Background Annually 57 million people across the globe require palliative care, 76% are from low- and-middle income countries. Continuity of palliative care contributes to a decline in emergency... Show moreBackground Annually 57 million people across the globe require palliative care, 76% are from low- and-middle income countries. Continuity of palliative care contributes to a decline in emergency room visits., decreased hospital deaths, improved patient satisfaction, better utilization of services, and cost savings. Despite efforts made to develop the palliative care guideline in Ethiopia, the service is not yet organized and linked to primary health care. This study aimed to explore barriers to the continuum of palliative care from facility to household for cancer patients in Addis Ababa. Methods Qualitative exploratory study was conducted with face-to-face interviews with a total of 25 participants. The study population was adult cancer patients, primary caregivers, healthcare providers, volunteers, and nationwide advocates. Data were audio recorded, transcribed verbatim and finally imported to Open code version 4.02 software for coding and analysis. Thematic analysis was guided by Tanahashi’s framework. Results The key barriers to continuity of palliative care included opioid scarcity and turnover and shortage of healthcare workers. A shortfall of diagnostic materials, cost of medications, lack of government backing, and homebased center’s enrollment capacity hampered accessibility. Care providers were instruments of cultural barriers in delivering appropriate end-of-life care, on the other hand, patients’ preference for conventional medicine hindered acceptability. Lack of community volunteers, failure of health extension workers to link patients, and spatial limits fraught utilization. The lack of defined roles and services at several levels and the workload on healthcare professionals affected the effectiveness of the nexus. Conclusion The continuum of palliative care service from health facility to household in Ethiopia is yet in its infancy compromised by factors related to availability, accessibility, acceptability, utilization, and effectiveness. Further research is required to delineate the roles of various actors; th Show less
Objective To assess the availability of an institutional-level respectful maternity care (RMC) index, its components, and associated factors.Methods A cross-sectional study design was applied to a... Show moreObjective To assess the availability of an institutional-level respectful maternity care (RMC) index, its components, and associated factors.Methods A cross-sectional study design was applied to a 2016 census of 3804 health facilities in Ethiopia. The availability of an institutional-level RMC index was computed as the availability of all nine items identified as important aspects of institutional-level RMC during childbirth. Logistic regression analysis was used to identify factors associated with availability of the index.Results Three components of the institutional-level RMC index were identified: "RMC policy," "RMC experience," and "facility for provision of RMC." Overall, 28% of facilities (hospitals, 29.9%; health centers, 27.8%) reported availability of the institutional-level RMC index. Facility location urbanization (urban region), percentage of maternal and newborn health workers trained in basic emergency obstetric and newborn care, and availability of maternity waiting homes in health facilities were positively associated with availability of the institutional-level RMC index.Conclusion Only one in three facilities reported availability of the institutional-level RMC index. The Ethiopian government should consider strengthening support mechanisms in different administrative regions (urban, pastoralist, and agrarian), implementing the provision training for health workers that incorporates RMC components, and increasing the availability of maternity waiting homes. Show less
Tura, A.K.; Aboul-Ela, Y.; Fage, S.G.; Ahmed, S.S.; Scherjon, S.; Roosmalen, J. van; ... ; Akker, T. van den 2020
With postpartum hemorrhage (PPH) continuing to be the leading cause of maternal mortality in most low-resource settings, an audit of the quality of care in health facilities is essential. The... Show moreWith postpartum hemorrhage (PPH) continuing to be the leading cause of maternal mortality in most low-resource settings, an audit of the quality of care in health facilities is essential. The purpose of this study was to identify areas of substandard care and establish recommendations for the management of PPH in Hiwot Fana Specialized University Hospital, eastern Ethiopia. Using standard criteria (n = 8) adapted to the local hospital setting, we audited 45 women with PPH admitted from August 2018 to March 2019. Four criteria were agreed as being low: IV line-setup (32 women, 71.1%), accurate postpartum vital sign monitoring (23 women, 51.1%), performing typing and cross-matching (22 women, 48.9%), and fluid intake/output chart maintenance (6 women, 13.3%). In only 3 out of 45 women (6.7%), all eight standard criteria were met. Deficiencies in the case of note documentation and clinical monitoring, non-availability of medical resources and blood for transfusion, as well as delays in clinical management were identified. The audit created awareness, resulting in self-reflection of current practice and promoted a sense of responsibility to improve care among hospital staff. Locally appropriate recommendations and an intervention plan based on available resources were formulated. Show less
While the inclusion of extreme poor people is a noble and necessary objective, it is challenging. Attempts to include extreme poor people in development interventìons have often been disappointing.... Show moreWhile the inclusion of extreme poor people is a noble and necessary objective, it is challenging. Attempts to include extreme poor people in development interventìons have often been disappointing. This book addresses the challenge of including the poorest people. lt provides deeper understanding of the mechanisms of in- and exclusion of extreme poor people, the structural causes of extreme poverty and the desirability of a univocal definition of extreme poverty. The book contributes to such an understanding through an analysis of extreme poor and marginalised people and their multiple dimensions of wellbeing. Furthermore, this book sheds light on the discourses and practices applied by development agencies in order to draw lessons about how the extreme poor can be sustainably included in development interventions. This is based on original field research - using a partipatory approach - carried out in Bangladesh, Benin, and (rural and urban) Ethiopia. Show less
The State of Addis Ababa 2017 report is aimed at providing a comprehensive assessment of existing socioeconomic and environmental conditions in the city, shedding light on the impacts of on-going... Show moreThe State of Addis Ababa 2017 report is aimed at providing a comprehensive assessment of existing socioeconomic and environmental conditions in the city, shedding light on the impacts of on-going fast paced urbanization. The report addresses policy makers and city planners and makes bold recommendations on how resources can be strategically developed and managed to sustainably meet the needs of the urban population of today and the future, improve the short- and long-term wellbeing of citizens and transform Addis Ababa into the city that the citizenry wants. Show less
The State of Addis Ababa 2017 report is aimed at providing a comprehensive assessment of existing socioeconomic and environmental conditions in the city, shedding light on the impacts of on-going... Show moreThe State of Addis Ababa 2017 report is aimed at providing a comprehensive assessment of existing socioeconomic and environmental conditions in the city, shedding light on the impacts of on-going fast paced urbanization. The report addresses policy makers and city planners and makes bold recommendations on how resources can be strategically developed and managed to sustainably meet the needs of the urban population of today and the future, improve the short- and long-term wellbeing of citizens and transform Addis Ababa into the city that the citizenry wants. Show less
This book brings together studies on the broad theme of elections and democratization in Africa since roughly 1989. It is based on a seminar held in The Netherlands in February 1997, and includes... Show moreThis book brings together studies on the broad theme of elections and democratization in Africa since roughly 1989. It is based on a seminar held in The Netherlands in February 1997, and includes chapters on both electoral processes, especially the role of foreign observers therein, and the historical and sociocultural backgrounds or contexts of democratization, elections and political legitimacy. Part 1 deals with elections and election observation in Africa in general (contributions by O. van Cranenburgh, S. Ellis, I. van Kessel, B. de Gaay Fortman). Part 2 consists of country studies (M. Doornbos on Uganda, D. Foeken en T. Dietz on Kenya, J. Abbink on Ethiopia, R. van Dijk on Malawi, R. Buijtenhuijs on Chad, and M.-F. Lange on Mali). Part 3 includes a chapter that reflects the discussions held at the seminar between observers, academics and policymakers in the Netherlands Ministry of Foreign Affairs (W. van Binsbergen en J. Abbink); a review of Dutch policies on election observation in Africa during the period 1992-1997 (O. van Cranenburgh); and a discussion of the 1997 general elections in Kenya, where a new approach of election observation was introduced (M. Rutten). Show less
