Ethiopian Medical Journal最新文献

{"title":"Dietary Practice and its Association with Glycemic Control among Individuals with Type 2 Diabetes Mellitus in Ethiopia: A Multi-Center Cross-Sectional Study","authors":"F. Asnake, Mpm Kitaw MD, Muluken Zeleke Megiso, Indris Ahmed Yesuf, Bersabel Hilawi, Y. Shiferaw, Blen Solomon, Mefthe Fikru, E. S. Weldesenbet, T. W. Leulseged","doi":"10.1101/2023.08.26.23294671","DOIUrl":"https://doi.org/10.1101/2023.08.26.23294671","url":null,"abstract":"Background: Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic disorder that needs a comprehensive management plan. The integral role of nutrition therapy in diabetes management is getting special attention in guidelines though the practice is in a primitive stage, especially in resource limited settings where lifestyle modifications have a large role in the overburdened healthcare system. Understanding the current dietary practice and its effect on disease control in settings where a tertiary level care is provided is a critical step in providing targeted intervention. Therefore, the aim of the study was to assess dietary practice and its association with level of glycemic control among individuals with T2DM who were on follow-up at two large tertiary hospitals in Ethiopia. Methods: A hospital based cross-sectional study was conducted from January to March 2023 among 314 systematically selected individuals with T2DM who were on follow-up at diabetes clinics of St. Paul's Hospital Millennium Medical College and Tikur Anbessa Specialized Hospital. Data was collected using a pre-tested structured questionnaire and summarized using frequency and median (interquartile range). To examine the association of dietary practice with level of glycemic control, a binary logistic regression model was run at 5% level of significance where Adjusted Odds Ratio (AOR) and 95% CI for AOR were used to interpret the results. Results: From the 314 participants, 146 (46.5%) patients had adequate knowledge regarding the recommended dietary practices and only 42 (13.4%) of the individuals practiced a healthy diet. A total of 107 (34.1%, 95% CI=29.0%-39.2%) had optimal glycemic control. Poor dietary practice (AOR=7.93, 95% CI=2.63-23.89, p<0.001), obesity (AOR=2.74, 95% CI=1.05-7.18%, p=0.04), and taking combination oral anti-diabetic drugs (AOR=6.22, 95% CI=3.05-12.69, p<0.001) were significantly associated with suboptimal glycemic control. Conclusions: Dietary knowledge and practice among individuals with T2DM were very low, as is the level of glycemic control, which are similar to studies conducted years back, indicating a lack of improvement in the desired behavior over time. Poor dietary practice in turn was associated with suboptimal glycemic control. It is important to target interventions that enhance the understanding and application of dietary practice in these individuals.","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44506651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pattern of Cutaneous Neoplasms and Associated Factors at a Tertiary Teaching Hospital Pathology Center in Ethiopia: An Eight-Year Histopathological Review","authors":"Fuad Temam, Samia Metena Yahya, Bereket Berhane, Frehiwot Daba, Amanuel Yeneneh Teka, Indris Ahmed Yesuf, T. W. Leulseged","doi":"10.1101/2023.08.26.23294667","DOIUrl":"https://doi.org/10.1101/2023.08.26.23294667","url":null,"abstract":"Background: Cancer is the leading cause of death globally and is on the rise in Africa. Cutaneous neoplasms are becoming increasingly common worldwide. Understanding the patterns of this disease is essential for developing data-driven preventive, screening, and treatment services. However, there are limited studies in Ethiopia so far. Therefore, the study aimed to assess the pattern and associated factors of cutaneous neoplasm among patients with histopathologically confirmed biopsy results at a tertiary teaching hospital in Ethiopia from March, 2014 to October, 2022. Methods: A retrospective record review study was conducted among 1006 patients with histopathologically confirmed cutaneous neoplasms from the biopsies that were assessed at St. Paul's Hospital Millennium Medical College. Data was summarized using frequencies (percentages), median (interquartile range), and graphs. To identify significant factors associated with malignant cutaneous neoplasm, a multivariable binary logistic regression model was fitted, where Adjusted Odds ratio (AOR), 95% CIs for AOR, and p-values were used for interpretation of results. Result: From the 1006 cases, 265 (26.3%, 95%CI=23.5%-29.3%) were malignant, of which sarcoma (26.0%) and squamous cell carcinoma (25.7%) were the most frequent and found to be prevalent in younger (19-29 years) and older ([≥] 60 years) patients, respectively. The trunk was the commonest site (54.2%) for all the malignancies, especially sarcoma (80.4%). Age was found to be a significant exposure that is associated with the development of malignant cutaneous neoplasm for those [≥]30 years as compared with those [≤]18 years, with the odds increasing with age (AOR=2.66, 95% CI=1.10,6.45 for 30-39 years, AOR=4.98, 95% CI= 2.01,12.36 for 40-49 years, AOR=5.33, 95% CI=2.15,13.22 for 50-59 years and AOR= 6.62, 95% CI=2.79,15.66 for [≥] 60). Conclusion: The prevalence of malignant cutaneous neoplasm is higher than previously reported in the country and the malignancy pattern and distribution are different from what is known so far. This could signal a shift in disease epidemiology, and the findings should be factored into clinical decision making and program design for disease prevention, screening, and treatment. It also calls for further prospective research to learn more about the condition in the context of additional relevant personal and clinical characteristics.","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45411896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative efficacy and safety of anti-infective drugs for patients with mild to severe COVID-19: A systematic review and network meta-analysis of randomized controlled trials.","authors":"Dejene Tolossa Debela, Tsegahun Manyazewal, Merga Belina, Kassahun Habtamu, Abebaw Fekadu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Different anti-infective drugs have been proposed for the treatment of patients with COVID-19. We carried out a network meta-analysis to assess their relative efficacy and safety.</p><p><strong>Methods: </strong>We searched relevant databases for all randomized controlled trials that reported the efficacy and or safety of any anti-infective drugs published up to April 30, 2022 for different outcomes. We did both pairwise and network meta-analysis with 95% confidence intervals using a fixed-effect model. We assessed studies for quality of evidence using an extension of the standard Grading of Recommendations, Assessment, Development and Evaluation approach considering P<0.05 to be statistically significant.</p><p><strong>Results: </strong>We included 68 RCTs for 27,680 participants on 22 anti-infective drugs. For clinical recovery at 14 days Ivermectin (OR= 3.00, 95%CI: [1.82; 4.96]; p < 0.0001; moderate certainty evidence), Baricitinib plus Remdesivir (OR= 2.20, 95%CI: [1.35; 3.53]; p = 0.005; low certainty evidence), and Favipiravir (OR= 2.16, 95%CI: [1.27; 3.68]; p = 0.004; moderate certainty evidence) were statistically effective than standard of care. There was no statistically significant difference between treatments for the viral clearance at 14 days outcome and standard of care. In terms of death outcome, only combined therapy of Baricitinib and Remdesivir showed statistically significant risks of ratio (RR= 0.47, 95%CI: [0.23; 0.99]; p = 0.03). Arbidol (RR= 0.46, 95% CI: [0.23; 0.95]; p = 0.04) was statistically safe drug than standard of care.</p><p><strong>Conclusion: </strong>This Network Meta-analysis suggests that Baricitinib plus Remdesivir is more effective than the other anti-infective drugs in treating patients with COVID-19 in terms of clinical recovery at 14 days, mortality and adverse events outcomes.</p>","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10836338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139680893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID -19 vaccine hesitancy and determinants in Ethiopia: A national pilot survey.","authors":"Sewit Timothewos, Hanna Negussie, Bethelhem Fekadu, Winini Belay, Eyerusalem Getachew, Medhin Selamu, Abigiya Wondimagegnehu, Tigist Eshetu, Tigest Ajeme, Charlotte Hanlon, Yimtubezinash Woldeamanuel, Tsegahun Manyazewal, Abebaw Fekadu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Despite major advances in Corona Virus Disease 2019 (COVID-19) vaccine development, vaccine hesitancy threatens the progress made to curb the disease. We aimed to assess the level of COVID-19 vaccine hesitancy and the underlying determinants in Ethiopia.</p><p><strong>Methods: </strong>A pilot mobile phone survey of adults in Ethiopia with mobile phones selected randomly.</p><p><strong>Results: </strong>The pilot survey included 614 participants who were predominantly male (71.7%), and married (68.2%) with a median age of 34 years (interquartile range [IQR] = 14.0). Overall, 150 (24.4%) participants reported to have been vaccinated; either the first [57 (38%)], second [19 (12.7%)], or both [74 (49.3%)] doses. About one in six participants (16.3%; n=100) reported vaccine hesitancy, with a significant difference by employment status, with self-employed more likely to show hesitancy [adjusted odds ratio (AOR) 1.85, 95% CI (1.05-3.27)], and region. Major drivers of hesitancy were lack of interest [n=30 (30%)], fear of side-effects [n=24 (24%)], and lack of trust in the vaccine [n=13 (13%)]. Having chronic disease conditions in the family had no association with hesitancy (p > 0.05).</p><p><strong>Conclusion: </strong>While representativeness of the sample is an issue, the findings show a relatively low rate of COVID-19 vaccine hesitancy among the Ethiopian population. The major drivers of hesitancy, lack of interest, fear of side-effects, and lack of trust in the vaccine, may be reversed by disseminating accurate and timely information using credible sources across communities.</p>","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10812837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139570137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to COVID -19 protective practices in Ethiopia: Use and predictors of face mask-wearing.","authors":"Hanna Negussie, Sewit Timothewos, Bethelhem Fekadu, Winini Belay, Medhin Selamu, Eyerusalem Getachew, Abigiya Wondimagegnehu, Tigist Eshetu, Rahel Birhane, Tigest Ajeme, Charlotte Hanlon, Eyasu Makonnen, Tsegahun Manyazewal, Abebaw Fekadu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The Ethiopian Ministry of Health strongly recommends that anyone, regardless of vaccination status, wears a standard face mask consistently when in public. This study aimed to assess the self-reported use and predictors of wearing face masks in the general population in Ethiopia.</p><p><strong>Methods: </strong>This was a population-based cross-sectional study using a telephone survey. Adults living in Ethiopia were randomly selected from the Ethio Telecom list of mobile phone numbers and interviewed about their mask-wearing practice and individual and household-level factors that could impact on the use of face masking. Multivariable logistic regression was used to measure associations.</p><p><strong>Results: </strong>A total of 614 participants were interviewed from September to November 2021. The prevalence of self-reported face mask use when in public was 81.1%. Living outside Addis Ababa, including Oromia [adjusted odds ratio [(AOR) 0.30, 95% confidence interval (CI) (0.14, 0.63)], Amhara [AOR 0.11, 95% CI (0.05, 0.23)], and Southern Nations, Nationalities and People's Region [AOR 0.31, 95% CI (0.12-0.79)] and being divorced or widowed [AOR 0.18, 95% CI (0.06, 0.62)] were found to be inversely associated with face mask use. Female gender [AOR 1.91, 95% CI (1.02, 3.58)] and older age [age ≥ 50, AOR 2.96, 95% CI (1.09-7.97)] were positively associated with the use of face masks. Attending social events [AOR 0.51, 95% CI (0.31-0.82)], was negatively associated with the use of face masks.</p><p><strong>Conclusion: </strong>Self-reported use of face masks was relatively high nationally, but inconsistent among different regions and demographics. The findings imply that policies and messaging campaigns may need to focus on specific populations and behaviors in this ongoing pandemic.</p>","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10753859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139058242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental wellbeing during the time of COVID-19 pandemic: A national pilot survey in Ethiopia.","authors":"Bethelhem Fekadu, Medhin Selamu, Eyerusalem Getachew, Hanna Negussie, Sewit Timothewos, Winini Belay, Abigiya Wondimagegnehu, Tigist Eshetu, Tigest Ajeme, Kehabtimer Shiferaw, Tsegahun Manyazewal, Abebaw Fekadu, Girmay Medhin, Charlotte Hanlon","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The Coronavirus Disease 2019 (COVID-19) pandemic substantially disrupts population health and wellbeing globally, while little is known about the effect on mental wellbeing in developing countries. This study aimed to assess the impact of COVID-19 on mental wellbeing of individuals and households in Ethiopia.</p><p><strong>Methods: </strong>A cross-sectional, national pilot survey was conducted through phone interviews from September to November 2021. Mental wellbeing and disability were assessed using a questionnaire adapted from the 5-item World Health Organization Wellbeing Index (WHO-5), the Oslo Social Support Scale (OSSS-3), and the WHO Disability Assessment Scale (WHODAS 2.0).</p><p><strong>Results: </strong>A total of 614 adults completed the pilot survey. The mean age was 36 years (standard deviation 11) and 71.7% were male. Mental wellbeing was poor in 218 (35.5%) participants. The most important predictors for poor mental wellbeing were rural residence (Adjusted Odds Ratio [AOR] 1.89; 95% CI 1.14, 3.14; p=0.012), perceived COVID-19 risk (AOR 1.75; 95% CI 1.18, 2.60; p=0.005), household stress (AOR 2.09; 95% CI 1.31, 3.34; p=0.002), experience of symptom of COVID-19 in the household (AOR 2.14; 95% CI 1.13, 4.04; p=0.019), and poor social support (AOR 2.43; 95% CI 1.51, 3.91; p<0.001).</p><p><strong>Conclusion: </strong>The study provides evidence that COVID-19 had a significant adverse impact on the mental wellbeing of individuals and households in Ethiopia. Further studies are needed to understand in detail the implications of the pandemic and interventions needed to keep mental wellbing of citizens.</p>","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139542227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of COVID-19 on population health and economic wellbeing in Ethiopia: A national pilot survey.","authors":"Winini Belay, Tsegahun Manyazewal, Yimtubezinash Woldeamanuel, Eyasu Makonnen, Solomon Teferra, Adamu Addissie, Charlotte Hanlon, Tewodros Haile, Wondwossen Amogne, Damen Hailemariam, Azeb Asaminew, Kassahun Habtamu, Mesele Araya, Tigest Ajeme, Tigist Eshetu, Haileleuel Bisrat, Kehabtimer Shiferaw, Munir Kassa, Aschalew Abayneh, Fentie Ambaw, Yemane Berhane, Rahel Gebremariam, Gail Davey, Girmay Medhin, Abebaw Fekadu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The COVD-19 pandemic has resulted in unprecedented global health and economic crisis, particularly in countries struggling with poverty. We conducted a national survey to understand the economic and health impacts of COVID-19 in Ethiopia.</p><p><strong>Methods: </strong>A pilot, population-based, cross-sectional survey was conducted among adults randomly selected from the Ethio Telecom list of mobile phone numbers. Participants underwent a comprehensive phone interview about the impact of COVID-19 on their economic well-being and the health-related risks associated with COVID-19.</p><p><strong>Results: </strong>Of 4,180 calls attempted, 1194 were answered, of which a successful interview was made with 614 participants. COVID-19 affected the family income of 343 [55.9%] participants, 56 [9.1%] lost their job, 105 [17.1%] perceived high stress in their household, and 7 [1.14%] reported death in their family in the past month. The odds of having a decreased income due to COVID-19 were 2.4 times higher among self-employed [adjusted odds ratio (AOR) 2.4, 95% CI (1.58-3.77)] and 2.8 times higher among unemployed [AOR 2.8, 95% CI (1.35-5.85)] participants. Two-hundred twenty-one [36%] participants had comorbidity in their household with hypertension, 72 [11.7%], diabetes,50 [8.1%], asthma, 48 [7.8%], and other chronic diseases, 51 [8.4%]. Forty-six [7.5%] participants had COVID-like symptoms in the previous month, where cough, headache, and fatigue were the most common.</p><p><strong>Conclusion: </strong>COVID-19 posed serious economic pressure on households. Self-employed and unemployed were the most affected. Continuous surveillance is needed to actively monitor the impact of COVID-19 in the community and safeguard the economic and health well-being of individuals and households.</p>","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10760987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139086459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Common Mental Disorders on Food Insecurity among Women in Butajira, Ethiopia: A Cohort Study","authors":"B. Endris, S. Gebreyesus, G. Medhin, M. Prince, A. Alem, L. Wissow, C. Hanlon","doi":"10.21203/rs.3.rs-26474/v1","DOIUrl":"https://doi.org/10.21203/rs.3.rs-26474/v1","url":null,"abstract":"Background:There is a growing body of evidence for an association between common mental disorders and food insecurity. However, since most studies have been cross-sectional, it has not been possible to differentiate the direction of the association. The aim of this study was to determine the effect of common mental disorders on food insecurity using a prospective cohort study design. Methods: The study was carried out in Butajira, south-central Ethiopiaamong mothers who were enrolled in the CMaMiEcohort. A total of 1815 enrolled women were evaluatedfor symptoms of CMD using the Self-Reporting Questionnaire-20 (SRQ-20) at two time points; August 2012 (time 1, T1) and in August 2014 (time 2, T2). Probable CMD was defined when mothers reportedsix or more affirmative (yes) responsesto the SRQ-20. Household food insecuritywas measured using the Household Food Insecurity Access Scale (HFIAS) in December 2017 (time 3, T3). Zero inflated negative binomial regression was used to determine the independent effects of CMDs at T1 and T2 on food insecurity score at T3. APoisson working model was also used to determine the risk of being severely food insecure associated with having CMD.","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44014401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Levels of the health system workforce’s competence and predictors to lead, manage, and govern in northwest Ethiopia","authors":"Yeshambel Agumas Ambelie, G. Alene, D. Gebrekiros","doi":"10.21203/rs.2.10541/v4","DOIUrl":"https://doi.org/10.21203/rs.2.10541/v4","url":null,"abstract":"\u0000 Aim: The purpose of this study was to determine the levels of competence and predictors to lead, manage, and govern among the health system workforce. Methods: A cross-sectional study was carried out in northwest Ethiopia. Eight hundred thirteen workforce were participated in the study. Competence to lead, manage, and govern was computed from 20 items. It was also leveled into four categories. Ordinal logistic regression analysis was conducted to identify predictors of this competence. Results: From 813 participants, 396 (48.7%) and 582 (71.6%) were females and service owners respectively. The estimates for low, moderate, high and very high levels of competence to lead, manage and govern were 41.3%; 42.7%; 13.5% and 2.5% respectively. Sex (p = .031) and responsibility (p = .019) were identified as main predictors. Conclusions: Competence to lead, manage and govern among the health system workforce in northwest Ethiopia is inadequate. Policymakers, program planners and researchers need to take action giving due attention to females and service owners. Feature research could be conducted considering hierarchical variables.","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47650614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatic veno-occlusive disease.","authors":"A. Bane","doi":"10.32388/8d4v06","DOIUrl":"https://doi.org/10.32388/8d4v06","url":null,"abstract":"","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44047267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}