to water supply shortage in the city great attention should be given for surface water development. Furthermore, surface water might serve as a recharging source for groundwater sources in the surrounding area. Through water conservation techniques around the water potential areas (boreholes sites) groundwater have to be recharged so as to balance the recharging and discharging rates. On the other hand, bottom-up community engagement should be promoted, and existing women's groups such as religious, trade, and professional associations should be involved in order to debate how to utilize water responsibly.

Prevalence of Trachoma from 66 Impact Surveys in 52 Woredas of Southern Nations, Nationalities and Peoples’ and Sidama Regions of Ethiopia, 2017–2019

ABSTRACT Purpose Trachoma is endemic in Southern Nations, Nationalities and Peoples’ (SNNP) and Sidama regions of Ethiopia. We aimed to measure the prevalence of trachomatous inflammation—follicular (TF) among children aged 1 – 9 years and the prevalence of trachomatous trichiasis (TT) unknown to the health system among people aged ≥15 years following interventions for trachoma in 52 woredas of SNNP and Sidama regions. Methods From 2017 – 2019, 66 two-stage cluster sampling cross-sectional population-based surveys were carried out in 52 woredas (third-level administrative divisions) using a standardized World Health Organization-recommended survey methodology. This included one impact survey in 40 woredas, two consecutive impact surveys in 10 woredas and three consecutive impact surveys in two woredas. Water, sanitation and Hygiene (WASH) access was assessed using a modified version of the United Nations Children’s Fund/WHO Joint Monitoring Programme questionnaire. Results By the end of this survey series, 15 (23%) of the woredas had met the active trachoma elimination threshold (TF prevalence <5%) and 12 (18%) had met the TT threshold (TT ≤ 0.2%). Regarding WASH coverage, 20% of households had access to an improved drinking water source within a 30-min journey and 3% had an improved latrine. There was strong evidence that TF was less common in 4 – 6-year-olds and 7 – 9-year-olds than 1 – 3-year-olds. Conclusion Based on the findings, further antibiotic mass drug administration is required in 37 woredas and active TT case finding is needed in 40 woredas. In these surveys, access to WASH facilities was very low; WASH improvements are required.