The FIGO Save the Mothers Initiative: the Ethiopia-Sweden collaboration.

The overall goal of the FIGO Save the Mothers Fund was to establish basic and comprehensive emergency obstetric care (EmOC) with the specific objectives of increasing the availability and utilization of quality obstetric care as measured by the UN indicators. As a result of this commitment by FIGO, the Ethiopian Society of Obstetricians and Gynecologists (ESOG) launched the Save the Mothers Project (SMP) in West Showa Zone (WSZ), Ethiopia in 1998 to implement and test a demonstration project and evaluate the feasibility and impact of the intervention. The overall objectives matched FIGO's-reducing maternal deaths by promoting the availability, access and utilization of EmOC services for women with complications of pregnancy and childbirth. The intervention package included capacity building as a major activity, and physicians and other service providers from Ambo Hospital, Shenen and Ijaji Health Centers were trained in EmOC. This was intended to combat the high staff turnover in the area. Equipment, materials and supplies were also provided to the demonstration sites to enable them provide basic and comprehensive EmOC services. The interventions, begun in 1999, led to improvements in availability, utilization and met need, which suggests that such an approach may eventually lead to the reduction of maternal deaths. The cesarean section rate for Ambo Hospital increased from 3.7% in 1998 to 17.3% in 2001--an almost six-fold increase. At Ambo Hospital both the total number of deliveries and cases admitted with obstetric complications have increased from baseline. Patients with obstructed labor comprise 39% of all obstetric patients making it the leading cause of hospitalization. Obstetric hemorrhage comes next with 24% of all admissions. The case fatality rate (CFR) (for direct maternal deaths) decreased from 7.2% at baseline, to 4.6% in 2001--showing a definite trend of improvement. Currently, there is 24-h EmOC service at Ambo Hospital where an obstetrician and general medical practitioners with EmOC training are responsible for the service. Shenen and Ijaji health Centers are upgraded in terms of training of staff members, provision of equipment and supplies, and regular supervision so that the community in these areas has access to basic EmOC services. To replicate similar activities, in a setting like ours, EmOC projects have to be low cost to attract decision-makers. The SMP used almost US dollars 100,000 over 3 years to ensure availability of EmOC services for women in WSZ. A favorable political climate such as maintenance of relative peace, and flexibility in adapting to local conditions also contributed to the success of the SMP.

Epidemiological study on clinical bovine dermatophilosis in northern Ethiopia.

A total of 5586 indigenous and cross breed cattle were examined for clinical dermatophilosis, and 292 (5.22%) were positive. In indigenous cattle, statistically discernible (p < 0.05) difference was recorded between the prevalence in wet (5.5%) and dry (4.0%) seasons. During both seasons, infestation with A. Variegatum significantly (p < 0.05, chi 2 = 59.9) influenced clinical dermatophilosis. A. variegatum-infested cattle were at 7x higher risk (OR, Odds Ratio = 6.8) of acquiring the disease than non-infested ones. Logistic regression analysis of the overall prevalence showed a significant difference (p < 0.05) between prevalence in indigenous and cross breeds; the crossbreeds being at about 3x higher risk (OR = 2.68). Improved management reduced the prevalence in cross breeds from 15.1% in dry to 8.6% in wet season suggesting the significance of management in the epidemiology of dermatophilosis. The disease occurrence was also significantly (p < 0.05, chi 2 = 133.05) affected by agro-climatic (altitude) variation suggesting the impact of rainfall, humidity, vegetation and vector population that varied with altitude. Age and gender had no influence (p > 0.05) on the disease. Our result showed that season of the year, breed, management, infestation with A. variegatum and agro climatic difference are important risk factors influencing the disease pattern in the region. A tick control strategy and a better and adequate management particularly when keeping cross breeds are recommended.