ACCESSIBILITY TO TUBERCULOSIS CONTROL SERVICES AND TUBERCULOSIS PROGRAMME PERFORMANCE IN SOUTHERN ETHIOPIA

ABSTRACT

Background: Despite the expansion of health services and community-based interventions in Ethiopia, limited evidence exists about the distribution of and access to health facilities and their relationship with the performance of tuberculosis (TB) control programmes. We aim to assess the geographical distribution of and physical accessibility to TB control services and their relationship with TB case notification rates (CNRs) and treatment outcome in the Sidama Zone, southern Ethiopia.

Design: We carried out an ecological study to assess physical accessibility to TB control facilities and the association of physical accessibility with TB CNRs and treatment outcome. We collected smear-positive pulmonary TB (PTB) cases treated during 2003–2012 from unit TB registers and TB service data such as availability of basic supplies for TB control and geographic locations of health services. We used ArcGIS 10.2 to measure the distance from each enumeration location to the nearest TB control facilities. A linear regression analysis was employed to assess factors associated with TB CNRs and treatment outcome.

Results: Over a decade the health service coverage (the health facility–to-population ratio) increased by 36% and the accessibility to TB control facilities also improved. Thus, the mean distance from TB control services was 7.6 km in 2003 (ranging from 1.8 to 25.5 km) between kebeles (the smallest administrative units) and had decreased to 3.2 km in 2012 (ranging from 1.5 to 12.4 km). In multivariate linear regression, as distance from TB diagnostic facilities (b-estimate=−0.25, p<0.001) and altitude (b-estimate=−0.31, p<0.001) increased, the CNRs of TB decreased, whereas a higher population density was associated with increased TB CNRs. Similarly, distance to TB control facilities (b-estimate=−0.27, p<0.001) and altitude (b-estimate=−0.30, p<0.001) were inversely associated with treatment success (proportion of treatment completed or cured cases).

Conclusions: Accessibility to TB control services improved despite the geographic variations. TB CNRs were higher in areas where people had better access to diagnostic and treatment centres. Community-based interventions also played an important role for the increased CNRs in most areas.

Comments

ፓርቲው ምርጫ ቦርድ ከተፅዕኖ ነፃ ሳይሆን የምርጫ ጊዜ ሰሌዳ ማውጣቱን ተቃወመ

የመንግሥት ስልጠና የምርጫ ቅስቀሳ አካል ነው ብሏል የምርጫ ጊዜ ሰሌዳ ለምን ወጣ መባሉ ተገቢ አይደለም - ምርጫ ቦርድ ምርጫ ቦርድ ከኢህአዴግ ተፅዕኖ ሙሉ ለሙሉ ነፃ መሆኑ ሳይረጋገጥና የምርጫ አፈፃፀም ችግሮች ሳይወገዱ የምርጫ የጊዜ ሰሌዳ ለማወጅ መዘጋጀቱ ተገቢ አይደለም ሲል ፕ/ር በየነ ጴጥሮስ የሚመሩት ኢማዴ-ደህአፓ ተቃወመ፡፡ መንግስት፤ የዩኒቨርሲቲ መምህራንና ተማሪዎችን ጨምሮ ለተለያዩ የህብረተሰብ ክፍሎች እየሰጠ ያለው ስልጠና የምርጫ ቅስቀሳ አካል ነው ሲልም ፓርቲው ኮንኗል፡፡ የኢትዮጵያ ማህበረ ዴሞክራሲ ደቡብ ህዝቦች አንድነት ፓርቲ ሰሞኑን ለብሄራዊ ምርጫ ቦርድ ባስገባው ግልፅ ደብዳቤ፤ ያለፉት አገር አቀፍና የአካባቢ ምርጫዎች ከመካሄዳቸው በፊት በምርጫ ችግሮችና መፍትሄዎቻቸው ዙሪያ ኢህአዴግ ከተቃዋሚዎች ጋር የሚወያይበት መድረክ እንዲዘጋጅ በተደጋጋሚ ብንጠይቅም እስካሁን ከቦርዱ የተሰጠ ተግባራዊ ምላሽ የለም ብሏል፡፡ ሃገሪቱ “በአንድ አውራ ፓርቲ” ብቸኛ ቁጥጥር ስር መውደቋ አደገኛና አሳሳቢ ነው ያለው ፓርቲው፤ የመድብለ ፓርቲ ስርአት የመገንባት ተስፋችን ጨርሶ እንዳይከስም ቦርዱ ሃላፊነቱን መወጣት እንዳለበት አሳስቧል፡፡ ነፃና ፍትሃዊ ምርጫ የሚካሄድበትን ሁኔታ ለመፍጠር ገዥው ፓርቲና ሃቀኛ ተቃዋሚ ፓርቲዎች የሚወያዩበት መድረክ እንዲያመቻች በህግ ስልጣን የተሰጠው ምርጫ ቦርድ የገባውን ቃል በማጠፍ መድረኩን ሳያመቻች የምርጫ ጊዜ ሰሌዳ ማዘጋጀቱ ፋይዳ የለውም ብሏል - ፓርቲው፡፡ ገዥው ፓርቲ ኢህአዴግ በተሻሻለው የምርጫ ህግ፣ ለቦርዱ የተሰጠውን የፖለቲካ ፓርቲዎች የጋራ መድረክ የማስተባበር ስልጣን ለመቀማት ታማኝ ፓርቲዎችን በተቃዋሚ ስም አሰባስቦ “የፖለቲካ ፓርቲዎች የጋራ መድረክ” በመፍጠር የምርጫ ውድድር አሯሯጭ አሰልፏል ሲ

የሐዋሳ ሐይቅ ትሩፋት

የለበሰው ያደፈ ቁምጣና ሹራብ ከቅዝቃዜው አላዳነውም፡፡ ካፊያው ልብሱን አርሶታል፡፡ ሽው እያለ ከሐይቁ የሚነሳው ነፋስ የሚፈጥረው ቅዝቃዜ ያንቀጠቅጠዋል፡፡ የተጫማው ያረጀ ሲሊፐር እግሩን ከምንም አላዳነውም፡፡ በባዶ እግሩ የሚራመድ ያህል ጨቅይቷል፡፡ ተደባዳቢ ይመስል ፊቱ የተሞነጫጨረ ነው፡፡ ገና 12 ዓመቱ ቢሆንም፣ ቁመናው እንደ ትልቅ ሰው ግዙፍ ነው፡፡ የሚለብሰውን እንደ ልቡ ባያገኝም፣ የሚያስፈልገውን ነገር ለማሟላት ቤሳቢስቲን የሌላቸው ወላጆቹን አያስቸግርም፡፡ ከቤተሰቦቹ ጋር ከሚኖሩበት ታቦር ተራራ ጀርባ ወዳለው ሐዋሳ ሐይቅ ከወረደ እንኳንስ የራሱን የቤተሰቦቹንም የዕለት ጉርስ የሚሸፍንበት ገንዘብ አያጣም፡፡ የአስጎብኚነት ዕውቀት፣ ከሐይቁም ውስጥ ዓሳ የሚያጠምድበት መረብም ሆነ ፈቃድ የለውም፡፡ ሙሉቀን (ስሙ ተቀይሯል) እና ጓደኞቹ ሐይቁን ለመጎብኘት የሚሄዱ ጎብኚዎች በካሜራቸው ጥሩ ፎቶ እንዲያስቀሩ ድባቡን የማሳመር ሥራ ይሠራሉ፡፡ ካሜራውን ይዞ ቁጭ ብድግ እያለ ጥሩ ፎቶ ለማንሳት ጥረት የሚያደርግ ሲያዩ፣ ቆርጠው የያዙትን የዓሳ ሥጋ ይዘው ጠጋ ጠጋ ይላሉ፡፡ ቁርጥራጩን የዓሳ ሥጋ ምግብ ለሚቀሙት አባኮዳዎች ሻሞ ይላሉ፡፡ የተወረወረላቸውን ቀድመው ለመቅለብ አባኮዳዎቹ ክንፋቸውን እየመቱ ወደ ላይ ብድግ ይላሉ፡፡ የናሽናል ጆግሪፊ የፎቶግራፍ ባለሙያዎች ያነሱት ዓይነት ፎቶዎች ሳያስቡት ያነሳሉ፡፡ በሁኔታው ተደስተው ደጋግመው ድንቅ ፎቶዎችን ለመውሰድ ሲዘጋጁ እነ ሙሉቀንም አጀንዳቸውን ይፋ ማድረግ ይጀምራሉ፡፡ አቶ ዳዊት አብርሃም ‹‹አንዱን ዓሳ በአሥር ብር ገዝቼ ነው እንዲህ የማዘጋጀው፤›› በማለት በቅድሚያ መረጃ ይሰጣሉ፡፡ ለቀጣዩ ዜና በዚህ መልኩ እንዲዘጋጁ ካደረጉ በኋላ፣ ሌሎች ሰዎች መቶም ሁለት መቶም ብር እንደሚሰጧቸው ቀለል

Sidama: the Luwa and the Anga Culture and their Social Implications

By Wolassa Kumo 1. Introduction In my previous articles, I mentioned the Sidama grand social constitution Seera, and various sub constitutions which derive from this grand constitution. We have also seen that all social constitutions or Seera in Sidama were based on the Sidama moral code of halale, the true way of life. In this socio-cultural and socio-political system, the role of the elders was very important. Elders were bestowed with the power of enforcing the Seera and referring the recalcitrant to Magano or God if he/she refuses to abide by the Seera. The power of elders in the Sidama society was not based on a simple age count as is the case in most modern societies. The Sidama elder is more the product of various social processes through which he passes than the product of a simple aging. For a person to become a recognised elder with authority in Sidama, he has to become a Cimeessa (respected elder with authority) or Cimeeyye for many respected elders. There are three importa

Worancha ወራንቻ

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