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
This study assesses the impact of a large, state-sponsored sugar plantation scheme on agro-pastoralists’ livelihoods and local land use change in southern Ethiopia, specifically in the lower Omo... Show moreThis study assesses the impact of a large, state-sponsored sugar plantation scheme on agro-pastoralists’ livelihoods and local land use change in southern Ethiopia, specifically in the lower Omo Valley. The study compares the local perceptions on the ongoing Omo-Kuraz sugar project — sugar cane plantations and a cane-crushing factory — and describes how it has affected local communities’ environmental and livelihood strategies vis-à-vis the alleged ‘new development opportunities’. Focus group discussion, key informant interviews, and field observations were applied to get in-depth information about the socio-economic and environmental impacts of large scale land acquisitions. The results show that the implementation of large scale land acquisitions in the lower Omo Valley has put enormous pressure on local land use and land management systems. The Omo-Kuraz I and II projects, started in 2011, neither met the stated economic purposes of the then Ethiopian federal government nor satisfied the pastoral communities’ needs. The LSAI project is still highly contentious among the local community, the project office, and the local government. Our study recommends that shifting the perspective towards the local agropastoralists’ activities, understanding their views and ways of ‘using’ the environment, and creating a broader consultation platform with them may create opportunities for cooperation and synergy to optimize benefits and sustainably adapt the development project to the local context. Show less
The bulk of the book is based on papers presented during two virtual conferences hosted by the University of Leiden (Netherlands) in 2021. At the Africa Knows! Conference, a panel was devoted to ... Show moreThe bulk of the book is based on papers presented during two virtual conferences hosted by the University of Leiden (Netherlands) in 2021. At the Africa Knows! Conference, a panel was devoted to ‘The language issue and knowledge communication in Africa.’ It was initiated by the Universities of Ilorin (Nigeria) and Chemnitz (Germany). The papers by Eleshin, Oloruntoba-Oju, Sanon-Ouattara, Van Pinxteren, and Zatolokina were all first presented at this panel, before being peer-reviewed for this volume. The central theme of the conference was the decolonization of Africa’s knowledge production and related processes. The second conference was the 10th World Congress on African Languages and Linguistics (WOCAL) in June, where a workshop took place under the auspices of the Edinburgh Circle on the Promotion of African Languages, entitled ‘Let’s turn to policy.’ The papers by Alfredo, Dissake, and Nguere and Smith were also first presented during this workshop before being peer-reviewed for this volume. In general, the position taken by the editors is that using indigenous languages in education can make an important contribution to national development as well as to personal empowerment. Africa is characterised in part by its continued use of former colonial languages in education. However, sixty years after independence, it seems high time to question this colonial heritage. In the context of global and digital communication today, old African values of multilingualism and culture-specific communicative strategies should not be neglected, but revalued and revived in new ways. We do not deny the importance of a good command of international languages. However, this should not be at the expense of indigenous languages. The introduction to the book argues that a transition towards increased use of African languages in formal domains will not only be necessary and practically possible, it will become inevitable. Show less
J. Abbink produced a new bibliography on Ethiopian-Eritrean studies in society and history. It is a by- product of research he did on these countries in the past five years and is the ultimate... Show moreJ. Abbink produced a new bibliography on Ethiopian-Eritrean studies in society and history. It is a by- product of research he did on these countries in the past five years and is the ultimate volume in the series. The volume covers the period from 2016 to July 2022 and contains all the crucial references to recent work in history, archaeology, sociology, anthropology, economics, agricultural studies, politics, international relations, environmental studies, religious and cultural studies. Also prominent are themes like the Nile Basin, (regional) conflict, food (in)security, gender relations, demographic developments, urban life, arts & crafts, and pastoral societies.A brief introduction situates the bibliography in the wider field of Ethiopian-Eritrean studies and clarifies the underlying criteria of inclusion and organization of the references. As much as possible, the individual references also contain a link to their digital publication website. The work is concluded with an author name index and is published as an E-book only. Show less
Why has Africa not been doing so well and what is the way forward? This book starts with the analysis of Vansina and Prah: the old cultural traditions in Africa have been destroyed in colonial... Show moreWhy has Africa not been doing so well and what is the way forward? This book starts with the analysis of Vansina and Prah: the old cultural traditions in Africa have been destroyed in colonial times; new ones are currently taking shape, based in part in African languages. The book uses cross-cultural psychology to show that such new cultural traditions are indeed forming in Africa. However, almost all African countries currently use a former colonial language in secondary and higher education. The book demonstrates that if more and more people get educated, this system will no longer scale. Over the next decade, more and more African countries will have to make a transition towards increased use of African languages. The book proposes a distinction between discerned and designed languages. All over the world, designed languages are made to serve speakers of several discerned languages. This could and should happen in Africa as well. The book contains a number of brief case studies, showing how in fact such a transition is practically possible. In future, African countries will be able to achieve success in their educational systems by using a small number of languages as medium of instruction. Such a transition will also help to form the new cultural traditions that are already taking shape on the continent. Show less
Music beats spoken language in identifying individuals uniquely in two disparate communities. In addition to their given names, which conform to the conventions of their languages, speakers of the... Show moreMusic beats spoken language in identifying individuals uniquely in two disparate communities. In addition to their given names, which conform to the conventions of their languages, speakers of the Oyda (Omotic; SW Ethiopia) and Yopno (Finisterre-Huon; NE Papua New Guinea) languages have “name tunes,” short 1–4 s melodies that can be sung or whistled to hail or to identify for other purposes. Linguistic given names, for both communities, are often non-unique: people may be named after ancestors or contemporaries, or bear given names common to multiple individuals. But for both communities, name tunes are generally non-compositional and unique to individuals. This means that each new generation is likely to bring thousands of new name tunes into existence. In both communities, name tunes are produced in a range of contexts, from quotidian summoning and mid-range communication, to ceremonial occasions. In their use of melodies to directly represent individual people, the Oyda and Yopno name tune systems differ from surrogate speech systems elsewhere that either: (a) mimic linguistic forms, or (b) use music to represent a relatively small set of messages. Also, unlike some other musical surrogate speech traditions, the Oyda and Yopno name tune systems continue to be used productively, despite societal changes that have led to declining use in some domains. Show less
Asemu, Y.M.; Yigzaw, T.; Desta, F.A.; Scheele, F.; Akker, T. van den 2021
Background Access to safe surgery has been recognized as an indispensable component of universal health coverage. A competent anesthesia workforce is a prerequisite for safe surgical care. In... Show moreBackground Access to safe surgery has been recognized as an indispensable component of universal health coverage. A competent anesthesia workforce is a prerequisite for safe surgical care. In Ethiopia, non-physician anesthetists are the main anesthesia service providers. The Government of Ethiopia implemented a program intervention to improve the quality of non-physician anesthetists' education, which included faculty development, curricula strengthening, student support, educational resources, improved infrastructure and upgraded regulations. This study aimed to assess changes following the implementation of this program. Methods A pre-and post-evaluation design was employed to evaluate improvement in the quality of non-physician anesthetists' education. A 10-station objective structured clinical examination (OSCE) was administered to graduating class anesthetists of 2016 (n = 104) to assess changes in competence from a baseline study performed in 2013 (n = 122). Moreover, a self-administered questionnaire was used to collect data on students' perceptions of the learning environment. Results The overall competence score of 2016 graduates was significantly higher than the 2013 class (65.7% vs. 61.5%, mean score difference = 4.2, 95% CI = 1.24-7.22, p < 0.05). Although we found increases in competence scores for 6 out of 10 stations, the improvement was statistically significant for three tasks only (pre-operative assessment, postoperative complication, and anesthesia machine check). Moreover, the competence score in neonatal resuscitation declined significantly from baseline (from 74.4 to 68.9%, mean score difference = - 5.5, 95% CI = -10.5 to - 0.5, p < 0.05). Initial gender-based performance differences disappeared (66.3% vs. 65.3%, mean score difference = - 1.0, 95% CI = - 6.11-3.9, p > 0.05 in favor of females), and female students scored better in some stations. Student perceptions of the learning environment improved significantly for almost all items, with the largest percentage point increase in the availability of instructors from 38.5 to 70.2% (OR = 3.76, 95% CI = 2.15-6.55, p < 0.05). Conclusion The results suggest that the quality of non-physician anesthetists' education has improved. Stagnation in competence scores of some stations and student perceptions of the simulated learning environment require specific attention. Show less
Summary: Global media discussion and policy responses to the armed conflict in Tigray Region, Ethiopia, that started op 4 November 2020 by the TPLF (Tigray People’s Liberation Front) party-led... Show moreSummary: Global media discussion and policy responses to the armed conflict in Tigray Region, Ethiopia, that started op 4 November 2020 by the TPLF (Tigray People’s Liberation Front) party-led Tigray Regional government, are marked by bias, incompleteness, lack of context understanding, credulity and an anti-federal goverment attitude. The conflict, provoked by an unannounced and treacherous nightly attack by TPLF forces on federal army troups stationed in Tigray to protect the Region, was the result of misplaced power-mongering by the TPLF, and its building up of tension with the federal Ethiopian goverment. The 4 November attack led to a major federal army response. Five days after the attack by TPLF, on 9 November 2021, over 800 Amharic-speaking civilian inhabitants of the town of Mai Kadra in Western Tigray were killed by TPLF-affiliated forces and militias in a gruesome manner – a classic case of ‘ethnic cleansing’. Perpetrators mostly fled to Sudanese refugee camps. These two events - the 4 November attack and the ‘ethnic cleansing’ - were defining dramatic moments in the war. While the conflict unfolded, leading to defeat of the TPLF forces on 28 November 2020 with the taking over of the regional capital Meqele and the flight of the TPLF leadership, many leading Western media and news websites focused on the aftermath and the effects of the fighting in Tigray Region and its population, easily shifting sympathy twards the perceived ‘underdog’ (TPLF). This was followed by hastily written statements by foreign policy makers in EU, USA and UN circles, leading to an emerging policy narrative whereby essential details of the context, the nature of the adversaries, the reasons of the conflict were sidelined. These Atlantic community spokespersons shifted to ‘blaming’ the federal Ethiopian government and ‘demanding’ all kinds of measures from it. Notable was the international community clamouring for ‘unlimited and full access’ for humanitarian aid to ‘prevent famine’, and demand a halt to all hostilities. But meanwhile it did not deliver much aid itself and did as if making it conditional on the federal government following their orders. Part of the international media, several academic associates and researchers who saw acces to their research sites blocked, and diverse TPLF associates in various international organizations continued to fuel the flames of this approach, next to the ‘digital activism’and the production of fake news reports by pro-TPLF persons in Ethiopa and especially in the Tigrayan ‘diaspora’ in the West.All this led to serious misperceptions and unfair bias on the part of the Atlantic countries and the UN vis-à-vis Ethiopia, which endangered integrity, balance, and a proper perspective on causes and consequences, as well as to policies that seemed akin to ‘development aid blackmail’ and sanctimonious lecturing of a fragile, low-income African developing country. In the exercise, the detailed press statements, reports and explanations by Ethiopian parties, including the government and reformist Prime Minister Abiy Ahmed, are routinely neglected or doubted. In contrast, the statements and international messages by TPLF remnants and advocates, marked by a high degree of unreliability, exaggeration and very often lacking truth content, are used uncritically. On the basis of a number of telling examples, this paper describes the above process, analyses the emerging Atlantic discourse and some of its mistakes and wrong assumptions. It thereby pleads for a more balanced, critical approach to the incomplete reporting and wilfull misinformation from questionable sources so as to have the media and Atlantic policy makers develop a more responsible approach.Résumé: parti TPLF (Tigray Peoples Liberation Front), sont marquées par des préjugés, des incomplétudes, un manque de compréhension du contexte, la crédulité et une attitude contre le gouvernement fédéral. Le conflit, provoqué par une attaque nocturne inopinée et perfide par les forces tigréennes contre les troupes de l'armée fédérale stationnées au Tigré pour protéger la région, était le résultat d'une politique de la force mal jugée par le TPLF et sa montée des tensions avec le gouvernement fédéral éthiopien. L'attaque du 4 novembre a évoquée à une réponse directe de l'armée fédérale. Cinq jours après l'attaque du TPLF, plus de 800 habitants civils de langue amharique de la ville de Mai Kadra dans le Tigray occidental ont été tués, le 9 novembre 2021, par des forces et des milices affiliées au TPLF d'une manière horrible - un cas classique de «nettoyage ethnique», et les auteurs ont pour la plupart fui vers les camps de réfugiés soudanais. Ces deux événements - l’attaque du 4 novembre et ce «nettoyage ethnique» - étaient des moments dramatiques cruciales de la guerre. Alors que le conflit se déroulait, conduisant à la défaite des forces du TPLF le 28 novembre 2020 avec la prise de contrôle de la capitale régionale Meqele et la fuite des dirigeants du TPL, de nombreux médias et sites Internet occidentaux de premier plan se sont concentrés sur les conséquences et les effets des combats dans la région du Tigray et sa population, la sympathie se déplaçant facilement vers le «perdant» perçu (TPLF). Cela a été suivi par des déclarations écrites à la hâte par des décideurs politiques étrangers aux cercles de l'UE, des États-Unis et de l'ONU, menant à un récit politique émergent dans lequel les détails essentiels du contexte, de la nature des adversaires et des raisons du conflit ont été mis de côté. Ces portes-parole de la communauté atlantique sont passés à toujours «blâmer» le gouvernement fédéral éthiopien et à «exiger» toutes sortes de mesures de sa part. Il convient de noter que la communauté internationale toujours réclamait un «accès illimité et complet pour l’aide humanitaire» pour «prévenir la famine» et exigeait «‘l’arrêt de toutes les hostilités, mais entre-temps, elle n'a pas fourni beaucoup d'aide et semble la conditionner à ce que le gouvernement fédéral suive ses ordres. Une partie de la presse mondiale, plusieurs universitaires qui ont vu l'accès à leurs sites de recherche bloqué, et divers associés du TPLF dans diverses organisations internationales ont continué à alimenter les flammes de cette approche, à côté de «l'activisme digitale» et de la production de «fake news» et rapports douteux de personnes pro-TPLF en Ethiopie et en particulier dans la «diaspora» tigréenne en Occident. Tout cela a conduit à de graves perceptions erronées et à des préjugés injustes de la part des pays atlantiques et de l'ONU vis-à-vis de l'Éthiopie qui ont mis en danger l'intégrité, l'équilibre et une bonne perspective des causes et des conséquences, ainsi qu’a des politiques qui semblent s'apparenter à une approche sur base de «development aid blackmail» et des discours moralisateurs envers un pays africain pauvre et en développement fragile. Dans l'exercice, les déclarations de presse détaillées et les explications de la part de l’Éthiopie, y compris le gouvernement et le Premier Ministre réformiste Abiy Ahmed, sont régulièrement négligés ou mis en doute. En revanche, les déclarations et les messages internationaux des défenseurs du TPLF, marqués par un degré élevé de manque de fiabilité, d'exagération et souvent dépourvus de contenu véridique, sont utilisés sans critique. Sur la base d'un certain nombre d'exemples révélateurs, cet article décrit le processus ci-dessus et analyse le discours atlantique émergent et certaines de ses erreurs et hypothèses erronées. Il plaide ainsi pour une approche plus équilibrée et critique du reportage incomplet et de la désinformation afin que les médias et la politique atlantique développent une politique plus responsable. Show less
This study has examined traditional coping systems, emerging adaptation strategies and barriers to the adoption of these strategies. Structured questionnaires on coping and adaptation strategies... Show moreThis study has examined traditional coping systems, emerging adaptation strategies and barriers to the adoption of these strategies. Structured questionnaires on coping and adaptation strategies were conducted among Nyangatom households, expounded by focus group discussions and key informant interviews. Correlations between times series (1987–2016) on rainfall, temperature and the local perceptions on CC were examined. The time series analysis confirmed pastoralists' perception that the frequency of extreme drought has increased since 1987. The Nyangatom responded by temporal migration and herd diversification. Other responses include flood cultivation and enhancing alliance formation with other ethnic groups. Multi-nominal logistic regression analyses indicated that age of household head (−), livestock ownership (+), crop productivity (+), off-farm income (+) and access to climate information (+) proved to be key determinants with a statistically significant (negative or positive) effect on adoption. Other factors that hindered climate change adaption include intermittent conflicts with neighbouring ethnic groups and limited access to alternative livelihood options. Interventions to facilitate transition towards sustainable, adaptation-based communities need to incorporate deliberate, longer-term, risk-reducing strategies, including rangeland management, water harvesting and small scale-irrigation schemes. Improved education access, extension services, and a conducive pastoral policy environment will help to enhance the Nyangatom adaptive capacity. Show less
This paper offers a political analysis of the development of the TPLF-induced armed conflict in northern Ethiopia and considers the international responses in media and international policy circles... Show moreThis paper offers a political analysis of the development of the TPLF-induced armed conflict in northern Ethiopia and considers the international responses in media and international policy circles. The extension of the conflict by the TPLF after the unilateral ceasefire proclaimed by the federal government on 28 June 2021 (followed by its retreat from Tigray) did not lead to an easing of the fighting. On the contrary, the TPLF used scorched-earth tactics, perpetrated substantial abuse of civilians (mass killings, burning down villages, destroying and looting hospitals, health centres and other economic infrastructure), and created food scarcity, hundreds of thousands of IDPs and hugely aggravated humanitarian problems in the Amhara and Afar regions. In spite of this unilateral TPLF extension of the armed conflict, the responses of international policy circles, notably from the Western ‘donor countries’ and the UN, have been negative towards the federal government and mild on the TPLF.This paper explores aspects of this paradoxical and problematic approach and argues that it will not lead to a political or other solution of the conflict, especially not in view of the undiminished belligerent strategy of the TPLF. The Ethiopian federal government and its leader PM Abiy Ahmed, having been confirmed in power after a relatively successful and credible parliamentary election on 21 June 2021, are pressurized by much of the global media and Western policy makers for the problems in Tigray – including the ‘famine’ declared by TPLF - and urged to negotiate. The TPLF, incorrectly identified with the people of Tigray as a whole, is not held to account. But an overbearing Western approach based on the threat of sanctions (by the US government) and on what often seem ‘neo-imperialist’ demands, as evident from serious interference in the conflict - even by a number of UN individuals (expelled from the country on 30 September 2021) - will not contribute to political negotiations or dialogue, restoration of peace, or rehabilitation of the war-torn regions, neither to stability in Ethiopia. Not only improved media reporting, based on solid local (Ethiopian) information and checking sources, but also a fundamental reset of certain UN and Western donor country policies on Ethiopia, are needed.RésuméCette étude propose une analyse politique du développement du conflit armé induit par les TPLF dans le nord de l'Éthiopie et examine les réponses internationales dans les médias et les cercles politiques internationaux. L'extension du conflit par le TPLF après le cessez-le-feu unilatéral proclamé par le gouvernement fédéral le 28 juin 2021 (suivi de son retrait du Tigré) n'a pas conduit à un apaisement des combats ; au contraire. Les tactiques de la terre brûlée, les abus sérieux contre les civils (meurtres en masse, incendies de villages, pillage et destruction des hôpitaux et autres infrastructures économiques), la pénurie alimentaire, des centaines de milliers de déplacés internes et des problèmes humanitaires extrêmement aggravés dans les régions d'Amhara et d'Afar en ont été le résultat. Malgré cette extension unilatérale du conflit par le TPLF, les réponses des cercles politiques internationaux, notamment des pays « bailleurs-de-fonds » occidentaux et de l'ONU, ont été négatives envers le gouvernement fédéral mais modérées envers le TPLF. Show less
We use three years of household panel data to analyze the effects of ill-health on household economic outcomes in rural Ethiopia. We examine the immediate effects of various ill-health measures on... Show moreWe use three years of household panel data to analyze the effects of ill-health on household economic outcomes in rural Ethiopia. We examine the immediate effects of various ill-health measures on health expenditure and labor supply, the subsequent coping responses, and finally the effect on income and consumption. We find evidence of substantial economic risk in terms of increased health expenditure and reduced agricultural productivity. Households are able to smooth consumption by resorting to intra-household labor substitution, borrowing and depleting assets. However, maintaining current consumption through borrowing and depletion of assets is unlikely to be sustainable and displays the need for health financing reforms and safety nets that reduce the financial consequences of ill-health. Show less
Sheferaw, E.D.; Bakker, R.; Taddele, T.; Geta, A.; Kim, Y.M.; Akker, T. van den; Stekelenburg, J. 2020
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
Human trafficking is a persistent global social and economic problem, and part of international organized crime, involving local regional, national, and global agents and networks, and victims... Show moreHuman trafficking is a persistent global social and economic problem, and part of international organized crime, involving local regional, national, and global agents and networks, and victims whose social characteristics traverse age (as they can be children, youths, or adults) and gender (women and men). Ethiopia is not an exception in this regard, and many disadvantaged Ethiopians have fallen victim to human trafficking. This study focuses on the trafficking of Ethiopian women to the Middle East to work as domestic workers. It documents how some of these trafficked women are recruited and transported, and often subjected to severe abuse, including denial of salary, sleep deprivation, passport confiscation, confinement, and physical and sexual assault. It is recognized that some women actively aim for irregular migratjon and try their luck, i.e., not all are by definition trafficked. They thereby aim to stay clear of trafficking agents and dependency but most become entangled in it. Only a few of the trafficked women can escape the above-mentioned abuses, depending on their employers and family or other social networks they may build up or appeal to in the host country. Forms of abuse and inhumane practices, however, predominate against most trafficked Ethiopian women and take place within the ambiguous framework of the kafala system, which is prevalent throughout the Middle Eastern countries.This study was motivated by at least two main concerns, one personal and the other academic. Personally I was intrigued by this tenacious phenomenon causing multiple problems for young women, often marking their lives, and by a concern to see the abusive aspects of the trafficking addressed. Academically, although there is a myriad of studies on the trafficking of Ethiopian women to the Middle East, there are few if any major academic research inquiries undertaken on the Arsi Zone, which is however one of the primary sources of Ethiopian women trafficked to the Middle East. Second, beyond responding to the need to study the root causes of human trafficking, a perplexing question is why human trafficking, in general, and women trafficking, in particular, is still on the increase, despite the proliferation of international, regional and national policy and legal frameworks and institutions established with the central aim of mitigating human trafficking through prevention, protection, and prosecution.Therefore, this study aims to explore the nature, prevalence, root causes, and societal consequences of human trafficking in the two Arsi zones of Arsi and Arsi West of Oromiya National Regional State, so as to inquire why they have persisted. To realize this objective, the data and information used in this study were collected from trafficked women themselves, from185their families, and from middlemen and agents, and relevant government officials, using both qualitative and quantitative methods of data collection in a complementary manner. The study has investigated the trafficking process, i.e., how those trafficked within Ethiopia and to Middle Eastern host countries are recruited and how they travel, are treated, tried to retain agency over their life, and tried to cope. It also sheds light on the role of women returnees from being trafficked, their experiences and tribulations, and (very occasional) successes.Theoretically, this study argues that although trafficking is a transnational phenomenon, its root causes are local, often determined by social and economic factors conducive to poverty, unemployment, gender inequality, and food insecurity, to mention the main ones. Therefore, mitigating women trafficking cannot be treated only as a matter of law and order in the liberal tradition of the individual-civic freedom and emancipation paradigm without giving due recognition to the persistent socio-economic factors which propelled trafficking in the first place. Integrating these two perspectives, which this study advocates, would have critical academic and policy implications for conceiving any credible and practicable interventions to mitigate human trafficking. 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
Vermeiden, T.; Schiffer, R.; Langhorst, J.; Klappe, N.; Asera, W.; Getnet, G.; ... ; Akker, T. van den 2018
