Haramaya University

The burden of patient harm from unsafe care is disproportionately high in low-income countries, particularly in intensive care units (ICUs). Despite this, there is limited empirical evidence explaining the underlying challenges that make patient safety difficult to achieve in resource-limited ICUs. To explore the barriers to patient safety and incident-reporting in ICUs at Ethiopian university hospital. An exploratory qualitative descriptive study was conducted using in-depth interviews guided by a semi-structured protocol and informed by the Theoretical Domains Framework (TDF). Participants were purposively selected, and sample size was determined based on principles of data sufficiency. Reflexive thematic analysis with inductive orientation was employed following Braun and Clarke's approach. Thirty-nine healthcare professionals participated: 23 (59%) nurses, 13 (33%) physicians, and 3 (8%) clinical pharmacists. The mean age of participants was 32±5 years. Three overarching themes captured the barriers to patient safety and incident reporting in ICUs: (i) Fragile systems: Governance failure and resource constraints; (ii) Normalisation of deviance: teaching-hospital dynamics and clinical oversight, normalised communication lapses, and weak teamwork and relational context; and (iii) Silence trap: Fear in punitive and blame-oriented culture and lack of incident-reporting systems. Patient safety in Ethiopian ICUs is undermined by systemic, operational, and clinician-related obstacles. Structural and cultural barriers further hinder incident-reporting creating a vicious cycle where unsafe care remains hidden and opportunities for learning and improvements are lost. Breaking this cycle requires strong governance, coordinated resource investment, enhancing just culture, strengthening teamwork, establishing robust incident-reporting systems, and ongoing professional development focused on patient safety. Identifying barriers to patient safety and incident reporting in ICUs may enables targeted interventions that reduce preventable harm, improve care quality, and promote incident reporting and learning to sustain safe clinical practice.

Onsite sanitation coverage has expanded significantly since 2020, driven by global commitments to eliminate open defecation and the need for adaptable solutions in rapidly urbanising small- and medium-sized cities (<1 million inhabitants) in Low- and Middle-Income Countries. Currently, 53% of individuals with access to a toilet depend on onsite sanitation systems. Despite this prevalence, the contribution of greenhouse gas emissions from household-level excreta storage to climate change remains poorly quantified due to limited empirical evidence. We addressed this gap by conducting direct measurements of methane emissions from 146 onsite sanitation containment units locally referred as pit latrines, holding tanks and septic tanks, across Senegal, Ethiopia, Uganda and Nepal. Methane emission rates exhibited strong skewness with a geometric mean of 7.9 g CH₄ capita⁻¹ day⁻¹, indicating that onsite sanitation containment units alone may account for approximately 3.8% of global anthropogenic CH₄ emissions.

ABSTRACT Severe malaria remains a major cause of acute kidney injury and multiorgan failure in endemic regions, often requiring renal replacement therapy. However, access to dialysis is limited in many resource‐constrained settings, making outcomes highly dependent on early diagnosis and effective antimalarial treatment. We report a 32‐year‐old man who presented with 5 days of fever, rigors, and myalgia, followed by the onset of oliguria and altered sensorium. Laboratory evaluation revealed high‐density Plasmodium falciparum parasitemia, acute kidney injury (serum creatinine ≥ 5 mg/dL), thrombocytopenia, anemia, and electrolyte abnormalities. Chest radiograph demonstrated bilateral alveolar infiltrates, and upper gastrointestinal endoscopy confirmed active gastrointestinal bleeding. The patient was diagnosed with complicated P.falciparum malaria. Owing to the unavailability of timely hemodialysis because of financial constraints, the patient was managed with intravenous artesunate as per national guidelines, mechanical ventilation support, and intensive supportive care, which focused on judicious fluid balance, correction of electrolyte abnormalities, blood transfusion, and close hemodynamic and biochemical monitoring in the intensive care unit. By Day 7 of hospitalization, parasitemia had cleared, renal function showed progressive recovery, and both hemorrhagic and neurological complications had resolved. The patient was successfully extubated and discharged with significant clinical improvement. At 1‐week follow‐up, renal and hematologic parameters had normalized, with no residual neurological or functional deficits. The case highlights that in resource‐limited settings without access to dialysis, early initiation of intravenous artesunate and meticulous supportive care may achieve complete recovery, even in severe malaria–associated acute kidney injury requiring an intensive dialysis.

Ethiopia’s special economic zones (SEZs) sustainability practices are aimed at achieving the country's sustainable development; however, their failure has resulted in repercussions for sustainable local community development. This study analyzed the repercussions on the sustainable development of local communities resulting from the failure of SEZs' sustainability practices, focusing on three SEZs: Eastern Special Economic Zone (ESEZ), Bole Lemi Special Economic Zone (BLSEZ), and Dire Dawa Free Trade Zone (DDFTZ). The study employed a mixed research approach with an exploratory sequential design in which the qualitative phase was carried out and analyzed using content and thematic analysis, followed by the quantitative phase using descriptive analysis and a multivariate multiple linear regression. The study found that SEZs' sustainability practices negatively contributed to the local community’s sustainable development in economic, social, environmental, and peace perspectives. The multivariate multiple linear regression results show that economic sustainability practices significantly influenced social and economic development challenges, while governance sustainability practices significantly influenced the environmental sustainability and sustainable peace of local communities. To this end, it is suggested that systemic measures should improve the sustainability practices of SEZs as they minimize the negative impacts of SEZs on the local communities' sustainable development.

Exclusive breastfeeding is defined as feeding infants only breast milk for the first six months of life, with no additional liquids or solids except prescribed medicines, vitamins, or mineral supplements. This study aimed to compare the prevalence of exclusive breastfeeding and identify factors associated with its practice among employed and unemployed mothers in Arada Subcity, Addis Ababa, Ethiopia, in 2024. A community-based comparative cross-sectional study was conducted from July–August 2024 in four randomly selected woredas of Arada Subcity, Addis Ababa. Using proportional stratified sampling, 808 mother–infant dyads (404 employed, 404 unemployed) with infants aged 0–6 months were enrolled. Exclusive breastfeeding status was determined using a 24-hour recall method, using a pretested interviewer-administered questionnaire adapted from the WHO Infant and Young Child Feeding indicators and the 2016 Ethiopian Demographic and Health Survey. multilevel logistic regression identified factors associated with EBF, reported as adjusted odds ratios (AORs) with 95% CIs. Exclusive breastfeeding during the first six months was reported by 440 mothers (54.7%): 69.0% (95% CI 64.3, 73.4) of nonemployed mothers and 40.3% (95% CI 35.6, 45.1) of employed mothers. Nonemployed mothers had 3.3 times greater odds of practicing EBF (AOR 3.3, 95% CI 2.47, 4.4). Among unemployed mothers, EBF was positively associated with being married, having ≥ 3 years of birth spacing, lacking religious barriers, being comfortable discussing breastfeeding, and receiving counseling. Among employed mothers, higher odds of EBF were linked to working < 20 h/week, being married, having a lower income, the absence of religious barriers, perceived workplace support, and high confidence in breastfeeding while employed. The prevalence of exclusive breastfeeding in Arada was low and more common among nonemployed mothers. EBF practices are significantly influenced by multiple factors. Strengthening workplace support; enhancing family and social support; addressing religious barriers; improving maternal confidence; ensuring effective counseling; and creating supportive environments at home, workplaces, and health facilities are recommended to improve EBF practices in cities. Not applicable.

Effective data management plays a pivotal role in public health facilities, where accurate recording, collection, and analysis of health information are fundamental to informed decision-making and improved health outcomes. This study evaluates the current data management practices among health professionals in Dire Dawa, Ethiopia, while identifying key influencing factors. By doing so, it aims to enhance data quality and establish a robust, evidence-based framework to address the operational and strategic needs of health administration. This descriptive cross-sectional study was conducted in Dire Dawa, Ethiopia, from April to May 2023, involving a simple random sample of 417 health professionals. Data were entered using EpiData version 7.0 and analyzed with SPSS version 22.0 to produce descriptive statistics. Multivariable logistic regression was employed to assess associations between variables, with adjusted odds ratios (AOR) and 95% confidence intervals (CI) used to quantify the strength of these relationships. Among the 409 participating health professionals (response rate: 98%), effective data management practices were evident in 53.1% (95% CI: 48.2-57.7). Significant predictors included good knowledge of data management (AOR = 2.28, 95% CI: 1.20-4.30), a favorable attitude (AOR = 2.33, 95% CI: 1.16-4.67), high competency in tasks (AOR = 4.63, 95% CI: 2.08-10.31), clear understanding of health management information system tools (AOR = 5.67, 95% CI: 1.74-18.44), proficient computer skills (AOR = 3.95, 95% CI: 1.85-8.44), provision of feedback (AOR = 2.25, 95% CI: 1.09-4.66), strong data analysis skills (AOR = 4.65, 95% CI: 2.23-9.71), and prior training (AOR = 3.45, 95% CI: 1.07-11.12). Data management practices within the Health Management Information System in Dire Dawa require substantial improvement. Targeted capacity-building initiatives, including education and training in data handling, analysis, and tool proficiency, are essential. Coupled with regular feedback and ongoing evaluations, these efforts can significantly elevate standards and support evidence-based public health strategies.

This study aimed to gather basic information on phenotypic characteristics and develop live weight estimation equations based on body measurements of indigenous goat types in selected districts of the South Gondar Zone. Multistage purposive sampling was employed based on the potential of goat production. For generating quantitative and qualitative data, linear body measurements were taken from 630 mature goats. Dentition was used to estimate the age of goats as age group one (1PPI), age group two (2PPI), and age group three (3PPI). Data were gathered through field observations and linear body measurements of sampled populations. The most frequently observed coat colors were white (23.80%), white and red (18.57%), red (13.70%), gray (13.17%), brown (9.50%), and black (6.03%). Moreover, the most frequently observed coat color patterns of the sampled goat population in the study area were plain (65.1%), followed by patchy (25.2%) and spotted (9.7%). Sex of animals affected (P&lt;0.05) body weight and all of the body measurements except for ear length and tail length. The animals' location difference affected all body measurements (P &lt; 0.05), except for heart girth. The age of animals contributed significantly to differences in body weight and all linear body measurements. The correlation coefficient was consistently highest between body weight and chest girth in males (r = 0.90) and females (r = 0.83). Multiple regression analysis revealed that Chest girth was the most crucial trait in predicting body weight. There was no standard weighing balance for selling live animals at reasonable prices.

Climate change alters patterns of infectious diseases and increases the risk of zoonotic spillover in vulnerable areas. This study examines how frontline healthcare workers (FHWs) in Ghana’s Ada East District understand and perceive the relationship between climate change and zoonotic disease transmission. We conducted a concurrent mixed-methods study in the Ada East District, Ghana. A cross-sectional survey of FHWs evaluated knowledge, attitudes, and practices (KAP) regarding climate change and its link to zoonotic diseases. KAP scores were classified using Bloom’s cut-off points; adjusted logistic regression models identified predictors of good KAP. A purposively selected focus group (n = 9) explored perceived links between climate change and zoonotic disease, lived experiences, and institutional barriers. Most participants demonstrated good knowledge (≥ 60% correct; 83.2%) and attitudes (≥ 60% positive attitudes; 86.8%), but fewer reported good climate-mitigation practices (≥ 60% of good practices; 62.4%). Clinical staff other than nurses and midwives were associated with higher odds of good knowledge (adjOR = 4.52, 95% CI 1.12–22.76), while those trained on the human monkeypox virus were associated with lower odds of good knowledge (adjOR = 0.24, 95% CI 0.08–0.64). For practices, working in a district/regional hospital was associated with lower odds (adjOR = 0.18, 95% CI 0.05–0.61), as was training delivered by the Ministry/Government authorities (adjOR = 0.44, 95% CI 0.21–0.91) and training on human monkeypox virus (adjOR = 0.39, 95% CI 0.17–0.90). Providers associated land-use change and bushmeat hunting with zoonotic spillover risk. They noted that spiritual beliefs, self-medication, and fear of income loss delayed care-seeking for suspected cases. Institutional preparedness was perceived as reactive. Participants called for climate-resilient infrastructure, integrated early-warning systems, and One Health training. FHWs in Ghana’s Ada East District are knowledgeable and motivated to address climate-sensitive zoonotic risks. Yet, structural and sociocultural barriers limit the translation of frontline commitment into system-wide resilience. Strengthening climate-health education, investing in facility-level preparedness, and integrating FHW’s insights into surveillance could enable a shift from reactive outbreak response to proactive, community-based preparedness.

Ethiopia has numerous tourism potentials that contribute to comprehensive sustainable development in many ways at both national and local levels. These tourism potentials are not yet utilized as expected due to various factors that require detailed assessments for each destination. Among these potential destinations, Eastern Ethiopia's tourism sites contribute to the country’s development, whereas their utilizations for entrepreneurship and biodiversity conservation are not assessed adequately. Based on these notions, this research assessment was conducted with the objectives of profiling the potential tourism destinations, identifying the existing contributions for local youth entrepreneurs, and assessing the challenges facing these places for further study and policy actions. Research Methodology: Accordingly, the purposive sampling method was used for site selection; as a result, East Hararghe, Harari region, and Maya City were included in the sample. Then, potential destinations in each selected site, specific places were identified to mention, Lake Haramaya and its watershed catchment lakes, Gara Mul’ata Mountain, the so-called Dabbal, the historical Lij Iyasu Prince Prison, and Harar Jegol. Moreover, a key informant interview with long-experienced locals was conducted to further strengthen the research.The result shows that these tourism destination sites have contributions to sustainable biodiversity conservation, climate change balance, income for local youths, foreign visitors’ attractions, educational research, and water sports. With all these contributions, however, these tourism destinations faced many challenges, such as society’s attitude towards these sites is low, less promotion of these sites to foreigners, and less attention to engaging domestic tourists and Ethiopian-born diasporas, poor infrastructures, especially for Gara Mul’ata Mountain, the so-called Dabbal, and Lij Eyasu Prince Prison.Therefore, it recommended that the government and other stakeholders should focus on sustainable awareness creation for the surrounding community about the importance of tourism, development of infrastructure, capacity building for small-scale local businesses, tourism managers, guides, community leaders, and registration of these sites at the global level.