ABSTRACT This study investigates the disparities of urban and rural land rights cadastral registration in Ethiopia, by using the Amhara region as a case study. Althoug h⁠ the country has made promising progress, especially through first and second-leve⁠l  rural land registration and certification programs, urban land  cadastral registratio n re mai⁠ns underdeveloped, characterized by incomplete coverage, institutional fragmentation, and widespread informal landholding. The study use d a mixed research method by c ollecting both quantitative and qualitative data. For the quantitative  data, about 385 respon⁠dents were surveyed across  six ru ral and urban sites, whereas the qualitative data we⁠r⁠e collected using ke y i⁠nformant interviews and focus group di⁠scussions. The research was conducted under university sponsorship during a period of restricted field acc⁠ess due to conflict-related⁠ limitations. The co llected d ata were analysed using both descriptive and thematic approaches to compare the⁠ urban and rural areas. The findings show deep stru⁠ctural disparities between urb an and rural a reas. Rura⁠l areas have achieved broader certi fication cover⁠age and higher percei ved tenure  security due to co⁠nsist⁠ent⁠ program i mplementat⁠ion, yet still face  ser ious challenges, including poor da⁠ta systems, limited skilled⁠ personne⁠l, weak enforcement, and reliance on customary practices. Urba n areas, w⁠hi le more technologically equipped and instit utionally resourced, stru ggle⁠ with legal ambiguities, fragmented governance, high registr⁠ation costs, and informality in peri-urban  zone⁠s. The cadastral disparities contribute to unequal tenure security, land disputes, unequal access to land⁠based credit, and unbalanced development outcomes. The study  concludes that minimizing the gaps needs harmonized legal frameworks, integrated and coordinated institutions, an d targeted support for both urban and rural cadastral systems. Responding to these issues is important for securing land rights, promoting equitable la n⁠d governance, and bringing sustainable development in Ethiopia Keywords: Cadastre, Land Rights, Urban-Rural Disparities, Land Tenure Security, Ethiopia.

Background: An estimated 75.8 under-five deaths per 1000 live births occurred in sub-Saharan Africa. This study aimed to investigate the prevalence and factors associated with under-five mortality in Sub-Saharan Africa. Methods: This study was based on secondary data sources from 33 Sub-Saharan countries’ recent Demography and Health surveys from 2010 to 2020. A weighted sample of 360,397 under-five children was included in the study. Bayesian multilevel binary logistic regression was fitted using the brms R package. Besides, leave one out information criteria was used for model comparison. The adjusted odds ratio (AOR) and its 95% credible interval (CrI) were reported for significant factors associated with under-five mortality. Clinical trial number: not applicable. Results: The prevalence of under-five mortality in sub Saharan Africa was 62 per 1000 live births (95%CI (56.29, 68.29). In sub region of SSA, it was 65 in central, 52 in eastern, 50 in southern and 73 in western region per 1000 live births. Multiple birth (AOR = 5.27; 95%CrI: 4.72, 5.87), number of under-five children 3 to 5 (AOR = 3.31; 95%CrI: 3.01, 3.60), caesarean section delivery (AOR = 1.64; 95%CrI: 1.47, 1.83), being unmarried (AOR = 1.16; 95%CrI 1.08, 1.26), using unimproved toilet (AOR = 1.08;95%CrI: 1.02, 1.16), birth order of 4th to 6th (AOR = 1.18; 95%CrI:1.1, 1.25),were risk factors of under-five mortality. Whereas, being female (AOR = 0.86; 95%CrI: 0.82, 0.91), preceding birth interval of 24–35 months (AOR = 0.61; 95%CrI: 0.57, 0.65) and above 36 months (AOR = 0.48; 95%CrI: 0.43, 0.49), ANC visit (AOR = 0.80; 95%CrI: 0.74 0.86), contraceptive use (AOR = 0.57; 95%CrI: 0.53, 0.61), were preventive factors of under-five mortality. Conclusion: Under-five mortality remains the highest in sub-Saharan Africa. Most of the risk factors of under-five mortality were found to be preventable. Policymakers and other stakeholders should enhance maternal education, lengthen birth interval, ANC visit, improved toilet facilities and, giving special attention to small size child and cesarean section delivery to reduce under-five mortality. Keywords: Under-five mortality, Associated factors, Bayesian, Sub-saharan Africa, DHS

Background: Despite progress in reducing neonatal mortality rates in Ethiopia, the country still has a high neonatal mortality rate compared with the global average. Primary hospitals are critical in delivering basic neonatal care, particularly in rural areas. However, data on neonatal mortality and contributing factors in these settings are scarce. This study aimed to determine the survival status and predictors of neonatal mortality among neonates admitted to Bichena Primary Hospital, Northwest Ethiopia.
Methods: A retrospective cohort study was conducted among 638 neonates admitted to the Bichena Primary Hospital neonatal intensive care unit from January 1, 2021, to April 30, 2023. Neonates were selected via a consecutive sampling method. Data were collected from medical records using a pretested checklist. A Kaplan-Meier survival curve was used to estimate the neonatal survival time, and a Cox proportional hazard regression model was used to identify independent predictors of neonatal mortality.
Results: Of the 638 neonates followed, 21.5% died during the study period. The overall incidence rate of death was 66.69 per 1,000 neonate days. Hypothermia, birth injury, perinatal asphyxia, preterm birth, maternal history of abortion, low birth weight, and neonatal hypoglycemia were independent predictors of neonatal mortality.
Conclusion and recommendation: The study found a high rate of neonatal mortality, exceeding rates reported in other regions of Ethiopia. Most predictors were preventable and treatable. Therefore, early identification of obstetric complications, immediate interventions and postnatal care are crucial to reduce neonatal mortality and enhance overall neonatal outcomes.
Keywords: Ethiopia; neonate; predictors; primary hospitals; survival status.

Weather information (WI) related reliability problems and constraints are commonly reported factors forfarmers’ adaptation decisions to climate-induced impacts in Ethiopia. However, the level of reliability of theWI, kinds of the WI constraints, and how these constraints impede farmers’ adaptation decisions have notsystematically been studied. The present study investigated the reliability and constraints of WI from farmers’perspective in East Gojjam Zone. Three hundred fifty-eight farm households were selected from three woredasthrough random sampling. Interview surveys, focus group discussions, and key informant interviews wereapplied to generate quantitative and qualitative datasets. Frequency, mean score, and correlation wereemployed to analyze the quantitative dataset, while descriptive-interpretative method was used to analyzethe qualitative ones. The findings disclosed that farmers in the study area have diverse WI sources thoughonly farmers’ own experiences and development agents were perceived to be reliable sources for them.The correlation coefficient results confirmed that the number of WI sources had significant positive relationswith family size, and farmland size, while it had a non-significant negative correlation with the farm experiencesof the household heads. The study also identified a range of socioeconomic, demographic and institutional factors, and programming mechanisms and information contents of which the four top that negatively affect farmers’ adaptation decisions were spatial ambiguity, lack of trust, lack of information about the seasonal onset, itsend, and its distribution within the season. To guide farmers’ effective adaptation decisions, these constraints inthe information contents of the WI have to be resolved.KeywordsWeather information, reliability, constraints, East Gojjam, Ethiopia 

Background: Diagnosing pulmonary tuberculosis (pTB) in children is challenging due to the difficulties in acquiring respiratory specimens, which unspecific and paucibacillary disease presentation, and the lack of sensitive diagnostic assays with non-invasive sample collection methods. As a result, millions of children around the world get tuberculosis (TB) each year, which is a leading cause of morbidity and mortality.  
Objective: The aim of this study was to assess the diagnostic accuracy of Stool and Respiratory Sample-based Genexpert MTB/RIF assay from presumptive TB among children in Northwest, Ethiopia.
 Methods and Materials: Hospital based cross-sectional with diagnostic accuracy study was conducted on consecutively recruited presumptive TB children. Data were collected by sem-structured questionnaires. Single respiratory (5ml) and 3g stool specimen were collected Lowenstein Jensen (LJ) and Xpert assay. Laboratory SOPs were strictly followed to assure the quality of whole procedures. The diagnostic accuracy of stool Xpert was evaluated against respiratory specimen Xpert, culture and composite reference standards (CRS). Sensitivity, specificity, and predictive values for the stool Xpert assay were calculated with a 95% confidence interval (95% CI) with MedCal statistical software. Data were entered in EPIData V4.2 and exported to SPSS 25 for further analysis.
Results: A total of 557 children were recruited; 510 of whom had complete microbiological results. Overall, pTB was diagnosed in 52/510 (10.2%) of the children with presumptive TB. Of these, only four had microbiologically unconfirmed pTB, were clinically diagnosed with positive response to anti-TB and the remaining 48 were microbiologically confirmed (Positive Xeprt and LJ culture). Stool specimen Xpert had sensitivity of 93.8 %( 95%CI: 82.8-98.6) and specificity of 99.8% (95%CI: 98.7–100) compared to culture; however, the sensitivity of stool was 88.5% (72-95.6) and specificity 100% (99.2-100) when compared to CRS. The Xpert on respiratory specimen had sensitivity and specificity of 95.8 % (85.8– 99.5) and 99.8% (98.7–100) to culture and 92.3 %( 81.4-97.9) and 100% (99.2-100) compared to CRS.
Conclusion: The sensitivity and specificity of Xpert assay for stool specimen is almost similar to that of respiratory specimen. Stool specimen is a highly promising alternative specimen in the diagnosis of pTB in children when respiratory specimen is impossible. 


Key words: Diagnostic accuracy, pulmonary tuberculosis, Xpert MTB/RIF, Stool, Children

 

Background: Hepatitis B virus (HBV) is highly infectious and poses significant global health challenges. Healthcare workers (HCWs) are particularly at risk of HBV infection due to occupational exposure through contact with infected blood or body fluids. To mitigate this risk, hepatitis B vaccination is recommended for all healthcare workers and is administered in three doses at 0, 1, and 6 months, aiming to reduce exposure and provide immunity against the virus. However, the effectiveness of the HBV vaccine remains uncertain in the study area.
Objective: This study aimed to evaluate hepatitis B vaccine efficacy and factors affecting vaccine effectiveness among healthcare workers in all Hospitals of East Gojjam Zone Amhara Region, North West Ethiopia
Materials and Methods: A hospital-based cross-sectional study was conducted among 422 healthcare workers from March 25, 2024, to November 30, 2024. Simple random sampling technique was used to recruit the study participants. Total sample size was allocated proportionally to each hospital. Socio-demographic and clinical data were collected using a pretested structured questionnaire. Moreover, venous blood samples (4–5 ml) were collected from the study participants, and serum samples were analyzed to measure and detect the concentrations of anti-hepatitis B surface antigen (anti-HBs), hepatitis B surface antigen (HBsAg), and anti-hepatitis B core antibody (anti-HBc) using a sandwich enzyme-linked immunosorbent assay (ELISA). Additionally, hepatitis B virus DNA (HBV DNA) was assessed using real-time polymerase chain reaction (qPCR). Data were analyzed using SPSS software version 25. Logistic regression model with 95% CI was used to show the statistical association. P value < 0.05 was considered as statistically significant.
Results: The overall sero-prevalence of HBsAg among all study participants was 23/422 (5.5%) (95% CI: 3.0-8.0). In multivariable logistic regression, blood transfusion (AOR: 16.5, 95% CI: 1.53, 29.24) (P<0.011) and dental extraction (AOR: 13.5, 95% CI: 3.99, 45.57) (P<0.000) were significantly associated with HBsAg positivity. In addition, the overall sero-reactivity of anti-HBc was 30/422 (7.1%) (95% CI: 5.0-10.0). Injectable medication (AOR: 4.3, 95% CI: 1.73, 10.72) (P<0.002) was significant determinant for anti-HBc sero-positivity. Furthermore, of fully vaccinated healthcare workers, 346/422 (82.0%) (95% CI: 78.0- 86.0 %) of them were sero-protected (had anti-HBs titer ≥ 10 mIU/ml). The paradoxical sero-positivity of HBsAg and anti-HBs among fully vaccinated healthcare workers was 16(4.6%). Moreover, among HBsAg-positive individuals, HBV DNA was detected in 17 (73.9%) of them.
Conclusions and recommendations: The study identified intermediate HBV seroprevalence among vaccinated healthcare workers, indicating suboptimal vaccine efficacy. These findings emphasize the necessity of monitoring post-vaccination anti-HBs antibody levels to address gaps in protection.
Keywords: Hepatitis B vaccine effectiveness, Healthcare workers, Hospitals   

Introduction: Growth monitoring and promotion services are strategies to promote child health and reduce child mortality. Even though Ethiopia is attempting different strategies to cope with the low rate of GMP utilization, the problem is still unresolved.
Objective: Determine the pooled proportion of GMP utilization and its contributing factors among children less than two years in Ethiopia.
Method: The review protocol was registered with PROSPERO, number CRD42023472746. The PRISMA-2020 statement guided the conduct of this review. Electronic databases and grey literature were used. Heterogeneity was evaluated using I2. Subgroup analysis was conducted. The random effect model was used to summarize the pooled effect sizes with their respective 95% CI with STATA version 17. To test the small study effect, the funnel plot and Egger’s test were applied.
Result: A total of seven (7) studies with 4027 participants were considered in this meta-analysis. The pooled proportion of GMP utilization reported by seven studies was 25.71% (95%CI: 24.39, 27.04). ANC follow-up (AOR = 2.11; 95% CI: 1.47, 2.76), PNC follow-up (AOR = 1.96; 95% CI: 1.44, 2.49), counseling (AOR = 2.88; 95% CI: 2.09, 3.68), maternal education (AOR = 2.89; 95% CI: 1.66, 4.13), paternal education (AOR = 3.78; 95% CI: 2.25, 5.32), family health card (AOR = 2.31; 95% CI: 1.67, 2.96), and mothers good knowledge towards GMP (AOR = 2.90; 95% CI: 1.72, 4.07) variables were positively associated with GMP service utilization.
Conclusion and recommendation: The pooled proportion of GMP remains low in Ethiopia. ANC and PNC follow-up, counseling, maternal and paternal education, family health cards, maternal knowledge towards GMP were significantly associated. Findings are essential for evidence-based policy making, intervention, and input for ongoing research.

Abstract Background: Hospitals usually encounter human, capital, and financial resource constraints which alerts the efficient use of allocated resources more than ever. Health system managers are required to identify inefficient hospitals and the drivers of the inefficiencies. Although there are multiple studies examining the efficiency of public hospitals in East Africa, their findings are often variable and inconsistent. Therefore, this study aimed to review published articles on technical efficiency of public hospitals in East African countries. Methods: A systematic search of published articles on the technical efficiency of public hospitals was employed using Pubmed, Cochrane library, and google scholar and thirteen studies were included to this review. The studies were described in terms of their publication year, sample size, inputs and outputs used in the efficiency analysis, and the technical efficiency levels. Finally, we assessed their quality and estimate the mean technical efficiency using meta-analysis. Results: The technical efficiency score of public hospitals varied across countries in east Africa which ranged from 0.64 ± 0.34 in Tanzania to 0.99 ± 0.03 in Ethiopia. The mean technical efficiency was 0.82 (95% CI = 0.56, 1.07) for primary hospitals and 0.88 (95% CI = 0.82, 0.95) for secondary level hospitals. Technical efficiency of public hospitals was negatively correlated with the number of hospitals (the sample size) and positively correlated with the number of inputs and outputs included in the efficiency analysis. Conclusions: This review revealed that the technical efficiency of public hospitals in east Africa requires an improvement. To enable effective and efficient hospital management and improvement in hospital efficiency, health man-agers and policymakers must identify the drivers of hospital inefficiency. Systematic reviews on public hospital efficiency, which are currently rare in Africa, should be conducted on a much larger scale in order to create more, and validated information for use in policy-making. Trial registration: This review protocol was registered and approved by the international prospective register of systematic reviews with a Protocol ID: CRD42023444729. Keywords: Technical efficiency, Hospitals, Data envelopment analysis, East Africa, Systematic review

ዐውድማ ሰብልን ለመውቃት ኣገልግሎት የሚውል በክብ ቅርጽ የሚዘጋጅ የራሱ የሆነ ሃይማኖታዊ ባህላዊ እና ኢኮኖሚያዊ ይትባህል ያለው በሃገራአችን ኢትዮጵያ ዘመን ተሻጋሪ ተግባር ነው። የዐውድማ ተግባር የጾታ፣ የ እድሜ እና መሰል ነገሮች የማይለያዩት ሁሉም በህብረት የሚመለከተውን ድርሻ የሚወጣበት፣ እንስሳቱም አስተዋጽኦ የሚያደርጉበት የአርሶአደሩ የመጨረሻ ውጤት የሚታይበት፣ ገለባው ለንእስሳት መኖ የሚሰበሰብበት ክዋኔ ነው።የዚህ ምርምር ዋና አላማ ዐውድማ በጎጃም አርሶ አደሮች ዘንድ ያለውን ባህላዊ፣ ሃይማኖታዊ እና ማህበራዊ ትውፊት በዐውዱ መተንተን፣ መሰነድ እና በሂደቱ ውስጥ የሚኖረውን የምርት ብክነት መንስኤዎችን መግለጽ ነው፡፡ ጥናቱ ያተኮረው በጤፍ፣ በስንዴና በገብስ ሰብሎች ላይ ነው። ጥናቱ  በምሥራቅ ጎጃም ዞን መልክአ ምድሩን መሠረት አድርጎ በተመረጡ ወረዳዎች ላይ ትኩረቱን አድርጓል፡፡ እነዚህም በደጋ፣ ወይና ደጋ እና ቆላማ ቦታዎች ላይ ትኩረት ተደርጎ የተመረጡ ናቸው፡፡ ጥናቱን የተሟላ ለማድረግ በፌኖሚኖሎጅ ዘዴ መረጃውን ከሚያውቁት ሰዎችና ከሚገኙበት ቦታ ድረስ በመሔድ በመስክ የቀጥታ ምልከታ ከቀዳማይ ምንጮች ለመሰብሰብ የሚያስችል ተጨባጭ የምርምር ዘዴ ነው፡፡ በመሆኑም በሃገራችን ኢትዮጵያ በተለይ በመረጥነው የምርምር ቦታ ዐውድማ ሃይማኖታዊ፣ ባህላዊ፣ ማህበራዊ እና ኢኮኖሚያዊ ጠቀሜት ያለው ከትውልድ ትውልድ ሲተላለፍ የመጣ የራሱ የሆነ ስነቃሎች ያሉት ጠቃሚ ስርዓት ነው። ነገር ግን አሁን ስርዓቱ እየቀዘቀዘ መምጣቱን እና አብሮነት እና መተጋገዝ እየጠፋ አቅመደካሞች በጋራ(ከብት የሌለው በጉልበቱ) የሚለውን ይትብሃል እንዳይጎለብት፣ በዐውድማ ክዋኔ ወቅት የሚኖረውን የምርት ብክነት ብቻ በማየት ጠቀሜታውን በመዘንጋት ወደ ዘመናዊ ኮምባይነር የመቀየር ተግባር መኖሩን በመረጃ ማረጋገጥ ተችሏል። አሁን በሚኖረው ሁኔታ በዐውድማ ስርዓት የሚኖሩ ሃይማኖታዊ፣ ባህላዊ እና ኢኮኖሚያዊ ክዋኔዎች በዚሁ ከቀጠሉ የሚረሱ እና የሚኖረው እሴት የሚጠፋ መሆኑን ድምዳሜ ላይ መድረስ ይቻላል። በመሆኑም እንደ ኢትዮጵያ ያሉ ሃገራት(የአርሶአደሩ የመሬት ጥበት፣ መልካምድሩ ገባ ወጣ ማለት፣የሰው ሃይል በብዛት ያለበት፣ለአቅመ ደካሞች የሚኖረውን ፋይዳ በመዘንጋት፣ የሰብሉ አደራረስ በተለያየ ጊዜ በሚደርስበት ወዘተ) ዐውድማ አስፈላአጊ ስርዓት በመሆኑ የሚመለከተው አካል ትኩረት እንዲሰጠው ማመላከት እንወዳለን።

AbstractPurpose – This study aims to identify determinants of single-family residential property values and fill the gap by analyzing respondents’ willingness to pay/receive data alongside real transaction data. Ordinal logistic regression and ordinal least square regression were used.Design/methodology/approach – Ordinal logistic regression effectively analyzes willingness-to-pay/receive data, accommodating the ordered nature of property value responses while incorporating multiple influencing factors. Ordinal least square regression quantifies the impact of continuous and categorical predictors on real transaction data.
Findings – Findings revealed strong associations between property values and several variables. Analysis of willingness-to-pay/accept data from 232 respondents showed significant impacts of factors such as the number of rooms, site area, construction material, property orientation, property age and proximity to bus stations and the central business district (p < 0.05). Similarly, ordinal least square regression analysis of transaction data confirmed the significance of most of these factors, except for property orientation, which indicates the difference of preference in the local market or reporting inconsistencies, demand further investigation. Variables such as views, proximity to wetlands, roads, green areas, religious institutions and schools were statistically insignificant across both data sets (p > 0.05).
Practical implications – It provides a robust basis for housing and urban development strategies. The stakeholders such as real estate developers, urban planners and policymakers are encouraged to incorporate these findings into housing policies, land value capture initiatives and urban planning frameworks to enhance residential property value and align with sustainable urban development goals.
Originality/value – This study contributes original insights into single-family residential property valuation by integrating willingness-to-pay and transaction data, substantiating the determinants of property value.
Keywords Appraisal, Ethiopia, Housing, Ordinal least square regression, Residential property, Value