Social and Ecological Aspects of Resettlement and Villagization among the Konso of Southwestern Ethiopia

Primary health care in Ethiopia under three political systems: community participation in a war-torn society

This paper examines primary health care (PHC) development with an emphasis on community participation in Ethiopia under the feudal regime of emperor Haile Sellassie, the socialist/military rule of Mengistu Haile Mariam and the sprouting democracy and free market economy of Meles Zenawi. In spite of the rapid expansion of primary care under Mengistu, community participation was hampered by the protracted war and centralized, urban-based, bureaucratic approaches and attitudes that failed to promote an enabling environment for community participation. The socialist government, although implementing various community programs and expanding the rural health services, did not succeed in revolutionizing the health services. A comparative examination of the democratized rebel health services of the Eritrean People's Liberation Front (EPLF) and the Tigray People's Liberation Front (TPLF) illustrates the inconsistencies between stated policies of the Ethiopian government and actual strategies, and identifies factors promoting and impeding participatory health care development in a war environment. Achievements, opportunities and potential dangers to PHC and community participation in the post-war era characterized by economic progress, democratization, decentralization, lingering ethnic conflict and private initiatives are briefly described.

Visceral leishmaniasis in Ethiopia. IV. Prevalence, incidence and relation of infection to disease in an endemic area

In a population of some 4600 people in southern Ethiopia, in which visceral leishmaniasis is endemic, 142 cases were recorded in an 8-year period to 1990. The cases were very unequally distributed between the six villages studied, with more than 90% in the four which were closest to the uninhabited valley of the Segen River. It was deduced that transmission occurs in the villages at lowest altitude, as well as in the Segen Valley. The youngest children were rarely affected and half as many cases were females as males. In a year-long intensive study, annual incidence of disease was estimated at 6.9/1000 in the whole population. Incorporating the results of previously published immuno-epidemiological studies, the annual incidence of disease in susceptible people was calculated as 1.9% while the rate of immunoconversion was 5.6 times greater. This indicates a high incidence of abortive or cryptic cases, but it remains to be demonstrated whether or not these cases are sources of infection.