Background Ethical reasoning and sensitivity are always important in public health, but it is especially important in the sensitive and complex area of public health emergency preparedness. Here, we explored the ethical challenges, and dilemmas encountered by frontline health workers amid the coronavirus disease-19 (COVID-19) pandemic in Ethiopia. Methods A nationwide survey was conducted amongst the frontline health workers from nineteen public hospitals. Health workers were invited to respond to a self-administered questionnaire. Data were weighted and analyzed using descriptive statistics. (...) Results Of the 285 frontline health workers to whom questionnaires were distributed, 217 of them gave their responses (response rate 76.1%). Respondents frequently reported encountering rationing dilemmas on health commodities directly used for the prevention and treatment of COVID-19. Most (83.9%) of the health workers agreed that they encountered ethical challenges very frequently or frequently. Almost all [215(99.1%)] claimed that the limitation of resources was directly used for the treatment and prevention of COVID-19. The frequency of difficulty in the provision of essential clinical services varied between 77% and 98.7% for different services. More than half of the study participants reported that they had encountered difficulty in the provision of clinical care on a daily or weekly basis. Regarding rationing strategies, isolating COVID-19 treatment units and limiting admission were the most frequent rationing strategies used by two-thirds of health workers on a daily or weekly basis. Conclusion Front-line health workers encountered numerous ethically challenging situations during COVID-19. More than half of health workers reported that they encountered ethical challenges in rationing the resources and delivery of different clinical services such as family planning services, maternal and childcare, immunization, and chronic care. With limited resources such as ventilators and hospital beds, healthcare providers have been faced with the difficult task of deciding who gets access to these resources and who doesn't. Overall, the COVID-19 pandemic has presented numerous ethical challenges for healthcare providers, highlighting the importance of ethical considerations in healthcare delivery. By being aware of these dilemmas and having policies in place to address them, healthcare providers can ensure that they are providing the best possible care to their patients while upholding ethical standards. (shrink)

The highly publicized killing of Black people in spring 2020 sparked a national and global social movement to address racial violence. This led to heightened national discourse about the deeply entrenched nature of systemic racism in American institutions, prompting organizations to make public statements supporting racial justice. While an essential first step in addressing systemic inequities within the workplace, these statements are primarily performative and do little to combat systemic racist practices and policies within their ranks. For instance, research has (...) shown that women of color, and particularly Black women, experience daily racial and gendered aggressions that negatively impact their career trajectories. Through in-depth semi-structured interviews of twenty Black women lawyers, this article demonstrates how systemic racism is deeply entrenched in white spaces, preventing a genuine and effective path to diversity, equity, and full inclusion. Moreover, it theorizes how emotional, cognitive, financial, and relational labors amount to an inclusion tax levied against Black women professionals in white spaces. The article concludes with practical implications and ethical considerations on how to address this dynamic across various occupations and industries. (shrink)

This study examined two key dimensions of women’s status in Southern Nations, Nationalities and Peoples Region of Ethiopia based on regional data collected from five randomly selected zones and one city administration; namely, Sidama, Hadya, Gamo Gofa, South Omo, Bench Maji and Hawassa City Administration. The analysis revealed that while joint decision is fairly high, women’s independent decision making on key household domains is generally low. Significant proportions of women in the region are exposed to violence by their partners ranging (...) from insult to heavy physical injury. The fact that nearly half of the women experienced insult and close to a quarter of them faced beating is indicative of the low status of women in society. The regression analysis indicated that seven variables determine the occurrence of violent acts against women in the study area, namely household size, education, access to radio, value of children index, wealth index and level of women autonomy. On the other hand, decision making autonomy is affected by wealth status, household size, access to radio and sex preference index. Finally, the study highlighted the importance of addressing the limited technical and operational capacities to implement gender policy and legal frameworks effectively and efficiently. (shrink)

The study was conducted in East Shewa, central Ethiopia, where durum wheat landraces were once popular, but were displaced and re-introduced. Combinations of survey techniques are employed to document the different home uses of durum wheat landraces and to assess whether these serve as an incentive to on-farm conservation. The findings reveal that wheat landraces have multiple dietary and sociocultural uses that contribute to the maintenance of landraces on-farm. Temporal analysis of historical information showed that (1) richness in food traditions (...) is associated with a high level of landrace diversity on-farm; (2) food traditions in East Shewa did not change radically as a result of the integration of farmers into the market economy; and (3) farm households still have an appreciation of, and a preference for, the home-use related qualities of the landraces, this despite their long term disappearance and the subsequent availability of several improved wheat varieties. The study illustrates the relationship between the local availability of landrace wheats and their on-farm survival. The home uses of landraces plays an instrumental role in the promotion of on-farm (in situ) conservation. Augmenting conservation activities with non-breeding approaches (e.g., awareness-creation) would support the survival of wheat landraces for the foreseeable future. (shrink)

BackgroundRespecting patients’ confidentiality is an ethical and legal responsibility for health professionals and the cornerstone of care excellence. This study aims to assess health professionals’ knowledge, attitudes, and associated factors towards patients’ confidentiality in a resource-limited setting.MethodsInstitutional based cross-sectional study was conducted among 423 health professionals. Stratified sampling methods were used to select the participants, and a structured self-administer questionnaire was used for data collection. The data was entered using Epi-data version 4.6 and analyzed using SPSS, version 25. Bi-variable and (...) multivariable binary logistic regression analyses were used to measure the association between the dependent and independent variables. Odds ratio with 95% confidence intervals and P value was calculated to determine the strength of association and to evaluate statistical significance.ResultOut of 410 participants, about 59.8% with [95% CI (54.8–68.8%)] and 49.5% with [95% CI (44.5–54.5%)] had good knowledge and favorable attitude towards patents confidentiality respectively. Being male (AOR = 1.63, 95% CI [1.03–2.59]), taking training on medical ethics (AOR = 1.73, 95% CI = [1.11–2.70]), facing ethical dilemmas (AOR = 3.07, 95% CI [1.07–8.79]) were significantly associated factors for health professional knowledge towards patients’ confidentiality. Likewise, taking training on medical ethics (AOR = 2.30, 95% CI [1.42–3.72]), having direct contact with the patients (AOR = 3.06, 95% CI [1.12–8.34]), visiting more patient (AOR = 4.38, 95% CI [2.46–7.80]), and facing ethical dilemma (AOR = 3.56, 95% CI [1.23–10.26]) were significant factors associated with attitude of health professionals towards patient confidentiality.ConclusionThe findings of this study revealed that health professionals have a limited attitude towards patient confidentiality but have relatively good knowledge. Providing a continuing medical ethics training package for health workers before joining the hospital and in between the working time could be recommended to enhance health professionals’ knowledge and attitude towards patient confidentiality. (shrink)

In the U.S., there is no requirement for research sponsors to compensate human research subjects who experience injuries as a result of their participation. In this article, we review the moral justifications that compel the establishment of a better research-related injury compensation system. We explore how other countries and certain institutions within the U.S. have adopted various systems of compensation. The existence of these systems demonstrates both that the U.S. lags behind other nations in its protection of human research subjects (...) and that the establishment of a compensation system is both practical and feasible. We then examine factors which have prevented the U.S. from establishing its own compensation system. We consider possible alternatives for the U.S. by examining the advantages and disadvantages of both established and proposed systems. We offer a new proposal that addresses the justice concerns which compel the establishment of a national compensation system, distributes the burdens of such a system on multiple stakeholders that benefit from research, and has the additional advantage of minimizing the administrative and logistical challenges associated with initiating such a system. (shrink)

IntroductionInternet addiction is characterized by excessive and uncontrolled use of the internet affecting everyday life. Adolescents are the primary risk group for internet addiction. Data on internet addiction is lacking in Africa. Thus, this review aimed to determine the pooled prevalence of internet addiction and its associated factors among high school and university students in Africa.MethodsA comprehensive literature search was conducted using electronic databases to locate potential studies. Heterogeneity between studies was checked using Cochrane Q test statistics and I2 test (...) statistics and small-study effects were checked using Egger's statistical test at a 5% significance level. A sensitivity analysis was performed. A random-effects model was employed to estimate the pooled prevalence and associated factors of internet addiction among students. The primary outcome of measure of this review was the prevalence of internet addiction and the secondary outcome of measures are the factors associated with internet addiction.ResultsA total of 5,562 studies were identified among the five databases. Of these, 28 studies from 10 countries with 14,946 high school and university students were included in this review. The overall pooled prevalence of internet addiction among the students was 34.53% [95% Confidence Interval : 26.83, 42.23, I2 = 99.20%]. Male sex [Pooled Odds Ratio = 1.92, 95% CI:1.43, 2.57 I2 = 0.00], urban residence, and duration of daily internet use for more than 4 h (POR = 2.25, 95% CI:1.20, 4.21, I2 = 0.00%, were significantly associated with internet addiction among adolescents.ConclusionAlmost one-third of university and high school students in Africa are addicted to the internet. Male students, those from urban areas, and those who use the internet for more than 4 h per day have higher odds of internet addiction. Thus, we recommend that health planners and policymakers pay attention to the use of the internet and internet addiction in Africa. (shrink)