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August 4, 2022NDMCBlog

The World Health Organization declares that Antimicrobial Resistance (AMR) occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to medicines making infections harder to treat and increasing the risk of disease spread, severe illness and death. This, in other words, implies that Antibiotics are becoming ineffective as drug-resistance spreads globally. As a result, this problem appears to have implications on the economy of different countries. 

AMR is caused by many dynamics, but the most common ones, as explained by the WHO, include: the misuse and overuse of antimicrobials; lack of access to clean water, sanitation and hygiene (WASH) for both humans and animals; poor infection and disease prevention and control in health-care facilities and farms; poor access to quality, affordable medicines, vaccines and diagnostics; lack of awareness and knowledge; and lack of enforcement of legislation. Globally, many studies have been conducted to show the scale and magnitude of problems caused by AMR. In that regard, the first comprehensive study published on The Lancet estimated that resistance itself caused 1.27 million deaths in 2019, and that antimicrobial-resistant infections played a role in 4.95 million deaths.

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December 21, 2021NDMCBlog

Ethiopia faces many of the agonies faced by an underdeveloped country. However, with all the challenges out there, the country aspires to achieve many of the targets in the United Nations’ Sustainable Development Goals (SDG). For instance, the second goal of the SDG targets mentions that ending hunger, achieving food security and improved nutrition shall be achieved by the year 2030. This seems a big encounter for Ethiopia. In that regard, a disparity between Ethiopia’s real condition and the SDG targets has been shown by a modelling study conducted by the National Data Management Centre for Health and National Information Platform for Nutrition, both under EPHI. The modelling study was a scenario based modelling conducted to assess the prevalence of stunting, wasting, and underweight among under-five children. Moreover it has given prediction on the future trends of these metrics in relation to the SDG and HSTP-II targets by the expected coverage of the interventions.

Methodologically, the study used datasets from the Ethiopian Demographic Health Survey (EDHS), United Nation (UN), and Global Burden of Disease 2019 (GBD-2019). In technical senses, it assumes three scenarios depending on the expected coverage of the interventions. The first scenario assumes moderate increments in most interventions for the years of 2024 and 2030; the second assumes a substantial increment in most interventions for the same years; and the third scenario assumes hypothetical increments which can help to ending of all forms of malnutrition including eliminating stunting, wasting, and underweight by 2030.

The findings of the modelling study show the following major results. First, the projected prevalence of stunting for 2025 is 30.2%. This is a 29.4% decrement compared to the prevalence in 2012, but still 10.63% lesser than the required international intermediate reduction target of 40%. In addition, the projected stunting prevalence for 2024 (HSTP-II) and 2030 are 31.3% and 24.8%, respectively. This indicates that Ethiopia is implausible to meet SDG and HSTP-II targets of reducing stunting to 25% and SDG target of ending all forms of malnutrition in the respective years if the trend continues. Besides, it has been found that 26.1%, 5.4%, 4.4% of under-five deaths were attributable to wasting, stunting, underweight, respectively. Also, malnutrition attributed to 21.3%, 12.9% and 1.6% of under-five deaths caused by diarrheal diseases, Lower Respiratory Infection (LRI) and measles, respectively. This clearly shows deaths from diarrheal and LRI will remain threats in Ethiopia unless severe and acute malnutrition in under-five are avoided.

Figure: Trends of malnutrition indicators in Ethiopia

To deal with these unwanted risks, the study has recommended some action points.

• Promoting, and supporting appropriate feeding practices for infant and young children is affirmative at any cost.
• Increasing access to WASH services, intensification of measures such as encouraging the use of family planning, and promoting and strengthening education for women are crucial tasks.
• Improving access to primary health care and strengthening the existing community-based platforms for nutrition education are vital to attaining an international target of ending all forms of malnutrition.

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November 22, 2021NDMCBlog

For many years, it has been witnessed that the prevalence of malnutrition among many African nations is registered to have a higher magnitude. Countries of the Nile Basin and Eastern African are cases-in-point where there is a significant rate of malnutrition. In that regard, possible mitigating strategies have been forwarded and developed by different scholars of the Africa, the diaspora, and international community. In fact, many studies prove the existence of strong correlation between households’ nutritional status and access to irrigation, with evidences suggesting that the irrigation-nutrition linkages play out both through the income and production pathways in developing countries.

In reaction to the continental and regional catastrophe of malnutrition, a study has been conducted by the National Data Management Centre for Health at EPHI[1]. The study, basically, was concerned with showing the prevalence of malnutrition in Eastern Africa and the Nile Basin countries, and it mainly uses data from the Global Burden of Disease. The aim of the study, hence, goes to giving insights on the significance of irrigation to reduce the high burden of malnutrition across the Eastern Africa and the Nile Basin Countries. On its way of showing some insights, the study brings three underpinning facts from different literatures. First, it mentions that the role of irrigation is crucial as it plays a role in generating income for a given community. Second, compared to other continents, Africa’s total cultivated land with irrigation is very small. That entails that the scale of irrigation is at its infant stage. However, there still are literatures which have estimated that by 2050 the number of dams will raise by 70%. In other words, this has an implication that there is a high potential of expanding irrigated agricultures with the aid of dams. Thirdly, literatures reviewed by the study have revealed that the impact of irrigation on communities and households would range from proper usage of time up to access to better nutrition.

While discussing the prevalence and death resulted from malnutrition, the study has made various comparisons among different countries. In relation to that, the prevalence of malnutrition in Somalia, Zambia, Malawi and Mozambique were registered to have 29, 26, 25 and 25 per 100 people, respectively. On the contrary, the total number of deaths attributed to malnutrition across the countries was 19.22 % in the global deaths attributed to malnutrition. Hence, the death rates were high in Ethiopia followed by DRC and Tanzania. Meanwhile, the death rate resulted from malnutrition among children below the age of five has been higher in Somalia and South Sudan -1245 and 1126 per 100,000 population, respectively.

Table: All-cause under 5-deaths per 100,000 attributable to malnutrition across EANB countries in 2019 (Source GBD 2019)

All in all, the study has urged that there need to be a planned and sustained effort to end malnutrition in the region. Besides, it has forwarded practical recommendation on the extensive use of dams for irrigation purposes. In line with that, it has acclaimed that there need to be evidences showing the correlation between dams, irrigation and nutrition.

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October 5, 2021NDMCBlog

The Sustainable Development Goals (SDGs) are a set of 17 goals which were adopted by the United Nations during the year 2015. These goals are part of the 2030 Development Agenda, and the targets should be met before 2030. The SDGs came into effect in January 2016, and they were adapted to all countries, actors, governments, companies and citizens.

Taking the water resource as a point of discussion, the UN estimates that there are currently 700 million people in 43 different countries suffering from water shortage problems. Likewise, it forecasts that 1,800 million people will live in countries or regions with no access to water and two thirds of the world’s population will have access to water under water stress conditions by 2025. In the current context, in which the world is suffering the effects of climate change, almost half of the world’s population will live in regions suffering from water stress by 2030, including big towns and regions in Africa. In addition, water scarcity in arid or semi-arid areas will result in major migratory movements. In relation to that, the Grand Ethiopian Renaissance Dam (henceforth GERD) is one of the promising facilities that intendeds to address many issues listed in the SDG targets.

A study conducted at the National Data Management Centre for Health at EPHI[1] presents the advantage of GERD from different dimensions. It mainly focuses on the implication of the dam to achieve health related SDG targets among countries of the Nile Basin. To do so, it has used data from the 2017 Global Burden of Disease’s study which forecasted the progress of SDG indicators between 2015 and 2030. In that regard, reflections have been made on the implications of GERD to ensure reliable energy and health related SDG targets among the Nile Basin Countries. For the sake of making valid comparisons between different countries, the study used four major plans planned in the SDG targets.

As ending hunger is one of the SDG targets, the study has shown that the prevalence of wasting and stunting in Ethiopia during the year 2021 is estimated to be 8.6% and 41%, respectively. Among the listed Nile Basin Countries, only Egypt, Kenya, Uganda, Tanzania, and Rwanda were estimated to have a 5% or lower prevalence of wasting and stunting. Besides, with the exception of Egypt, it has been found out that almost all countries of the Nile Basin have the prevalence of stunting with more than 30% during the year 2021.

Moreover, according to the data shown in the study, Egypt, with regard to stunting and wasting, has proved to show figures that are close to the SDG targets of ending hunger.

As the study keeps the discussion, the presence of good health and well-being appears to be another SDG target, and Egypt has achieved the SDG target of maternal mortality ratio of less than 70/100,000 population. However, Ethiopia, Uganda, and Rwanda were estimated to have a maternal mortality ratio of less than 200/100,000 during the year 2021. Conversely, during the same year, the rate of under-five morality in Egypt has been 15.7/1000 live births. Parallel to this, the coverage of essential health coverage in Sudan and Egypt has reached more that 62% and 68%, respectively. Nevertheless, Ethiopia, Eritrea, South Sudan, DRC, and Burundi registered health service coverage of below 5%.

The availability of clean water is another parameter used for comparison. Under this parameter, Egypt and Sudan have shown a lower risk-weighted prevalence of a population that uses unsafe/unclean water. Yet, the remaining countries of the Nile Basin have a higher risk-weighted prevalence of using unsafe water.

As a final remark, the availability of affordable and clean energy is another SDG target planned to be met. The study has compared countries with the weighted prevalence of air pollution. In that regard, Ethiopia, Uganda, Tanzania, Rwanda, South Sudan, DRC and Burundi have shown a 50 % of risk-weighted prevalence. However, in Egypt the weighted risk prevalence of house-hold air pollution appears to be 0.3%, which is insignificant as compared to other countries in the Nile Basin.

How will GERD Assist Ethiopia to Achieve SDG Target?

  The study has stipulated that GERD has a strong potency of empowering Ethiopia to meet the SDG targets in many ways. First and foremost, it has been shown that the dam will ensure better health conditions and livelihood for the people through increasing health facility electrification in Ethiopia. Second, it is expected to improve household income through irrigation, which will correlate with many positive results. Third, there will be better provision of clean water and energy used for different purposes. Last but not least, GERD will enable Ethiopia to secure affordable and clean energy. Needless to say GERD is going to bring dramatic changes in the livelihood of the Ethiopian community; it is also going to make Ethiopia shine in the arena of development all across the globe.

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October 5, 2021NDMCBlog

The United Nations has estimated that over 10 million people are infected with tuberculosis (TB). For many years from now, studies have shown that TB is the leading cause of death among people with HIV and also a major contributor to antimicrobial resistance. According to a report by the WHO, although people who fall ill with TB live in low- and middle-income countries, the disease is prevalent all across the world. Surprisingly, reports have been made that half of all people with TB are found in 8 countries of the world: Bangladesh, China, India, Indonesia, Nigeria, Pakistan, Philippines and South Africa. Despite numerous national and international attempts to prevent and control TB, the disease remains a major global public health concern, particularly among the low- and middle-income countries.

Nevertheless, a study has revealed that Ethiopia is achieving better in the fight against TB. The study, basically, aimed to estimate the burden of TB among HIV-negative individuals in Ethiopia from the year 1990 up to 2019 with gender, age group, status of drug resistance, and regions. To do so, it used some data from the Global Burden of Disease Study (GBD) 2019. In that regard, the major findings of the study have revealed that, first, among both sexes, the majority of incident cases are 93% and the deaths are 69% among people under the age of 65. Second and most importantly, the Annualized Rate of Change (ARC) in age-standardized TB incidence has decreased by 2.2% from 1990 to 2015. Besides, a 0.05% decrement was observed from 2016 to 2019 in the ARC. Third, the ARC in mortality from XDR-TB was 0.23%, from 2016 to 2019, which is a higher rate of decrement than the 16.8% increase seen from 1990 to 2015. According to the discussion, in 2019, Dire Dawa reported the lowest age-standardized TB incidence rate of 192 per 100,000 populations while Afar reported the highest 425 per 100,000, and that has made the burden of TB decrease for both regions compared to the years before 2019. Moreover, all regions of Ethiopia, except Somali, Gambella, and SNNPs show a slower rate of decline in ARC in mortality between the years 1990-2015.

Figure 1. Age-standardized tuberculosis mortality rate (per 100,000 populations) across regional states from 1990 to 2019

In essence, the study has briefly shown that there is a declining trend in TB burden among HIV-negative individuals in Ethiopia from 1990 to 2019. Indeed, the improvement could be attributed to the significant progress that occurred in TB prevention and control, with resources and decentralized primary health care actions. However, efforts are still needed to ensure that Ethiopia is not left behind in the current global move to end TB.

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July 17, 2021NDMCBlog

The World Health Organization (WHO) declared the outbreak of COVID-19 as a global pandemic during March 11, 2020. By June 11, 2021, there were 174.4Million confirmed cases across the globe. In Ethiopia, on June 11, 2021, there were 273,678 total number of confirmed cases, and there were 4,231 total reported deaths. This evidence shows that the pandemic is still a national and global threat. Preventing and controlling the spread of COVDI 19, reducing disease severity and mortality require strict implementation of Non-Pharmaceutical Interventions (NPIs) and vaccination until proven treatment is made available.

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July 17, 2021NDMCBlog

To support government decision-making to address the COVID-19 outbreak, the National Data Management Center (NDMC) of the Ethiopia Public Health Institute (EPHI) conducted a systematic review of the economic evaluations of public health measures for the prevention and control of pandemics. The study explored literature published between the years 1998-2020 on pharmaceutical and non-pharmaceutical interventions including stockpiling drugs and vaccines, treatment with antivirals, prophylaxis, vaccination, testing, tracking exposed persons, personal protective, school closure, equipment, quarantines, and border closure.

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