Mache Tsadik - Academia.edu (original) (raw)

Papers by Mache Tsadik

Research paper thumbnail of Trends and causes of neonatal mortality from 2010 to 2017 at a Health and Demographic Surveillance site in Northern Ethiopia

Global Health Action, Dec 20, 2023

Research paper thumbnail of War and Health Care Services Utilization for Chronic Diseases in Rural and Semiurban Areas of Tigray, Ethiopia

JAMA Network Open

ImportanceThe war in Tigray, Ethiopia, has disrupted the health care system of the region. Howeve... more ImportanceThe war in Tigray, Ethiopia, has disrupted the health care system of the region. However, its association with health care services disruption for chronic diseases has not been well documented.ObjectiveTo assess the association of the war with the utilization of health care services for patients with chronic diseases.Design, Setting, and ParticipantsOf 135 primary health care facilities, a registry-based cross-sectional study was conducted on 44 rural and semiurban facilities of Tigray. Data on health services utilization were extracted for patients with tuberculosis, HIV, diabetes, hypertension, and psychiatric disorders in the prewar period (September 1, to October 31, 2020) and during the first phase of the war period (November 4, 2020, to June 30, 2021).Main Outcomes and MeasuresRecords on the number of follow-up, laboratory tests, and patients undergoing treatment of the aforementioned chronic diseases were counted during the prewar and war periods.ResultsOf 4645 reco...

Research paper thumbnail of PREVALENCE AND CHARACTERISTICS OF INTERSTITIAL LUNG DISEASES IN AYDER COMPREHENSIVE SPECIALIZED HOSPITAL, MEKELLE, ETHIOPIA

Ethiopian Medical Journal, 2020

Introduction: Interstitial lung diseases represent a large number of conditions that involve the ... more Introduction: Interstitial lung diseases represent a large number of conditions that involve the parenchyma of the lung, the perivascular and lymphatic tissues. The causes are not known for most patients. Knowledge of local prevalence and characteristics of the case will help to design preventive measures for those who are at high risk. Thus, this study aimed to determine the prevalence and characteristics of interstitial lung disease among patients visiting specialized hospital. Methods: A facility based retrospective cross-sectional study design was employed and 595 patients' charts were reviewed. Patients with interstitial lung disease were employed using consecutive sampling method presented during the study period. Further analysis was done for those individuals presented with the diagnoses of interstitial lung disease. Data were collected using data extraction format by the trained hospital nurse working in the chest clinic. SPSS software version 20 was used analysis Results: The prevalence of interstitial lung disease was 8.4%. The top three causes of morbidity in chest clinic among 595 patients were Asthma, Post Tuberculosis Bronchiectasis and Interstitial Lung Disease respectively. The mean age of patients was 55 years and female patients accounted for 52%. Conclusion: Interstitial Lung Disease is the third common diagnosis in chest clinic. Idiopathic Interstitial Pneumonias are the leading types out of which Nonspecific Interstitial Pneumonitis is the most common. This is an alarm to give due attention to the prevention, diagnose and manage of Interstitial Lung Disease

Research paper thumbnail of Child health services and armed conflict in Tigray, North Ethiopia: a community-based study

Conflict and Health

Background Access to basic health services, notably child health services, is severely hampered b... more Background Access to basic health services, notably child health services, is severely hampered by the armed conflict in Tigray, North Ethiopia. Little is known regarding the impacts of the armed conflict during the war in Tigray on access to child health services. The current study investigates the impact of the armed conflict on the utilization of child health services in Tigray. Methods 4,381 caregivers from randomly recruited households (HHs) with at least one child younger than 1 year old participated in a community-based cross-sectional survey. We collected data on childhood immunizations and illness-related treatment seeking from August 4 to 20, 2021. We describe data using frequency and percentage and carry out an internal comparison among the study participants using chi-square tests. Results 4,381 children under the age of one included in the study. In total, 39% of infants received no basic vaccines, 61.3% of the children under the age of one received at least one vaccine...

Research paper thumbnail of Immediate health and economic impact of the Tigray war on internally displaced persons and hosting households

Scientific Reports

Globally, war is the major cause of displacement from the usual place of the biological environme... more Globally, war is the major cause of displacement from the usual place of the biological environment. The war of Tigray exposed thousands of people to internal displacement and migration. Evidence has shown that displaced people and migrants shoulder the health and economic burden to ensure survival. However, evidence of the impact of the war on health and the economy related to the displaced people and their hosting communities is not documented. Thus, this study aimed to investigate the health and economic impact of the war on displaced people and the hosting community. A community-based survey was conducted among randomly selected 3572 households of 48 woredas/districts from August 06 to 30/2021 in Tigray. Each district had 4 enumeration sites and there were 20 households (HHs) to be sampled per each enumeration site. Data were collected using a pretested structured questionnaire using face-to-face interviews of displaced and hosting household heads. The entered data is exported t...

Research paper thumbnail of Individual and community-level factors influencing optimal breastfeeding: A multilevel analysis from a national survey study in Ethiopia

The previous studies in Ethiopia mainly concentrated on individual-level factors and analysis was... more The previous studies in Ethiopia mainly concentrated on individual-level factors and analysis was made using ordinary logistic regression. However, as EDHS data has a hierarchical nature, a multilevel logistic regression analysis is preferred to consider the individual and community level factors simultaneously. Thus, this study aimed to identify factors associated with optimal breastfeeding among children age 0-5 month in Ethiopia. Methods Study Area, design and population

Research paper thumbnail of Assessment of Knowledge, Attitude, Practice and Associated Factors of Emergency Contraceptive Pills among Female Youths

Research & Reviews: A Journal of Health Professions, Apr 16, 2015

Research paper thumbnail of Night Blindness is a Serious Public Health Problem of Pregnant Women’s in Tahtay Koraro District, Tigray Region, Northern Ethiopia

Journal of Food and Nutrition Sciences, 2015

Introduction: Night blindness is significant public health problem among pregnant women in Ethiop... more Introduction: Night blindness is significant public health problem among pregnant women in Ethiopia and estimated to be more severe in rural areas. However; there is insufficient information about the magnitude of night blindness among pregnant women's of rural Ethiopia. The same is true in the study region. Objective: To assess the prevalence and associated factors of night blindness among pregnant Women's in Tahtay Koraro District, Tigray region, Northern Ethiopia. Methods: Community based cross sectional study design was employed in February 2013 among selected 323 pregnant women's. Two stage cluster sampling was employed; in the first stage seven kebeles were selected randomly, in the second stage study subjects were selected with considering probability proportional to population size (PPS). A structured and pretested questionnaire was used for data collection based on the objective of the study. The data was entered, cleaned and analyzed using statistical package for social science (SPSS) version 16. Bivariate & multivariate logistic regression analysis was done to identify factors associated with night blindness at confidence limits of 95% and P-value less than 5% significant. Frequencies, proportion, summary statistics were used for presenting the result of the study. Results: out of 323 pregnant women 56 (17%) were suffered from night blindness. Pregnant women's age beyond 35 years were 4.9 times more likely to be night blinded than those with age less than 25 years [AOR=4.9; 95% CI: (1.6-14.9)]. Pregnant women's income less than 500 Ethiopian birr per month were 2 times more likely to be night blinded than those who can earn more than that [AOR=2.0; 95% CI:(1.02-3.9)]. Pregnant women's didn't have own cattle were 5.6 times more likely to be night blinded than those who have cattle [AOR=5.6; 95% CI: (2.9, 11.0)]. Pregnant women's with no hand washing practice after toilet were 3 times more likely to be night blinded than having hand washing practice after toilet [AOR=3.0; 95% CI:(1.3-7.1)]. Conclusion: Night blindness is a serious public health problem of pregnant women's. Pregnant Women's age greater than 35 years, not having cattle, no hand washing practice after toilet and income less than 500 Ethiopian birr per month, were significantly affected by night blindness.

Research paper thumbnail of Patient referral alone is not an effective strategy to capture partners of patients with sexually transmitted infections in low-resource settings: a case-control study

Journal Of Public Health, Sep 26, 2017

Aim Partner notification (PN) is a key public health intervention aimed at preventing re-infectio... more Aim Partner notification (PN) is a key public health intervention aimed at preventing re-infection and controlling the spread of STIs. However, only limited research has been conducted to investigate factors associated with PN in Ethiopia. Subject and methods A nested case-control study was undertaken within a cohort of individuals being treated for STIs in public health facilities in Ethiopia. Hierarchical binary logistic regression was used to identify socio-demographic, behavioral and psychosocial factors associated with PN. Results A total of 250 patients on STI treatment who notified their partners (cases) were compared with 185 patients who did not notify their partners (controls). STI patients were less likely to notify their partner if they were single [AOR = 0.33, 95%

Research paper thumbnail of Individual and community-level factors influencing optimal breastfeeding: A multilevel analysis from a national survey study of Ethiopia

PLOS ONE, Apr 29, 2021

Background Optimal breastfeeding is critical for healthy growth of the child. Globally, 820,000 c... more Background Optimal breastfeeding is critical for healthy growth of the child. Globally, 820,000 children and 20,000 women lost due to in appropriate breastfeeding each year. In Ethiopia, 50,000 children lost related to malnutrition with 18% were due to poor breastfeeding habit. Little is known on the determinants of breastfeeding with hierarchical level. Therefore, this study aimed to identify factors influencing optimal breastfeeding among children under six month in Ethiopia using a multilevel analysis. Methods The data of this study were obtained from Ethiopian Demographic and health survey conducted from January to June 2016. A total 1,087 children aged 0-5 months were selected using two stage stratified sampling technique. Multilevel logistic regression analysis was done to identify significant explanatory variables. Akaike information criteria were used to select the best model fit. Fixed effect was done to estimate the association between the outcome and explanatory variable and also random effect to measure the variation explained by the higher level. Result Among the total of 1,087 children, 45.4% were optimally breastfeed. Children from the richest wealth index (AOR = 2.87; 95% CI: 1.53-5.43) was positively associated with optimal breastfeeding but, children aged 4-5 months (AOR = 0.19; 95%CI: 0.12-0.27), children born through cesarean section (AOR = 0.18; 955 CI: 0.07-0.51) and residing in Afar region (AOR = 0.13; 95%CI: 0.02-0.92) were found inversely associated with optimal breastfeeding. The random-effects showed that the variation between communities was statistically significant.

Research paper thumbnail of The magnitude of, and factors associated with, loss to follow-up among patients treated for sexually transmitted infections: a multilevel analysis

BMJ Open, Jul 1, 2017

Objectives The loss to follow-up (LTFU) among patients attending care for sexually transmitted in... more Objectives The loss to follow-up (LTFU) among patients attending care for sexually transmitted infections (STIs) in Sub-Saharan Africa is a major barrier to achieving the goals of the STI prevention and control programme. The objective of this study was to investigate individual-and facility-level factors associated with LTFU among patients treated for STIs in Ethiopia. Methods A prospective cohort study was conducted among patients attending care for STIs in selected facilities from January to June 2015 in the Tigray region of Ethiopia. LTFU was ascertained if a patient did not present in person to the same facility within 7 days of the initial contact. Multilevel logistic regression was used to identify factors associated with LTFU. Results Out of 1082 patients, 59.80% (647) were LTFU. The individual-level factors associated with LTFU included having multiple partners (adjusted OR (AOR) 2.89, 95% CI 1.74 to 4.80), being male (AOR 2.23, 95% CI 1.63 to 3.04), having poor knowledge about the means of STI transmission (AOR 2.08, 95% CI 1.53 to 2.82), having college level education (AOR 0.38, 95% CI 0.22 to 0.65), and low perceived stigma (AOR 0.60, 95% CI 0.43 to 0.82). High patient flow (AOR 3.06, 95% CI 1.30 to 7.18) and medium health index score (AOR 2.80, 95% CI 1.28 to 6.13) were facility-level factors associated with LTFU. Conclusions Improving patient retention in STI followup care requires focused interventions targeting those who are more likely to be LTFU, particularly patients with multiple partners, male index cases and patients attending facilities with high patient flow.

Research paper thumbnail of Predictors of lost to follow up to antiretroviral therapy in primary public hospital of Wukro, Tigray, Ethiopia: A case control study

Journal of AIDS and HIV Research, Jan 31, 2015

In spite of the well proven benefits of antiretroviral therapy (ART) in prolonging life expectanc... more In spite of the well proven benefits of antiretroviral therapy (ART) in prolonging life expectancy, being lost to ART follow-up is a problem to the success of antiretroviral therapy programs in resource limited countries including Ethiopia. Thus the aim of the study was to assess the magnitude and predictors of loss to follow-up among adult ART clients. A case-control study design was employed using patients' chart review. For each case three controls were selected based on the closest day of enrollment. Both bivariate and multivariate logistic regression was performed to test association. A total of 727 adult patients were started on antiretroviral therapy during the study period. Among these, 80 (11%) were found to be lost from follow up for a period of ≥ 3 months and 240 controls were randomly selected for 80 cases in a ratio of 1:3. Presence of bereavement concern, not being provided with isoniazide (INH) prophylaxis, the presence of side effects and earlier periods after ART initiating were found to be associated with increased odds for being lost to follow up. The proportion of lost to follow up in this study was lower than those figures reported for resource poor countries. Thus, more targeted health education, counseling and follow-up is needed for patients with identified risk factors.

Research paper thumbnail of Treatment Outcomes and Associated Risk Factors of Severely Malnourished under Five Children Admitted to Therapeutic Feeding Centers of Mekelle City, Northern Ethiopia

OAlib, 2014

Background: Despite presence of clinical management protocols for treating severe acute malnutrit... more Background: Despite presence of clinical management protocols for treating severe acute malnutrition, its case fatality rate remains high in health facilities from developing countries. Objectives: To assess treatment outcomes and associated risk factors for death of children aged 6-59 months with complicated severe acute malnutrition. Methods: A cohort of 469 children aged 6-59 months with complicated severe acute malnutrition admitted to nutritional rehabilitation units of Mekelle City were followed retrospectively. Data on nutritional status, socio-demographic factors, admission medical conditions and management characteristics were collected. Median test, Chi-square test and Cox's proportional hazard regression were used for statistical analysis. Results: Overall case fatality rate was 12.8%. The median length of stay and median weight gain was 17 days and 12.1 g/kg/day, respectively. Two third of the deaths occurred during the first week of admission.

Research paper thumbnail of Prevalence and Risk Factors of Child Malnutrition in Community Based Nutrition Program Implementing and Nonimplementing Districts from South East Amhara, Ethiopia

OAlib, 2014

Background: The burden of malnutrition in Ethiopia is the second highest in sub Saharan Africa. A... more Background: The burden of malnutrition in Ethiopia is the second highest in sub Saharan Africa. According to the recently released Ethiopian Demographic and Health Survey report of 2011, the prevalence of child stunting, underweight and wasting were 44% stunted, 10% wasted and 29% underweight respectively. Objectives: To determine the magnitude and risk factors of malnutrition among 6-59 months children from Community Based Nutrition Program implementing and nonimplementing districts from south east Amhara. Methodology: Descriptive community based, cross sectional study in which a total of 987 children (620 from Community Based Nutrition implementing and 367 from nonimplementing districts) were sampled. A structured questionnaire was administered to mothers or caregivers of the children. Anthropometric measurements were taken following standard procedures. Nutritional status of the children was determined based on Z scores of < −2 or >= −2 Standard Deviation. Logistic regression was used to test significant associations between outcome and factor variables. Setting: Rural communities from Artuma Fursi and Kemissie districts. Results: A total of 987 children of 6-59 months of age and 987 mothers/caregivers had participated in the study, giving a response rate of 99%. The percentage of male and female children in CBNP district was 330 (53.2%) and 290 (46.8%) and that of non Community Based Nutrition Program (CBNP) district was 192 (52.3%) & 175 (47.7%) respectively. The prevalence of stunting, underweight and wasting were 60.6%, 31.1%, 12.6% and 39.0%, 27.5%, 14.7% in CBNP and nonCBNP implementing districts, respectively. The possible risk factors for child B. Tariku et al. 2 malnutrition were area specific and different for the two districts. Conclusion: Child under nutrition is a serious public health problem in both districts, so that holistic programs need to be designed and implemented according to the guidelines.

Research paper thumbnail of Readiness of female sex workers for HIV testing and its associated factors in Shire Endaselassie town, Tigray, Ethiopia: a cross-sectional study

Journal Of Public Health, Mar 8, 2019

Aim HIV testing for vulnerable populations such as female sex workers (FSWs) is a critical step t... more Aim HIV testing for vulnerable populations such as female sex workers (FSWs) is a critical step to achieve the first 90s proposed by UNAIDS. However, the level of readiness for an HIV test and associated factors among FSWs have been rarely studied in Tigray, though it is a proxy indicator of HIV testing. Thus, this study aimed at assessing the readiness level for an HIV test and associated factors among FSWs. Subjects and methods A community-based cross-sectional study was conducted and 368 FSWs were recruited using systematic random sampling in Shire Endaselassie from March 2 to 30, 2018. Data were collected via a structured and pretested questionnaire. The data were entered into Epi Info 7 and then exported to SPSS 20 for analysis. Both descriptive and inferential analyses were done with 95% confidence intervals (CIs) at a p-value of less than 5% for the final model. Results The overall readiness level for HIV testing among FSWs was 53.2%. Educational status [adjusted odds ratio, AOR (95% CI) = 1.74 (1.07-2.85)], vulnerability to HIV [AOR (95% CI) = 2.45 (1.38-4.42)], fear of HIV testing [AOR (95% CI) = 0.48 (0.29-0.77)], planning to leave sex work [AOR (95% CI) = 1.79 (1.05-3.08)], fear of quick development of severe signs and symptoms [AOR (95% CI) = 0.53 (0.33-0.86)], being a member of women development groups [AOR (95% CI) = 2.79 (1.74-4.45)], and encountering condom breakage [AOR (95% CI) = 0.43 (0.27-0.68)] were found to be associated with readiness level. Conclusion The readiness level for HIV testing was relatively low. Most of the social and psychosocial issues were found to be factors that influence the readiness level for HIV testing among FSWs. Thus, efforts should be made to develop educational programs that boost the level of awareness and readiness of FSWs for HIV testing.

Research paper thumbnail of Contextual Disparity on Trend and Determinants of Optimal Antenatal Care (ANC4+) Use for Women in Eastern Tigray, Ethiopia: Evidence from KA-HDSS Database

International Journal of Women's Health, Apr 1, 2023

Background: Though optimal antenatal care (ANC4+) use is absolutely critical, only 43% of women h... more Background: Though optimal antenatal care (ANC4+) use is absolutely critical, only 43% of women had ANC4+ in Ethiopia and nearly 64% in Tigray in 2019. Furthermore, only 20% of women had their first ANC visit during their first trimester in 2016. However, there is no literature on area based disparity of ANC4+ use in Tigray. Therefore, this study is aimed to generate evidence for ANC4+ use using the Kilite-Awlaelo Health and Demographic Surveillance System (KA-HDSS) database. Methods: A population-based longitudinal study was employed on 5,414 women from 12 kebelles included in the KA-HDSS site of Tigray. A pregnancy database was used as a source of data. A Line graph was used to depict the trend of ANC4+ use. A stratified robust Poisson model was fitted to estimate the incidence rate ratio (IRR) for women from rural and urban areas separately. Results: The ANC4+ coverage was 36.3% (95% CI=35.0-37.6%)-34.2% in rural versus 52.8% urban areas, with an increasing linear trend. Single marital status (IRR=1.29; 95% CI=1.17-1.42); able to read and write (IRR=1.15; 95% CI=1.01-1.32); primary education (IRR=1.22; 95% CI=1.11-1.34); ANC follow-up (2015-2018) (IRR=1.42; 95% CI=1.23-1.64); previous pregnancy exposure (IRR=2.20; 95% CI=1.98-2.45); and having 6+ children (IRR=1.11; 95% CI=1.01-1.21) determined ANC4+ use for rural women. Marital status (Divorced/widowed/separated) (IRR=0.79; 95% CI=0.66-0.95); primary education (IRR=1.44; 95% CI=1.16-1.79); ANC follow-up (2015-2018) (IRR=2.00; 95% CI=1.59-2.50); previous pregnancy exposure (IRR=1.54; 95% CI=1.31-1.80); and having 6+ children (IRR=1.18; 95% CI=1.07-1.31) determined the ANC4+ use for urban women. Conclusion: The optimal ANC coverage is significantly low, with significant disparity by geographical area and increasing trend. However, further efforts have to be made to maximize the optimal use of ANC, particularly for women from rural areas.

Research paper thumbnail of What factors are associated with maternal undernutrition in eastern zone of Tigray, Ethiopia? Evidence for nutritional well-being of lactating mothers

BMC Public Health, Aug 8, 2020

Background: Maternal undernutrition is a pervasive health problem among Ethiopian mothers. This s... more Background: Maternal undernutrition is a pervasive health problem among Ethiopian mothers. This study aims at identifying the level of maternal undernutrition and its associated factors in Kilte Awaleo-Health and Demographic Surveillance Site (KA-HDSS), Tigray region, Ethiopia. Methods: Nutritional status of 2260 lactating mothers was evaluated using the mid-upper-arm circumference (MUAC). Data from the vital events and verbal autopsy databases were linked to the survey and baseline recensus data to investigate the association of adult mortality from chronic causes of death (CoD) on maternal undernutrition. We employed a generalized log-binomial model to estimate the independent effects of the fitted covariates. Results: The overall prevalence of maternal undernutrition based on MUAC < 23 cm was 38% (95% CI: 36.1, 40.1%). Recent occurrence of household morbidity (adjusted prevalence ratio (adjPR) = 1.49; 95%CI: 1.22, 1.81) was associated with increased risk of maternal undernutrition. In addition, there was a 28% higher risk (adjPR = 1.28; 95%CI: 0.98, 1.67) of maternal undernutrition for those mothers who lived in households with history of adult mortality from chronic diseases. Especially, its association with severe maternal undernutrition was strong (adjusted OR = 3.27; 95%CI: 1.48, 7.22). In contrast, good maternal health-seeking practice (adjPR = 0.86; 95%CI: 0.77, 0.96) and production of diverse food crops (adjPR = 0.72; 95%CI: 0.64, 0.81) were associated with a lower risk of maternal undernutrition. Relative to mothers with low scores of housing and environmental factors index (HAEFI), those with medium and higher scores of HAEFI had 0.81 (adjPR = 0.81; 95%CI: 0.69, 0.95) and 0.82 (adjPR = 0.82; 95%CI: 0.72, 0.95) times lower risk of maternal undernutrition, respectively.

Research paper thumbnail of Maternal mortality during war time in Tigray, Ethiopia: A community‐based study

BJOG: An International Journal of Obstetrics & Gynaecology

ObjectiveThis study seeks to examine the impact of war on maternal mortality following an exacerb... more ObjectiveThis study seeks to examine the impact of war on maternal mortality following an exacerbation in the dynamics of inequality in maternal health caused by the continuing conflict.DesignCommunity‐based cross‐sectional study.SettingTigray region of Northern Ethiopia, between November 2020 and May 2022.PopulationThis study surveyed a total of 189 087 households from six of the seven zones of Tigray in 121 tabiyas from 31 districts selected. A multistage cluster sampling technique was used to select the districts and tabiyas.MethodsThe study was conducted in two phases. In the first phase, reproductive‐age deaths that occurred during the study period were screened. In the second phase, verbal autopsies were conducted at the screened households.Main Outcome MeasuresMaternal mortality ratio level and cause‐specific mortality.ResultsThe results of the study showed that the maternal mortality ratio was 840 (95% CI 739–914) per 100 000 live births. Haemorrhage, 107 (42.8%), pregnancy‐...

Research paper thumbnail of Extent of Adhesion Losses in The Wheel- Rail Contact Under Contaminated Conditions

Railway vehicles require a certain level of adhesion between wheel and rail to operate efficientl... more Railway vehicles require a certain level of adhesion between wheel and rail to operate efficiently, reliably, and economically. Different levels of adhesion are needed depending on the vehicle running conditions. In the wheel tread–railhead contact, the dominant problem is low adhesion, as low adhesion on the railhead negatively affects railway operation: on one hand, the vehicle will lose traction resulting in delay when driving on low-adhesion tracks; on the other hand, low adhesion during deceleration will extend the braking distance, which is a safety issue. This thesis examines the influence of several contaminants, i.e., water, mud, leaves, oil and grease, on the adhesion in the wheel tread–railhead contact. This study will also improve our knowledge of the low-adhesion mechanism and of how various contaminants influence adhesion. In this thesis, the adhesion conditions were assessed using a twin disc test machine. Thus the research methodology used was a laboratory test; the ...

Research paper thumbnail of The contribution of Productive Safety Net Program for food security of the rural households in the case of Bale Zone, Southeast Ethiopia

Agriculture & Food Security, 2017

Background: Developing countries in general and Ethiopia in particular are affected by a growing ... more Background: Developing countries in general and Ethiopia in particular are affected by a growing problem of food insecurity. Millions of individuals and households especially the rural poor are the main victims of the problem. The government of Ethiopia together with other development partners launched the Productive Safety Net Program (PSNP) in 2005 to help chronically food-insecure households. This study discusses the role of PSNP on the improvement in consumption needs and asset base of the households, effect on community development and determinants of food insecurity level of beneficiaries. Methodology: Three Woredas have been selected agro-ecologically. Both qualitative and quantitative data-generating techniques were employed. Qualitative data were analyzed thematically and using narration. Frequency distribution table and t test were used. Logistic regression was employed to analyze the determinants of food insecurity. Results and conclusion: Results indicated that PSNP was helping beneficiaries for consumption smoothing, asset accumulation, and development of the local community. The effectiveness of PSNP was significantly determined by age and education level of the household head and occurrence of shocks on the last five consecutive years. The practice of PSNP was challenged by a lack of monitoring and evaluation of structures, low payment and limited awareness of beneficiaries. To assure the positive role of PSNP, culture of savings and accumulation of assets, engagement of beneficiary households in diversified asset building livelihood strategies, targeting and minimizing wrong inclusion and exclusion, and the management as well as monitoring practices of locally constructed community development infrastructures should be enhanced.

Research paper thumbnail of Trends and causes of neonatal mortality from 2010 to 2017 at a Health and Demographic Surveillance site in Northern Ethiopia

Global Health Action, Dec 20, 2023

Research paper thumbnail of War and Health Care Services Utilization for Chronic Diseases in Rural and Semiurban Areas of Tigray, Ethiopia

JAMA Network Open

ImportanceThe war in Tigray, Ethiopia, has disrupted the health care system of the region. Howeve... more ImportanceThe war in Tigray, Ethiopia, has disrupted the health care system of the region. However, its association with health care services disruption for chronic diseases has not been well documented.ObjectiveTo assess the association of the war with the utilization of health care services for patients with chronic diseases.Design, Setting, and ParticipantsOf 135 primary health care facilities, a registry-based cross-sectional study was conducted on 44 rural and semiurban facilities of Tigray. Data on health services utilization were extracted for patients with tuberculosis, HIV, diabetes, hypertension, and psychiatric disorders in the prewar period (September 1, to October 31, 2020) and during the first phase of the war period (November 4, 2020, to June 30, 2021).Main Outcomes and MeasuresRecords on the number of follow-up, laboratory tests, and patients undergoing treatment of the aforementioned chronic diseases were counted during the prewar and war periods.ResultsOf 4645 reco...

Research paper thumbnail of PREVALENCE AND CHARACTERISTICS OF INTERSTITIAL LUNG DISEASES IN AYDER COMPREHENSIVE SPECIALIZED HOSPITAL, MEKELLE, ETHIOPIA

Ethiopian Medical Journal, 2020

Introduction: Interstitial lung diseases represent a large number of conditions that involve the ... more Introduction: Interstitial lung diseases represent a large number of conditions that involve the parenchyma of the lung, the perivascular and lymphatic tissues. The causes are not known for most patients. Knowledge of local prevalence and characteristics of the case will help to design preventive measures for those who are at high risk. Thus, this study aimed to determine the prevalence and characteristics of interstitial lung disease among patients visiting specialized hospital. Methods: A facility based retrospective cross-sectional study design was employed and 595 patients' charts were reviewed. Patients with interstitial lung disease were employed using consecutive sampling method presented during the study period. Further analysis was done for those individuals presented with the diagnoses of interstitial lung disease. Data were collected using data extraction format by the trained hospital nurse working in the chest clinic. SPSS software version 20 was used analysis Results: The prevalence of interstitial lung disease was 8.4%. The top three causes of morbidity in chest clinic among 595 patients were Asthma, Post Tuberculosis Bronchiectasis and Interstitial Lung Disease respectively. The mean age of patients was 55 years and female patients accounted for 52%. Conclusion: Interstitial Lung Disease is the third common diagnosis in chest clinic. Idiopathic Interstitial Pneumonias are the leading types out of which Nonspecific Interstitial Pneumonitis is the most common. This is an alarm to give due attention to the prevention, diagnose and manage of Interstitial Lung Disease

Research paper thumbnail of Child health services and armed conflict in Tigray, North Ethiopia: a community-based study

Conflict and Health

Background Access to basic health services, notably child health services, is severely hampered b... more Background Access to basic health services, notably child health services, is severely hampered by the armed conflict in Tigray, North Ethiopia. Little is known regarding the impacts of the armed conflict during the war in Tigray on access to child health services. The current study investigates the impact of the armed conflict on the utilization of child health services in Tigray. Methods 4,381 caregivers from randomly recruited households (HHs) with at least one child younger than 1 year old participated in a community-based cross-sectional survey. We collected data on childhood immunizations and illness-related treatment seeking from August 4 to 20, 2021. We describe data using frequency and percentage and carry out an internal comparison among the study participants using chi-square tests. Results 4,381 children under the age of one included in the study. In total, 39% of infants received no basic vaccines, 61.3% of the children under the age of one received at least one vaccine...

Research paper thumbnail of Immediate health and economic impact of the Tigray war on internally displaced persons and hosting households

Scientific Reports

Globally, war is the major cause of displacement from the usual place of the biological environme... more Globally, war is the major cause of displacement from the usual place of the biological environment. The war of Tigray exposed thousands of people to internal displacement and migration. Evidence has shown that displaced people and migrants shoulder the health and economic burden to ensure survival. However, evidence of the impact of the war on health and the economy related to the displaced people and their hosting communities is not documented. Thus, this study aimed to investigate the health and economic impact of the war on displaced people and the hosting community. A community-based survey was conducted among randomly selected 3572 households of 48 woredas/districts from August 06 to 30/2021 in Tigray. Each district had 4 enumeration sites and there were 20 households (HHs) to be sampled per each enumeration site. Data were collected using a pretested structured questionnaire using face-to-face interviews of displaced and hosting household heads. The entered data is exported t...

Research paper thumbnail of Individual and community-level factors influencing optimal breastfeeding: A multilevel analysis from a national survey study in Ethiopia

The previous studies in Ethiopia mainly concentrated on individual-level factors and analysis was... more The previous studies in Ethiopia mainly concentrated on individual-level factors and analysis was made using ordinary logistic regression. However, as EDHS data has a hierarchical nature, a multilevel logistic regression analysis is preferred to consider the individual and community level factors simultaneously. Thus, this study aimed to identify factors associated with optimal breastfeeding among children age 0-5 month in Ethiopia. Methods Study Area, design and population

Research paper thumbnail of Assessment of Knowledge, Attitude, Practice and Associated Factors of Emergency Contraceptive Pills among Female Youths

Research & Reviews: A Journal of Health Professions, Apr 16, 2015

Research paper thumbnail of Night Blindness is a Serious Public Health Problem of Pregnant Women’s in Tahtay Koraro District, Tigray Region, Northern Ethiopia

Journal of Food and Nutrition Sciences, 2015

Introduction: Night blindness is significant public health problem among pregnant women in Ethiop... more Introduction: Night blindness is significant public health problem among pregnant women in Ethiopia and estimated to be more severe in rural areas. However; there is insufficient information about the magnitude of night blindness among pregnant women's of rural Ethiopia. The same is true in the study region. Objective: To assess the prevalence and associated factors of night blindness among pregnant Women's in Tahtay Koraro District, Tigray region, Northern Ethiopia. Methods: Community based cross sectional study design was employed in February 2013 among selected 323 pregnant women's. Two stage cluster sampling was employed; in the first stage seven kebeles were selected randomly, in the second stage study subjects were selected with considering probability proportional to population size (PPS). A structured and pretested questionnaire was used for data collection based on the objective of the study. The data was entered, cleaned and analyzed using statistical package for social science (SPSS) version 16. Bivariate & multivariate logistic regression analysis was done to identify factors associated with night blindness at confidence limits of 95% and P-value less than 5% significant. Frequencies, proportion, summary statistics were used for presenting the result of the study. Results: out of 323 pregnant women 56 (17%) were suffered from night blindness. Pregnant women's age beyond 35 years were 4.9 times more likely to be night blinded than those with age less than 25 years [AOR=4.9; 95% CI: (1.6-14.9)]. Pregnant women's income less than 500 Ethiopian birr per month were 2 times more likely to be night blinded than those who can earn more than that [AOR=2.0; 95% CI:(1.02-3.9)]. Pregnant women's didn't have own cattle were 5.6 times more likely to be night blinded than those who have cattle [AOR=5.6; 95% CI: (2.9, 11.0)]. Pregnant women's with no hand washing practice after toilet were 3 times more likely to be night blinded than having hand washing practice after toilet [AOR=3.0; 95% CI:(1.3-7.1)]. Conclusion: Night blindness is a serious public health problem of pregnant women's. Pregnant Women's age greater than 35 years, not having cattle, no hand washing practice after toilet and income less than 500 Ethiopian birr per month, were significantly affected by night blindness.

Research paper thumbnail of Patient referral alone is not an effective strategy to capture partners of patients with sexually transmitted infections in low-resource settings: a case-control study

Journal Of Public Health, Sep 26, 2017

Aim Partner notification (PN) is a key public health intervention aimed at preventing re-infectio... more Aim Partner notification (PN) is a key public health intervention aimed at preventing re-infection and controlling the spread of STIs. However, only limited research has been conducted to investigate factors associated with PN in Ethiopia. Subject and methods A nested case-control study was undertaken within a cohort of individuals being treated for STIs in public health facilities in Ethiopia. Hierarchical binary logistic regression was used to identify socio-demographic, behavioral and psychosocial factors associated with PN. Results A total of 250 patients on STI treatment who notified their partners (cases) were compared with 185 patients who did not notify their partners (controls). STI patients were less likely to notify their partner if they were single [AOR = 0.33, 95%

Research paper thumbnail of Individual and community-level factors influencing optimal breastfeeding: A multilevel analysis from a national survey study of Ethiopia

PLOS ONE, Apr 29, 2021

Background Optimal breastfeeding is critical for healthy growth of the child. Globally, 820,000 c... more Background Optimal breastfeeding is critical for healthy growth of the child. Globally, 820,000 children and 20,000 women lost due to in appropriate breastfeeding each year. In Ethiopia, 50,000 children lost related to malnutrition with 18% were due to poor breastfeeding habit. Little is known on the determinants of breastfeeding with hierarchical level. Therefore, this study aimed to identify factors influencing optimal breastfeeding among children under six month in Ethiopia using a multilevel analysis. Methods The data of this study were obtained from Ethiopian Demographic and health survey conducted from January to June 2016. A total 1,087 children aged 0-5 months were selected using two stage stratified sampling technique. Multilevel logistic regression analysis was done to identify significant explanatory variables. Akaike information criteria were used to select the best model fit. Fixed effect was done to estimate the association between the outcome and explanatory variable and also random effect to measure the variation explained by the higher level. Result Among the total of 1,087 children, 45.4% were optimally breastfeed. Children from the richest wealth index (AOR = 2.87; 95% CI: 1.53-5.43) was positively associated with optimal breastfeeding but, children aged 4-5 months (AOR = 0.19; 95%CI: 0.12-0.27), children born through cesarean section (AOR = 0.18; 955 CI: 0.07-0.51) and residing in Afar region (AOR = 0.13; 95%CI: 0.02-0.92) were found inversely associated with optimal breastfeeding. The random-effects showed that the variation between communities was statistically significant.

Research paper thumbnail of The magnitude of, and factors associated with, loss to follow-up among patients treated for sexually transmitted infections: a multilevel analysis

BMJ Open, Jul 1, 2017

Objectives The loss to follow-up (LTFU) among patients attending care for sexually transmitted in... more Objectives The loss to follow-up (LTFU) among patients attending care for sexually transmitted infections (STIs) in Sub-Saharan Africa is a major barrier to achieving the goals of the STI prevention and control programme. The objective of this study was to investigate individual-and facility-level factors associated with LTFU among patients treated for STIs in Ethiopia. Methods A prospective cohort study was conducted among patients attending care for STIs in selected facilities from January to June 2015 in the Tigray region of Ethiopia. LTFU was ascertained if a patient did not present in person to the same facility within 7 days of the initial contact. Multilevel logistic regression was used to identify factors associated with LTFU. Results Out of 1082 patients, 59.80% (647) were LTFU. The individual-level factors associated with LTFU included having multiple partners (adjusted OR (AOR) 2.89, 95% CI 1.74 to 4.80), being male (AOR 2.23, 95% CI 1.63 to 3.04), having poor knowledge about the means of STI transmission (AOR 2.08, 95% CI 1.53 to 2.82), having college level education (AOR 0.38, 95% CI 0.22 to 0.65), and low perceived stigma (AOR 0.60, 95% CI 0.43 to 0.82). High patient flow (AOR 3.06, 95% CI 1.30 to 7.18) and medium health index score (AOR 2.80, 95% CI 1.28 to 6.13) were facility-level factors associated with LTFU. Conclusions Improving patient retention in STI followup care requires focused interventions targeting those who are more likely to be LTFU, particularly patients with multiple partners, male index cases and patients attending facilities with high patient flow.

Research paper thumbnail of Predictors of lost to follow up to antiretroviral therapy in primary public hospital of Wukro, Tigray, Ethiopia: A case control study

Journal of AIDS and HIV Research, Jan 31, 2015

In spite of the well proven benefits of antiretroviral therapy (ART) in prolonging life expectanc... more In spite of the well proven benefits of antiretroviral therapy (ART) in prolonging life expectancy, being lost to ART follow-up is a problem to the success of antiretroviral therapy programs in resource limited countries including Ethiopia. Thus the aim of the study was to assess the magnitude and predictors of loss to follow-up among adult ART clients. A case-control study design was employed using patients' chart review. For each case three controls were selected based on the closest day of enrollment. Both bivariate and multivariate logistic regression was performed to test association. A total of 727 adult patients were started on antiretroviral therapy during the study period. Among these, 80 (11%) were found to be lost from follow up for a period of ≥ 3 months and 240 controls were randomly selected for 80 cases in a ratio of 1:3. Presence of bereavement concern, not being provided with isoniazide (INH) prophylaxis, the presence of side effects and earlier periods after ART initiating were found to be associated with increased odds for being lost to follow up. The proportion of lost to follow up in this study was lower than those figures reported for resource poor countries. Thus, more targeted health education, counseling and follow-up is needed for patients with identified risk factors.

Research paper thumbnail of Treatment Outcomes and Associated Risk Factors of Severely Malnourished under Five Children Admitted to Therapeutic Feeding Centers of Mekelle City, Northern Ethiopia

OAlib, 2014

Background: Despite presence of clinical management protocols for treating severe acute malnutrit... more Background: Despite presence of clinical management protocols for treating severe acute malnutrition, its case fatality rate remains high in health facilities from developing countries. Objectives: To assess treatment outcomes and associated risk factors for death of children aged 6-59 months with complicated severe acute malnutrition. Methods: A cohort of 469 children aged 6-59 months with complicated severe acute malnutrition admitted to nutritional rehabilitation units of Mekelle City were followed retrospectively. Data on nutritional status, socio-demographic factors, admission medical conditions and management characteristics were collected. Median test, Chi-square test and Cox's proportional hazard regression were used for statistical analysis. Results: Overall case fatality rate was 12.8%. The median length of stay and median weight gain was 17 days and 12.1 g/kg/day, respectively. Two third of the deaths occurred during the first week of admission.

Research paper thumbnail of Prevalence and Risk Factors of Child Malnutrition in Community Based Nutrition Program Implementing and Nonimplementing Districts from South East Amhara, Ethiopia

OAlib, 2014

Background: The burden of malnutrition in Ethiopia is the second highest in sub Saharan Africa. A... more Background: The burden of malnutrition in Ethiopia is the second highest in sub Saharan Africa. According to the recently released Ethiopian Demographic and Health Survey report of 2011, the prevalence of child stunting, underweight and wasting were 44% stunted, 10% wasted and 29% underweight respectively. Objectives: To determine the magnitude and risk factors of malnutrition among 6-59 months children from Community Based Nutrition Program implementing and nonimplementing districts from south east Amhara. Methodology: Descriptive community based, cross sectional study in which a total of 987 children (620 from Community Based Nutrition implementing and 367 from nonimplementing districts) were sampled. A structured questionnaire was administered to mothers or caregivers of the children. Anthropometric measurements were taken following standard procedures. Nutritional status of the children was determined based on Z scores of < −2 or >= −2 Standard Deviation. Logistic regression was used to test significant associations between outcome and factor variables. Setting: Rural communities from Artuma Fursi and Kemissie districts. Results: A total of 987 children of 6-59 months of age and 987 mothers/caregivers had participated in the study, giving a response rate of 99%. The percentage of male and female children in CBNP district was 330 (53.2%) and 290 (46.8%) and that of non Community Based Nutrition Program (CBNP) district was 192 (52.3%) & 175 (47.7%) respectively. The prevalence of stunting, underweight and wasting were 60.6%, 31.1%, 12.6% and 39.0%, 27.5%, 14.7% in CBNP and nonCBNP implementing districts, respectively. The possible risk factors for child B. Tariku et al. 2 malnutrition were area specific and different for the two districts. Conclusion: Child under nutrition is a serious public health problem in both districts, so that holistic programs need to be designed and implemented according to the guidelines.

Research paper thumbnail of Readiness of female sex workers for HIV testing and its associated factors in Shire Endaselassie town, Tigray, Ethiopia: a cross-sectional study

Journal Of Public Health, Mar 8, 2019

Aim HIV testing for vulnerable populations such as female sex workers (FSWs) is a critical step t... more Aim HIV testing for vulnerable populations such as female sex workers (FSWs) is a critical step to achieve the first 90s proposed by UNAIDS. However, the level of readiness for an HIV test and associated factors among FSWs have been rarely studied in Tigray, though it is a proxy indicator of HIV testing. Thus, this study aimed at assessing the readiness level for an HIV test and associated factors among FSWs. Subjects and methods A community-based cross-sectional study was conducted and 368 FSWs were recruited using systematic random sampling in Shire Endaselassie from March 2 to 30, 2018. Data were collected via a structured and pretested questionnaire. The data were entered into Epi Info 7 and then exported to SPSS 20 for analysis. Both descriptive and inferential analyses were done with 95% confidence intervals (CIs) at a p-value of less than 5% for the final model. Results The overall readiness level for HIV testing among FSWs was 53.2%. Educational status [adjusted odds ratio, AOR (95% CI) = 1.74 (1.07-2.85)], vulnerability to HIV [AOR (95% CI) = 2.45 (1.38-4.42)], fear of HIV testing [AOR (95% CI) = 0.48 (0.29-0.77)], planning to leave sex work [AOR (95% CI) = 1.79 (1.05-3.08)], fear of quick development of severe signs and symptoms [AOR (95% CI) = 0.53 (0.33-0.86)], being a member of women development groups [AOR (95% CI) = 2.79 (1.74-4.45)], and encountering condom breakage [AOR (95% CI) = 0.43 (0.27-0.68)] were found to be associated with readiness level. Conclusion The readiness level for HIV testing was relatively low. Most of the social and psychosocial issues were found to be factors that influence the readiness level for HIV testing among FSWs. Thus, efforts should be made to develop educational programs that boost the level of awareness and readiness of FSWs for HIV testing.

Research paper thumbnail of Contextual Disparity on Trend and Determinants of Optimal Antenatal Care (ANC4+) Use for Women in Eastern Tigray, Ethiopia: Evidence from KA-HDSS Database

International Journal of Women's Health, Apr 1, 2023

Background: Though optimal antenatal care (ANC4+) use is absolutely critical, only 43% of women h... more Background: Though optimal antenatal care (ANC4+) use is absolutely critical, only 43% of women had ANC4+ in Ethiopia and nearly 64% in Tigray in 2019. Furthermore, only 20% of women had their first ANC visit during their first trimester in 2016. However, there is no literature on area based disparity of ANC4+ use in Tigray. Therefore, this study is aimed to generate evidence for ANC4+ use using the Kilite-Awlaelo Health and Demographic Surveillance System (KA-HDSS) database. Methods: A population-based longitudinal study was employed on 5,414 women from 12 kebelles included in the KA-HDSS site of Tigray. A pregnancy database was used as a source of data. A Line graph was used to depict the trend of ANC4+ use. A stratified robust Poisson model was fitted to estimate the incidence rate ratio (IRR) for women from rural and urban areas separately. Results: The ANC4+ coverage was 36.3% (95% CI=35.0-37.6%)-34.2% in rural versus 52.8% urban areas, with an increasing linear trend. Single marital status (IRR=1.29; 95% CI=1.17-1.42); able to read and write (IRR=1.15; 95% CI=1.01-1.32); primary education (IRR=1.22; 95% CI=1.11-1.34); ANC follow-up (2015-2018) (IRR=1.42; 95% CI=1.23-1.64); previous pregnancy exposure (IRR=2.20; 95% CI=1.98-2.45); and having 6+ children (IRR=1.11; 95% CI=1.01-1.21) determined ANC4+ use for rural women. Marital status (Divorced/widowed/separated) (IRR=0.79; 95% CI=0.66-0.95); primary education (IRR=1.44; 95% CI=1.16-1.79); ANC follow-up (2015-2018) (IRR=2.00; 95% CI=1.59-2.50); previous pregnancy exposure (IRR=1.54; 95% CI=1.31-1.80); and having 6+ children (IRR=1.18; 95% CI=1.07-1.31) determined the ANC4+ use for urban women. Conclusion: The optimal ANC coverage is significantly low, with significant disparity by geographical area and increasing trend. However, further efforts have to be made to maximize the optimal use of ANC, particularly for women from rural areas.

Research paper thumbnail of What factors are associated with maternal undernutrition in eastern zone of Tigray, Ethiopia? Evidence for nutritional well-being of lactating mothers

BMC Public Health, Aug 8, 2020

Background: Maternal undernutrition is a pervasive health problem among Ethiopian mothers. This s... more Background: Maternal undernutrition is a pervasive health problem among Ethiopian mothers. This study aims at identifying the level of maternal undernutrition and its associated factors in Kilte Awaleo-Health and Demographic Surveillance Site (KA-HDSS), Tigray region, Ethiopia. Methods: Nutritional status of 2260 lactating mothers was evaluated using the mid-upper-arm circumference (MUAC). Data from the vital events and verbal autopsy databases were linked to the survey and baseline recensus data to investigate the association of adult mortality from chronic causes of death (CoD) on maternal undernutrition. We employed a generalized log-binomial model to estimate the independent effects of the fitted covariates. Results: The overall prevalence of maternal undernutrition based on MUAC < 23 cm was 38% (95% CI: 36.1, 40.1%). Recent occurrence of household morbidity (adjusted prevalence ratio (adjPR) = 1.49; 95%CI: 1.22, 1.81) was associated with increased risk of maternal undernutrition. In addition, there was a 28% higher risk (adjPR = 1.28; 95%CI: 0.98, 1.67) of maternal undernutrition for those mothers who lived in households with history of adult mortality from chronic diseases. Especially, its association with severe maternal undernutrition was strong (adjusted OR = 3.27; 95%CI: 1.48, 7.22). In contrast, good maternal health-seeking practice (adjPR = 0.86; 95%CI: 0.77, 0.96) and production of diverse food crops (adjPR = 0.72; 95%CI: 0.64, 0.81) were associated with a lower risk of maternal undernutrition. Relative to mothers with low scores of housing and environmental factors index (HAEFI), those with medium and higher scores of HAEFI had 0.81 (adjPR = 0.81; 95%CI: 0.69, 0.95) and 0.82 (adjPR = 0.82; 95%CI: 0.72, 0.95) times lower risk of maternal undernutrition, respectively.

Research paper thumbnail of Maternal mortality during war time in Tigray, Ethiopia: A community‐based study

BJOG: An International Journal of Obstetrics & Gynaecology

ObjectiveThis study seeks to examine the impact of war on maternal mortality following an exacerb... more ObjectiveThis study seeks to examine the impact of war on maternal mortality following an exacerbation in the dynamics of inequality in maternal health caused by the continuing conflict.DesignCommunity‐based cross‐sectional study.SettingTigray region of Northern Ethiopia, between November 2020 and May 2022.PopulationThis study surveyed a total of 189 087 households from six of the seven zones of Tigray in 121 tabiyas from 31 districts selected. A multistage cluster sampling technique was used to select the districts and tabiyas.MethodsThe study was conducted in two phases. In the first phase, reproductive‐age deaths that occurred during the study period were screened. In the second phase, verbal autopsies were conducted at the screened households.Main Outcome MeasuresMaternal mortality ratio level and cause‐specific mortality.ResultsThe results of the study showed that the maternal mortality ratio was 840 (95% CI 739–914) per 100 000 live births. Haemorrhage, 107 (42.8%), pregnancy‐...

Research paper thumbnail of Extent of Adhesion Losses in The Wheel- Rail Contact Under Contaminated Conditions

Railway vehicles require a certain level of adhesion between wheel and rail to operate efficientl... more Railway vehicles require a certain level of adhesion between wheel and rail to operate efficiently, reliably, and economically. Different levels of adhesion are needed depending on the vehicle running conditions. In the wheel tread–railhead contact, the dominant problem is low adhesion, as low adhesion on the railhead negatively affects railway operation: on one hand, the vehicle will lose traction resulting in delay when driving on low-adhesion tracks; on the other hand, low adhesion during deceleration will extend the braking distance, which is a safety issue. This thesis examines the influence of several contaminants, i.e., water, mud, leaves, oil and grease, on the adhesion in the wheel tread–railhead contact. This study will also improve our knowledge of the low-adhesion mechanism and of how various contaminants influence adhesion. In this thesis, the adhesion conditions were assessed using a twin disc test machine. Thus the research methodology used was a laboratory test; the ...

Research paper thumbnail of The contribution of Productive Safety Net Program for food security of the rural households in the case of Bale Zone, Southeast Ethiopia

Agriculture & Food Security, 2017

Background: Developing countries in general and Ethiopia in particular are affected by a growing ... more Background: Developing countries in general and Ethiopia in particular are affected by a growing problem of food insecurity. Millions of individuals and households especially the rural poor are the main victims of the problem. The government of Ethiopia together with other development partners launched the Productive Safety Net Program (PSNP) in 2005 to help chronically food-insecure households. This study discusses the role of PSNP on the improvement in consumption needs and asset base of the households, effect on community development and determinants of food insecurity level of beneficiaries. Methodology: Three Woredas have been selected agro-ecologically. Both qualitative and quantitative data-generating techniques were employed. Qualitative data were analyzed thematically and using narration. Frequency distribution table and t test were used. Logistic regression was employed to analyze the determinants of food insecurity. Results and conclusion: Results indicated that PSNP was helping beneficiaries for consumption smoothing, asset accumulation, and development of the local community. The effectiveness of PSNP was significantly determined by age and education level of the household head and occurrence of shocks on the last five consecutive years. The practice of PSNP was challenged by a lack of monitoring and evaluation of structures, low payment and limited awareness of beneficiaries. To assure the positive role of PSNP, culture of savings and accumulation of assets, engagement of beneficiary households in diversified asset building livelihood strategies, targeting and minimizing wrong inclusion and exclusion, and the management as well as monitoring practices of locally constructed community development infrastructures should be enhanced.