Search results for: Temtim Assefa
Commenced in January 2007
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Edition: International
Paper Count: 19

Search results for: Temtim Assefa

19 A Conceptual Framework for Knowledge Integration in Agricultural Knowledge Management System Development

Authors: Dejen Alemu, Murray E. Jennex, Temtim Assefa

Abstract:

Agriculture is the mainstay of the Ethiopian economy; however, the sector is dominated by smallholder farmers resulting in land fragmentation and suffering from low productivity. Due to these issues, much effort has been put into the transformation of the sector to bring about more sustainable rural economic development. Technological advancements have been applied for the betterment of farmers resulting in the design of tools that are potentially capable of supporting the agricultural sector; however, their use and relevance are still alien to the local rural communities. The notion of the creating, capturing and sharing of knowledge has also been repetitively raised by many international donor agencies to transform the sector, yet the most current approaches to knowledge dissemination focus on knowledge that originates from the western view of scientific rationality while overlooking the role of indigenous knowledge (IK). Therefore, in agricultural knowledge management system (KMS) development, the integration of IKS with scientific knowledge is a critical success factor. The present study aims to contribute in the discourse on how to best integrate scientific and IK in agricultural KMS development. The conceptual framework of the research is anchored in concepts drawn from the theory of situated learning in communities of practice (CoPs): knowledge brokering. Using the KMS development practices of Ethiopian agricultural transformation agency as a case area, this research employed an interpretive analysis using primary and secondary qualitative data acquired through in-depth semi-structured interviews and participatory observations. As a result, concepts are identified for understanding the integration of the two major knowledge systems (i.e., indigenous and scientific knowledge) and participation of relevant stakeholders in particular the local farmers in agricultural KMS development through the roles of extension agent as a knowledge broker including crossing boundaries, in-between position, translation and interpretation, negotiation, and networking. The research shall have a theoretical contribution in addressing the incorporation of a variety of knowledge systems in agriculture and practically to provide insight for policy makers in agriculture regarding the importance of IK integration in agricultural KMS development and support marginalized small-scale farmers.

Keywords: communities of practice, indigenous knowledge, knowledge management system development, knowledge brokering

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18 Agricultural Knowledge Management System Design, Use, and Consequence for Knowledge Sharing and Integration

Authors: Dejen Alemu, Murray E. Jennex, Temtim Assefa

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This paper is investigated to understand the design, the use, and the consequence of Knowledge Management System (KMS) for knowledge systems sharing and integration. A KMS for knowledge systems sharing and integration is designed to meet the challenges raised by knowledge management researchers and practitioners: the technical, the human, and social factors. Agricultural KMS involves various members coming from different Communities of Practice (CoPs) who possess their own knowledge of multiple practices which need to be combined in the system development. However, the current development of the technology ignored the indigenous knowledge of the local communities, which is the key success factor for agriculture. This research employed the multi-methodological approach to KMS research in action research perspective which consists of four strategies: theory building, experimentation, observation, and system development. Using the KMS development practice of Ethiopian agricultural transformation agency as a case study, this research employed an interpretive analysis using primary qualitative data acquired through in-depth semi-structured interviews and participant observations. The Orlikowski's structuration model of technology has been used to understand the design, the use, and the consequence of the KMS. As a result, the research identified three basic components for the architecture of the shared KMS, namely, the people, the resources, and the implementation subsystems. The KMS were developed using web 2.0 tools to promote knowledge sharing and integration among diverse groups of users in a distributed environment. The use of a shared KMS allows users to access diverse knowledge from a number of users in different groups of participants, enhances the exchange of different forms of knowledge and experience, and creates high interaction and collaboration among participants. The consequences of a shared KMS on the social system includes, the elimination of hierarchical structure, enhance participation, collaboration, and negotiation among users from different CoPs having common interest, knowledge and skill development, integration of diverse knowledge resources, and the requirement of policy and guideline. The research contributes methodologically for the application of system development action research for understanding a conceptual framework for KMS development and use. The research have also theoretical contribution in extending structuration model of technology for the incorporation of variety of knowledge and practical implications to provide management understanding in developing strategies for the potential of web 2.0 tools for sharing and integration of indigenous knowledge.

Keywords: communities of practice, indigenous knowledge, participation, structuration model of technology, Web 2.0 tools

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17 Granulomatous Mycoses Fungoides: A Case Report

Authors: Girum Tedla Assefa

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Background: Granulomatous mycosis fungoides is an extremely rare type of cutaneous T-cell lymphoma (<55 cases reported worldwide). Case report: A 36-year-old female presented with soft tissue atrophy of right lower limb (dermis + hypodermis) of 22 years and plaques over trunk of 3 years duration. Histological examination of a biopsy taken from the atrophied tissue showed a granulomatous reaction with epidermotropic atypical lymphocytes. However, in other areas there were only findings of conventional MF without granuloma. Conclusion: The diagnosis of a granulomatous mycosis fungoides depends exclusively on the histological demonstration of granulomas. Distinct clinical characteristics are not present. This case highlights the importance of thorough investigation of lipoatrophic skin changes in the adult to exclude underlying causes, including MF.

Keywords: cutaneous lymphoma, granulomatous skin lymphoma, mycoses fungoides, skin atrophy

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16 Optimization of Organic Rankine Cycle System for Waste Heat Recovery from Excavator

Authors: Young Min Kim, Dong Gil Shin, Assmelash Assefa Negash

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This study describes the application of a single loop organic Rankine cycle (ORC) for recovering waste heat from an excavator. In the case of waste heat recovery of the excavator, the heat of hydraulic oil can be used in the ORC system together with the other waste heat sources including the exhaust gas and engine coolant. The performances of four different cases of single loop ORC systems were studied at the main operating condition, and critical design factors are studied to get the maximum power output from the given waste heat sources. The energy and exergy analysis of the cycles are performed concerning the available heat source to determine the best fluid and system configuration. The analysis demonstrates that the ORC in the excavator increases 14% of the net power output at the main operating condition with a simpler system configuration at a lower expander inlet temperature than in a conventional vehicle engine without the heat of the hydraulic oil.

Keywords: engine, excavator, hydraulic oil, organic Rankine cycle (ORC), waste heat recovery

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15 Amharic Text News Classification Using Supervised Learning

Authors: Misrak Assefa

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The Amharic language is the second most widely spoken Semitic language in the world. There are several new overloaded on the web. Searching some useful documents from the web on a specific topic, which is written in the Amharic language, is a challenging task. Hence, document categorization is required for managing and filtering important information. In the classification of Amharic text news, there is still a gap in the domain of information that needs to be launch. This study attempts to design an automatic Amharic news classification using a supervised learning mechanism on four un-touch classes. To achieve this research, 4,182 news articles were used. Naive Bayes (NB) and Decision tree (j48) algorithms were used to classify the given Amharic dataset. In this paper, k-fold cross-validation is used to estimate the accuracy of the classifier. As a result, it shows those algorithms can be applicable in Amharic news categorization. The best average accuracy result is achieved by j48 decision tree and naïve Bayes is 95.2345 %, and 94.6245 % respectively using three categories. This research indicated that a typical decision tree algorithm is more applicable to Amharic news categorization.

Keywords: text categorization, supervised machine learning, naive Bayes, decision tree

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14 Supply and Marketing of Floriculture in Ethiopia

Authors: Assefa Mitike Janko, Gosa Alemu

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The review of supply and marketing of floriculture in Ethiopia was conducted to analyses the production potential and to know the marketing share of the country. The data was collected from secondary and primary. Ethiopia has been operating in the floriculture industry for over 20 years. As is the case in many developing countries, the major export items of Ethiopia are dominated by few agricultural products that earn very small amounts in the international market. Moreover, most of the exports are destined to only few countries. Given the highly capital intensive nature of production and processing, rose farming is not a smallholder activity. It is also important to note the extremely tightly controlled time dimension of the logistics process, given the product attributes desired and the fragility and perishability of the roses. Another characteristic of the Ethiopian floriculture sector is the lack of domestically produced inputs that flower producers can access. The export volume and value of cut-flowers accounts for a small proportion of the total exports of Ethiopia. In recent years the sector is showing improvements in terms of the quality and quantity of exports to the international market.

Keywords: roses, production, value chain, floriculture, supply

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13 Investigation the Effect of Partial Replacement of Fine Aggregates with Ceramic

Authors: Yared Assefa Demessie

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This study may help to establish the appropriateness of ceramic waste aggregate for concrete production since it is obviously understood that the rising from continuous urbanization and industrialization development leads depletion of natural construction resource and the disposal of waste material. It can be used as base to conduct a study on the alternative readily available materials like ceramic industrial waste aggregates can lead to environmental concrete. The study assessed the fresh and hardened properties of the concrete produced by replacing part of the natural fine aggregate with an aggregate produced from ceramic industrial waste. In the study, experimental investigation was employed which involved two major tasks: material specifications and experimental evaluation of concrete were done in the laboratory. Experimental investigations such that workability, unit weight, compressive strength test, tensile strength test and flexural strength test for C-25 concrete mixes with different percentages of ceramic industrial waste aggregate after a curing period of 7 and 28 days has done and interpreted the result statically using mean, standard deviation and coefficient of variance.

Keywords: ceramic industrial waste, fresh concrete, hardened concrete, fine aggregate

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12 Impact of Mass Rape on HIV Incidence and Prevalence in Conflict Situations: Mathematical Analysis of the War in Tigray, Ethiopia

Authors: Abdelkadir Muzey Mohammed, Habtu Alemayehu Atsbaha, Yohannes Yirga Kefela, Woldegebriel Assefa Woldegerima, Kiros Tedla Gebrehiwot

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The circumstances of war and conflict have long been associated with concerns about heightening HIV infection due to the use of sexual violence and rape as a weapon of war and lack of health services access to the patients with HIV as well as sexual violence and rape victims. This paper examines the impact of war related mass rape on HIV incidence and prevalence in the war ravaged Tigray, Ethiopia. Risk equation model and uncertainty analyses with sampled ranges of parameters were employed using data from WHO, Ethiopian Public Health Institute and Ethiopian Central Statistical Agency was used. Our analysis indicated that the mass rape committed in Tigray could cause an increase of incidence and prevalence by a median of 63.01% and 1.14% respectively. The significant increase in HIV incidence and prevalence due to mass rape demands a special attention including region wide improved surveillance and tracing of rape survivors. Furthermore, HIV prevention and treatment strategies such as delivery of emergency health service, providing pre and post exposure treatments on the basis of human rights should priority of governmental and nongovernmental organizations in a conflict situation.

Keywords: conflict situation, mass rape, HIV, mathematical model, uncertainty analysis

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11 Urban Household Waste Disposal Modes and Their Determinants: Evidence from Bure Town, North-Western Ethiopia

Authors: Mastawal Melese, Yismaw Assefa

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This study aims to identify household-level determinants of solid waste disposal (SWD) practices in Bure Town, north-western Ethiopia. Using a cross-sectional design and a mixed-methods approach, data were collected from 238 randomly selected households through structured interviews, focus group discussions, and field observations. Descriptive analysis revealed that 14.7% of households used composting as a primary SWD method, 37.4% practiced open dumping, 25.6% used burning, and 22.3% resorted to burial. Multinomial logistic regression showed that factors such as monthly income, age, family size, length of residence, sex, home ownership, solid waste sorting procedures, and education significantly influenced the choice of disposal method. Households with lower education, income, home ownership, and shorter residence times were more likely to use improper disposal methods. Females were found to be more likely to engage in better waste disposal practices than males. These findings underscore the need for context-specific interventions in newly developing towns to enhance household-level SWM systems by addressing key socio-economic factors.

Keywords: multinomial logistic regression, solid waste management, solid waste disposal, urban household

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10 State of the Art and Future Perspectives of Virtual Reality, Augmented Reality, and Mixed Reality in Cardiovascular Care

Authors: Adisu Mengesha Assefa

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The field of cardiovascular care is being transformed by the incorporation of Virtual Reality (VR), Augmented Reality (AR), and Mixed Reality (MR), collectively known as Extended Reality (XR), into medical education, procedural planning, and patient care. This review examines the state-of-the-art applications of XR in cardiology, emphasizing its role in enhancing the precision of interventional procedures and understanding complex anatomical structures. XR technologies complement conventional imaging methods by enabling immersive three-dimensional interaction that facilitates both preoperative planning and intraoperative guidance. Despite these promising developments, challenges such as harmonizing data, integrating various imaging systems, and addressing the prevalence of cybersickness remain. Ethical considerations, including maintaining physician focus and ensuring patient safety, are crucial when implementing XR in clinical settings. This review summarizes the existing literature and highlights the need for more rigorous future studies to validate therapeutic benefits and ensure safe application. By examining both the potential and the challenges, this paper aims to delineate the current and future roles of XR in cardiovascular care, emphasizing the necessity for continued innovation and ethical oversight to improve patient outcomes.

Keywords: virtual reality, augmented reality, mixed reality, cardiovascular care, education, preprocedural planning, intraoperative guidance, postoperative patient rehabilitation

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9 Bayesian Semiparametric Geoadditive Modelling of Underweight Malnutrition of Children under 5 Years in Ethiopia

Authors: Endeshaw Assefa Derso, Maria Gabriella Campolo, Angela Alibrandi

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Objectives:Early childhood malnutrition can have long-term and irreversible effects on a child's health and development. This study uses the Bayesian method with spatial variation to investigate the flexible trends of metrical covariates and to identify communities at high risk of injury. Methods: Cross-sectional data on underweight are collected from the 2016 Ethiopian Demographic and Health Survey (EDHS). The Bayesian geo-additive model is performed. Appropriate prior distributions were provided for scall parameters in the models, and the inference is entirely Bayesian, using Monte Carlo Markov chain (MCMC) stimulation. Results: The results show that metrical covariates like child age, maternal body mass index (BMI), and maternal age affect a child's underweight non-linearly. Lower and higher maternal BMI seem to have a significant impact on the child’s high underweight. There was also a significant spatial heterogeneity, and based on IDW interpolation of predictive values, the western, central, and eastern parts of the country are hotspot areas. Conclusion: Socio-demographic and community- based programs development should be considered compressively in Ethiopian policy to combat childhood underweight malnutrition.

Keywords: bayesX, Ethiopia, malnutrition, MCMC, semi-parametric bayesian analysis, spatial distribution, P- splines

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8 Servant Leadership and Organizational Citizenship Behavior: The Mediating Role of Perceived Organizational Politics and the Moderating Role of Political Skill in Public Service Organizations

Authors: Debalkie Demissie Addisu, Ejigu Alemu Abebe, Tsegay Tensay Assefa

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This study examines the indirect effect of servant leadership on organizational citizenship behavior through perceptions of organizational politics moderated by political skill. This study reports the responses of 321 respondents from six federal public service organizations in Ethiopia. A multi-stage random sampling procedure was employed to select the sampled federal public service organizations. To test hypotheses, the study employed structural equation modeling using AMOS version-26 software. The result revealed that all direct effects have a significant effect. Specifically, servant leadership has a positive effect on organizational citizenship behavior. Likewise, servant leadership has a negative effect on perceptions of organizational politics. Also, a perception of organizational politics has a negative effect on organizational citizenship behavior. Moreover, perceptions of organizational politics competitively mediated the effect of servant leadership on organizational citizenship behavior. As well, political skill moderated the effect of perceptions of organizational politics on organizational citizenship behavior but not the indirect effect. To the best of our knowledge, no one else employs perceptions of organizational politics as a mediating effect between servant leadership and organizational citizenship behavior. Furthermore, we are not aware of anyone else employing political skill as a moderating role in the indirect effect of servant leadership on organizational citizenship behavior through perceptions of organizational politics.

Keywords: servant leadership, organizational citizenship behavior, perceptions of organizational politics, political skill, public service organization, Ethiopia

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7 Survey and Identification of Coinfecting Botryosphaeriales Causing Stem Canker Diseases of Eucalyptus camaldulensis in Ethiopia

Authors: Wendu Admasu, Assefa Sintayehu, Alemu Gezahgne, Zewdu Terefework

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Eucalyptus is the most widely planted forest tree species in the world. In Ethiopia, pathogenic fungi pose an increasing threat to Eucalyptus species. Due to limited research, there is insufficient information on the associated diseases and pathogens. This study investigated Eucalyptus diseases, the extent of their damage, and the causal fungal pathogens. A Eucalyptus disease survey was conducted in the Eucalyptus forestry areas of Ethiopia during the growth years 2019/20 and 2020/21. Disease assessment and sampling were carried out in eighteen plantations at nine locations. E. camaldulensis was the most dominant species planted in the surveyed areas. The field study shows a high incidence and severity of canker diseases. Diseased stem and branch samples were collected, cultured on malt extract agar media and studied. The results of morphological and ITS sequence analysis confirmed that the fungal species Neofusicoccum parvum, Lasiodiplodia theobromae, and Aplosporella hesperidica caused the observed canker symptoms. This is the first report of Lasiodiplodia theobromae and Aplosporella hesperidica causing diseases in Eucalyptus plants in Ethiopia. Changes in global climate and environmental factors, such as altitude, are believed to have a strong impact on the susceptibility of Eucalyptus plants to diseases. Strict quarantine practices and continuous monitoring of pathogenic and endophytic fungal species associated with Eucalyptus trees are issued to be prioritized to effectively control and manage the disease.

Keywords: Neofusicoccum, Lasiodiplodia, Aplosporella, pathogenicity, phylogeny, severity

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6 Wound Healing and Antioxidant Properties of 80% Methanol Leaf Extract of Verbascum sinaiticum (Scrophulariaceae), an Ethiopian Medicinal Plant

Authors: Solomon Assefa Huluka

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Wounds account for severe morbidity, socioeconomic distress, and mortality around the globe.For several years, various herbal products are used to expediteand augment the innate wound healing process. In Ethiopian folkloricmedicine, Verbascum sinaiticum L. (V. sinaiticum) is commonlyapplied as a wound-healing agent. The present study investigated the potential wound healing and antioxidant properties of hydroalcoholic leaf extract of V. sinaiticum. The 80% methanol extract, formulated as 5% (w/w) and 10% (w/w) ointments, was evaluated in excision and incision wound models using nitrofurazone and simple ointment as positive and negative controls, respectively. Parameters such as wound contraction, period of epithelialization, and tensile strength were determined. Moreover, its in vitro antioxidant property was evaluated using a DPPH assay. In the excision model, both doses (5% and 10% w/w) of the extract showed a significant (p<0.001) wound healing efficacy compared to the negative control, as evidenced by enhanced wound contraction rate and shorter epithelialization time records. In the incision model, the lower dose (5% w/w) ointment formulation of the extract exhibited the maximum increment in tensile strength (85.6%) that was significant (p<0.001)compared to negative and untreated controls. Animals treated with 5% w/wointment, furthermore, showed a significantly (p < 0.05) higher percentage of tensile strength than nitrofurazone treated ones. Moreover, the hydroalcoholic extract of the plant showed a noticeable free radical scavenging property. The result of the present study upholds the folkloric use of V. sinaiticum in the treatment of wounds.

Keywords: wound healing, antioxidant, excision wound model, incision wound model, verbascum sinaiticum

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5 Effect of Thermal Treatment on Phenolic Content, Antioxidant, and Alpha-Amylase Inhibition Activities of Moringa stenopetala Leaves

Authors: Daniel Assefa, Engeda Dessalegn, Chetan Chauhan

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Moringa stenopetala is a socioeconomic valued tree that is widely available and cultivated in the Southern part of Ethiopia. The leaves have been traditionally used as a food source with high nutritional and medicinal values. The present work was carried out to evaluate the effect of thermal treatment on the total phenolic content, antioxidant and alpha-amylase inhibition activities of aqueous leaf extracts during maceration and different decoction time interval (5, 10 and 15 min). The total phenolic content was determined by the Folin-ciocalteu methods whereas antioxidant activities were determined by 2,2-diphenyl-1-picryl-hydrazyl(DPPH) radical scavenging, reducing power and ferrous ion chelating assays and alpha-amylase inhibition activity was determined using 3,5-dinitrosalicylic acid method. Total phenolic content ranged from 34.35 to 39.47 mgGAE/g. Decoction for 10 min extract showed ferrous ion chelating (92.52), DPPH radical scavenging (91.52%), alpha-amylase inhibition (69.06%) and ferric reducing power (0.765), respectively. DPPH, reducing power and alpha-amylase inhibition activities showed positive linear correlation (R2=0.853, R2= 0.857 and R2=0.930), respectively with total phenolic content but ferrous ion chelating activity was found to be weakly correlated (R2=0.481). Based on the present investigation, it could be concluded that major loss of total phenolic content, antioxidant and alpha-amylase inhibition activities of the crude leaf extracts of Moringa stenopetala leaves were observed at decoction time for 15 min. Therefore, to maintain the total phenolic content, antioxidant, and alpha-amylase inhibition activities of leaves, cooking practice should be at the optimum decoction time (5-10 min).

Keywords: alpha-amylase inhibition, antioxidant, Moringa stenopetala, total phenolic content

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4 Non-Conformance Clearance through an Intensified Mentorship towards ISO 15189 Accreditation: The Case of Jimma and Hawassa Hospital Microbiology Laboratories, Ethiopia

Authors: Dawit Assefa, Kassaye Tekie, Gebrie Alebachew, Degefu Beyene, Bikila Alemu, Naji Mohammed, Asnakech Agegnehu, Seble Tsehay, Geremew Tasew

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Background: Implementation of a Laboratory Quality Management System (LQMS) is critical to ensure accurate, reliable, and efficient laboratory testing of antimicrobial resistance (AMR). However, limited LQMS implementation and progress toward accreditation in the AMR surveillance laboratory testing setting exist in Ethiopia. By addressing non-conformances (NCs) and working towards accreditation, microbiology laboratories can improve the quality of their services, increase staff competence, and contribute to mitigate the spread of AMR. Methods: Using standard ISO 15189 horizontal and vertical assessment checklists, certified assessors identified NCs at Hawassa and Jimma Hospital microbiology laboratories. The Ethiopian Public Health Institute AMR mentors and IDDS staff prioritized closing the NCs through the implementation of an intensified mentorship program that included ISO 15189 orientation training, resource allocation, and action plan development. Results: For the two facilities to clear their NCs, an intensified mentorship approach was adopted by providing ISO 15189 orientation training, provision of buffer reagents, controls, standards, and axillary equipment, and facilitating equipment maintenance and calibration. Method verification and competency assessment were also conducted along with the implementation of standard operating procedures and recommended corrective actions. This approach enhanced the laboratory's readiness for accreditation. After addressing their NCs, the two laboratories applied to Ethiopian Accreditation Services for ISO 15189 accreditation. Conclusions: Clearing NCs through the implementation of intensified mentorship was crucial in preparing the two laboratories for accreditation and improving quality laboratory test results. This approach can guide other microbiology laboratories’ accreditation attainment efforts.

Keywords: non-conformance clearance, intensified mentorship, accreditation, ISO 15189

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3 Public Preferences and Willingness to Pay for Social Health Insurance in Iran: A Discrete Choice Experiment

Authors: Mohammad Ranjbar, Mohammad Bazyar, Blake Angell, Thomas Lung, Yibeltal Assefa

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Background: Current health insurance programs in Iran suffer from low enrolment and are not sufficient to attain the country to universal health coverage (UHC). We hypothesize that improving the enrollment rate and moving towards a more sustainable UHC can be achieved by improving the benefits package and providing new incentives. The objective of this study is to assess public preferences and willingness to pay (WTP) for social health insurance (SHI) in Iran. Methods: A discrete choice experiment (DCE) was conducted in 2021, using a self-administered questionnaire on 500 participants to estimate WTP and determine individual preferences for the SHI in Yazd, Iran. Respondents were presented with an eight-choice set and asked to select their preferred one. In each choice set, scenarios were described by eight attributes with varying levels. The conditional logit regression model was used to analyze the participants' preferences. Willingness to pay for each attribute was also calculated. Results: Most included attributes were significant predictors of the choice of a health insurance package. The maximum coverage of hospitalization costs in the private sector, ancillary services such as glasses, canes, etc., as well as coverage for hospitalization costs in the public sector and drug costs, were the most important determining factors for this choice. Coverage of preventive dental care did not significantly influence respondent choices. Estimating WTP showed that individuals are willing to pay more for higher financial protection, particularly against private sector costs; the WTP to increase the coverage of hospitalization costs in the private sector from 50% to 90% is estimated at 362,068 IR, Rials per month. Conclusion: This study identifies the key factors that the population value with regard to health insurance and the tradeoffs they are willing to make between them. Hospitalization, drugs, and ancillary services were the most important determining factors for their choice. The data suggest that additional resources coming into the Iranian health system might best be prioritized to cover hospitalization and drug costs and those associated with ancillary services.

Keywords: social health insurance, preferences, discrete choice experiment, willingness to pay

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2 Risk Factors Associated with Dengue Fever Outbreak in Diredawa Administration City, Ethiopia, October 2015: A Case Control Study

Authors: Luna Degife, Desalegn Belay, Yoseph Worku, Tigist Tesfaye, Assefa Tufa, Abyot Bekele, Zegeye Hailemariam, Abay Hagos

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Half of the world’s population is at risk of Dengue Fever (DF), a highly under-recognized and underreported mosquito-borne viral disease with high prevalence in the tropical and subtropical regions. Globally, an estimated 50 to 200 million cases and 20, 000 DF deaths occur annually as per the world health organization report. In Ethiopia, the first outbreak occurred in 2013 in Diredawa administration city. Afterward, three outbreaks have been reported from the eastern part of the country. We received a report of the fifth DF outbreak for Ethiopia and the second for Diredawa city on October 4, 2015. We conducted the investigation to confirm the outbreak, identify the risk factors for the repeatedly occurrence of the disease and implement control measures. We conducted un- matched case-control study and defined a suspected DF case as any person with fever of 2-7 days and 2 or more of the following: a headache, arthralgia, myalgia, rash, or bleeding from any part of the body. Controls were residents of Diredawa city without DF symptoms. We interviewed 70 Cases and 140 controls from all health facilities in Diredawa city from October 7 to 15; 2015. Epi Info version 7.1.5.0 was used to analyze the data and multivariable logistic regression was conducted to assess risk factors for DF. Sixty-nine blood samples were collected for Laboratory confirmation.The mean age for cases was 23.7±9.5 standard deviation (SD) and for controls 31.2±13 SD. Close contact with DF patient (Adjusted odds ratio (AOR)=5.36, 95% confidence interval(CI): 2.75-10.44), nonuse of long-lasting insecticidal nets (AOR=2.74, 95% CI: 1.06-7.08) and availability of stagnant water in the village (AOR=3.61, 95% CI:1.31-9.93) were independent risk factors associated with higher rates of the disease. Forty-two samples were tested positive. Endemicity of DF is becoming a concern for Diredawa city after the first outbreak. Therefore, effective vector control activities need to be part of long-term preventive measures.

Keywords: dengue fever, Diredawa, outbreak, risk factors, second

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1 Comparing Quality of Care in Family Planning Services in Primary Public and Private Health Care Facilities in Ethiopia

Authors: Gizachew Assefa Tessema, Mohammad Afzal Mahmood, Judith Streak Gomersall, Caroline O. Laurence

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Introduction: Improving access to quality family planning services is the key to improving health of women and children. However, there is currently little evidence on the quality and scope of family planning services provided by private facilities, and this compares to the services provided in public facilities in Ethiopia. This is important, particularly in determining whether the government should further expand the roles of the private sector in the delivery of family planning facility. Methods: This study used the 2014 Ethiopian Services Provision Assessment Plus (ESPA+) survey dataset for comparing the structural aspects of quality of care in family planning services. The present analysis used a weighted sample of 1093 primary health care facilities (955 public and 138 private). This study employed logistic regression analysis to compare key structural variables between public and private facilities. While taking the structural variables as an outcome for comparison, the facility type (public vs private) were used as the key exposure of interest. Results: When comparing availability of basic amenities (infrastructure), public facilities were less likely to have functional cell phones (AOR=0.12; 95% CI: 0.07-0.21), and water supply (AOR=0.29; 95% CI: 0.15-0.58) than private facilities. However, public facilities were more likely to have staff available 24 hours in the facility (AOR=0.12; 95% CI: 0.07-0.21), providers having family planning related training in the past 24 months (AOR=4.4; 95% CI: 2.51, 7.64) and possessing guidelines/protocols (AOR= 3.1 95% CI: 1.87, 5.24) than private facilities. Moreover, comparing the availability of equipment, public facilities had higher odds of having pelvic model for IUD demonstration (AOR=2.60; 95% CI: 1.35, 5.01) and penile model for condom demonstration (AOR=2.51; 95% CI: 1.32, 4.78) than private facilities. Conclusion: The present study suggests that Ethiopian government needs to provide emphasis towards the private sector in terms of providing family planning guidelines and training on family planning services for their staff. It is also worthwhile for the public health facilities to allocate funding for improving the availability of basic amenities. Implications for policy and/ or practice: This study calls policy makers to design appropriate strategies in providing opportunities for training a health care providers working in private health facility.

Keywords: quality of care, family planning, public-private, Ethiopia

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