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      Environmental Health Services and Professionals Level of Engagement in Different Sectors in Eastern Ethiopia: A Mixed Methods Study Design

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          Abstract

          Introduction:

          Environmental health (EH) services have a long history in Ethiopia, but data on environmental health services quality and the magnitude of environmental health professionals’ engagement has never been addressed. This study was conducted to assess the quality of environmental health services in different sectors and professionals’ level of engagement in Eastern Ethiopia.

          Methods:

          Institution based cross-sectional mixed study design was implemented. A cluster sampling technique was employed to select 83 participants. Data were collected using a pretested questionnaire and an interview guide. Descriptive, bivariate, multivariate, and thematic analysis was carried out.

          Results:

          Professionals’ performance in most services were reported to be average or low. Only 19.5% of participants responded as having good satisfaction in their job. The multiple logistic regression analysis showed factors associated with selected environmental health services. The odds of identifying environmental problems was associated with profession (adjusted odds ratio (AOR): 4.1; 95% confidence interval (CI): 1.3-7.6) and level of education (AOR: 3.1; 95%CI: 0.9-5.9). The factors contributing to introducing innovative solutions to EH problems were type of institution (AOR: 3.1, 95%CI = 1.6-9.3), profession (AOR: 3.4, 95%CI = 1.1-12.2), and level of support and emphasis offered (OR: 5.6, 95% CI = 2.2-11.9). Level of job satisfaction was also associated with the above-mentioned independent variables.

          Conclusion:

          The current study showed low level of professionals’ engagement and factors associated with the quality of environmental health services in different sectors. Therefore, Ethiopian Federal Ministry of Health and other concerned ministries, agencies, and authorities should intervene accordingly to improve the service and level of professionals’ engagement.

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          Most cited references48

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          Community health extension program of Ethiopia, 2003–2018: successes and challenges toward universal coverage for primary healthcare services

          Background Ethiopia has been implementing a community health extension program (HEP) since 2003. We aimed to assess the successes and challenges of the HEP over time, and develop a framework that may assist the implementation of the program toward universal primary healthcare services. Methods We conducted a systematic review and synthesis of the literature on the HEP in Ethiopia between 2003 and 2018. Literature search was accomplished in PubMed, Embase and Google scholar databases. Literature search strategies were developed using medical subject headings (MeSH) and text words related to the aim of the review. We used a three-stage screening process to select the publications. Data extraction was conducted by three reviewers using pre-prepared data extraction form. We conducted an interpretive (not aggregative) synthesis of studies. Findings The HEP enabled Ethiopia to achieve significant improvements in maternal and child health, communicable diseases, hygiene and sanitation, knowledge and health care seeking. The HEP has been a learning organization that adapts itself to community demands. The program is also dynamic enough to shift tasks between health centers and community. The community has been a key player in the successful implementation of the HEP. In spite of these successes, the program is currently facing challenges that remain to be addressed. These challenges are related to productivity and efficiency of health extension workers (HEWs); working and living conditions of HEWs; capacity of health posts; and, social determinants of health. These require a systemic approach that involves the wider health system, community, and sectors responsible for social determinants of health. We developed a framework that may assist in the implementation of the HEP. Conclusion The HEP has enabled Ethiopia to achieve significant improvements. However, several challenges remain to be addressed. The framework can be utilized to improve community health programs toward universal coverage for primary healthcare services.
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            Community-Based Participatory Research: Lessons Learned from the Centers for Children’s Environmental Health and Disease Prevention Research

            Over the past several decades there has been growing evidence of the increase in incidence rates, morbidity, and mortality for a number of health problems experienced by children. The causation and aggravation of these problems are complex and multifactorial. The burden of these health problems and environmental exposures is borne disproportionately by children from low-income communities and communities of color. Researchers and funding institutions have called for increased attention to the complex issues that affect the health of children living in marginalized communities—and communities more broadly—and have suggested greater community involvement in processes that shape research and intervention approaches, for example, through community-based participatory research (CBPR) partnerships among academic, health services, public health, and community-based organizations. Centers for Children’s Environmental Health and Disease Prevention Research (Children’s Centers) funded by the National Institute of Environmental Health Sciences and U.S. Environmental Protection Agency were required to include a CBPR project. The purpose of this article is to provide a definition and set of CBPR principles, to describe the rationale for and major benefits of using this approach, to draw on the experiences of six of the Children’s Centers in using CBPR, and to provide lessons learned and recommendations for how to successfully establish and maintain CBPR partnerships aimed at enhancing our understanding and addressing the multiple determinants of children’s health.
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              The impact of the environment on health by country: a meta-synthesis

              Background Health gains that environmental interventions could achieve are main questions when choosing environmental health action to prevent disease. The World Health Organization has recently released profiles of environmental burden of disease for 192 countries. Methods These country profiles provide an estimate of the health impacts from the three major risk factors 'unsafe water, sanitation & hygiene', 'indoor air pollution from solid fuel use' and 'outdoor air pollution'. The profiles also provide an estimate of preventable health impacts by the environment as a whole. While the estimates for the three risk factors are based on country exposures, the estimates of health gains for total environmental improvements are based on a review of the literature supplemented by expert opinion and combined with country health statistics. Results Between 13% and 37% of the countries' disease burden could be prevented by environmental improvements, resulting globally in about 13 million deaths per year. It is estimated that about four million of these could be prevented by improving water, sanitation and hygiene, and indoor and outdoor air alone. The number of environmental DALYs per 1000 capita per year ranges between 14 and 316 according to the country. An analysis by disease group points to main preventions opportunities for each country. Conclusion Notwithstanding the uncertainties in their calculation, these estimates provide an overview of opportunities for prevention through healthier environments. The estimates show that for similar national incomes, the environmental burden of disease can typically vary by a factor five. This analysis also shows that safer water, sanitation and hygiene, and safer fuels for cooking could significantly reduce child mortality, namely by more than 25% in 20 of the lowest income countries.
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                Author and article information

                Journal
                Environ Health Insights
                Environ Health Insights
                EHI
                spehi
                Environmental Health Insights
                SAGE Publications (Sage UK: London, England )
                1178-6302
                21 January 2021
                2021
                : 15
                : 1178630220988554
                Affiliations
                [1-1178630220988554]Department of Environmental Health Science, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
                Author notes
                [*]Yohannes Tefera Damtew, Department of Environmental Health Science, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia. Email: yhnnstefera@ 123456gmail.com
                Author information
                https://orcid.org/0000-0003-2936-2462
                Article
                10.1177_1178630220988554
                10.1177/1178630220988554
                7829608
                14454528-e9b8-4803-bb8a-a80322601d3b
                © The Author(s) 2021

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 5 November 2020
                : 28 December 2020
                Categories
                Original Research
                Custom metadata
                January-December 2021
                ts1

                Public health
                environmental health,services,level of engagement,professionals,ethiopia
                Public health
                environmental health, services, level of engagement, professionals, ethiopia

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