Search

Your search keyword '"Gebremichael, MW"' showing total 15 results
Start Over Author "Gebremichael, MW"
15 results on '"Gebremichael, MW"'

1. Female genital mutilation: prevalence, perceptions and effect on women's health in Kersa district of Ethiopia

Author

Gebremichael MW, Kassa NA, Yirga WS, and Aro AR

Subjects
Gynecology and obstetrics, RG1-991
Abstract

Wondimu Shanko Yirga1,2, Nega Assefa Kassa2, Mengistu Welday Gebremichael2, Arja R Aro31University of Southern Denmark, Faculty of Health Sciences, Esbjerg, Denmark; 2Haramaya University College of Health Sciences, Harar, Ethiopia; 3University of Southern Denmark, Unit for Health Promotion Research, Esbjerg, DenmarkBackground: Female genital mutilation (FGM) is nontherapeutic surgical modification of the female genitalia. It is an ancient tradition in large parts of Africa, including Ethiopia, especially in the eastern part of the country. This study aimed to identify the prevalence, perceptions, perpetuators, reasons for conducting FGM, and factors associated with this practice with regard to women's health.Methods: Community-based cross-sectional house-to-house interviews were conducted during 2008 among 858 females of reproductive age (15–49 years), in Kersa district, East Hararge, Oromia region, Ethiopia. Proportions and Chi-square tests were used to describe the data and logistic regression was used to describe statistical associations. Statistical significance was set at P < 0.05.Results: FGM was reported to be known by 327 (38.5%) of the interviewees. The majority (n = 249, 76.1%) reported that local healers were the main performers of FGM, and 258 (78.9%) respondents stated that the clitoris was the part removed during circumcision. The main reason for the practice of FGM was reduction of female sexual hyperactivity (reported by 198 women [60.3%]). Circumcision of daughters was reported by 288 (88.1%) respondents, and this showed a statistically significant association with the Christian religion (P = 0.003), illiteracy (P = 0.01), and Amhara ethnicity (P = 0.012). The majority of the respondents (792, 92.3%) were themselves circumcised and 68.8% did not know of any health-related problems associated with FGM.Conclusion: In spite of FGM being a common practice in the study area, only one third of the respondents stated that they knew about it. Local healers were the main performers of FGM. Some of the women knew about the negative reproductive health effects of FGM and some had also experienced these themselves. However, only a few had tried to stop the practice and the majority had taken no steps to do so. This may be attributable to the fear of becoming alienated from the cultural system and fear of isolation.Keywords: female genital mutilation, reasons, health consequences, Ethiopia

Published
2012

2. Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990–2015: a novel analysis from the Global Burden of Disease Study 2015

Author

Barber, RM, Fullman, N, Sorensen, RJD, Bollyky, T, McKee, M, Nolte, E, Abajobir, AA, Abate, KH, Abbafati, C, Abbas, KM, Abd-Allah, F, Abdulle, AM, Abdurahman, AA, Abera, SF, Abraham, B, Abreha, GF, Adane, K, Adelekan, AL, Adetifa, IMO, Afshin, A, Agarwal, A, Agarwal, SK, Agarwal, S, Agrawal, A, Kiadaliri, AA, Ahmadi, A, Ahmed, KY, Ahmed, MB, Akinyemi, RO, Akinyemiju, TF, Akseer, N, Al-Aly, Z, Alam, K, Alam, N, Alam, SS, Alemu, ZA, Alene, KA, Alexander, L, Ali, R, Ali, SD, Alizadeh-Navaei, R, Alkerwi, A, Alla, F, Allebeck, P, Allen, C, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Martin, EA, Alvis-Guzman, N, Amare, AT, Amini, E, Ammar, W, Amo-Adjei, J, Amoako, YA, Anderson, BO, Androudi, S, Ansari, H, Ansha, MG, Antonio, CAT, Ärnlöv, J, Artaman, A, Asayesh, H, Assadi, R, Astatkie, A, Atey, TM, Atique, S, Atnafu, NT, Atre, SR, Avila-Burgos, L, Avokpaho, EFGA, Quintanilla, BPA, Awasthi, A, Ayele, NN, Azzopardi, P, Saleem, HOB, Bärnighausen, T, Bacha, U, Badawi, A, Banerjee, A, Barac, A, Barboza, MA, Barker-Collo, SL, Barrero, LH, Basu, S, Baune, BT, Baye, K, Bayou, YT, Bazargan-Hejazi, S, Bedi, N, Beghi, E, Béjot, Y, Bello, AK, Bennett, DA, Bensenor, IM, Berhane, A, Bernabé, E, Bernal, OA, Beyene, AS, Beyene, TJ, Bhutta, ZA, Biadgilign, S, Bikbov, B, Birlik, SM, Birungi, C, Biryukov, S, Bisanzio, D, Bizuayehu, HM, Bose, D, Brainin, M, Brauer, M, Brazinova, A, Breitborde, NJK, Brenner, H, Butt, ZA, Cárdenas, R, Cahuana-Hurtado, L, Campos-Nonato, IR, Car, J, Carrero, JJ, Casey, D, Caso, V, Castañeda-Orjuela, CA, Rivas, JC, Catalá-López, F, Cecilio, P, Cercy, K, Charlson, FJ, Chen, AZ, Chew, A, Chibalabala, M, Chibueze, CE, Chisumpa, VH, Chitheer, AA, Chowdhury, R, Christensen, H, Christopher, DJ, Ciobanu, LG, Cirillo, M, Coggeshall, MS, Cooper, LT, Cortinovis, M, Crump, JA, Dalal, K, Danawi, H, Dandona, L, Dandona, R, Dargan, PI, das Neves, J, Davey, G, Davitoiu, DV, Davletov, K, De Leo, D, Del Gobbo, LC, del Pozo-Cruz, B, Dellavalle, RP, Deribe, K, Deribew, A, Des Jarlais, DC, Dey, S, Dharmaratne, SD, Dicker, D, Ding, EL, Dokova, K, Dorsey, ER, Doyle, KE, Dubey, M, Ehrenkranz, R, Ellingsen, CL, Elyazar, I, Enayati, A, Ermakov, SP, Eshrati, B, Esteghamati, A, Estep, K, Fürst, T, Faghmous, IDA, Fanuel, FBB, Faraon, EJA, Farid, TA, Farinha, CSES, Faro, A, Farvid, MS, Farzadfar, F, Feigin, VL, Feigl, AB, Fereshtehnejad, S-M, Fernandes, JG, Fernandes, JC, Feyissa, TR, Fischer, F, Fitzmaurice, C, Fleming, TD, Foigt, N, Foreman, KJ, Forouzanfar, MH, Franklin, RC, Frostad, J, G/hiwot, TT, Gakidou, E, Gambashidze, K, Gamkrelidze, A, Gao, W, Garcia-Basteiro, AL, Gebre, T, Gebremedhin, AT, Gebremichael, MW, Gebru, AA, Gelaye, AA, Geleijnse, JM, Genova-Maleras, R, Gibney, KB, Giref, AZ, Gishu, MD, Giussani, G, Godwin, WW, Gold, A, Goldberg, EM, Gona, PN, Goodridge, A, Gopalani, SV, Goto, A, Graetz, N, Greaves, F, Griswold, M, Guban, PI, Gugnani, HC, Gupta, PC, Gupta, R, Gupta, T, Gupta, V, Habtewold, TD, Hafezi-Nejad, N, Haile, D, Hailu, AD, Hailu, GB, Hakuzimana, A, Hamadeh, RR, Hambisa, MT ; https://orcid.org/0000-0003-3193-8053, Hamidi, S, Hammami, M, Hankey, GJ, Hao, Y, Harb, HL, Hareri, HA, Haro, JM, Hassanvand, MS, Havmoeller, R, Hay, RJ, Hay, SI, Hendrie, D, Heredia-Pi, IB, Hoek, HW, Horino, M, Horita, N, Hosgood, HD, Htet, AS, Hu, G, Huang, H, Huang, JJ, Huntley, BM, Huynh, C, Iburg, KM, Ileanu, BV, Innos, K, Irenso, AA, Jahanmehr, N, Jakovljevic, MB, James, P, James, SL, Javanbakht, M, Jayaraman, SP, Jayatilleke, AU, Jeemon, P, Jha, V ; https://orcid.org/0000-0002-8015-9470, John, D, Johnson, C, Johnson, SC, Jonas, JB, Juel, K, Kabir, Z, Kalkonde, Y, Kamal, R, Kan, H, Karch, A, Karema, CK, Karimi, SM, Kasaeian, A, Kassebaum, NJ, Kastor, A, Katikireddi, SV, Kazanjan, K, Keiyoro, PN, Kemmer, L, Kemp, AH, Kengne, AP, Kerbo, AA, Kereselidze, M, Kesavachandran, CN, Khader, YS, Khalil, I, Khan, AR, Khan, EA, Khan, G, Khang, Y-H, Khoja, ATA, Khonelidze, I, Khubchandani, J, Kibret, GD, Kim, D, Kim, P, Kim, YJ, Kimokoti, RW, Kinfu, Y, Kissoon, N, Kivipelto, M, Kokubo, Y, Kolk, A, Kolte, D, Kopec, JA, Kosen, S, Koul, PA, Koyanagi, A, Kravchenko, M, Krishnaswami, S, Krohn, KJ, Defo, BK, Bicer, BK, Kuipers, EJ, Kulkarni, VS, Kumar, GA, Kumsa, FA, Kutz, M, Kyu, HH, Lager, ACJ, Lal, A, Lal, DK, Lalloo, R, Lallukka, T, Lan, Q, Langan, SM, Lansingh, VC, Larson, HJ, Larsson, A, Laryea, DO, Latif, AA, Lawrynowicz, AEB, Leasher, JL, Leigh, J, Leinsalu, M, Leshargie, CT, Leung, J ; https://orcid.org/0000-0001-5816-2959, Leung, R, Levi, M, Liang, X, Lim, SS, Lind, M, Linn, S, Lipshultz, SE, Liu, P, Liu, Y, Lo, L-T, Logroscino, G, Lopez, AD, Lorch, SA, Lotufo, PA, Lozano, R, Lunevicius, R, Lyons, RA, Macarayan, ERK, Mackay, MT, El Razek, HMA, El Razek, MMA, Mahdavi, M, Majeed, A, Malekzadeh, R, Malta, DC, Mantovani, LG, Manyazewal, T, Mapoma, CC, Marcenes, W, Marks, GB ; https://orcid.org/0000-0002-8976-8053, Marquez, N, Martinez-Raga, J, Marzan, MB, Massano, J, Mathur, MR, Maulik, PK ; https://orcid.org/0000-0001-6835-6175, Mazidi, M, McAlinden, C, McGrath, JJ, McNellan, C, Meaney, PA, Mehari, A, Mehndiratta, MM, Meier, T, Mekonnen, AB, Meles, KG, Memish, ZA, Mengesha, MM, Mengiste, DT, Mengistie, MA, Menota, BG, Mensah, GA, Mereta, ST, Meretoja, A, Meretoja, TJ, Mezgebe, HB, Micha, R, Millear, A, Mills, EJ, Minnig, S, Mirarefin, M, Mirrakhimov, EM, Mock, CN, Mohammad, KA, Mohammed, S, Mohanty, SK, Mokdad, AH, Mola, GLD, Molokhia, M, Monasta, L, Montico, M, Moradi-Lakeh, M, Moraga, P, Morawska, L, Mori, R, Moses, M, Mueller, UO, Murthy, S, Musa, KI, Nachega, JB, Nagata, C, Nagel, G, Naghavi, M, Naheed, A, Naldi, L, Nangia, V, Nascimento, BR, Negoi, I, Neupane, SP, Newton, CR, Ng, M, Ngalesoni, FN, Ngunjiri, JW, Nguyen, G, Ningrum, DNA, Nolte, S, Nomura, M, Norheim, OF, Norrving, B, Noubiap, JJN, Obermeyer, CM, Ogbo, FA, Oh, I-H, Okoro, A, Oladimeji, O, Olagunju, AT, Olivares, PR, Olsen, HE, Olusanya, BO, Olusanya, JO, Opio, JN, Oren, E, Ortiz, A, Osborne, RH, Osman, M, Owolabi, MO, PA, M, Pain, AW, Pakhale, S, Castillo, EP, Pana, A, Papachristou, C, Parsaeian, M, Patel, T, Patton, GC, Paudel, D, Paul, VK, Pearce, N, Pereira, DM, Perez-Padilla, R, Perez-Ruiz, F, Perico, N, Pesudovs, K ; https://orcid.org/0000-0002-6322-9369, Petzold, M, Phillips, MR, Pigott, DM, Pillay, JD, Pinho, C, Polinder, S, Pond, CD, Prakash, V, Purwar, M, Qorbani, M, Quistberg, DA, Radfar, A, Rafay, A, Rahimi, K, Rahimi-Movaghar, V, Rahman, M, Rahman, MHU, Rai, RK, Ram, U, Rana, SM, Rankin, Z, Rao, PV, Rao, PC, Rawaf, S, Rego, MAS, Reitsma, M, Remuzzi, G, Renzaho, AMNN, Resnikoff, S ; https://orcid.org/0000-0002-5866-4446, Rezaei, S, Rezai, MS, Ribeiro, AL, Roba, HS, Rokni, MB, Ronfani, L, Roshandel, G, Roth, GA, Rothenbacher, D, Roy, NK, Sachdev, PS ; https://orcid.org/0000-0002-9595-3220, Sackey, BB, Saeedi, MY, Safiri, S, Sagar, R, Sahraian, MA, Saleh, MM, Salomon, JA, Samy, AM, Sanabria, JR, Sanchez-Niño, MD, Sandar, L, Santos, IS, Santos, JV, Milicevic, MMS, Sarmiento-Suarez, R, Sartorius, B, Satpathy, M, Savic, M, Sawhney, M, Saylan, MI, Schöttker, B, Schutte, AE ; https://orcid.org/0000-0001-9217-4937, Schwebel, DC, Seedat, S, Seid, AM, Seifu, CN, Sepanlou, SG, Serdar, B, Servan-Mori, EE, Setegn, T, Shackelford, KA, Shaheen, A, Shahraz, S, Shaikh, MA, Shakh-Nazarova, M, Shamsipour, M, Islam, SMS, Sharma, J, Sharma, R, She, J, Sheikhbahaei, S, Shen, J, Shi, P, Shigematsu, M, Shin, M-J, Shiri, R, Shoman, H, Shrime, MG, Sibamo, ELS, Sigfusdottir, ID, Silva, DAS, Silveira, DGA, Sindi, S, Singh, A, Singh, JA, Singh, OP, Singh, PK, Singh, V, Sinke, AH, Sinshaw, AE, Skirbekk, V, Sliwa, K, Smith, A, Sobngwi, E, Soneji, S, Soriano, JB, Sousa, TCM, Sposato, LA, Sreeramareddy, CT, Stathopoulou, V, Steel, N, Steiner, C, Steinke, S, Stokes, MA, Stranges, S, Strong, M, Stroumpoulis, K, Sturua, L, Sufiyan, MB, Suliankatchi, RA, Sun, J, Sur, P, Swaminathan, S, Sykes, BL, Tabarés-Seisdedos, R, Tabb, KM, Taffere, GR, Talongwa, RT, Tarajia, M, Tavakkoli, M, Taveira, N, Teeple, S, Tegegne, TK, Tehrani-Banihashemi, A, Tekelab, T, Tekle, DY, Shifa, GT, Terkawi, AS, Tesema, AG ; https://orcid.org/0000-0003-0618-4499, Thakur, JS, Thomson, AJ, Tillmann, T, Tiruye, TY, Tobe-Gai, R, Tonelli, M, Topor-Madry, R, Tortajada, M, Troeger, C, Truelsen, T, Tura, AK, Uchendu, US, Ukwaja, KN, Undurraga, EA, Uneke, CJ, Uthman, OA, van Boven, JFM, Van Dingenen, R, Varughese, S, Vasankari, T, Venketasubramanian, N, Violante, FS, Vladimirov, SK, Vlassov, VV, Vollset, SE, Vos, T, Wagner, JA, Wakayo, T, Waller, SG, Walson, JL, Wang, H, Wang, Y-P, Watkins, DA, Weiderpass, E, Weintraub, RG, Wen, C-P, Werdecker, A, Wesana, J, Westerman, R, Whiteford, HA, Wilkinson, JD, Wiysonge, CS, Woldeyes, BG, Wolfe, CDA, Won, S, Workicho, A, Workie, SB, Wubshet, M, Xavier, D, Xu, G, Yadav, AK, Yaghoubi, M, Yakob, B, Yan, LL, Yano, Y, Yaseri, M, Yimam, HH, Yip, P, Yonemoto, N, Yoon, S-J, Younis, MZ, Yu, C, Zaidi, Z, El Sayed Zaki, M, Zambrana-Torrelio, C, Zapata, T, Zenebe, ZM, Zodpey, S, Zoeckler, L, Zuhlke, LJ, Murray, CJL, Barber, RM, Fullman, N, Sorensen, RJD, Bollyky, T, McKee, M, Nolte, E, Abajobir, AA, Abate, KH, Abbafati, C, Abbas, KM, Abd-Allah, F, Abdulle, AM, Abdurahman, AA, Abera, SF, Abraham, B, Abreha, GF, Adane, K, Adelekan, AL, Adetifa, IMO, Afshin, A, Agarwal, A, Agarwal, SK, Agarwal, S, Agrawal, A, Kiadaliri, AA, Ahmadi, A, Ahmed, KY, Ahmed, MB, Akinyemi, RO, Akinyemiju, TF, Akseer, N, Al-Aly, Z, Alam, K, Alam, N, Alam, SS, Alemu, ZA, Alene, KA, Alexander, L, Ali, R, Ali, SD, Alizadeh-Navaei, R, Alkerwi, A, Alla, F, Allebeck, P, Allen, C, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Martin, EA, Alvis-Guzman, N, Amare, AT, Amini, E, Ammar, W, Amo-Adjei, J, Amoako, YA, Anderson, BO, Androudi, S, Ansari, H, Ansha, MG, Antonio, CAT, Ärnlöv, J, Artaman, A, Asayesh, H, Assadi, R, Astatkie, A, Atey, TM, Atique, S, Atnafu, NT, Atre, SR, Avila-Burgos, L, Avokpaho, EFGA, Quintanilla, BPA, Awasthi, A, Ayele, NN, Azzopardi, P, Saleem, HOB, Bärnighausen, T, Bacha, U, Badawi, A, Banerjee, A, Barac, A, Barboza, MA, Barker-Collo, SL, Barrero, LH, Basu, S, Baune, BT, Baye, K, Bayou, YT, Bazargan-Hejazi, S, Bedi, N, Beghi, E, Béjot, Y, Bello, AK, Bennett, DA, Bensenor, IM, Berhane, A, Bernabé, E, Bernal, OA, Beyene, AS, Beyene, TJ, Bhutta, ZA, Biadgilign, S, Bikbov, B, Birlik, SM, Birungi, C, Biryukov, S, Bisanzio, D, Bizuayehu, HM, Bose, D, Brainin, M, Brauer, M, Brazinova, A, Breitborde, NJK, Brenner, H, Butt, ZA, Cárdenas, R, Cahuana-Hurtado, L, Campos-Nonato, IR, Car, J, Carrero, JJ, Casey, D, Caso, V, Castañeda-Orjuela, CA, Rivas, JC, Catalá-López, F, Cecilio, P, Cercy, K, Charlson, FJ, Chen, AZ, Chew, A, Chibalabala, M, Chibueze, CE, Chisumpa, VH, Chitheer, AA, Chowdhury, R, Christensen, H, Christopher, DJ, Ciobanu, LG, Cirillo, M, Coggeshall, MS, Cooper, LT, Cortinovis, M, Crump, JA, Dalal, K, Danawi, H, Dandona, L, Dandona, R, Dargan, PI, das Neves, J, Davey, G, Davitoiu, DV, Davletov, K, De Leo, D, Del Gobbo, LC, del Pozo-Cruz, B, Dellavalle, RP, Deribe, K, Deribew, A, Des Jarlais, DC, Dey, S, Dharmaratne, SD, Dicker, D, Ding, EL, Dokova, K, Dorsey, ER, Doyle, KE, Dubey, M, Ehrenkranz, R, Ellingsen, CL, Elyazar, I, Enayati, A, Ermakov, SP, Eshrati, B, Esteghamati, A, Estep, K, Fürst, T, Faghmous, IDA, Fanuel, FBB, Faraon, EJA, Farid, TA, Farinha, CSES, Faro, A, Farvid, MS, Farzadfar, F, Feigin, VL, Feigl, AB, Fereshtehnejad, S-M, Fernandes, JG, Fernandes, JC, Feyissa, TR, Fischer, F, Fitzmaurice, C, Fleming, TD, Foigt, N, Foreman, KJ, Forouzanfar, MH, Franklin, RC, Frostad, J, G/hiwot, TT, Gakidou, E, Gambashidze, K, Gamkrelidze, A, Gao, W, Garcia-Basteiro, AL, Gebre, T, Gebremedhin, AT, Gebremichael, MW, Gebru, AA, Gelaye, AA, Geleijnse, JM, Genova-Maleras, R, Gibney, KB, Giref, AZ, Gishu, MD, Giussani, G, Godwin, WW, Gold, A, Goldberg, EM, Gona, PN, Goodridge, A, Gopalani, SV, Goto, A, Graetz, N, Greaves, F, Griswold, M, Guban, PI, Gugnani, HC, Gupta, PC, Gupta, R, Gupta, T, Gupta, V, Habtewold, TD, Hafezi-Nejad, N, Haile, D, Hailu, AD, Hailu, GB, Hakuzimana, A, Hamadeh, RR, Hambisa, MT ; https://orcid.org/0000-0003-3193-8053, Hamidi, S, Hammami, M, Hankey, GJ, Hao, Y, Harb, HL, Hareri, HA, Haro, JM, Hassanvand, MS, Havmoeller, R, Hay, RJ, Hay, SI, Hendrie, D, Heredia-Pi, IB, Hoek, HW, Horino, M, Horita, N, Hosgood, HD, Htet, AS, Hu, G, Huang, H, Huang, JJ, Huntley, BM, Huynh, C, Iburg, KM, Ileanu, BV, Innos, K, Irenso, AA, Jahanmehr, N, Jakovljevic, MB, James, P, James, SL, Javanbakht, M, Jayaraman, SP, Jayatilleke, AU, Jeemon, P, Jha, V ; https://orcid.org/0000-0002-8015-9470, John, D, Johnson, C, Johnson, SC, Jonas, JB, Juel, K, Kabir, Z, Kalkonde, Y, Kamal, R, Kan, H, Karch, A, Karema, CK, Karimi, SM, Kasaeian, A, Kassebaum, NJ, Kastor, A, Katikireddi, SV, Kazanjan, K, Keiyoro, PN, Kemmer, L, Kemp, AH, Kengne, AP, Kerbo, AA, Kereselidze, M, Kesavachandran, CN, Khader, YS, Khalil, I, Khan, AR, Khan, EA, Khan, G, Khang, Y-H, Khoja, ATA, Khonelidze, I, Khubchandani, J, Kibret, GD, Kim, D, Kim, P, Kim, YJ, Kimokoti, RW, Kinfu, Y, Kissoon, N, Kivipelto, M, Kokubo, Y, Kolk, A, Kolte, D, Kopec, JA, Kosen, S, Koul, PA, Koyanagi, A, Kravchenko, M, Krishnaswami, S, Krohn, KJ, Defo, BK, Bicer, BK, Kuipers, EJ, Kulkarni, VS, Kumar, GA, Kumsa, FA, Kutz, M, Kyu, HH, Lager, ACJ, Lal, A, Lal, DK, Lalloo, R, Lallukka, T, Lan, Q, Langan, SM, Lansingh, VC, Larson, HJ, Larsson, A, Laryea, DO, Latif, AA, Lawrynowicz, AEB, Leasher, JL, Leigh, J, Leinsalu, M, Leshargie, CT, Leung, J ; https://orcid.org/0000-0001-5816-2959, Leung, R, Levi, M, Liang, X, Lim, SS, Lind, M, Linn, S, Lipshultz, SE, Liu, P, Liu, Y, Lo, L-T, Logroscino, G, Lopez, AD, Lorch, SA, Lotufo, PA, Lozano, R, Lunevicius, R, Lyons, RA, Macarayan, ERK, Mackay, MT, El Razek, HMA, El Razek, MMA, Mahdavi, M, Majeed, A, Malekzadeh, R, Malta, DC, Mantovani, LG, Manyazewal, T, Mapoma, CC, Marcenes, W, Marks, GB ; https://orcid.org/0000-0002-8976-8053, Marquez, N, Martinez-Raga, J, Marzan, MB, Massano, J, Mathur, MR, Maulik, PK ; https://orcid.org/0000-0001-6835-6175, Mazidi, M, McAlinden, C, McGrath, JJ, McNellan, C, Meaney, PA, Mehari, A, Mehndiratta, MM, Meier, T, Mekonnen, AB, Meles, KG, Memish, ZA, Mengesha, MM, Mengiste, DT, Mengistie, MA, Menota, BG, Mensah, GA, Mereta, ST, Meretoja, A, Meretoja, TJ, Mezgebe, HB, Micha, R, Millear, A, Mills, EJ, Minnig, S, Mirarefin, M, Mirrakhimov, EM, Mock, CN, Mohammad, KA, Mohammed, S, Mohanty, SK, Mokdad, AH, Mola, GLD, Molokhia, M, Monasta, L, Montico, M, Moradi-Lakeh, M, Moraga, P, Morawska, L, Mori, R, Moses, M, Mueller, UO, Murthy, S, Musa, KI, Nachega, JB, Nagata, C, Nagel, G, Naghavi, M, Naheed, A, Naldi, L, Nangia, V, Nascimento, BR, Negoi, I, Neupane, SP, Newton, CR, Ng, M, Ngalesoni, FN, Ngunjiri, JW, Nguyen, G, Ningrum, DNA, Nolte, S, Nomura, M, Norheim, OF, Norrving, B, Noubiap, JJN, Obermeyer, CM, Ogbo, FA, Oh, I-H, Okoro, A, Oladimeji, O, Olagunju, AT, Olivares, PR, Olsen, HE, Olusanya, BO, Olusanya, JO, Opio, JN, Oren, E, Ortiz, A, Osborne, RH, Osman, M, Owolabi, MO, PA, M, Pain, AW, Pakhale, S, Castillo, EP, Pana, A, Papachristou, C, Parsaeian, M, Patel, T, Patton, GC, Paudel, D, Paul, VK, Pearce, N, Pereira, DM, Perez-Padilla, R, Perez-Ruiz, F, Perico, N, Pesudovs, K ; https://orcid.org/0000-0002-6322-9369, Petzold, M, Phillips, MR, Pigott, DM, Pillay, JD, Pinho, C, Polinder, S, Pond, CD, Prakash, V, Purwar, M, Qorbani, M, Quistberg, DA, Radfar, A, Rafay, A, Rahimi, K, Rahimi-Movaghar, V, Rahman, M, Rahman, MHU, Rai, RK, Ram, U, Rana, SM, Rankin, Z, Rao, PV, Rao, PC, Rawaf, S, Rego, MAS, Reitsma, M, Remuzzi, G, Renzaho, AMNN, Resnikoff, S ; https://orcid.org/0000-0002-5866-4446, Rezaei, S, Rezai, MS, Ribeiro, AL, Roba, HS, Rokni, MB, Ronfani, L, Roshandel, G, Roth, GA, Rothenbacher, D, Roy, NK, Sachdev, PS ; https://orcid.org/0000-0002-9595-3220, Sackey, BB, Saeedi, MY, Safiri, S, Sagar, R, Sahraian, MA, Saleh, MM, Salomon, JA, Samy, AM, Sanabria, JR, Sanchez-Niño, MD, Sandar, L, Santos, IS, Santos, JV, Milicevic, MMS, Sarmiento-Suarez, R, Sartorius, B, Satpathy, M, Savic, M, Sawhney, M, Saylan, MI, Schöttker, B, Schutte, AE ; https://orcid.org/0000-0001-9217-4937, Schwebel, DC, Seedat, S, Seid, AM, Seifu, CN, Sepanlou, SG, Serdar, B, Servan-Mori, EE, Setegn, T, Shackelford, KA, Shaheen, A, Shahraz, S, Shaikh, MA, Shakh-Nazarova, M, Shamsipour, M, Islam, SMS, Sharma, J, Sharma, R, She, J, Sheikhbahaei, S, Shen, J, Shi, P, Shigematsu, M, Shin, M-J, Shiri, R, Shoman, H, Shrime, MG, Sibamo, ELS, Sigfusdottir, ID, Silva, DAS, Silveira, DGA, Sindi, S, Singh, A, Singh, JA, Singh, OP, Singh, PK, Singh, V, Sinke, AH, Sinshaw, AE, Skirbekk, V, Sliwa, K, Smith, A, Sobngwi, E, Soneji, S, Soriano, JB, Sousa, TCM, Sposato, LA, Sreeramareddy, CT, Stathopoulou, V, Steel, N, Steiner, C, Steinke, S, Stokes, MA, Stranges, S, Strong, M, Stroumpoulis, K, Sturua, L, Sufiyan, MB, Suliankatchi, RA, Sun, J, Sur, P, Swaminathan, S, Sykes, BL, Tabarés-Seisdedos, R, Tabb, KM, Taffere, GR, Talongwa, RT, Tarajia, M, Tavakkoli, M, Taveira, N, Teeple, S, Tegegne, TK, Tehrani-Banihashemi, A, Tekelab, T, Tekle, DY, Shifa, GT, Terkawi, AS, Tesema, AG ; https://orcid.org/0000-0003-0618-4499, Thakur, JS, Thomson, AJ, Tillmann, T, Tiruye, TY, Tobe-Gai, R, Tonelli, M, Topor-Madry, R, Tortajada, M, Troeger, C, Truelsen, T, Tura, AK, Uchendu, US, Ukwaja, KN, Undurraga, EA, Uneke, CJ, Uthman, OA, van Boven, JFM, Van Dingenen, R, Varughese, S, Vasankari, T, Venketasubramanian, N, Violante, FS, Vladimirov, SK, Vlassov, VV, Vollset, SE, Vos, T, Wagner, JA, Wakayo, T, Waller, SG, Walson, JL, Wang, H, Wang, Y-P, Watkins, DA, Weiderpass, E, Weintraub, RG, Wen, C-P, Werdecker, A, Wesana, J, Westerman, R, Whiteford, HA, Wilkinson, JD, Wiysonge, CS, Woldeyes, BG, Wolfe, CDA, Won, S, Workicho, A, Workie, SB, Wubshet, M, Xavier, D, Xu, G, Yadav, AK, Yaghoubi, M, Yakob, B, Yan, LL, Yano, Y, Yaseri, M, Yimam, HH, Yip, P, Yonemoto, N, Yoon, S-J, Younis, MZ, Yu, C, Zaidi, Z, El Sayed Zaki, M, Zambrana-Torrelio, C, Zapata, T, Zenebe, ZM, Zodpey, S, Zoeckler, L, Zuhlke, LJ, and Murray, CJL

Abstract

Background National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. Methods We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure-the Healthcare Quality and Access (HAQ) Index-on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r=0·88), an index of 11 universal health coverage interventions (r=0·83), and human resources for health per 1000 (r=0·77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertilit

Published
2017

3. Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970-2016: a systematic analysis for the Global Burden of Disease Study 2016

Author

Wang, H, Abajobir, AA, Abate, KH, Abbafati, C, Abbas, KM, Abd-Allah, F, Abera, SF, Abraha, HN, Abu-Raddad, LJ, Abu-Rmeileh, NME, Adedeji, IA, Adedoyin, RA, Adetifa, IMO, Adetokunboh, O, Afshin, A, Aggarwal, R, Agrawal, A, Agrawal, S, Kiadaliri, AA, Ahmed, MB, Aichour, AN, Aichour, I, Aichour, MTE, Aiyar, S, Akanda, S, Akinyemiju, TF, Akseer, N, Al-Eyadhy, A, Al Lami, FH, Alabed, S, Alahdab, F, Al-Aly, Z, Alam, K, Alam, N, Alasfoor, D, Aldridge, RW, Alene, KA, Alhabib, S, Ali, R, Alizadeh-Navaei, R, Aljunid, SM, Alkaabi, JM, Alkerwi, A, Alla, F, Allam, SD, Allebeck, P, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Martin, EA, Alvis-Guzman, N, Amare, AT, Ameh, EA, Amini, E, Ammar, W, Amoako, YA, Anber, N, Andrei, CL, Androudi, S, Ansari, H, Ansha, MG, Antonio, CAT, Anwari, P, Arnlov, J, Arora, M, Al, A, Aryal, KK, Asayesh, H, Asgedom, SW, Asghar, RJ, Assadi, R, Atey, TM, Atre, SR, Avila-Burgos, L, Avokpaho, EFGA, Awasthi, A, Quintanilla, BPA, Babalola, TK, Bacha, U, Badawi, A, Balakrishnan, K, Balalla, S, Barac, A, Barber, RM, Barboza, MA, Barker-Collo, SL, Barnighausen, T, Barquera, S, Barregard, L, Barrero, LH, Baune, BT, Bazargan-Hejazi, S, Bedi, N, Beghi, E, Bejot, Y, Bekele, BB, Bell, ML, Bello, AK, Bennett, DA, Bennett, JR, Bensenor, IM, Benson, J, Berhane, A, Berhe, DF, Bernabe, E, Beuran, M, Beyene, AS, Bhala, N, Bhansali, A, Bhaumik, S ; https://orcid.org/0000-0001-9579-4453, Bhutta, ZA, Bikbov, B, Birungi, C, Biryukov, S, Bisanzio, D, Bizuayehu, HM, Bjerregaard, P, Blosser, CD, Boneya, DJ, Boufous, S ; https://orcid.org/0000-0002-5686-1729, Bourne, RRA, Brazinova, A, Breitborde, NJK, Brenner, H, Brugha, TS, Bukhman, G, Negesa, L, Bulto, B, Bumgarner, BR, Burch, M, Butt, ZA, Cahill, LE, Cahuana-Hurtado, L, Campos-Nonato, IR, Car, J, Car, M, Crdenas, R, Carpenter, DO, Carrero, JJ, Carter, A, Castaneda-Orjuela, CA, Rivas, JC, Castro, FF, Castro, RE, Catala-Lopez, F, Chen, H, Chiang, PP-C, Chibalabala, M, Chisumpa, VH, Chitheer, AA, Choi, J-YJ, Christensen, H, Christopher, DJ, Ciobanu, LG, Cirillo, M, Cohen, AJ, Colquhoun, SM, Coresh, J, Criqui, MH, Cromwell, EA, Crump, JA, Dandona, L, Dandona, R, Dargan, PI, das Neves, J, Davey, G, Davitoiu, DV, Davletov, K, de Courten, B, De Leo, D, Degenhardt, L ; https://orcid.org/0000-0002-8513-2218, Deiparine, S, Dellavalle, RP, Deribe, K, Deribew, A, Des Jarlais, DC, Dey, S, Dharmaratne, SD, Dherani, MK, Diaz-Torne, C, Ding, EL, Dixit, P, Djalalinia, S, Huyen, PD, Doku, DT, Donnelly, CA, Priscila, K, dos Santos, B, Douwes-Schultz, D, Driscoll, TR, Duan, L, Dubey, M, Duncan, BB, Dwivedi, LK, Ebrahimi, H, El Bcheraoui, C, Ellingsen, CL, Enayati, A, Endries, AY, Ermakov, SP, Eshetie, S, Eshrati, B, Eskandarieh, S, Esteghamati, A, Estep, K, Fanuel, BBF, Faro, A, Farvid, MS, Farzadfar, F, Feigin, VL, Fereshtehnejad, S-M, Fernandes, JG, Fernandes, JC, Feyissa, TR, Filip, I, Fischer, F, Foigt, N, Foreman, KJ, Frank, T, Franklin, RC, Fraser, M, Friedman, J, Frostad, JJ, Fullman, N, Furst, T, Furtado, JM, Futran, ND, Gakidou, E, Gambashidze, K, Gamkrelidze, A, Gankpe, FG, Garcia-Basteiro, AL, Gebregergs, GB, Gebrehiwot, TT, Gebrekidan, KG, Gebremichael, MW, Gelaye, AA, Geleijnse, JM, Gemechu, BL, Gemechu, KS, Genova-Maleras, R, Gesesew, HA, Gething, PW, Gibney, KB, Gill, PS, Gillum, RF, Giref, AZ, Girma, BW, Giussani, G, Goenka, S, Gomez, B, Gona, PN, Gopalani, SV, Goulart, AC, Graetz, N, Gugnani, HC, Gupta, PC, Gupta, R, Gupta, T, Gupta, V, Haagsma, JA, Hafezi-Nejad, N, Bidgoli, HH, Hakuzimana, A, Halasa, YA, Hamadeh, RR, Hambisa, MT ; https://orcid.org/0000-0003-3193-8053, Hamidi, S, Hammami, M, Hancock, J, Handal, AJ, Hankey, GJ, Hao, Y, Harb, HL, Hareri, HA, Harikrishnan, S, Haro, JM, Hassanvand, MS, Havmoeller, R, Hay, RJ, Hay, SI, He, F, Heredia-Pi, IB, Herteliu, C, Hilawe, EH, Hoek, HW, Horita, N, Hosgood, HD, Hostiuc, S, Hotez, PJ, Hoy, DG, Hsairi, M, Htet, AS, Hu, G, Huang, H, Huang, JJ, Iburg, KM, Igumbor, EU, Ileanu, BV, Inoue, M, Irenso, AA, Irvine, CMS, Islam, N, Jacobsen, KH, Jaenisch, T, Jahanmehr, N, Jakovljevic, MB, Javanbakht, M, Jayatilleke, AU, Jeemon, P, Jensen, PN, Jha, V ; https://orcid.org/0000-0002-8015-9470, Jin, Y, John, D, John, O ; https://orcid.org/0000-0002-9008-1726, Johnson, SC, Jonas, JB, Jurisson, M, Kabir, Z, Kadel, R, Kahsay, A, Kalkonde, Y, Kamal, R, Kan, H, Karch, A, Karema, CK, Karimi, SM, Karthikeyan, G, Kasaeian, A, Kassaw, NA, Kassebaum, NJ, Kastor, A, Katikireddi, SV, Kaul, A, Kawakami, N, Kazanjan, K, Keiyoro, PN, Kelbore, SG, Kemp, AH, Kengne, AP, Keren, A, Kereselidze, M, Kesavachandran, CN, Ketema, EB, Khader, YS, Khalil, IA, Khan, EA, Khan, G, Khang, Y-H, Khera, S, Khoja, ATA, Khosravi, MH, Kibret, GD, Kieling, C, Kim, C-I, Kim, D, Kim, P, Kim, S, Kim, YJ, Kimokoti, RW, Kinfu, Y, Kishawi, S, Kissimova-Skarbek, KA, Kissoon, N, Kivimaki, M, Knudsen, AK, Kokubo, Y, Kopec, JA, Kosen, S, Koul, PA, Koyanagi, A, Kravchenko, M, Krohn, KJ, Defo, BK, Bicer, BK, Kuipers, EJ, Kulikoff, XR, Kulkarni, VS, Kumar, GA, Kumar, P, Kumsa, FA, Kutz, M, Lachat, C, Lagat, AK, Lager, ACJ, Lal, DK, Lalloo, R, Lambert, N, Lan, Q, Lansingh, VC, Larson, HJ, Larsson, A, Laryea, DO, Lavados, PM, Laxmaiah, A, Lee, PH, Leigh, J, Leung, J ; https://orcid.org/0000-0001-5816-2959, Leung, R, Levi, M, Li, Y, Liao, Y, Liben, ML, Lim, SS, Linn, S, Lipshultz, SE, Liu, S, Lodha, R, Logroscino, G, Lorch, SA, Lorkowski, S, Lotufo, PA, Lozano, R, Lunevicius, R, Lyons, RA, Ma, S, Macarayan, ERK, Machado, IE, Mackay, MT, Abd el Razek, MM, Magis-Rodriguez, C, Mahdavi, M, Majdan, M, Majdzadeh, R, Majeed, A, Malekzadeh, R, Malhotra, R, Malta, DC, Mantovani, LG, Manyazewal, T, Mapoma, CC, Marczak, LB, Marks, GB ; https://orcid.org/0000-0002-8976-8053, Martinez-Raga, J, Martins-Melo, FR, Massano, J, Maulik, PK ; https://orcid.org/0000-0001-6835-6175, Mayosi, BM, Mazidi, M, McAlinden, C, McGarvey, ST, McGrath, JJ, Mckee, M, Mehata, S, Mehndiratta, MM, Mehta, KM, Meier, T, Mekonnen, TC, Meles, KG, Memiah, P, Memish, ZA, Mendoza, W, Mengesha, MM, Mengistie, MA, Tadese, D, Menon, MGR, Menota, BG, Mensah, GA, Meretoja, A, Meretoja, TJ, Mezgebe, HB, Micha, R, Mikesell, J, Miller, TR, Mills, EJ, Minnig, S, Mirarefin, M, Mirrakhimov, EM, Misganaw, A, Mishra, SR, Mohammad, KA, Mohammadi, A, Mohammed, KESM, Mohan, MBV, Mohanty, SK, Mokdad, AH, Assaye, AM, Mollenkopf, SK, Molokhia, M, Monasta, L, Hernandez, JCM, Montico, M, Mooney, MD, Moore, AR, Moradi-Lakeh, M, Moraga, P, Morawska, L, Velasquez, IM, Mori, R, Morrison, SD, Mruts, KB, Mueller, UO, Mullany, E, Muller, K, Venkata, G, Murthy, S, Musa, KI, Nachega, JB, Nagata, C, Nagel, G, Naghavi, M, Naidoo, KS ; https://orcid.org/0000-0001-8261-9779, Nanda, L, Nangia, V, Nascimento, BR, Natarajan, G, Negoi, I, Cuong, TN, Ningrum, DNA, Nisar, MI, Nomura, M, Vuong, MN, Norheim, OF, Norrving, B, Noubiap, JJN, Nyakarahuka, L, Obermeyer, CM, O'Donnell, MJ, Ogbo, FA, Oh, I-H, Okoro, A, Oladimeji, O, Olagunju, AT, Olusanya, BO, Olusanya, JO, Oren, E, Ortiz, A, Osgood-Zimmerman, A, Ota, E, Owolabi, MO, Oyekale, AS, Pa, M, Pacella, RE, Pakhale, S, Pana, A, Panda, BK, Panda-Jonas, S, Park, E-K, Parsaeian, M, Patel, T, Patten, SB, Patton, GC, Paudel, D, Pereira, DM, Perez-Padilla, R, Perez-Ruiz, F, Perico, N, Pervaiz, A, Pesudovs, K ; https://orcid.org/0000-0002-6322-9369, Peterson, CB, Petri, WA, Petzold, M, Phillips, MR, Piel, FB, Pigott, DM, Pishgar, F, Plass, D, Polinder, S, Popova, S, Postma, MJ, Poulton, RG, Pourmalek, F, Prasad, N, Purwar, M, Qorbani, M, Rabiee, RHS, Radfar, A, Rafay, A, Rahimi-Movaghar, A, Rahimi-Movaghar, V, Rahman, M, Rahman, MHU, Rahman, SU, Rai, RK, Rajsic, S, Ram, U, Rana, SM, Ranabhat, CL, Rao, PV, Rawaf, S, Ray, SE, Rego, MAS, Rehm, J, Reiner, RC, Remuzzi, G, Renzaho, AMNN, Resnikoff, S ; https://orcid.org/0000-0002-5866-4446, Rezaei, S, Rezai, MS, Ribeiro, AL, Rokni, MB, Ronfani, L, Roshandel, G, Roth, GA, Rothenbacher, D, Roy, A, Rubagotti, E, Ruhago, GM, Saadat, S, Sabde, YD, Sachdev, PS ; https://orcid.org/0000-0002-9595-3220, Sadat, N, Safdarian, M, Safiri, SSS, Sagar, R, Sahathevan, R, Sahebkar, A, Sahraian, MA, Salama, J, Salamati, P, Salomon, JA, Salvi, SS, Samy, AM, Sanabria, JR, Sanchez-Nino, MD, Santos, IS, Milicevic, MMS, Sarmiento-Suarez, R, Sartorius, B, Satpathy, M, Sawhney, M, Saxena, S, Saylan, MI, Schmidt, MI, Schneider, IJC, Schutte, AE ; https://orcid.org/0000-0001-9217-4937, Schwebel, DC, Schwendicke, F, Seedat, S, Seid, AM, Sepanlou, SG, Servan-Mori, EE, Shackelford, KA, Shaheen, A, Shahraz, S, Shaikh, MA, Shamsipour, M, Shamsizadeh, M, Islam, SMS, Sharma, J, Sharma, R, She, J, Shen, J, Shetty, BP, Shi, P, Shibuya, K, Shigematsu, M, Shiri, R, Shiue, I, Shrime, MG, Sigfusdottir, ID, Silberberg, DH, Silpakit, N, Silva, DAS, Silva, JP, Silveira, DGA, Sindi, S, Singh, A, Singh, JA, Singh, PK, Singh, V, Sinha, DN, Skiadaresi, E, Sligar, A, Smith, DL, Sobaih, BHA, Sobngwi, E, Soneji, S, Soriano, JB, Sreeramareddy, CT, Srinivasan, V, Stathopoulou, V, Steel, N, Stein, DJ, Steiner, C, Stockl, H, Stokes, MA, Strong, M, Sufiyan, MB, Suliankatchi, RA, Sunguya, BF, Sur, PJ, Swaminathan, S, Sykes, BL, Szoeke, CEI, Tabares-Seisdedos, R, Tadakamadla, SK, Tadese, F, Tandon, N, Tanne, D, Tarajia, M, Tavakkoli, M, Taveira, N, Tehrani-Banihashemi, A, Tekelab, T, Tekle, DY, Shifa, GT, Temsah, M-H, Terkawi, AS, Tesema, CL, Tesssema, B, Theis, A, Thomas, N, Thompson, AH, Thomson, AJ, Thrift, AG, Tiruye, TY, Tobe-Gai, R, Tonelli, M, Topor-Madry, R, Topouzis, F, Tortajada, M, Tran, BX, Trujillo, TTU, Tsilimparis, N, Tuem, KB, Tuzcu, EM, Tyrovolas, S, Ukwaja, KN, Undurraga, EA, Uthman, OA, Uzochukwu, BSC, van Boven, JFM, Varakin, YY, Varughese, S, Vasankari, T, Vasconcelos, AMN, Venketasubramanian, N, Vidavalur, R, Violante, FS, Vishnu, A, Vladimirov, SK, Vlassov, VV, Vollset, SE, Vos, T, Waid, JL, Wakayo, T, Wang, Y-P, Weichenthal, S, Weiderpass, E, Weintraub, RG, Werdecker, A, Wesana, J, Wijeratne, T, Wilkinson, JD, Wiysonge, CS, Woldeyes, BG, Wolfe, CDA, Workicho, A, Workie, SB, Xavier, D, Xu, G, Yaghoubi, M, Yakob, B, Yalew, AZ, Yan, LL, Yano, Y, Yaseri, M, Ye, P ; https://orcid.org/0000-0002-2924-1436, Yimam, HH, Yip, P, Yirsaw, BD, Yonemoto, N, Yoon, S-J, Yotebieng, M, Younis, MZ, Zaidi, Z, Zaki, MES, Zeeb, H, Zenebe, ZM, Zerfu, TA, Zhang, AL, Zhang, X, Zodpey, S, Zuhlke, LJ, Lopez, AD, Murray, CJL, Wang, H, Abajobir, AA, Abate, KH, Abbafati, C, Abbas, KM, Abd-Allah, F, Abera, SF, Abraha, HN, Abu-Raddad, LJ, Abu-Rmeileh, NME, Adedeji, IA, Adedoyin, RA, Adetifa, IMO, Adetokunboh, O, Afshin, A, Aggarwal, R, Agrawal, A, Agrawal, S, Kiadaliri, AA, Ahmed, MB, Aichour, AN, Aichour, I, Aichour, MTE, Aiyar, S, Akanda, S, Akinyemiju, TF, Akseer, N, Al-Eyadhy, A, Al Lami, FH, Alabed, S, Alahdab, F, Al-Aly, Z, Alam, K, Alam, N, Alasfoor, D, Aldridge, RW, Alene, KA, Alhabib, S, Ali, R, Alizadeh-Navaei, R, Aljunid, SM, Alkaabi, JM, Alkerwi, A, Alla, F, Allam, SD, Allebeck, P, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Martin, EA, Alvis-Guzman, N, Amare, AT, Ameh, EA, Amini, E, Ammar, W, Amoako, YA, Anber, N, Andrei, CL, Androudi, S, Ansari, H, Ansha, MG, Antonio, CAT, Anwari, P, Arnlov, J, Arora, M, Al, A, Aryal, KK, Asayesh, H, Asgedom, SW, Asghar, RJ, Assadi, R, Atey, TM, Atre, SR, Avila-Burgos, L, Avokpaho, EFGA, Awasthi, A, Quintanilla, BPA, Babalola, TK, Bacha, U, Badawi, A, Balakrishnan, K, Balalla, S, Barac, A, Barber, RM, Barboza, MA, Barker-Collo, SL, Barnighausen, T, Barquera, S, Barregard, L, Barrero, LH, Baune, BT, Bazargan-Hejazi, S, Bedi, N, Beghi, E, Bejot, Y, Bekele, BB, Bell, ML, Bello, AK, Bennett, DA, Bennett, JR, Bensenor, IM, Benson, J, Berhane, A, Berhe, DF, Bernabe, E, Beuran, M, Beyene, AS, Bhala, N, Bhansali, A, Bhaumik, S ; https://orcid.org/0000-0001-9579-4453, Bhutta, ZA, Bikbov, B, Birungi, C, Biryukov, S, Bisanzio, D, Bizuayehu, HM, Bjerregaard, P, Blosser, CD, Boneya, DJ, Boufous, S ; https://orcid.org/0000-0002-5686-1729, Bourne, RRA, Brazinova, A, Breitborde, NJK, Brenner, H, Brugha, TS, Bukhman, G, Negesa, L, Bulto, B, Bumgarner, BR, Burch, M, Butt, ZA, Cahill, LE, Cahuana-Hurtado, L, Campos-Nonato, IR, Car, J, Car, M, Crdenas, R, Carpenter, DO, Carrero, JJ, Carter, A, Castaneda-Orjuela, CA, Rivas, JC, Castro, FF, Castro, RE, Catala-Lopez, F, Chen, H, Chiang, PP-C, Chibalabala, M, Chisumpa, VH, Chitheer, AA, Choi, J-YJ, Christensen, H, Christopher, DJ, Ciobanu, LG, Cirillo, M, Cohen, AJ, Colquhoun, SM, Coresh, J, Criqui, MH, Cromwell, EA, Crump, JA, Dandona, L, Dandona, R, Dargan, PI, das Neves, J, Davey, G, Davitoiu, DV, Davletov, K, de Courten, B, De Leo, D, Degenhardt, L ; https://orcid.org/0000-0002-8513-2218, Deiparine, S, Dellavalle, RP, Deribe, K, Deribew, A, Des Jarlais, DC, Dey, S, Dharmaratne, SD, Dherani, MK, Diaz-Torne, C, Ding, EL, Dixit, P, Djalalinia, S, Huyen, PD, Doku, DT, Donnelly, CA, Priscila, K, dos Santos, B, Douwes-Schultz, D, Driscoll, TR, Duan, L, Dubey, M, Duncan, BB, Dwivedi, LK, Ebrahimi, H, El Bcheraoui, C, Ellingsen, CL, Enayati, A, Endries, AY, Ermakov, SP, Eshetie, S, Eshrati, B, Eskandarieh, S, Esteghamati, A, Estep, K, Fanuel, BBF, Faro, A, Farvid, MS, Farzadfar, F, Feigin, VL, Fereshtehnejad, S-M, Fernandes, JG, Fernandes, JC, Feyissa, TR, Filip, I, Fischer, F, Foigt, N, Foreman, KJ, Frank, T, Franklin, RC, Fraser, M, Friedman, J, Frostad, JJ, Fullman, N, Furst, T, Furtado, JM, Futran, ND, Gakidou, E, Gambashidze, K, Gamkrelidze, A, Gankpe, FG, Garcia-Basteiro, AL, Gebregergs, GB, Gebrehiwot, TT, Gebrekidan, KG, Gebremichael, MW, Gelaye, AA, Geleijnse, JM, Gemechu, BL, Gemechu, KS, Genova-Maleras, R, Gesesew, HA, Gething, PW, Gibney, KB, Gill, PS, Gillum, RF, Giref, AZ, Girma, BW, Giussani, G, Goenka, S, Gomez, B, Gona, PN, Gopalani, SV, Goulart, AC, Graetz, N, Gugnani, HC, Gupta, PC, Gupta, R, Gupta, T, Gupta, V, Haagsma, JA, Hafezi-Nejad, N, Bidgoli, HH, Hakuzimana, A, Halasa, YA, Hamadeh, RR, Hambisa, MT ; https://orcid.org/0000-0003-3193-8053, Hamidi, S, Hammami, M, Hancock, J, Handal, AJ, Hankey, GJ, Hao, Y, Harb, HL, Hareri, HA, Harikrishnan, S, Haro, JM, Hassanvand, MS, Havmoeller, R, Hay, RJ, Hay, SI, He, F, Heredia-Pi, IB, Herteliu, C, Hilawe, EH, Hoek, HW, Horita, N, Hosgood, HD, Hostiuc, S, Hotez, PJ, Hoy, DG, Hsairi, M, Htet, AS, Hu, G, Huang, H, Huang, JJ, Iburg, KM, Igumbor, EU, Ileanu, BV, Inoue, M, Irenso, AA, Irvine, CMS, Islam, N, Jacobsen, KH, Jaenisch, T, Jahanmehr, N, Jakovljevic, MB, Javanbakht, M, Jayatilleke, AU, Jeemon, P, Jensen, PN, Jha, V ; https://orcid.org/0000-0002-8015-9470, Jin, Y, John, D, John, O ; https://orcid.org/0000-0002-9008-1726, Johnson, SC, Jonas, JB, Jurisson, M, Kabir, Z, Kadel, R, Kahsay, A, Kalkonde, Y, Kamal, R, Kan, H, Karch, A, Karema, CK, Karimi, SM, Karthikeyan, G, Kasaeian, A, Kassaw, NA, Kassebaum, NJ, Kastor, A, Katikireddi, SV, Kaul, A, Kawakami, N, Kazanjan, K, Keiyoro, PN, Kelbore, SG, Kemp, AH, Kengne, AP, Keren, A, Kereselidze, M, Kesavachandran, CN, Ketema, EB, Khader, YS, Khalil, IA, Khan, EA, Khan, G, Khang, Y-H, Khera, S, Khoja, ATA, Khosravi, MH, Kibret, GD, Kieling, C, Kim, C-I, Kim, D, Kim, P, Kim, S, Kim, YJ, Kimokoti, RW, Kinfu, Y, Kishawi, S, Kissimova-Skarbek, KA, Kissoon, N, Kivimaki, M, Knudsen, AK, Kokubo, Y, Kopec, JA, Kosen, S, Koul, PA, Koyanagi, A, Kravchenko, M, Krohn, KJ, Defo, BK, Bicer, BK, Kuipers, EJ, Kulikoff, XR, Kulkarni, VS, Kumar, GA, Kumar, P, Kumsa, FA, Kutz, M, Lachat, C, Lagat, AK, Lager, ACJ, Lal, DK, Lalloo, R, Lambert, N, Lan, Q, Lansingh, VC, Larson, HJ, Larsson, A, Laryea, DO, Lavados, PM, Laxmaiah, A, Lee, PH, Leigh, J, Leung, J ; https://orcid.org/0000-0001-5816-2959, Leung, R, Levi, M, Li, Y, Liao, Y, Liben, ML, Lim, SS, Linn, S, Lipshultz, SE, Liu, S, Lodha, R, Logroscino, G, Lorch, SA, Lorkowski, S, Lotufo, PA, Lozano, R, Lunevicius, R, Lyons, RA, Ma, S, Macarayan, ERK, Machado, IE, Mackay, MT, Abd el Razek, MM, Magis-Rodriguez, C, Mahdavi, M, Majdan, M, Majdzadeh, R, Majeed, A, Malekzadeh, R, Malhotra, R, Malta, DC, Mantovani, LG, Manyazewal, T, Mapoma, CC, Marczak, LB, Marks, GB ; https://orcid.org/0000-0002-8976-8053, Martinez-Raga, J, Martins-Melo, FR, Massano, J, Maulik, PK ; https://orcid.org/0000-0001-6835-6175, Mayosi, BM, Mazidi, M, McAlinden, C, McGarvey, ST, McGrath, JJ, Mckee, M, Mehata, S, Mehndiratta, MM, Mehta, KM, Meier, T, Mekonnen, TC, Meles, KG, Memiah, P, Memish, ZA, Mendoza, W, Mengesha, MM, Mengistie, MA, Tadese, D, Menon, MGR, Menota, BG, Mensah, GA, Meretoja, A, Meretoja, TJ, Mezgebe, HB, Micha, R, Mikesell, J, Miller, TR, Mills, EJ, Minnig, S, Mirarefin, M, Mirrakhimov, EM, Misganaw, A, Mishra, SR, Mohammad, KA, Mohammadi, A, Mohammed, KESM, Mohan, MBV, Mohanty, SK, Mokdad, AH, Assaye, AM, Mollenkopf, SK, Molokhia, M, Monasta, L, Hernandez, JCM, Montico, M, Mooney, MD, Moore, AR, Moradi-Lakeh, M, Moraga, P, Morawska, L, Velasquez, IM, Mori, R, Morrison, SD, Mruts, KB, Mueller, UO, Mullany, E, Muller, K, Venkata, G, Murthy, S, Musa, KI, Nachega, JB, Nagata, C, Nagel, G, Naghavi, M, Naidoo, KS ; https://orcid.org/0000-0001-8261-9779, Nanda, L, Nangia, V, Nascimento, BR, Natarajan, G, Negoi, I, Cuong, TN, Ningrum, DNA, Nisar, MI, Nomura, M, Vuong, MN, Norheim, OF, Norrving, B, Noubiap, JJN, Nyakarahuka, L, Obermeyer, CM, O'Donnell, MJ, Ogbo, FA, Oh, I-H, Okoro, A, Oladimeji, O, Olagunju, AT, Olusanya, BO, Olusanya, JO, Oren, E, Ortiz, A, Osgood-Zimmerman, A, Ota, E, Owolabi, MO, Oyekale, AS, Pa, M, Pacella, RE, Pakhale, S, Pana, A, Panda, BK, Panda-Jonas, S, Park, E-K, Parsaeian, M, Patel, T, Patten, SB, Patton, GC, Paudel, D, Pereira, DM, Perez-Padilla, R, Perez-Ruiz, F, Perico, N, Pervaiz, A, Pesudovs, K ; https://orcid.org/0000-0002-6322-9369, Peterson, CB, Petri, WA, Petzold, M, Phillips, MR, Piel, FB, Pigott, DM, Pishgar, F, Plass, D, Polinder, S, Popova, S, Postma, MJ, Poulton, RG, Pourmalek, F, Prasad, N, Purwar, M, Qorbani, M, Rabiee, RHS, Radfar, A, Rafay, A, Rahimi-Movaghar, A, Rahimi-Movaghar, V, Rahman, M, Rahman, MHU, Rahman, SU, Rai, RK, Rajsic, S, Ram, U, Rana, SM, Ranabhat, CL, Rao, PV, Rawaf, S, Ray, SE, Rego, MAS, Rehm, J, Reiner, RC, Remuzzi, G, Renzaho, AMNN, Resnikoff, S ; https://orcid.org/0000-0002-5866-4446, Rezaei, S, Rezai, MS, Ribeiro, AL, Rokni, MB, Ronfani, L, Roshandel, G, Roth, GA, Rothenbacher, D, Roy, A, Rubagotti, E, Ruhago, GM, Saadat, S, Sabde, YD, Sachdev, PS ; https://orcid.org/0000-0002-9595-3220, Sadat, N, Safdarian, M, Safiri, SSS, Sagar, R, Sahathevan, R, Sahebkar, A, Sahraian, MA, Salama, J, Salamati, P, Salomon, JA, Salvi, SS, Samy, AM, Sanabria, JR, Sanchez-Nino, MD, Santos, IS, Milicevic, MMS, Sarmiento-Suarez, R, Sartorius, B, Satpathy, M, Sawhney, M, Saxena, S, Saylan, MI, Schmidt, MI, Schneider, IJC, Schutte, AE ; https://orcid.org/0000-0001-9217-4937, Schwebel, DC, Schwendicke, F, Seedat, S, Seid, AM, Sepanlou, SG, Servan-Mori, EE, Shackelford, KA, Shaheen, A, Shahraz, S, Shaikh, MA, Shamsipour, M, Shamsizadeh, M, Islam, SMS, Sharma, J, Sharma, R, She, J, Shen, J, Shetty, BP, Shi, P, Shibuya, K, Shigematsu, M, Shiri, R, Shiue, I, Shrime, MG, Sigfusdottir, ID, Silberberg, DH, Silpakit, N, Silva, DAS, Silva, JP, Silveira, DGA, Sindi, S, Singh, A, Singh, JA, Singh, PK, Singh, V, Sinha, DN, Skiadaresi, E, Sligar, A, Smith, DL, Sobaih, BHA, Sobngwi, E, Soneji, S, Soriano, JB, Sreeramareddy, CT, Srinivasan, V, Stathopoulou, V, Steel, N, Stein, DJ, Steiner, C, Stockl, H, Stokes, MA, Strong, M, Sufiyan, MB, Suliankatchi, RA, Sunguya, BF, Sur, PJ, Swaminathan, S, Sykes, BL, Szoeke, CEI, Tabares-Seisdedos, R, Tadakamadla, SK, Tadese, F, Tandon, N, Tanne, D, Tarajia, M, Tavakkoli, M, Taveira, N, Tehrani-Banihashemi, A, Tekelab, T, Tekle, DY, Shifa, GT, Temsah, M-H, Terkawi, AS, Tesema, CL, Tesssema, B, Theis, A, Thomas, N, Thompson, AH, Thomson, AJ, Thrift, AG, Tiruye, TY, Tobe-Gai, R, Tonelli, M, Topor-Madry, R, Topouzis, F, Tortajada, M, Tran, BX, Trujillo, TTU, Tsilimparis, N, Tuem, KB, Tuzcu, EM, Tyrovolas, S, Ukwaja, KN, Undurraga, EA, Uthman, OA, Uzochukwu, BSC, van Boven, JFM, Varakin, YY, Varughese, S, Vasankari, T, Vasconcelos, AMN, Venketasubramanian, N, Vidavalur, R, Violante, FS, Vishnu, A, Vladimirov, SK, Vlassov, VV, Vollset, SE, Vos, T, Waid, JL, Wakayo, T, Wang, Y-P, Weichenthal, S, Weiderpass, E, Weintraub, RG, Werdecker, A, Wesana, J, Wijeratne, T, Wilkinson, JD, Wiysonge, CS, Woldeyes, BG, Wolfe, CDA, Workicho, A, Workie, SB, Xavier, D, Xu, G, Yaghoubi, M, Yakob, B, Yalew, AZ, Yan, LL, Yano, Y, Yaseri, M, Ye, P ; https://orcid.org/0000-0002-2924-1436, Yimam, HH, Yip, P, Yirsaw, BD, Yonemoto, N, Yoon, S-J, Yotebieng, M, Younis, MZ, Zaidi, Z, Zaki, MES, Zeeb, H, Zenebe, ZM, Zerfu, TA, Zhang, AL, Zhang, X, Zodpey, S, Zuhlke, LJ, Lopez, AD, and Murray, CJL

Abstract

Background: Detailed assessments of mortality patterns, particularly age-specific mortality, represent a crucial input that enables health systems to target interventions to specific populations. Understanding how all-cause mortality has changed with respect to development status can identify exemplars for best practice. To accomplish this, the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) estimated age-specific and sex-specific all-cause mortality between 1970 and 2016 for 195 countries and territories and at the subnational level for the five countries with a population greater than 200 million in 2016. Methods: We have evaluated how well civil registration systems captured deaths using a set of demographic methods called death distribution methods for adults and from consideration of survey and census data for children younger than 5 years. We generated an overall assessment of completeness of registration of deaths by dividing registered deaths in each location-year by our estimate of all-age deaths generated from our overall estimation process. For 163 locations, including subnational units in countries with a population greater than 200 million with complete vital registration (VR) systems, our estimates were largely driven by the observed data, with corrections for small fluctuations in numbers and estimation for recent years where there were lags in data reporting (lags were variable by location, generally between 1 year and 6 years). For other locations, we took advantage of different data sources available to measure under-5 mortality rates (U5MR) using complete birth histories, summary birth histories, and incomplete VR with adjustments; we measured adult mortality rate (the probability of death in individuals aged 15-60 years) using adjusted incomplete VR, sibling histories, and household death recall. We used the U5MR and adult mortality rate, together with crude death rate due to HIV in the GBD model life table system, to

Published
2017

4. Armed conflict and maternal health service utilization in Ethiopia's Tigray Region: a community-based survey.

Author

Tsadik M, Teka H, Gebremichael MW, Gebretnsae H, Yemane A, Fisseha G, Gebregzabher T, Buruh G, Gebresellasie F, Tekie M, Kiros G, Mehari M, Tewelde B, Alemayehu Y, Tesfay FH, and Godefay H

Subjects
Humans, Female, Cross-Sectional Studies, Adult, Ethiopia, Young Adult, Adolescent, Pregnancy, Health Services Accessibility statistics & numerical data, Middle Aged, Infant, Maternal Health Services statistics & numerical data, Armed Conflicts, Patient Acceptance of Health Care statistics & numerical data
Abstract

Background: Evidence generated on utilization of maternal health services during times of conflict can inform the development of targeted interventions. The deadly war in Tigray caused the health system to collapse. However, utilization of maternal health services is not well documented that might help in design effective interventions applicable during armed conflict. Thus, this study aimed to assess maternal health service utilization and bridge the gap in healthcare provision and support during conflict. ., Methods: A community-based cross-sectional survey was conducted among mothers of children under the age of 1 year in six accessible zones of Tigray from August 4-20, 2021. The study participants were selected through a random sampling method. The study was conducted during the armed conflict where the access to health services was limited due to the damaged and looted health facilities. A descriptive study was used to characterize the study population and data were presented using proportions and percentages. A Chi-square test was used for categorical variables and a P-value of 0.05 was considered significant. ., Results: A total of 4,381 participants were included in the study. Modern contraceptives were used by 1002 (22.9%) of women, and injectable contraceptives were the most common method used by 472 (47.1%) women. Likewise, only 830 (36.5%),1956 (47.1%), and 623 (15.0%) respondents reported the use of optimal antenatal care (ANC), skilled delivery, and postnatal care (PNC) in the first 24 h by mothers, respectively. About 34% of women received comprehensive abortion care services. Most delivery services took place in hospitals. Residence has shown a significant difference in using maternal health services at p-value < 0.001., Conclusion: The conflict in Tigray has had a profound impact on maternal health services, resulting in a significant disruption that is disproportionately high in rural areas. Immediate action is required to provide access to lifesaving interventions for basic maternal health services. The timely initiation of these services is crucial in addressing the pressing needs of pregnant women and their infants. By implementing comprehensive and targeted interventions, we can mitigate the potential long-term consequences and ensure that maternal health services are effectively reinstated., (© 2024. The Author(s).)

Published
2024
Full Text
View/download PDF

5. Trends and causes of neonatal mortality from 2010 to 2017 at a Health and Demographic Surveillance site in Northern Ethiopia.

Author

Gebremichael MW, Tsadik M, Abebe HT, Gebreegzabiher A, Beyene S, Aregawi AB, and Weldemariam S

Subjects
Pregnancy, Female, Infant, Newborn, Humans, Ethiopia epidemiology, Asphyxia, Cause of Death, Infant Mortality, Perinatal Death, Premature Birth, Sepsis, Pneumonia
Abstract

Background: Half of global under-five mortalities is neonatal. The highest rates are found in low-income countries such as Ethiopia. Ethiopia has made progress in reducing under-five mortality, but neonatal mortality remains high. Evidence collected continuously at the community level is crucial for understanding the trends and causes of neonatal mortality., Objectives: To analyse the trends and causes of neonatal mortality at the Kilte-Awlelo Health and Demographic Surveillance System (KAHDSS) site in Ethiopia from 2010 to 2017., Methods: A descriptive study was conducted using data from neonates born between 2010 and 2017 at the KAHDSS site. Data were collected using interviewer-administered questionnaires. Causes of death were examined, and neonatal mortality trends were described using simple linear regression., Results: The overall average neonatal mortality rate was 17/1000 live births (LBs). The rate increased from 12 per 1000 LBs in 2010 to 15 per 1000 LBs in 2017. The majority of neonatal deaths occurred during the first week of life, and more than one-half died at home. The leading causes were sepsis, pre-term birth (including respiratory distress), disease related to the perinatal period, birth asphyxia, and neonatal pneumonia., Conclusions: The high neonatal mortality in Ethiopia requires urgent attention and action. Sepsis, preterm birth, perinatal diseases, asphyxia, and neonatal pneumonia are the leading causes of death in neonates. Facility- and community-based health services should target the leading causes of neonatal deaths.

Published
2023
Full Text
View/download PDF

6. Rape survivors' experience in Tigray: a qualitative study.

Author

Gebremichael MW, Gebremariam B, Mitiku M, Hadush Z, Tesfay B, Gerezgiher A, and Alemu MG

Subjects
Child, Adolescent, Humans, Female, Young Adult, Adult, Infant, Violence, Qualitative Research, Survivors psychology, Rape psychology, Sex Offenses psychology
Abstract

Introduction: As consequences of war, women and girls are the most likely segment of society to be impacted by violence. War also affects the critical facilities and makes the situation worse as victims cannot get the vital basic services. According to media and unpublished reports, Tigrayan women have been victimized by gang rape and sexual violence. Furthermore, there is substantive evidence of intentional destruction and vandalization of health facilities due to the one-year-old-armed conflict. This study aimed to explore experiences of rape survivors in areas hit by armed conflict in the Tigray region of Ethiopia., Methods: In this qualitative study, a phenomenological study design was employed among Tigrayan sexual assault survivors in a war-ravaged of Tigray. Survivors were selected purposively and included in the study for an in-depth interview. An interview guide was used to collect the data. Audio records from the in-depth interviews in Tigrigna were transcribed verbatim and then translated into English for analysis. Atlas-ti 7 software was used to code the interview transcripts of the qualitative data, and categorizations and thematizing of the codes were done. Direct quotes were used to describe categories or themes., Results: Ten women who were survivors of sexual violence and rape related to the war in Tigray participated in the interview. The age of the women ranged between 16 and 30 years with a mean age of 21.7. Among the participants, five were teenagers, six were single and/or economically dependent on their family or husband, and two did not attend any school and were not able to read and write. This study has generated five major thematic areas: (1) infliction of long-lasting trauma on children (2) effects of the rape (3) means of escaping from rape and killings (4) home remedies as means of life saving in war affected areas, and (5) beyond rape., Conclusions: Rape in war-stricken Tigray has been widespread which includes teenagers and it caused immense psychological and physical damage to the survivors and their families. Damage of critical facilities such as the absence of safe houses for survivors and health services was an added complexity to the victims of rape. Hence, a coordinated effort by the government of Tigray and international partners is required to heal, support and rehabilitate the victims and rebuild the damaged health institutions and reequip the health facilities., (© 2023. The Author(s).)

Published
2023
Full Text
View/download PDF

7. War-related sexual and gender-based violence in Tigray, Northern Ethiopia: a community-based study.

Author

Fisseha G, Gebrehiwot TG, Gebremichael MW, Wahdey S, Meles GG, Gezae KE, Legesse AY, Asgedom AA, Tsadik M, Woldemichael A, Gebreyesus A, Abebe HT, Haile YA, Gezahegn S, Aregawi M, Berhane KT, Godefay H, and Mulugeta A

Subjects
Female, Humans, Pregnancy, Ethiopia epidemiology, Sexual Behavior, Violence, Adolescent, Young Adult, Adult, Middle Aged, Gender-Based Violence, HIV Infections
Abstract

Introduction: Sexual and gender-based violence (SGBV) during armed conflicts has serious ramifications with women and girls disproportionally affected. The impact of the conflict that erupted in November 2020 in Tigray on SGBV is not well documented. This study is aimed at assessing war-related SGBV in war-affected Tigray, Ethiopia., Methods: A community-based survey was conducted in 52 (out of 84) districts of Tigray, excluding its western zone and some districts bordering Eritrea due to security reasons. Using a two-stage multistage cluster sampling technique, a total of 5171 women of reproductive age (15-49 years) were randomly selected and included in the study. Analysis used weighted descriptive statistics, regression modelling and tests of associations., Results: Overall, 43.3% (2241/5171) of women experienced at least one type of gender-based violence. The incidents of sexual, physical and psychological violence, and rape among women of reproductive age were found to be 9.7% (500/5171), 28.6% (1480/5171), 40.4% (2090/5171) and 7.9% (411/5171), respectively. Of the sexual violence survivors, rape accounted for 82.2% (411/500) cases, of which 68.4% (247) reported being gang raped. Young women (aged 15-24 years) were the most affected by sexual violence, 29.2% (146/500). Commonly reported SGBV-related issues were physical trauma, 23.8% (533/2241), sexually transmitted infections, 16.5% (68/411), HIV infection, 2.7% (11/411), unwanted pregnancy, 9.5% (39/411) and depression 19.2% (431/2241). Most survivors (89.7%) did not receive any postviolence medical or psychological support., Conclusions: Systemic war-related SGBV was prevalent in Tigray, with gang-rape as the most common form of sexual violence. Immediate medical and psychological care, and long-term rehabilitation and community support for survivors are urgently needed and recommended., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2023
Full Text
View/download PDF

9. Magnitude, trends and determinants of skilled delivery from Kilite-Awlaelo Health Demographic Surveillance System, Northern Ethiopia, 2009- 2017.

Author

Abebe HT, Adhana MT, Gebremichael MW, Gezae KE, and Gebreslassie AA

Subjects
Adolescent, Adult, Delivery, Obstetric statistics & numerical data, Female, Humans, Longitudinal Studies, Middle Aged, Pregnancy, Pregnancy Outcome, Urban Population, Young Adult, Delivery, Obstetric trends, Health Knowledge, Attitudes, Practice, Health Services Accessibility, Maternal Health Services standards, Prenatal Care standards, Residence Characteristics
Abstract

Background: The fundamental approach to improve maternal and neonatal health is increasing skilled delivery rate. Women giving birth at health institutions can prevent maternal and neonatal deaths by getting skilled birth attendance. In Ethiopia, despite a significant decrease in maternal mortality over the past decade, still a significant number of women give birth at home. Moreover, evidence from population-based longitudinal studies on skilled delivery is limited. Therefore, this study aims to investigate the magnitude, trend, and determinants of skilled delivery in Kilite-Awlaelo Health Demographic Surveillance System (KA-HDSS), Northern Ethiopia., Method: Population-based longitudinal study design was conducted by extracting data for nine consecutive years (2009-2017) from KA-HDSS database. In order to measure the trends of skilled delivery, KA-HDSS data sets were analyzed (2009-2017). Bivariate and multivariate analyses were performed using STATA version 16. A multivariable binary logistic regression model was fitted to assess determinants of skilled delivery and odds ratio with 95% CI was used to assess presence of associations at a 0.05 level of significance., Results: The skilled delivery rate have continuously increased among reproductive age women from 15.12% (95% CI: 13.30% - 17.09%) in 2010 to 95.85% (95% CI: 94.58% - 96.895%) in 2017. The skilled delivery rate becomes high (> = 82) in the period of 2014-2017. Education, residence, marital status, occupation and antenatal care (ANC) visits were the most important determinants for skilled delivery among reproductive age women during the period of high skilled delivery rate (2014-2017). Women urban dwellers had about 28 times (AOR = 27.66; 95% CI: 3.86-196.97) higher odds to deliver by skilled birth attendants than rural dwellers. Unmarried women who gave birth were 2.18 (AOR: 2.18; 95% CI: 1.30-3.64) times more likely to have skilled delivery service compared to those married. Likewise, women with four or more ANC visits were 3.2 times more likely to undergo skilled delivery service than those having no ANC visits (AOR: 3.16; 95% CI: 2.33-4.28). Moreover, women having at least a secondary education were 2 times more likely to have skilled delivery service compared to those women with no formal education (AOR = 2.10, 95% CI: 1.18-3.74)., Conclusion: Regardless of the importance of health facility delivery, a significant number of women still deliver at home attended by unskilled birth attendants. There has been a substantial increase in use of health facilities for delivery among women in the reproductive age. The factors affecting skilled delivery among reproductive age women were educational level, residence, marital status, occupation and use of ANC service. Maternal health related interventions are needed to change women's attitudes towards skilled delivery. Moreover, ANC coverage should be increased to improve skilled delivery service., Competing Interests: The authors have declared that no competing interests exist.

Published
2021
Full Text
View/download PDF

10. Frequency and patterns of first- and second-line drug resistance-conferring mutations in Mycobacterium tuberculosis isolated from pulmonary tuberculosis patients in a cross-sectional study in Tigray Region, Ethiopia.

Author

Welekidan LN, Skjerve E, Dejene TA, Gebremichael MW, Brynildsrud O, Tønjum T, and Yimer SA

Subjects
Antitubercular Agents pharmacology, Cross-Sectional Studies, Ethiopia epidemiology, Humans, Microbial Sensitivity Tests, Mutation, Drug Resistance, Bacterial genetics, Mycobacterium tuberculosis genetics, Tuberculosis, Pulmonary epidemiology, Tuberculosis, Pulmonary microbiology
Abstract

Objectives: Tuberculosis (TB) is a preventable and treatable infectious disease, but the continuing emergence and spread of multidrug-resistant TB is threatening global TB control efforts. This study aimed to describe the frequency and patterns of drug resistance-conferring mutations of Mycobacterium tuberculosis (MTB) isolates detected from pulmonary TB patients in Tigray Region, Ethiopia., Methods: A cross-sectional study design was employed to collect sputum samples from pulmonary TB patients between July 2018 to August 2019. Culture and identification tests were done at Tigray Health Research Institute (THRI). Mutations conferring rifampicin (RIF), isoniazid (INH) and fluoroquinolone (FQ) resistance were determined in 227 MTB isolates using GenoType MTBDRplus and GenoType MTBDRsl., Results: Mutations conferring resistance to RIF, INH and FQs were detected in 40/227 (17.6%), 41/227 (18.1%) and 2/38 (5.3%) MTB isolates, respectively. The majority of mutations for RIF, INH and FQs occurred at codons rpoB S531L (70%), katG S315T (78%) and gyrA D94Y/N (100%), respectively. This study revealed a significant number of unknown mutations in the rpoB, katG and inhA genes., Conclusion: High rates of mutations conferring resistance to RIF, INH and FQs were observed in this study. A large number of isolates showed unknown mutations, which require further DNA sequencing analysis. Periodic drug resistance surveillance and scaling-up of drug resistance testing facilities are imperative to prevent the transmission of drug-resistant TB in the community., (Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Published
2021
Full Text
View/download PDF

11. Determinants of Neonatal Jaundice among Neonates Admitted to Neonatal Intensive Care Unit in Public General Hospitals of Central Zone, Tigray, Northern Ethiopia, 2019: a Case-Control Study.

Author

Asefa GG, Gebrewahid TG, Nuguse H, Gebremichael MW, Birhane M, Zereabruk K, Zemicheal TM, Hailay A, Abrha WA, Hadera SA, Hailu AG, Beyene BH, Dagnazgi EA, Tekulu FG, and Welay F

Subjects
Adult, Asphyxia Neonatorum complications, Asphyxia Neonatorum diagnosis, Asphyxia Neonatorum mortality, Breast Feeding adverse effects, Case-Control Studies, Ethiopia epidemiology, Female, Hospitals, General, Hospitals, Public, Humans, Incidence, Infant, Infant Mortality, Infant, Low Birth Weight, Infant, Newborn, Intensive Care Units, Neonatal, Jaundice, Neonatal diagnosis, Jaundice, Neonatal etiology, Jaundice, Neonatal mortality, Male, Obstetric Labor Complications diagnosis, Obstetric Labor Complications mortality, Polycythemia complications, Polycythemia diagnosis, Polycythemia mortality, Pregnancy, Sample Size, Asphyxia Neonatorum epidemiology, Jaundice, Neonatal epidemiology, Obstetric Labor Complications epidemiology, Polycythemia epidemiology, Rh-Hr Blood-Group System adverse effects
Abstract

Background: Neonatal jaundice is common a clinical problem worldwide. Globally, every year, about 1.1 million babies develop severe hyperbilirubinemia with or without bilirubin encephalopathy and the vast majority reside in sub-Saharan Africa and South Asia. Strategies and information on determinants of neonatal jaundice in sub-Saharan Africa are limited. So, investigating determinant factors of neonatal jaundice has paramount importance in mitigating jaundice-related neonatal morbidity and mortality. Methodology . Hospital-based unmatched case-control study was conducted by reviewing medical charts of 272 neonates in public general hospitals of the central zone of Tigray, northern Ethiopia. The sample size was calculated using Epi Info version 7.2.2.12, and participants were selected using a simple random sampling technique. One year medical record documents were included in the study. Data were collected through a data extraction format looking on the cards. Data were entered to the EpiData Manager version 4.4.2.1 and exported to SPSS version 20 for analysis. Descriptive and multivariate analysis was performed. Binary logistic regression was used to test the association between independent and dependent variables. Variables at p value less than 0.25 in bivariate analysis were entered to a multivariable analysis to identify the determinant factors of jaundice. The level of significance was declared at p value <0.05., Results: A total of 272 neonatal medical charts were included. Obstetric complication (AOR: 5.77; 95% CI: 1.85-17.98), low birth weight (AOR: 4.27; 95% CI:1.58-11.56), birth asphyxia (AOR: 4.83; 95% CI: 1.617-14.4), RH-incompatibility (AOR: 5.45; 95% CI: 1.58-18.74), breastfeeding (AOR: 6.11; 95% CI: 1.71-21.90) and polycythemia (AOR: 7.32; 95% CI: 2.51-21.311) were the determinants of neonatal jaundice., Conclusion: Obstetric complication, low birth weight, birth asphyxia, RH-incompatibility, breastfeeding, and polycythemia were among the determinants of neonatal jaundice. Hence, early prevention and timely treatment of neonatal jaundice are important since it was a cause of long-term complication and death in neonates., Competing Interests: The authors declare that they have no conflict of interests., (Copyright © 2020 Guesh Gebreayezgi Asefa et al.)

Published
2020
Full Text
View/download PDF

12. Characteristics of pulmonary multidrug-resistant tuberculosis patients in Tigray Region, Ethiopia: A cross-sectional study.

Author

Welekidan LN, Skjerve E, Dejene TA, Gebremichael MW, Brynildsrud O, Agdestein A, Tessema GT, Tønjum T, and Yimer SA

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Antitubercular Agents therapeutic use, Cross-Sectional Studies, Ethiopia epidemiology, Female, HIV Infections epidemiology, HIV Infections microbiology, HIV Infections pathology, Humans, Isoniazid therapeutic use, Male, Microbial Sensitivity Tests, Middle Aged, Mycobacterium tuberculosis pathogenicity, Rifampin therapeutic use, Risk Factors, Sputum drug effects, Sputum microbiology, Tuberculosis, Multidrug-Resistant epidemiology, Tuberculosis, Multidrug-Resistant microbiology, Tuberculosis, Multidrug-Resistant pathology, Tuberculosis, Pulmonary epidemiology, Tuberculosis, Pulmonary microbiology, Tuberculosis, Pulmonary pathology, Young Adult, HIV Infections drug therapy, Mycobacterium tuberculosis drug effects, Tuberculosis, Multidrug-Resistant drug therapy, Tuberculosis, Pulmonary drug therapy
Abstract

Background: Tuberculosis (TB) is among the top 10 causes of mortality and the first killer among infectious diseases worldwide. One of the factors fuelling the TB epidemic is the global rise of multidrug resistant TB (MDR-TB). The aim of this study was to determine the magnitude and factors associated with MDR-TB in the Tigray Region, Ethiopia., Method: This study employed a facility-based cross-sectional study design, which was conducted between July 2018 and August 2019. The inclusion criteria for the study participants were GeneXpert-positive who were not under treatment for TB, PTB patients' ≥15 years of age and who provided written informed consent. A total of 300 participants were enrolled in the study, with a structured questionnaire used to collect data on clinical, sociodemographic and behavioral factors. Sputum samples were collected and processed for acid-fast bacilli staining, culture and drug susceptibility testing. Drug susceptibility testing was performed using a line probe assay. Logistic regression was used to analyze associations between outcome and predictor variables., Results: The overall proportion of MDR-TB was 16.7% (11.6% and 32.7% for new and previously treated patients, respectively). Of the total MDR-TB isolates, 5.3% were pre-XDR-TB. The proportion of MDR-TB/HIV co-infection was 21.1%. A previous history of TB treatment AOR 3.75; 95% CI (0.7-2.24), cigarette smoking AOR 6.09; CI (1.65-2.50) and patients who had an intermittent fever (AOR = 2.54, 95% CI = 1.21-5.4) were strongly associated with MDR-TB development., Conclusions: The magnitude of MDR-TB observed among new and previously treated patients is very alarming, which calls for an urgent need for intervention. The high proportion of MDR-TB among newly diagnosed cases indicates ongoing transmission, which suggests the need for enhanced TB control program performance to interrupt transmission. The increased proportion of MDR-TB among previously treated cases indicates a need for better patient management to prevent the evolution of drug resistance. Assessing the TB control program performance gaps and an optimal implementation of the WHO recommended priority actions for the management of drug-resistant TB, is imperative to help reduce the current high MDR-TB burden in the study region., Competing Interests: The authors have declared that no competing interests exist

Published
2020
Full Text
View/download PDF

13. Women suffer more from disrespectful and abusive care than from the labour pain itself: a qualitative study from Women's perspective.

Author

Gebremichael MW, Worku A, Medhanyie AA, Edin K, and Berhane Y

Subjects
Adult, Attitude of Health Personnel, Delivery, Obstetric psychology, Ethiopia, Female, Humans, Maternal Health Services standards, Pregnancy, Qualitative Research, Workforce, Young Adult, Agonistic Behavior, Parturition physiology, Professional Misconduct psychology, Professional-Patient Relations
Abstract

Background: Utilization of institutional delivery services could be hampered by women's experience of disrespectful and abusive care during childbirth. However, such experiences are not well documented and taken into consideration id planning maternal health services in many developing countries. The aim of this study was to describe women's experience of disrespect and abuse during giving birth at health facilities in northern Ethiopia., Methods: A qualitative phenomenological study was conducted in Tigray, Ethiopia. Focus group discussions (FGDs) with primipara and multipara women were conducted to collect the necessary information. All study participants had their last delivery at a health facility in the year preceding the study. A semi-structured discussion guide was used to elicit discussion. Discussions were audio recorded and transcribed verbatim in the local language and then translated to English. Data were analyzed using thematic analysis approach assisted by the Open Code qualitative data management software., Results: The study participants described disrespect and abuse as serious obstacles to utilization of maternal health services. Women reported experiencing feelings of being infantilized, losing self-control, being overlooked, being informed bad news without proper preparation, repeated examination without being properly communicated/informed, disallow companions, and left unattended during labor. Facility related issues include women's perception of incompetence of professionals attending delivery, unhygienic facilities, and unavailability of basic supplies., Conclusion: Women consider health facilities not fully prepared to provide respectful maternal care. Sustainable increase in institutional delivery requires ensuring quality, compassionate and caring services in all health facilities.

Published
2018
Full Text
View/download PDF

14. Mothers' experience of disrespect and abuse during maternity care in northern Ethiopia.

Author

Gebremichael MW, Worku A, Medhanyie AA, and Berhane Y

Subjects
Adult, Cross-Sectional Studies, Ethiopia, Female, Humans, Pregnancy, Surveys and Questionnaires, Young Adult, Attitude of Health Personnel, Interpersonal Relations, Maternal Health Services, Mothers psychology, Patient Acceptance of Health Care psychology, Professional-Patient Relations
Abstract

Background: The provision of respectful and satisfactory maternity care is essential for promoting timely care-seeking behaviour, and ultimately ensuring the health and well-being of mothers and their babies. Disrespectful and abusive care has been recognized as one of the barriers to seeking timely maternity health services. However, the issue has not been adequately researched in community settings in low- and middle-income countries using validated measurement tools., Objective: This study was conducted to assess the extent of, and factors associated with, disrespectful and abusive maternity care reported by women who utilized facility-based delivery services in northern Ethiopia., Methods: We conducted a community-based cross-sectional study in Tigray, northern Ethiopia. Women who gave birth in the preceding year and visited health institutions for these deliveries were selected using a multistage cluster sampling procedure. Data were collected using a pretested questionnaire. Six domains of disrespect and abuse (D and A) were included in the questionnaire. Socio-demographic and obstetric related factors associated with D and A were tested using a negative binomial regression model., Results: Of the 1125 women in the sample, 248 (22%; 95% CI: 19.8%, 24.4%) reported at least one incident of D and A during delivery at a public health facility in northern Ethiopia. Higher incidents of D and A were reported by women who were older than 19 years at the time of delivery (aIRR = 2.649 (95% CI: 1.455, 4.825) compared to younger women. Incidents of D and A were reported more by women residing in urban areas, by women educated to the ninth grade and above, by women who experienced longer labour duration, and also by women who were not permitted to have support persons attend labour and delivery., Conclusions: A fifth of the women reported D and A while receiving care during labour and delivery. Policies and practices aimed at ensuring universal coverage for institutional deliveries need to promote respectful maternity care for women in all facilities.

Published
2018
Full Text
View/download PDF

15. Female genital mutilation: prevalence, perceptions and effect on women's health in Kersa district of Ethiopia.

Author

Yirga WS, Kassa NA, Gebremichael MW, and Aro AR

Abstract

Background: Female genital mutilation (FGM) is nontherapeutic surgical modification of the female genitalia. It is an ancient tradition in large parts of Africa, including Ethiopia, especially in the eastern part of the country. This study aimed to identify the prevalence, perceptions, perpetuators, reasons for conducting FGM, and factors associated with this practice with regard to women's health., Methods: Community-based cross-sectional house-to-house interviews were conducted during 2008 among 858 females of reproductive age (15-49 years), in Kersa district, East Hararge, Oromia region, Ethiopia. Proportions and Chi-square tests were used to describe the data and logistic regression was used to describe statistical associations. Statistical significance was set at P < 0.05., Results: FGM was reported to be known by 327 (38.5%) of the interviewees. The majority (n = 249, 76.1%) reported that local healers were the main performers of FGM, and 258 (78.9%) respondents stated that the clitoris was the part removed during circumcision. The main reason for the practice of FGM was reduction of female sexual hyperactivity (reported by 198 women [60.3%]). Circumcision of daughters was reported by 288 (88.1%) respondents, and this showed a statistically significant association with the Christian religion (P = 0.003), illiteracy (P = 0.01), and Amhara ethnicity (P = 0.012). The majority of the respondents (792, 92.3%) were themselves circumcised and 68.8% did not know of any health-related problems associated with FGM., Conclusion: In spite of FGM being a common practice in the study area, only one third of the respondents stated that they knew about it. Local healers were the main performers of FGM. Some of the women knew about the negative reproductive health effects of FGM and some had also experienced these themselves. However, only a few had tried to stop the practice and the majority had taken no steps to do so. This may be attributable to the fear of becoming alienated from the cultural system and fear of isolation.

Published
2012
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results