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The aim of this essay is to examine how the foreign relationships of Ethiopia has developed as a result of the construction and filling of the Grand Ethiopian Renaissance Dam between 2011 and 2021. This essay therefore asks: How has Ethiopia’s foreign relations with the EU, Egypt, Sudan and China changed, have those relationships become more conflictual or cooperative, and how could potential changes be explained using a constructivist perspective? Constructivism is used as a means of explaining changes in the statements, positions and policies of these countries through concepts such as “norms” and “identities”. It additionally utilizes concepts from other studies such as “Hydro-hegemony”, “Benefit Sharing” and “Ethiopian renaissance”. It uses the BAR-scale from Wolf et al. (2003) to determine the different stages of Ethiopia’s relationships. The study concludes that Ethiopia’s relationship with the EU and China have progressed positively as a result of the GERD, and they have now started considering Ethiopia a more equitable partner for further cooperation. The relationship with Egypt and Sudan initially improved, with new Ethiopian norms of cooperation and equitable utilization becoming mainstay. However, Ethiopia’s unilateral action during recent events broke these norms, and has turned the relations conflictual once again.

The aim of this essay is to examine how the foreign relationships of Ethiopia has developed as a result of the construction and filling of the Grand Ethiopian Renaissance Dam between 2011 and 2021. This essay therefore asks: How has Ethiopia’s foreign relations with the EU, Egypt, Sudan and China changed, have those relationships become more conflictual or cooperative, and how could potential changes be explained using a constructivist perspective? Constructivism is used as a means of explaining changes in the statements, positions and policies of these countries through concepts such as “norms” and “identities”. It additionally utilizes concepts from other studies such as “Hydro-hegemony”, “Benefit Sharing” and “Ethiopian renaissance”. It uses the BAR-scale from Wolf et al. (2003) to determine the different stages of Ethiopia’s relationships. The study concludes that Ethiopia’s relationship with the EU and China have progressed positively as a result of the GERD, and they have now started considering Ethiopia a more equitable partner for further cooperation. The relationship with Egypt and Sudan initially improved, with new Ethiopian norms of cooperation and equitable utilization becoming mainstay. However, Ethiopia’s unilateral action during recent events broke these norms, and has turned the relations conflictual once again.

Background: Optimal infant and young child feeding practices are essential for normal growth, better health, and mental and physical development. Even though there are a lot of nutrition intervention programs in Ethiopia, still suboptimal feeding practices are prevalent. This study was devised to assess a level of minimum acceptable diet (MAD) and predictors among children aged 6-23 months in Mareka District, south Ethiopia. Method: A community-based cross-sectional study was employed on 662 study participants from August 15 to September 15/ 2015. They were selected by a multi-stage sampling technique. Data were collected by interviewer-administered semi-structured questionnaires. Statistical significance was declared at p-value <0.05 at multivariable logistic regression. Result: The study showed that 35.5 % of the children aged 6-23 months met the recommended MAD. Maternal primary and secondary education (AOR: 1.90; 95% CI: 1.15-3.16 and AOR: 2.06, 95% CI: 1.12-3.77), Media exposure (AOR: 2.16; 95% CI: 1.46-3.29), health facility delivery (AOR:2.52; 95% CI: 1.54-4.13), child age of 9-11 and 12-23 months (AOR:2.73; 95% CI: 1.41-5.49 and AOR:2.55; 95% CI: 1.39-4.69) and GMP service utilization (AOR: 4.09; 95% CI: 2.51-6.65) were associated with MAD of children. Conclusion: The level of MAD among children was low. Maternal educational status, media exposure, institutional delivery, child age, and GMP service utilization were associated with MAD. Increasing utilization of GMP service, health facility delivery, maternal education, and media promotion was recommended to increase the level of MAD.

Knowledge of family planning has increased to 87% among currently married women. However, it is uses still lagging as, about 22% of young married women and 26% of sexually active unmarried women in this country are reported having an unmet need for family planning. Ethiopia is one of the highest unmet need for family planning according to EDHS-2016 but the level and factors that determine unmet need for FP are not well understood. This study assess the magnitude and factors associated with unmet need for family planning among married women of urban and rural communities in Jigjiga city administration. A community based cross-sectional study design was used, with 375 households. Sampling frame was used listing all households in the selected kebeles (smallest administration units) in which married women resided. A structured questionnaire adopted from literature was used. Data was checked, edited, coded and entered into EPIDATA version 3.1 and transported to SPSS version 23 for analysis. Bivariate and multivariate logistic regression was carried out to see any associations between outcome and explanatory variables and P-Value of 0.05 was considered significant. This study revealed that 22.6 % of married women had unmet need for family planning out of which, 68(21.5%) was for spacing and 4(1.1%) for limiting.In this study, unavailability of health facility that provide family planning services was 2.3 (AOR=2.31, 95%CI: 1.087, 4.912 1.042, 4.3) times more likely to have unmet need for FP than those who had. Women who desire to have more than or equal to ten children were 3.7 (AOR=3.7, 95%CI:1.427, 9.822) times more likely to have unmet need for FP than those who desired to have less than ten children and FP practice (non-user and ever-users) were 8 [(AOR=8.8, 95%CI: 1.327, 58.61) and (AOR=8.5, 95%CI: 1.552, 46.04)] times more likely to have unmet need for Family planning than those of current users. It also concluded that the overall prevalence of unmet need for FP amon

Background: despite the documented evidence on the vital role of breastfeeding on the health and development of infants, the exclusive breastfeeding practice for the first six months of life is lower than the international recommendation of exclusive breast feeding practice in the world, in Africa and particularly in Ethiopia. This study is aimed to assess the determinants of exclusive breast feeding practice among mothers of infant aged under 6 months, Jigjiga town, Eastern, Ethiopia. Methods: A facility based cross-sectional study design was used to select 592 mothers with infant under 6 months in Jigjiga town. Data was collected by using interview Structured questioner. Bivariate and Multivariable logistic regression was used to check the associations and for controlling confounding. Result: Prevalence of exclusive breastfeeding was 54.91 %( 95% CI; 50.79-58.90). Exclusive breastfeeding were more likely practiced by mothers who had infants age 0-1 [AOR= 7.29 (1.05, 10.24)], mothers who visited facilities for ANC 4 times and above [AOR=10.29 (1.41 20.12)] and mothers who received PNC [AOR=4.14(1.34, 9.48)]. Conclusions and recommendations: The magnitude of Exclusive breastfeeding in the study area was low. Age of the infants, number of Antenatal care and postnatal care were found to be determinant factors for the continuation of exclusive breastfeeding.

Knowledge of family planning has increased to 87% among currently married women. However, it is uses still lagging as, about 22% of young married women and 26% of sexually active unmarried women in this country are reported having an unmet need for family planning. Ethiopia is one of the highest unmet need for family planning according to EDHS-2016 but the level and factors that determine unmet need for FP are not well understood. This study assess the magnitude and factors associated with unmet need for family planning among married women of urban and rural communities in Jigjiga city administration. A community based cross-sectional study design was used, with 375 households. Sampling frame was used listing all households in the selected kebeles (smallest administration units) in which married women resided. A structured questionnaire adopted from literature was used. Data was checked, edited, coded and entered into EPIDATA version 3.1 and transported to SPSS version 23 for analysis. Bivariate and multivariate logistic regression was carried out to see any associations between outcome and explanatory variables and P-Value of 0.05 was considered significant. This study revealed that 22.6 % of married women had unmet need for family planning out of which, 68(21.5%) was for spacing and 4(1.1%) for limiting.In this study, unavailability of health facility that provide family planning services was 2.3 (AOR=2.31, 95%CI: 1.087, 4.912 1.042, 4.3) times more likely to have unmet need for FP than those who had. Women who desire to have more than or equal to ten children were 3.7 (AOR=3.7, 95%CI:1.427, 9.822) times more likely to have unmet need for FP than those who desired to have less than ten children and FP practice (non-user and ever-users) were 8 [(AOR=8.8, 95%CI: 1.327, 58.61) and (AOR=8.5, 95%CI: 1.552, 46.04)] times more likely to have unmet need for Family planning than those of current users. It also concluded that the overall prevalence of unmet need for FP amon

Background: despite the documented evidence on the vital role of breastfeeding on the health and development of infants, the exclusive breastfeeding practice for the first six months of life is lower than the international recommendation of exclusive breast feeding practice in the world, in Africa and particularly in Ethiopia. This study is aimed to assess the determinants of exclusive breast feeding practice among mothers of infant aged under 6 months, Jigjiga town, Eastern, Ethiopia. Methods: A facility based cross-sectional study design was used to select 592 mothers with infant under 6 months in Jigjiga town. Data was collected by using interview Structured questioner. Bivariate and Multivariable logistic regression was used to check the associations and for controlling confounding. Result: Prevalence of exclusive breastfeeding was 54.91 %( 95% CI; 50.79-58.90). Exclusive breastfeeding were more likely practiced by mothers who had infants age 0-1 [AOR= 7.29 (1.05, 10.24)], mothers who visited facilities for ANC 4 times and above [AOR=10.29 (1.41 20.12)] and mothers who received PNC [AOR=4.14(1.34, 9.48)]. Conclusions and recommendations: The magnitude of Exclusive breastfeeding in the study area was low. Age of the infants, number of Antenatal care and postnatal care were found to be determinant factors for the continuation of exclusive breastfeeding.

Background: despite the documented evidence on the vital role of breastfeeding on the health and development of infants, the exclusive breastfeeding practice for the first six months of life is lower than the international recommendation of exclusive breast feeding practice in the world, in Africa and particularly in Ethiopia. This study is aimed to assess the determinants of exclusive breast feeding practice among mothers of infant aged under 6 months, Jigjiga town, Eastern, Ethiopia. Methods: A facility based cross-sectional study design was used to select 592 mothers with infant under 6 months in Jigjiga town. Data was collected by using interview Structured questioner. Bivariate and Multivariable logistic regression was used to check the associations and for controlling confounding. Result: Prevalence of exclusive breastfeeding was 54.91 %( 95% CI; 50.79-58.90). Exclusive breastfeeding were more likely practiced by mothers who had infants age 0-1 [AOR= 7.29 (1.05, 10.24)], mothers who visited facilities for ANC 4 times and above [AOR=10.29 (1.41 20.12)] and mothers who received PNC [AOR=4.14(1.34, 9.48)]. Conclusions and recommendations: The magnitude of Exclusive breastfeeding in the study area was low. Age of the infants, number of Antenatal care and postnatal care were found to be determinant factors for the continuation of exclusive breastfeeding.

Knowledge of family planning has increased to 87% among currently married women. However, it is uses still lagging as, about 22% of young married women and 26% of sexually active unmarried women in this country are reported having an unmet need for family planning. Ethiopia is one of the highest unmet need for family planning according to EDHS-2016 but the level and factors that determine unmet need for FP are not well understood. This study assess the magnitude and factors associated with unmet need for family planning among married women of urban and rural communities in Jigjiga city administration. A community based cross-sectional study design was used, with 375 households. Sampling frame was used listing all households in the selected kebeles (smallest administration units) in which married women resided. A structured questionnaire adopted from literature was used. Data was checked, edited, coded and entered into EPIDATA version 3.1 and transported to SPSS version 23 for analysis. Bivariate and multivariate logistic regression was carried out to see any associations between outcome and explanatory variables and P-Value of 0.05 was considered significant. This study revealed that 22.6 % of married women had unmet need for family planning out of which, 68(21.5%) was for spacing and 4(1.1%) for limiting.In this study, unavailability of health facility that provide family planning services was 2.3 (AOR=2.31, 95%CI: 1.087, 4.912 1.042, 4.3) times more likely to have unmet need for FP than those who had. Women who desire to have more than or equal to ten children were 3.7 (AOR=3.7, 95%CI:1.427, 9.822) times more likely to have unmet need for FP than those who desired to have less than ten children and FP practice (non-user and ever-users) were 8 [(AOR=8.8, 95%CI: 1.327, 58.61) and (AOR=8.5, 95%CI: 1.552, 46.04)] times more likely to have unmet need for Family planning than those of current users. It also concluded that the overall prevalence of unmet need for FP amon

Competition in the economy can create a positive prospect for economic growth and development of a country. Competition in Ethiopian financial sector in general and insurance industry in particular should be strong enough for enhancement of efficiency, provision of better service to customers, greater innovation and lower prices thus resulting in improvement of consumers welfare and overall economic growth of the country.This research is developed to conduct a study to empirically assess the efficiency of the insurance companies in the Ethiopian insurance industry. Data Envelopment Analysis (DEA) approaches was used to measure the efficiencies of the insurance companies. The proposed study attempted to address (focus) on what is the efficiency of the insurance companies in Ethiopia? What factors affect their efficiency? In what mechanism the insurance companies in Ethiopia could improve or enhance their efficiency? These and other related issues have not been largely answered and not empirically supported in the Ethiopian context. In general the study seeks to find the determinants of the insurance companies’ ‘performance/efficiency’. In order to achieve this objective, the study used Panel data covering ten years period from 2006– 2015. The proposed study attempted to provide its contributions to the literature, policy, managerial and methodological implications. Based on the result Ethiopian insurance corporation and Nyala insurance company were relatively efficient taking first and second rank respectively. It was found that company size and number of branches were significantly affecting efficiency score at 95% confidence.

Background: Neonatal morbidity and mortality remains a major health problem, and contributes largely to under-five mortality, especially in developing countries. Hence, identifying the reasons for neonatal admission and outcomes in a hospital setting is important to improve the quality of existing practices in the hospital.Objective: The aim of this study was to assess the pattern of admission and outcomes of neonates admitted to Adama Hospital Medical College, Neonatal Intensive Care Unit (NICU). Method: Institution based cross sectional study design was conducted. A total of 384 selected neonates who were admitted to Adama Hospital Medical College, Neonatal Intensive Care Unit (NICU) from 11/09/2015 to 10/09/2016 were included in this study. The data was collected using data collection check list. By using SPSS version 20, simple frequency and bivariate logistic regression used to summarize socio-demographic and other variables. 95% CI and P value less than 0.05 were considered statistically significant. Results: A total of 1550 neonates were admitted to NICU from 11/09/2015 to 10/09/2016, of those 384 were selected.The most common cause of admission diagnosis at NICU was sepsis 78.4% (301), followed by prematurity 14.1% (54) and respiratory distress 8.3% (32).Out of 384 selected neonates, 91.9% (353) improved and discharged, 4.9% (19) died, 1.8% (7) referred and 1.3% (5) left against medical advice. Among selected neonates deaths were high with the diagnosis of sepsis 52.6% (10) and respiratory distress 26.3% (5).Conclusion: This study shows that sepsis, prematurity and respiratory distress were the most common cause of neonatal admission; and also neonatal jaundice, perinatal asphyxia and meconium aspiration syndrome contribute less. From admitted neonates 91.9% were improved and discharged and 4.9% were died, among this fatality was highest for sepsis.

Self-employment and Entrepreneurship are considered as being major means for development, employment and wealth creation and, therefore, gaining an increasing attention from governments and policy makers. However, very little is known about what factors determine self-employment decisions of individuals in the study area. Therefore, the main objective of this study is to investigate the various determinants of self-employment decision using the survey data collected from a total of 242 randomly selected respondents (147 self employed and 95 paid employed) from four towns of West Shoa Zone, Oromia Region, Ethiopia. The study employed Logistic Regression technique to estimate the determinants of self-employment. The study came with the finding that age of the respondents, educational attainment, household size, having self employed parent, inheritance, and access to credit variables have significant and positive influences on the decision to participate in self employment. On the other hand, age squared of the respondents and access to paid employment affects self employment status negatively and significantly. Based on the results and discussions, study suggests that government organization and other development practitioners who are concerned with unemployment reduction and poverty alleviation through the promotion of self employment need to take these determining factors in to account to achieve better outcome and enhance the self employment and entrepreneurship activities in the study area and in the country in general.

Competition in the economy can create a positive prospect for economic growth and development of a country. Competition in Ethiopian financial sector in general and insurance industry in particular should be strong enough for enhancement of efficiency, provision of better service to customers, greater innovation and lower prices thus resulting in improvement of consumers welfare and overall economic growth of the country.This research is developed to conduct a study to empirically assess the efficiency of the insurance companies in the Ethiopian insurance industry. Data Envelopment Analysis (DEA) approaches was used to measure the efficiencies of the insurance companies. The proposed study attempted to address (focus) on what is the efficiency of the insurance companies in Ethiopia? What factors affect their efficiency? In what mechanism the insurance companies in Ethiopia could improve or enhance their efficiency? These and other related issues have not been largely answered and not empirically supported in the Ethiopian context. In general the study seeks to find the determinants of the insurance companies’ ‘performance/efficiency’. In order to achieve this objective, the study used Panel data covering ten years period from 2006– 2015. The proposed study attempted to provide its contributions to the literature, policy, managerial and methodological implications. Based on the result Ethiopian insurance corporation and Nyala insurance company were relatively efficient taking first and second rank respectively. It was found that company size and number of branches were significantly affecting efficiency score at 95% confidence.

Competition in the economy can create a positive prospect for economic growth and development of a country. Competition in Ethiopian financial sector in general and insurance industry in particular should be strong enough for enhancement of efficiency, provision of better service to customers, greater innovation and lower prices thus resulting in improvement of consumers welfare and overall economic growth of the country.This research is developed to conduct a study to empirically assess the efficiency of the insurance companies in the Ethiopian insurance industry. Data Envelopment Analysis (DEA) approaches was used to measure the efficiencies of the insurance companies. The proposed study attempted to address (focus) on what is the efficiency of the insurance companies in Ethiopia? What factors affect their efficiency? In what mechanism the insurance companies in Ethiopia could improve or enhance their efficiency? These and other related issues have not been largely answered and not empirically supported in the Ethiopian context. In general the study seeks to find the determinants of the insurance companies’ ‘performance/efficiency’. In order to achieve this objective, the study used Panel data covering ten years period from 2006– 2015. The proposed study attempted to provide its contributions to the literature, policy, managerial and methodological implications. Based on the result Ethiopian insurance corporation and Nyala insurance company were relatively efficient taking first and second rank respectively. It was found that company size and number of branches were significantly affecting efficiency score at 95% confidence.

Self-employment and Entrepreneurship are considered as being major means for development, employment and wealth creation and, therefore, gaining an increasing attention from governments and policy makers. However, very little is known about what factors determine self-employment decisions of individuals in the study area. Therefore, the main objective of this study is to investigate the various determinants of self-employment decision using the survey data collected from a total of 242 randomly selected respondents (147 self employed and 95 paid employed) from four towns of West Shoa Zone, Oromia Region, Ethiopia. The study employed Logistic Regression technique to estimate the determinants of self-employment. The study came with the finding that age of the respondents, educational attainment, household size, having self employed parent, inheritance, and access to credit variables have significant and positive influences on the decision to participate in self employment. On the other hand, age squared of the respondents and access to paid employment affects self employment status negatively and significantly. Based on the results and discussions, study suggests that government organization and other development practitioners who are concerned with unemployment reduction and poverty alleviation through the promotion of self employment need to take these determining factors in to account to achieve better outcome and enhance the self employment and entrepreneurship activities in the study area and in the country in general.

Background: Neonatal morbidity and mortality remains a major health problem, and contributes largely to under-five mortality, especially in developing countries. Hence, identifying the reasons for neonatal admission and outcomes in a hospital setting is important to improve the quality of existing practices in the hospital.Objective: The aim of this study was to assess the pattern of admission and outcomes of neonates admitted to Adama Hospital Medical College, Neonatal Intensive Care Unit (NICU). Method: Institution based cross sectional study design was conducted. A total of 384 selected neonates who were admitted to Adama Hospital Medical College, Neonatal Intensive Care Unit (NICU) from 11/09/2015 to 10/09/2016 were included in this study. The data was collected using data collection check list. By using SPSS version 20, simple frequency and bivariate logistic regression used to summarize socio-demographic and other variables. 95% CI and P value less than 0.05 were considered statistically significant. Results: A total of 1550 neonates were admitted to NICU from 11/09/2015 to 10/09/2016, of those 384 were selected.The most common cause of admission diagnosis at NICU was sepsis 78.4% (301), followed by prematurity 14.1% (54) and respiratory distress 8.3% (32).Out of 384 selected neonates, 91.9% (353) improved and discharged, 4.9% (19) died, 1.8% (7) referred and 1.3% (5) left against medical advice. Among selected neonates deaths were high with the diagnosis of sepsis 52.6% (10) and respiratory distress 26.3% (5).Conclusion: This study shows that sepsis, prematurity and respiratory distress were the most common cause of neonatal admission; and also neonatal jaundice, perinatal asphyxia and meconium aspiration syndrome contribute less. From admitted neonates 91.9% were improved and discharged and 4.9% were died, among this fatality was highest for sepsis.

Background: Neonatal morbidity and mortality remains a major health problem, and contributes largely to under-five mortality, especially in developing countries. Hence, identifying the reasons for neonatal admission and outcomes in a hospital setting is important to improve the quality of existing practices in the hospital.Objective: The aim of this study was to assess the pattern of admission and outcomes of neonates admitted to Adama Hospital Medical College, Neonatal Intensive Care Unit (NICU). Method: Institution based cross sectional study design was conducted. A total of 384 selected neonates who were admitted to Adama Hospital Medical College, Neonatal Intensive Care Unit (NICU) from 11/09/2015 to 10/09/2016 were included in this study. The data was collected using data collection check list. By using SPSS version 20, simple frequency and bivariate logistic regression used to summarize socio-demographic and other variables. 95% CI and P value less than 0.05 were considered statistically significant. Results: A total of 1550 neonates were admitted to NICU from 11/09/2015 to 10/09/2016, of those 384 were selected.The most common cause of admission diagnosis at NICU was sepsis 78.4% (301), followed by prematurity 14.1% (54) and respiratory distress 8.3% (32).Out of 384 selected neonates, 91.9% (353) improved and discharged, 4.9% (19) died, 1.8% (7) referred and 1.3% (5) left against medical advice. Among selected neonates deaths were high with the diagnosis of sepsis 52.6% (10) and respiratory distress 26.3% (5).Conclusion: This study shows that sepsis, prematurity and respiratory distress were the most common cause of neonatal admission; and also neonatal jaundice, perinatal asphyxia and meconium aspiration syndrome contribute less. From admitted neonates 91.9% were improved and discharged and 4.9% were died, among this fatality was highest for sepsis.

Self-employment and Entrepreneurship are considered as being major means for development, employment and wealth creation and, therefore, gaining an increasing attention from governments and policy makers. However, very little is known about what factors determine self-employment decisions of individuals in the study area. Therefore, the main objective of this study is to investigate the various determinants of self-employment decision using the survey data collected from a total of 242 randomly selected respondents (147 self employed and 95 paid employed) from four towns of West Shoa Zone, Oromia Region, Ethiopia. The study employed Logistic Regression technique to estimate the determinants of self-employment. The study came with the finding that age of the respondents, educational attainment, household size, having self employed parent, inheritance, and access to credit variables have significant and positive influences on the decision to participate in self employment. On the other hand, age squared of the respondents and access to paid employment affects self employment status negatively and significantly. Based on the results and discussions, study suggests that government organization and other development practitioners who are concerned with unemployment reduction and poverty alleviation through the promotion of self employment need to take these determining factors in to account to achieve better outcome and enhance the self employment and entrepreneurship activities in the study area and in the country in general.

Competition in the economy can create a positive prospect for economic growth and development of a country. Competition in Ethiopian financial sector in general and insurance industry in particular should be strong enough for enhancement of efficiency, provision of better service to customers, greater innovation and lower prices thus resulting in improvement of consumers welfare and overall economic growth of the country.This research is developed to conduct a study to empirically assess the efficiency of the insurance companies in the Ethiopian insurance industry. Data Envelopment Analysis (DEA) approaches was used to measure the efficiencies of the insurance companies. The proposed study attempted to address (focus) on what is the efficiency of the insurance companies in Ethiopia? What factors affect their efficiency? In what mechanism the insurance companies in Ethiopia could improve or enhance their efficiency? These and other related issues have not been largely answered and not empirically supported in the Ethiopian context. In general the study seeks to find the determinants of the insurance companies’ ‘performance/efficiency’. In order to achieve this objective, the study used Panel data covering ten years period from 2006– 2015. The proposed study attempted to provide its contributions to the literature, policy, managerial and methodological implications. Based on the result Ethiopian insurance corporation and Nyala insurance company were relatively efficient taking first and second rank respectively. It was found that company size and number of branches were significantly affecting efficiency score at 95% confidence.

Introduction: In spite of concerted efforts by governmental and non-governmental organizations, water and adequate sanitation are still remained a challenge worldwide. Therefore, this study assessed the availability and utilization of sanitation facilities in Enderta district of Tigray, Ethiopia.Methods: A cross-sectional study was conducted in May 2016. An interview and observation were conducted in a total of 450 households. An interviewer administered questionnaire and observation checklist were used to collect the data. Multivariable logistic regression was done to identify the predictors of availability and utilization of latrine, hand washing, and drinking water.Results: Out of 450 households, only 68.4% had latrine of which only 21.4% had hand washing facility near the toilet. Likewise, only 9.3% washed their hand after toilet. However, all households had access to improved water source. The proper utilization was low in which 53%, 42.4% and 36.2% of households utilize latrine, hand washing, and water properly, respectively. The family size and getting sanitation information from health care providers, health extension workers, and health development army had a positive effect on availability and utilization.Conclusion: Though Community-Led total sanitation and hygiene approach has been implemented in the study area, the availability and proper utilization of latrine, and hand washing are still low. And, only a few were used drinking water properly. The education or information on hygienic practices found to affect the availability and utilization of the sanitation facilities positively. Therefore, strengthening the health extension workers and health development army to provide sustainable education and health information is needed.

Introduction: In spite of concerted efforts by governmental and non-governmental organizations, water and adequate sanitation are still remained a challenge worldwide. Therefore, this study assessed the availability and utilization of sanitation facilities in Enderta district of Tigray, Ethiopia.Methods: A cross-sectional study was conducted in May 2016. An interview and observation were conducted in a total of 450 households. An interviewer administered questionnaire and observation checklist were used to collect the data. Multivariable logistic regression was done to identify the predictors of availability and utilization of latrine, hand washing, and drinking water.Results: Out of 450 households, only 68.4% had latrine of which only 21.4% had hand washing facility near the toilet. Likewise, only 9.3% washed their hand after toilet. However, all households had access to improved water source. The proper utilization was low in which 53%, 42.4% and 36.2% of households utilize latrine, hand washing, and water properly, respectively. The family size and getting sanitation information from health care providers, health extension workers, and health development army had a positive effect on availability and utilization.Conclusion: Though Community-Led total sanitation and hygiene approach has been implemented in the study area, the availability and proper utilization of latrine, and hand washing are still low. And, only a few were used drinking water properly. The education or information on hygienic practices found to affect the availability and utilization of the sanitation facilities positively. Therefore, strengthening the health extension workers and health development army to provide sustainable education and health information is needed.

Competition in the economy can create a positive prospect for economic growth and development of a country. Competition in Ethiopian financial sector in general and insurance industry in particular should be strong enough for enhancement of efficiency, provision of better service to customers, greater innovation and lower prices thus resulting in improvement of consumers welfare and overall economic growth of the country.This research is developed to conduct a study to empirically assess the efficiency of the insurance companies in the Ethiopian insurance industry. Data Envelopment Analysis (DEA) approaches was used to measure the efficiencies of the insurance companies. The proposed study attempted to address (focus) on what is the efficiency of the insurance companies in Ethiopia? What factors affect their efficiency? In what mechanism the insurance companies in Ethiopia could improve or enhance their efficiency? These and other related issues have not been largely answered and not empirically supported in the Ethiopian context. In general the study seeks to find the determinants of the insurance companies’ ‘performance/efficiency’. In order to achieve this objective, the study used Panel data covering ten years period from 2006– 2015. The proposed study attempted to provide its contributions to the literature, policy, managerial and methodological implications. Based on the result Ethiopian insurance corporation and Nyala insurance company were relatively efficient taking first and second rank respectively. It was found that company size and number of branches were significantly affecting efficiency score at 95% confidence.

The utilization of skilled delivery care services has been stressed due to its effectiveness in reducing maternal & infant mortality. Taking in to account the national and regional interest in improving the utilization of skilled delivery care, determining the factors affecting the use of skilled delivery care is an important step. Several studies have looked at different factors contributing to women’s behavior to seek for skilled delivery care services. Nonetheless, no studies were conducted to assess the regional variation. This study aims to assess differences among regions of Ethiopia in the utilization of skilled delivery care services. In this study, information on the last birth recorded in the last five years preceding of EDHS, 2011 were taken from ever-married women aged 15-49. Univariate, bivariate and multivariate logistic regression analyses were adapted to assess the regional differences in utilizations of skilled delivery care.The results shows that 6,756 ever-married women were included in this study. The mean age of women who were participated in this study was 29.2 years, and their average parity was 4 children per woman. Statistically significant differences were observed in utilizations of skilled delivery care services across regions. The results showed that the effects of socio-demographic factors in utilization of skilled delivery care services differ across regions. Moreover, utilization of ANC has statistically significant contribution in the utilization of skilled delivery care services in all regions except in Tigray and Dire dawa regions. Unequally distributed utilization of skilled deliver care services across regions was observed.It was identified that each region has different socio-demographic factors that influence the use of skilled delivery care. Though the determinants are the same in some regions; the strength of their effect may differ. Utilization of ANC is the most significant predictor which influences the use of skilled

The use of literary works for diverse practical purposes is a long established tradition. It can be traced back to the days of our earliest ancestors who had been using different genres of oral literature to entertain, enlighten or instill moral lesson in small children. These days, in addition to the traditional entertainment and instruction functions, different forms of written literature are serving diverse purposes. Historical fictions, for example, are tracing the past and helping us to be proud of our prestigious achievements or learn from our mistakes. Speculative science fiction on the other is predicting the future and helping humanity to prepare for it in advance. In the same token, this paper focuses on the use of ethnographic novels in tourist promotion. Culture and cultural practices constitute a staple tourist attraction. Given the role of ethnographic novels to vividly portray the cultural peculiarities of a particular community, they can be used as a promotional tool to attract tourists to the destination. Such novels can also serve as a preliminary source of information about the tradition of the community at the destination. An ethnographic novel by Fikremarkos Desta, Land of the Yellow Bull, which accurately depicts the life of the Hamar people and neighboring ethnic groups found in the Southern part of Ethiopia, is used for illustrating the case. The author of the novel gives the reader a bifocal view of this community with intact cultural traditions. Charlotte Alfred

The utilization of skilled delivery care services has been stressed due to its effectiveness in reducing maternal & infant mortality. Taking in to account the national and regional interest in improving the utilization of skilled delivery care, determining the factors affecting the use of skilled delivery care is an important step. Several studies have looked at different factors contributing to women’s behavior to seek for skilled delivery care services. Nonetheless, no studies were conducted to assess the regional variation. This study aims to assess differences among regions of Ethiopia in the utilization of skilled delivery care services. In this study, information on the last birth recorded in the last five years preceding of EDHS, 2011 were taken from ever-married women aged 15-49. Univariate, bivariate and multivariate logistic regression analyses were adapted to assess the regional differences in utilizations of skilled delivery care.The results shows that 6,756 ever-married women were included in this study. The mean age of women who were participated in this study was 29.2 years, and their average parity was 4 children per woman. Statistically significant differences were observed in utilizations of skilled delivery care services across regions. The results showed that the effects of socio-demographic factors in utilization of skilled delivery care services differ across regions. Moreover, utilization of ANC has statistically significant contribution in the utilization of skilled delivery care services in all regions except in Tigray and Dire dawa regions. Unequally distributed utilization of skilled deliver care services across regions was observed.It was identified that each region has different socio-demographic factors that influence the use of skilled delivery care. Though the determinants are the same in some regions; the strength of their effect may differ. Utilization of ANC is the most significant predictor which influences the use of skilled

The use of literary works for diverse practical purposes is a long established tradition. It can be traced back to the days of our earliest ancestors who had been using different genres of oral literature to entertain, enlighten or instill moral lesson in small children. These days, in addition to the traditional entertainment and instruction functions, different forms of written literature are serving diverse purposes. Historical fictions, for example, are tracing the past and helping us to be proud of our prestigious achievements or learn from our mistakes. Speculative science fiction on the other is predicting the future and helping humanity to prepare for it in advance. In the same token, this paper focuses on the use of ethnographic novels in tourist promotion. Culture and cultural practices constitute a staple tourist attraction. Given the role of ethnographic novels to vividly portray the cultural peculiarities of a particular community, they can be used as a promotional tool to attract tourists to the destination. Such novels can also serve as a preliminary source of information about the tradition of the community at the destination. An ethnographic novel by Fikremarkos Desta, Land of the Yellow Bull, which accurately depicts the life of the Hamar people and neighboring ethnic groups found in the Southern part of Ethiopia, is used for illustrating the case. The author of the novel gives the reader a bifocal view of this community with intact cultural traditions. Charlotte Alfred

The utilization of skilled delivery care services has been stressed due to its effectiveness in reducing maternal & infant mortality. Taking in to account the national and regional interest in improving the utilization of skilled delivery care, determining the factors affecting the use of skilled delivery care is an important step. Several studies have looked at different factors contributing to women’s behavior to seek for skilled delivery care services. Nonetheless, no studies were conducted to assess the regional variation. This study aims to assess differences among regions of Ethiopia in the utilization of skilled delivery care services. In this study, information on the last birth recorded in the last five years preceding of EDHS, 2011 were taken from ever-married women aged 15-49. Univariate, bivariate and multivariate logistic regression analyses were adapted to assess the regional differences in utilizations of skilled delivery care.The results shows that 6,756 ever-married women were included in this study. The mean age of women who were participated in this study was 29.2 years, and their average parity was 4 children per woman. Statistically significant differences were observed in utilizations of skilled delivery care services across regions. The results showed that the effects of socio-demographic factors in utilization of skilled delivery care services differ across regions. Moreover, utilization of ANC has statistically significant contribution in the utilization of skilled delivery care services in all regions except in Tigray and Dire dawa regions. Unequally distributed utilization of skilled deliver care services across regions was observed.It was identified that each region has different socio-demographic factors that influence the use of skilled delivery care. Though the determinants are the same in some regions; the strength of their effect may differ. Utilization of ANC is the most significant predictor which influences the use of skilled

The use of literary works for diverse practical purposes is a long established tradition. It can be traced back to the days of our earliest ancestors who had been using different genres of oral literature to entertain, enlighten or instill moral lesson in small children. These days, in addition to the traditional entertainment and instruction functions, different forms of written literature are serving diverse purposes. Historical fictions, for example, are tracing the past and helping us to be proud of our prestigious achievements or learn from our mistakes. Speculative science fiction on the other is predicting the future and helping humanity to prepare for it in advance. In the same token, this paper focuses on the use of ethnographic novels in tourist promotion. Culture and cultural practices constitute a staple tourist attraction. Given the role of ethnographic novels to vividly portray the cultural peculiarities of a particular community, they can be used as a promotional tool to attract tourists to the destination. Such novels can also serve as a preliminary source of information about the tradition of the community at the destination. An ethnographic novel by Fikremarkos Desta, Land of the Yellow Bull, which accurately depicts the life of the Hamar people and neighboring ethnic groups found in the Southern part of Ethiopia, is used for illustrating the case. The author of the novel gives the reader a bifocal view of this community with intact cultural traditions. Charlotte Alfred

A total of 756 cattle sera from 74 herds of intensive (dairy) and extensive (mixed crop-livestock) production systems were collected and serially tested by Rose Bengal Plate Test (RBT) and by Complement Fixation Test (CFT) between November 2009 and March 2010 in Arsi Zone of Ethiopia with objective of determining seroprevalence and risk factors. The overall herd and animal level seroprevalences were 9.5% and 2.6%, respectively. Herd level seroprevalences were 40% (n=5) in intensive system and 7.3% (n=69) in extensive system. Animal level and within-herd range of brucellosis seroprevalence in cattle under intensive system were 4.4% (n=274) and 0.0 - 7.5%, while for those in extensive system were 1.7% (n=482) and 0.0 - 30%, respectively. Binary logistic regression showed both herd and animal level seroprevalence to be significantly higher (p < 0.05) in intensive than in extensive system. The statistical significant difference observed between production systems in this study implied different control strategies need to be addressed in Arsi zone. Thus, implementing a culling practice in the extensive system to eliminate the existing low risk of brucellosis and targeting calves in the intensive system for vaccination in addition to culling reactors could minimize the economic loss and reduce the potential occupational exposures in particular.

A total of 756 cattle sera from 74 herds of intensive (dairy) and extensive (mixed crop-livestock) production systems were collected and serially tested by Rose Bengal Plate Test (RBT) and by Complement Fixation Test (CFT) between November 2009 and March 2010 in Arsi Zone of Ethiopia with objective of determining seroprevalence and risk factors. The overall herd and animal level seroprevalences were 9.5% and 2.6%, respectively. Herd level seroprevalences were 40% (n=5) in intensive system and 7.3% (n=69) in extensive system. Animal level and within-herd range of brucellosis seroprevalence in cattle under intensive system were 4.4% (n=274) and 0.0 - 7.5%, while for those in extensive system were 1.7% (n=482) and 0.0 - 30%, respectively. Binary logistic regression showed both herd and animal level seroprevalence to be significantly higher (p < 0.05) in intensive than in extensive system. The statistical significant difference observed between production systems in this study implied different control strategies need to be addressed in Arsi zone. Thus, implementing a culling practice in the extensive system to eliminate the existing low risk of brucellosis and targeting calves in the intensive system for vaccination in addition to culling reactors could minimize the economic loss and reduce the potential occupational exposures in particular.

A total of 756 cattle sera from 74 herds of intensive (dairy) and extensive (mixed crop-livestock) production systems were collected and serially tested by Rose Bengal Plate Test (RBT) and by Complement Fixation Test (CFT) between November 2009 and March 2010 in Arsi Zone of Ethiopia with objective of determining seroprevalence and risk factors. The overall herd and animal level seroprevalences were 9.5% and 2.6%, respectively. Herd level seroprevalences were 40% (n=5) in intensive system and 7.3% (n=69) in extensive system. Animal level and within-herd range of brucellosis seroprevalence in cattle under intensive system were 4.4% (n=274) and 0.0 - 7.5%, while for those in extensive system were 1.7% (n=482) and 0.0 - 30%, respectively. Binary logistic regression showed both herd and animal level seroprevalence to be significantly higher (p < 0.05) in intensive than in extensive system. The statistical significant difference observed between production systems in this study implied different control strategies need to be addressed in Arsi zone. Thus, implementing a culling practice in the extensive system to eliminate the existing low risk of brucellosis and targeting calves in the intensive system for vaccination in addition to culling reactors could minimize the economic loss and reduce the potential occupational exposures in particular.

A total of 756 cattle sera from 74 herds of intensive (dairy) and extensive (mixed crop-livestock) production systems were collected and serially tested by Rose Bengal Plate Test (RBT) and by Complement Fixation Test (CFT) between November 2009 and March 2010 in Arsi Zone of Ethiopia with objective of determining seroprevalence and risk factors. The overall herd and animal level seroprevalences were 9.5% and 2.6%, respectively. Herd level seroprevalences were 40% (n=5) in intensive system and 7.3% (n=69) in extensive system. Animal level and within-herd range of brucellosis seroprevalence in cattle under intensive system were 4.4% (n=274) and 0.0 - 7.5%, while for those in extensive system were 1.7% (n=482) and 0.0 - 30%, respectively. Binary logistic regression showed both herd and animal level seroprevalence to be significantly higher (p < 0.05) in intensive than in extensive system. The statistical significant difference observed between production systems in this study implied different control strategies need to be addressed in Arsi zone. Thus, implementing a culling practice in the extensive system to eliminate the existing low risk of brucellosis and targeting calves in the intensive system for vaccination in addition to culling reactors could minimize the economic loss and reduce the potential occupational exposures in particular.

A total of 756 cattle sera from 74 herds of intensive (dairy) and extensive (mixed crop-livestock) production systems were collected and serially tested by Rose Bengal Plate Test (RBT) and by Complement Fixation Test (CFT) between November 2009 and March 2010 in Arsi Zone of Ethiopia with objective of determining seroprevalence and risk factors. The overall herd and animal level seroprevalences were 9.5% and 2.6%, respectively. Herd level seroprevalences were 40% (n=5) in intensive system and 7.3% (n=69) in extensive system. Animal level and within-herd range of brucellosis seroprevalence in cattle under intensive system were 4.4% (n=274) and 0.0 - 7.5%, while for those in extensive system were 1.7% (n=482) and 0.0 - 30%, respectively. Binary logistic regression showed both herd and animal level seroprevalence to be significantly higher (p < 0.05) in intensive than in extensive system. The statistical significant difference observed between production systems in this study implied different control strategies need to be addressed in Arsi zone. Thus, implementing a culling practice in the extensive system to eliminate the existing low risk of brucellosis and targeting calves in the intensive system for vaccination in addition to culling reactors could minimize the economic loss and reduce the potential occupational exposures in particular.

Introduction: Ensuring access to universal primary health care is essential to secure a safe and pleasant motherhood and to provide compassionate care for mothers and newborns.However, inequalities in the access to maternal health services still remain a prominent problem in many countries. As part of reducing inequalities, Ethiopia launched the Health Extension Program (HEP) in 2003. The HEP is a community based program designed with a defined package of essential promotive, preventive and basic curative services targeting households, particularly mothers and children. Despite the construction of over 600 health posts and deploying more than 1200 Health Extension Workers (HEWs), preliminary data suggests a low utilization of maternal health care services. This thesis explores the HEP contribution in improving women’s access to maternal health care, and the reasons for the low use of maternal health care services from the perspectives of the involved actors in the Tigray region in Ethiopia. The five dimensions of access were used as a framework to explore the access to maternal health care utilization in this setting. Methods: A total of four districts were included in the study. Both quantitative and qualitative methods were applied. In the first sub-study, we assessed the HEP and its association with change in the utilization of antenatal, delivery and postnatal care services. Retrospective longitudinal data for 10 years was extracted from three selected districts and checked for accuracy. Segmented linear regression technique was used to control the secular trends adjusted for correlation of the data. For the second sub-study, we conducted a cross sectional survey with 1115 women (aged 15-49 years who had given birth within five years prior to the survey period) to determine the prevalence of antenatal care and institutional delivery utilization and explore their determinant factors of low utilization. For the third sub-study, we conducted six focus group discuss

Introduction: Ensuring access to universal primary health care is essential to secure a safe and pleasant motherhood and to provide compassionate care for mothers and newborns.However, inequalities in the access to maternal health services still remain a prominent problem in many countries. As part of reducing inequalities, Ethiopia launched the Health Extension Program (HEP) in 2003. The HEP is a community based program designed with a defined package of essential promotive, preventive and basic curative services targeting households, particularly mothers and children. Despite the construction of over 600 health posts and deploying more than 1200 Health Extension Workers (HEWs), preliminary data suggests a low utilization of maternal health care services. This thesis explores the HEP contribution in improving women’s access to maternal health care, and the reasons for the low use of maternal health care services from the perspectives of the involved actors in the Tigray region in Ethiopia. The five dimensions of access were used as a framework to explore the access to maternal health care utilization in this setting. Methods: A total of four districts were included in the study. Both quantitative and qualitative methods were applied. In the first sub-study, we assessed the HEP and its association with change in the utilization of antenatal, delivery and postnatal care services. Retrospective longitudinal data for 10 years was extracted from three selected districts and checked for accuracy. Segmented linear regression technique was used to control the secular trends adjusted for correlation of the data. For the second sub-study, we conducted a cross sectional survey with 1115 women (aged 15-49 years who had given birth within five years prior to the survey period) to determine the prevalence of antenatal care and institutional delivery utilization and explore their determinant factors of low utilization. For the third sub-study, we conducted six focus group discuss

Introduction: Ensuring access to universal primary health care is essential to secure a safe and pleasant motherhood and to provide compassionate care for mothers and newborns.However, inequalities in the access to maternal health services still remain a prominent problem in many countries. As part of reducing inequalities, Ethiopia launched the Health Extension Program (HEP) in 2003. The HEP is a community based program designed with a defined package of essential promotive, preventive and basic curative services targeting households, particularly mothers and children. Despite the construction of over 600 health posts and deploying more than 1200 Health Extension Workers (HEWs), preliminary data suggests a low utilization of maternal health care services. This thesis explores the HEP contribution in improving women’s access to maternal health care, and the reasons for the low use of maternal health care services from the perspectives of the involved actors in the Tigray region in Ethiopia. The five dimensions of access were used as a framework to explore the access to maternal health care utilization in this setting. Methods: A total of four districts were included in the study. Both quantitative and qualitative methods were applied. In the first sub-study, we assessed the HEP and its association with change in the utilization of antenatal, delivery and postnatal care services. Retrospective longitudinal data for 10 years was extracted from three selected districts and checked for accuracy. Segmented linear regression technique was used to control the secular trends adjusted for correlation of the data. For the second sub-study, we conducted a cross sectional survey with 1115 women (aged 15-49 years who had given birth within five years prior to the survey period) to determine the prevalence of antenatal care and institutional delivery utilization and explore their determinant factors of low utilization. For the third sub-study, we conducted six focus group discuss

The development of water storage schemes in Sub-Saharan Africa (SSA) is considered a major aid for those regions with unequal water distribution, limited accessibility and anticipated climate change impacts. Great attention is given by many SSA countries to set up different water storage schemes that may improve rural and urban development on a national level. The funding for the water storage schemes is often derived from foreign agencies which conduct feasibility studies for the financing of potential investments. Often however, the feasibility studies rely on a single monetary criterion which may not identify the most appropriate water storage in each case. In addition, limited data availability in many SSA countries increases the difficulty of identifying the most suitable storage option. This paper develops a multicriteria framework for the integrated evaluation of water storage strategies in Sub-Saharan African countries. A set of economic, agronomic and opinion-based criteria are assessed through the PROMETHEE II outranking approach. The introduction of crop modeling complements the limited field data available in agronomic criteria and enhances the scientific rigor of the method. Ethiopia is adopted as a representative case of SSA countries where a diverse set of water storage options is currently under construction, often financed by foreign agencies.

Introduction: Ensuring access to universal primary health care is essential to secure a safe and pleasant motherhood and to provide compassionate care for mothers and newborns.However, inequalities in the access to maternal health services still remain a prominent problem in many countries. As part of reducing inequalities, Ethiopia launched the Health Extension Program (HEP) in 2003. The HEP is a community based program designed with a defined package of essential promotive, preventive and basic curative services targeting households, particularly mothers and children. Despite the construction of over 600 health posts and deploying more than 1200 Health Extension Workers (HEWs), preliminary data suggests a low utilization of maternal health care services. This thesis explores the HEP contribution in improving women’s access to maternal health care, and the reasons for the low use of maternal health care services from the perspectives of the involved actors in the Tigray region in Ethiopia. The five dimensions of access were used as a framework to explore the access to maternal health care utilization in this setting. Methods: A total of four districts were included in the study. Both quantitative and qualitative methods were applied. In the first sub-study, we assessed the HEP and its association with change in the utilization of antenatal, delivery and postnatal care services. Retrospective longitudinal data for 10 years was extracted from three selected districts and checked for accuracy. Segmented linear regression technique was used to control the secular trends adjusted for correlation of the data. For the second sub-study, we conducted a cross sectional survey with 1115 women (aged 15-49 years who had given birth within five years prior to the survey period) to determine the prevalence of antenatal care and institutional delivery utilization and explore their determinant factors of low utilization. For the third sub-study, we conducted six focus group discuss, ሽፋን መሰረታዊ ክንክን ጥዕና ምዕባይ ድሕንነት ኣዴታትን ህፃናትን ንኽረጋገፅ ዝለዓለ ተራ ከምዘለዎ ይፍለጥ፡፡ ይኹንደኣምበር ግልጋሎት ጥዕና ኣዴታት ብማዕረ ኣብ ምብፃሕን ብምዕሩይ ኣገባብ ኣብ ምሃብን ብዙሓት ሃገራት እናተፀገማ እየን፡፡ ነዚ ዘይምዕሩይን ማዕረ ዘይኾነን ኣዋህባ ግልጋሎት ጥዕና ንምምሕያሽ ኣብ ሃገርና (ኢትዮጵያ) ብ1994-1995 (ብአቆፃፅራ ግእዝ) ዝተኣታተወ ፕሮግራም ምግፋሕ ጥሙር ጥዕና ቤተሰብ (Health Extension Program/HEP) 10 ዓመታት ኣሕሊፉ ይርከብ፡፡ ፕሮግራም ምግፋሕ ጥሙር ጥዕና (HEP)፣ ሕብረተሰብ መሰረት ዝገበረ-ምክልኻል ሕማማትን ምስጓም ጥዕናን - ምትእትታው ግልጋሎት ሕክምና ቀለልቲ ሕማማትን ብፍላይ ድማ ንኣዴታትን ህፃናትን ትኹረት ብምግባር ስድራ ቤት ብምሕቋፍ ዝንቀሳቐስ ፕሮግራም እዩ፡፡ እዚ ፕሮግራም ንምትግባር ኣብ ክልል ትግራይ ልዕሊ 600 ኬላታት ጥዕና ተሃኒፀን፡፡ ልዕሊ 1200 ሞያተኛታት ጥሙር ጥዕና እውን ሰልጢነን እየን፡፡ ክልተ ሞያተኛታት ኣብ ሓደ ኬላ ጥዕና ተመዲበን ካብ 5000-7000 በዝሒ ንዘለዎ ሕብረተሰብ ግልጋሎት እናሃባ ይርከባ፡፡ እንተኾነ ግን ዝተፈላለዩ መፅናዕታታት ከምዘመላኽትዎ ግልጋሎት ኣዴታት ጥዕና (ወሊድን ድሕሪ ወሊድን) ትሑት ሽፋን ከምዘለዎ ይሕበር፡፡ ዕላማ እዚ ዝገበርናዮ መፅናዕቲ እውን ኩነታት እቲ ግልጋሎት ብኣሃዝ ንምዕቃንን ከምኡ እውን ምኽንያታት እቲ ትሑት ግልጋሎት ንምድህሳስን እዩ፡፡ ኣብዚ መፅናዕቲ እዚ ምኽንያታት ትሑት ሽፋን ግልጋሎት ክንክን ጥንሲ ወሊድን ድሕረ ወሊድን እንታይ ምዃኑ ካብ ሕሉፍ ልምዲ (ተሞክሮ) ኣዴታትን ሰብ ሞያ ጥዕናን ብዝርዝር ብምድህሳስ - ፕሮግራም ምግፋሕ ጥሙር ጥዕና ንቐረብ ግልጋሎት ኣዴታት ጥዕና ንምምሕያሽ ዘለዎ ኣስተዋፅኦ እንታይ ከምዝመስል ተተንቲኑ ቐሪቡ ኣሎ፡፡ እቲ ቀረብ ግልጋሎት ጥዕና ሓሙሽተ መዐቀኒታት ብዘለዎ ፍሬም ዎርክ እዩ ተዳህሲሱ እቶም ሓሙሽተ መመዘኒታት 1. ቅርበት ትካል ጥዕናን ሰብ ሞያ ጥዕናን ንተገልገልቲ 2. ህልውነት ሰብ ሞያ ጥዕናን ናውትን ድሌት ተገልገልትን 3. ሰብ ሞያ ጥዕና ብተገልገልቲ ዘለዎም ተቐባልነት 4. ትካል ጥዕና ንድሌት ተገልገልቲ ንምዕጋብ ዘለዎ ድልውነት 5. ተገልገልቲ ወፃኢታት ሕክምና ንምሽፋን/ንምኽፋል ዘለዎም ድሌትን ዓቕምን እዮም፡፡ እዞም ሓሙሽተ መዐቀኒታት መሰረት ዝገበሩ ኣርባዕተ ዓይነታዊን አሃዛዊን ሜላታት ብምጥቃም ዝተኻየዱ መፅናዕትታት ኣብ ኣብ 4ተ ወረዳታት ትግራይ እዮም ተኻይዶም፡፡ ኣብቲ ቀዳማይ መፅናዕቲ ፕሮግራም ምግፋሕ ጥሙር ጥዕና ቤተሰብ (HEP) ኣብ ምምሕያሽ ክንክን ጥንሲ-ወሊድን-ድሕረ ወሊድን ግልጋሎት ዘምፅኦ ለውጢ ኣብ ሰለስተ ወረዳታት (ጋንታአፈሹም፤ ክልተ ኣውላዕሎ፣ ሕንጣሎ ዋጅራት) ንዝሓለፉ 10 ዓመታት ኣብ ዝተዋህበ ግልጋሎት ብምድራኽ እዩ ዳህሰሳ ተኻይዱ፡፡ ትኽክለኛነት እቲ ፀብፃብ እውን ካብ ትካላት ጥዕና ዝተልኣኸ ወርሓዊ ኣብ ወረዳ ምስ ዘሎ ፀብፃብ ብምንፅፃር ንኽረጋግፅ ተገይሩ እዩ፡፡ እቲ ካልኣይ መፅናዕቲ ኣብ ወረዳ ሰሓርቲ ሳምረ ካብ 19 ጣብያታት ካብ ዝተመረፃ 30 ቑሸታት ዕድሚአን ካብ 15-49 ዓመት ምስ ዝኾና 1115 ደቂኣንስትዮ ኣስታት 30 ደቓይቕ ዝወደአ ቃለ መሕትት ብምኽያድ እዩ ዳህሰሳ ተኻይዱ፡፡ ኣብ ወሊድ ግልጋሎት ዘሎ ልምድን ተሞክሮን ንምድህሳስ 51 ኣዴታት ዝተሳተፋሉ ሽዱሽተ ጉጅላዊ ምይይጥ በቲ ሳልሳይ መፅናዕቲ ምርምር ዝተፈፀመ እንትኾን ምስ ሸሞንተ ሞያተኛታት ጥሙር ጥዕናን ኣርባዕተ ነርስ መዋልዳንን ቃለ መሕትት ብምኽያድ እቲ 4ይ ምርምር/መፅናዕቲ ተፈፂሙ እዩ፡፡ ውፅኢት ቀዳማይ መፅናዕታዊ

Introduction: Ensuring access to universal primary health care is essential to secure a safe and pleasant motherhood and to provide compassionate care for mothers and newborns.However, inequalities in the access to maternal health services still remain a prominent problem in many countries. As part of reducing inequalities, Ethiopia launched the Health Extension Program (HEP) in 2003. The HEP is a community based program designed with a defined package of essential promotive, preventive and basic curative services targeting households, particularly mothers and children. Despite the construction of over 600 health posts and deploying more than 1200 Health Extension Workers (HEWs), preliminary data suggests a low utilization of maternal health care services. This thesis explores the HEP contribution in improving women’s access to maternal health care, and the reasons for the low use of maternal health care services from the perspectives of the involved actors in the Tigray region in Ethiopia. The five dimensions of access were used as a framework to explore the access to maternal health care utilization in this setting. Methods: A total of four districts were included in the study. Both quantitative and qualitative methods were applied. In the first sub-study, we assessed the HEP and its association with change in the utilization of antenatal, delivery and postnatal care services. Retrospective longitudinal data for 10 years was extracted from three selected districts and checked for accuracy. Segmented linear regression technique was used to control the secular trends adjusted for correlation of the data. For the second sub-study, we conducted a cross sectional survey with 1115 women (aged 15-49 years who had given birth within five years prior to the survey period) to determine the prevalence of antenatal care and institutional delivery utilization and explore their determinant factors of low utilization. For the third sub-study, we conducted six focus group discuss, ሽፋን መሰረታዊ ክንክን ጥዕና ምዕባይ ድሕንነት ኣዴታትን ህፃናትን ንኽረጋገፅ ዝለዓለ ተራ ከምዘለዎ ይፍለጥ፡፡ ይኹንደኣምበር ግልጋሎት ጥዕና ኣዴታት ብማዕረ ኣብ ምብፃሕን ብምዕሩይ ኣገባብ ኣብ ምሃብን ብዙሓት ሃገራት እናተፀገማ እየን፡፡ ነዚ ዘይምዕሩይን ማዕረ ዘይኾነን ኣዋህባ ግልጋሎት ጥዕና ንምምሕያሽ ኣብ ሃገርና (ኢትዮጵያ) ብ1994-1995 (ብአቆፃፅራ ግእዝ) ዝተኣታተወ ፕሮግራም ምግፋሕ ጥሙር ጥዕና ቤተሰብ (Health Extension Program/HEP) 10 ዓመታት ኣሕሊፉ ይርከብ፡፡ ፕሮግራም ምግፋሕ ጥሙር ጥዕና (HEP)፣ ሕብረተሰብ መሰረት ዝገበረ-ምክልኻል ሕማማትን ምስጓም ጥዕናን - ምትእትታው ግልጋሎት ሕክምና ቀለልቲ ሕማማትን ብፍላይ ድማ ንኣዴታትን ህፃናትን ትኹረት ብምግባር ስድራ ቤት ብምሕቋፍ ዝንቀሳቐስ ፕሮግራም እዩ፡፡ እዚ ፕሮግራም ንምትግባር ኣብ ክልል ትግራይ ልዕሊ 600 ኬላታት ጥዕና ተሃኒፀን፡፡ ልዕሊ 1200 ሞያተኛታት ጥሙር ጥዕና እውን ሰልጢነን እየን፡፡ ክልተ ሞያተኛታት ኣብ ሓደ ኬላ ጥዕና ተመዲበን ካብ 5000-7000 በዝሒ ንዘለዎ ሕብረተሰብ ግልጋሎት እናሃባ ይርከባ፡፡ እንተኾነ ግን ዝተፈላለዩ መፅናዕታታት ከምዘመላኽትዎ ግልጋሎት ኣዴታት ጥዕና (ወሊድን ድሕሪ ወሊድን) ትሑት ሽፋን ከምዘለዎ ይሕበር፡፡ ዕላማ እዚ ዝገበርናዮ መፅናዕቲ እውን ኩነታት እቲ ግልጋሎት ብኣሃዝ ንምዕቃንን ከምኡ እውን ምኽንያታት እቲ ትሑት ግልጋሎት ንምድህሳስን እዩ፡፡ ኣብዚ መፅናዕቲ እዚ ምኽንያታት ትሑት ሽፋን ግልጋሎት ክንክን ጥንሲ ወሊድን ድሕረ ወሊድን እንታይ ምዃኑ ካብ ሕሉፍ ልምዲ (ተሞክሮ) ኣዴታትን ሰብ ሞያ ጥዕናን ብዝርዝር ብምድህሳስ - ፕሮግራም ምግፋሕ ጥሙር ጥዕና ንቐረብ ግልጋሎት ኣዴታት ጥዕና ንምምሕያሽ ዘለዎ ኣስተዋፅኦ እንታይ ከምዝመስል ተተንቲኑ ቐሪቡ ኣሎ፡፡ እቲ ቀረብ ግልጋሎት ጥዕና ሓሙሽተ መዐቀኒታት ብዘለዎ ፍሬም ዎርክ እዩ ተዳህሲሱ እቶም ሓሙሽተ መመዘኒታት 1. ቅርበት ትካል ጥዕናን ሰብ ሞያ ጥዕናን ንተገልገልቲ 2. ህልውነት ሰብ ሞያ ጥዕናን ናውትን ድሌት ተገልገልትን 3. ሰብ ሞያ ጥዕና ብተገልገልቲ ዘለዎም ተቐባልነት 4. ትካል ጥዕና ንድሌት ተገልገልቲ ንምዕጋብ ዘለዎ ድልውነት 5. ተገልገልቲ ወፃኢታት ሕክምና ንምሽፋን/ንምኽፋል ዘለዎም ድሌትን ዓቕምን እዮም፡፡ እዞም ሓሙሽተ መዐቀኒታት መሰረት ዝገበሩ ኣርባዕተ ዓይነታዊን አሃዛዊን ሜላታት ብምጥቃም ዝተኻየዱ መፅናዕትታት ኣብ ኣብ 4ተ ወረዳታት ትግራይ እዮም ተኻይዶም፡፡ ኣብቲ ቀዳማይ መፅናዕቲ ፕሮግራም ምግፋሕ ጥሙር ጥዕና ቤተሰብ (HEP) ኣብ ምምሕያሽ ክንክን ጥንሲ-ወሊድን-ድሕረ ወሊድን ግልጋሎት ዘምፅኦ ለውጢ ኣብ ሰለስተ ወረዳታት (ጋንታአፈሹም፤ ክልተ ኣውላዕሎ፣ ሕንጣሎ ዋጅራት) ንዝሓለፉ 10 ዓመታት ኣብ ዝተዋህበ ግልጋሎት ብምድራኽ እዩ ዳህሰሳ ተኻይዱ፡፡ ትኽክለኛነት እቲ ፀብፃብ እውን ካብ ትካላት ጥዕና ዝተልኣኸ ወርሓዊ ኣብ ወረዳ ምስ ዘሎ ፀብፃብ ብምንፅፃር ንኽረጋግፅ ተገይሩ እዩ፡፡ እቲ ካልኣይ መፅናዕቲ ኣብ ወረዳ ሰሓርቲ ሳምረ ካብ 19 ጣብያታት ካብ ዝተመረፃ 30 ቑሸታት ዕድሚአን ካብ 15-49 ዓመት ምስ ዝኾና 1115 ደቂኣንስትዮ ኣስታት 30 ደቓይቕ ዝወደአ ቃለ መሕትት ብምኽያድ እዩ ዳህሰሳ ተኻይዱ፡፡ ኣብ ወሊድ ግልጋሎት ዘሎ ልምድን ተሞክሮን ንምድህሳስ 51 ኣዴታት ዝተሳተፋሉ ሽዱሽተ ጉጅላዊ ምይይጥ በቲ ሳልሳይ መፅናዕቲ ምርምር ዝተፈፀመ እንትኾን ምስ ሸሞንተ ሞያተኛታት ጥሙር ጥዕናን ኣርባዕተ ነርስ መዋልዳንን ቃለ መሕትት ብምኽያድ እቲ 4ይ ምርምር/መፅናዕቲ ተፈፂሙ እዩ፡፡ ውፅኢት ቀዳማይ መፅናዕታዊ

The major objective of the survey is to assess the availability and preparedness of health facilities in Ethiopia to provide quality Tuberculosis services. The survey was part of the 2014 Ethiopia Service Provision Assessment Plus Survey. A total of 1,327 health facilities were assessed. The results shows that more than two out of three (69%) facilities excluding health posts in Ethiopia offer any TB diagnostic, treatment or/and treatment follow up services. Among all health posts, 29% of them offer any TB diagnostic services and any treatment and/or treatment follow up services. Six in ten (59%) of facilities excluding health posts use sputum smear only to diagnose TB. Of those facilities offering any TB services more than half (60%) have trained staff. Among facilities excluding health posts offering any TB services, 44% have guidelines for diagnosis and treatment of TB, 18% have guideline for diagnosis and treatment of MDR-TB, and 9% have guideline for management of HIV and TB co-infection.As a conclusion we can say that any TB diagnostic, treatment or/and treatment follow up services is available in more than half of the facilities in Ethiopia excluding health post. Half of the health facilities in Ethiopia excluding health post have guidelines for diagnosis and treatment of TB.

The study was conducted in Gera district, southwestern Ethiopia. Currently, in different parts of Africa, wild animals seriously compete for resource with human being. This affects the economy of the community and the conservation of wildlife. Therefore, this study was conducted to identify crop raiding species and to estimate the magnitude of agricultural field crop and domestic animals loss due to wild animals in the Gera district, Jimma zone, southwestern Ethiopia.

The major objective of the survey is to assess the availability and preparedness of health facilities in Ethiopia to provide quality Tuberculosis services. The survey was part of the 2014 Ethiopia Service Provision Assessment Plus Survey. A total of 1,327 health facilities were assessed. The results shows that more than two out of three (69%) facilities excluding health posts in Ethiopia offer any TB diagnostic, treatment or/and treatment follow up services. Among all health posts, 29% of them offer any TB diagnostic services and any treatment and/or treatment follow up services. Six in ten (59%) of facilities excluding health posts use sputum smear only to diagnose TB. Of those facilities offering any TB services more than half (60%) have trained staff. Among facilities excluding health posts offering any TB services, 44% have guidelines for diagnosis and treatment of TB, 18% have guideline for diagnosis and treatment of MDR-TB, and 9% have guideline for management of HIV and TB co-infection.As a conclusion we can say that any TB diagnostic, treatment or/and treatment follow up services is available in more than half of the facilities in Ethiopia excluding health post. Half of the health facilities in Ethiopia excluding health post have guidelines for diagnosis and treatment of TB.

The major objective of the survey is to assess the availability and preparedness of health facilities in Ethiopia to provide quality Tuberculosis services. The survey was part of the 2014 Ethiopia Service Provision Assessment Plus Survey. A total of 1,327 health facilities were assessed. The results shows that more than two out of three (69%) facilities excluding health posts in Ethiopia offer any TB diagnostic, treatment or/and treatment follow up services. Among all health posts, 29% of them offer any TB diagnostic services and any treatment and/or treatment follow up services. Six in ten (59%) of facilities excluding health posts use sputum smear only to diagnose TB. Of those facilities offering any TB services more than half (60%) have trained staff. Among facilities excluding health posts offering any TB services, 44% have guidelines for diagnosis and treatment of TB, 18% have guideline for diagnosis and treatment of MDR-TB, and 9% have guideline for management of HIV and TB co-infection.As a conclusion we can say that any TB diagnostic, treatment or/and treatment follow up services is available in more than half of the facilities in Ethiopia excluding health post. Half of the health facilities in Ethiopia excluding health post have guidelines for diagnosis and treatment of TB.

The study was conducted in Gera district, southwestern Ethiopia. Currently, in different parts of Africa, wild animals seriously compete for resource with human being. This affects the economy of the community and the conservation of wildlife. Therefore, this study was conducted to identify crop raiding species and to estimate the magnitude of agricultural field crop and domestic animals loss due to wild animals in the Gera district, Jimma zone, southwestern Ethiopia.

The study was conducted in Gera district, southwestern Ethiopia. Currently, in different parts of Africa, wild animals seriously compete for resource with human being. This affects the economy of the community and the conservation of wildlife. Therefore, this study was conducted to identify crop raiding species and to estimate the magnitude of agricultural field crop and domestic animals loss due to wild animals in the Gera district, Jimma zone, southwestern Ethiopia.

The major objective of the survey is to assess the availability and preparedness of health facilities in Ethiopia to provide quality Tuberculosis services. The survey was part of the 2014 Ethiopia Service Provision Assessment Plus Survey. A total of 1,327 health facilities were assessed. The results shows that more than two out of three (69%) facilities excluding health posts in Ethiopia offer any TB diagnostic, treatment or/and treatment follow up services. Among all health posts, 29% of them offer any TB diagnostic services and any treatment and/or treatment follow up services. Six in ten (59%) of facilities excluding health posts use sputum smear only to diagnose TB. Of those facilities offering any TB services more than half (60%) have trained staff. Among facilities excluding health posts offering any TB services, 44% have guidelines for diagnosis and treatment of TB, 18% have guideline for diagnosis and treatment of MDR-TB, and 9% have guideline for management of HIV and TB co-infection.As a conclusion we can say that any TB diagnostic, treatment or/and treatment follow up services is available in more than half of the facilities in Ethiopia excluding health post. Half of the health facilities in Ethiopia excluding health post have guidelines for diagnosis and treatment of TB.

The major objective of the survey is to assess the availability and preparedness of health facilities in Ethiopia to provide quality Tuberculosis services. The survey was part of the 2014 Ethiopia Service Provision Assessment Plus Survey. A total of 1,327 health facilities were assessed. The results shows that more than two out of three (69%) facilities excluding health posts in Ethiopia offer any TB diagnostic, treatment or/and treatment follow up services. Among all health posts, 29% of them offer any TB diagnostic services and any treatment and/or treatment follow up services. Six in ten (59%) of facilities excluding health posts use sputum smear only to diagnose TB. Of those facilities offering any TB services more than half (60%) have trained staff. Among facilities excluding health posts offering any TB services, 44% have guidelines for diagnosis and treatment of TB, 18% have guideline for diagnosis and treatment of MDR-TB, and 9% have guideline for management of HIV and TB co-infection.As a conclusion we can say that any TB diagnostic, treatment or/and treatment follow up services is available in more than half of the facilities in Ethiopia excluding health post. Half of the health facilities in Ethiopia excluding health post have guidelines for diagnosis and treatment of TB.

The aim of the study was to document information on medicinal plants and to describe the traditional health care practices of Gondar Zuria district, North-West Ethiopia. Field trip was made in each village of the district to collect ethnomedicinal information from the traditional healers by using semi-structured questionnaire and field observation. Forty-two plant species representing forty-one genera and thirty-one families were encountered during the study. Results of the study were analysed using two quantitative tools: informant consensus factor for the analysis of general use of medicinal plants and fidelity level for calculating the most frequently occurring diseases for the categories with the highest informant consensus factor. The result of the informant consensus factor showed that the general health category had the greatest agreement followed by the respiratory, malarial, and gastrointestinal categories. The present study has documented curious ethno medicinal facts on the plant therapies currently utilised in Gondar Zuria district. Evaluation of the pharmacological activity for the promising medicinal plant is suggested.

This paper examined and identifies the important determinants of infant and child mortality in Ethiopia. The 2000 and 2005 Demographic and Health Surveys (EDHS) data were used. Logistic regression method were used to determine the impact of bio-demographic (proximate) and socioeconomic determinants on infant and child mortality. The infant and child mortality reduced during the period 2000 and 2005. The results show that among bio-demographic factors marital status, birth order, type of birth and preceding birth interval are the important proximate determinants for both infant and child mortality. However, breast feeding has a significant impact on infant mortality. Among Socioeconomic determinants education, household size and sex of household are the most important determinants for both infant and child mortality. However, other socioeconomic variables diminished their impact and environmental factors lack their impact on infant and child mortality. Therefore policies should be revised and implement and health intervention program that focus on mothers and children health should be strong to achieve the Millennium Development Goals (MDGs) of infant and child mortality in the remaining years and in addition the policies should be focus on improving both mothers and fathers education and prolonged breast feeding should be encouraged.

To document information on medicinal plants and to describe the traditional health care practices of ethnic groups of Denbia district. Field survey and personal discussion methods had been used in the collection of data. A list of 25 plants belonging to 24 genera and 18 families that are used for their therapeutic purposes by the ethnic groups of Denbia district, North Gondar zone, North western Ethiopia with their local names, ethno medicinal claims, modes of preparation and methods of applications to treat common ailments are highlighted here. The present study has documented curious ethno medicinal facts on the plant therapies currently utilized by the ethnic groups of Denbia district. The study could contribute partial remedies in the preservation of cultural heritage and a base to researchers for further pharmacological and phytochemical studies.