The magnitude and associated factors of immediate postpartum anemia among women who gave birth in Ethiopia: systematic review and meta-analysis, 2023.

BACKGROUND: The immediate postpartum period is a very crucial phase for both the life of the mother and her newborn baby. Anemia is the most indirect leading cause of maternal mortality. However, anemia in the immediate postpartum period is a neglected public health problem in Ethiopia. Therefore, this systematic review and meta-analysis aimed to estimate the pooled magnitude of immediate postpartum anemia and the pooled effect size of associated factors in Ethiopia. METHODS: Searching of published studies done through PubMed, Medline, Cochrane, African index Medicus, List of Reference Index, Hinari, and Google Scholar. This systematic review and meta-analysis follow the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) godliness. The quality of studies was assessed by using a Newcastle- Ottawa Scale (NOS) assessment tool. Analysis was performed using a random effect model by using STATA 17 version software. Egger's weighted regression and I2 test were used to evaluate publication bias and heterogeneity respectively. RESULTS: In this systematic review and meta-analysis, a total of 6 studies were included. The pooled magnitude of immediate postpartum anemia in Ethiopia was 27% (95%CI: 22, 32). Instrumental mode of delivery (OR = 3.14, 95%CI: 2.03, 4.24), mid-upper arm circumference (MUAC) measurement < 23 cm (OR = 3.19, 95%CI: 1.35, 5.03), Antepartum Hemorrhage (OR = 4.75, 95%CI: 2.46, 7.03), postpartum hemorrhage (OR = 4.67, 95%CI: 2.80, 6.55), and no iron/foliate supplementation (OR = 2.72, 95%CI: 1.85, 3.60) were the identified factors associated with developing anemia in the immediate postpartum period. CONCLUSION: The overall pooled magnitude of anemia in the immediate postpartum period among Ethiopian women was still a moderate public health problem. Instrumental mode of delivery, mid upper arm circumference (MUAC) measurement < 23 cm, antepartum hemorrhage, postpartum hemorrhage, and no iron/foliate supplementation were the identified factors associated with higher odds of developing anemia among immediate postpartum women in Ethiopia. Therefore, midwives, and doctors, shall focus on prevention of maternal hemorrhage, nutritional advice and counseling including iron /foliate supplementation, and avoid unnecessary instrumental delivery to prevent and reduce anemia related maternal mortality and morbidity in Ethiopia. PROSPERO REGISTRATION: CRD42023437414 with registration date on 02/08/2023.

Health professionals' perspectives on the role of obstetric ultrasonography in maternity care in rural eastern Ethiopia: a qualitative descriptive study.

OBJECTIVE: The purpose of this exploratory study was to assess healthcare providers' perspectives on maternity care following the introduction of ultrasound services in the area. DESIGN: The qualitative descriptive study. STUDY SETTING: This study was carried out in health centres under Child Health and Mortality Prevention Surveillance (CHAMPS) pregnancy surveillance catchment areas in Kersa, Haramaya and Harar districts in eastern Ethiopia. PARTICIPANTS: The study participants were 14 midwives working in the maternity units and 14 health centre managers in the respective health facilities. Purposive sampling was used to select participants for in-depth interviews using a semistructured interview guide. Data were analysed using thematic analysis. RESULTS: We identified one overarching theme "improved perinatal care" and six subthemes. Based on the accounts of the participants, the introduction of ultrasound services has led to a remarkable transformation in the overall provision of maternity care at health centres. The participants have reported a substantial rise in the utilisation of antenatal, delivery and postnatal care services. The availability of ultrasound has enabled midwives to deliver comprehensive maternity care. CONCLUSION: Ultrasound service utilisation at health centres improves maternity care. The utilisation of ultrasound in healthcare enables providers to closely monitor the growth and development of the fetus, identify potential complications or abnormalities and administer timely interventions. This integration of ultrasound technology translates into enhanced prenatal care, early detection of issues and prompt management, ultimately leading to improved outcomes for both the mother and the baby.

A Review of the Prospective Effects of Spacing and Varieties on Onion Yield and Yield Components (Allium cepa L.) in Ethiopia.

Onion (Allium cepa L.) is the most important commercial vegetable crop widely grown throughout the world. It is also an important bulb crop in Ethiopia. However, its production and productivity are restricted by different factors, including biotic and abiotic stresses. This review investigates the potential impacts of spacing and varieties on onion yield and yield components in Ethiopia. Countries around the world are producing onion for its nutritional value, medicinal properties, minerals, proteins, and carbohydrates. In terms of production, onion ranks second only after tomatoes. The average onion yield in Ethiopia is estimated to be 8.8 tons/ha, while in the world, it is approximately 19.7 tons/ha. Inappropriate spacing and inadequate onion varieties are some of the limitations widely described for yield variation in Ethiopia. Thus, to control the size, shape, and yield of onion bulbs, spacing determination and variety improvement are some of the techniques currently employed in Ethiopia. Adama red, Bombay red, and red creole are some of the known varieties in the country, and the intrarow spacings for Adama red and Bombay red are reported to be 4 cm and 6 cm, respectively. Different spacing between onion plants affects how much they produce and other factors such as size and quality, depending on the variety. It is important to assess whether changing spacing makes sense from both a farming and economic standpoint, alongside considering other agricultural methods.

Client satisfaction and contributing factors towards sexual and reproductive health services delivery system among youth at Family Guidance Association of north Ethiopia (FGAE) clinics, 2023: mixed method study.

BACKGROUND: The Family Guidance Association of Ethiopia (FGAE) operates as a non-governmental organization dedicated to offering family planning and reproductive health services to the Ethiopian population. The gap in the study regarding client satisfaction and contributing factors towards sexual and reproductive health services for youth at FGAE clinics highlights the need for a comprehensive investigation to fill this void. By conducting a mixed-method study, this research aims to provide a holistic understanding of the factors influencing client satisfaction in the delivery of sexual and reproductive health services to youth at FGAE clinics. The added value of this study lies in its potential to offer valuable insights and recommendations for improving service delivery systems and enhancing client satisfaction levels, ultimately contributing to the overall well-being and health outcomes of youth in North Ethiopia. Therefore study aimed to asses Client Satisfaction and Contributing Factors towards in sexual and reproductive health services delivery system among youth at Family Guidance Association of North Ethiopia (FGAE) Clinics, 2023. METHOD: The study was conducted within the clinics of the Family Guidance Association of Ethiopia (FGAE), spanning Dessie, Kombolcha, and Woldia city administrations, involving a participant cohort of 416 clients. Facility-based concurrent type mixed method study design both quantitative and qualitative techniques were applied. Quantitative research employed a simple random sampling technique and conversely, the qualitative study utilized a heterogeneous type of purposive sampling strategy to recruit participants The collected data underwent a rigorous process of entry, cleaning, and coding using Epi-Data 4.6 software, followed by analysis in STATA V17. Descriptive statistics and binary logistic regression were employed to highlight the impact of independent variables on the dependent variable. A more comprehensive examination was provided through multivariable logistic regression. Crude and adjusted odds ratios, along with a 95% confidence interval, were computed, with significance set at a p-value ≤ 0.05. RESULT: Nearly more than half of the clients 194 (47.8%) came to receive family planning services followed by maternal and child health 107 (26.4%). Sixty patients (14.8%) didn't receive all the services they wanted or came for. Half of the participants 30 (50%) raised the unavailability of the service as a reason for not taking the service followed by not having enough time in the clinic 12 (20%). About 65.52% (60.74-70.00%) of the participants were satisfied with the Sexual and Reproductive Health services provided by the clinics of FGAE in northeast Ethiopia. Clients in the age group of 25-34 (AOR = 2.04; 95%CI: 1.11-3.72). Clients who had primary and secondary education (AOR = 2.49; 95%CI: 1.03-6.02) and (AOR = 3.05; 95%CI: 1.25-7.49) respectively. Clients who responded that physicians show respect (AOR = 5.59; 95%CI: 1.89-16.49). clients who received an explanation about the side effects of the utilized methods and follow-up dates (AOR = 4.59;95%CI:1.68-12.53) and (AOR = 2.89;95%CI:1.53-5.49) respectively. CONCLUSION: The proportion of client satisfaction with Client Satisfaction in the Services delivery system at Family Guidance Association of Ethiopia (FGAE) Clinics was low as compared to the previous study. Age group 25-34 years, primary and secondary education, showing respect, explaining side-effects and follow-up visits were significant associated factors of client service satisfaction. Enhancing service delivery at Family Guidance Association of Ethiopia (FGAE) Clinics by targeting specific areas identified in the study. Strategies should focus on improving communication regarding side effects, ensuring respectful interactions, and prioritizing follow-up visits, particularly for clients aged 25-34 with primary and secondary education backgrounds.

Traditional lore on the healing effects of therapeutic plants used by the local communities around Simien Mountains National Park, northwestern Ethiopia.

BACKGROUND: Simien Mountain National Park is a world heritage site with spectacular landscapes and rich in floral diversity. Exploring the plethora of conventional wisdom regarding therapeutic flora for sustainable use and drug development is a timely endeavor. Thus, the present study was aimed at investigating therapeutic plant uses and conservation practices by the local communities dwelling in the vicinity of the Park. METHODS: Eighty randomly selected general informants and 20 purposefully selected key informants were used to collect the traditional lore from 10 purposefully selected kebeles that border the Park. Data were collected using face-to-face interviews, guided field walks, group discussions and market surveys. Descriptive statistics were used to analyze the basic information collected from the informants. An independent sample t test was computed to compare the knowledge variations among different informant groups. Clustering and ranking techniques were employed to validate traditional wisdom of informants. RESULTS: Significant differences in traditional wisdom (P < 0.05) were observed only between general and key informants. Hundred thirteen therapeutic plant species belonging to 56 families were recorded. Asteraceae was the most species-rich family (10%). The majority of therapeutic species were collected from the wild (77%). Herbs and roots were the most preferred habit (47%) and plant parts (37%) for remedy preparation, respectively. Pounding was the most common preparation method (50.1%). The most frequently practiced route of administration was the oral route (48.1%). The highest Informant Consensus Factor (ICF) value (84%) was recorded for respiratory and febrile illnesses. Rumex nepalensis was the most preferred for the treatment of wounds, and Olea europaea subsp cuspidata was the first-ranked multipurpose plant. CONCLUSION: The Park is rich in therapeutic species serving as a refuge for many endemic and endangered species associated with the local community rich medicinal traditional lore. Erosion of therapeutic plants, verbal transfer of the traditional wisdom and young generation negligence in acquiring traditional lore led to the deterioration of the long tradition of using therapeutic plants for health care. Endangered multipurpose therapeutic plants like Echinops kebericho should get conservation priority. Therapeutic plants with the highest ICF and fidelity level could be candidates for drug development.

Determinants of externally visible birth defects among perinatal deaths at Adama Comprehensive Specialized Hospital: a case-control study.

BACKGROUND: Birth defects (BDs) are the major causes of infant morbidity and mortality in both developed and developing countries. Regardless of their clinical importance, few studies on predisposing factors have been conducted in Ethiopia. However, due to a lack of advanced diagnostic materials, we only considered the externally visible BDs. OBJECTIVE: To assess the determinants of externally visible birth defects among perinatal deaths at Adama Comprehensive Specialized Hospital. METHODS: A retrospective unmatched case-control study design was conducted from November 01 to 30, 2021. The sample size was determined by Epi Info version 7 software considering sample size calculation for an unmatched case-control study. A total of 315 participants (63 cases, and 252 controls) were selected by simple random sampling. Data were collected by an open data kit (ODK) and transported to a statical package for social sciences (SPSS) version 26 software for analysis. The bivariate followed by multivariable logistic regression analyses were done to determine the factors associated with the BD. RESULTS: This study showed that drinking alcohol during pregnancy (AOR = 6.575; 95% CI: 3.102,13.937), lack of antenatal care (ANC) follow-up during pregnancy (AOR = 2.794; 95% CI: 1.333, 5.859), having a history of stillbirth in a previous pregnancy (AOR = 3.967; 95% CI: 1.772, 8.881), exposure to pesticides during pregnancy (AOR = 4.840; 95% CI: 1.375, 17.034), having a history of BDs in a previous pregnancy (AOR = 4.853; 95% CI: 1.492, 15.788), and lack of folic acid supplementation during early pregnancy (AOR = 4.324; 95% CI: 2.062, 9.067) were significant determinants of externally visible BDs among perinatal deaths. CONCLUSION: In this study, alcohol use, exposure to pesticides, and lack of folic acid supplementation during pregnancy were identified as the major determinants of externally visible BDs among perinatal deaths. Thus, health education regarding the associated factors of BDs and their preventive strategies should be given to pregnant mothers.

Nutritional Composition and Antinutritional Factors of Five Wild Edible Fruits Grown in the Mekdela District, South of Wollo, Ethiopia.

This study was carried out to determine the mineral content and nutritional properties of five wild fruits Rhus vulgaris, Rosa abyssinica, Rhus natalensis, Euclea racemosa, and Ficus sur. The proximate composition parameters (moisture, ash, crude fiber, crude fat, and crude protein) and antinutritional factors were evaluated using methods of the Association of Official Analytical Chemists and elemental analysis using the atomic absorption spectroscopy technique. Among the five wild edible fruit species, Rhus vulgaris had the highest carbohydrate content (83.3 ± 0.28 g/100 g) and a high total energy (344.5 ± 2.21 kcal/100 g). Euclea racemosa was found to have the maximum ash content (12.8 ± 0.37 g/100 g), protein content (3.22 ± 0.01 g/100 g), and moisture (16.24 ± 0.003 g/100 g), respectively. Rhus natalensis showed the highest fiber content (9.54 ± 0.003 g/100 g). Mineral analysis showed that local wild fruits contained a considerable amount of minerals. The calcium concentration ranged from 99.51 mg/100 g in Euclea racemosa to 160.12 mg/100 g in Ficus sur. Potassium concentration varied from 54.34 mg/100 g in Euclea racemosa to 234 mg/100 g in Rhus vulgaris. Iron ranges from 21.4 mg/100 g in Rosa abyssinica to 41 mg/100 g in Rhus natalensis, and zinc ranges from 2.3 mg/100 g in Rhus vulgaris to 4.2 mg/100 g in Ficus sur. A high saponin content (2.12 mg/100 g) and a low tannin content (0.23 mg/100 g) were obtained in Rosa abyssinica. The phytate content (1.52 mg/100 g) and the oxalate content (0.9 mg/100 g) were high in Rhus natalensis. In conclusion, the present study shows that wild fruits can be used as food supplementation in food in a safe area.

Response of tef yield and yield components to nitrogen and phosphorus fertilizers.

The challenge facing Ethiopian farmers are the combination of low soil fertility and reduced agricultural productivity. The study aimed to quantify nitrogen and phosphorus-containing fertilizers for tef production in Sekota and Lasta-Lalibela districts, using four nitrogen and three phosphorus levels from urea and triple super phosphate sources. The Results showed that nitrogen and phosphorus fertilizers significantly affected tef yield and yield components. Application of nitrogen at the rate of 92 kg ha-1 increased tef grain yield by 131.01%, 87.78% and 182.23% in Woleh, Sayda and Lasta Lalibela districts, respectively, compared to control treatment. Similarly, 23 kg ha-1 phosphorus increased tef grain yield by 7.42 and 8.52% in Woleh and Lasta Lalibela, respectively. In Lalibela and Woleh, the application of 92 kg N ha-1 resulted in a maximum net benefits of 2099.6 and 2007 United States Dollar (USD) respectively. Furthermore, in Sayda, the application of 92 kg N ha-1 and 23 kg P2O5 ha-1 yielded a net benefit of 1812.55 USD. The marginal rate of return (MRR) from these applications was 539.6% in Lalibela, 781% in Woleh and 352.44% in Sayda. Therefore, application of 92 N and 23 kg P2O5 ha-1 is appropriate for maximum tef production in Sekota and Lasta districts of Amhara region. Further research and extension services should focus on promoting the adoption of these optimized fertilizer practices among smallholder farmers to maximize the sustainable production of tef.

Immediate postpartum anemia and associated factors at shewarobit health facilities, Amhara, Ethiopia, 2022: a cross sectional study.

BACKGROUND: Immediate postpartum anemia occurs when the amount of red blood cell count is reduced or hemoglobin concentration is below 10 g/dl in the immediate postpartum. It occurs primarily due to inadequate iron intake before and during pregnancy and blood loss during delivery. The aim of this study is to assess the proportion of immediate postpartum anemia and associated factors among mothers who gave birth at Shewarobit health facilities; in Amhara, Ethiopia. METHODS: Institutional-based cross-sectional study was conducted from June to September 2022. A systematic random sampling method was employed to select the study participants. The data were collected through interviewer-assisted questions. Data were entered into Epi Data software version 4.6.0.4 and exported to SPSS 21 for analysis, and descriptive statistics were computed. Logistic regression was applied, and P-values less than 0.05 were considered statistically significant. RESULTS: This study was conducted among 307 study participants and, the proportion of immediate postpartum anemia was 41.4% [95% CI: 36.7-46.6]. Having postpartum hemorrhage [AOR = 4.76, 95% CI: 2.44-9.28], not taking iron and folic acid supplementation [AOR = 6.19, 95% CI: 2.69, 14.22], having a prolonged second stage of labor [AOR = 2.52, 95% CI: 1.16-5.44], and mid-upper arm circumference < 23 cm [AOR = 2.02, 95% CI: 1.11-3.68] were factors significantly associated with immediate postpartum anemia. CONCLUSIONS: The proportion of immediate postpartum anemia was public problem in Shewarobit health facilities. Following the progress of labor using a partograph, closely monitoring and immediate intervention of PPH, and prevent undernutrition during antenatal care is recommended.

The effect of UNIMMAP multiple micronutrient supplements versus iron-folic acid and placebo in anemia reduction among women of reproductive age in Kebribeyah Woreda, Somali Regional State, Ethiopia: a study protocol for a community-based individual RCT.

BACKGROUND: Women of reproductive age (WRA) in developing countries are often at risk of micronutrient deficiencies due to inadequate intakes and excessive losses. OBJECTIVE: The purpose of this trial is to assess the effectiveness of United Nations International Multiple Micronutrient Antenatal Preparation-Multiple Micronutrient Supplements (UNIMMAP-MMS) versus iron-folic acid (IFA) among WRA in reducing anemia. METHODS: Three parallel groups of WRA will participate in a community-based, individually randomized, double-blinded, placebo-controlled superiority trial. After consent, the sample of 375 mildly or moderately anemic women based on hemoglobin by Hemocue will be randomly assigned across two interventions and one control arm. Trial participants in intervention arms will receive UNIMMAP-MMS or IFA while those in the control arm will receive placebos twice a week for 17 weeks. The primary outcome will be a change in mean hemoglobin (Hb) concentrations. Outcome assessors and study participants will be blinded to the type of supplements and study arm. DISCUSSION: The World Health Organization (WHO) added UNIMMAP-MMS to its essential medicine lists in 2021 but recommended rigorous study. Several factors in addition to inadequate intakes of iron and folic acid contribute to the high prevalence of anemia among WRA in the Somali region. The findings of this study will provide evidence on the effect of UNIMMAP-MMS and IFA on Hb concentrations and anemia prevalence among anemic WRA. TRIAL REGISTRATION: ClinicalTrials.gov NCT05682261. Registered on January 12, 2023.

Ethnobotany of traditional cosmetics among the Oromo women in Madda Walabu District, Bale Zone, Southeastern Ethiopia.

Traditional cosmetics play a significant role in the cultural practices and personal hygiene of many ethnic groups worldwide. The Oromo, an indigenous community in Ethiopia, has a rich history of utilizing local plants for cosmetic purposes. However, the use of plants as traditional cosmetics has only been poorly investigated as more emphasis was given to traditional medicines. The study thus aimed to identify and document plant species, and parts used in traditional cosmetics and associated knowledge, and practices among Oromo women in the Madda Walabu district, Southeastern Ethiopia. A total of 150 Oromo women were interviewed to gather ethnobotanical information including the plant species used for cosmetics, their preparation methods, and their applications. Ethnobotanical indices were computed to determine the most important species used by the women. A total of 48 plant species belonging to 31 families used as sources of traditional cosmetics were recorded. Most of these plants were trees. Leaves were the most commonly used plant part in traditional cosmetics, and maceration and decoction were the most common preparation methods applied to prepare traditional cosmetics. Topical application of traditional cosmetics was the most common, while oral infusions were rarely reported type of administration. All categories had high informant consensus factor (ICF) values, ranging from 0.80 to 0.98. The highest ICF value was found for skin treatment, followed by the hair, and face mask. Overall, Commiphora habessinica, Gnidia stenophylla, Kalanchoe lanceolata, Mimusops kummel, Sesamothamnus rivae, Terminalia brownii, T. laxiflora, Acacia drepanolobium, A. mellifera, and Aloe citrina were the most frequently cited and culturally important plants by Oromo women for traditional cosmetics in the area. The study highlights the importance of local plant resources for maintaining cultural practices and personal hygiene. However, the cultural heritage associated with traditional cosmetics is facing threats from various factors. Therefore, a continuous effort to document and disseminate knowledge about traditional cosmetics practices to ensure their preservation and transmission and awakening younger generations about the importance of traditional cosmetics and their role in cultural heritage is crucial.

Antibacterial activity and phytochemical screening of traditional medicinal plants most preferred for treating infectious diseases in Habru District, North Wollo Zone, Amhara Region, Ethiopia.

Ethiopia's healthcare system relies on traditional medicinal practices that use medicinal plants to treat human and livestock ailments. However, the lack of empirical validation regarding the efficacy of these treatments against specific infectious diseases necessitates rigorous scientific investigations. The objective of this study was to investigate the antibacterial activity and phytochemical screening on five selected medicinal plant species, namely Solanum somalense Franchet., Verbascum sinaiticum Benth., Rumex nervosus Vahl, Withania somnifera (L.) Dunal and Calpurnia aurea (Ait.) Benth. The plants were first identified jointly with local informants and later considering mainly their high informant consensus and fidelity level values for their efficacy in treating infectious diseases in the area. Ethanol and aqueous extracts were prepared from the plant materials, and their antibacterial activities were evaluated against standard bacterial strains, representing both gram-positive and gram-negative types. To assess the antibacterial activity of the extracts, the minimum inhibitory concentration (MIC) was determined using the broth dilution method. Additionally, phytochemical screening was performed using standard qualitative tests to identify various secondary metabolites. The results indicated antibacterial efficacy in the ethanol extracts of S. somalense, W. somnifera, and C. aurea against particular bacterial strains (S. somalense against S. agalactiae with MIC of 1.5 mg/mL; W. somnifera against S. aureus and E. coli, with MIC of 2 mg/mL; C. aurea against E. coli and K. pneumoniae, with MICs of 3 mg/mL and 3.5 mg/mL, respectively). The results of the phytochemical screening indicated the presence of steroids, alkaloids, flavonoids, saponins, and terpenoids. The selected medicinal plants demonstrated promising antibacterial activity against certain bacterial strains. The current findings support the long-standing claim of the traditional medical system of the study area for their continued use of these plants in their treatment of infectious diseases. Further investigation is required to isolate the responsible active compounds and characterize the constituents and description of their antibacterial effect for possible use in areas where these infectious diseases are major health problems.

Ethnoveterinary medicinal plants and their utilization by indigenous and local communities of Dugda District, Central Rift Valley, Ethiopia.

BACKGROUND: Ethnoveterinary medicinal plants have been used by the people of Dugda District in the primary health care system to treat various livestock ailments for generations, particularly, in underserved rural areas. However, these ethnoveterinary practices and medicinal plants are dwindling without proper documentation, due to undergoing socio-cultural and environmental changes. Hence, this study aimed at inventory and analysis of ethnoveterinary medicinal plants and the associated indigenous and local knowledge used in the treatment of livestock health problems in Dugda District. METHODS: Data were collected from 378 local inhabitants through semi-structured interviews, 18 focus group discussions with 6 to 8 participants in each couple with participant field observations. Informant consensus factor (ICF), fidelity-level (FL) and relative importance value (RI) were used to evaluate the agreement of informants on ethnoveterinary practices, healing potential of medicinal plants and the most multipurpose species. Using standard taxonomic procedures, voucher specimens were collected, identified and deposited at the National Herbarium of Addis Ababa University. RESULTS: In total, 64 medicinal plants of ethnoveterinary uses, belonging to 33 families were reported to treat 37 livestock health problems. Anthrax, inappetence and diarrhoea were said to be the most prevalent veterinary health problems treated by traditional medicinal plants. Family Fabaceae was the most widely reported (7 spp.), followed by Apocynaceae, Cucurbitaceae and Solanaceae (5 spp. each). Herbs were the dominant life forms (21spp.), followed by shrubs (20 spp.). The most commonly sought plant parts were leaves (55.25%), followed by roots (23.44%). The principal method of preparation was pounding remedial parts (46.85%) and mixing with cold water. The main route of administration was via oral application (72.67%), drenching diseased livestock. Withania somnifera and Kedrostis foetidissima were the most cited medicinal plants with 53 and 43 use reports (URs), respectively. ICF showed that respiratory diseases scored the highest value (0.94), while most of the reported medicinal plants were gastrointestinal agents. RI value analysis revealed that Croton macrostachyus had highest diversity of uses, followed by K. foetidissima and W. somnifera. Ethnoveterinary uses of some medicinal plants such as Phytolacca dodecandra, Calpurnia aurea, Cyphostemma cyphopetalum and Verbascum sinaiticum as prophylaxis against rabies were a new input for ethnoveterinary database. CONCLUSION: The study revealed that the people of the Dugda District are endowed with rich ethnoveterinary knowledge and medicinal plants. However, ethnoveterinary knowledge associated with medicinal plant species significantly differ (P < 0.05) between general and key informants, young and matured age groups and informants' educational level. This infers the impact of mode of ethnoveterinary knowledge transfer, literacy, modern education and globalization on ethnoveterinary uses of medicinal plant species. And also most of the medicinal plants are found in wild habitats with nearly no conservation attention. Therefore, it is imperative to implement participatory conservation actions for medicinal plants in collaboration with traditional institutions (Gada system). The disparity of ethnoveterinary knowledge could be also minimized through awareness creation among local communities about the knowledge and its revitalization. Furthermore, medicinal plants, which are widely utilized and multipurpose, should be screened for their phytochemicals, pharmacological and toxicological activities to confirm ethnoveterinary uses and for future development of veterinary pharmaceuticals.

The role of a community conversation intervention in reducing stigma related to lower limb lymphoedema in Northern Ethiopia.

BACKGROUND: Stigma related to lower-limb lymphoedema poses a major psychosocial burden to affected persons and acts as a barrier to them accessing morbidity management and disability prevention (MMDP) services. Community Conversation (CC), which actively engages community members and disseminates health information amongst them, is believed to break the vicious cycle of stigma by enhancing disease-related health literacy at the community level. METHODS: A quasi-experimental study was conducted in Northern Ethiopia to assess the role of the CC intervention in reducing stigma. In two control districts, a comprehensive and holistic MMDP care package was implemented that included physical health, mental health and psychosocial interventions, whilst in the intervention district the CC intervention was added to the MMDP care package. A total of 289 persons affected by lymphoedema and 1659 community members without lymphoedema were included in the study. RESULTS: Over the course of the intervention, in all sites, community members' knowledge about the causes of lymphoedema increased, and perceived social distance and stigmatizing attitudes towards people with lymphoedema decreased in the community, whilst experienced and internalized stigma decreased amongst affected persons. There were no significant changes for perceived social support. However, the changes were greater in the control sites overall, i.e. those districts in which the holistic care package was implemented without CC. CONCLUSION: The findings suggest that the CC intervention provides no additional stigma reduction when used alongside a holistic MMDP care package. Provision of comprehensive and holistic MMDP services may be adequate and appropriate to tackle stigma related to lower-limb lymphoedema in a resource-constrained setting like Ethiopia.

Level of Family centered care and associated factors among parents of children with cancer at tertiary level hospital, Ethiopia.

OBJECTIVE: To determining level and factors affecting Family Centered Care (FCC) in pediatric oncology unit of Tikur Anbessa Specialized hospital (TASH), Ethiopia. METHOD: A cross sectional study was conducted from June to December 2022. Three hundred ninety-three parents of children with cancer were consecutively interviewed using Measure of Processes of Care (MPOC-20). Multivariable linear regression was used to identify independent predictors of FCC. RESULT: The total MPOC 20 means was 3.71(SD = 1.04). The mean score for respectful and supportive care, coordinated and comprehensive care, enabling and partnership, providing specific information and providing general information were found to be 4.8, 4.6, 3.7, 2.3 and 2.6, respectively. Family employment (-0.33(95% CI = -0.63, -0.03; P = .029)), low family education (-0.40 (95% CI = -0.70, -0.11; P = .008)), referral cases (-0.37(95% CI = -0.59, -0.14; P = .001)), shorter time spent in hospital (-0.49(95% CI = -0.85, -0.12; P = .010)) and psychological distress (-0.01(95% CI = -0.026, -0.001; P = .028)) were associated with lower mean score of FCC. CONCLUSION: The total FCC mean score was found to be low. From the five FCC components providing general and specific information scored the lowest mean level. PRACTICE IMPLICATIONS: Mechanism to improve information delivery that address parents from different background and referred from other health facility should be in place in order to improve FCC level. In addition, the FCC should be designed to address parents of children with different lengths of stay.

Midwives' experiences of performing obstetric ultrasounds in antenatal care in eastern Ethiopia: Qualitative exploratory study.

BACKGROUND: In 2016, the World Health Organization recommended inclusion of an ultrasound scan as part of routine antenatal care to improve pregnancy outcomes. However, most rural women in Ethiopia do not have access to ultrasound scanning as part of their routine antenatal care. Recently, ultrasonography services were introduced at health centers in Harar, Kersa, and Haramaya districts in Eastern Ethiopia. This expoloratory study aimed to examine experiences of pregnancy surveillance midwives in the Child Health and Mortality Prevention Surveillance (CHAMPS) who performed ultrasonography at health centers that are in the catchment area of Health and Demographic Surveillance Systems, in Eastern Ethiopia. OBJECTIVE: To explor midwives' experiences across 14 health centers in Eastern Ethiopia, located in the Kersa, Haramaya, and Harar Health and Demographic Surveillance Systems from February to April 2022. DESIGN: Exploratory qualitative study. METHODS: The methods used were based on the Standards for Reporting Qualitative Research framework. Purposeful sampling was used to explore experiences of midwives who performed ultrasonography at selected health centers. The Midwives are recurited, trained and stationed at the health ceners to do ultrasound scanning and other activities by the Child Helath and Mortality Prevention Surveillance (CHAMPS) pregancny surveillance activities. Among 17 midwives who had undergone ultrasonography training and who were actively involved in ultrasound scanning at health centers in Kersa, Haramaya, and Harar Health and Demographic Surveillance Systems, three midwives who worked at health centers with no power or near a hospital were excluded. Using tape recordings and note-taking, data were collected through in-depth interviews based on a semi-structured interview guide. Thematic analysis used for data categorization, and the trustworthiness of data was kept throughout the procedure using credibility, dependability, confirmability, and transferability. RESULTS: In this study, we identified five main themes: Ultrasonography positively impacts midwives trained as sonographers; performing ultrasound scans enhances the skills and confidence of midwives, improving their professional development, Individual perception of self-efficacy; midwives' belief in their abilities to perform ultrasound scans effectively influences their job satisfaction and motivation, Provision of care; integrating ultrasound into antenatal care enhances the quality, therapeutic communication, and personalized nature of care provided to pregnant women, Barriers to providing ultrasonography services; challenges such as shortage of ultrasonography-trained staff and workload can hinder the delivery of ultrasound services in rural areas, Community acceptance; the level of community understanding, trust, and support towards ultrasound technology and midwives as sonographers impacts the successful implementation and sustainability of ultrasound services. CONCLUSION: Ultrasonography performed by midwives at rural health centers had a considerable impact on antenatal care services and incareased confidence of midwives.

Midwives' Experiences with Ultrasound Scans for Pregnant WomenThe World Health Organization recommends that pregnant women undergo at least four antenatal care (now eight times) visits during their pregnancy. The goal is to reduce feto-maternal complications. Recently, ultrasonography services are introduced in Harar, Kersa and Haramaya districts, Eastern Ethiopia.Midwives who performed ultrasonography at selected health centers were part of this exploaroty study. The information were generated through code, categories, and themes.Five themes were identified. Ultrasonography positively impacts midwives trained as sonographers, individual perception of self-efficacy, provision of care, barriers to providing ultrasonography services, and community acceptance.Ultrasonography performed by midwives at rural health centers had a considerable impact on antenatal care services and midwives confidence.

Influence of socio-demographic factors on medicinal plant knowledge among three selected ethnic groups in south-central Ethiopia.

BACKGROUND: The influence of socio-demographic variables was widely explored to evaluate their impact on indigenous and local ethnobotanical knowledge. However, the studies conducted in Ethiopia mainly focused on rural areas. They were limited to exploring and documenting ethnobotanical knowledge and the associated impacts of socio-demographic variables in rural-urban interface areas among ethnic groups. Hence, this study aimed to document plant-based indigenous and local ethnomedicinal knowledge and the associated impacts of socio-demographic variables among selected three ethnic groups in south-central Ethiopia. METHODS: Ethnobotanical data were collected using semi-structured interviews with 189 key informants, floristic species inventories, and field observations. Quantitative approaches were used to evaluate the use values (UV) of the most important medicinal plants, the informant consensus factor (ICF), fidelity level (FL), relative popularity level (RPL), and rank-order priority (ROP). Statistical tests were applied to evaluate the influences of socio-demographic factors and associations between variables on local ethnobotanical knowledge across ethnic groups in different informant categories. RESULTS: Statistical analysis revealed significant differences (p < 0.05) in the mean number of medicinal plants reported among age categories. There was also a positive association between the respondent's age and plant knowledge acquisition. Croton macrostachyus Hochst. ex Delile, Albizia gummifera C.A.Sm., Zingiber officinale Roscoe, Aloe macrocarpa Tod., Gymnanthemum amygdalinum (Delile) Sch.Bip., Calpurnia aurea (Aiton) Benth, and Allium sativum L. had the highest use values among ethnic groups. The highest informant consensus factor values were recorded for circulatory system disorders (0.68) followed by febrile illness and reproductive organ complications (0.66 each) across the three studied ethnic groups. The highest FL, RPL, and ROP values were noted for Lactuca inermis Forssk., Moringa stenopetala (Baker f.) Cufod., Withania somnifera (L.) Dunal, Allium sativum L., Citrus limon (L.) Osbeck, Ricinus communis L., Schinus molle L., Antiaris toxicaria (J.F.Gmel.) Lesch., Brucea antidysenterica J.F.Mill., Echinops kebericho Mesfin, Ocimum jamesii Sebald, Afrocarpus falcatus (Thunb.) C.N.Page, Searsia natalensis (Bernh. ex Krauss) F.A.Barkley, and Ricinus communis L. across ethnic groups in the study areas, which showed the conformity of knowledge on species curing potential and their prevalent uses. CONCLUSION: The study revealed that the ethnic groups of Gedeo, Oromo, and Sidama have considerable indigenous and local ethnobotanical knowledge practices. Statistical analysis shown high variation in the acquisition of local ethnobotanical knowledge among age groups, which boosted our understanding of the effects of socio-demographic factors on the local ethnobotanical knowledge dynamics. Thus, this finding advocates for efforts to repair the observed generation gap via continued professional support and educating local communities to preserve traditional knowledge and practices through systematic documentation.

Evaluation of the quality and safety of commercial complementary foods: Implications for nutrient adequacy and conformance with national and international standards.

Optimal nutrition in early childhood increases growth and development while preventing morbidity and mortality in later life. This study focused on the quality and safety of 32 commercially produced complementary foods collected from supermarkets in Addis Ababa, Ethiopia. The proximate composition (moisture, protein, fat, crude fibre, and ash); and the mineral profile (calcium, iron, zinc, manganese, and magnesium) were determined using the AOAC method. The determination of antinutritional factors (Condensed tannin and oxalate) was done using a UV spectrophotometer. A rapid visco analyzer was used to measure the rheological property. The microbial load of commercially produced complimentary foods was identified using aerobic colony counts for mold and yeast. Labeling practice was evaluated using the WHO and Ethiopian standard tools. The results of proximate compositions were: protein (0.92-18.16 g/100g), fat (0.63-6.44 g/100g), crude fiber (1.04-13.2 g/100g), energy (410-337 kcal/100g), moisture (0.03-17 g/100g), and ash (0.60-4.67 g/100g). The protein and fat content of all the products is below international standards. Only three products met the standards for energy. Moisture and ash contents partially met the requirement, while all of the carbohydrate contents of the products fell under the specified standard. The lowest and highest mineral contents of the products were: Fe (1.38 to 15.10 mg/100g), Zn (0.64 to 6.78 mg/100g), Ca (30.55 to 364.45 mg/100g), Mg (1.2 to 34.2 mg/100g), and Mn (0.80 to 32 mg/100g). Based on these, 21.5% of the foods met the Fe standard, and 31.5% didn't meet the Zn standard. The Ca and Mg of all the products met the requirement. Except for one product, all met standards. The highest and lowest results for the tannin and oxalate content of the products were 49.20 to 90.09 mg/100g and 0.47 to 30.10 mg/100g, respectively and this shows that the products are below the permissible range for tannin and oxalate. The counts of yeast and mold were 0.00-2.95 log10 cfu/g and 0.00-2.91 log10 cfu/g, respectively. Only one product fell below the standard for yeast count, and none of the products showed a mold count that exceeded the standard. The final viscosity was 63.5-3476 RVU, and only 31.25% of the samples fell under the permissible peak viscosity range, of 83-250 RVU. Thus, regular monitoring of the raw material and processing trends and the inclusion of animal sources in the raw material are suggested for having well-enriched complementary foods. Regulatory bodies should also conduct frequent market surveillance to safeguard the health of the consumer.

Ethnobotanical study of traditional medicinal plants used by the local Gamo people in Boreda Abaya District, Gamo Zone, southern Ethiopia.

BACKGROUND: Medicinal plants have been used for centuries and are still relied upon by over 80% of the Ethiopian population. The people of Gamo, southern Ethiopia, have a rich cultural and traditional lifestyle with a long history of using plant resources for various uses including traditional herbal medicine. However, their traditional knowledge of traditional medicinal plants in Boreda Abaya District has not been explored Ethnobotanically yet, despite preserving diverse indigenous traditional medicinal plants. Hence, the study aimed to document and analyze traditional medicinal plants and associated traditional knowledge and practices used by local people. MATERIALS AND METHODS: Quantitative ethnobotanical data were collected via semi-structured interviews, face-to-face conversations, group discussions, and guided field trips between September 2022 and February 2023. In total, 92 informants participated, of which 25 were key informants. Quantitative data indices (informant consensus factor-ICF-and use report-Ur) were computed by MS Excel spreadsheet software. Scientific names of medicinal plants were checked via World Flora Online. RESULTS: In the present study, we recorded 188 traditional medicinal plant species belonging to 163 genera and 73 plant families. Lamiaceae (16 species), Asteraceae (16 species), Fabaceae (11 species), and Euphorbiaceae (8 species) contributed highest number of species and were found to be predominant family in the area. Leaves and seeds were most frequently used plant parts, and pounding (46%) was the main method to prepare remedies. The sudden sickness disease category scored the highest consensus (ICF: 0.35), followed by blood and circulatory-related disease categories (ICF: 0.33). The highest number of plant taxa (61 species) used to treat dermal disease has a 71-use report score, while fewer plant taxa (21 species) were utilized to treat genitourinary system-related disease category, having 25 use reports. Ocimum lamiifolium (Ur:56) and Moringa stenopetala (Ur:51) are widely used species and received highest use report value. CONCLUSION: Gamo people possess extensive traditional knowledge of ethnomedicine. The region's vegetation hosts diverse medicinal species, but deforestation, agriculture, and droughts threaten them. Local conservation practices require scientific support, prioritizing species having higher use reports (Ur), and in-depth investigations of promising species for drug development are essential.

Ethnobotanical study of wild edible plants in Dibatie district, Metekel zone, Benishangul Gumuz Regional State, western Ethiopia.

BACKGROUND: Plants deliver livelihood and food for millions of people in the world. Indeed, wild edible plants support rural communities in developing countries to overcome seasonal unfavorable conditions. In rural areas of Ethiopia, wild edible plants play an indispensable role in fighting food insecurity as emergency or supplementary foods. Hence, this research was aimed at studying the ethnobotanical assessment of wild edible plants in Dibatie district, Metekel zone, western Ethiopia. METHODS: Ethnobotanical data was collected using a semi-structured interview, field observation, focus group discussions, a market survey, and the ranking of selected plants. Besides, voucher specimens were collected and stored at the National Herbarium of Ethiopia. Descriptive statistics, preference ranking, direct matrix ranking, and familiarity index were computed for data analysis. RESULTS: This study has documented 54 wild edible plant species belonging to 33 plant families and 46 genera. Of these, most (38.90%) had tree growth habits. Wild edible plants bear mostly fruits (72.20%) as edible parts. Local people usually consume these plants freshly raw as complementary foods, though some wild edibles require processing. They were mostly harvested in the January (31.48%) and May (27.78%) months, with the least collected in September (7.41%). Most wild edible plants (78.57%) were available in uncontrolled habitats, while others (21.43%) live in farmlands, home gardens, and as live fences. Out of the recorded plants, about 98% had additional uses besides their nutritional values. CONCLUSION: Wild edible plants assist the livelihoods of the local people in food security, agriculture, energy sources, construction, medicines, ecological services, aesthetics, income generation, and household utensils. Nevertheless, wild edible plants are recently threatened due to various anthropogenic factors in the study area. Thus, they need wise use and in-situ and ex-situ conservation measures from all the concerned bodies for sustainable use in the future.