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This chapter focuses on the Ethiopian government's successful use of debt-based financial statecraft. It examines Ethiopia's shift from heavy reliance on traditional donor aid to borrowing from Chinese lenders and issuing a debut international bond. Using interviews with government and donor officials, it highlights how this diversification of external finance allowed the Ethiopian government to obtain more favorable terms in aid agreements, including lenience from donors on governance issues, flexibility on economic monitoring, and donor support for the government's state-led approach to development. When Ethiopia's financing options later narrowed, the government's bargaining leverage with donors declined, further corroborating the role of alternative finance in aid negotiations. The chapter underscores the importance of donors' perceptions of Ethiopia's strategic value and donors' trust in the government for their willingness to accommodate the Ethiopian government's preferences.
This chapter describes the book's case study approach, which compares Ethiopia, Ghana, and Kenya. All three countries experienced the regional trend of increased borrowing from China and in international bond markets in the 2000s. However, the countries vary in strategic significance and donor trust, allowing for tests of heterogeneity in the financial statecraft of borrowers. The chapter discusses the data collection process for the case studies, with over 170 elite interviews, mostly with government and donor officials participating in aid negotiations, and how this data is used to trace debt-based financial statecraft in each country. The chapter briefly provides background on each country's political and economic context and previews findings on how their external finance portfolios impacted aid negotiations with traditional donors.
This paper traces discourse and practices among Jewish communal leaders in Western Europe and the United States regarding the need for Jewish missions to China and Ethiopia. Though thousands of miles apart, China and Ethiopia became closely entwined in their racial imagination. Beginning in the 1840s, the Jewish international press depicted both as biblical lost tribes, languishing in isolation and ignorance, and in need of a guiding hand with the mounting threat of Christian missionizing. Jewish communal leaders began to call for Jewish missions in the 1850s, and they looked to contemporary scientific, evangelical, and civilizing missions as models, merging elements from all three. Throughout the 1860s, in debates over who should lead a Jewish mission, three different types surfaced: an explorer, rabbinic emissary, and Orientalist. Each of these reframed prophetic calls for the return of the lost tribes within a modern scientific and imperial project. Drawing on the work of Sylvia Wynter, I argue that these communities in China and Ethiopia came to serve as boundary markers, demarcating the outer limits of the Jewish world, of Jewishness, and Judaism as it became increasingly circumscribed through theological, behavioral, and racial norms. Not only does this upend assumptions about Jewish solidarity and internationalism, but it also points to how missionizing was deployed by minoritized communities in the nineteenth century.
Combating the double burden of malnutrition (DBM) in adolescents is a critical public health challenge in low-income countries like Ethiopia. However, past efforts have lacked focus and exhibited diverse governance strategies. Therefore, this study assesses the effect of selected double-duty interventions (DDIs) on DBM among adolescents in Central Ethiopia. The DBM status (thinness, normal, overweight/obesity) was determined using WHO AnthroPlus software. A two-arm parallel cluster randomised controlled trial was used among 708 adolescents (356 for the intervention group [IG] and 352 for the control group [CG]) from 13 October 2022 to 30 June 2023. The intervention’s effect was analysed through difference-in-difference (DID) analysis and a multivariable multinomial generalised estimating equation (GEE) model with significance set at P < 0.05. The overall DBM prevalence decreased by nearly 7% (4.7% for thinness, 2.2% for overweight/obesity) in the DID analysis. After adjusting for possible confounders, the GEE model indicated that adolescents in the IG were 34% less likely to have higher DBM than those in the CG (AOR = 0.66, 95% CI [0.46, 0.94]). Additionally, the probability of DBM decreased by 59% at the end line compared to baseline measurements (AOR = 0.41, 95% CI [0.03, 0.92]). Adolescents in the category of time and IG interaction were 44% less likely to have increased DBM (AOR = 0.56, 95% [CI 0.02, 0.38]). Thus, this study underscores the effectiveness of selected DDIs in addressing DBM among adolescents using a health belief model. These results advocate for the integration of DDI strategies into existing nutrition guidelines, programmes, and policies.
The trial was registered prospectively in ClinicalTrials.gov with registration number NCT05574842.
This study aimed to assess nutritional status and associated factors among adult tuberculosis patients in public health centres in Horro Guduru Wollega Zone, Western Ethiopia, 2021. An institutional-based cross-sectional study was conducted among 334 randomly selected adult TB patients at public health centres from May 7, 2021, to June 21, 2021. Data were collected using structured questionnaires and anthropometric measurements. The nutritional status was measured by using body mass index (BMI). Data was entered into EpiData version 4.6 and exported to SPSS version 25 for analysis. A bivariate and multivariable multinomial logistic regression analysis was done to identify factors associated with nutritional status. The prevalence of under and overnutrition was found to be 48.2% and 8.7%, respectively. Female TB patients (AOR = 3.48, 95% CI: (1.918–6.314)), patients who didn’t receive dietary counselling (AOR = 2.51, 95% CI: (1.335–4.720)), TB patients on the initiation phase of treatment (AOR = 3.76, 95% CI: (2.072–6.852)), and meal frequency less than three times per day (AOR = 3.6, 95% CI: (1.942–6.676)) were significantly associated with under nutrition. The prevalence of undernutrition was high in the study area. Being a female, being in the initiation phase of treatment, lack of dietary counselling, and having meal less than three per day were independently associated with undernutrition. Hence, regular nutritional assessments, dietary counselling, and nutritional support should be encouraged at the facility and community level.
This chapter focuses on two Ethiopian Sharīʿa court decisions related to divorce initiated by the wife (khulʿ) with a focus on the amount and kind of compensation which a wife must pay to the husband in order to terminate the marriage. Sharīʿa courts have a long history in Ethiopia, where Muslims constitute some 30-35% of the population. In the present federal constitution of Ethiopia, the power of Sharīʿa courts to adjudicate disputes is subject to the precondition of ‘consent’ of the disputing parties. The first case presented in this chapter concerns an appeal by the husband for an increased amount of compensation than that decided by lower courts. The second case concerns the court’s decision to accept the decision of family arbitrators to order a wife to pay compensation for the ‘moral damage’ caused to husband by the wife’s demand for divorce.
Early childhood growth is associated with cognitive function. However, the independent associations of fat mass (FM) and fat-free mass (FFM) with cognitive function are not well understood. We investigated associations of FM and FFM at birth and 0–5 years accretion with cognitive function at 10 years. Healthy-term newborns were enrolled in this cohort. FM and FFM were measured at birth, 1·5, 2·5, 3·5, 4·5 and 6 months and 4 and 5 years. Cognitive function was assessed using the Peabody Picture Vocabulary Test (PPVT) at 10 years. FM and FFM accretions were computed using statistically independent conditional accretion from 0 to 3 months, 3 to 6 months, 6 months to 4 years and 4 to 5 years. Multiple linear regression was used to assess associations. At the 10-year follow-up, we assessed 318 children with a mean (sd) age of 9·8 (1·0) years. A 1 sd higher birth FFM was associated with a 0·14 sd (95 % CI 0·01, 0·28) higher PPVT at 10 years. FFM accretion from 0 to 3 and 3 to 6 months was associated with PPVT at 10 years: β = 0·5 sd (95 % CI 0·08, 0·93) and β = −0·48 sd (95 % CI −0·90, −0·07, respectively. FFM accretion after 6 months showed no association with PPVT. Neither FM at birth nor 0–5 years accretion showed an association with PPVT. Overall, birth FFM, but not FM, was associated with cognitive function at 10 years, while the association of FFM accretion and cognitive function varied across distinct developmental stages in infancy. The mechanisms underlying this varying association between body composition and cognitive function need further investigation.
Selenium (Se) deficiency among populations in Ethiopia is consistent with low concentrations of Se in soil and crops that could be addressed partly by Se-enriched fertilisers. This study examines the disease burden of Se deficiency in Ethiopia and evaluates the cost-effectiveness of Se agronomic biofortification. A disability-adjusted life years (DALY) framework was used, considering goiter, anaemia, and cognitive dysfunction among children and women. The potential efficiency of Se agronomic biofortification was calculated from baseline crop composition and response to Se fertilisers based on an application of 10 g/ha Se fertiliser under optimistic and pessimistic scenarios. The calculated cost per DALY was compared against gross domestic product (GDP; below 1–3 times national GDP) to consider as a cost-effective intervention. The existing national food basket supplies a total of 28·2 µg of Se for adults and 11·3 µg of Se for children, where the risk of inadequate dietary Se reaches 99·1 %–100 %. Cereals account for 61 % of the dietary Se supply. Human Se deficiency contributes to 0·164 million DALYs among children and women. Hence, 52 %, 43 %, and 5 % of the DALYs lost are attributed to anaemia, goiter, and cognitive dysfunction, respectively. Application of Se fertilisers to soils could avert an estimated 21·2–67·1 %, 26·6–67·5 % and 19·9–66·1 % of DALY via maize, teff and wheat at a cost of US$129·6–226·0, US$149·6–209·1 and US$99·3–181·6, respectively. Soil Se fertilisation of cereals could therefore be a cost-effective strategy to help alleviate Se deficiency in Ethiopia, with precedents in Finland.
Ethiopia is home to a unique Christian culture dating back to Late Antiquity. Even after the Ethiosemitic language of Gəʿəz died out as a spoken language after the collapse of the kingdom of Aksum, it remained for centuries and, indeed, down to the present, as one of the mainstays of the Ethiopian Church. This ancient culture has been shaped by such historical factors as the kingdom of Aksum and its contact with the Roman Empire, relations between medieval Ethiopia and the Coptic Church of Egypt, and political events within Ethiopia. In the course of its long history, the Ethiopian Church has not only produced a vast literature of its own but has also preserved translations of literature now lost in its original language.
Globally, each year 1.3 million neonates acquire human immunodeficiency virus during pregnancy, labour, and breastfeeding time. Replacing breastfeeding with recommended safe infant feeding practices significantly reduces the risk of transmission, nearly eliminating it. This study aimed to assess Human immunodeficiency virus exposed child feeding among 314 mothers with infants under 24 months old. Participants were selected using a systematic random sampling technique, and data were collected through a semi-structured questionnaire. Bivariable and multivariable logistic regression analyses employed to identify determinants for safe infant feeding. During interviews, the mean age of women was 32.35 years (standard deviation±4.5), and infants were 10.8(±3.951) months. The overall safe infant feeding was 67.2% (95% CI: 61.7, 72.9), with a mean knowledge score. By the study’s end, 9 infants (2.89%) were confirmed to be infected with virus based on dried blood sample test. Maternal promoting factors for safe infant practice included infant age 25–35 years (adjusted odd ratio (aOR) =2.9) completing high school education (adjusted odd ratio = 9.2), having a good knowledge score for infant feeding (adjusted odd ratio = 8.2), and urban residency (adjusted odd ratio = 2.2). On the other hand, being married made it 83% less likely for safe infant feeding practices (adjusted odd ratio = 0.17) compared to those never in a union. Two in three mothers practiced safe infant feeding for their HIV-exposed infants, with a mean knowledge score of 70.3%. Therefore, healthcare providers give accurate information and counselling services to make informed decisions about infant safe feeding.
The objective of this study was to explore how selected sub-national (provincial) primary healthcare units in Ethiopia responded to coronavirus disease 2019 (COVID-19) and what impact these measures had on essential health services.
Background:
National-level responses against the spread of COVID-19 and its consequences are well studied. However, data on capacities and challenges of sub-national health systems in mitigating the impact of COVID-19 on essential health services are limited. In countries with decentralized health systems like Ethiopia, a study of COVID-19 impacts on essential health services could inform government bodies, partners, and providers to strengthen the response against the pandemic and document lessons learned.
Methods:
We conducted a qualitative study, using a descriptive phenomenology research design. A total of 59 health leaders across Ethiopia’s 10 regions and 2 administrative cities were purposively selected to participate in key informant interviews. Data were collected using a semi-structured interview guide translated into a local language. Interviews were conducted in person or by phone. Coding of transcripts led to the development of categories and themes, which were finalized upon agreement between two investigators. Data were analysed using thematic analysis.
Findings:
Essential health services declined in the first months of the pandemic, affecting maternal and child health including deliveries, immunization, family planning services, and chronic disease services. Services declined due to patients’ and providers’ fear of contracting COVID-19, increased cost of transport, and reallocation of financial and human resources to the various activities of the response. Authorities of local governments and the health system responded to the pandemic immediately, capitalizing on multisectoral support and redirecting resources; however, the intensity of the response declined as time progressed. Future investments in health system hardware – health workers, supplies, equipment, and infrastructure as well as carefully designed interventions and coordination are needed to shore up the COVID-19 response.
The aim of this study is to assess nutritional status and associated factors among infants and young children aged 6–23 months in Yeka sub-city, Ethiopia, 2021. An institution-based cross-sectional study was conducted in selected health centres found in the Yeka sub-city from May 2021 to July 2021. In total, 396 systematically selected infants and young children aged 6–23 months attended the selected health centres were included in the study. Data were collected by using a structured questionnaire and anthropometric measurements. A multinomial logistic regression model was used.
The overall magnitude of undernutrition and overnutrition among infants and young children were 24.7% and 5.5%, respectively. Dietary diversity score (DDS) ((adjusted odd ratio (AOR) = 5.65; 95% CI = 2.301, 10.87; P value = 0.003), minimum meal frequency (MMF) (AOR = 5.435; 95% CI = 2.097, 11.09; P value = 0.0052), and diarrhoea (AOR = 2.52; 95% CI = 1.007, 6.310; P value = 0.002) were statistically significantly associated factors for nutritional status among infants and young children. Malnutrition (undernutrition and overnutrition) is a public health problem among infants and young children in Yeka sub-city, Ethiopia. DDS, MMF, and diarrhoeal disease were associated with higher odds of undernutrition.
Addis Ababa initiated a universal Home-Grown School Feeding Program (HGSFP) in February 2019 to address hunger and improve the educational outcomes of schoolchildren. This study aimed to document the perceived benefits and challenges of the HGSFP in Addis Ababa, where such information was lacking. In May 2023, a qualitative phenomenological study was conducted to collect data from 20 schools participating in the HGSFP. Data were collected through key informant interviews and focus group discussions (FGDs) involving 98 purposively selected participants. The study encompassed 48 student mothers in 5 FGDs, 20 student interviews, 20 school principals, and 10 experts from the Ministry of Education, Sub-cities, and the School Feeding Agency for in-depth interviews. Data collected in the local language were transcribed, translated into English, and thematically analysed using ATLAS-TI software. The study’s findings unveiled the transformative impact of the HGSFP in Addis Ababa, Ethiopia. It demonstrated remarkable improvements in attendance, concentration, academic performance, reduced dropout rates, financial relief, enhanced behaviour, and a safer learning environment. However, urgent measures are imperative to tackle pressing challenges such as underpaid kitchen workers, operational issues, reduced reading time, rising food costs, limited market access, inadequate infrastructure, and growing dependency. To ensure the enduring sustainability of HGSFP, addressing challenges like workload reduction, kitchen infrastructure enhancement, government guideline implementation, promoting self-reliance, overcoming budget limitations, and addressing school gardening obstacles is vital.
People who are forced to leave home often experience emotional suffering and may be disproportionately subjected to risk factors for suicide. Although it is a grave concern for the global public health community, it has not been understood in Ethiopia.
Aims
This study aims to assess the prevalence and factors associated with suicidal ideation and attempts among war-affected internally displaced people in northwest Ethiopia, 2022.
Method
From 23 May to 22 June 2022, a cross-sectional study design was conducted, and a sample of 765 participants was selected through simple random sampling. A structured interview was employed to collect data. Suicidal ideation and attempts were assessed using the Composite International Diagnostic Interview.
Results
Out of 751 interviewed participants with a response rate of 98.2%, the magnitude of suicidal ideation and attempt was 22.4% (95% CI: 19.5%, 25.4%) and 6.7% (95% CI: 5.1%, 8.7%), respectively. People of female gender, having depression, family with a history of mental illness, and poor social support were significantly associated with both suicidal ideation and attempts. Furthermore, post-traumatic stress symptoms and the death of a family member were significantly associated with suicide ideation and attempt, respectively.
Conclusion
At least one in five of the displaced people in this population had experienced suicide ideation, and one in fifteen had attempted suicide. Therefore, strengthening early detection and intervention for individuals is recommended, especially for females with depression, post-traumatic stress symptoms, family with a history of mental illness, poor social support and the death of family members.
Maternal knowledge and attitudes towards nutrition are essential for achieving healthy dietary behaviours for a positive pregnancy outcome. Therefore, this study aimed to assess the level and determinants of knowledge and attitudes towards nutrition among pregnant women in the Minjar Shenkora district, Ethiopia. Institution-based cross-sectional study was conducted between June and August 2021 among 334 pregnant women who were selected using a systematic random sampling technique. Data were collected using a semi-structured questionnaire and analysed using SPSS version 21. Bivariate and multivariate logistic regression analyses were used to identify the determinants of nutritional knowledge and attitudes. P < 0.05, with a 95% CI was used to declare statistical significance. Overall, 69.2% and 44.0% of the pregnant women were not knowledgeable and had an unfavourable attitude toward nutrition, respectively. The educational status of pregnant women (P < 0.01) and access to nutritional information (P < 0.01) were significantly associated with nutritional knowledge, while the educational status of pregnant women (P < 0.01) was associated with nutritional attitude. Respondents’ knowledge of and attitudes toward nutrition were low. Pregnant women’s educational levels and access to nutritional information are strongly related to their nutritional knowledge. Likewise, the educational status of the pregnant women was significantly associated with their nutritional attitudes. Therefore, education and counselling on maternal nutrition are needed to improve healthy maternal nutrition tips in the study area.
In his search for allies who would help him challenge Nasserism and other radical movements, the shah found a companion in the emperor of Ethiopia, Haile Selassie I. This chapter investigates the early years of this relationship and some of the issues that prompted the two sides to cooperate – including common security concerns in the Red Sea, threats to the global monarchical institution, and the challenges that decolonisation presented to conservative regimes in the Global South. Ethiopia provided Iran with its first ally in sub-Saharan Africa, but it was not until the Summit Conference of Independent African States in Addis Ababa in 1963 that Iran began seriously to consider its future role in Africa. Several emissaries from Africa had already visited Iran, for example from Nigeria and Cameroon, and in 1964, a report was published by the Imperial Court on the opportunities Africa could present to Iran. Subsequently, the decision was taken to deepen ties with the continent as a matter of urgency. Because Addis Ababa was the de facto diplomatic capital of Africa, it was perceived as a bridge to the rest of Africa.
This Cambridge Element offers an interdisciplinary introduction to the histories of the Ethiopian and Eritrean highlands from late antiquity to the late medieval period, updating traditional Western academic perspectives. Early scholarship, often by philologists and religious scholars, upheld 'Ethiopia' as an isolated repository of ancient Jewish and Christian texts. This work reframes the region's history, highlighting the political, economic, and cultural interconnections of different kingdoms, polities, and peoples. Utilizing recent advancements in Ethiopian and Eritrean Studies as well as Medieval Studies, it reevaluates key instances of contact between 'Ethiopia' and the world of Afro-Eurasia, situating the histories of the Christian, Muslim, and local-religious or 'pagan' groups living in the Red Sea littoral and the Eritrean-Ethiopian highlands in the context of the Global Middle Ages.
Stigma is significantly impacted by cultural and contextual value systems. People with mental health conditions frequently have to deal with the condition itself and the associated stigma and discrimination. Contextual understanding is essential to design measures and interventions.
Objective
This study aimed to explore the experiences and perceptions of people with mental health conditions, their families and key stakeholders.
Method
A qualitative method used to understand mental health-related stigma and its local contexts. Sixteen participants, including service users, caregivers, service providers and health service administrators, were interviewed.
Result
People with mental health conditions and their caregivers experienced various forms of stigmatization which is linked to attributions about the causality of the illness, overt manifestations of mental health condition leading to easy identification and functional impairments that adversely affect participation. Social contact, lived experiences sharing and training of service providers are relevant intervention strategy to address stigma.
Implication
Stigma and exclusion are prominent in the experiences of people with mental health conditions and their caregivers in this rural Ethiopian setting. Measurement of stigma and the development of interventions should consider how stigma is socially constructed. Anti-stigma interventions need to be implemented alongside expanded local access to mental healthcare.
Elections in divided societies and in countries undergoing political transitions are precarious events. Hastened democratisation may ignite inter-communal antagonism and mobilise voters for conflict. Sub-national elections are even more prone to challenge national policies to defend regional autonomy and self-determination. The relationship between the Tigray Peoples' Liberation Front (TPLF) and the Ethiopian Federal government had been deteriorating since the coming to power of Prime Minister Abiy Ahmed in 2018. It was formally breached in September 2020 when the TPLF insisted on organising a separate regional election in Tigray in defiance of the federal government's decision to postpone national elections due to the outbreak of the COVID-19 pandemic, leading to one of Africa's most devastating civil wars in modern times. In the pursuit of democratic legitimacy, and conversely consciously framing the federal government as non-democratic, the TPLF ‘weaponised’ the election. This article analyses the process leading up to the decision to conduct separate elections in Tigray, its conduct and result. The analysis demonstrates how elections and the contestation to claim a democratic legitimacy in transition countries may contribute to a politics of violence, ultimately leading to war.
Tetraploid wheat species from Ethiopia hold ample genetic variation, which could provide a source for improvement of wheat. A total of 196 Ethiopian tetraploid wheat (Triticum turgidum spp.) accessions, including 174 landraces and 22 improved cultivars, were evaluated at Sinana and Debrezeit to assess morphological variation, genetic advance, heritability and correlation based on 11 phenotypic traits. Except for spike length, highly significant variation (P < 0.001) among genotypes for all traits was observed. The observed mean and range values of the phenotypic traits revealed high variability in the accessions. Phenotypic coefficient of variation (PCV) and genotypic coefficient of variation (GCV) values were high for grain yield, biomass yield and harvest index. Seed yield showed highly significant (P < 0.001) negative correlation with days to booting and days to maturity and positive correlation with all traits. The estimates of heritability (H2) for grain yield and the number of spikelets per spike respectively ranged from 41.78 to 84.62%. The genetic advance as a percentage of mean was low for the number of seeds per spikelet, days to booting and days to maturity; intermediate for plant height, thousand kernel weight and spike length and high for the number of spikelets per spike, the number of effective tillers per plant, grain yield, biomass yield and harvest index, respectively. The number of spikelets per spike gave a high value of genetic advance and heritability implying high genetic gain from its selection.