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BackgroundThere is presently dearth of evidence in Ethiopia on patients' perception on quality of care given for multi-drug resistant tuberculosis (MDR-TB) and their satisfaction with the care and services they receive for the disease. Moreover, there is no evidence on the experiences and practices of caregivers for MDR-TB regarding the functionality of the programmatic management of MDR-TB at referral hospitals in Ethiopia. Thus, this study was conducted to address these gaps. Evidence in these areas would help to institute interventions that could enhance patient satisfaction and their adherence to the treatment given for MDR-TB.Design and methodsThis study employed an inductive phenomenological approach to investigate patients' perception of the quality of care given for MDR-TB, level of their satisfaction with the care they received for MDR-TB and the experiences and practices of caregivers for MDR-TB on the functionality of the programmatic management of MDR-TB at referral hospitals in Ethiopia. The data were analysed manually, and that helped to get more control over the data.ResultsThe majority of the patients were satisfied with the compassionate communication and clinical care they received at hospitals. However, as no doctor was dedicated exclusively for the MDR-TB centre of the hospitals, patients could not get timely medical attention during emergent medical conditions. Patients were dissatisfied with the poor communication and uncaring practice of caregivers found at treatment follow-up centres (TFCs). Patients perceived that socio-economic difficulties are both the cause of MDR-TB and it has also challenged their ability to cope-up with the disease and its treatment. Patients were dissatisfied with the poor quality and inadequate quantity of the socio-economic support they got from the programme. Despite the high MDR-TB and HIV/AIDS co-infection, services for both diseases were not available under one roof.ConclusionsSocio-economic challenges, inadequate socio-economic support, absence of integrated care for MDR-TB and HIV/AIDS, and the uncaring practice of caregivers at treatment follow-up centres are found to negatively affect patients' perceived quality of care and their satisfaction with the care given for MDR-TB. Addressing these challenges is recommended to assist patients' coping ability with MDR-TB and its treatment.

Bedilu Deribe,1 Mohammed Ayalew,1 Dereje Geleta,2 Lalisa Gemechu,3 Netsanet Bogale,4 Kurabachew Mengistu,4 Anteneh Gadissa,4 Dubale Dula,5 Girma Ababi,6 Achamyelesh Gebretsadik2 1Hawassa University School of Nursing, Hawassa, Ethiopia; 2Hawassa University School of Public Health, Hawassa, Ethiopia; 3Hawassa University Department of Environmental Health, Hawassa, Ethiopia; 4Hawassa University Faculty of Medicine, Hawassa, Ethiopia; 5Hawassa University Department of Midwifery, Hawassa, Ethiopia; 6Yanet Medical Center, Hawassa, EthiopiaCorrespondence: Bedilu DeribeHawassa University School of Nursing, Hawassa, South Ethiopia, EthiopiaTel +251933220151Email bediluderibe2002@gmail.comBackground: Cancer has become one of the most common and the second leading cause of death. According to grounded theory, quality care is meeting all the needs of the patients. Low-quality nursing care relates omission of nursing care required to meet patients’ need. Quality of nursing care in oncologic setting was nursing practice area where studies are limited.Objective: The aim of the study was to assess the perceived quality of nursing care among patients with cancer attending Hawassa University comprehensive specialized Hospital.Methods: A quantitative Cross-sectional study was conducted. Among the proposed 422 patients with cancer, using a simple random sampling technique 415 patients were included in this study. Seven data were discarded due to incompleteness and inconsistency between collected data and patient medical record. Data were collected using structured questionnaires and Quality of Oncology Nursing Care Scale. We carried out statistical analysis using SPSS V-20. We used descriptive analysis to examine the quality of oncology nursing care.Results: The mean age of patients was 42.51 (± 14.24) years, among patients diagnosed with cancer more than one-third 148 (35.70%) had breast cancer. The majority of patients with cancer 173 (41.70%) were in stage-III. Nearly two-third 266 (64.10%) of patients were on chemotherapy. Among study participants on treatment, 249 (60.00%) perceived they received good quality of nursing care. The mean score related to the domain of support and confirmation is 62.73 ± 7.26. In terms of spiritual care, the mean score is 21.03 ± 5.37.Conclusion: The perceived quality of nursing care was high however not all domains of oncology care were achieved. We recommend Detail and focused study to explore important predictors’ quality nursing care.Keywords: cancer, Hawassa, patents with cancer, quality of nursing care

Dubale Dulla Koboto,1 Bedilu Deribe,2 Achamyelesh Gebretsadik,3 Girma Ababi,4 Netsanet Bogale,4 Dereje Geleta,3 Lalisa Gemechu,5 Kurabachew Mengistu4 1Department of Midwifery, College of Medicine and Health Sciences, Hawassa University, Hawassa, SNNPR, Ethiopia; 2School of Nursing, College of Medicine and Health Sciences, Hawassa University, Hawassa, SNNPR, Ethiopia; 3School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, SNNPR, Ethiopia; 4Fuculty of Medicine, College of Medicine and Health Sciences, Hawassa University, Hawassa, SNNPR, Ethiopia; 5Department of Environmental Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, SNNPR, EthiopiaCorrespondence: Dubale Dulla KobotoHawassa University, CMHS, Department of Midwifery, Hawassa, SNNPR, EthiopiaTel +251913850895Email dzmhkb2012@gmail.comBackground: Breast cancer affects the overall quality of life (QOL) among its survivors. Limited evidence is available about the QOL among cases. Therefore, this study was intended to assess the quality of life of breast cancer patients attending the cancer treatment center at Hawassa University Comprehensive Specialized Hospital, Hawassa, southern Ethiopia.Methods: An institution-based cross-sectional study was conducted among breast cancer patients attending cancer treatment at the Hawassa University Comprehensive Specialized Hospital between April and June, 2019. All breast cancer patients attending treatment the center were included in the study by universal sampling. Data were collected using a structured questionnaire containing demographic data, patient clinical factors and Quality of Life Instrument (WHOQOL)-BREF version 3.0. The collected data were entered into EpiData software version 3.1 and analyzed using SPSS Version 20.0. Descriptive statistics were presented in tables.Results: A total of 259 respondents with a mean age of (SD) 44.89 (12.56) participated in study. The mean score of overall global health scale was 75.3 (SD± 17.1) with the mean health satisfaction was 12.43 (SD± 3.98). The highest mean score was observed in environmental domain, 93.31 (SD± 19.76), despite social domain being very low, 36.69 (SD± 7.62). Most of the participants were highly satisfied with the health care service that was provided, with a mean score of 16.1 (SD± 3.1). In contrast, the majority of study participants were disappointed with the need for any medical treatment, body appearance, luxurious activities, and sexual life, with mean scores of 8.93 (SD± 3.68), 8.74 (SD± 4.26), 9.1 (SD± 4.22), and 8.1 (SD± 4.14), respectively.Conclusion: Breast cancer patients in southern Ethiopia suffered from poor social and psychological support that, in turn, highly affected their life value. Therefore, due attention should be given to enhance social and psychological support for breast cancer patients as a whole.Keywords: breast cancer, quality of life, domains of QOL, Hawassa

Background There is limited empirical evidence in Ethiopia on the determinants of treatment outcomes of patients with multidrug-resistant tuberculosis (MDR-TB) who were enrolled to second-line anti-tuberculosis drugs. Thus, this study investigated the determinants of treatment outcomes in patients with MDR-TB at referral hospitals in Ethiopia. Design and methods This study was underpinned by a cross-sectional quantitative research design that guided both data collection and analysis. Data is collected using structured questionnaire and data analyses was performed using the Statistical Package for Social Sciences. Multi-variable logistic regression was used to control for confounders in determining the association between treatment outcomes of patients with MDR-TB and selected predictor variables, such as co-morbidity with MDR-TB and body mass index. Results From the total of 136 patients with MDR-TB included in this study, 31% had some co-morbidity with MDR-TB at baseline, and 64% of the patients had a body mass index of less than 18.5 kg/m2. At 24 months after commencing treatment, 76 (69%), n = 110), of the patients had successfully completed treatment, while 30 (27%) died of the disease. The odds of death was significantly higher among patients with low body mass index (AOR = 2.734, 95% CI: 1.01–7.395; PConclusion The higher proportion of mortality among patients treated for MDR-TB at Adama and Nekemte Hospitals, central Ethiopia, is attributable to co-morbidities with MDR-TB, including HIV/AIDS and malnutrition. Improving socio-economic and nutritional support and provision of integrated care for MDR-TB and HIV/AIDS is recommended to mitigate the higher level of death among patients treated for MDR-TB.

Kassahun Mengistu1 Mulugeta Shegaze2 Kifle Woldemichael3 Hailay Gesesew3,4 Yohannes Markos5 1Department of Zonal Health Office, Gamo Goffa Zone, Arba Minch, Ethiopia; 2Department of Nursing, Arba Minch University, Arba Minch, Ethiopia; 3Department of Epidemiology, Jimma University, Jimma, Ethiopia; 4Discipline of Public Health, Flinders University, Adelaide, Australia; 5Department of Medical Physiology, Jimma University, Jimma, Ethiopia Background: Trachoma is the leading cause of preventable blindness worldwide. It is common in areas where people are socioeconomically deprived. Globally, approximately 1.2 billion people live in trachoma-endemic areas, in which, 40.6 million individuals have active trachoma and 8.2 million have trichiasis. According to the World Health Organization’s 2007 report, globally close to 1.3 million people are blind due to trachoma, while approximately 84 million suffer from active trachoma. The National Survey (2007) of Ethiopia showed a prevalence of 40.1% active trachoma among children aged 1–9 years. Trachoma is still endemic in most parts of Ethiopia.Objective: To assess prevalence of trachoma and factors associated with it among children aged 1–9 years in Zala district, Gamo Gofa Zone, Southern Nations, Nationalities, and Peoples’ Region.Methods: A community-based cross-sectional study was conducted in Zala district from February 28 to March 26, 2014. A total of 611 children were examined for trachoma based on the simplified World Health Organization 1983 classification. A multistage stratified sampling technique with a systematic random sampling technique was used to select study participants. Data were collected by using a semistructured pretested questionnaire and clinical eye examination. The data were entered using EpiData version 3.1 and analyzed using SPSS version 16. Multivariable logistic regression analysis was used to identify independently associated factors.Results: The overall prevalence of active trachoma cases was 224 (36.7%) consisting of 207 (92.4%) trachomatous follicles, eight (3.6%) trachomatous intense, and nine (4.0%) combination of trachomatous follicle and trachomatous intense. Inadequate knowledge of family head about trachoma (adjusted odds ratio [AOR] =2.8 [95% CI: 1.9, 4.2]); ≤10 m latrine distance (AOR =1.6 [95% confidence interval {CI}: 1.09, 2.4]); presence of above two preschool children (AOR =2.2 [95% CI: 1.3, 3.7]), flies on the face (AOR =6.3 [95% CI: 2.7, 14.7]), and unclean face (AOR =2.4 [95% CI: 1.5, 3.9]) were found to be independently associated with trachoma.Conclusion: Trachoma among children in Zala district is a disease of public health importance. Factors like inadequate knowledge about trachoma by the head of the family, ≤10 m latrine distance, presence of above two preschool children, flies on the face, and an unclean face were independently associated with trachoma among children. So strengthening of antibiotic use, face washing, and environmental improvement strategy implementation is mandatory. Keywords: trachoma, children, prevalence, associated factors, Ethiopia

Abstract Agricultural technology adoption intensely improve agricultural production and it is a promising source for smallholder farmers’ means of achieving sustained well-being in Ethiopia. However, adoption of multiple wheat production technologies is not well practiced and its overall adoption level is low in the country. Hence, this study is aimed at identifying factors associated with farmers’ adoption of wheat production technology packages in the Horo Guduru Wollega zone, Ethiopia. The analysis of the study was based on a survey data collected from a randomly selected 373 sample households and a two-limit Tobit model was used to assess determinants of wheat production technology packages of farm households. The adoption index result of the descriptive model revealed that the adoption intensity of wheat producers’ technology package is 57.52%, while the highest adoption was in the highland agro-ecology (59.96%), followed by the midland agro-ecology (58.77%), and the lowest was in the lowland agro-ecology (50.21%). Results show that education level of household head, access to credit, access and purchase of improved seed, livestock owned, farmer’s perception wheat yield, farm training received, and annual farm income are positively and significantly associated with the adoption intensity of wheat technology packages while distance from nearest market had negative and significant effect. The results of the study forward that agricultural policymakers, development organizations, and qualified agricultural practitioners should engage in the improvement of wheat production technology adoption rate of which need upgrading farmers’ literacy level, strengthening farm-oriented institutions for improving accessibility of agricultural inputs, financial services, training and advisory services for farmers on the application of technology adoption in combinations. Minimizing input market barriers, subsidizing farmers through credit provision, enhancing farmers’ skills and valuable insight about the wheat technology packages could improve their adoption rate of wheat production technology packages.

AbstractThis study aimed to analyze the technical efficiency of wheat production and sources of inefficiency among smallholder farmers in the West Shewa Zone, Oromia National Regional State, Ethiopia. The study employed a two-stage random sampling method to select 199 wheat-producing households during the 2018/19 production season. The stochastic Cobb-Douglas production function was estimated to measure the level of technical efficiency. The estimation result of the parameters that entered the production function which is given in the form of partial production elasticities with a direct interpretation of its parametric coefficients with respect to the input used revealed that, a 1% increase in land, labor, DAP, chemical, and oxen power increases the wheat output of farmers by 0.335%, 0.305%, 0.009%, 0.006%, and 0.129%, respectively. As the results indicated the mean technical efficiency was 0.82, implying on average, farmers can increase output by 18%. Out of the total sampled farmers, 68.84% of them operated in a technical efficiency range between 0.61 to 0.90. Educational level, frequency of extension contact, credit utilization, wheat production experience, soil fertility status, and access to training are negatively determined technical inefficiency levels. However, labor hours spent on off-farm/non-farm activities positively affect the technical inefficiency level of farmers. Improving farmers’ knowledge and skills by strengthening education and providing continuous training, promoting better credit facilities via the establishment of adequate rural financial institutions, and enhancing the existing extension service can be considered a panacea to improve the existing inefficiency in the study area.

Climate shocks have been shown to reduce agricultural output and cause production fluctuations in developing countries. When livelihoods depend on rain-fed agriculture, like in Ethiopia, climate shocks will translate into consumption shocks. Despite significant improvements in household consumption in Ethiopia, shocks caused by climate and other factors are negatively affecting household consumption dynamics. Therefore, examining household consumption dynamics in the context of climate-induced shocks helps to guide resilience capacity and establish appropriate programs and interventions. The study used a three-round panel dataset based on the Ethiopian socioeconomic survey and spatial rainfall data. The results of the linear dynamic panel model show that lagged consumption values, market shocks, and changes in rainfall positively affect consumption dynamics. In contrast, production, temperature, and rainfall shocks have an inverse relationship. Strategies for mitigating climate shocks and consumption aftershocks help stabilize consumption over time. Support to strengthen household coping strategies may involve restoring existing livelihoods and forms of production or reducing household vulnerability. Therefore, government intervention is required for asset accumulation programs to support household coping strategies and responses to shocks. In addition, the dynamic link between consumption and essential socioeconomic and institutional factors must be considered to minimize the impact of climate shocks on consumption dynamics.

IntroductionFarm mechanization has multi-dimensional impacts on agricultural production systems like economic efficiency and productivity, thereby improving the quality of life in the farming community by reducing work drudgeries. However, these impacts were not studied empirically in Ethiopia. Hence, this research was initiated to estimate the level of economic efficiency, and productivity of wheat and barley, and the impact of farm mechanization on economic efficiency and productivity of wheat and barley.MethodsThe analysis was done for 232 and 257 wheat and barley producer farmers respectively who are selected from the Arsi and West Arsi zones. The stochastic frontier model was used to estimate economic efficiency while augmented inverse probability weighted (AIPW) was used to estimate the impact.Results and discussionBased on the result, it is apparent that farm mechanization has a significant positive impact on wheat productivity while the percentage change in average treatment effect for the barley was not statistically significant. Farm mechanization also affects wheat and barley economic efficiency positively. Hence, we recommended the wider use of farm mechanization to improve economic efficiency and productivity. Therefore, policy design should focus on ways to avail farm machinery easily like establishing farm mechanization service centers and facilitating credit services for mechanization service renders.

Abstract Small-scale urban farmers' active involvement in the urban agriculture (UA) output market is one strategy to ease an urban food shortage while sustaining their livelihoods and income. Enhancing market participation and intensity requires identifying the factors that affect UA market participation. Thus, the study aimed to determine the factors influencing UA market participation decisions and intensity in Eastern Ethiopia. Using a semi-structured questionnaire, the study utilized primary data collected from 270 randomly selected urban farmers. The Double Hurdle (DH) Model was used to determine the factors influencing urban farmers' participation and intensity in the UA output market. According to the first stage DH Model results, age, education, occupation, family size, farming experience, UA-related training, dependency ratio, and market information, all had a significant impact on the decision to participate in the UA output market. The second stage DH Model of Truncated regression indicated that the intensity of UA output market participation decision was significantly affected by the education, land size, UA-related training, and market information are all important factors determine the intensity of UA output market participation. Improving the ability to use the land for UA purposes, awareness creation through short-term training, and improving information access are important recommendations to enhance UA output market participation and intensity of participation.

The Ethiopian government and various stakeholders have made significant efforts to improve household consumption, poverty, and food security. However, the results have not met expectations. To ensure that programs are effective, it is critical to have a robust measure of well-being that considers social, economic, institutional and environmental challenges. Previous studies on welfare have focused on a single measurement, but it is important to recognize the interdependence between various well-being indicators to formulate comprehensive interventions and initiatives for rural households in the context of climate change and variability. This paper examines the dynamic link between unidimensional poverty, multidimensional poverty, and food security using panel data from Ethiopia. The interdependency of welfare measurements was estimated using a seemingly unrelated multivariate probit model with a conditional mixed process estimator with full information, a simulated maximum likelihood approach, and the presumption that different metrics can have various policy implications. The chances of interdependence wellbeing status were low for households that were simultaneously food insecure and poor or nonpoor. Multidimensional poverty has a higher success rate than food insecurity or consumption poverty. Unlike unidimensional poverty and food insecurity, multidimensional poverty has a higher chance of to be deprived. Policymakers must consider the synergies and trade-offs of different types of welfare and the dynamic linkage between climate-induced shocks and other covariates with household welfare to minimize households' vulnerability to climate-induced shocks for effective intervention for rural households to obtain a whole picture of wellbeing.

Abstract More than 95% of crop production in Ethiopia comes from smallholder farmers operating on a farm size of less than 2 hectares. This implies that agriculture is dominantly operated by smallholders nationally. Agricultural commercialization is believed to improve farmers’ livelihoods; hence, commercializing agriculture in Ethiopia means contributing to the smallholder farmer’s welfare. To do so, a study of participation and level of commercialization and their determinant factors is vital. Hence, this study was initiated to evaluate crop output commercialization status and its determinants in rural Ethiopia. Heckman’s two-step model was employed for the analysis. The mean commercialization index (CI) for the sample was 43.40% while 26% and 35% of households were commercially oriented and subsistent farmers respectively. The decision to participate in crop output marketing was affected by age, market distance, and instrument for the level of farm mechanization negatively. In contrast, it was affected positively by livestock size (TLU), being in mid-highland agroecology, ownership of equines, amount of annual income, and access to market information. The intensity of commercialization was positively affected by annual income, access to market information, and number of oxen; while it was negatively affected by operational land, level of crop diversification, and market distance significantly. Improving the resource endowment, and minimizing transaction costs by improving access to market centers, market information, and means of transportation can further enhance commercialization. Improving access to farm mechanization and enhancing productivity in highland areas are also issues that shall get policy and development practitioners’ focus.

Although urban agriculture (UA) can aid economic development, food inflation, unemployment, and nutritional insecurity often necessitate urban households to engage in various agricultural practices. Hence, the study aimed to identify UA practices adopted and their determinants in the Eastern Haraghe zone of the Oromia region and Dire Dawa City Administration, Eastern Ethiopia. Data was collected from 385 randomly selected urban households using a semi-structured questionnaire. Descriptive statistics and a Multivariate Probit (MVP) model were used to analyze the data. The results of the MVP model reveal that sex, age, education level, land size, extension contact, credit access, community group participation, training, and household non-farm income significantly influenced vegetable farming adoption. On the other hand, livestock production adoption was also affected by factors such as sex, land size, perception, credit access, farming experience, community group participation, market distance, training, and non-farm income. Crop-fruit production adoption was also influenced by factors like age, perception, farming experience, market distance, training, and dependency ratio. Improving the ability to use the land for UA purposes, empowering female-headed households, improving livestock breeds, creating awareness through short-term training, and improving credit accessibility are important recommendations to enhance the adoption of UA practices in the study areas.

Background: Neonatal danger signs contribute to the high mortality of neonates in developing countries. Delays in recognition of danger signs and the decision to seek care contribute to most neonatal deaths in Ethiopia. Therefore, the current study aimed to assess mothers’ knowledge and associated factors on neonatal danger signs in Nekemte town, Western Ethiopia. Methods: The current community-based cross-sectional study was conducted in Nekemte, Ethiopia, in March 2019. The sample included 727 mothers who had given birth within the past 12 months. A multistage sampling technique was utilized to recruit participants and data were collected using face-to-face interviews. The collected data were entered into EPI info (version 7.2.0.1) and analyzed using SPSS (version 23). To evaluate the knowledge of neonatal danger signs, a median score was used as the cut-off point. Mothers who spontaneously mentioned at least five danger signs were considered to have good knowledge of neonatal danger signs. Bivariable and multivariable logistic regression analyses were performed to identify factors associated with knowledge of danger signs. Results: Of 727 participants, 707 mothers were interviewed, yielding a response rate of 98.3%. The median age of the participants was 27 years, with an interquartile range of ± 5. The result of the study indicated that 55.6% [95%CI (52.1% - 59.3%)] of mothers had good knowledge of neonatal danger signs. The adds ratio of having good knowledge of neonatal danger signs were associated with being married [AOR=2.87, 95%CI (1.27, 6.52)], mother’s educational status of secondary level or higher [AOR= 1.71, 95%CI (1.03, 2.84)], antenatal care visits of four and more [AOR=1.58, 95%CI (1.09, 2.31)], and postnatal follow-up [AOR=2.13, 95%CI (1.39, 3.27)]. Furthermore, delivery at health institutions [AOR=3.11, 95%CI (1.10, 8.76)], access to TV [AOR=1.58, 95%CI (1.05, 2.37)], and Internet use [AOR=2.39, 95%CI (1.52, 3.77)] were also significantly associated with good knowledge. Conclusion: The proportion of mothers with good knowledge of neonatal danger signs was found to be low. Therefore, it is recommended to enhance counseling services during antenatal care and strengthen community-based health information dissemination efforts related to neonatal danger signs.

AbstractThis study examined the impact of rural out-migration on the poverty of migrant-sending households by applying the new economics labor migration theory as a theoretical framework, and the multinomial endogenous switching regression as an analytical model in southern Ethiopia. Data were gathered from 415 sample rural households using stratified random sampling in the year 2021. The cost of basic needs approach and the Foster, Greer, and Thorbecke (FGT) method were used to establish the poverty line and create the poverty indices, respectively. The average annual food and non-food poverty lines are Birr 8997.52 and 2249.38 per adult equivalent. The incidence, depth, and severity of general poverty are 39.76, 10.11, and 3.55%, respectively, while the incidence, depth, and severity of food poverty are 34.70, 9.47, and 3.58%, respectively. When compared to other households, households with international migrants have a lower incidence, depth, and severity of poverty. The regression result of the multinomial endogenous switching model showed that international migration increases consumption per adult equivalent of households by 29.8% and is significant at the 1% level. Participation in rural-urban and international migration increases kilocalories per adult equivalent per day by 7.4 and 36.4%, respectively, in migrant-sending rural households. The findings support the new economics labor migration theory’s remittance hypothesis. Promoting access to land, capital, farm and non-farm employment, irrigation, family planning, and basic public services would improve rural household welfare and reduce the current wave of rural out-migration in Southern Ethiopia.

AbstractThe integrated use of various levels of climate change adaptation practices is a means of increasing farm productivity to meet the food demand of the world’s growing population without harming the environment. Both primary and secondary data were used. In the 2020/21 production year, primary data was collected from 461 sample households of East Hararghe Zone, Oromia, Ethiopia, for the study. For data analysis, the study employed descriptive statistics and multinomial endogenous switching econometric model. Gender, education, extension, livestock holding, cooperatives, market information, soil fertility, farm land slopes, training on land management, climate change information, training, perception of land degradation, climate change perception, and weather road distance are estimated to have a significant influence on the probability of adopting different levels of climate smart practices. According to the impact evaluation results, adopting low levels of climate smart practices increases households’ food and nutrition security by 28% and 4.3%, respectively. Adopting medium-level climate-smart practices boosts food and nutrition security by 43% and 20%, respectively. Adopting high and higher levels of climate smart practices increases food and nutrition security by 56% and 19%, respectively, over very low adopter households. As a result, policymakers should place a premium on climate change adaptation agricultural practices in order to improve rural households’ livelihoods.

AbstractCrop diversification is the cultivation of more than one variety of crops belonging to the same or different species in a given area to develop a resilient agricultural system. In Ethiopia, crop diversification is recognized as a strategy to improve nutrition and climate risk coping mechanisms. Despite the national aspiration to use crop diversification as a mechanism to ensure nutritional security and increase agricultural production, this effort has not been investigated in the central and southern Oroima where cereal production is dominating. The area is commonly known as the wheat belt of Ethiopia. Accordingly, this study was initiated to estimate the crop diversification level and identify the core drivers. The research was conducted in the central and northern Oromia region, Ethiopia. Four districts were selected from which a total of 390 household respondents were selected randomly. Simpson Diversification Index (SDI) was employed to estimate the crop diversification level, while ordered logit was employed to identify its determinants. Accordingly, about 25, 44, and 31% of the households were low, medium, and high diversifiers, respectively. Mitigating market and price risk (73%) and risk of crop failure (62%), food self-sufficiency (63%), and diversifying labor pressure during peak agricultural seasons (17%) were significant reasons for diversification. Family size, landholding, level of farm mechanization, land fragmentation, and spatial location strongly determine crop diversification levels. Improving access to farm mechanization, including irrigation technologies, and availing of alternative crop varieties by agricultural research institutes shall be given emphasis to improve crop diversification level.

Climate impact mitigation through improved agricultural practices is one means by which agricultural productivity increases to meet the growing food demands in the world. This study evaluated the impacts of climate-smart Practices on rural households’ nutrition security. The study used both primary and secondary data sources. Primary data was collected from sample respondents in the 2020/21 production year. Descriptive statistics and econometric models were employed for data analysis. Multinomial logit result indicated that the probability of adopting climate-smart agricultural practices is influenced by the education level of the head, extension contact, livestock holding, membership coop, market information, advice on land management, climate change information, farmers training, climate change perception, and weather road distance. The result from GPS estimation indicated that treatment level two the number of climate-smart practices increases household nutritional status by16%. Likewise, treatment level three and four of the number of climate-smart practices increases the household level nutritional status by 37% and 76% respectively over that of treatment level one of the climate-smart practices and is significant at a 1% statistical probability level. This study has found evidence that the adoption of climate-smart on the households’ nutrition security status. Therefore, the result of this study would be expected to significantly contribute as policy and strategic inputs for policymakers in designing rural livelihood improvement policies and to the beneficiary in enhancing their welfare and living standard.

The study has been conducted to assess the farm mechanization level and tried to identify the determinants. The research utilizes primary data, collected through personal interview of 397 farm households located in the four districts of central and southeast Oromia region of Ethiopia. Multi-stage, purposive and random sampling procedures were used to select the respondents using probability proportional to size from each district. Mechanization Index (MI) based on the matrix use of animate and mechanical energy inputs that incorporate cost factors was used to estimate farm mechanization level, while Tobit model was employed to analyze factors that determine the farm mechanization level. Household’s sex, educational background, experience in farming, family labor availability and social capital, location of household, access to all-weather roads and distance to farm mechanization service providers centers, participation in market and off-farm activities, landholding, land fragmentation and size of livestock owned (TLU) are statistically significant in determining level of farm mechanization. Land consolidation, availing infrastructural facilities and facilitating adult education and short-term trainings are important recommendations to enhance farm mechanization level in the study area.

Research background: Participatory Forest Management program (PFMP) is initiated to manage forest resources and promote household participation to enhance their livelihood. In contrast, the long-term evaluation of many programs' timing remains low attention. Thus, it is vital to measure livelihood impacts on membership duration associated with the PFM program in Ethiopian farm households Purpose of the article: To evaluate the impact of membership duration in participatory forest management on livelihoods of program participating households in south-western Ethiopia. The results of the program's periodic assessment data were analysed on the long-term effect of the activities of forest management members. Methods: The study applied the generalized propensity score method. The research depends on cross-sectional survey data collected in mid-2018 from 267 farm households from Sheka and Kafa zones of south-western Ethiopia. The procedure matched families with similar covariates with different years of membership duration in the participatory forest management program. The technique was used members' annual per capita expenditure as an indicator outcome variable for measuring rural livelihood. Findings, value-added & novelty: Impacts studies of PFMP on heterogeneous effects across different groups of membership duration are scarce, and there is a research gap on how membership duration affects outcomes. Our study addresses this gap by measuring the long-term evaluation of program outcomes and their impacts on the participatory member households. Furthermore, the result revealed that the program's effects were initially low but positively affected when approaching an optimum year of membership dose. The program's optimal duration of the membership dose was 11-12 years, and 4263.75 birrs were the optimal level of yearly household per capita consumption spending. Recommendation: The results recommend more work on the participating household members by encouraging new forest-related income sources and integrating the socio-economic network more closely with the forest's ecosystem services. Although the relationship among participating members of households' longevity and income is substantial, the program has been focused on the medium and longer duration of the forest program participating.

Some studies have quantified the extent and examined the determinants of the global multidimensional poverty index (G-MPI) which contains only three dimensions of welfare. But studies on the extent and determinants of rural multidimensional poverty index (R-MPI) which contains rural livelihood as one dimension of welfare are scarce. Hence, this study quantified the extent and examined the determinants of rural multidimensional poverty index using the Alkire–Foster method and the ordered logistic regression model, respectively. Data were gathered from 415 random sample households in southern Ethiopia. The incidence, intensity, and adjusted headcount ratio of rural multidimensional poverty are 72.3%, 57.3%, and 41.4% respectively. Besides, 7.47%, 20.24%, 30.60%, and 41.69% of households are non-poor, vulnerable, poor, and extremely poor, respectively. The living standard and rural livelihood dimensions jointly contributed 60% to rural multidimensional poverty. Fuel for cooking, electricity, and housing are the primary contributors to rural poverty from the living standard dimension, while land ownership, off-farm activity, and tropical livestock units are the leading contributors from the rural livelihood dimension to rural deprivation. Regression results showed that education, land size, tropical livestock unit, off-farm participation, and saving are negatively and significantly related to rural poverty, while dependency ratio, distance from market, distance from the road, and sickness of family members are positively and significantly related to rural poverty. Female-headed households were more deprived than male-headed households. Hence, promoting access to land, non-farm employment, markets, electricity, drinking water, and a road network would reduce rural multidimensional poverty in southern Ethiopia.

AbstractWith the available resources and existing production technology, to minimize the gap between demand and supply of malt barley grain, improving productivity by enhancing production efficiency is the best option available as the vast majority of Ethiopian farmers are poor and lack the required capital to adopt new technologies and to reallocate the resources. This research estimated the technical, allocative, and economic efficiencies using the stochastic production frontier and identified their determinants by employing the two-limit Tobit regression for randomly selected malt barley farmers in Arsi zone, Ethiopia. The mean technical, allocative, and economic efficiency levels were found to be 87.1%, 80.6% and 70.6%, respectively. The Tobit model results show that education, credit access, livestock size, distance from market, proximity to homestead, and soil fertility status were significant factors affecting all efficiency estimates. Family size and landholding had a significant effect on allocative and economic efficiencies, whereas cooperative membership, extension contact, and off/non-farm income were the major determinants of technical efficiency. The results, in general, demonstrated that the production efficiency of malt barley farmers could be improved with the existing farm resources and level of technology. Based on the findings, the production efficiency malt barley producers in Arsi zone can be enhanced by expanding formal and informal education, creating ways of experience sharing amongst farmers, improving input distribution systems, and providing quality extension, financial, market and transportation services.

The economic reports on income inequality, poverty, and other welfare indicators are relevant if it was supported by the evidence of income traps because rural households in developing countries were frequently hit by several shocks. This study intended to investigate the households' vulnerability to covariate and idiosyncratic shocks in Ethiopia using three waves of the household panel survey for the period of 2011–2016. The study applied a three-level mixed effect model for analysis. The result of the three-level mixed effect model points out that both covariate and idiosyncratic shocks) were found to influence household consumption and covariate shocks are a relatively larger and more significant effect on households' consumption than idiosyncratic shocks. Based on the finding of this study, it is suggested that the implementation of different policies that address factors contributing vulnerability to covariate and idiosyncratic shocks of rural households in Ethiopia.

This paper examines factors determining farmers’ adoption decision for improved maize varieties in the maize-common bean intercropping practices in two districts of East Hararghe zone, Eastern Ethiopia. It is based on data collected from 129 farm households using structured questionnaire. Descriptive results revealed that adopters of improved maize varieties had better food and nutrition security status. Furthermore, logit model output indicated that the decision to adopt improved maize varieties is influenced by location (district) dummy, education status of the household head, age of the household head, distance from the main road, and the number of plots owned. Major recommendations include improving the rural road infrastructure, educating and training farmers, organizing experience sharing events among farmers, and raising awareness about the food and nutrition security benefits of sustainable agricultural intensification practices like intercropping improved maize with improved common bean varieties.

Kidist Mulugeta Bekele, Ahmed Moges Abay, Kidist Abiye Mengistu, Berhanemeskel Weldegerima Atsbeha, Chilot Abiyu Demeke, Wudneh Simegn Belay, Dawit Kumilachew Yimenu Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Dawit Kumilachew YimenuDepartment of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara Regional State, EthiopiaTel +251 920 760 099Email dawitkumilachew@yahoo.comBackground: Self-medication with over-the-counter (OTC) medications is common among medicine and health science students. For safe use of OTC medications, students are expected to have proper knowledge, attitude, and practice (KAP) towards OTC medications and subsequent adverse drug reactions (ADRs).Objective: The aim of this study was to assess KAP of OTC medications use and related factors among medical and pharmacy students at the University of Gondar, Gondar, Northwest Ethiopia.Methods: A cross-sectional study was conducted. Data were collected using a self-administered questionnaire and analyzed using Statistical Package for Social Sciences (SPSS) version 24. Chi-square analysis was conducted and multivariable logistic regression analysis was used to determine the association between KAP and OTC use and its related adverse effects. A P value of less than 0.05 was used to declare statistical significance.Results: A total of 380 students (229 medical students and 151 pharmacy students) participated in the study. The majority of the respondents 303 (79.7%) reported that they have the practice of self-medication. Fever 69 (80.2%), headache 21 (24.4%), and abdominal cramp 20 (23.3%) were the most common conditions for which the students go for self-medication while paracetamol 51 (59.3%) followed by non-steroidal anti-inflammatory drugs (NSAIDs) 44 (51.2%) were the most commonly used classes of drugs. An intention for time-saving caused by the waiting time due to crowds in medical consultation rooms 212 (77.4%) and a desire for quick relief 171 (62.4%) were the main reasons for the self-medication practice with OTC medications.Conclusion: Self-medication is widely practiced among medical and pharmacy students. Significant problems and malpractices were identified, such as sharing of OTC medications, the use of expired medicines, doubling the dose of medications when they were ineffective, storage of OTC medications, and not reading labels and expiry dates.Keywords: self-medication, pharmacy students, medical students, over-the-counter, Gondar

Abstract Background Childhood stunting and malnutrition condemn millions of people globally to a life of disadvantage and cognitive and physical impairment. Though increasing egg consumption is often seen as an important solution for low and middle income countries (including Ethiopia), emerging evidence suggests that greater exposure to poultry feces may also inhibit child growth due to the effects of enteric bacteria, especially Campylobacter, on gut health. Methods In this rapid ethnographic study, we explored village poultry production, child dietary practices, and environmental hygiene conditions as they relate to Campylobacter risk and intervention in 16 villages in Haramaya Woreda, Eastern Ethiopia. Results In the study area, we found that women assumed primary responsibility to care for both chickens and children: in feeding, housing, and healthcare. Most chickens were free-range local indigenous breeds, and flock sizes were small and unstable due to epidemics, seasonal trends, reproductive patterns, and lack of food. Generally, eggs were seen as “too luxurious” to be eaten, and were predominantly sold at local markets for scarce cash, despite high malnutrition rates. Local narratives of extreme poverty, social dietary norms, parental fatalism, and lack of “dietary consciousness” (as it was called) were invoked to explain this. We found that homesteads were highly contaminated with human and animal feces. Although community members viewed chicken feces and poultry gastrointestinal contents as particularly noxious in comparison to other animals because of their feeding behaviour, they did not relate them to any particular disease. Shared human-animal housing and childcare practices place children at high risk of exposure to enteric bacteria from animal manure, despite daily routines designed to manage the domestic landscape. Conclusions Addressing childhood stunting and malnutrition through egg production in rural landscapes like Haramaya must navigate three distinct health and care regimes: for children, chickens, and home environments. Interventions should be based on a holistic approach to social and economic empowerment, one that considers both women and men and integrates nutrition, health, and community change as its overarching goal.

Background: Somalia, a country with a long history of instability, has a fragile healthcare system that is consistently understaffed. A large number of healthcare workers (HCWs) have become infected during the coronavirus disease-19 (COVID-19) pandemic. Objective: This report presents the preliminary findings of COVID-19 infection in Somali HCWs, the first of such information from Somalia. Methods: This preliminary retrospective study analysed available data on infection rates among Somali HCWs. Results: As of 30 September 2020, 3700 cases of COVID-19, including 98 deaths, had been reported in Somalia; 191 (5%) of these cases were HCWs. During the first 180 days of the outbreak, 311 HCWs were tested for COVID-19 and 191 tested positive (positivity rate: 61%). During the epidemic’s peak, HCWs represented at least 5% of cases. Of the 191 infected cases, 52 (27%) were doctors, 63 (33%) were nurses, seven (4%) were laboratory technicians, and 36% were other staff. Conclusion: More information must be sought to put measures in place to protect the health and safety of HCWs in Somalia’s already understaffed and fragile healthcare system.

In Ethiopia, sesame is mainly cultivated as a cash crop, important source of foreign exchange and income for many smallholders. Thus, improvement in production efficiency of sesame is crucial for Ethiopian economy and for smallholder farmer’s livelihood. Socioeconomic, demographic and institutional factors were collected from randomly selected 385 sample households using multi-stage sampling techniques and interviewed using semi-structured questionnaire. The Cobb-Douglas stochastic frontier production function result shows that all input variables except land was positive and significant effect on sesame production efficiency. Labour inputs have the highest elasticity, followed by sesame seed, pesticides/herbicides and fertilizer accordingly. The model result shows that across all mean technical, allocative, and economic efficiencies estimates are 72, 49 and 35 percent respectively, implies that a substantial level of inefficiency in sesame production. Improvement of production efficiency requires availability of enough labour particularly during harvesting because of its shattering problem. Therefore, the local and regional government needs to devise mechanisms for hired labour availability in the area. Moreover, the econometric model result indicates that sesame production efficiency was positively and significantly influenced by age, education level, livestock ownership, association membership, off/non-farm income, extension contact, credit access, mobile phone ownership and training participation. The key policy implication therefore is that promoting farmer’s cooperatives, address farmers in formal and informal education programs, enhancing farmer’s access to financial resources through providing easy and affordable credit services, strengthen the extension services in terms of promoting livestock and crop production improving technologies are crucial.

One of the challenges of perishable vegetable production is selecting appropriate market outlets to deliver the produce fresh and earn better price. Various factors affect producers’ decision to choose among the alternative market outlets. This study was aimed to identify determinants of smallholder vegetable producers’ decision on market outlet choice and verify the existence of difference in productivity and income of households among different market outlets in Lake Tana basin, Ethiopia. Using primary data collected from a survey of 385 farmers in three districts located in Lake Tana basin, the study estimated multivariate probit model to explain the factors that influence market outlet choice of smallholder vegetable producers. F-statistics was sued to verify the effect of market outlets on productivity and income. The results show that those households choosing both farm gate and local market simultaneously are found at better level of productivity and income. Multivariate probit results show that buyers visit and age of household head simultaneously determined all market outlets decision of producers. Those households visited by buyers at farm or village were found more likely to choose farm gate and roadside market outlets and less likely to sell the produce at market place. The implication is that as far as smallholder producers had access to alternative market outlets, they would earn better income by choosing appropriate combination of market outlets. Interventions that improve access to all market outlets could improve income and boost production of vegetables.

Livestock farming provides a possible mechanism by which smallholder farmers can meet their household need for animal source foods (ASF), which may reduce the risk of stunting. However, direct/indirect contacts with domestic animals may increase colonization by Campylobacter spp., which has been associated with Environmental Enteric Dysfunction (EED) and stunting. A cross-sectional study involving 102 randomly selected children between 12 and 16 months of age was conducted in rural eastern Ethiopia to establish prevalence rates of Campylobacter colonization, EED, and stunting, and evaluate potential risk factors. Data were collected between September and December 2018. The prevalence of EED and stunting was 50% (95% CI: 40–60%) and 41% (95% CI: 32–51%), respectively. Among enrolled children, 56% had consumed some ASF in the previous 24 h; 47% had diarrhea and 50% had fever in the past 15 days. 54, 63, 71 or 43% of households owned at least one chicken, cow/bull, goat, or sheep; 54 (53%) households kept chickens indoors overnight and only half of these confined the animals. Sanitation was poor, with high levels of unimproved latrines and open defecation. Most households had access to an improved source of drinking water. The prevalence of Campylobacter colonization was 50% (95% CI: 41–60%) by PCR. In addition to the thermotolerant species Campylobacter jejuni, Campylobacter coli and Campylobacter upsaliensis, non-thermotolerant species related to Campylobacter hyointestinalis and Campylobacter fetus were frequently detected by Meta-total RNA sequencing (MeTRS). Current breastfeeding and ASF consumption increased the odds of Campylobacter detection by PCR, while improved drinking water supply decreased the odds of EED. No risk factors were significantly associated with stunting. Further studies are necessary to better understand reservoirs and transmission pathways of Campylobacter spp. and their potential impact on child health.

Abstract Background Absence of reliable health insurance schemes is a key challenge to meet the universal health coverage target of the Sustainable Development Goals (SDGs). Ethiopian health system is characterized by under financing, low protection mechanisms for the poor, and lack of mechanisms of risk pooling and cost sharing. Ethiopia is implementing social health insurance (SHI) scheme to reduce out of pocket payment (OOP) and improve access and use of healthcare. This study aimed to determine the demand for SHI among civil servants and associated factors in Northwest Ethiopia. Methods An institution-based cross-sectional study was conducted in Bahir Dar city from 557 randomly selected civil servants using structured and self-administered questionaire. The questionnaire included questions measuring demand for SHI and demographic, socio-economic, healthcare related and personal and behavioral factors. Data were first entered in Epi-Info version 7.0 and transferred to SPSS version 20 for analysis. Descriptive statistics, bivariate and multivariable logistic regression analysis were performed. Results From the total calculated sample size of 557, 488 respondents returned the questionnaire giving a response rate of 88%. Nearly three-fourth of the respondents, 355 (72.7%), reported their need to be enrolled in a SHI scheme. Two-third of the respondents 325 (66.6%) were willing to pay for their enrollment. Overall, three hundred and two (61.9%) were demanding SHI. Having good awareness about health insurance [AOR = 4.39, 95% CI = (1.82–12.89)] and trust on a health insurance agency [AOR = 3.0, 95% CI = (1.57–5.72)], were significantly associated with the demand for SHI among civil servants. Conclusion The demand for SHI among civil servants were higher. The awareness towards SHI and trust on the SHI agency were significantly associated with demand for SHI. As Ethiopia aspires to insure all employees of the formal sector, and improving the awareness of civil servants about SHI and the agency providing the service could improve demand for SHI. Further research is important on healthcare organizational and professional readiness to handle the upcoming insurance driven quality health service need and health seeking behavioral change.

In most developing countries like Ethiopia, blood count of a microscopic image is done manually which is tedious, time consuming and error-prone. Recent advances in technology have introduced the use image processing software especially mobile technology. This research designed a low-cost smart phone microscope adapter, and developed a decision support system for automatic blood cell count and malaria. The image acquisition and processing applying the adapter and the software was tested in two clinics. The result, compared to the manual way of diagnosing microscopic images, is simple for diagnostic process and provides better decision support for malaria and blood cell counting, as well as speed up the diagnosis process. For blood cell counting and malaria detection, it takes about 30 s to 1 min using this system, but using a manual system it takes around 10–20 min. The preliminary result indicates that the developed system is cost-effective for higher and medium clinics in rural and urban clinic setup. This reduces the initial, running and maintenance cost of the laboratory equipment and also improves the quality of services. Keywords: Blood cell counting, Ethiopia malaria, Smartphone, Technology, Telepathology

Production of wheat by smallholder farmers in Ethiopia contributes a significant share to the agricultural production of the country. However, the actual productivity of the crop has been far below its potential. Varied levels of technology adoption are often observed among smallholder farmers producing the crop. For enhanced dissemination of technology packages and improving wheat productivity, it is vital to elucidate socio-economic factors that are behind disparity in technology adaption among smallholder farmers. Therefore, this study was conducted to analyse the socio-economic, institutional, and other pertinent variables that determine the existing disparity observed among smallholder farmers in terms of adopting wheat production technology packages in Gurawa and Meta districts of eastern Ethiopia. The study utilized survey data collected from 124 randomly selected wheat households producing wheat. For this purpose, an ordered logit model was applied. The econometric results revealed that age of the household head, membership in cooperative institutions, and household annual income significantly and positively explained the disparity observed in adoption of wheat production technology packages. Conversely, gender of household head (sex), farming experiences, number of plots owned, and frequency of contacts with extension agents explained the disparity significantly, but negatively. It could be concluded that development practitioners, planners, and policy makers should give due considerations to the aforementioned socio-economic and institutional factors when designing dissemination of wheat production technology packages for adoption by farmers.

Abstract This paper examines impacts of Prosopis juliflora (hereinafter may be referred as ‘Prosopis’) invasion on livelihoods of agro (pastoral) households using detailed household data in rural Dire Dawa Administration of Ethiopia. Cross-sectional data were collected from a total of 450 sample households whereby 250 were from Prosopis-invaded households and the remaining 200 from non-Prosopis-invaded households. The major research question of the study was, ‘what would be the livelihoods of Prosopis-invaded households had they not been invaded by Prosopis?’ To answer this question, descriptive and econometric tools were employed. The study results revealed that family size, dependency ratio and access to irrigation had negative and significant relationships with Prosopis invasion. On the other hand, age of the household head, Tropical Livestock Unit (TLU) and engagement in food for work programmes were positively related to Prosopis invasion. The results of this study show that the positive effects of Prosopis invasion were pronounced in terms of education expenditure, average annual income from crop production, off-farm income, food and non-food expenditure and physical food consumption, whereas there has been negative effects of Prosopis invasion due to reduced income generation from milk products. In this study, possible recommendations were drawn for stakeholders in order to reverse Prosopis adverse effects and optimize the positive impacts of this species in the study area.

A study was conducted to analyze factors influencing adoption of wheat technology packages by smallholder farmers in Gurawa, Meta and Habro districts in eastern Ethiopia. The analysis was based on a household survey data collected from 136 randomly selected households. A Two-limit Tobit model was used to elucidate factors affecting adoption of technology packages measured based on an index derived from five components of wheat technologies which included row planting, pesticide application, use of improved varieties, and application of inorganic fertilizers, namely, Diammonium Phosphate (DAP) and Urea. Among the variables included in the model, variation in district, gender, age of the household head, education status of the household head, farm size, distance to market, distance to FTC (Farmers’ Training Centers), cooperative membership, dependency ratio, and annual income of the households were found to significantly affect the adoption of wheat technology packages. Policy makers, planners and development practitioners should give due attention to these determinants to support smallholder farmers in wheat production and enhance gains derived from it.

The study was aimed at mapping the dairy value chain, assessing constraints and opportunities in the sector, and identifying factors affecting channel choices of producers in Harar and Dire Dawa milkshed areas. Data were collected from 93 producers, six collectors, seven wholesalers, seven retailers, and ten consumers. Both descriptive and econometric analysis were employed. The study revealed that the channel choices available to producers include selling to collectors, wholesalers, retailers, and directly to consumers. The multinomial model output indicated that being in rural areas, breed type, separate milking place, and supply of hay negatively determined the choice to sell to wholesalers, retailers, and consumers. In contrast, education status and milk storage duration positively determined producers’ choice not to sell to collectors. The major recommendations include provision of training, disseminating dairy technologies, encouraging value chain actors to add values; and enhancing collective actions of producers.

Potato production plays an important role in improving household income and nutrition and thereby contributes to food security. Despite of this, the current productivity of the crop is below the potential. Low level of use of improved potato technology package is among the causes for low productivity. In this context, this study analysed the factors influencing adoption of potato technology package by smallholder farmers in Gurawa, Haramaya, Kombolcha, Meta, and Habro districts of Eastern Ethiopia. The analysis was based on a household survey conducted on 214 randomly selected potato growing households. A two-limit Tobit model was used to analyse the factors affecting adoption which is measured in an index computed from five components of the technology package. Variation in districts, access to irrigation, farm size, membership to cooperatives, and annual income of the households were found to significantly affect the adoption of potato technology package. Policy makers, planners and development practitioners are required to give due attention to these determinants in order to support smallholder farmers in production and productivity improvements from potato production.

In Ethiopia, the national agricultural research system has been generating and disseminating different agricultural technologies since its establishment in 1966. Although these technologies are meant to increase agricultural productivity, they have to be evaluated for their impact on production and for the benefit that the farmers get out of them. Hence, the main objectives of this study were to examine the impact of technological innovations on wheat production and to decompose the total change in wheat output resulting from the introduction of new technologies into its constituent parts. Cobb-Douglas production function was employed to estimate the regression coefficients under old variety growers, new variety growers, and pooled data cases. Output decomposition model was applied to decompose the total change in output into its constituent parts. The econometric results of this study indicated that, out of 55% of the observed productivity difference between old and new variety grown plots, technological change and change in associated input levels contributed about 24% and 31%, respectively. Of the 31% increment attributed to input use levels, an increased use of herbicides and fertilizers caused the biggest jump in the productivity of improved wheat varieties (15.5% and 11% respectively). The major implications included the need to exploit the full potential of new varieties using recommended input levels, strengthening the research system, fostering coordinated efforts among various actors in agricultural development, and strengthening the technology instrument in rural development and poverty reduction strategies of the country.

Pepper is an important cash crop for its contribution to income-generating, employment opportunity and improvement of food security to the majority of the rural households. However, enhancing pepper producers to reach the market is a key issue needed in Wonberma district. This study sought to analyze determinants of market outlet choices among smallholder pepper producers in Wonberma district of West Gojjam Zone of Amhara Region, Ethiopia. Both primary and secondary source of data were used to collect qualitative and quantitative data. Two-stage sampling method was used and data were collected from 130 pepper producers. Multivariate probit (MVP) model was used to analyze factors affecting market outlet choices of smallholder pepper producers. The MVP model results indicated that quantity of pepper produced, pepper farming experience, extension contact, year of schooling, bargaining power of the producer; post-harvest value addition, market distance, and livestock ownership had a statistically significant influence on choices of the market outlet. Therefore, this study underscores increasing productivity of pepper; enhancing post harvest value addition practices, improve farmers bargaining power through cooperative; strengthen institutional services and infrastructure development like road and transportation facility for policy implication.

Over the last two decades, while contraceptive use has improved in Ethiopia, the contraceptive prevalence rate remains low. In addition to socio-demographic and cultural factors, the quality of care in Family Planning (FP) services is an important determining factor of FP utilization. However, little research exists on the determinants of quality of care in FP services in Ethiopia. This study aims to identify the client and facility level determinants of quality of care in FP services in Ethiopia.This study was based on the first Ethiopian Services Provision Assessment Plus (ESPA+) survey conducted in 2014. A total of 1247 clients nested in 374 health facilities were included in the analysis. Multilevel mixed-effects logistic regression modelling was conducted. The outcome variable, client satisfaction, was created using polychoric principal component analysis using eleven facets that reflect client satisfaction.The results showed that both client-level and facility-level factors were associated with quality of care in FP services in Ethiopia. At the client-level; provision of information on potential side effects of contraceptive method (AOR = 5.22, 95% CI: 2.13-12.80), and number of history and physical assessments (AOR = 1.19, 95% CI: 1.03-1.34) were positively associated with client satisfaction, whereas waiting times of 30 minutes to two hours (AOR = 0.11, 95% CI: 0.03-0.33) was negatively associated with client satisfaction. At the facility-level; urban location (AOR = 4.61, 95% CI: 1.04-20.58), and availability of FP guidelines/protocols for providers (AOR = 4.90, 95% CI: 1.19-20.19) had positive significant effect on client satisfaction.Quality improvement programs in FP services in Ethiopia should focus on shortening waiting times and provision of information about the potential side effects of contraceptive methods. It is also important to improve health providers' skills in thorough client history taking and physical assessment. Further distribution and implementation of best practice guidelines for providers working in the FP services must be a priority.

Since the launch of the Global Polio Eradication Initiative in 1988, substantial progress has been made in the interruption of wild poliovirus (WPV) transmission worldwide: global eradication of WPV types 2 and 3 were certified in 2015 and 2019, respectively, and endemic transmission of WPV type 1 continues only in Afghanistan and Pakistan. After the synchronized global withdrawal of all serotype 2 oral poliovirus vaccines (OPVs) in 2016, widespread outbreaks of circulating vaccine-derived poliovirus type 2 (cVDPV2) have occurred, which are linked to areas with low population immunity to poliovirus. Officials in Somalia have detected ongoing cVDPV2 transmission since 2017. Polio vaccination coverage and surveillance data for Somalia were reviewed to assess this persistent transmission. During January 2017-March 2024, officials in Somalia detected 39 cVDPV2 cases in 14 of 20 regions, and transmission has spread to neighboring Ethiopia and Kenya. Since January 2021, 28 supplementary immunization activities (SIAs) targeting cVDPV2 were conducted in Somalia. Some parts of the country are security-compromised and inaccessible for vaccination campaigns. Among 1,921 children with nonpolio acute flaccid paralysis, 231 (12%) had not received OPV doses through routine immunization or SIAs, 95% of whom were from the South-Central region, and 60% of whom lived in inaccessible districts. Enhancing humanitarian negotiation measures in Somalia to enable vaccination of children in security-compromised areas and strengthening campaign quality in accessible areas will help interrupt cVDPV2 transmission., Competing Interests: All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.

Introduction: We examined the contribution of community health workers as frontline responders for the community-based surveillance in Somalia during the first year of the COVID-19 pandemic for detection of COVID-19 cases and identification of contacts., Methods: We retrieved COVID-19 surveillance data from 16 March 2020 to 31 March 2021 from the health ministry's central database. These data were collected through community health workers, health facilities or at the points of entry. We compared the number of suspected COVID-19 cases detected by the three surveillance systems and the proportion that tested positive using the chi-squared test. We used logistic regression analysis to assess association between COVID-19 infection and selected variables., Results: During the study period, 154,004 suspected cases of COVID-19 were detected and tested, of which 10,182 (6.6%) were positive. Of the notified cases, 32.7% were identified through the community-based surveillance system, 54.0% through the facility-based surveillance system, and 13.2% at points of entry. The positivity rate of cases detected by the community health workers was higher than that among those detected at health facilities (8.6% versus 6.4%; p  < 0.001). The community health workers also identified more contacts than those identified through the facility-based surveillance (13,279 versus 1,937; p  < 0.001). The odds of COVID-19 detection generally increased by age. Community-based surveillance and health facility-based surveillance had similar odds of detecting COVID-19 cases compared with the points-of-entry surveillance (aOR: 7.0 (95% CI: 6.4, 7.8) and aOR: 7.5 (95% CI: 6.8, 8.3), respectively)., Conclusion: The community health workers proved their value as first responders to COVID-19. They can be effective in countries with weak health systems for targeted community surveillance in rural and remote areas which are not covered by the facility-based surveillance system., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The handling editor OO declared a shared parent affiliation with the authors at the time of review., (Copyright © 2023 Nyagah, Bangura, Omar, Karanja, Mirza, Shajib, Njiru, Mengistu and Malik.)

Background: We already know that incorporating information and Communication technology (ICT) into every aspect of human activity result in significant change and makes tasks easier to complete. It can help in areas of healthcare systems and medical education. Therefore, this study aimed to assess utilization ICT and its associated factors among Arba Minch University College Medicine and Health Science students., Methods: A cross sectional study design was conducted in June through August 2021 among under graduate students in college of medicine and health science at Arba Minch University, Ethiopia. A self-administered questionnaire was used to collect information on the students' socio-demographic factors as well as the utilization ICT. The data entry form was prepared with Epi-data 3.1 versions software and STATA version 14 software was used to analyze the data., Results: A total of 355 participants enrolled in the study, with a response rate of 98.34%. The percentage of students who used ICT was 55.77% [95% CI, 0.50, 0.60]. Regarding of field of study, health informatics students (84%) used the most ICT, while midwifery students (52%) used the least. Urban resident [AOR = 1.85, 95% CI = 1.08, 3.16], ICT knowledge [AOR = 3.8, 95% CI = 2.25, 6.40], having formal training of ICT [AOR = 1.9, 95% CI = 1.06,3.48], having IT in current course study [AOR = 2.2, 95% CI = 1.23, 3.84], and had good IT skill [AOR = 2.4, 95% CI = 1.34, 4.23] revealed a significant and positive correlation with the use of ICT., Conclusion: In the current study previous residence, ICT knowledge, having formal training, having IT in current courses, and IT skill were significantly associated with student ICT utilization. Therefore, the university should continue to invest in professional development in order to improve teaching and student performance, as well as provide the college with student-centered ICT computer labs to encourage students to use technology., (© 2022. The Author(s).)

Purpose: To assess state-level variation in changes in uninsurance among Black, Hispanic, and low-income Americans after implementation of the Affordable Care Act (ACA). Methods: We analyzed data from the Behavioral Risk Factor Surveillance System from 2012 to 2016, excluding 2014. For Black, Hispanic, and low-income (<$35,000/year) adults 18-64 years of age, we estimated multivariable regression adjusted pre- (2012-2013) to post-ACA (2015-2016) percentage point changes in uninsurance for each U.S. state. We compared absolute and relative changes and the proportion remaining uninsured post-ACA across states. We also examined whether state-level variation in coverage gains was associated with changes in forgoing needed care due to cost. Results: The range in the percentage point reduction in uninsurance varied substantially across states: 19-fold for Black (0.9-17.4), 18-fold for Hispanic (1.2-21.5), and 23-fold for low-income (1.0-27.8) adults. State-level variation in changes in uninsurance relative to baseline uninsurance rates also varied substantially. In some states, more than one quarter of Black, one half of Hispanic, and approaching one half of low-income adults remained uninsured after full implementation of the ACA. Compared with states in the lowest quintile of change in coverage, states in the highest quintile experienced greater improvements in ability to see a physician. Conclusions: Performance on reducing uninsurance for Black, Hispanic, and low-income Americans under the ACA varied substantially among U.S. states with some making substantial progress and others making little. Post-ACA uninsurance rates remained high for these populations in many states., Competing Interests: No competing financial interests exist., (© Gregory Lines et al., 2021; Published by Mary Ann Liebert, Inc.)