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Book ; Online: The double-edged sword of keeping livestock

Zerfu, Taddese Alemu

Balancing nutritional benefits with disease risks in poor nations

2023

Abstract: In many low- and lower-middle-income countries, particularly in Sub-Saharan Africa (SSA), where mixed crop-livestock farming is widely practiced, livestock keeping provides income, food, nutrition and other benefits for the rural poor. The nutritional ... ...

Abstract	In many low- and lower-middle-income countries, particularly in Sub-Saharan Africa (SSA), where mixed crop-livestock farming is widely practiced, livestock keeping provides income, food, nutrition and other benefits for the rural poor. The nutritional benefits of livestock keeping are particularly important since malnutrition continues to cause nearly half of annual global child deaths, and can have lasting effects on the physical growth and cognitive development of millions of surviving children. However, the relationship between livestock keeping, human nutrition and the health of most vulnerable population groups—under-five children and women of reproductive age—has remained a complex problem in many LMICs. This problem prompted us to work together and synthesize global evidence to assess the role of livestock keeping on the health and nutritional status of children and women in LMICs.
Keywords	farmers ; food ; income ; livestock ; malnutrition ; nutrition ; rural poor
Language	English
Publishing date	2023-04-28T13:48:46Z
Publisher	Cambridge University Press
Publishing country	fr
Document type	Book ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: What could be the potential reasons for relatively low coronavirus disease 2019 (COVID-19) fatality rates in Africa? The case for Ethiopia.

Zerfu, Taddese Alemu / Tareke, Amare Abera

Journal of global health

2021 Volume 11, Page(s) 3057

MeSH term(s)	Age Factors ; Air Pollution/prevention & control ; COVID-19/immunology ; COVID-19/mortality ; Developing Countries ; Ethiopia ; Humans ; Non-Smokers ; SARS-CoV-2/isolation & purification ; Temperature
Language	English
Publishing date	2021-04-17
Publishing country	Scotland
Document type	Journal Article ; Review
ZDB-ID	2741629-X
ISSN	2047-2986 ; 2047-2986
ISSN (online)	2047-2986
ISSN	2047-2986
DOI	10.7189/jogh.11.03057
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Challenges and experience of the Ethiopian rural health extension program: implications for reform and revitalization.

Zerfu, Taddese Alemu / Tareke, Amare Abera / Biadgilign, Sibhatu

BMC health services research

2023 Volume 23, Issue 1, Page(s) 1309

Abstract: Background: Despite remarkable gains over the past decade, mounting evidence suggests that Ethiopia's rural health extension program (HEP) is facing serious implementation challenges. We investigated the current and potential future program design and ... ...

Abstract	Background: Despite remarkable gains over the past decade, mounting evidence suggests that Ethiopia's rural health extension program (HEP) is facing serious implementation challenges. We investigated the current and potential future program design and implementation challenges of Ethiopia's rural HEP based on the lived experiences of health extension workers (HEW) implementing the program at the grassroots level. Methods: We employed a longitudinal qualitative exploration linked to a larger cluster-randomized trial (RCT) which was implemented in 282 villages randomly selected from 18 Kebeles of the Gedeo zone, southern Ethiopia. Data were collected using in-depth interviews with key informants, focus group discussion, and passive observation of program implementation. The data were analyzed manually using a thematic framework analysis approach. Themes and sub-themes were generated by condensing, summarizing, and synthesizing data collected in the field in the form of extended notes and field observation checklists. Findings: Despite considerable gains in availing basic health services to the rural population, HEP seems to suffer serious design and implementation flaws that demand thoughtful and immediate adjustment. The design constraints span from the number and type of intervention packages to the means of dissemination (vehicle) as well as the target population emphasized. As such, some low-cost high-impact interventions that were strongly desired by the community were overlooked, while others were inappropriately packed. The means of distribution - female health extension workers trained with basic prevention skills, were lacking essential skills. They also had high burnout rates and with little engagement with men, were repeatedly mentioned flaws of the program demanding revitalization. Furthermore, the sheer structure of HEP precluded adult and adolescent men, non-reproductive women, and the elderly. Conclusion: Despite significant gains over the last couple of months, Ethiopia's rural HEP appears to have reached a tipping point that requires a comprehensive revamp of the program package, means of distribution, and target beneficiaries rather than the "usual" tweaks to reap maximum benefits.
MeSH term(s)	Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Ethiopia ; Health Promotion ; Rural Health ; Rural Population ; Women's Health ; Qualitative Research ; Longitudinal Studies
Language	English
Publishing date	2023-11-27
Publishing country	England
Document type	Journal Article
ZDB-ID	2050434-2
ISSN	1472-6963 ; 1472-6963
ISSN (online)	1472-6963
ISSN	1472-6963
DOI	10.1186/s12913-023-10253-9
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Article ; Online: Challenges and experience of the Ethiopian rural health extension program

Taddese Alemu Zerfu / Amare Abera Tareke / Sibhatu Biadgilign

BMC Health Services Research, Vol 23, Iss 1, Pp 1-

implications for reform and revitalization

2023 Volume 9

Abstract: Abstract Background Despite remarkable gains over the past decade, mounting evidence suggests that Ethiopia’s rural health extension program (HEP) is facing serious implementation challenges. We investigated the current and potential future program ... ...

Abstract	Abstract Background Despite remarkable gains over the past decade, mounting evidence suggests that Ethiopia’s rural health extension program (HEP) is facing serious implementation challenges. We investigated the current and potential future program design and implementation challenges of Ethiopia’s rural HEP based on the lived experiences of health extension workers (HEW) implementing the program at the grassroots level. Methods We employed a longitudinal qualitative exploration linked to a larger cluster-randomized trial (RCT) which was implemented in 282 villages randomly selected from 18 Kebeles of the Gedeo zone, southern Ethiopia. Data were collected using in-depth interviews with key informants, focus group discussion, and passive observation of program implementation. The data were analyzed manually using a thematic framework analysis approach. Themes and sub-themes were generated by condensing, summarizing, and synthesizing data collected in the field in the form of extended notes and field observation checklists. Findings Despite considerable gains in availing basic health services to the rural population, HEP seems to suffer serious design and implementation flaws that demand thoughtful and immediate adjustment. The design constraints span from the number and type of intervention packages to the means of dissemination (vehicle) as well as the target population emphasized. As such, some low-cost high-impact interventions that were strongly desired by the community were overlooked, while others were inappropriately packed. The means of distribution - female health extension workers trained with basic prevention skills, were lacking essential skills. They also had high burnout rates and with little engagement with men, were repeatedly mentioned flaws of the program demanding revitalization. Furthermore, the sheer structure of HEP precluded adult and adolescent men, non-reproductive women, and the elderly. Conclusion Despite significant gains over the last couple of months, Ethiopia’s rural HEP appears to ...
Keywords	Health extension program ; Challenges ; Revitalization ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2023-11-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Magnitude, Trends, and Determinants of Iodized Salt Availability among Households in Ethiopia: Analysis of Ethiopian Demographic and Health Surveys (2000-2016).

Tareke, Amare Abera / Zerfu, Taddese Alemu

Nutrition and metabolic insights

2021 Volume 14, Page(s) 11786388211025342

Abstract: Background: Iodine deficiency causes various health problems such as mental defects, goiter, reproductive damage, hypo and hyperthyroidism, stillbirth, abortion, congenital abnormalities, cretinism, mental retardation, muscle anomalies, and reduced work ...

Abstract	Background: Iodine deficiency causes various health problems such as mental defects, goiter, reproductive damage, hypo and hyperthyroidism, stillbirth, abortion, congenital abnormalities, cretinism, mental retardation, muscle anomalies, and reduced work output. Although the adverse effects on health and socio-economic development are well known, they persisted as a public health problem worldwide. Salt iodization is recommended as a simple cost-effective method to prevent iodine deficiency disorders. This study aimed to determine the magnitude, trends, and determinants of iodized salt availability in the household in Ethiopia. Methods: The current study used the Ethiopian Demographic and Health Surveys conducted from 2000 to 2016 with a total of 57 939 households. Descriptive statistics were performed on selected background characteristics to provide an overall picture of the sample after considering sample weights. To ensure the representativeness of the sample we applied a complex sample design considering household weights, primary sampling units, and the strata associated with it. The Cochran-Armitage test was performed to assess the trend of iodized salt availability in the household. Multivariate logistic regression was used to determine the association between the dependent variable and independent variables. A significance level of .05 was chosen for all analyses. Results: The magnitude of iodized salt availability in the household was 28.45% in 2000, 54.34% in 2005, 15.42% in 2011, and 89.28% in 2016. Iodized salt availability increased from 28.45% [95% CI: 27.69-29.21] in 2000 to 89.28% [95% CI: 88.79-89.75] in 2016. Despite the decline from 2005 to 2011 in the percentage of households with iodized salt, overall, there was a significant increment from 2000 to 2016 in Ethiopia ( Conclusion: Remarkable progress has been made in Ethiopia regarding iodized salt availability in recent years. Besides the current efforts to achieve universal salt iodization, future interventions should prioritize specific groups like those with lower socioeconomic status and geographic areas with lower availability of iodized salt in the household.
Language	English
Publishing date	2021-06-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	2594646-8
ISSN	1178-6388
ISSN	1178-6388
DOI	10.1177/11786388211025342
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Article ; Online: Challenges and experience of the Ethiopian rural health extension program

Zerfu, Taddese Alemu / Tareke, Amare Abera / Biadgilign, Sibhatu / Zerfu, Taddese

BMC Health Services Research 23: 1309

Implications for reform and revitalization

2023

Abstract: Background Despite remarkable gains over the past decade, mounting evidence suggests that Ethiopia’s rural health extension program (HEP) is facing serious implementation challenges. We investigated the current and potential future program design and ... ...

Abstract	Background Despite remarkable gains over the past decade, mounting evidence suggests that Ethiopia’s rural health extension program (HEP) is facing serious implementation challenges. We investigated the current and potential future program design and implementation challenges of Ethiopia’s rural HEP based on the lived experiences of health extension workers (HEW) implementing the program at the grassroots level. Methods We employed a longitudinal qualitative exploration linked to a larger cluster-randomized trial (RCT) which was implemented in 282 villages randomly selected from 18 Kebeles of the Gedeo zone, southern Ethiopia. Data were collected using in-depth interviews with key informants, focus group discussion, and passive observation of program implementation. The data were analyzed manually using a thematic framework analysis approach. Themes and sub-themes were generated by condensing, summarizing, and synthesizing data collected in the field in the form of extended notes and field observation checklists. Findings Despite considerable gains in availing basic health services to the rural population, HEP seems to suffer serious design and implementation flaws that demand thoughtful and immediate adjustment. The design constraints span from the number and type of intervention packages to the means of dissemination (vehicle) as well as the target population emphasized. As such, some low-cost high-impact interventions that were strongly desired by the community were overlooked, while others were inappropriately packed. The means of distribution - female health extension workers trained with basic prevention skills, were lacking essential skills. They also had high burnout rates and with little engagement with men, were repeatedly mentioned flaws of the program demanding revitalization. Furthermore, the sheer structure of HEP precluded adult and adolescent men, non-reproductive women, and the elderly. Conclusion Despite significant gains over the last couple of months, Ethiopia’s rural HEP appears to have ...
Keywords	ETHIOPIA ; EAST AFRICA ; AFRICA SOUTH OF SAHARA ; AFRICA ; data ; data analysis ; health ; implementation ; rural areas ; health extension program (HEP) ; health extension workers (HEW)
Subject code	360
Language	English
Publisher	BMC
Publishing country	us
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Ownership of small livestock species, but not aggregate livestock, is associated with an increased risk of anemia among children in Ethiopia

Zerfu, Taddese Alemu / Abera, Amare / Duncan, Alan / Baltenweck, Isabelle / McNeill, Geraldine / Zerfu, Taddese

Food Science & Nutrition 11(9): 5157-5165

A propensity score matching analysis

2023

Abstract: Consumption of animal source foods, through livestock production, improves children's growth and micronutrient status. However, research on the relationship between livestock ownership and childhood anemia has produced conflicting results. The current ... ...

Abstract	Consumption of animal source foods, through livestock production, improves children's growth and micronutrient status. However, research on the relationship between livestock ownership and childhood anemia has produced conflicting results. The current study used robust analytical approaches to examine the effect of household livestock ownership on children's anemia using the most recent secondary data from the national demographic and health survey. We followed a 1:1 closest neighborhood propensity score matching analysis. A propensity score was generated using the binary logistic regression model to compute the probability of owning livestock. From a total of 18,008 households enrolled in the latest Ethiopian Demographic and Health Survey (EDHS 2016), data of 721 index children aged 6–59 months from households owning livestock were matched with a comparable number (721) of children from households without livestock. The paired and independent t-test, matched relative risk (RR), and standardized mean differences were used to compare the distributions of hemoglobin concentration and anemia risks between treatment and control groups. Anemia was found in more than half (54.1% and 58.8%) of children aged 6–59 months from livestock-owning and nonowning families, respectively (p > .05). Aggregate ownership of livestock was not associated with hemoglobin concentration or anemia status (RR = 0.95, 95% confidence interval [95% CI] [0.87–1.04]). Species-wise, poultry was associated with a lower (RR = 0.88, 95% CI [0.84–0.95]) anemia risk, while ownership of goat/sheep was associated with higher (RR = 1.10, 95% CI [1.03–1.17]) risk. In conclusion, ownership of small livestock species (sheep/goats and poultry), but not aggregate livestock ownership, was associated with the risk of anemia among children in Ethiopia. Therefore, agriculture-sensitive nutrition, with a One Health lens approach, is recommended to mitigate the high burden of anemia among children in Ethiopia. In the future, a well-controlled interventional ...
Keywords	ETHIOPIA ; EAST AFRICA ; AFRICA SOUTH OF SAHARA ; AFRICA ; agriculture ; anaemia ; animal source foods ; children ; growth ; livestock ; micronutrient deficiencies ; nutrition ; research methods ; surveys
Subject code	333
Language	English
Publisher	John Wiley & Sons
Publishing country	us
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Ownership of small livestock species, but not aggregate livestock, is associated with an increased risk of anemia among children in Ethiopia: A propensity score matching analysis.

Zerfu, Taddese Alemu / Abera, Amare / Duncan, Alan / Baltenweck, Isabelle / McNeill, Geraldine

Food science & nutrition

2023 Volume 11, Issue 9, Page(s) 5157–5165

Abstract	Consumption of animal source foods, through livestock production, improves children's growth and micronutrient status. However, research on the relationship between livestock ownership and childhood anemia has produced conflicting results. The current study used robust analytical approaches to examine the effect of household livestock ownership on children's anemia using the most recent secondary data from the national demographic and health survey. We followed a 1:1 closest neighborhood propensity score matching analysis. A propensity score was generated using the binary logistic regression model to compute the probability of owning livestock. From a total of 18,008 households enrolled in the latest Ethiopian Demographic and Health Survey (EDHS 2016), data of 721 index children aged 6-59 months from households owning livestock were matched with a comparable number (721) of children from households without livestock. The paired and independent t-test, matched relative risk (RR), and standardized mean differences were used to compare the distributions of hemoglobin concentration and anemia risks between treatment and control groups. Anemia was found in more than half (54.1% and 58.8%) of children aged 6-59 months from livestock-owning and nonowning families, respectively (
Language	English
Publishing date	2023-06-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	2703010-6
ISSN	2048-7177
ISSN	2048-7177
DOI	10.1002/fsn3.3474
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Pregnant women have inadequate fiber intake while consuming fiber-rich diets in low-income rural setting: Evidences from Analysis of common "ready-to-eat" stable foods.

Zerfu, Taddese Alemu / Mekuria, Aleme

Food science & nutrition

2019 Volume 7, Issue 10, Page(s) 3286–3292

Abstract: The intake of fiber-rich foods during pregnancy has several health benefits to the pregnant woman including lowering the risks of diabetes, preeclampsia, and constipation. However, little is known about the content, daily intake levels, and adequacy of ... ...

Abstract	The intake of fiber-rich foods during pregnancy has several health benefits to the pregnant woman including lowering the risks of diabetes, preeclampsia, and constipation. However, little is known about the content, daily intake levels, and adequacy of fiber among pregnant women in many low-income settings. We aimed to identify common food items and determine adequacy of dietary fiber intake levels among pregnant women in rural Ethiopia. Dietary data were collected from a subsample (
Language	English
Publishing date	2019-09-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	2703010-6
ISSN	2048-7177
ISSN	2048-7177
DOI	10.1002/fsn3.1188
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Article ; Online: Inhaled Corticosteroids and the Risk of Lung Cancer in Chronic Obstructive Pulmonary Disease Patients: A Systematic Review and Meta-Analysis.

Tareke, Amare Abera / Debebe, Wondwosen / Alem, Addis / Bayileyegn, Nebiyou Simegnew / Zerfu, Taddese Alemu / Ayana, Andualem Mossie

Pulmonary medicine

2022 Volume 2022, Page(s) 9799858

Abstract: Background: The global prevalence of chronic obstructive pulmonary disease (COPD) is increasing, and the risk of lung cancer in these patients is high. The use of inhaled corticosteroids (ICSs) in COPD patients could help to decrease potential lung ... ...

Abstract	Background: The global prevalence of chronic obstructive pulmonary disease (COPD) is increasing, and the risk of lung cancer in these patients is high. The use of inhaled corticosteroids (ICSs) in COPD patients could help to decrease potential lung cancer risk. We planned to conduct this systematic review and meta-analysis to determine the role of ICS in the risk of lung cancer among COPD patients. Methods: A comprehensive search of PubMed, Science Direct, Google Scholar, and Cochrane library and a manual search of the list of references were conducted. Studies with cohort, case-control, and randomized clinical trial designs for any ICS use reporting the incidence/hazard ratio (HR) of lung cancer were included. The random-effects model was used to pool hazard ratios. Subgroup analysis and metaregression analysis were employed. Funnel plot and Egger regression test were used to assess publication bias. Results: Combining the results of 14 observations, the pooled HR for cancer risk reduction was 0.69 (95% CI 0.59-0.79), Conclusion: The use of ICS in COPD patients reduces the risk of lung cancer. The risk reduction was independent of smoking status and latency period. Future studies should focus on the optimum dose and controlling confounders like asthma.
MeSH term(s)	Administration, Inhalation ; Adrenal Cortex Hormones/adverse effects ; Asthma ; Humans ; Lung Neoplasms ; Pulmonary Disease, Chronic Obstructive/complications ; Pulmonary Disease, Chronic Obstructive/drug therapy ; Randomized Controlled Trials as Topic
Chemical Substances	Adrenal Cortex Hormones
Language	English
Publishing date	2022-08-21
Publishing country	Egypt
Document type	Journal Article ; Meta-Analysis ; Review ; Systematic Review
ZDB-ID	2603580-7
ISSN	2090-1844 ; 2090-1844
ISSN (online)	2090-1844
ISSN	2090-1844
DOI	10.1155/2022/9799858
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