Southern Nations Nationalities And Peoples Research Articles

Prevalence of mortality among mechanically ventilated patients in the intensive care units of Ethiopian hospitals and the associated factors: A systematic review and meta-analysis.

In the intensive care unit (ICU), mechanical ventilation (MV) is a typical way of respiratory support. The severity of the illness raises the likelihood of death in patients who require MV. Several studies have been done in Ethiopia; however, the mortality rate differs among them. The objective of this systematic review and meta-analysis is to provide a pooled prevalence of mortality and associated factors among ICU-admitted patients receiving MV in Ethiopian hospitals. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 criteria to conduct a comprehensive systematic review and meta-analysis in this study. We searched PubMed/Medline, SCOPUS, Embase, Hinari, and Web of Science and found 22 articles that met our inclusion criteria. We used a random-effects model. To identify heterogeneity within the included studies, meta-regression and subgroup analysis were used. We employed Egger's regression test and funnel plots for assessing publication bias. STATA version 17.0 software was used for all statistical analyses. In this systematic review and meta-analysis, the pooled prevalence of mortality among 7507 ICU-admitted patients from 22 articles, who received MV was estimated to be 54.74% [95% CI = 47.93, 61.55]. In the subgroup analysis by region, the Southern Nations, Nationalities, and Peoples (SNNP) subgroup (64.28%, 95% CI = 51.19, 77.37) had the highest prevalence. Patients with COVID-19 have the highest mortality rate (75.80%, 95% CI = 51.10, 100.00). Sepsis (OR = 6.85, 95%CI = 3.24, 14.46), Glasgow Coma Scale (GCS) score<8 (OR = 6.58, 95%CI = 1.96, 22.11), admission with medical cases (OR = 4.12, 95%CI = 2.00, 8.48), Multi Organ Dysfunction Syndrome (MODS) (OR = 2.70, 95%CI = 4.11, 12.62), and vasopressor treatment (OR = 19.06, 95%CI = 9.34, 38.88) were all statistically associated with mortality. Our review found that the pooled prevalence of mortality among mechanically ventilated ICU-admitted patients in Ethiopia was considerably high compared to similar studies in the United States (US), China, and other countries. Sepsis, GCS<8, medical cases, MODS, and use of vasopressors were statistically associated with mortality. Clinicians should exercise caution while mechanically ventilating ICU-admitted patients with these factors. However, it should be noted that the exact cause and effect relationship could not be established with this meta-analysis, as the available evidence is not sufficient. Thus, more studies using prospective methods will be required.

Individual and community level determinants of delayed antenatal care initiation in Ethiopia: A multilevel analysis of the 2019 Ethiopian Mini Demographic Health Survey.

Antenatal care (ANC) is essential health care and medical support provided to pregnant women, with the aim of promoting optimal health for both the mother and the developing baby. Pregnant women should initiate ANC within the first trimester of pregnancy to access a wide range of crucial services. Early initiation of ANC significantly reduces adverse pregnancy outcomes, yet many women in Sub-Saharan Africa delay its initiation. The aim of this study was to assess prevalence and determinants of delayed ANC initiation in Ethiopia. We conducted a secondary data analysis of the 2019 Ethiopian Mini Demographic and Health Survey (EMDHS). The study involved women of reproductive age who had given birth within the five years prior to the survey and had attended ANC for their most recent child. A total weighted sample of 2,895 pregnant women were included in the analysis. Due to the hierarchical nature of the data, we employed a multi-level logistic regression model to examine both individual and community level factors associated with delayed ANC initiation. The findings of the regressions were presented with odds ratios (OR), 95% confidence intervals (CI), and p-values. All the statistical analysis were performed using STATA-14 software. This study showed that 62.3% (95% CI: 60.5, 64.1) of pregnant women in Ethiopia delayed ANC initiation. Participants, on average, began their ANC at 4 months gestational age. Women with no education (AOR = 2.1; 95% CI: 1.4, 3.0), poorest wealth status (AOR = 1.9; 95% CI: 1.3, 2.8), from the Southern Nations, Nationalities, and Peoples (SNNP) region (AOR = 2.1; 95% CI: 1.3, 3.3), and those who gave birth at home (AOR = 1.4; 95% CI: 1.1, 1.7) were more likely to delay ANC initiation. The prevalence of delayed ANC initiation in Ethiopia was high. Enhancing mothers' education, empowering them through economic initiatives, improving their health-seeking behavior towards facility delivery, and universally reinforcing standardized ANC, along with collaborating with the existing local community structure to disseminate health information, are recommended measures to reduce delayed ANC initiation.

Challenges to joint planning, monitoring, and evaluation for nutrition-sensitive agriculture in Ethiopia: an exploratory qualitative study

BackgroundNutrition-sensitive agriculture is an effective multi-sectoral approach to address the underlying causes of malnutrition. However, successful implementation requires the involvement of different sectors to jointly plan, monitor, and evaluate key activities, which is often challenged by contextual barriers. Previous studies in Ethiopia have not adequately explored these contextual barriers. Hence, the current study aimed to qualitatively explore the challenges to joint planning, monitoring, and evaluation for nutrition-sensitive agriculture among sectors in Ethiopia.MethodsA qualitative exploratory study was conducted in Tigray and Southern Nations, Nationalities, and Peoples (SNNP) of Ethiopia regional states in 2017. Ninety-four key informants were purposively selected from government agencies primarily in health and agriculture, from local (kebele) to national levels, and ranging from academic organizations, research institutions, and implementing partners. Researchers developed a semi-structured guide and conducted key informant interviews which were audiotaped, transcribed verbatim in local language, and translated to English. All transcriptions were imported into ATLAS.ti Version 7.5 software for coding and analysis. The data analysis followed an inductive approach. Transcriptions were coded line by line; then similar codes were grouped into categories. Subsequently, non-repetitive themes were identified from the categories using thematic analysis methodology.ResultsThe following themes were identified as challenges that hinder joint planning, monitoring, and evaluation to link nutrition to agriculture: (1) limited capacity, (2) workload in home sector (agriculture or nutrition), (3) lack of attention to nutrition interventions, (4) inadequate supportive supervision, (5) problematic reporting system, and (6) weak technical coordinating committees.Conclusions and recommendationsGaps in human and technical resources, limited attention from different sectors, and absence of routine monitoring data hindered joint planning, monitoring, and evaluation activities for nutrition-sensitive agriculture in Ethiopia. Short-term and long-term training for experts and intensification of supportive supervision may address gaps in capacity. Future studies should address whether routine monitoring and surveillance in nutrition-sensitive multi-sectoral activities provides long-term improvement in outcomes.

Genetic diversity and population structure of sorghum [Sorghum bicolor (L.) Moench] in Ethiopia as revealed by microsatellite markers

ABSTRACT Ethiopia is the center of origin of sorghum (Sorghum bicolor L.). Understanding of the genetic diversity of the species is fundamental to design appropriate conservation and management strategies. The present study addressed the genetic diversity of sorghum accessions collected from major growing regions of Ethiopia. Eighty sorghum accessions representing five populations namely Amhara, Dire Dawa, Oromia, Southern Nations, Nationalities and Peoples (SNNP) and Tigray were analyzed with 11 simple sequence repeat (SSR) markers. Analysis of molecular variance (AMOVA) was conducted to evaluate genetic variation within and among populations. The unweighted neighbour-joining-based cluster analysis, principal components of analysis (PCoA) and structure analysis were done to elucidate clustering of populations. The polymorphic information contents (PIC) ranges from 0.50 to 0.86. A high within-populations genetic diversity was confirmed with gene diversity values ranging from 0.51 to 0.77. AMOVA revealed 93.26% of the total genetic variation within populations and 6.74% among populations. Cluster analyses did not show clear grouping of accessions according to their geographical origins, confirming gene flow (Nm = 6.65) among populations. In conclusion, the SSR markers used were polymorphic and highly informative Oromia and Amhara populations displayed genetic diversity greater than mean value of 0.67 suggesting possible target populations for breeding and conservation.

Determinants of adoption of climate-smart agricultural technologies and practices in the coffee-based farming system of Ethiopia

ObjectivesThis study explored the adoption status of different Climate Smart Agricultural (CSA) practices and factors that influence their adoption for sustainable soil resource utilization in the changing climate.MethodologyWe used quantitative and qualitative primary data collected from smallholder farmers and other stakeholders from major coffee-growing regions of Ethiopia: Oromia, and Southern Nations, Nationalities, and Peoples (SNNP). We used the multivariate probit (MVP) model to study factors that influence the adoption of climate-smart agricultural technologies, namely, manure application, minimum tillage, intercropping, use of improved forage, and physical soil and water management practices.ResultsThe study result shows that 35% of farmers apply manure on their farm plots. Minimum tillage is also applied to 36% of farms. Intercropping improved forages and physical soil and water management structures are adopted by 45, 19, and 47% of farmers, respectively. The finding of the study indicates the positive and significant effect of education, extension (access to extension services and participation on field days), and ownership of communication devices specifically radio on the adoption of climate-smart agricultural practices.RecommendationsConcerning bodies must pay due attention to problems affecting effective farmers-extension linkage. The positive effect of radio ownership on technology adoption also suggests the need for increased accessibility of FM radio channels to farmers to be aware of climate change and innovative agricultural technologies, practices, and information that mitigate the problem.

Sero-prevalence of syphilis and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis

BackgroundSyphilis remained a major cause of reproductive morbidity and poor pregnancy outcomes in developing countries. Previously, studies showed inconsistent results and failed to show the actual picture of the diseases in Ethiopia. Thus, the aim of this meta-analysis was, first, to determine the updated pooled prevalence of syphilis among pregnant women in Ethiopia and, second, to assess its associated factors.MethodsA comprehensive search was made on PubMed, Google scholar, Science Direct, and African Journals Online databases to identify relevant articles. A random effects model was used to estimate pooled syphilis prevalence and odds ratio (OR) with the respective 95% confidence intervals (CIs) using STATA 14 statistical software. I2 statistics and Egger’s regression test in conjunction with funnel plot was used to determine heterogeneity and publication bias among included studies respectively.ResultWe identified 13 suitable studies in this analysis. Accordingly, the pooled prevalence of syphilis among pregnant women in Ethiopia was 2.32% (95% CI, 1.68–2.97). Specifically, syphilis prevalence was 2.53% (95% CI, 1.92–3.14%) and 1.90% (95% CI, 0.40–3.40%) as per the treponemal and non-ytreponemal diagnostic test, respectively. On the other hand, regional analysis indicated that 4.06% (95% CI, 2.86–5.26) in Southern Nations Nationalities and Peoples (SNNP), 2.16% (95% CI, 1.57–2.75) in Amhara and 1.46% (95% CI, 0.69–2.23) in Oromia region. Being married (OR, 0.37 (95% CI, 0.12–0.91%)) was less likely to develop syphilis. On the other hand, women with history of multiple sexual partner (OR, 2.98 (95% CI, 1.15–7.70)) and women with history of previous sexually transmitted infection (STI) (OR, 4.88 (95% CI, 1.35–17.62)) have higher risk to develop syphilis. Besides, the pooled syphilis-HIV coinfection was 0.80% (95% CI, 0.60–1.01%).ConclusionThis study provides evidence of relatively high prevalence of syphilis among pregnant women in Ethiopia. Therefore, it is recommended to further ramping up of current intervention measures to prevent future generations.Systematic review registrationPROSPERO CRD42020211650

Geographic variation and associated factors of long-acting contraceptive use among reproductive-age women in Ethiopia: a multi-level and spatial analysis of Ethiopian Demographic and Health Survey 2016 data

BackgroundHigh fertility rates and unintended pregnancies are public health concerns of lower and middle income countries such as Ethiopia. Long acting contraceptives (LACs) take the lion’s share in reducing unintended pregnancies and high fertility rates. Despite their numerous advantages, the utilization of LACs remains low in Ethiopia. This study is aimed to explore the geographic variation and associated factors of long acting contraceptive use among reproductive-age women in Ethiopia.MethodsThis is a secondary data analysis of 2016 Ethiopian Demographic and Health Survey (EDHS) data. A total of weighted sample sizes of 10,439 reproductive-age women were included in the final analysis. To clean and analyze the none-spatial data Stata 14 was used while ArcGIS 10.6 and SaTScanTM version 9.6 software were used for spatial analysis. Multilevel Mixed-effect Logistic regression model was used to identify associated factors of LACs utilization. An Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was reported to identify significant variables.ResultsLong acting contraceptive utilization was non-random (Moran’s I: 0.30, p-value < 0.01). Statistically, clusters with significant low utilization of LACs were found in Somali, Afar, Gambela, northern Amhara, eastern Oromia and western part of Southern Nations Nationalities and Peoples (SNNP) regions. Adjusting for other factors such as being married (AOR = 2.51, 95% CI: 1.29–4.87), having one to two (AOR = 2.14, 95% CI: 1.43–3.22), and three to four children (AOR = 1.68, 95% CI: 1.02–2.76), urban (AOR = 1.59, 95% CI: 1.16–2.19), want no more children (AOR = 1.40, 95% CI: 1.08–1.83), working status of women (AOR = 1.33, 95% CI: 1.07–1.65) increased the odds of LACs utilization. While previous history of abortion (AOR = 0.56, 95% CI: 0.39–0.80), and living in the pastoralist community (AOR = 0.22, 95% CI: 0.14–0.35) reduced the odds of LACs utilization in EthiopiaConclusionsSignificant geographic variation of LACs utilization was observed in Ethiopia. Spots with Low LACs utilization were found in the eastern, north eastern and western part of the country. Socio-demographic and pregnancy related factors were significant determinants of LACs utilization. Designing intervention programs targeting the identified hot spot clusters, and variables that can hinder the utilization of LACs is very important to increase the utilization.

Spatial clusters distribution and modelling of health care autonomy among reproductive\u2010age women in Ethiopia: spatial and mixed\u2010effect logistic regression analysis

BackgroundWhile millions of women in many African countries have little autonomy in health care decision-making, in most low and middle-income countries, including Ethiopia, it has been poorly studied. Hence, it is important to have evidence on the factors associated with women’s health care decision making autonomy and the spatial distribution across the country. Therefore, this study aimed to investigate the spatial clusters distribution and modelling of health care autonomy among reproductive-age women in Ethiopia.MethodsWe used the 2016 Ethiopian Demographic and Health Survey (EDHS) data for this study. The data were weighted for design and representativeness using strata, weighting variable, and primary sampling unit to get a reliable estimate. A total weighted sample of 10,223 married reproductive-age women were included in this study. For the spatial analysis, Arc-GIS version 10.6 was used to explore the spatial distribution of women health care decision making and spatial scan statistical analysis to identify hotspot areas. Considering the hierarchical nature of EDHS data, a generalized linear mixed-effect model (mixed-effect logistic regression) was fitted to identify significant determinants of women’s health care decision making autonomy. The Intra-Class Correlation (ICC) were estimated in the null model to estimate the clustering effect. For model comparison, deviance (-2LLR), Akakie Information Criteria (AIC), and Bayesian Information Criteria (BIC) parameters were used to choose the best-fitted model. Variables with a p-value < 0.2 in the bivariable analysis were considered for the multivariable analysis. In the multivariable mixed-effect logistic regression analysis, the Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were reported to declare the strength and significance of the association between women’s decision-making autonomy and independent variables.ResultsIn this study, about 81.6% (95% CI: 80.6%, 82.2%) of women have autonomy in making health care decisions. The spatial distribution of women’s autonomy in making health decisions in Ethiopia was non-random (global Moran’s I = 0.0675, p < 0.001). The significant hotspot areas of poor women’s autonomy in making health care decisions were found in north Somali, Afar, south Oromia, southwest Somali, Harari, and east Southern Nations Nationalities and Peoples (SNNP) regions. In the mixed-effect logistic regression analysis; being urban (AOR = 1.59, 95% CI: 1.04, 2.45), having secondary education (AOR = 1.60, 95% CI: 1.06, 2.41), having an occupation (AOR = 1.19, 95% CI: 1.01, 1.40) and being from the richest household (AOR = 2.14, 95% CI: 1.45, 3.14) were significantly associated with women autonomy in deciding for health care.ConclusionsThe spatial distribution of women’s autonomy in making the decision for health care was non-random in Ethiopia. Maternal education, residence, household wealth status, region, and maternal occupation were found to influence women’s autonomy. Public health interventions targeting the hotspot areas of poor women autonomy through enhancing maternal occupation and employment is needed to improve women empowerment in making decisions for health care.

The burden of household out-of-pocket health expenditures in Ethiopia: estimates from a nationally representative survey (2015-16).

In Ethiopia, little is known about the extent of out-of-pocket health expenditures and the associated financial hardships at national and regional levels. We estimated the incidence of both catastrophic and impoverishing health expenditures using data from the 2015/16 Ethiopian household consumption and expenditure and welfare monitoring surveys. We computed incidence of catastrophic health expenditures (CHE) at 10% and 25% thresholds of total household consumption and 40% threshold of household capacity to pay, and impoverishing health expenditures (IHE) using Ethiopia's national poverty line (ETB 7184 per adult per year). Around 2.1% (SE: 0.2, P < 0.001) of households would face CHE with a 10% threshold of total consumption, and 0.9% (SE: 0.1, P < 0.001) of households would encounter IHE, annually in Ethiopia. CHE rates were high in the regions of Afar (5.8%, SE: 1.0, P < 0.001) and Benshangul-Gumuz (4.0%, SE: 0.8, P < 0.001). Oromia (n = 902 000), Amhara (n = 275 000) and Southern Nations Nationalities and Peoples (SNNP) (n = 268 000) regions would have the largest numbers of affected households, due to large population size. The IHE rates would also show similar patterns: high rates in Afar (5.0%, SE: 0.96, P < 0.001), Oromia (1.1%, SE: 0.22, P < 0.001) and Benshangul-Gumuz (0.9%, SE: 0.4, P = 0.02); a large number of households would be impoverished in Oromia (n = 356 000) and Amhara (n = 202 000) regions. In summary, a large number of households is facing financial hardship in Ethiopia, particularly in Afar, Benshangul-Gumuz, Oromia, Amhara and SNNP regions and this number would likely increase with greater health services utilization. We recommend regional-level analyses on services coverage to be conducted as some of the estimated low CHE/IHE regional values might be due to low services coverage. Periodic analyses on the financial hardship status of households could also be monitored to infer progress towards universal health coverage.

Altitude is the main driver of coffee leaf rust epidemics: a large-scale survey in Ethiopia

Arabica coffee (Coffea arabica L.) is a native from Africa, particularly from Ethiopia. Previously of little concern to Ethiopian farmers, coffee leaf rust (CLR), caused by the fungus Hemileia vastatrix, is an emergent disease globally. To update the status of CLR, a large survey was conducted in 405 coffee fields across nine production zones of Oromia and Southern Nations Nationalities and Peoples (SNNP) regions. The disease, evaluated one time during the month of the peak for CLR intensity for each region, was present in every single field; mean incidence and severity ranged from 5 to 86.7% (mean = 35.3%) and 0.22 to 55.5 (mean = 9.09), respectively. A complimentary log-log model was developed to predict mean field severity from mean field incidence. Altitude, a known surrogate variable for temperature, was the main driver of the epidemics. Incidence and severity were highest at the lowland fields, where poorly managed plantations of local varieties grown under open sun were also more dominant. CLR intensity decreased with the increase in altitude at the highlands where well-managed and improved varieties grown under the shade in forest systems dominate the scenario. Our results contribute to increase awareness of a growing problem threatening coffee fields that are still under lower risk, such as at the highlands, particularly if temperatures rise and farmers cut forest to grow plantations of susceptible cultivars. Improving genetic resistance and adoption of best management practices are urgent to prevent the rapid surge of new races and mitigate crop losses currently overlooked by coffee farmers at the lowlands.

Genetic diversity assessment of sorghum (Sorghum bicolor (L.) Moench) landraces using SNP markers

Systematic genetic profiling of the genetic pool is fundamental to select desirable parents for conventional and genomic-assisted breeding. The objective of this study was to assess genetic variation and population structure in a diverse population of sorghum (Sorghum bicolor (L.) Moench) accessions collected from various regions of Ethiopia. Using single nucleotide polymorphism (SNP) markers, potential breeding parents were then selected. In all, 342 sorghum accessions were genotyped using diversity array technology sequence-derived 5060 SNPs with > 5% minor allele frequency. Population structure, clustering, PCA, and analysis of molecular variance (AMOVA) were conducted to deduce variability within the germplasm. The AMOVA results revealed a higher percentage (58.8%) of variation among the populations followed by variation within accessions (40.4%). Polymorphic information content (PIC) values ranged from 0.184 for accessions collected from the Somali to 0.260 for the Oromia and Southern Nations, Nationalities, and Peoples (SNNP) regions. Higher genetic variation was detected among sorghum collections from Oromia followed by those of the SNNP region. The selected SNP markers were the most powerful in discriminating the tested sorghum accessions. Population structure analysis revealed the presence of two main distinct genetic clusters in which accessions were grouped based on area of collection. The present findings indicated abundant genetic variability among Ethiopian sorghum accessions, confirming that they will be useful for breeding, germplasm conservation and genomic selection.

Farmers’ and AI Technicians’ Characteristics and Their Impact on AI Technology Adoption, Utilization and Its Efficiency in Ethiopia

The AI delivery system in Ethiopia constrained with various technical, infrastructural and financial problems and thus it is said to be inefficient in terms of genetics and productivity improvement. A study conducted in 2017,2018 and 2019 in Amhara, Oromia, Southern Nations Nationalities and Peoples (SNPP) and Tigray regional states of the country to provide information on the impact of farmers’ and AI technicians characteristics that influence the adoption, utilization and efficiency of Artificial Insemination (AI) technology in Ethiopia. The overall mean age of AI technicians in the four studied regions was about 35 years. The total number of AI technicians in 2017/18 was 1,293 of which 93 (7.2%) were female. The engagement of women in the AI delivery system increased in 2017/18 from 1.8% to 7.2%. About 42% of the total AI technicians considered in this study trained for 45 days while the other 22%, 32%, and 7% trained for a period of three, six and nine months, respectively. AI technicians in the four study regions served as AI technician for an average of 8.17 years. Experience of AI technicians was positively correlated with the number of inseminations during regular (r=0.144), peak (r=0.159*) and off (r=0.219**) seasons. However, it was found to be negatively correlated with service per conception (r=-0.034). The average dairy farming household’s family size in the four studied regions was 6.18 persons per household. Total household income, income from livestock sale and livestock products was significantly different ( p &lt;0.05) among the four regions. Keywords: Adoption, Experience, Extension, Households, DOI: 10.7176/JCSD/58-01 Publication date: April 30 th 2020

Survey data on factors that constrain the adoption of soil carbon enhancing technologies in Ethiopia

The data described in this paper were collected in two watersheds – Azuga-suba watershed in Angacha woreda (district) of Southern Nations, Nationalities and Peoples (SNNP) region and Yesir watershed of Bure woreda (district) of the Amhara region – in Ethiopia. The data were collected from 379 households with the main objective being to assess the factors constraining the adoption of sustainable land management technologies (SLMT) that enhance soil organic carbon sequestration. The data were collected using a structured questionnaire that was designed in SurveyCTO. The data cleaning and analysis was done using STATA SE version 14. This data can be used by researchers to assess the extent of adoption of SLMTs in Ethiopia by, for example, comparing the North and the South regions of Ethiopia. It can also be used to assess the probability of adoption as well as the benefit and costs of adopting SLMTs in Ethiopia both at farm and plot level.

The Procedure for the Creation of New Regional States under the FDRE Constitution: Some Overlooked Issues

The Ethiopian Federation which was created by the 1995 Federal Democratic Republic of Ethiopia (FDRE) Constitution had nine member states and one city administration. Apart from the creation of Dire Dawa as a city administration, no new state has been introduced in the Ethiopian federation since the adoption of the Constitution. However, several ethnic-based Zonal administrations in the country’s Southern Nations, Nationalities and Peoples (SNNP) region are now demanding to form their own regional states. Apparently, the demands are justified under Article 47(2) of the 1995 Ethiopian constitution which follows a purely ethnic-centered approach by giving “each nation, nationality and people” living in the nine States of the federation “the right to establish their own States at any time.” However, since this right has so far never been exercised in practice, the new demands are creating anxiety in some quarters and drawing a growing attention to the constitutional procedure for the creation of new states. This article aims to critically examine the relevant constitutional provisions dealing with the issue of creation of new states. Drawing insights from some other federations, we argue that the ethnic-centered approach taken under the FDRE Constitution for the creation of new states overlooks several important issues such as economic viability, administrative efficiency, equity, sustainable peace, and resilience of the federal system. Key terms: Creation of new states · Ethnic federalism · Self-determination · Nation, Nationality or People (NNP)

Assessment of Diarrheal Disease Management Practice in Under-Five-Year Children According to WHO Guideline in Health Facilities of Hawassa City, SNNPR, Ethiopia

Objective: To explore the practice of management of diarrhea in under-5-year children at health facilities found in Hawassa town, and associated factors with malpractice in comparison. Methodology: Cross Sectional study was conducted in 2 hospitals, 2 health centers and 2 private clinics that are found in Hawassa city which is found in Southern Nations, Nationalities and peoples (SNNP), 275 KM to south from Addis Ababa, capital city of Ethiopia from august 2017-October 2017. Structured checklist was used to retrieve the required information from the patients on arrival and stay in pediatrics OPDs and wards. The data analysis carried out using SPSS version 20.0. Logistic regression was carried out to analyze the association between the independent and dependent variables. Statistically significant associations were declared at p-values of less than or equal to 0.05. Results: Out of 420, about 397 (94.5%) children with diarrheal disease between the ages of 3 - 59 months were studied. The study subjects were from governmental hospitals (35.5%), health centers (34.5%) and private clinics (30%) that are found in Hawassa City. Sign of dehydration was 66 (17%) of which majority 59 (83%) of them were rehydrated. As to Zink supplementation, only 180 (45%) received it; antibiotics were the commonly (59.1%) prescribed drugs. Only 43.3% of children were appropriately managed. Hospitals had higher odds of inappropriate management of diarrhea with AOR = 1.61 (95% CI: 1.04 - 2.5) and children one year or younger were more inappropriately managed for diarrhea at the health facilities with AOR of 2.3 (95% CI: 1.57 - 4.41). Conclusions: In the current study the management of diarrhea at the health facilities is unsatisfactory as only less than half of children with diarrhea were properly managed. Treatment of diarrhea at hospital level and the patient’s age being less than 1 year were found to significantly affect the level of mismanagement of the diarrheal disease. Therefore, orientation and trainings for health care providers especially GPs and Residents should be given to adhere to recommended zinc therapy, Oral Rehydration Salts (ORS) replacement therapy and rational antibiotics prescription.

Determinants of early initiation of breastfeeding in Ethiopia: a population-based study using the 2016 demographic and health survey data

BackgroundTimely breastfeeding initiation is a simple but important measure that has protective effects on infants and mothers. This study aims to determine the predictors of early breastfeeding initiation among mothers residing in Ethiopia.MethodsThis study employed the 2016 Ethiopian Demographic and Health Survey data. A total of 5546 children born during the last 24 months at the time of survey were included for analysis from nine regional states and two city administration areas. Socio-demographic and socio-economic factors including individual, household and community-level factors were examined of their significance against the outcome variable of early initiation of breastfeeding using a mixed-effect logistic regression model.ResultsThe proportion of infants who had timely initiation of breastfeeding was 74.3% (n = 3064). In the multivariate logistic regression analysis, mothers who delivered with assistance of one or more health professionals had 68% (AOR 1.68; 95% CI: 1.23, 2.29) higher odds of initiating timely breastfeeding. In addition, mothers delivering by a caesarean section had 86% reduced odds of early breastfeeding initiation (AOR 0.14; 95% CI: 0.09, 0.22) when compared to mothers who had vaginal delivery. In terms of socio-demographic factors, the odds of early breastfeeding initiation were more than two and half times higher particularly for mothers residing particularly in Oromiya (AOR 2.58; 95% CI: 1.84, 3.63) and Southern Nations Nationalities and Peoples (SNNP) (AOR 2.75; 95% CI: 1.86, 4.05). In addition, timely breastfeeding initiation was also significantly associated with wealth index with wealthier mothers having 43% higher odds compared to mothers of poorest households (AOR 1.43; 95% CI: 1.07, 1.92). Other factors such as age, gender and birth order of the infant also had significant associations with early breastfeeding initiation.ConclusionEarly breastfeeding initiation in Ethiopia is inextricably associated with various socio-demographic, biomedical, and socio-economic factors. The study findings can potentially inform mothers and the wider community on the benefits of timely breastfeeding initiation and policymakers and community leaders to target health promotional interventions and resources where needed.

Legal and Practical Aspects of Child Custody, Visitation and Maintenance: A Case Study in SNNP Regional State

Although divorce disrupts the marital bond thereby terminating marital rights and obligations, each parent’s obligations to the wellbeing and upbringing of children (custody, visitation rights, and maintenance) persists. This article examines the practice of courts with regard to child custody, visitation rights and obligation to supply maintenance in the Southern Nations, Nationalities and Peoples (SNNP) Regional State. The experience of various court decisions in SNNP Regional State with respect to these matters is explored. Since the laws do not have detailed provisions that regulate the various issues of child custody, visitation and child support, there is inconsistency in judicial decisions. Many decisions do not distinguish between physical and legal custody. As a result, the legal and physical custody of the child usually rest on the same person. With regard to visitation, there is variation in court decisions although the conventional arrangement seems standard visitation. In some cases, courts specify the duration and form of visitation. However, in many cases, courts do not indicate how and when visitation shall be allowed. There are cases where courts overlook the issue of visitation. There is also inconsistency in court decisions with regard to child support. These problems call for detail provisions to ensure consistency and predictability in child custody, visitation and child support decisions. Key terms Family · Divorce · Child custody · Visitation · Maintenance

Total aflatoxins in complementary foods produced at community levels using locally available ingredients in Ethiopia

ABSTRACTThis study was conducted to determine the occurrence and levels of total aflatoxins in complementary foods (CFs) and their ingredients. A total of 126 samples collected from 20 Districts from Amhara, Tigray, Oromia, and Southern Nations Nationalities and Peoples (SNNP) regions were analysed for levels of total aflatoxins using enzyme linked immunosorbent assay (ELISA). Aflatoxins were detected in 62 out of 66 pre-milling samples with mean range of 0.3–9.9 µg/kg. Aflatoxins were also detected in 19 out of 20 post-production CFs and in all of the one-month stored CFs at households and grain banks, with a mean range of 0.5–8.0, 3.6–11.3, and 0.2–12.4 µg/kg, respectively. Overall, 3 out of 126 samples exceeded the maximum limit (10 µg/kg). Although most aflatoxin levels were below the maximum limit and thus considered to be safe for consumption, more effort should be implemented to reduce contamination, as these CFs are intended for consumption by young children.

Assessment of mothers’ knowledge and practice towards aflatoxin contamination in complementary foods in Ethiopia: from pre-harvest to household

This study assessed the knowledge and practices of the mothers in Ethiopia on issues related to aflatoxin in complementary foods (CFs) using structured questionnaires. The study involved 195 mothers from Amhara, Tigray, Oromia, and Southern Nations Nationalities and Peoples (SNNP) regions and addressed a range of issues used to prevent the risks of mould and aflatoxin contamination from farm-to-table. Of the 195 mothers who responded; 186 (95%) were ploughing their land before growing the next crop, 177 (91%) used the crop rotation schedule, 157 (81%) reported the practice of removing old seed heads and stalks used as an inoculum for aflatoxin contamination, 185 (95%) harvested the crops as soon as the crops were matured, 138 (70%) used a threshing method known as ‘trampling by hoofed animals’. After threshing, about 124 (64%) respondents had the knowledge and practice of drying cereals and legumes to decrease the moisture content, 134 (68%) used solar drying on a bare ground, 184 (94%) cleaned and disinfected the storage structures before storage. Almost all the respondents practiced the CFs processing steps properly and they used colour, type, odour, insect infestations, mouldiness and all these criteria to select the CFs ingredients. A total of 78 (40%) respondents had the practice of feeding mouldy cereals and legumes to animals, and 89 (46%) of the respondents erroneously believed that roasting can decontaminate the aflatoxin produced from mouldy cereals. As a general conclusion, the majority of the respondents are practicing good agricultural practices in the field, but they use poor storage and processing practices at homes which are susceptible to mould and aflatoxin contamination. Besides, they lack awareness about the toxic effects of aflatoxin on human health. Therefore, awareness creation about the health impacts of aflatoxin and methods of prevention need to be implemented in the study areas.

Assessment of genetic diversity in Ethiopian cowpea [Vigna unguiculata (L.) Walp.] germplasm using simple sequence repeat markers

The genetic diversity of cowpea (Vigna unguiculata L. Walp.) in Ethiopia was analyzed using 19 uniform accessions, 62 variable accessions (yielding 185 sub-types), and two mungbean (Vigna radiata) accessions (four subtypes) as outgroup. A set of 23 polymorphic simple sequence repeat (SSR) markers was identified, and polymorphism in the various accessions was scored by determining amplicon variability. Allele frequency, genetic diversity, and polymorphism information content (PIC) were determined for each SSR marker, and a neighbor joining dendrogram was generated to show the genetic relationship among the individual accessions. A total of 75 allelic variants was defined, with the average number of alleles per locus calculated to be three. The average genetic diversity (D) was 0.47, and PIC was 0.4. Three main clusters were identified by phylogenetic analysis, and the clusters and sub-grouping were supported by STRUCTURE and principal component analysis. This grouping had a moderate fixation index value of 0.075 and gene flow (Nm) of 3.176, indicating that the accessions possess wide diversity within individuals and populations. The accessions showed no clustering by geographical origins. Three well-characterized molecular markers (SSR1, C42-2B, and 61RM2) for race specific resistance to Striga gesnerioides in the cowpea cultivar B301 were used to evaluate the accessions for their potential for use in genetic improvement against this pest. Based on this analysis, only two accessions, 222890–2 from Gambela and 286–2 from the Southern Nations, Nationalities, and Peoples (SNNP) region, were found to cluster with B301 and contain the SSR1 resistance allele. These findings will assist in germplasm conservation efforts by the Institute of Biodiversity and Conservation of Ethiopia, and contribute to future studies aimed at the genetic improvement of local germplasm for improved overall agronomic performance as well as Striga resistance in particular.