Ethiopian Health Extension Workers' Training Status and Perceived Competency

BACKGROUND: Training and work experience are critical inputs for delivering quality health services. However, no nationwide assessment has been conducted on the status of training and the competency of Health Extension Workers (HEWs). Therefore, this study aimed to assess HEWs' pre service training status and perceived competency in Ethiopia. METHODS: The study was conducted in all regions and all HEWs training institutions in Ethiopia. We used cross sectional study design with a mixed method approach that included 585 HEWs, 1,245 HEW trainees, 192 instructors, and 43 key informants. Descriptive statistics and thematic analysis were used to analyse quantitative and quantitative data respectively. RESULT: Twenty-six percent of the HEWs said that they were competent to deliver all the HEP activities, and 73% of the HEWs said that they could confidently deliver 75% of the HEP activities. Receiving in-service training and having level III/IV qualifications are positively associated with the competency of HEWs. Similarly, HEP trainees perceived themselves as highly competent in executing their professional work, except in using computer and mobile health technology. Both instructors and trainees rated the quality of the curriculum and course materials positively. However, basic services and facilities in most training institutions were perceived to be inadequate. Additionally, individual learning, problem-solving, case-analysis, and assessment methods such as project work and portfolios were rarely practiced. CONCLUSIONS: Although the perceived competence of HEW trainees is high, the HEWs' training is not provided as per the curriculum because of limited resources. All the necessary resources should be made available to produce competent HEWs

Bullying in schools: prevalence, bystanders' reaction and associations with sex and relationships.

BACKGROUND: Bullying and peer victimization are the most pressing social problems affecting the wellbeing of children and adolescents. This study attempts to estimate the prevalence and examine the association of bystander's sex, her/his relationship with the victim and with the bully, and bystander's reaction to school bullying in East Gojjam Administrative Zone, Ethiopia. METHODS: This study followed an explanatory mixed-method study design. For the quantitative phase, 612 participants were selected using multistage cluster sampling techniques and for qualitative phase, 18 participants were selected using purposive sampling technique. We used self-reported questionnaires and semi-structured interviews to collect data from students attending grades 7, 8, 9, and 10. RESULTS: This study revealed that 55% of bystanders remained passive while 38% of them defended the victim upon witnessing bullying incidents. Pearson Chi-Square test for independence indicated a significant association between bystanders' relationship with the victim and/or bully, and bystanders' reaction. In contrast, sex has no significant association with bystanders' reaction. The semi-structured interview data also suggested that large number of bystanders most often stood by passively while some of them defended the victim. CONCLUSION: The practice of defending among students attending their education in governmental primary and secondary schools in East Gojjam Administrative Zone was low. Close social relationships (being close friends, relatives, and classmates) with the victim and bully were significantly associated with the practice of defending.