Dawit Siraw

Background: Malaria is a preventable and treatable mosquito-borne disease. Approximately 52 million people (68%) live in malaria risk areas in Ethiopia. Dembecha woreda annual report shows that malaria is responsible for 13,852 morbidities (10% of the community) (2012/13 EFY). Observation and rumors of not hanging nets at all, hanging nets in a wrong manner and place and not giving priority to children and pregnant mothers deserve close examination. Thus, this study tries to describe Insecticide Treated Bed Net ownership, utilization and factors affecting in Dembecha woreda, Amhara region, Ethiopia. Objective: The main objective of this study is to assess the ownership and factors affecting utilization of Insecticide Treated bed nets in Dembecha woreda, west gojjam zone, Ethiopia. Methodology:A Cross sectional study was used and interview was conducted using structured questionnaire to assess the ownership and factors affecting utilization of Insecticide Treated bed nets in Dembecha...

Background: The Urban Health Extension Program (UHEP) is an innovative Ethiopian government plan to ensure health service equity by creating demand for essential health services through the provision of appropriate health information at the household level. Even though the HEP was launched in Ethiopia in 2003 as the flagship program for the implementation of primary health care in the country, studies looking at its quality are limited. Adherence to set standards within a program is one of the parameters that indicate process quality. This paper, part of a larger survey to assess the quality of services provided by the UHEP in Ethiopia, looks at the degree of adherence to the service delivery process to the standards set nationally. Methodology: The study included an assessment of the degree of adherence of the urban health services delivery process to the national standards in selected urban health extension facilities within the catchment areas of sampled institutions. The assessm...

Background: The Urban Health Extension Program (UHEP) is an innovative Ethiopian government plan to ensure health service equity by creating demand for essential health services through the provision of appropriate health information at the household level. Even though the HEP was launched in Ethiopia in 2003 as the flagship program for the implementation of primary health care in the country, studies looking at its quality are limited. Adherence to set standards within a program is one of the parameters that indicate process quality. This paper, part of a larger survey to assess the quality of services provided by the UHEP in Ethiopia, looks at the degree of adherence to the service delivery process to the standards set nationally. Methodology: The study included an assessment of the degree of adherence of the urban health services delivery process to the national standards in selected urban health extension facilities within the catchment areas of sampled institutions. The assessm...

Background: The Urban Health Extension Program (UHEP) – an innovative Ethiopian government plan to ensure health service equity by creating demand for essential health services through the provision of appropriate health information at a household level – is one of the three approaches of the national Health Extension Program (HEP). As health extension workers (HEWs) are the backbone of the program, the present study was designed to assess their expectations and satisfaction regarding their service delivery environment. Methodology: The study for this assessment involved in-depth interviews that included urban health extension professionals (UHE-ps), supervisors of UHE-ps, as well as village health committee members and health service managers and supervising health workers in 76 selected urban health extension facilities within the five major regions (Amhara; Harari; Oromia; Southern Nations, Nationalities, and Peoples’ (SNNP); and Tigray), as well as the two city administrations o...

Background: The Urban Health Extension Program (UHEP) – an innovative Ethiopian government plan to ensure health service equity by creating demand for essential health services through the provision of appropriate health information at the household level – is one of the three approaches of the national Health Extension Program (HEP). There are very few studies on the quality of health care provided by the UHEP in Ethiopia. This study is part of a comprehensive survey designed to assess the quality of health service delivered by the UHEP, and looks at the pattern of utilization, expectations, and satisfaction of the community in relation to services provided within the UHEP. Methodology: The study covered sampled households for a community-based cross-sectional survey using structured questionnaires among 589 households within five major regions (Amhara; Harari; Oromia; Southern Nations, Nationalities, and Peoples’ (SNNP); and Tigray), as well as the two city administrations of Addi...

Background: The Urban Health Extension Program (UHEP) – an innovative Ethiopian government plan to ensure health service equity by creating demand for essential health services through the provision of appropriate health information at a household level – is one of the three approaches of the national Health Extension Program (HEP).The UHEP is organized to deliver services within 16 packages. This study is aimed at assessing the preparedness of the program to provide priority health services identified in its packages. Methodology: The study covered sampled urban health extension facilities within five study regions, and included 26 facility assessments, and 330 urban health extension professionals’ (UHE-ps’) assessments. Results: According to the findings of the facility assessment, most items within the UHEP packages are available, even though very few facilities were found to stock delivery kits, dressing materials, and oxytocin. Adrenaline was also observed to be found in only a...

Background: Real-time monitoring of fine particulate matter (PM2.5) concentrations and assessing the health impact are limited in Ethiopia. The objective of this study is to describe current levels of PM2.5 air pollution in Addis Ababa and examine temporal patterns and to consider the health impact of current PM2.5 exposure levels. Methods: PM2.5 concentrations were measured using a centrally-located Beta Attenuator Monitor (BAM-1022) for 3 years (1 April 2017 to 31 March 2020), with data downloaded biweekly. Deaths attributable to current PM2.5 concentration levels were estimated using the AirQ+ tool. The daily average was estimated using hourly data. Results: The daily mean (SD) PM2.5 concentration was 42.4 µg/m3 (15.98). Two daily extremes were observed: morning (high) and afternoon (low). Sundays had the lowest PM2.5 concentration, while Mondays to Thursdays saw a continuous increase; Fridays showed the highest concentration. Seasons showed marked variation, with the highest values during the wet season. Concentration spikes reflected periods of intensive fuel combustion. A total of 502 deaths (4.44%) were attributable to current air pollution levels referenced to the 35 µg/m3 WHO interim target annual level and 2,043 (17.7%) at the WHO 10 µg/m3 annual guideline. Conclusion: PM2.5 daily levels were 1.7 times higher than the WHO-recommended 24-hour guideline. The current annual mean PM2.5 concentration results in a substantial burden of attributable deaths compared to an annual mean of 10 µg/m3. The high PM2.5 level and its variability across days and seasons calls for citywide interventions to promote clean air.

Background: At present there is remarkable expansion of urbanization in Ethiopia. By 2050, 38% of the population in Ethiopia is expected to reside in urban settings. The majority of this future urban population is believed to live in slums. In response to this daunting health challenge, the Ministry of Health launched urban health extension program in 2009. The outcome of this initiative, however, is still uncertain - Urban Health Extension Professionals seem to have failed to meet the desired end. To improve the situation, experiences were drawn from middle-income countries and piloted in Addis Ababa in 2014. This is a report of the study conducted to assess the implementation of the pilot initiatives. In the assessment of the implementation, attempts were also made to identify lessons and challenges encountered. Methods: Qualitative data were collected from purposively selected individuals involved in the design, implementation, and use of the pilot initiative. Checklists develope...