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Background The decrease in the magnitude of stunting over the past 20 years has been slow in Ethiopia. To date, in Ethiopia, the trends in and extent of inequality in stunting have not been investigated using methods suitably developed for disparity studies. This paper investigated both the extent and overtime dynamics of stunting inequality in Ethiopia over the last 17 years. Methods Using the World Health Organization's Health Equity Assessment Toolkit software, data from the Ethiopia Demographic and Health surveys (EDHS) were analyzed between 2000 and 2016. The inequality analysis consisted of disaggregated rates of stunting using five equity stratifiers (economic status, education, residence, region and sex) and four summary measures (Difference, Population Attributable risk, Ratio and Absolute Concentration Index). A 95% uncertainty interval was constructed around point estimates to measure statistical significance. Results The study showed that both absolute and relative inequalities in stunting exist in all the studied years in Ethiopia. The inequality disfavors children of mothers who are poor, uneducated and living in rural areas and specific regions such as Amhara. The pro-rich (R = 1.2; 1.1, 1.3 in 2000 to R = 1.7; 1.4, 2 in 2016) and pro-educated (R = 1.6; 95%UI = 1.3, 1.9 in 2000 and R = 2.3; 95%UI = 1.5, 3 in 2011) inequalities slightly increased with time. Male children bear a disproportionately higher burden of stunting, and the disparity increased between the first and the last time points (PAR = −1.5 95%UI = −2.5, −0.6 in 2000 and PAR = −2.9 95%UI = −3.9, −1.9) based on complex measures but remained constant with simple measures (R = 1; 95%UI = 0.9, 1.1 in 2000 and R = 1.1 95%UI = 1, 1.2 in 2016). Similarly, both the sub-national regional and residence-related stunting disparities generally widened over time according to some of the inequality measures. Conclusions Stunting appeared to be highly prevalent among certain sub-groups (i.e. poor, uneducated and living in rural regions). The subpopulations experiencing excessively high stunting prevalence should be the focus of policy makers' attention as they work to achieve the WHO 40% reduction in stunting target by 2025 and the UN Agenda 2030 for Sustainable Development Goals. [ABSTRACT FROM AUTHOR]

This study analyzes uni-and multidimensional poverty and inequalities in rural and small towns in Ethiopia. Unlike the unidimensional measure, the multidimensional measure of poverty shows all the channels through which poverty may manifest itself; it also shows the extent of deprivation. The analysis uses 6 dimensions with 14 indicators to construct a multidimensional index of poverty and inequalities using Ethiopian Households' Socioeconomic Survey dataset. The study also uses multiple correspondence analyses for determining relative weights in computing a multidimensional index and conducts a stochastic dominance analysis of distribution of poverty for different population segments. The paper sheds light on the degree of inequalities in consumption expenditure and multidimensional deprivations. In addition, it also compares the degree of poverty using the conventional measure of poverty and the multidimensional approach. It also examines the determinants of household poverty status using both unidimensional and multidimensional measures using the logit model. The results show that the intensity, severity, and depth of poverty varies substantially across the 2 measures. The unidimensional measure of poverty shows that 36 percent of the households were poor as compared to 46 percent multidimensionally poor households. Moreover, demographic, regional, and household heads' characteristics also affect households' poverty status. [ABSTRACT FROM AUTHOR]

During the post-Green Revolution era, numerous improved wheat varieties were released and disseminated to enhance tolerance to biotic and abiotic stresses and increase productivity. Still, in the wheat-based farming systems of the Global South, gender-based and other social inequalities continue to undermine equitable access to improved varieties, especially for women, poor, and marginalized farmers. Here, we present a case for gender-sensitive technology development, dissemination, and evaluation as part of wheat varietal improvement programs. We take stock of the various challenges that persist in the uptake of modern wheat varieties by male and female smallholders. We focus on Ethiopia and India, two geographies with substantive wheat economies, widespread poverty, and gender inequalities. The socio-economic literature on wheat is relatively thin with limited and dated gender-sensitive evaluation studies on varietal technologies in these countries. Varietal technology evaluations could ideally cover gender differences in relation to wheat varietal trait preferences, technology adoption, and associated decision-making and labor-use changes related to new varieties and complementary technologies, as well as nutritional and economic benefits. The paper calls for a need to change the institutional arrangements in wheat research-and-development (R&D) programs to understand and pursue better paths for wheat improvement to proactively contribute toward gender equity and inclusivity. [ABSTRACT FROM AUTHOR]

Ensuring diet quality in the first 2 years of life is critical to preventing malnutrition and instilling healthy food preferences. Children's diet quality has changed little over time and inequalities by socioeconomic status, rural–urban residence, but also by food group may exist. Using data from the 2011, 2016 and 2019 demographic and health surveys (DHS), we estimated the prevalence and inequalities in the minimum diet diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD). We further assessed food group‐level inequities. In 2019, only 13.5% of children 6–23 months of age met the MDD, 55% met the MMF and only 11% met the MAD indicator. Absolute and relative measures of inequality were calculated. Modest increases in MDD, MMF and MAD were observed over the past decade (2011–2019). These modest improvements were concentrated in limited geographical areas, among children in wealthier households, and urban residents. Unhealthy practices such as bottle‐feeding and zero fruit and vegetables have been increasing; whereas, inequities in the consumption of nutrient‐dense foods have widened. Nevertheless, children from the wealthiest quintile also failed to meet the MDD. Multisectoral efforts that span from diversifying the food supply, regulating the marketing of unhealthy foods, and promoting minimal processing of perishables (i.e., to extend shelf‐life) are needed. Context‐adapted behavioural change communication along with nutrition‐sensitive social protection schemes are also needed to equitably improve the diet quality of children in Ethiopia. Key messages: Improvements in child diet quality are concentrated in limited geographical areas, primarily among wealthier households, and urban residents.Unhealthy practices such as bottle‐feeding and zero fruit and vegetables have been increasing over the past decade.Inequalities in the consumption of nutrient‐dense foods have been widening in the last decade. [ABSTRACT FROM AUTHOR]

Anaemia in women of reproductive age (WRA) can be effectively addressed if supported by a better understanding of the spatial variations, magnitude, severity and distribution of anaemia. This study aimed to map the subnational spatial distribution of anaemia (any, moderate and severe forms) among WRA in Ethiopia. We identified and mapped (any, moderate and severe) anaemia hotspots in WRA (n = 14,923) at the subnational level and identified risk factors using multilevel logistic regression. Kulldorff scan statistics were used to identify hotspot regions. Ordinary kringing was used to predict the anaemia prevalence in unmeasured areas. The overall anaemia prevalence increased from 16.6% in 2011 to 23.6% in 2016, a rise that was mostly related to the widening of existing hotspot areas. The primary clusters of (any) anaemia were in Somali and Afar regions. The horn of the Somali region represented a cluster of 330 km where 10% of WRA were severely anaemic. The Oromia–Somali border represented a significant cluster covering 247 km, with 9% severe anaemia. Population‐dense areas with low anaemia prevalence had high absolute number of cases. Women education, taking iron‐folic‐acid tablets during pregnancy and birth‐delivery in health facilities reduced the risk of any anaemia (P < 0.05). The local‐level mapping of anaemia helped identify clusters that require attention but also highlighted the urgent need to study the aetiology of anaemia to improve the effectiveness and safety of interventions. Both relative and absolute anaemia estimates are critical to determine where additional attention is needed. [ABSTRACT FROM AUTHOR]

This article analyses the central themes running through the collection of papers in this special issue of Childhood, which were all given as papers at the XVI Durban World Congress of Sociology, 23-29 July 2006. These themes encompass the ways in which global processes of social change combining modernity with tradition have become important for both the perception of childhood and for childrens real lives. They also include the ways in which those processes intertwined with social inequalities — of gender, generation and socioeconomic status — among children and between children and other age groups. The article goes on to provide an outline of the ways in which more general theoretical concerns in the sociology of childhood globally are related to local situations, to a variety of practical settings, to the conceptual concerns in different sociological fields and other social science disciplines in South Africa, Ethiopia, Taiwan, Germany, Sweden, and Italy. [ABSTRACT FROM AUTHOR]

The revitalization of Ethiopian higher education (HE) has been underway since the early 2000s. As well as the economic optimism evident in the ‘knowledge-driven poverty reduction’ discourse, social equity goals underscore the reform and expansion of the system. Notwithstanding the widening participation and the equity policy provisions put in place, the problem of inequality has persisted along the lines of ethnicity, gender, rurality and socio-economic background. This paper reviews major equity policy instruments and highlights the enduring inequalities in Ethiopian HE. It argues that this persistence is related in part to the ways in which the problem is represented in policy, and that redressing the problem necessitates framing inequality as capability deprivation rather than as issues of access and disparities in enrolment. [ABSTRACT FROM PUBLISHER]

Summary Household-level impacts of environmental shocks are often negative, but may vary considerably due to heterogeneous vulnerability. This paper considers how differential vulnerability among households affects inequality within rural communities in Ethiopia. This study makes novel use of the Demographic and Health Surveys (DHS) and a NASA agro-climatology dataset. Results show that rainfall deficits have an equalizing effect on within-community livestock inequality in parts of Ethiopia, but regional differences are observed. A non-significant effect is observed with respect to asset inequality. As an initial study on this topic, this paper outlines an agenda for future data collection and analysis efforts. [ABSTRACT FROM AUTHOR]

Background: Persistent inequalities in coverage of maternal health services in sub-Saharan Africa (SSA), a region home to two-thirds of global maternal deaths in 2017, poses a challenge for countries to achieve the Sustainable Development Goal (SDG) targets. This study assesses wealth-based inequalities in coverage of maternal continuum of care in 16 SSA countries with the objective of informing targeted policies to ensure maternal health equity in the region. Methods: We conducted a secondary analysis of Demographic and Health Survey (DHS) data from 16 SSA countries (Angola, Benin, Burundi, Cameroon, Ethiopia, Gambia, Guinea, Liberia, Malawi, Mali, Nigeria, Sierra Leone, South Africa, Tanzania, Uganda, and Zambia). A total of 133,709 women aged 15-49 years who reported a live birth in the five years preceding the survey were included. We defined and measured completion of maternal continuum of care as having had at least one antenatal care (ANC) visit, birth in a health facility, and postnatal care (PNC) by a skilled provider within two days of birth. We used concentration index analysis to measure wealth-based inequality in maternal continuum of care and conducted decomposition analysis to estimate the contributions of sociodemographic and obstetric factors to the observed inequality. Results: The percentage of women who had 1) at least one ANC visit was lowest in Ethiopia (62.3%) and highest in Burundi (99.2%), 2) birth in a health facility was less than 50% in Ethiopia and Nigeria, and 3) PNC within two days was less than 50% in eight countries (Angola, Burundi, Ethiopia, Gambia, Guinea, Malawi, Nigeria, and Tanzania). Completion of maternal continuum of care was highest in South Africa (81.4%) and below 50% in nine of the 16 countries (Angola, Burundi, Ethiopia, Guinea, Malawi, Mali, Nigeria, Tanzania, and Uganda), the lowest being in Ethiopia (12.5%). There was pro-rich wealth-based inequality in maternal continuum of care in all 16 countries, the lowest in South Africa and Liberia (concentration index = 0.04) and the highest in Nigeria (concentration index = 0.34). Our decomposition analysis showed that in 15 of the 16 countries, wealth index was the largest contributor to inequality in primary maternal continuum of care. In Malawi, geographical region was the largest contributor. Conclusions: Addressing the coverage gap in maternal continuum of care in SSA using multidimensional and people-centred approaches remains a key strategy needed to realise the SDG3. The pro-rich wealth-based inequalities observed show that bespoke pro-poor or population-wide approaches are needed. [ABSTRACT FROM AUTHOR]

During 2014–2019, cattle exports from Ethiopia declined more than 95 percent. This trade depends largely on Borana pastoralists of southern Ethiopia and a credit system of deferred payments. The article asks: How did the deferred payment system contribute to the collapse of the trade? It argues that credit defaults ripple through the entire value chain and help to explain the export collapse. By examining how the circulation of credit and debt in the cattle export business disadvantages pastoralists and local traders, the article demonstrates how a once booming trade was undermined by its own contradictory processes and unequal relationships. [ABSTRACT FROM AUTHOR]

This study aims to investigate welfare inequality between households in rural and urban Ethiopia using secondary data obtained from the Living Standards Measurement Surveys (LSMS) available on the World Bank website. The data was analyzed using the Atkinson Index to identify welfare inequality among households and quantile regression to identify determinants of welfare inequality in rural and urban Ethiopia. The results show that the Atkinson index for the rural group is 0.123006, while it is 0.110899 for the urban group, indicating a higher level of welfare inequality in rural areas. Furthermore, the quantile regression analysis reveals that among the factors measured, the number of assets, access to health services, and saving are important determinants of welfare inequality in rural households. On the other hand, the number of livestock and household size are found to be significant factors contributing to welfare inequality in urban areas. This study provides valuable insights into the specific drivers of welfare inequality in both rural and urban settings and can inform policymakers on how to address these inequalities to promote social and economic development in Ethiopia. [ABSTRACT FROM AUTHOR]

Background: Immunization is among the most cost-effective health interventions to improve child survival. However, many countries in sub-Saharan Africa failed to achieve their national and international coverage targets repeatedly. The present study investigated trends of coverage and inequalities in coverage in Ethiopia.Methods: This study used data from five rounds of the Demographic and Health Surveys conducted in Ethiopia in 2000, 2005, 2011, 2016, and 2019. The surveys used a multistage cluster sampling procedure to obtain a nationally and sub-nationally representative data. The outcome variables included in the study were full immunization coverage and inequality. The World Health Organization's Health Equity Assessment Toolkit was used to conduct the inequality analysis. Projections for 2025 were based on smoothed averages generated using the demographic and health survey data from 2000 to 2019.Results: The full (basic) immunization coverage in Ethiopia has increased steadily from 14.3% in 2000 to 44.1% in 2019. Based on the average past performance, the immunization coverage is projected to reach 53.6% by 2025, which will be short of the 75% national full (basic) immunization coverage target for the year 2025. Mothers with higher levels of education are more likely to get their children all basic vaccinations than those with lower levels of education. Similarly, the inequality gaps due to wealth and residency are significant; where children in the lowest wealth strata and those living in rural areas remained disadvantaged.Conclusion: Despite a steady increase in immunization coverage in the past two decades the country is yet to achieve its immunization target. Thus, more efforts are needed to achieve the current and future national immunization targets. A more focused intervention targeting the disadvantaged groups could be an effective strategy to achieve coverage and minimize the inequality gaps in immunization. [ABSTRACT FROM AUTHOR]

Background: Antenatal care is an essential platform to provide all the necessary health interventions during pregnancy that aim to reduce maternal and newborn morbidity and mortality. Although the antenatal care coverage has been increasing in Ethiopia in the last two decades, the country has not been able to meet its own coverage target to date. Most pregnant women who initiated antenatal care also do not complete the full recommended follow up contacts. This study investigated the trend in coverage and the inequalities related to the use of antenatal care in Ethiopia.Methods: This study utilized data from five rounds of Demographic and Health Surveys (DHSs) conducted in Ethiopia in the period between 2000 and 2019. The DHS respondents were women in the age group 15-49 who had a live birth within the five years preceding the surveys. The outcome of interest for this study was antenatal care utilization coverage. We used concentration curve and concentration index to identify the inequalities using the World Health Organization recommended Health Equity Analysis Toolkit software. We did a regression analysis to identify the drivers of urban-rural inequalities.Result: The coverage trend for both initiating Antenatal care and completing the recommended four antenatal contacts showed a steady increase during 2000-2019. However, the coverages have not yet reached the national target and unlikely to meet targets by 2025. Although the economically better-off, urban and educated mother still have a better coverage, the inequality gaps within the wealth, residence and education categories generally showed significant reduction. Women in the lowest wealth quantile, those who were uneducated and those living in rural areas remained disadvantaged. Household economic status and maternal education was the stronger drivers of urban-rural inequalities.Conclusion: The Antenatal care coverage is lagging below the country's target. Despite narrowing inequality gaps women from poor households, who are uneducated and residing in rural areas are still less likely to fully attend the recommended number of antenatal care contacts. Addressing these inequalities through a multisectoral efforts is critical to increase the chances of achieving the national antenatal care coverage targets in Ethiopia. [ABSTRACT FROM AUTHOR]

The paper investigates the impact of growth on poverty in Ethiopia by analysing panel data covering 1994–97, a period of economic recovery driven by peace, good weather, and much improved macroeconomic management. The analysis of poverty shows land ownership, education, type of crops planted, occupations in urban areas, dependency ratios, and location to be important determinants. The characteristics of households that fell into or escaped from poverty are examined; in addition, the profile of those that remained poor during the period (the “chronic” poor) is looked at. In rural areas, the cultivation of a nontraditional export crop (chat) has significantly improved the welfare of households. Primary education plays a more important role in improving welfare in urban than in rural areas. Decomposition of changes in poverty into growth and redistribution components indicates that potential poverty reduction due to the increase in real per capita income was to some extent counteracted by worsening income distribution. The implications of the results for a propoor policy are discussed. [Copyright &y& Elsevier]

Background: In Ethiopia, there is a paucity of studies on inequality in caesarean section using methodologically rigorous and well-established approaches. In this study, we showed extent and the overtime dynamics of inequality in caesarean section in Ethiopia following rigorous methodologies.Methods: The data for analysis came from Ethiopia Demographic and Health Surveys (EDHS) conducted between 2000 and 2016. We used the World Health Organization's (WHO) Health Equity Assessment Toolkit (HEAT) to analyze the data. Caesarean delivery was disaggregated by four equity stratifiers, namely education, wealth, residence and regions. Relative and absolute summary measures were calculated for each equity stratifier to capture inequality from different perspectives. 95% Uncertainty Interval was calculated around a point estimate to measure statistical significance.Results: We found large socioeconomic and area-based inequalities in use of caesarean section in all study surveys. The inequalities have occurred in favour of socioeconomically advantaged women and those living in urban areas and certain regions such as Addis Ababa. While area-related inequality had generally increased with time, socioeconomic inequality showed fluctuation. Adoption of different measures in the study for the inequality analysis has caused the emergence of mix of patterns in caesarean section inequality over time.Conclusions: In all the surveys, wealthy and more educated women, and those residing in urban areas had higher chance of obtaining caesarean delivery. Policy makers should work to ensure caesarean section that is in the accepted normal range. More emphasis should be drawn to subpopulation with under use of caesarean section while at the same time, discouraging unjustified use of it. [ABSTRACT FROM AUTHOR]

Background: Until recently, global public health initiatives have tended to overlook the ways that social factors shape adolescent health, and particularly how these dynamics affect the specific needs of adolescents in relation to information about puberty, menstruation and sexual health. This article draws on mixed methods data from rural and urban areas of Ethiopia to explore how access to health information and resources - and subsequently health outcomes - for adolescents are mediated by gender and age norms, living in different geographical locations, poverty, disability and migration. Methods: Data was collected in 2017–2018 for the Gender and Adolescence: Global Evidence (GAGE) mixed-methods longitudinal research baseline in three regions of Ethiopia (Afar, Amhara and Oromia). Quantitative data was collected from over 6800 adolescents and their caregivers, with qualitative data obtained from a sub-sample of 220 adolescents, their families and communities. Adolescent participants shared their experiences of health, illness and nutrition over the previous year; their knowledge and sources of information about sexual and reproductive health and puberty; and their attitudes toward sexual and reproductive health. Regression analysis was used to explore differences by gender, age, rural/urban residence, and disability status, across a set of adolescents' health knowledge and other outcomes in the quantitative data. Intersectional analysis was used in analysing the qualitative data. Results: Analysis suggested that gender inequality intersects with age, disability and rural/urban differences to shape young people's access to information about puberty, with knowledge about this topic particularly lacking amongst younger adolescents in rural areas. Drought and lack of access to clean water exacerbates health challenges for adolescents in rural areas, where a lack of information and absence of access to preventive healthcare services can lead to permanent disability. The research also found that gaps in both school-based and alternative sources of education about puberty and menstruation reinforce stigma and misinformation, especially in rural areas where adolescents have higher school attrition rates. Gendered cultural norms that place high value on marriage and motherhood generate barriers to contraceptive use, particularly in certain rural communities. Conclusions: As they progress through adolescence, young people's overall health and access to information about their changing bodies is heavily shaped by intersecting social identities. Structural disadvantages such as poverty, distress migration and differential access to healthcare intersect with gender norms to generate further inequalities in adolescent girls' and boys' health outcomes. [ABSTRACT FROM AUTHOR]

As stated in the 2018 global Multidimensional Poverty Index (MPI) report, Ethiopia has the second largest multidimensionally poor population in Africa (after Nigeria). The global MPI was created to measure household's multiple deprivations, but little systematic study has been carried out on the application of MPI measures on a smaller scale and vis-à-vis other measures of poverty. In addition, most of the few existing studies ignore any measure of inequality amongst the multidimensionally poor. This study explored multidimensional poverty in three different drought-prone agro-ecological settings of the Upper Blue Nile basin, Ethiopia. A preliminary participatory exercise was carried out at the study sites to select important indicators and then a structured survey was administered to 390 systematically and randomly selected households. The Alkire–Foster method was used to analyse multidimensional poverty and verified it with Correlation Sensitive Poverty Index (CSPI). Multidimensional poverty incidence, adjusted head count ratio and inequality were significantly different between study sites (p < 0.001). Results indicated a high incidence (88%, 82% and 80%), intensity (52%, 55% and 56%), MPI (46%, 45% and 45%) and inequality (53%, 60% and 63%) of poverty in Aba Gerima, Guder and Dibatie study sites, respectively. A high level of divergence was revealed between the MPI and CSPI in terms of identifying the poor. The living standard and land and livestock ownership dimensions contributed the most to MPI. The case study signifies the importance of inclusion of land and livestock indicators for the national MPI. Besides, it implies that researchers and policymakers need to account for smaller scale contextualised indicators and location differences when studying and designing anti-poverty interventions. [ABSTRACT FROM AUTHOR]

Ethiopia has been lauded for its economic growth and progress in human development indicators. For some, that success is rooted in the developmental state approach advocated by the government. For others, the theory of the developmental state and the practice in Ethiopia were often at odds. Up until 2018, ideas that challenged the state and its approaches were not welcome, and politicians, academics and journalists were jailed for expressing alternative views. However, this appears to have changed, and in June 2018 the Deputy Prime Minister called for debate on the developmental state model. This article explores Ethiopia's developmental state model using the building stability framework, analysing its ability to establish fair power structures, foster inclusive economic growth, develop conflict‐resolution mechanisms, create effective and legitimate institutions, and enable a supportive regional environment. We find the developmental state was effective in a number of ways, but that this modality of governance appears to have passed its peak of securing advantage in Ethiopia. A shift from the developmental state to developmental democracy appears to be underway. Decision‐making and economic policies need to align with this change. [ABSTRACT FROM AUTHOR]

Gender inequalities in Sub-Saharan Africa are deemed relevant but data to support this view are scanty. Retrospective analysis of a large dataset of 105,025 patients admitted to an Ethiopian rural private, non-for-profit hospital over a 11 years period (2005-2015). Since 2001, the hospital and the local community are involved in a long-term, comprehensive and externally-supported health care intervention. The total number of admissions was higher for females (61.9% of the total) mainly because of the high frequency of admissions for obstetrics conditions. The total male-to-female ratio (M:F) was 0.6. Except for malaria, men had more admissions for the other leading causes, with the highest M:F being found for injuries (2.7) and musculoskeletal diseases (1.7). Overall, excluding admissions for pregnancy-related issues, the M:F was 1.4. The frequency of admissions changed with age and gender. Female admissions prevailed in the reproductive age period (from 15 to 44 years of age) while males admissions prevailed in the younger and older age groups. The case fatality rate was higher for men (M:F = 2.0). The total M:F and the M:F excluding pregnancy-related admissions did not change during the study period. Gender inequalities do exist in rural remote setting but tend to affect women differently during their lifespan. Even if gender inequalities generally favor males, the substantial proportion of admissions for pregnancy-related situations is encouraging. [ABSTRACT FROM AUTHOR]

Background: The fifth Millennium Development Goal (MDG) targeted at improving maternal health. In this regard, Ethiopia has shown substantial progresses in the past two decades. Nonetheless, these impressive gains are unevenly distributed among Ethiopian women with different socio-economic characteristics. This study aimed at investigating levels and trends of skilled delivery service, and wealth and education related inequalities from 2000 to 16. Methods: Longitudinal data analysis was conducted on Ethiopian Demographic and Health Survey (EDHS) data of 2000, 2005, 2011 and 2016. The outcome variable was skilled delivery, while data on economic status and education level were used as dimensions of inequality. Rate Ratio (RR) and Rate Difference (RD) inequality measures were applied. STATA for windows version 10.1 statistical software was utilized for data analysis and presentation. The strength of association of inequality dimensions with the outcome variable was assessed using a 95% confidence interval. Results: From total deliveries, 5.62%, 6.3%, 10.8% and 28% of them were attended by skilled birth attendant in 2000, 2005, 2011 and 2016 respectively. In the most recent survey (EDHS 2016), proportion of births attended by skilled birth attendance among women who completed secondary and above education was about 5.42 [95% CI (4.53, 6.09)] times more when compared to women with no formal education. Proportion of births attended by skilled birth attendance among women in the richest quintile was about 5.11 [95% CI (3.98, 6.12)] times higher than that of women in the poorest quintile. Moreover, gap of inequality on receiving skilled delivery service has increased substantially from 24.2 (2000) to 53.8 (2016) percentage points between women in the richest and poorest quintiles; and from 44.9 (2000) to 76.0 (2016) percentage points between women who completed secondary and above education and women with no formal education. Conclusions: Skilled birth attendance remained low and virtually unchanged during the period 2000-2011, but increased substantially in 2016. Gap on wealth and education related inequalities increased linearly during 2000-16. Most pronounced inequalities were observed in women's level of education revealing women with no formal education were the most underserved subgroups. Encouraging women in education and economic development programs should be strengthened as part of the effort to attain Universal Health Coverage (UHC) of Sustainable Development Goals (SDGs) in Ethiopia. [ABSTRACT FROM AUTHOR]

Background: Health systems aim to narrow inequality in access to health care across socioeconomic groups and area of residency. However, in low-income countries, studies are lacking that systematically monitor and evaluate health programs with regard to their effect on specific inequalities. We aimed to measure changes in inequality in access to maternal and child health (MCH) interventions and the effect of Primary Health Care (PHC) facilities expansion on the inequality in access to care in Ethiopia.Methods: The Demographic and Health Survey datasets from Ethiopia (2005 and 2011) were used. We calculated changes in utilization of MCH interventions and child morbidity. Concentration and horizontal inequity indices were estimated. Decomposition analysis was used to calculate the contribution of each determinant to the concentration index.Results: Between 2005 and 2011, improvements in aggregate coverage have been observed for MCH interventions in Ethiopia. Wealth-related inequality has remained persistently high in all surveys. Socioeconomic factors were the main predictors of differences in maternal and child health services utilization and child health outcome. Utilization of primary care facilities for selected maternal and child health interventions have shown marked pro-poor improvement over the period 2005-2011.Conclusions: Our findings suggest that expansion of PHC facilities in Ethiopia might have an important role in narrowing the urban-rural and rich-poor gaps in health service utilization for selected MCH interventions. [ABSTRACT FROM AUTHOR]

The aim of the study was to examine the determinants of forest dependence and the role of community forest on income inequality in rural Ethiopia. Regression results, using Heckman’s two-stage estimation method, suggest that the probability of households’ participation in low-return forest activities is determined by farm size, number of male members in the household and distance from the forest plot to the household’s homestead. Further, the likelihood of households’ participation in high-return forest activities is determined by the number of male household members, the distance from the households’ homestead to the community forest block and being a member of the forest user group’s executive committee. Using instrumental variable method, we found that, in relative terms, households with more non-forest income are less likely to depend on forest commons for their livelihood. Further, wealthier households are less dependent on forest products for their livelihood. We also found that forest products play a crucial role in reducing income inequality in the study area. Income inequality increases by 24% when we exclude forest income from the calculation of inequality measure (Gini coefficient). [ABSTRACT FROM AUTHOR]

In the last couple of decades, the scaling up of successful pilot projects has been considered a crucial development strategy. The majority of scaling-up programs in developing countries stipulate the integration of gender as a central objective. In the article we argue that while the integration of gender in the scaling up of pilot projects has the potential to empower women, care should be taken not to overly focus on a segment of the women category (particular female heads of households) and overstate temporary gender gains that do not transform exploitative gender norms and practices. The article draws on evaluation research undertaken by researchers of the Scaling-up of Pulse Innovation for Food and Nutrition Security (SPIFoNS) Project, implemented in Southern Ethiopia. Data of this write-up were gathered using semi-structured questions, focus group discussions and observation. The article argues that if projects such as SPIFoNS are to adequately challenge patriarchy and contribute to bringing about gender equity, they need to recognize the heterogeneity of women and design multidimensional programs that can help married women to gain full access to resources and participate in important household decision-making processes. [ABSTRACT FROM PUBLISHER]