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Background: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that has manifestations of inattention, hyperactivity, and impulsivity. It affects every facet of a child's life, including one's own emotions, family and school life, and social interaction. The few available studies on ADHD conducted in Ethiopia focus on teachers' awareness and the prevalence of ADHD. None of these studies has taken into account parents of children who have ADHD. The present study, therefore, aimed to find out the challenges and coping mechanisms of parents who have children with ADHD. Methods: A phenomenological qualitative study was conducted to explore the experiences of parents who have children with ADHD. The study was carried out in Addis Ababa, the capital city of Ethiopia. Fourteen parents and two healthcare providers were involved in the study. Participants were selected using a purposive sampling technique. In-depth interviews were conducted with parents of children with ADHD (n = 8) and healthcare providers (n = 2). One focus group discussion (FGD), consisting of six members, was also conducted with parents. A topic guide for conducting the interviews and FGD was developed. Interviews and the FGD were audio-recorded. The data were transcribed verbatim, translated into English, and then analyzed using a thematic analysis approach. Results: With regard to challenges of parents of children with ADHD, three themes emerged: social challenges, economic challenges and psychological challenges. Stigma is found to be the most common challenge. Other challenges included worry about the child's future, lack of social support, strained relationships with others, impact on their job, and marital conflict. Concerning coping mechanisms, two themes emerged: Inward and outward means of coping. The inward means of coping included prayer and developing an optimistic mindset whereas the outward means were family support, healthcare providers' guidance, and social avoidance. Conclusions: The study found that parents of children with ADHD experience several aspects of psychological, social, and economic challenges. Support from healthcare professionals, family members, and the community at large is found to be useful for parents to cope with these challenges. Future research should focus on evaluating interventions that would help parents with ADHD cope with the challenges they experience. [ABSTRACT FROM AUTHOR]

Armed conflict is a complicated topic with multidimensional impact on population health. This study aimed to assess of the health consequences of the northern Ethiopian conflict, 2022. We used a mixed method study design with a retrospective cross-sectional study supplemented by a qualitative study conducted from May to June 2022. We interviewed 1806 individuals from 423 households and conducted 100 in-depth interviews and focused group discussion. We identified 224 people who self-reported cases of illness (124/1000 people) with only 48 (21%) people who fell ill visited a health institution. We also detected 27 cases of deaths (15/1000 people) during the conflict. The collapse of the health system, evacuation of health personnel, and shortage of medical supplies, and instability with a lack of transportation were consequences of the conflict. The northern Ethiopian conflict has greatly affected the community's health through the breakdown of the health system and health-supporting structures. Key Messages: The conflict in Northern Ethiopia has had a substantial impact on the communities health, both directly through conflict-related causalities and indirectly through the disintegration of the health system and health-supporting structures, which has severely hampered the supply and utilization of health services. The main coping strategies of patients and health providers for the breakdown of the health system included the use of traditional medications and home remedies, obtaining medications from non-conflict-affected areas, and providing home-to-home service by health providers and using available supplies. The study recommended immediate rehabilitating interventions for affected individuals and damaged health infrastructure. [ABSTRACT FROM AUTHOR]

Background: Out-of-pocket (OOP) health expenditures for cancer care expose households to unanticipated economic consequences. When the available health services are mainly dependent on OOP expenditure, the household faces catastrophic health expenditure (CHE). This study aimed to estimate the incidence and intensity of CHE in hospitalized cancer patients and identify coping strategies and associated factors. Method and Material: Hospital-based cross-sectional study design was conducted on 305 cancer inpatients in Addis Ababa between November 2021 and February 2022. All patients with cancer who were hospitalized during the data collection period were included in the study. The incidence of CHE was estimated at the 40% threshold of households' non-food expenditure and the intensity of CHE was captured based on the amount by which household expenditure exceeded the threshold and mean positive overshoot, the mean level by which CHE exceeds the threshold used. Multivariate logistic regression was used to assess the relationship between CHE levels and the independent variables. Results: The incidence of CHE at the 40% threshold of households' non-food expenditure was 77.7%, while the O and MPO were 36.2% and 46.6%, respectively. CHE for cancer care was significantly associated with patient residence, increased number of chemotherapy cycles, increased duration of hospital admission, lack of insurance enrolment, and lower-income quintiles. Saving and selling assets were identified as the primary coping mechanisms. Conclusion: The incidence and intensity of CHE among inpatients with cancer were high and which could lead to impoverishment of households. Improved quality and coverage of health insurance and decentralizing cancer care to regions standards similar to Addis Ababa will save households from incurring CHE. [ABSTRACT FROM AUTHOR]

Background: Conflict is a complicated topic with a multidimensional consequences for community health. Its effects have a broad pattern, starting from direct war-related morbidity and mortality caused by bullets and bombs to indirect consequences due to the interruption of the delivery of preventive and curative health services. This study aimed to explore the health consequences of the northern Ethiopian conflict in the North Wollo zone, northeast Ethiopia, in 2022. Methods: This descriptive qualitative study was conducted from May to June 2022 on six conflict-affected Woredas in the north Wollo zone. A total of 100 purposively selected participants, which included patients, pregnant women, elders, community and religious leaders, and health professionals, were interviewed using IDI and FGD. The data was entered, coded, and analyzed using Open Code version 4.03. Thematic analysis approach employed to conduct the interpretation. Data was presented using descriptive statistics in the form of texts and tables. Results: The findings indicate that the conflict has caused a profound consequence on population health. It has resulted in a wide range of direct and indirect consequences, ranging from war-related casualties, famine, and disruptions of supply chains and forced displacement to instances of violence and rape associated with insecurity. The conflict also caused a breakdown in the health system by causing distraction of health infrastructure, fleeing of health workers and shortage of medication, together with insecurity and lack of transportation, which greatly affected the provision and utilization of health services. Additionally, the conflict has resulted in long-term consequences, such as the destruction of health facilities, interruption of immunization services, posttraumatic stress disorders, and lifelong disabilities. The coping strategies utilized were using available traditional medicines and home remedies, obtaining medications from conflict-unaffected areas, and implementing home-to-home healthcare services using available supplies. Conclusion: The Northern Ethiopian conflict has an impact on community health both directly and indirectly through conflict-related causalities and the breakdown of the health system and health-supporting structures. Therefore, this study recommends immediate rehabilitation interventions for damaged health infrastructure and affected individuals. [ABSTRACT FROM AUTHOR]

This study examines the institutional challenges of poverty and its coping mechanism in eastern Ethiopia. A sample of 800 households was randomly selected and interviewed from three local administratives namely: Dirree-Xiyyaara, Biiftuu-Gadaa and Hawwi-Gelan. The descriptive statistics indicate that majority of the households reported that they: do not feel secured on the current land ownership status; perceive that their family members, relatives, and communities do not help to them to fight poverty; do not trust in the local or woreda authorities; perceive that their local authorities are not accountable; think that their local authorities are not transparent; perceive that their local authorities are not participatory; and know that their local authorities demand bribe to provide services to the community. Similarly, the econometric result of the probit regression illustrates that distance to the nearest market center, saving culture and saving amount, land ownership status and active participation in social networks significantly determine poverty status of the households in the study areas. [ABSTRACT FROM AUTHOR]

Background: Vulnerability to HIV infection is a major concern in an effort to control further infections. What drives vulnerability among pastoral settings of Ethiopia is not well documented. Objectives: This study aims to identify drivers of vulnerability to HIV infection among the Borana pastoral community of Ethiopia. Methods: Data were collected during 2008–2009 as part of a PhD work and subsequently in 2014 and 2016, during a follow-up visit to Borana. Data on perceived threats of HIV, facilitators of vulnerability, coping mechanisms and perceived consequences were collected by trained research assistants using topic guides developed for this purpose. In-depth and key informant interviews and Focus Group Discussions (FGDs) with selected married men and women, opinion leaders, and HIV focal persons of public sectors and Non Governmental Organizations in Teltele, Arero, Yabelo and Moyale were carried out. Sample transcripts were checked for consistency and completeness before data collection was completed. Two qualitative researchers read transcripts and suggested themes and subthemes in reference to the objective of the study. Transcripts were imported to MAXQDA software. Thematic analysis was applied to reduce data into defined themes. Findings were interpreted following the objective of the study. Findings: The results show that HIV is a major threat in Borana with individual and community level consequences. Concurrent extramarital sexual practices, men's role in the selling of livestock and consequent encounters with "other" women facilitate vulnerability to HIV. Lack of information about HIV, availability and use of condoms, and failure to use local resources for HIV prevention were key limitations to coping with the problem. After nearly 40 years of HIV intervention in Ethiopia, coping mechanisms are not exploited in Borana. Conclusion: Vulnerability to HIV among the Borana pastoral community is facilitated by multiple factors that work in tandem, thus calling for interventions that address the different factors at the same time. [ABSTRACT FROM AUTHOR]

Research on obstetric fistula has paid limited attention to the lived experiences of survivors. This qualitative study explored the evolution of survivors' perceptions of their social relationships and health since developing this obstetric complication. In-depth interviews were conducted with eight survivors who were selected based on purposive and snowball sampling techniques. Thematic categorization and content analysis was used to analyze the data. The resultant themes included participants' understanding of factors predisposing to fistula, challenges they encounter, their coping responses, and the meaning of their experiences. First, the participants had a common understanding of the factors that predisposed them to obstetric fistula. They mentioned poor knowledge about pregnancy, early marriage, cultural practices, and a delay in or lack of access to emergency obstetric care. Second, the participants suffered from powerlessness experienced during their childhood and married lives. They also faced prolonged obstructed labor, physical injury, emotional breakdown, depression, erosion of social capital, and loss of healthy years. Third, to control their negative emotions, participants reported isolating themselves, having suicidal thoughts, positive interpretation about the future, and avoidance. To obtain relief from their disease, the women used their family support, sold their properties, and oriented to reality. Fourth, the participants were struggling to keep going, to accept their changed reality, and to change their perspectives on life. In conclusion, obstetric fistula has significant physical, psychosocial, and emotional consequences. The study participants were not passive victims but rather active survivors of these challenges. Adequate support was not provided by their formal or informal support systems. To prevent and manage obstetric fistula successfully, there should be family-based interventions that improve access to and provision of emergency obstetric care. These initiatives should also ensure men's participation, women's empowerment, and the utilization of community-based institutions. [ABSTRACT FROM AUTHOR]

Abstract: This paper provides empirical evidence on the gendered impact of the 2007–2008 food price crisis using panel data on 1400 households from rural Ethiopia that were initially surveyed before the onset of the crisis, in 1994–1995, 1997, and 2004, and after food prices spiked, in 2009. It investigates whether female-headed households are more likely to report experiencing a food price shock, and whether female-headed households experiencing a shock are more (or less) likely to adopt certain coping strategies, controlling for individual, household, and community characteristics. Our findings suggest that female-headed households are more vulnerable to food price changes and are more likely to have experienced a food price shock in 2007–2008. Because female-headed households are also resource poor and have a larger food gap compared with male-headed households, they cope by cutting back on the number of meals they provide their households during good months and eating less preferred foods in general. A combination of short-term measures to protect diet diversity and micronutrient consumption of vulnerable groups and longer-term measures to promote investment in sustainable agriculture, such as strengthening women’s property rights, may increase the ability of poor and vulnerable households to cope better with food price increases. [Copyright &y& Elsevier]

This study analyzed the livelihoods of households located in and around forests in Ethiopia, and investigated the impacts of two major forest policies of the country, delegation and devolution. The results showed that forest-related livelihoods are an important mechanism to cope with drought and concomitant food shortages. The forest is also an important source of income, especially for the relatively resource-poor community and for the poor and very poor households in the community. The delegation policy has frustrated this role of the forest in local people's livelihoods while devolution yielded mixed results, with some forest-related benefits declining while others showed increase. [ABSTRACT FROM AUTHOR]

The depth and geographical scope of the impacts of the 2007-2008 food price hikes have received wide attention, and calls have been made for urgent actions to minimise the short- and long-term negative effects on vulnerable groups, including women in farming communities. This article, based on research from farming households in Bangladesh and Ethiopia, confirms that it is gender inequality that makes women more vulnerable to the food price hikes, yet they are resourcefully devising ways to cope with scarcity in availability, access and consumption of food. [ABSTRACT FROM AUTHOR]

Background: Obstetric fistula is a debilitating condition resulted from poorly (un) managed prolonged obstructed labor. It has significant psychosocial and economic consequences on those affected and their families. Data regarding experiences and coping mechanisms of Ethiopian women with fistula is scarce.Methods: Qualitative design was employed with in depth interview technique by using open ended interview guide. Eleven fistula patients waiting for surgical repair at the fistula treatment center of Gondar Specialized Referral Hospital were selected with typical case selection. Thedata were audio-taped, transcribed and translated from Amharic to English. Open code version 4.03was used to organize data and identify themes for analysis.Results: The age of participants of the study ranged between 19 to 43 years. Ten of them were from rural areas. Regarding their educational status eight cannot read and write. Similar number were either separated or divorced. Six of them lived with obstetric fistula without treatment from one to five years. Five women related their condition to their fate. The women faced challenges in role performance, marital and social relationships and economic capability. Frequent bathing, use of stripes of old clothes as a pad, self-isolation and hiding from being observed, wearing extra clothes as cover, increasing water intake and reducing hot drinks and fluids other than water were the ways they have devised to cope with the incontinence.Conclusion: The study participants reported that they experienced deep sense of loss, diminished self-worth and multiple social challenges. They coped with the incontinence in various ways among which some were non effective and might have continuing negative impact on woman's quality of life even after corrective surgery. Developing bridging intervention for early identification and referral could reduce period of women's suffering. [ABSTRACT FROM AUTHOR]