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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 ; Online: Gender Difference and Correlates of Physical Activity Among Urban Children and Adolescents in Ethiopia

Sibhatu Biadgilign / Bereket Gebremichael / Admas Abera / Tsedey Moges

Frontiers in Public Health, Vol

A Cross-Sectional Study

2022 Volume 10

Abstract: BackgroundStudies indicate that children and adolescent populations in most countries show a low level of physical activity (PA) and an increasing prevalence of obesity. Addressing gender disparity in PA is the main element of public health programs. ... ...

Abstract	BackgroundStudies indicate that children and adolescent populations in most countries show a low level of physical activity (PA) and an increasing prevalence of obesity. Addressing gender disparity in PA is the main element of public health programs. There is currently a paucity of studies, particularly, in developing countries that investigate gender differences and correlates of PA among children and adolescents.ObjectiveThe study is aimed to assess the gender difference and correlates of PA among children and adolescents in Ethiopia.MethodsAn observational population-based cross-sectional study was conducted in representative samples of children and adolescents in the capital city of Ethiopia, Addis Ababa. Multivariable logistic regression models with robust estimation of SEs were fitted to predict the odds ratios (ORs) and 95% CIs.ResultsA total of 632 children and adolescents-parent dyads were included in the study. More boys than girls (17.0 and 11.7%) were engaged in moderate intensity PA 3 days a week or more (p = 0.057). Age, mothers working in a private business, attending public schools, longer sleep duration, and being taught the benefits of PA were positively associated with meeting moderate-to-vigorous PA (MVPA) in both sexes combined and in a sub-sample of boys. Furthermore, an inverse association was found between overweight/obesity and MVPA in the overall children and girls as well. For moderate PA (MPA); the age of the children, maternal education and occupation, school type, overweight/obesity, and sleep duration on school nights were significant correlates among the studied children.ConclusionsThe present study provided evidence of several correlates identified associated with meeting MVPA and MPA in both sexes combined. Girls are less likely than boys to engage in PA. Therefore, there is a need to take into perspectives the provision of a comprehensive multifaceted health behavior modification and interventions, such as focused and regular physical education in schools.
Keywords	physical activity and exercise ; childhood ; overweight/obesity ; Ethiopia ; gender difference ; Public aspects of medicine ; RA1-1270
Subject code	796
Language	English
Publishing date	2022-03-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Drought, hunger and coping mechanisms among rural household in Southeast Ethiopia

Betemariam Gebre / Habtamu Yesigat Ayenew / Sibhatu Biadgilign

Heliyon, Vol 7, Iss 3, Pp e06355- (2021)

2021

Abstract: Protracted and prolonged droughts lead to famine and substantial decline in agricultural productivity that contribute to food insecurity and hunger in sub-Saharan Africa which needs to explore the risk coping strategies to better target risk mitigation. ... ...

Abstract	Protracted and prolonged droughts lead to famine and substantial decline in agricultural productivity that contribute to food insecurity and hunger in sub-Saharan Africa which needs to explore the risk coping strategies to better target risk mitigation. The main research question of this paper was to analyze ex-post coping strategies and their determinants in rural Ethiopia. We use a cross-section data collected in 2013 from vulnerable rural households in Rayitu district, Bale Zone of Oromia Regional State. Using population-proportionate to size (PPS) sampling technique, a total number of 1,402 households in the district participated in this study. The data were analyzed using a three-stage least squares (3SLS) method. Our analysis confirms that rural households in Rayitu district experience drought and are vulnerable to the consequences of shocks. As a response, rural households adopt interdependent risk coping strategies. This supports the notion of addressing the problem of risk through integrated rural development strategies (and policies) to help the poor to improve the vulnerability to shock and help to escape out of poverty. In addition, we found that the risk coping strategies that households adopt are influenced by the resource holdings and income levels of the rural households, their access to product and financial market, and their socio-demographic characteristics. Hence, we argue that strategies and interventions to improve the livelihood of the poor and to support the vulnerable ones should be targeted to fit to the needs and priorities of households.
Keywords	Coping strategies ; Drought ; Hunger ; Shock ; Rural ; Livelihood ; Science (General) ; Q1-390 ; Social sciences (General) ; H1-99
Subject code	910
Language	English
Publishing date	2021-03-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The association of household and child food insecurity with overweight/obesity in children and adolescents in an urban setting of Ethiopia

Sibhatu Biadgilign / Mekdes K. Gebremariam / Tennyson Mgutshini

BMC Public Health, Vol 21, Iss 1, Pp 1-

2021 Volume 8

Abstract: Abstract Background Existing evidence on the association between food insecurity and childhood obesity is mixed. In addition, literature from developing countries in general and Ethiopia in particular on the nexus and impact of household and child food ... ...

Abstract	Abstract Background Existing evidence on the association between food insecurity and childhood obesity is mixed. In addition, literature from developing countries in general and Ethiopia in particular on the nexus and impact of household and child food insecurity on childhood obesity in the context of urbanization remains limited. The objective of this study was to explore the association between household and child food insecurity and childhood obesity in an urban setting of Ethiopia. Methods An observational population based cross-sectional study was conducted in five sub-cities of Addis Ababa. Multi-stage sampling techniques were employed to identify the study unit from the selected sub-cities. Multivariable logistic regression models with robust estimation of standard errors were utilized to determine the associations. Interactions by age and sex in the associations explored were tested. Results A total of 632 children and adolescents-parent dyads were included in the study. About 29.4% of those in food secure households and 25% of those in food insecure households were overweight/obese. Similarly, 29.8% of food secure children and 22% of food insecure children were overweight/obese. Household and child food insecurity status were not significantly associated with child and adolescent overweight or obesity in the final adjusted models. Conclusions Household and childhood food insecurity status were not associated with child and adolescent overweight/obesity in the study setting. Interventions aimed at combating overweight and obesity in the study setting should target children and adolescents irrespective of their food security status.
Keywords	Food insecurity ; Childhood ; Adolescents ; Overweight ; Obesity ; Ethiopia ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2021-07-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The role of universal health coverage and global health security nexus and interplay on SARS-CoV-2 infection and case-fatality rates in Africa

Sibhatu Biadgilign / Alemayehu Hailu / Bereket Gebremichael / Mekitew Letebo / Etsub Berhanesilassie / Arega Shumetie

Globalization and Health, Vol 19, Iss 1, Pp 1-

a structural equation modeling approach

2023 Volume 13

Abstract: Abstract Background The Coronavirus Disease (COVID-19) caused by SARS-CoV-2 infections remains a significant health challenge worldwide. There is paucity of evidence on the influence of the universal health coverage (UHC) and global health security (GHS) ...

Abstract	Abstract Background The Coronavirus Disease (COVID-19) caused by SARS-CoV-2 infections remains a significant health challenge worldwide. There is paucity of evidence on the influence of the universal health coverage (UHC) and global health security (GHS) nexus on SARS-CoV-2 infection risk and outcomes. This study aimed to investigate the effects of UHC and GHS nexus and interplay on SARS-CoV-2 infection rate and case-fatality rates (CFR) in Africa. Methods The study employed descriptive methods to analyze the data drawn from multiple sources as well used structural equation modeling (SEM) with maximum likelihood estimation to model and assess the relationships between independent and dependent variables by performing path analysis. Results In Africa, 100% and 18% of the effects of GHS on SARS-CoV-2 infection and RT-PCR CFR, respectively were direct. Increased SARS-CoV-2 CFR was associated with median age of the national population (β = -0.1244, [95% CI: -0.24, -0.01], P = 0.031 ); COVID-19 infection rate (β = -0.370, [95% CI: -0.66, -0.08], P = 0.012 ); and prevalence of obesity among adults aged 18 + years (β = 0.128, [95% CI: 0.06,0.20], P = 0.0001) were statistically significant. SARS-CoV-2 infection rates were strongly linked to median age of the national population (β = 0.118, [95% CI: 0.02,0.22 ], P = 0.024); population density per square kilometer, (β = -0.003, [95% CI: -0.0058, -0.00059], P = 0.016 ) and UHC for service coverage index (β = 0.089, [95% CI: 0.04,0.14, P = 0.001 ) in which their relationship was statistically significant. Conclusions The study shade a light that UHC for service coverage, and median age of the national population, population density have significant effect on COVID-19 infection rate while COVID-19 infection rate, median age of the national population and prevalence of obesity among adults aged 18 + years were associated with COVID-19 case-fatality rate. Both, UHC and GHS do not emerge to protect against COVID-19-related case fatality rate.
Keywords	UHC ; GHS ; SARS-CoV-2 ; Africa ; Infection rate ; Case fatality rate ; Public aspects of medicine ; RA1-1270
Subject code	910
Language	English
Publishing date	2023-07-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Pregnant mothers have limited knowledge and poor dietary diversity practices, but favorable attitude towards nutritional recommendations in rural Ethiopia

Taddese Alemu Zerfu / Sibhatu Biadgilign

BMC Nutrition, Vol 4, Iss 1, Pp 1-

evidence from community-based study

2018 Volume 9

Abstract: Abstract Background Mothers’ nutrition is crucial for good pregnancy outcomes and in improving children’s nutritional status. The present study aimed to examine the level of knowledge and attitude towards maternal nutrition and dietary diversity ... ...

Abstract	Abstract Background Mothers’ nutrition is crucial for good pregnancy outcomes and in improving children’s nutritional status. The present study aimed to examine the level of knowledge and attitude towards maternal nutrition and dietary diversity practices among pregnant mothers in rural central Ethiopia. Methods In-depth analysis of data from a prospective study involving a total of 389 eligible pregnant women, enrolled during their second antenatal care (ANC) visit was conducted between August 2014 and March 2015. Study participants were selected by employing systematic sampling techniques. Dietary diversity practices were assessed by asking each individual pregnant woman to provide a single 24-h dietary recall. Simple frequencies and graphs were used to present the analyzed data and interpretations. Results Vegetables were listed top as major sources of vitamin A (45.5%) and iron (23.8%). Nearly half (47%) of the mothers lacked awareness on balanced and diversified diets. Conversely, nearly three fourths (73.8%) and two thirds (66.8%) of them had favorable attitudes towards dietary diversity and early initiation of antenatal care follow up. With a median dietary diversity score of four, starchy staples (100%), legumes and nuts (89.2%) were major food groups consumed by almost all of the mothers included in the study. Conclusion Though pregnant mothers had limited knowledge and poor dietary diversity practices, they exhibited a relatively favorable attitude towards major nutritional recommendations. Use of antenatal care and its follow up as a point of entry for educating pregnant women and increasing nutrition knowledge and attitude is recommended.
Keywords	Attitude ; Ethiopia ; Dietary diversity ; Knowledge ; Nutrition ; Pregnant mother ; Nutrition. Foods and food supply ; TX341-641 ; Food processing and manufacture ; TP368-456 ; Medicine (General) ; R5-920
Subject code	360
Language	English
Publishing date	2018-12-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The role of multi-dimensional women's empowerment in agriculture to improve the nutritional status of under-five children in rural cash crop producing, resource-limited settings of Ethiopia

Meskerem Jisso / Tizalegn Tesfaye / Sibhatu Biadgilign / Amare Abera Tareke / Tadesse Alemu Zerfu

Journal of Nutritional Science, Vol

2022 Volume 11

Abstract: Little is known about the relation between the women empowerment in agriculture index, and health and nutrition outcomes among under-five children in Ethiopia. The study's objective was to examine women's empowerment in agriculture and its association ... ...

Abstract	Little is known about the relation between the women empowerment in agriculture index, and health and nutrition outcomes among under-five children in Ethiopia. The study's objective was to examine women's empowerment in agriculture and its association with the nutritional status of children (6–59 months) in rural, cash crop producing, and resource-limited settings of Ethiopia. A community-based cross-sectional study was conducted employing 422 households; having women of reproductive age group and children under-five. Stratified simple random sampling was used to identify households; a simple random sampling was used to select villages and households. Women empowerment in agriculture was measured by the abbreviated women empowerment in agriculture index. Even if the overall multi-dimensional five domains of empowerment index (5DE) was not a significant predictor of nutritional status in children (P > 0⋅05), sub-indicators had a pivotal role in child nutritional status. Disempowerment in decisions about input into production [AOR = 8⋅85], empowerment on control of income [AOR = 0⋅35] and availability of livestock [AOR = 0⋅38] were predictors of child stunting, whereas women's disempowerment in production decisions seems beneficiary for wasting, disempowered women have 84 % less likely to have wasted child than empowered women [AOR = 0⋅16]. Dietary and agricultural diversity [particularly livestock farming], and women's empowerment in production decisions were predictors of better nutritional outcomes in children. Therefore, a concentrated effort is needed towards strengthening the multi-dimensional empowerment of women in agriculture emphasising women's input into production decisions, dietary and agricultural diversification, mainly livestock farming.
Keywords	Child nutrition ; Stunting ; Wasting ; Women empowerment in agriculture ; Nutrition. Foods and food supply ; TX341-641 ; Medicine ; R
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Cambridge University Press
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Impact of good governance, economic growth and universal health coverage on COVID-19 infection and case fatality rates in Africa

Bereket Gebremichael / Alemayehu Hailu / Mekitew Letebo / Etsub Berhanesilassie / Arega Shumetie / Sibhatu Biadgilign

Health Research Policy and Systems, Vol 20, Iss 1, Pp 1-

2022 Volume 9

Abstract: Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has disrupted lives across all countries and communities. It significantly reduced the global economic output and dealt health systems across the world a serious blow. There is growing ... ...

Abstract	Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has disrupted lives across all countries and communities. It significantly reduced the global economic output and dealt health systems across the world a serious blow. There is growing evidence showing the progression of the COVID-19 pandemic and the impact it has on health systems, which should help to draw lessons for further consolidating and realizing universal health coverage (UHC) in all countries, complemented by more substantial government commitment and good governance, and continued full implementation of crucial policies and plans to avert COVID-19 and similar pandemic threats in the future. Therefore, the objective of the study was to assess the impact of good governance, economic growth and UHC on the COVID-19 infection rate and case fatality rate (CFR) among African countries. Methods We employed an analytical ecological study design to assess the association between COVID-19 CFR and infection rate as dependent variables, and governance, economic development and UHC as independent variables. We extracted data from publicly available databases (i.e., Worldometer, Worldwide Governance Indicators, Our World in Data and WHO Global Health Observatory Repository). We employed a multivariable linear regression model to examine the association between the dependent variables and the set of explanatory variables. STATA version 14 software was used for data analysis. Results All 54 African countries were covered by this study. The median observed COVID-19 CFR and infection rate were 1.65% and 233.46%, respectively. Results of multiple regression analysis for predicting COVID-19 infection rate indicated that COVID-19 government response stringency index (β = 0.038; 95% CI 0.001, 0.076; P = 0.046), per capita gross domestic product (GDP) (β = 0.514; 95% CI 0.158, 0.87; P = 0.006) and infectious disease components of UHC (β = 0.025; 95% CI 0.005, 0.045; P = 0.016) were associated with COVID-19 infection rates, while noncommunicable disease ...
Keywords	Governance ; Economic growth ; Universal health coverage ; COVID-19 ; Infection rates ; Fatality rates ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2022-11-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Mid-upper-arm circumference based case-detection, admission, and discharging of under five children in a large-scale community-based management of acute malnutrition program in Nigeria

Stanley Chitekwe / Sibhatu Biadgilign / Assaye Tolla / Mark Myatt

Archives of Public Health, Vol 76, Iss 1, Pp 1-

2018 Volume 10

Abstract: Abstract Background Severe acute malnutrition (SAM) threatens the lives of millions of children worldwide particularly in low and middle-income countries (LMICs). Community-based management of acute malnutrition (CMAM) is an approach to treating large ... ...

Abstract	Abstract Background Severe acute malnutrition (SAM) threatens the lives of millions of children worldwide particularly in low and middle-income countries (LMICs). Community-based management of acute malnutrition (CMAM) is an approach to treating large numbers of cases of severe acute malnutrition (SAM) in a community setting. There is a debate about the use of mid-upper arm circumference (MUAC) for admitting and discharging SAM children. This article describes the experience of using MUAC for screening, case-finding, referral, admission, and discharge in a large-scale CMAM program delivered through existing primary health care facilities in Nigeria. Methods Over one hundred thousand (n = 102,245) individual CMAM beneficiary records were collected from two of the eleven states (i.e. Katsina and Jigawa) that provide CMAM programming in Nigeria. The data were double entered and checked using EpiData version 3.2 and analyzed using the R language for data-analysis graphics. Results The median MUAC at admission was 109 mm. Among admissions, 37.4% (38,275) had a comorbidity recorded at admission and 7.4% (7537) were recorded as having developed comorbidity during the treatment. Analysis in the better performing state program in the most recent year for which data were available found that 87.1% (n = 13,273) of admitted cases recovered and were discharged as cured, 9.2% (n = 1396) defaulted and were lost to follow-up, 2.9% (n = 443) were discharged as non-recovered, 0.7% (n = 104) were transferred to inpatient services, and 0.2% (n = 27) were known (died, to be dead or to have passed) during the treatment episode. The program met SPHERE minimum standards for treatment outcomes for therapeutic feeding programs. Factors associated with negative outcomes (default, non-recovery, transfer, and death) were distance between home and the treatment center; lower MUAC, diarrhea and cough at admission; or developing diarrhea, vomiting, fever, or cough during the treatment episode. Conclusions This study confirms that MUAC can be ...
Keywords	Case-detection ; MUAC ; Admission ; Discharging ; CMAM ; Nigeria ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2018-04-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Correction to

Stanley Chitekwe / Sibhatu Biadgilign / Assaye Tolla / Mark Myatt

Archives of Public Health, Vol 76, Iss 1, Pp 1-

Mid-upper-arm circumference based case-detection, admission, and discharging of under five children in a large-scale community-based management of acute malnutrition program in Nigeria

2018 Volume 1

Abstract: The author requests to correct errors in the original article [1]. Area where it needs amendment are as follows. ...

Abstract	The author requests to correct errors in the original article [1]. Area where it needs amendment are as follows.
Keywords	Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2018-06-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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