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Yadate O, Yesuf A, Hunduma F, Habtu Y. Determinants of pneumonia among under-five children in Oromia region, Ethiopia: unmatched case-control study. Arch Public Health 2023; 81:87. [PMID: 37165410 PMCID: PMC10170023 DOI: 10.1186/s13690-023-01103-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 04/29/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Pneumonia is the single largest infectious disease that causes more under-five morbidity and mortality than any other infectious disease in the world, including Ethiopia. The aim of this study is to assess determinants of pneumonia among under-five children in the South West Shewa Zone, Oromia Region, Ethiopia, 2021. METHODS We used an unmatched case-control study design from March 15 to April 30, 2021, in the South West Shewa Zone, Ethiopia. A sample of 398 (199 cases and 199 controls) participated in the study. Trained data collectors through a pre-tested structured questionnaire collected data. We used Epi Info to enter data and analyzed using SPSS version 23. We described our data using descriptive statistics. We identified predictors of pneumonia using logistic regression analysis. We declared predictors of pneumonia at a P-value of 0.05 or less. RESULTS Breastfeeding for less than 6 months [AOR:3.51, 95%CI:(1.12,11.00)], lack of Vitamin A supplementation [AOR:3.56,95%CI:(1.58, 8.05)], history of URTI [AOR:9.66, 95%CI:(4.69,19.87)], family child care practices [AOR:6.46, 95%CI, (2.83,14.76)], sleeping with three to five persons in a room [AOR:2.90, 9%CI: (1.23,6.84)], having above five persons in a room [AOR: 3.88, 95%CI: 1.02,14.77), use of wood as a source of fuel [AOR = 3.02 95% CI: 1.41,6.46)] and not opening windows [AOR:2.56 95%CI: (1.21,5.41)] were independent factors of pneumonia among under five children. CONCLUSION Pneumonia is associated with breastfeeding for less than 6 months, lack of vitamin A supplementation, history of URTI, types of childcare practice, indoor overcrowding, use of wood as a source of fuel, and not opening windows. Therefore, exclusive breastfeeding, improving vitamin A supplementation, early control of respiratory tract infection through promoting good hygiene and ventilation strategies in crowded homes, and promoting how to reduce indoor air pollution through affordable clean stoves will be relevant interventions to reduce under-five pneumonia.
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Affiliation(s)
- Olana Yadate
- School of Public Health, St. Paul's Hospital Millennium Medical College, Addis Ababa City Administrative, Addis Ababa, Ethiopia
| | - Aman Yesuf
- School of Public Health, St. Paul's Hospital Millennium Medical College, Addis Ababa City Administrative, Addis Ababa, Ethiopia
| | - Fufa Hunduma
- School of Public Health, St. Paul's Hospital Millennium Medical College, Addis Ababa City Administrative, Addis Ababa, Ethiopia
| | - Yitagesu Habtu
- Department of Public Health, Hossana College of Health Sciences, Hossana City Administrative, Southern Ethiopia, Ethiopia.
- School of Public Health, Department of Preventive Medicine, Addis Ababa University, Addis Ababa City Administrative, Addis Ababa, Ethiopia.
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Temsesgen D, Wordofa B, Tesfaye T, Etafa W. Delay in seeking healthcare for pneumonia and associated factors among mothers/caregivers of children aged 2-59 months in public health facilities in Nekemte town, Ethiopia. BMC Pediatr 2023; 23:17. [PMID: 36635692 PMCID: PMC9835356 DOI: 10.1186/s12887-022-03825-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 12/27/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Pneumonia is the most significant infectious disease and the predominant cause of death among under-five children (U5C) in low- and middle-income countries. It is the second leading cause of death in Ethiopia. Delay in seeking healthcare is one of the contributing factors to pneumonia-associated mortality. There is a limitation to the study aimed at identifying health-seeking behavior and risk factors in the western part of Ethiopia. The study aimed to determine the level of delay in seeking healthcare for pneumonia and associated factors among caregivers of U5C in public health facilities in Nekemte town, Ethiopia. METHODS A health facility-based cross-sectional study was conducted from 1st March to 5thApril, 2022 using a structured interviewer-administered questionnaire to collect data from 410 caregivers of children aged 2-59 months. We used a systematic sampling technique for collecting the data. For analysis, data were entered into Epi Data version 4.6 and exported to SPSS version 25. Binary logistic regression was used to identify the associated factors of delay in seeking healthcare for pneumonia at a p-value < 0.05 using a 95% confidence interval (CI) in multivariable logistic regression. RESULTS A proportion of delays in seeking healthcare for pneumonia among children aged 2-59 months is 62.2%. Rural residence (AOR = 2.77, CI:2.48-5.17), child aged ≥12 months (AOR = 5.4,95%CI:4.17-7.20), monthly income < 1000 Ethiopian birr (AOR = 6.11,95%CI:2.16-17.26,), not using health insurance (AOR = 8.93,95%CI:5.43-14.68), use of self-medication (AOR = 10.97,95%CI:1.85-65.3), poor knowledge (AOR = 4.63,95%CI: 1.35-15.9), perceiving illness due to pneumonia as mild (AOR = 14.97,95%CI:9.76-22.9) and no previous admission history (AOR = 2.85,95%CI:1.77-4.56) were significant factors for delay in seeking healthcare for pneumonia among children aged 2-59 months. CONCLUSION The study emphasizes that caregivers' delay in seeking healthcare for pneumonia is high. Creating caregivers' awareness or providing adequate health education to develop early healthcare-seeking behavior and encouraging caregivers to use health insurance is essential.
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Affiliation(s)
- Dereje Temsesgen
- Department of Pediatrics and Child Health Nursing, Institute of Health Sciences, Wallaga University, Nekemte, Ethiopia
| | - Berhanu Wordofa
- grid.7123.70000 0001 1250 5688Psychiatry Nursing, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tewodros Tesfaye
- grid.7123.70000 0001 1250 5688Pediatric Program and Child Health Nursing, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Werku Etafa
- Department of Pediatrics and Child Health Nursing, Institute of Health Sciences, Wallaga University, Nekemte, Ethiopia
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Quach A, Spence H, Nguyen C, Graham SM, von Mollendorf C, Mulholland K, Russell FM. Slow progress towards pneumonia control for children in low-and-middle income countries as measured by pneumonia indicators: A systematic review of the literature. J Glob Health 2022; 12:10006. [PMID: 36282893 PMCID: PMC9595578 DOI: 10.7189/jogh.12.10006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background The integrated Global Action Plan for Prevention and Control of Pneumonia and Diarrhoea (GAPPD) has the goal of ending preventable childhood deaths from pneumonia and diarrhoea by 2025 with targets and indicators to monitor progress. The aim of this systematic review is to summarise how low-and-middle income countries (LMICs) reported pneumonia-specific GAPPD indicators at national and subnational levels and whether GAPPD targets have been achieved. Methods We searched MEDLINE, Embase, PubMed and Global Health Databases, and the World Health Organization (WHO) website. Publications/reports between 2015 and 2020 reporting on two or more GAPPD-pneumonia indicators from LMICs were included. Data prior to 2015 were included if available in the same report series. Quality of publications was assessed with the Quality Assessment Tool for Quantitative Studies. A narrative synthesis of the literature was performed to describe which countries and WHO regions were reporting on GAPPD indicators and progress in GAPPD coverage targets. Results Our search identified 17 publications/reports meeting inclusion criteria, with six from peer-reviewed publications. Data were available from 139 LMICs between 2010 and 2020, predominantly from Africa. Immunisation coverage rates were the indicators most commonly reported, followed by exclusive breastfeeding rates and pneumonia case management. Most GAPPD indicators were reported at the national level with minimal reporting at the subnational level. Immunisation coverage (Haemophilus influenzae, measles, diphtheria-tetanus-pertussis vaccines) in the WHO Europe, Americas and South-East Asia regions were meeting 90% coverage targets, while pneumococcal conjugate vaccine coverage lagged globally. The remaining GAPPD indicators (breastfeeding, pneumonia case management, antiretroviral prophylaxis, household air pollution) were not meeting GAPPD targets in LMICs. There was a strong negative correlation between pneumonia specific GAPPD coverage rates and under-five mortality (Pearson correlation coefficient range = -0.74, -0.79). Conclusion There is still substantial progress to be made in LMICs to achieve the 2025 GAPPD targets. Current GAPPD indicators along with country reporting mechanisms should be reviewed with consideration of adding undernutrition and access to oxygen therapy as important indicators which impact pneumonia outcomes. Further research on GAPPD indicators over longer time periods and at subnational levels can help identify high-risk populations for targeted pneumonia interventions.
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Affiliation(s)
- Alicia Quach
- Asia-Pacific Health Group, Murdoch Children's Research Institute, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Victoria, Australia
| | - Hollie Spence
- Murdoch Children's Research Institute, Victoria, Australia.,The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Cattram Nguyen
- Asia-Pacific Health Group, Murdoch Children's Research Institute, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Victoria, Australia
| | - Stephen M Graham
- Department of Paediatrics, The University of Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Victoria, Australia.,The Royal Children's Hospital, Parkville, Victoria, Australia.,Burnet Institute, Melbourne, Victoria, Australia
| | - Claire von Mollendorf
- Asia-Pacific Health Group, Murdoch Children's Research Institute, Victoria, Australia
| | - Kim Mulholland
- Department of Paediatrics, The University of Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Victoria, Australia.,London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Fiona M Russell
- Asia-Pacific Health Group, Murdoch Children's Research Institute, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Victoria, Australia
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The Impact of 3S2E Nursing Management on the Psychological Status of Respiratory Function and Quality of Life of Patients with Severe Pneumonia in the ICU. Emerg Med Int 2022; 2022:4949498. [PMID: 36193544 PMCID: PMC9525793 DOI: 10.1155/2022/4949498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/06/2022] [Accepted: 09/09/2022] [Indexed: 11/17/2022] Open
Abstract
Objective. This study examines the effects of the 3S2E nursing management mode on patients with severe pneumonia in the intensive care unit’s respiratory function, psychological status, and quality of life (ICU). Methods. According to a random number table, 82 ICU patients with severe pneumonia who were admitted between March 2021 and March 2022 were enrolled and assigned to the control and observation class (n = 41, respectively) in a 1 : 1 ratio. The observation class added 3S2E manner in addition to ordinary breastfeeding, whereas the control class received treatment in the usual nursing mode. The two groups’ preintervention and postintervention times for mechanical ventilation, white blood cell count (WBC) recovery, duration of hospital stay, problems, respiratory function, psychological state, and living quality were compared. Results. Fever time abatement, mechanical ventilation time, WBC recovery time, and length of hospital stay in the observation category were found to be shorter in comparison with the control class (
). In contrast to the other group, the observation group had fewer issues (
). Both teams’ oxygenation indices and SaO2 were higher after the intervention (
), with the observation team’s index being higher than the control group’s index. The total SAS and SDS scores of the two groups were less in the postintervention period than in the preintervention period, with the observational class having lower postintervention SAS and SDS ratings than the comparison group (
). The postintervention ratings in the observation class were higher than those in the control, and the World Health Organization Quality of Life (WHOQOL) scale scores in the 2 categories were greater after the intervention than they were before (
). Conclusion. 3S2E nursing management model improves respiratory function, alleviates negative emotions, and improves living quality in ICU patients with severe pneumonia.
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Tariku A, Berhane Y, Worku A, Biks GA, Persson LÅ, Okwaraji YB. Health postservice readiness and use of preventive and curative services for suspected childhood pneumonia in Ethiopia: a cross-sectional study. BMJ Open 2022; 12:e058055. [PMID: 35477882 PMCID: PMC9047705 DOI: 10.1136/bmjopen-2021-058055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 04/08/2022] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Pneumonia is the single-leading cause of infectious disease deaths in children under-5. Despite this challenge, the utilisation of preventive and curative child health services remains low in Ethiopia. We investigated the association between health post service readiness and caregivers' awareness of pneumonia services, care-seeking and utilisation of pneumonia-relevant immunisation in four Ethiopian regions. DESIGN AND SETTING This cross-sectional study was conducted in 52 districts of four regions of Ethiopia from December 2018 to February 2019. The health posts preparedness for sick child care was assessed using the WHO Health Service Availability and Readiness Assessment tool. Multilevel analyses were employed to examine the associations between health post readiness and household-level awareness and utilisation of services. PARTICIPANTS We included 165 health posts, 274 health extension workers (community health workers) and 4729 caregivers with 5787 children 2-59 months. OUTCOME MEASURES Awareness of pneumonia treatment, care-seeking behaviour and coverage of pentavalent-3 immunisation. RESULTS Only 62.8% of health posts were ready to provide sick child care services. One-quarter of caregivers were aware of pneumonia services, and 56.8% sought an appropriate care provider for suspected pneumonia. Nearly half (49.3%) of children (12-23 months) had received pentavalent-3 immunisation. General health post readiness was not associated with caregivers' awareness of pneumonia treatment (adjusted OR, AOR 0.9, 95% CI 0.7 to 1.1) and utilisation of pentavalent-3 immunisation (AOR=1.2, 95% CI 0.8 to 1.6), but negatively associated with care-seeking for childhood illnesses (AOR=0.6, 95% CI 0.4 to 0.8). CONCLUSION We found no association between facility readiness and awareness or utilisation of child health services. There were significant deficiencies in health post preparedness for services. Caregivers had low awareness and utilisation of pneumonia-related services. The results underline the importance of enhancing facility preparedness, providing high-quality care and intensifying demand generation efforts to prevent and treat pneumonia.
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Affiliation(s)
- Amare Tariku
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara Region, Ethiopia
- Department of Epidemiology and Biostatistics and Department of Reproductive Health and Population, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Yemane Berhane
- Department of Epidemiology and Biostatistics and Department of Reproductive Health and Population, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Alemayehu Worku
- Department of Epidemiology and Biostatistics and Department of Reproductive Health and Population, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Gashaw Andargie Biks
- Department of Health System and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Lars Åke Persson
- London School of Hygiene and Tropical Medicine, London, UK
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Yemisrach Behailu Okwaraji
- London School of Hygiene and Tropical Medicine, London, UK
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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Areru HA, Dangisso MH, Lindtjørn B. Low and unequal use of outpatient health services in public primary health care facilities in southern Ethiopia: a facility-based cross-sectional study. BMC Health Serv Res 2021; 21:776. [PMID: 34362376 PMCID: PMC8344135 DOI: 10.1186/s12913-021-06846-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 07/28/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Outpatient department visits per individual for each year are one of the core indicators of healthcare delivery to assess accessibility or quality of services. In addition, this study aimed to assess health service utilisation and disease patterns in southern Ethiopia, by including the health authorities' suggestions to improve the services. No study has assessed this in Ethiopia previously. METHODS An institution-based cross-sectional design study was done in 65 primary health care units in Dale and Wonsho districts, in Sidama region, for all patients visiting health facilities from 1 July 2017 to 30 June 2018. We estimated the utilisation rate as visits per person per year, the odds ratio for health use and proportions of diseases' diagnoses. The results of our study were presented to local health authorities, and their suggestions for improvements were incorporated into the analysis. RESULT A total of 81,129 patients visited the health facilities. The annual outpatient health service utilisation was 0.18 (95% CI: 0.18-0.19) new visits per person per year. The health service utilisation rate per year for the rural population was lower than the urban utilisation by 91% (OR = 0.09; 95% CI: 0.08-0.09). Children in the age group of 5-14 years had lower odds of health service utilisation by 78% (OR = 0.22; 95% CI: 0.21-0.23), compared to children under 5 years of age. Females were four times (OR = 4.17; 95% CI: 4.09-4.25) more likely to utilise health services than males. Febrile illness constituted 17.9% (14,847 of 83,148) of the diagnoses in all age groups. Almost half of the febrile cases, 46.5% (3827 of 8233), were among children under 5 years of age. There were very few cases of non-communicable diseases diagnosed in the health facilities. The health authorities suggested improving diagnostic capacities at health centres, enhancing health professionals' skill and attitudes, and improving affordability and physical accessibility of the services. CONCLUSION The health service utilisation rate was low in Sidama. The use of health services was lower among rural residents, men, children and elderly, and health post users. Improving the quality, affordability and accessibility of the health services, by involving responsible stakeholders could increase service usage.
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Affiliation(s)
- Hiwot Abera Areru
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, P.O.BOX: 1560, Hawassa, Ethiopia
- Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway
| | - Mesay Hailu Dangisso
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, P.O.BOX: 1560, Hawassa, Ethiopia
| | - Bernt Lindtjørn
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, P.O.BOX: 1560, Hawassa, Ethiopia
- Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway
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Tariku A, Okwaraji YB, Worku A, Biks GA, Åke Persson L, Berhane Y. Prevention and treatment of suspected pneumonia in Ethiopian children less than five years from household to primary care. Acta Paediatr 2021; 110:602-610. [PMID: 32478446 PMCID: PMC7891650 DOI: 10.1111/apa.15380] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 05/18/2020] [Accepted: 05/26/2020] [Indexed: 11/28/2022]
Abstract
Aim Ethiopia has implemented the integrated community case management to reduce mortality in childhood diseases. We analysed prevention, care seeking and treatment of suspected pneumonia from household to health facility in Ethiopia. Methods Analyses were based on a survey in four regions that included modules covering 5714 households, 169 health posts with 276 health extension workers and 155 health centres with 175 staff. Caregivers of children aged 2‐59 months responded to questions on awareness of services and care seeking for suspected pneumonia. Pneumonia‐related knowledge of health workers was assessed. Results When a child had suspected pneumonia, 46% (95% CI: 25,68) sought care at health facilities, and 27% (95% CI: 12,51) received antibiotics. Forty‐one per cent had received full immunisation. One‐fifth (21%, 95%: 19,22) of the caregivers were aware of pneumonia treatment. Sixty‐four per cent of the health extension workers correctly mentioned fast or difficult breathing as signs of suspected pneumonia, and 88% suggested antibiotics treatment. Conclusion The caregivers' awareness of suspected pneumonia treatment and the utilisation of these services were low. Some of the health extension workers were not knowledgeable about suspected pneumonia. Strengthening primary health care, including immunisation, and enhancing the utilisation of services are critical for further reduction of pneumonia mortality.
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Affiliation(s)
- Amare Tariku
- Department of Human Nutrition Institute of Public Health College of Medicine and Health Sciences University of Gondar Gondar Ethiopia
- Addis Continental Institute of Public Health Addis Ababa Ethiopia
| | - Yemisrach B. Okwaraji
- Ethiopian Public Health Institute Addis Ababa Ethiopia
- London School of Hygiene & Tropical Medicine London UK
| | - Alemayehu Worku
- Addis Continental Institute of Public Health Addis Ababa Ethiopia
- School of Public Health Addis Ababa University Addis Ababa Ethiopia
| | - Gashaw Andargie Biks
- Department of Health System and Policy College of Medicine and Health Sciences Institute of Public Health University of Gondar Gondar Ethiopia
| | - Lars Åke Persson
- Ethiopian Public Health Institute Addis Ababa Ethiopia
- London School of Hygiene & Tropical Medicine London UK
| | - Yemane Berhane
- Addis Continental Institute of Public Health Addis Ababa Ethiopia
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Lindtjørn B. Could devolving pneumonia treatment to local health centres reduce mortality in developing countries? Acta Paediatr 2021; 110:389-390. [PMID: 33034067 DOI: 10.1111/apa.15584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 12/21/2022]
Affiliation(s)
- Bernt Lindtjørn
- Centre for International Health University of Bergen Bergen Norway
- School of Public Health Hawassa University Hawassa Ethiopia
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