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IHME Offers Training on Subnational Burden of Disease Estimation in Ethiopia

September 2, 2022NDMC Front Page News

The Institute for Health Metrics and Evaluation (IHME) offered training on the sub-national burden of disease estimation on August 31 and September 1, 2022, at Raddison BLU hotel, Addis Ababa. The National Data Management Center for Health (NDMC) took the role of organizing the training; the whole training aimed to capacitate staff members of MOH, EPHI, GBD collaborators, researchers from universities, and representatives of Health and Demographic Surveillance sites (HDSS), officers from regional public health institutes and regional health bureaus on the sub-national burden of disease estimation. In the technical sense, it focused on estimating the burden and distribution of diseases in small areas. In that regard, demographics, causes of death, non-fatal health outcomes, risk factors, and policy applications were the areas given the emphasis in the training. By far, the Global Burden of Disease (GBD) has provided tools to quantify health loss from hundreds of diseases, injuries, and risk factors. The aim of doing so is to improve health systems and eliminate disparities.

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Antimicrobial Resistance: The Subsequent Challenge of Ethiopia’s Health Care System

August 4, 2022NDMC Blog

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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Burden and Cause of Maternal Disorders in Sub-Saharan Africa: Trends and Patterns from 1990 to 2019

July 20, 2022NDMC 2022

Background

Maternal Mortality (MM) and Maternal Disorders (MDs) remain daunting global challenges.
The Sub-Saharan African (SSA) region has carried two-thirds of the global burden while Ethiopia alone has carried about 5% of the global burden.
Most of the causes of MDSs are preventable and treatable with available interventions and technologies. However, evidence are scarce on the causes of MDs, disease burden attributable to each cause and the changes over time in SSA countries to inform policies, strategies, programs and responses.
This study intends to address these evidence gaps using thirty years’ data from the Global Burden of Diseases (GBD) 2019 study for the entire SSA super-region, for Central (CSSA), Eastern (ESSA), Southern (SSSA) and Western (WSSA) regions and the countries in the regions.

Burden and Cause of Maternal Disorders in Sub-Saharan Africa: Trends and Patterns from 1990 to 2019

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NDMC Camps for Scientific Writing

April 4, 2022Anteneh Tsegaye Front Page News

The National Data Management Centre for Health hosted a mentor-based training on scientific writing from the 28^th of March to the 1^st of April 2022 at Adama. Accompanied by different lectures and practical sessions, the training aimed to achieve three major objectives: building the capacity of staff members, producing high-quality manuscripts and evidence, and creating long-living collaboration between senior researchers and the center.

At the dawn of the current Ethiopian fiscal year, the center prioritized eight topics to be investigated based on a demand assessment made at the Ministry of Health. As a result, concept notes have been produced, and junior researchers of NDMC are teamed up with the invited senior researchers to work on the topics.

Experts of high caliber have participated in the mentor-based training. In that regard, Professor Yifru Berhan (former minister of MOH), Professor Taddesse (Gondar University), Dr. Mezgbu (Gondar University), Professor Getinet (International Primary Health Care Ethiopia), Dr. Zewdie (Jimma University), Mr. Bedilu (Debre Tabor University) have been assigned to be mentors for researchers of NDMC.

AAU accredits NDMC’s training manual

March 30, 2022Anteneh Tsegaye Front Page News

The college of health sciences at Addis Ababa University has, lately, given a certificate of accreditation on the training manual of data science developed by NDMC. It is known that the college is mandated to give accreditation on training manuals prepared on health and health-related issues. Taking the role of facilitation, EPHI’s Training Centre has played a key role in making follow-ups on the accreditation process. The manual on the ‘Basics of Health Data Science’ is taken to be one of a kind that aims to give pieces of training for individuals who will be work data science.

NDMC prepared this manual for in-service training to equip health professionals with knowledge, skills, and competencies on the basics of Data Science. It is expected that; it will ensure the scaling up of the data science application to solve analytically demanding health challenges.

Considering the interdisciplinary nature of health data science, the experts involved in the preparation of the syllabus and manual are from different backgrounds and institutions. Provided that, NDMC has assigned some of its experts for the whole task, the inclusion, and consultation of different experts have been found imperative. In that regard, Professor Tadesse Awoke and Dr. Adane Letta from the University of Gondor; Basiliyos Betru from Jimma University; Dr. Yabibal Fantaye from 10 Academy and P2P; Dr. Addisu Gezahign and Dr. Robel Tezera from Addis Ababa University; Mohammed Ahmed, Firewieni G/hiwot, and Dr. Feven Tadesse from National Training Center of EPHI; Latera Tesfaye, Nahom Alemseged, Rediet Million, Kemal Sherefa, and Dr. Alemnesh Hailemariam Mirkuzie from NDMC are experts who have worked on the preparation of the manual.

Lancet publishes NDMC’s, IHME’s collaborative burden of disease results

March 15, 2022Anteneh Tsegaye Front Page News

The oldest and most renowned journal of medical sciences, The Lancet, publishes a collaborative manuscript entitled ‘Progress in health among regions of Ethiopia, 1990–2019: a subnational country analysis for the Global Burden of Disease Study 2019′. The lead investigators of this study were Dr. Awoke Misganaw, a senior researcher and advisor of NDMC and Clinical Assistant Professor of IHME, and Professor Mohsen Naghavi of IHME. Apart from that, Ethiopia’s Minister of Health, Dr. Lia Taddese is the senior author of the study with Prof. Christopher Murray of IHME. States Ministers, along with, researchers and higher officials from the Ethiopian Public Health Institute, IHME, GBD collaborators, and different institutions have co-authored the study. ( https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02868-3/fulltext)

In the technical sense, the study was part of the collaborative work between EPHI and IHME as part of the Global Burden of Disease Study 2019, and it was funded by Bill and Melinda Gates Foundation. To this day, the study can be considered as the first of its kind in identifying the major improvements and pitfalls of Ethiopia’s health sector over the last three decades. To do so, it applied data from all available data sources, and come up with tangible findings, policy recommendations, and a call to action.

The major findings of the study have shown that Ethiopia has made substantial improvements in health over the last three decades. First, it is noted that the socio-demographic index has steadily increased in all regions and cities since 1990. Except for the Somali region, there were substantial declines in total fertility rates among all regions. Second, life expectancy improved across the subnational states from 1990 to 2019, and inequality in life expectancy across the regions is decreasing despite increasing socio-demographic index disparities. Along with that, the study shows the declines in causes of premature mortality among the different regions of the country.

Given that there are achievements mentioned, the study has also identified drawbacks that need improvements. For instance, the signs of progress made by Ethiopia were not uniform across the country’s highly diverse, multi-ethnic, and predominantly rural population. Besides, social and economic determinants of health appear to be overriding concerns. In addition to that, non-communicable diseases were found among the leading causes of death for regions, and pastoralist and agro-pastoralist regions have a high burden of non-communicable diseases. Last but not least, particulate matter pollution, mainly household air pollution from solid fuels and ambient air pollution in urban areas, was found to be the first leading risk factor for high premature mortality and disability rates across regions.

Finally, the study has put forward the following key recommendations.

Federal and regional health policymakers need to align strategies, resources, and interventions to levels of disease burden and risk factors across regions and cities to achieve national and regional plans, SDGs, and universal health coverage targets;
Multi-sectorial transformation and coordination is required to address the social and structural drivers of health loss, and health interventions should be tailored to pastoralist, agrarian, and urban populations to address gaps in access and quality of healthcare;
Urgent solutions are needed at a federal and regional level to address the ongoing conflicts in Tigray, Amhara, Afar, Oromia, and Benishangul-Gumuz as well as the COVID-19 pandemic, which threaten the overall health and gains in life expectancy across all regions;
There is a need for the socio-economic development of poorer parts of the country, and quality health-care services in underserved areas.

For further references about the study, please visit the following links.

Facebook: https://fb.watch/bLl3MZzNYW/
Twitter: https://twitter.com/IHME_UW/status/1503270957049434114
IHME’s website article link: https://www.healthdata.org/research-article/progress-health-among-regions-ethiopia-1990%E2%80%932019-subnational-country-analysis

Ministry inaugurates health atlas, guideline

March 15, 2022Anteneh Tsegaye Front Page News

The National Data Management Centre for Health (NDMC) at Ethiopian Public Health Institute (EPHI) and the Policy, Plan, Monitoring and Evaluation Directorate (PPMED) at the Ministry of Health, jointly, organized a conference to launch a national health atlas and data access and sharing guideline on the 14^th of March, 2022. The health atlas, produced by NDMC, appears to be the first of its kind in the health system of Ethiopia. Given the name ‘National and Regional Health Atlas’, the document is produced from the national and subnational burden of disease analysis in Ethiopia. Under the Ministry of Health’s leadership, the National Data Management Centre for Health at EPHI and the Institute for Health Metrics and Evaluation (IHME) at the University of Washington have collaboratively been working to produce a comparable national and subnational burden of disease results from 1990 to 2019. Granted that, the atlas presents the burden of diseases between the years 1990-2019, it is highlighted that the Ministry of Health, as well as, the regional health bureaus of Ethiopia will benefit in making informed decisions. Through the entire route of preparing the document, the IHME offered technical support, and the Bill & Melinda Gates Foundation provided financial support.

The second document presented was a guideline on health data access and sharing, which was prepared by NDMC and PPMED and experts from different institutions have participated in the preparation of the document. Again, it has been stressed that this guideline is the first document prepared to govern issues related to health data access and sharing in Ethiopia.

Overall, keynote speeches, presentations, and discussions were the major activities at the event. In that regard, Dr. Ruth Nigatu, a delegate of the minster and chief of staff at the minister’s office, was the guest of honor and keynote speaker. Apart from that, the delegate of EPHI’s Deputy Director, Dr. Assefa Deressa also made a speech in the presence of other higher officials of the ministry, as well as, the institute. Moreover, Professor. Christopher Murray, the director for IHME, also made a keynote speech virtually.

The presentations of the conference were made by two experts. Dr. Awoke Misganaw (advisor of NDMC and Ass. Professor at the University of Washington) presented the key findings of the national and regional burden of disease in Ethiopia, and Dr. Kedir Seid (from the ministry’s Plan, Policy Monitoring and Evaluation directorate), on his part, presented major issues on how to implement the guideline on national health data access and sharing. All in all, researchers, representatives of regional health bureaus, representatives of different institutions, local GBD collaborators, partners, and different individuals have attended the conference both physically and virtually.

Meanwhile, the Ministry of Health promulgates that the days between March 14 and March 18, 2022, shall be commemorated as Health Data Week. And in the future, every year within the month of March, a week will be dedicated to commemorate Health Data Week at a national level. Taking the catchphrase ‘Enhanced Partnership and Collaboration to Strengthen the Health Information System’, the week is expected to be a milestone in promoting data use for informed decisions through collaborative works.

Tracking progress in reducing/ending childhood malnutrition in Ethiopia: a scenario-based modeling study

December 31, 2021NDMC 2021 Evidence Briefs

Stunting, wasting, and underweight are three widely recognized indicators of child’s nutritional status, resulting in increased childhood morbidity and mortality in Ethiopia.
Ethiopia has been implementing several high-impact, efficient, targeted, and multi-dimensional nutrition specific and nutrition-sensitive interventions, to eliminate and mitigate the public health and socio-economic impacts of these malnutrition indicators. However, scenario-based modeling for tracking progress on the effect of these interventions to achieve health targets for these indicators is limited.
This evidence brief makes use of EDHS, UN, and GBD-2019 datasets to assess the prevalence of stunting, wasting, and underweight among under-five children and to predict their future trends in relation to the SDG and HSTP-II targets by varying major nutritional intervention coverages.

Malnutrition: The Long Living Death-Trap of Ethiopian Children

December 21, 2021NDMC Blog

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.

NDMC Hosts Workshop on System Customization for HDSS

November 26, 2021NDMC Front Page News

The National Data Management Centre for Health, at EPHI, has hosted a workshop between November, 23 -26, 2021 on the customization of HDSS database system and data sharing platform. Given that the purpose of Health and Demographic Surveillance Sites is to generate longitudinal information on the health and population of a geographically defined population, there is a need to upgrade the existing system employed to execute the data management of the sites. In technical senses, the workshop has presented short term plan that are aimed at alleviating the existing problems open HDS system. Hence, it has been agreed that the customization of the system needs to take place the sooner possible.

Participants in the workshop were representatives of 10 different universities (owning HDSS sites). Moreover, software experts of the NDMC have also taken part in the workshop. Apparently, an action plan, with specific details, on how to customize the existing database system of HDSS has been prepared. Besides, major inputs for the software have been identified and incorporated into the plan. The workshop was coordinated by a staff member of NDMC and a technical assistant to HDSS sites – Mr. Yihune Lakew.