Africa: World Bank and WHO: Half The World Lacks Access to Essential Health Services

PRESS RELEASE

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Tokyo — At least half of the world’s population cannot obtain essential health services, according to a new report from the World Bank and the World Health Organization. And each year, large numbers of households are being pushed into poverty because they must pay for health care out of their own pockets.

Currently, 800 million people spend at least 10 percent of their household budgets on health expenses for themselves, a sick child or other family member. For almost 100 million people these expenses are high enough to push them into extreme poverty, forcing them to survive on just $1.90 or less a day. The findings, released today in Tracking Universal Health Coverage: 2017 Global Monitoring Report, have been simultaneously published in Lancet Global Health.

“It is completely unacceptable that half the world still lacks coverage for the most essential health services,” said Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “And it is unnecessary. A solution exists: universal health coverage (UHC) allows everyone to obtain the health services they need, when and where they need them, without facing financial hardship.”

“The report makes clear that if we are serious – not just about better health outcomes, but also about ending poverty – we must urgently scale up our efforts on universal health coverage,” said World Bank Group President Dr. Jim Yong Kim. “Investments in health, and more generally investments in people, are critical to build human capital and enable sustainable and inclusive economic growth. But the system is broken: we need a fundamental shift in the way we mobilize resources for health and human capital, especially at the country level. We are working on many fronts to help countries spend more and more effectively on people, and increase their progress towards universal health coverage.”

There is some good news: The report shows that the 21st century has seen an increase in the number of people able to obtain some key health services, such as immunization and family planning, as well as antiretroviral treatment for HIV and insecticide-treated bed nets to prevent malaria. In addition, fewer people are now being tipped into extreme poverty than at the turn of the century.

Progress, however, is very uneven.

There are wide gaps in the availability of services in Sub-Saharan Africa and Southern Asia. In other regions, basic health care services such as family planning and infant immunization are becoming more available, but lack of financial protection means increasing financial distress for families as they pay for these services out of their own pockets. This is even a challenge in more affluent regions such as Eastern Asia, Latin America and Europe, where a growing number of people are spending at least 10 percent of their household budgets on out-of-pocket health expenses. Inequalities in health services are seen not just between, but also within countries: national averages can mask low levels of health service coverage in disadvantaged population groups. For example, only 17 percent of mothers and children in the poorest fifth of households in low- and lower-middle income countries received at least six of seven basic maternal and child health interventions, compared to 74 percent for the wealthiest fifth of households.

The report is a key point of discussion at the global Universal Health Coverage Forum 2017, currently taking place in Tokyo, Japan. Convened by the Government of Japan, a leading supporter of UHC domestically and globally, the Forum is cosponsored by the Japan International Cooperation Agency (JICA), UHC2030, the leading global movement advocating for UHC, UNICEF, the World Bank, and WHO. Japanese Prime Minister Shinzo Abe, UN Secretary-General Antonio Guterres, World Bank President Kim, WHO Director-General Tedros and UNICEF Executive Director Anthony Lake will all be in attendance, in addition to heads of state and ministers from over 30 countries.

“Past experiences taught us that designing a robust health financing mechanism that protects each individual vulnerable person from financial hardship, as well as developing health care facilities and a workforce including doctors to provide necessary health services wherever people live, are critically important in achieving ‘Health for All,'” said Mr. Katsunobu Kato, Minister of Health, Labour and Welfare, Japan. “I firmly believe that these early-stage investments for UHC by the whole government were an important enabling factor in Japan’s rapid economic development later on.”

The Forum is the culmination of events in over 100 countries, which began on Dec. 12—Universal Health Coverage Day—to highlight the growing global momentum on UHC. It seeks to showcase the strong high-level political commitment to UHC at global and country levels, highlight the experiences of countries that have been pathfinders on UHC progress, and add to the knowledge base on how to strengthen health systems and effectively promote UHC.

The main high-level sessions of the Forum take place tomorrow, Dec. 14, and will also feature an all-day “innovation showcase,” highlighting innovations driving progress in health systems around the world, and a celebratory public event in the evening. A commitment to action, called the Tokyo Declaration on Universal Health Coverage, will be released during the Forum’s closing ceremony.

“Without health care, how can children reach their full potential?  And without a healthy, productive population, how can societies realize their aspirations?” said UNICEF Executive Director Anthony Lake. “Universal health coverage can help level the playing field for children today, in turn helping them break intergenerational cycles of poverty and poor health tomorrow.”

Building on the G7 Ise-Shima Summit and the TICAD VI in 2016, both of which stress the need for UHC, the Forum in Tokyo is seen as a milestone for accelerating progress towards the target of UHC by 2030, a key part of the Sustainable Development Goals. Countries will then gear up for the next global moment: a high-level meeting of the UN General Assembly on UHC in 2019.

Source : World Bank

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Citizens demand better healthcare in Pakistan — and get it

By Kashif Ali, Acting Director of Resources, Transparency International Pakistan

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One of the problems Transparency International Pakistan hears about most often at its Advocacy and Legal Advice Center(ALAC) is that of the deplorable state of the health sector. Complaints usually fall under a wide spectrum of issues: absent doctors, lack of available beds, substandard facilities, poor rapport between doctors and patients and a lack of cleanliness.

Infrastructure is a major challenge in many government hospitals in Pakistan, but a more pressing problem is doctor absenteeism and inadequate levels of staff.

Doctors in public hospitals in Pakistan are not allowed to work in private clinics while they should be treating patients in a public hospital. But a lack of transparency and proper enforcement of the rules means that many doctors continue to see their private patients when they are supposed to be at the hospital.

Transparency International Pakistan came across one such case during a Mobile ALAC visit to Usta Muhammad, in Jaffarabad, Balochistan province in January 2017.

The citizens of Usta Muhammed told us that their hospital not only lacked even the most basic facilities but also that the doctors were running their own private clinics. The hospital didn’t even have a single ambulance available for the entire population of more than one hundred thousand people.

Transparency International Pakistan took up the matter with the authorities.

In response, they stepped into action and formed a committee to take prompt action to redress this issue. Four months later, the people of Usta Muhammad told us that conditions in the government hospital was were much better: doctors were no longer absent and were visiting patients regularly. There was also more medicine available to patients.

Furthermore, the provincial Health Ministry announced a ban on private practices by state hospital doctors during normal working hours, and has given instructions to the district administration for effectively implementing this policy.

The story highlights the importance of giving citizens a channel through which they can voice their concerns. Transparency International Pakistan’s Mobile ALAC can get to the front lines of corruption and take action so that essential public services are properly delivered.

Source :  Transparency International

Africa: Focused On Ending Hunger, Africa Neglects Rising Obesity

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Dakar — In Africa people are often unaware that highly processed foods are unhealthy and do not necessarily see being overweight as a problem

Focused for decades on ending hunger, African countries have largely failed to address a rising obesity epidemic that could soon become the greater public health crisis, experts said as new data was released.

A quarter of the world’s 41 million overweight children under five live in Africa, a figure that has nearly doubled on the continent in the last two decades, according to the Global Nutrition Report published on Saturday.

There are still six times more children on the continent whose growth is stunted from malnutrition, and that number is also increasing, the report said.

But noncommunicable diseases such as diabetes and heart disease, most of which are obesity-related, are expected to become the biggest killer in Africa by 2030, according to the World Health Organisation (WHO).

“Diets are changing, but they are not becoming more nutritious,” said Corinna Hawkes, co-chair of the Global Nutrition Report.

“We’re worried that because attention hasn’t been paid to this issue, obesity has had the space to grow,” she told the Thomson Reuters Foundation.

More than 30 percent of adults in Africa are overweight, according to WHO, with obesity rates nearing 10 percent even in very poor countries such as Sierra Leone and Liberia.

In some places people are both overweight and malnourished, experts said. Sometimes a mother is obese but her children are stunted, said Hawkes.

Highly processed foods have become increasingly affordable and available worldwide, which is one of the primary drivers, said Bruce Lee, executive director of the Global Obesity Prevention Center at Johns Hopkins University.

Moreover, in Africa people are often unaware that these foods are unhealthy and do not necessarily see being overweight as a problem, he said.

“If you have a country where the concern was always not getting enough food, it’s going to take a while to shift people’s perceptions,” Lee told the Thomson Reuters Foundation.

West Africa’s regional health organisation (WAHO) makes no mention of weight gain or obesity in all 60 pages of its 2016-2020 strategic plan, although it notes “alarming” rates of diabetes and growing prevalence of high blood pressure.

Aid organisations that address hunger should adapt their existing programs to also prevent obesity, said Hawkes.

School meal programmes in West Africa, for example, are usually focused on making sure children get enough food but sometimes have no standards for quality, she said.

Obesity-related conditions are usually expensive to treat and will take a heavy toll on developing countries’ economies, experts say.

“If we invest in nutrition, we’ll be helping to achieve other development goals,” said Hawkes. “This is not a side issue.”

(Reporting By Nellie Peyton; Editing by Ros Russell; Please credit Thomson Reuters Foundation, the charitable arm of Thomson Reuters, that covers humanitarian news, women’s rights, trafficking, property rights, and climate change. Visit http://www.trust.org)

Our Standards: The Thomson Reuters Trust Principles.

Source : Thomas Reuters Foundation

The Novartis Foundation launches Healthy Schools for Healthy Communities with the University of Basel and other partners

PRESS RELEASE

The DASH study provided evidence that improvements in children’s nutrition and physical activity not only contributes to their cognitive performance in school, but can also contribute to a reduction of hypertension, heart disease, and overall cardiovascular risk factors
BASEL, Switzerland, October 11, 2017/ — The Novartis Foundation (www.NovartisFoundation.org) and the University of Basel (http://APO.af/QvHtDX), together with other partners are pleased to announce the launch of Healthy Schools for Healthy Communities. The initiative aims to address poor health in disadvantaged schools in South Africa and is the first Novartis Foundation program to include the education sector, bringing new opportunities for achieving impact.

Following the successful first stage of the Disease, Activity and Schoolchildren’s Health (DASH) research project, coordinated by the University of Basel in Port Elizabeth, South Africa, this second phase builds on learnings to further develop and scale successful interventions to more schools in the country, and potentially across other geographies in the future.

The goal of Healthy Schools for Healthy Communities (known locally as ‘KaziBantu’) is to improve the overall and cardiovascular health of schoolchildren and their teachers. Its focus will be on promoting health literacy, ensuring a formalized physical exercise program, providing access to medical examinations including anti-helminthic treatment, monitoring cardiovascular risk factors and providing nutritional supplementation where necessary.

In 2014, a partnership between the University of Basel (http://APO.af/QvHtDX), the Nelson Mandela University [1] (www.Mandela.ac.za) and the Swiss Tropical and Public Health Institute (http://APO.af/DGkMqD) created the DASH project to identify the causes and address the impact of poor health on children in schools from disadvantaged neighborhoods in Port Elizabeth.

The program investigated the health and wellbeing of children in eight schools, with a particular focus on the link between physical activity, infectious diseases and risk factors for cardiovascular and metabolic disease. This study was the first of its kind for African children and discovered that one-third of all examined schoolchildren had high blood pressure, while 16-21% were overweight or obese. [2]

The DASH study provided evidence that improvements in children’s nutrition and physical activity not only contributes to their cognitive performance in school, but can also contribute to a reduction of hypertension, heart disease, and overall cardiovascular risk factors. Physical activity was also found to correlate with health-related quality of life. To date, little to no comprehensive interventions have been examined to address cardiovascular health among students and teachers in low-income school settings. The aim of this expansion phase from DASH to Healthy Schools for Healthy Communities is therefore to generate the evidence that simple interventions can improve cardiovascular health.

“At the Novartis Foundation, we realize that the complex nature of cardiovascular diseases makes achieving impact, scale and sustainability extremely difficult. No single actor can tackle hypertension alone and to address hypertension and its complications, multisector and multidisciplinary action is needed. That is why we are excited for Healthy Schools for Healthy Communities to enter this new phase, and to work to further develop the initiative with our partners,” said Ann Aerts, Head of the Novartis Foundation.

In collaboration with many partners, the Novartis Foundation is working to address hypertension around the world – from pilot models to approaches that aim to achieve impact at scale from the start.

Launched this year, Better Hearts Better Cities convenes networks of multisector partners to contribute expertise and resources to solutions that improve cardiovascular health at scale in cities.

The other hypertension programs supported by the Novartis Foundation – Communities for Healthy Hearts in Vietnam and the Community-based Hypertension Improvement Project (ComHIP) in Ghana – aim to bring hypertension detection and management closer to local communities by maximizing hypertension screening and awareness opportunities.

As its first program to include the education sector, Healthy Schools for Healthy Communities marks an important next step in the Novartis Foundation’s multisector approach to addressing hypertension. As with all our programs, learnings from Healthy Schools for Healthy Communities will inform other hypertension initiatives as part of an ongoing process of evaluation and adaptation.

The Novartis Foundation’s partners for this initiative include the University of Basel, the Government of South Africa, the Nelson Mandela University, and the Swiss Tropical and Public Health Institute (Swiss TPH).

Hedwig Kaiser, former Vice President for Education at the University of Basel, notes that “KaziBantu or Healthy Schools for Healthy Communities offers an opportunity to continue the successful work we have already started, continue to make improvements and, through collaboration, impact the lives of many more children in South Africa.”

“To address rising rates of obesity and poor heart health, we all need to work together and start early. Through KaziBantu, if we can build health literacy and foster better health in our children from a young age, then we can look toward healthier generations in the future,” stated Professor Lungile Pepeta, the Dean in the Faculty of Health Sciences at the Nelson Mandela University.

Peter Steinmann from Swiss TPH said, “Our research during the DASH program found that a third of children were hypertensive. This is a staggering number when you consider these are children in primary school. We’re pleased to be part of the continuation of this project and hope it will be able to positively impact the lives of many more children in the future.”

Source : APO

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National Allied Health Professionals Condemn the Commercialization of Health Facilities in Nigeria

The National Union Of Allied Health Professionals(NUAHP) has again condemned the  commercialization of the nation’s  health sector, which it described as a disservice to Nigerians.

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The union made this position known recently, in a communique it issued and signed by the union’s National President and  General Secretary, Dr. O.C Ogbonna and O.A Obisesan  respectively at the end of its  National  Executive Council Meeting in Jos, Plateau state.

 

” The Union once again condemns in strong terms the commercialization of Public health facilities in the name of Public Private Partnership (PPP) concept to a profit making venture to the detriment of patients/clients which has led to untold hardship on Nigerians. We therefore demand that the original concept of PPP which was meant to make quality healthcare available, accessible and affordable be reverted to, so that all Nigerians anytime can access quality health care services in the government owned hospitals. The union say No to privatization and commercialization”.

The communique maintained that the union was still contending with a number of challenges, stating ”The Union noted with dismay, the discriminatory act of the Federal Ministry of Health (FMOH) in actualizing the central placements of House Officers while neglecting Interns of other Health Professions. The Union therefore demand that the FMOH should immediately include interns of the other Health Professions in the proposed central placement scheme for equity, fairness, justice and to avoid marginalization of other Health Professionals”.

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”The Union expresses serious concerns and frown at the unnecessary delay of appropriate agencies which includes FMOH, Office of the Secretary to the Federal Government (SGF), Salaries Incomes and wages Commission (NSIWC) in coming up with the approved adjusted CONHESS Salary Scale. The Union hereby demands the immediate release of the scale and implementation effective from Jan, 2014. If this is not done on or before August, 31st, 2017. The Union may be forced against her wish to declare industrial strike to press home her demands”.

The Union observes the consistent high level of attrition of Health professionals due to retirement, death, or relocation to greener pastures without replacement. This has brought acute shortage of man power and heavy work load on Health Professionals. In the same vein, the Union frowns at the illegality of employing locum/volunteer workers rather than the employment of permanent staff”, the communique concluded

 

 

 

 

 

 

 

 

South Sudan: Botched Vaccine Campaign Kills 15 Children in South Sudan

At total of 15 children have died in South Sudan after being given contaminated measles vaccines. Health officials said that the vaccines had been improperly refrigerated and were also administered by an untrained team.

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The UN has appealed for more funding to help nearly two million people who have fled South Sudan. A World Food Programme (WFP) official called their suffering “unimaginable.” (15.05.2017)

A new study has found that cases of the highly contagious disease have jumped significantly in the past year. Adults are poorly informed about their own vulnerability, the report found. (24.04.2017)

Children in rural South Sudan died as a result of a bungled vaccination campaign to combat measles, the United Nations and South Sudan’s government announced on Friday.

South Sudanese Health Minister Riek Gai Kok expressed “deep regret and sadness” at the deaths of the 15 children, who lived in the rural, south-eastern village of Kapoeta.

An investigation into the deaths supported by the World Health Organization (WHO) and the UN children’s fund UNICEF found that the children died as a result of “the administration of a contaminated vaccine.”

Around 300 children up to 5-years-old were treated during the four-day campaign which saw the local team using a single reconstitution syringe to mix multiple vaccine vials. The UNICEF-supplied vaccines were also kept in a building with inadequate refrigeration.

Another 32 children suffered from fever, vomiting, and diarrhea, but were able to recover from their symptoms, a joint statement from the WHO and UNICEF said.

Children administering vaccines

Although local teams had been trained by development partners and the WHO, the investigation showed that local officials failed to follow immunization guidelines.

“We have to look into why the training was not passed on to the teams on the ground,” said WHO spokesman Tarik Jasarevic in Geneva.

South Sudanese Health Minister Kok also noted that the team that administered the vaccines was not well-trained.

“The team that vaccinated the children in this tragic event were neither qualified nor trained for the immunization campaign,” Kok told a news conference.

The untrained team also recruited two children aged 13 and 12-years-old to administer the vaccines, the health minister added.

The risk of measles remains high in South Sudan due to an ongoing military conflict that has killed tens of thousands and seen almost 2 million people flee the country. According to the UN, the country has suffered from measles outbreaks caused by a backlog of unvaccinated children.

Source : DW

An Health System To Watch

Poor infrastructure and equipment which are inadequate and gradually becoming obsolete characterize Government owned hospitals.

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Despite this fact, fees charged at the hospitals are cut throat, even as the prevalence of diseases has become the order of the day.

Several states are presently contending with the outbreak of meningitis.

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Incessant industrial action by medical and health workers, declining productivity and corruption are stumbling blocks in the health system in Nigeria, which is a suggestion that Government attaches little importance to the health status of Nigerians.

The major discussion among most Nigerians include how Government can increase the life expectancy of citizens, by ensuring high and substantial levels of immunization against all vaccine preventable diseases.

With the access to primary health care hinged on substantial Government support still the issue, the eradication, control and prevention of epidemic diseases remains a mirage.

Happenings around the country and the sight of helpless patients, who are left to their fate, calls for concern and worry.

Health professionals are not in the right frame of mind to give their best, as a result of poor remuneration and working conditions. Government remains unshaken, despite the rising number of deaths recorded at the various hospitals on a daily basis.

Nigerians, up till this moment, do not know the cornerstone of the health policy of the present administration in the country, even though a well bred and well educated scholar, is at the helm of  affairs in the health Ministry.

These days, most Nigerians are  taking every precaution not to migrate from their present status to that of an hospital patient, however, should in case  the inevitable happen, such people take solace in traditional medicine.

Is this good, for a country, endowed with an impressive  combination of human and natural resources ? Definitely not, but the praise singers still live in ”fantasy Island”.

Cases of Suicide Attempts On The Increase In Nigeria-Consultant Psychiatrist

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A Consultant Psychiatrist has said that over 10 per cent of referral cases at the Lagos University Teaching Hospital(LUTH),Lagos, Nigeria were suicide attempts.

According to Dr. Yewande Oshodi, who made this declaration at a programme organized by the hospital to campaign against suicide,the increasing rate of suicide in the country, could be attributed to the stigma associated with mental health .

”The stigma of psychotics and mental health makes it difficult for people to come out when they are going through issues”, Dr. Oshodi said.

She maintained that over a five-year study period, 7.2 per cent of the cases referred to psychiatry consultation-liaison services in LUTH were suicide related cases, while noting that  reports had shown that during lifetime, about 3.0 per cent of Nigerians have had thoughts of ending their lives, 1.0 per cent will plan on how to kill themselves, while just under 1.0 per cent will carry out the actual attempt.

Dr Oshodi also disclosed that suicide was the most unfortunate incident anyone could like to experience or lose a loved one to.

Anxious Indigent Oyo Residents Await Free Medical Services

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Residents of  Ibadan have expressed gratitude to the Federal Government, on its  soon to commence Free Medical services for indigent citizens at the University College Hospital(UCH)Ibadan, Nigeria.

The Federal Government had  stated through the Chief Medical Director of the hospital, Prof. Temitope Alonge  that close to  3,000 indigent residents drawn from the rural areas in Oyo State would benefit from the  Government’s free screening and treatment for non-communicable diseases including uterine fibroid, diabetes and hypertension.

The screening and treatment,  “Rapid Results Initiative’ is a collaborative initiative between  the Federal Ministry of Health and the University College Hospital (UCH), Ibadan.

According to Prof. Alonge  the initiative, which would be a routine, would cover the 11 Local Government  Councils in Ibadan, and gradually reach out to other councils in the state.

Before this time, indigent citizens, who are patients of the hospital, were in the habit of begging at the main gate of UCH and at various bus-stops and in traffic jams, for money to offset their hospital bills.

For the Chairman,  Association of Medical Laboratory Scientists, UCH chapter, Oladayo Odedoyin, ”we welcome the development, with open arms, and as professionals, our core area of competence is offering  laboratory diagnosis which is very paramount to medical treatment in the health sector, so we welcome the programme with open arms and we are ever ready to participate fully whenever the  programme is commencing especially at the UCH”.

However, the General Secretary and Treasurer of the Association of Resident Doctors(ARD)UCH, Drs. Oladimeji Adebayo and Kelvin Egbuchulem , outlined the plans they had for members of their association in 2017.

The duo maintained that ”   we are aware of the  Federal Government’s initiative and we believe in the principles of  Government there are quite a number of plans bothering on welfare, and bothering on ensuring that certain issues that have been affecting our members for quite a while are addressed. One of the main things that have been affecting us is the fact that, majority of the centres across Nigeria are collecting full salaries, or to a very great extent almost full implementation of their salaries, however, in UCH, we are still on a much, much, lower percentage”.

 

 

Ethiopia: One Bln. Usd Nutrition Programme Launched

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The Ministry of Health and stakeholders from various ministries Thursday launched a 1.14 billion USD nutrition programme running 2016 -2020.

The Second National Nutrition Programme aims at providing a framework for coordinated and integrated implementation of nutrition interventions by the government and pertinent stakeholders to end hunger by 2030.

Keeping food and nutrition quality, safety and security as well as setting post-harvest management system are also the priorities of the programme.

The program was signed by Health, Industry, Labor and Social Affairs, Women and Youth, State Ministers Dr. Kebede Worku, Dr. Mebrhatu Meles, Tadelech Dalecho, and Bizunesh Meseret respectively.

During the presentation, which preceded the signing ceremony, it was indicated that Ethiopia lost about 55.5 billon Birr, equivalent to 16.5 percent of the country’s GDP in 2009.

Ministry Nutrition Program Coordinator Birara Melese said the government implemented the First National Programme 2008-2015 realizing the problem.

Over 515 million USD is allocated for the Second National Nutrition Programme to address the underlying determinants of malnutrition, he added.

Of this, donor groups have contributed over 198 million USD, it was indicated.

According to the coordinator, the country has managed to reduce under five stunting rate from 50 percent in 2000 to 38.4 percent in 2016.

Mortality rate was also reduced from 166 per 1,000 cases to 67 per 1,000 in the stated period.

Source : The Ethiopian Herald