Land Tenure Disputes and Resolution Mechanisms: Evidence from Peri-Urban and Nearby Rural Kebeles of Debre Markos Town, Ethiopia

In Ethiopia, like in other developing countries, land disputes are critical problems both in peri-urban and rural areas. Handling such disputes requires scientific and evidence-based interventions. This study analyzes the nature, types, and causes of land tenure disputes and the resolution mechanisms thereof in peri-urban and nearby rural kebeles of Debre Markos town. Interviews for the investigation were conducted with sample landholders and concerned legal experts in Debre Markos town’s peri-urban area and Gozamin Wereda of Amhara National Regional State in Ethiopia. Compared to rural areas, the incidence of land tenure disputes is high in peri-urban areas. The land tenure disputes identified in the study areas are boundary trespassing disputes, landholding disputes, land rental disagreements, divorce-related land disputes, bequeath disputes, parcel exchange disputes, and land use-related disputes. The land tenure disputes are resolved mainly by formal means such as court litigations and administrative decisions, or by informal means known as alternative dispute resolution mechanisms (ADRMs). In both study areas, negotiation, mediation/conciliation, and arbitration are the most frequently employed ADRMs. In particular, mediation plays a significant role in resolving symmetrical land tenure disputes both in peri-urban and rural areas.

Mortality and Its Associated Factors of Bowel Obstruction after Surgical Treatment Among Adult Patients at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia 2021 (Retrospective Cross-Sectional Study)

Background: - Bowel obstruction is a mechanical or functional obstruction of bowel that prevents the normal movements of products of digestions. Even if Treatment outcome of bowel obstruction varies from area to area, time to time, and also increasing age is significant factor of treatment outcomes of bowel obstruction. Outcome of bowel obstruction and associated factors on adults have been poorly explored in the previous Ethiopian study particularly in the study area. Objective: To assess prevalence and its associated factors of mortality after surgical treatment of bowel obstruction among adult patients at Debre Markos comprehensive specialized hospital, Northwest Ethiopia 2021 Methodology: - Institution based Cross sectional study design was used. A total 517 study participates was included by using consecutive sampling techniques from 23/02/2017 to 23/02/2021 at Debre Markos Comprehensive specialized Hospital. Data was collected from patient registration books and medical records available in the hospital by using checklists. Then data were entered to Epi data version 4.1 and exported to SPSS version 25 for analysis. A binary logistic regression model was fitted to identify factors associated with treatment outcome of bowel obstruction. P value less than 0.05 considered as significant in multivariable analysis Result: Among patients treated for bowel obstruction 70(13.5%) was died. Old age (>=55) ((AOR=3.70; 95% CI [1.02,3.39, p=0.046], Gangrenous large bowel (AOR 5.58; 95%CI [2.33, 3.36), p=0.0001].. prolonged hospital stay(AOR= 2.42; 95%CI [1.10, 5.55, p=0.043]). late presentation (AOR=2.84; 95% CI [1.33, 6.04]), comorbidity (AOR=3.79; 95%CI [(1.75, 8.21), p=0.001]), WBC(AOR=3.53 ;95% CI [(1.61, 7.70), P=0.002]). Low hemoglobin (AOR=3.50, 95%CI [(1, 62, 7.60), P=0.001]) was independent predicator of mortality.Conclusion: Mortality after surgical treatment of bowel obstruction were high and having gangrenous bowel, low hemoglobin level, late presentation, post-operative complications, leukocytosis and comorbidity was independent predicator of unfavorable outcomes. Give special care for patients treated with low hemoglobin, late presentation, having complications and leucocytosis. Create awareness to the public on advantage of early presentation to hospital.

Magnitude of Preterm Birth Admissions, Immediate Outcomes And Their Predictors In Debre Markos Referral Hospital, North West, Ethiopia, 2019.

Background: Each year 15 million preterm babies are born. Pre-term birth complications account for 35% of the estimated 3.1 million global neonatal deaths and are the second leading cause of death in children less than 5 years aged.Objective: we assessed the magnitude of preterm birth admissions, immediate outcomes and their predictors in Debre Markos Referral Hospital, North West, Ethiopia, 2019. Methodology: An institutional based retrospective cross- sectional study design was conducted. Bivariable and multivariable logistic regression analysis were done. Variables with p value <0.05 in multivariate analysis were declared as statistically significant at a 95% confidence interval. Results: Out of 212 neonates involved in the study, 27.8% were preterm birth admissions. From this 36.3% of neonates was died before discharge. Hypertension during pregnancy was significantly associated with preterm admissions (P= 0.013, AOR= 4.464, 95% CI: (1.375, 14.498)) and being extreme low and very low birth weight (P= 0.005, AOR= 2.107, 95% CI: (0.023, 0.508)), and those preterm babies with low APGAR score (P= 0.016, AOR= 3.113, 95% CI: (0.019, 0.669)) were significantly associated with death before discharge. Conclusion: Preterm admissions accounted for a significant percentage of neonatal admissions with significant death outcomes. Maternal medical problems like hypertension during pregnancy was significantly associated with preterm admissions. Also, preterm babies with extreme low birth weight and very low birth weight, low APGAR score were significantly associated with death outcome. Therefore, strategies should be designed to prevent preterm birth and their complications.

An Investigation into Major Causes for Postharvest Losses of Horticultural Crops and Their Handling Practice in Debre Markos, North-Western Ethiopia

In developing countries, food systems are mainly characterized by unorganized, traditional supply chains, and limited market infrastructure. Bulk quantity of the harvested produce is lost every year because of the absence of proper postharvest handling and management practices. The current study was conducted to estimate and identify the major causes for postharvest losses of fruits and vegetables in Debre Markos, north-western Ethiopia. Forty respondents who were retailing fruits and vegetables were randomly selected and qualitative and quantitative data were collected by using direct market observation and semistructured questioners. The result of the present study revealed significant differences between sociodemographic factors, handling practices, and postharvest loss. Educational status, selling experience, and packaging material have a significant relationship with postharvest loss. A significant difference was obtained among the transportation methods used, the selling place, storage methods, and materials. The result also indicated that fewer than 20 percent of respondents practiced selling fruits and vegetables in the resident mini shop. The majority of damaged produce was sold at a discount price. Retailers do not have formal knowledge of postharvest handling practices. The average postharvest losses of fruits and vegetables were estimated to be five to eighty-three percent of the market share. Mainly, during retailing, rotting, mechanical damage, poor handling, improper management of temperature and relative humidity, and hygiene problems during handling are among the major causes of postharvest losses. To reduce the high postharvest loss and supply quality products for consumers throughout the year, intervention activities such as the construction of permanent selling place for perishables, practicing various evaporative cooling technologies, outset training, awareness creation, and infrastructures should be effectively and urgently addressed.

Magnitude of anemia and associated factors among children aged 6–59 months at Debre Markos referral hospital, Northwest Ethiopia: a hospital-based cross-sectional study

Background Anemia, the most common micro-nutrient deficiency disorder, is the world’s second leading cause of morbidity and morbidity, affecting 24.8% of the population, of which 47.4% are under-five children. The prevalence of anemia ranges from 44 to 56% in Ethiopia. Although its magnitude has shown decreases across regions; it continues to be a significant public health problem, particularly in developing countries including Ethiopia. Despite this evidence, the magnitude and associated factors of anemia was not systematically explored and there is a limited information or limited evidences in the study area. Hence, the aim of this study was to assess the magnitude and associated factors of anemia among children aged 6–59 months attending at Debre Markos Referral Hospital, Northwest Ethiopia. Methods A hospital-based cross-sectional study was conducted at Debre Markos referral hospital Northwest Ethiopia from September 30 to December 30, 2019. Data on socio-demographic and socio-economic factors, health and nutritional features of children and their mothers were obtained using pre-tested structured questionnaires in a face-to-face interview with child care providers. Blood samples and stool examination for intestinal parasites were performed. Hemoglobin level was analyzed using the HemoCue device (HemoCueHb 301). The collected data were coded, cleared and entered into Epi-Data version 3.1, and analyzed using Stata version 14 software. To identify candidates and predictor variables, bivariate and multivariate logistic regressions were applied respectively. The significance level was determined at a confidence interval of 95% at p-value < 0.05. Results Of the total of 341 participants planned to be participated, about 310 mother-child pairs participated in the study, giving a response rate of 91%; and data were collected from children as well as their parents or guardians. In this study, the magnitude of anemia was 11.9% (95% CI, 8.5, 16.2%). Poor dietary diversity (AOR = 2.3; 95% CI: 1.12, 5.14), food-insecure households (AOR = 3.24; 95% CI: 1.85, 4.52), complementary feeding initiation time (AOR = 3.20; 95% CI:1.23, 6.61), intestinal parasites infection (AOR = 3.20; 95% CI:1.23, 6.61) and family income (AOR = 2.87; 95% CI:1.57, 5.0) were found to be factors significantly associated with anemia. Conclusion Overall, anemia is considered a public health problem among children aged 6–59 months attending at Debre Markos referral hospital, based on the cut-off point of the World Health Organization. Poor dietary diversity, complementary feeding initiation time, household food insecurity, intestinal parasite infection and family income were significantly associated with childhood anemia. Thus, it needs for proven interventions in public health such as food diversification, anti-helmintic drug provision and household food security. In addition, educating women about nutrition and diet diversification, as well as involving them in alternative sources of income-generating activity, can be vital in the study area.

Predictors of recovery rate among undernourished HIV-positive adults treated with ready-to-use therapeutic food at Debre Markos Comprehensive Specialized Hospital: A retrospective cohort study

Background Nutritional support is becoming more widely acknowledged as a crucial component of the key package of care for HIV/AIDS patients. This nutritional support is exceptionally important for patients in sub-Saharan Africa, including Ethiopia, where HIV/AIDS is very prevalent. However, there is a lack of evidence on the recovery rate and predictors at the study site and at large in Ethiopia. Therefore, this study will give some insight into the recovery rate and its predictors among under-nourished HIV-positive adults treated with Ready to Use Therapeutic Food (RUTF) attending at Debre Markos referral hospital. Moreover, the findings of this study will be used by both governmental and non-governmental organizations to allocate more resources to mitigate the nutritional problems for people living with HIV. Methods An institution-based retrospective cohort study was conducted among 453 under-nourished HIV positive adults treated with RUTF at Debre Markos referral Hospital from the 1st of July, 2015 to the 31st of December, 2017. The study participants were selected using a simple random sampling technique. Data were extracted from patient charts using a standardized data extraction checklist. Data were entered into Epi-Data Version 4.2 and analyzed using Stata Version 14. The Kaplan-Meier survival curve was used to estimate the time to recovery. Log-rank test was used to compare the recovery time between different baseline categorical variables. The bivariable and multivariable Cox-proportional hazard regression models were fitted for potential predictors of recovery time. Adjusted hazard Ratios (AHRs) with 95% CIs were used to measure the strength of association and test statistical significance. Results A total of 453 undernourished HIV-positive adults were included in the final analysis. About 201, 44.4% (95%CI: 38.9, 49.0%) patients participating in the RUTF program were recovered based on predetermined exit criteria with incidence of 10.65 (95% CI: 9.28, 12.23) per 100 person-month observations. Being moderately undernourished (AHR: 11.0, 95% CI: 5.3, 23.1), WHO clinical stage (I or II) (AHR:1.8, 95% CI: 1.2, 2.6), and working functional status at baseline (AHR = 2.34, 95%CI: 1.01,5.45) were predictors of recovery time. Conclusion This study concluded that the overall nutritional recovery rate was below the acceptable minimum requirement which at least 75% of patients should recovered. Mild to moderate undernutrition at baseline, WHO clinical stage I or II at enrolment, and working functional status were found to be predictors of recovery time in HIV/AIDS patients treated with the RUTF. As a result, special attention should be paid to severely malnourished patients, WHO clinical stages III or higher, and patients who are bedridden or ambulatory during treatment.