BackgroundIn primary health care, provider-patient interaction is fundamental platform and critically affects service delivery. Nevertheless, it is often ignored in medical research and practice and it is infrequently subjected to scientific inquiry, particularly in Ethiopia. This study aimed to assess patient satisfaction with health care provider interactions and its influencing factors among out-patients at health centers in West Shoa, Central Ethiopia.MethodsA cross sectional facility based study was conducted on 768 out-patients of six health centers in West Shoa Zone, Central Ethiopia. The total sample size was allocated to each of the six health centers based on patient flow during the ten days prior to the start of data collection. Pre-tested instruments were used for data collection and the data were analyzed using SPSS version 16.0 statistical software. Factor score was computed for the items identified to represent the satisfaction scale by varimax rotation method. Using this regression factor score, multivariate linear regression analysis was performed and the effect of independent variables on the regression factor score was quantified.ResultsSeventy three percent of the respondents perceived that provider's empathy was good and 35% complained that providers were not technically competent enough. In addition, 82% of the respondents rated non-verbal communication by the providers to be good, very good or excellent on a five-point ordinal scale. Regardless of the process, only 34.1% of the patients implied that the consultations made a difference in understanding their illness and coping with it. Generally speaking, 62.6% of the patients reported that they have been satisfied with their visit. Perceived empathy, perceived technical competency, non-verbal communication, patient enablement, being told the name of once illness, type and frequency of visit, knowing the providers and educational status were main independent predictors of patient satisfaction in this study. Furthermore, very good empathy (Beta = -4.323), fair non-verbal communication (Beta = -0.188), fewer expectations met (Beta = -0.169) and disagreement to technical competency (Beta = -0.156) had greater negative influence on patient satisfaction. On the other hand, excellent non-verbal communication (Beta = 0.114) and being told the name of once illness (0.109) had pronounced positive influence on patient satisfaction.ConclusionThe present study showed that interpersonal processes including perceived empathy, perceived technical competency, non-verbal communication and patient enablement significantly influence patient satisfaction. Therefore, health care providers should work towards improving the communication skill of their professionals along with having technically competent workers which could possibly affect the perception of the patient about all of the variables identified as independent predictors of patient satisfaction in this study.

Summary The Common Agricultural Policy currently allows the support of agricultural insurance, with a particular focus on mutuals. This article analyses the experience of mutuals in the Netherlands over the past 20 years. A total of nine mutuals are reviewed, some operating on a purely private basis, others receiving some form of public support. Results illustrate that mutuals are well equipped to insure risks that are uninsurable in the commercial market. This is especially true for animal and crop disease risks. Mutuals are furthermore able to fulfil the EU conditions for receiving premium support hence opening up the opportunity for farmers to insure against multi‐peril weather risks. Experience has however demonstrated that mutuals are not always successful, even with substantial public support. Lack of members caused several mutuals to be discontinued only a few years after their foundation. In order to secure the benefits of mutuals, it is shown that there is a need to carefully balance size of risk, affordability of premiums, financial robustness and solidarity. These issues are even more important in the case of mutuals providing income stabilisation tools as these have the added responsibility of data and (classified) market information management.

Background One of the key interventions to reduce unintended pregnancy and unsafe abortion outlined in the national youth strategy is availability of emergency contraception. However, there are no studies which document emergency contraception use and the factors influencing the use of emergency contraceptives among university girls in Ethiopia. This study was carried out to assess emergency contraception use and its predictor factors among regular female students at Adama University. Methods A cross-sectional study was conducted during the month of February 2009, among randomly selected 660 female students of Adama University Central Ethiopia. Data were collected through pre-tested selfadministered questionnaire. Bivariate and multivariable logistic regression models were fitted to identify variables predicting emergency contraception use. Results One hundred ninety four (29.4%) students were sexually active and 63 (9.4%) had a previous history of pregnancy. And most of the pregnancies (92%) were unintended. Majority (77.7%) of pregnancies were terminated by way of induced abortions carried out by untrained persons. Only 26.7% of those who had unprotected sex used emergency contraception. Lack of knowledge, fear of being seen by others, and inconvenient service delivery were pointed out as the main reasons for not using emergency contraceptives. Previous use of contraceptives (AOR: 1.953; 95% CI = 1.72- 6.345), being married (AOR: 9.254; 95% CI = 2.538-20.73) and age of 20 years and above (AOR: 2.372; 95% CI = 1.102-7.246) were significant predictors use of emergency contraception, while poor knowledge of emergency contraception was a significant predictor of non-use of emergency contraception (AOR: 0.09; 95% CI = 0.041-0.189). Conclusion The study pointed out the need for increasing the knowledge of university going young women about emergency contraception, and the need for availing youth friendly reproductive health services to promote preventive behavior.

Agricultural prices in European food markets have become more volatile over the past decade exposing agribusinesses to risk and uncertainty. This study goes beyond the farm stage and explores through interviews the price risk perceptions and management strategies in multiple stages of the food supply chain. Respondents were farmers, wholesalers, processors, and retailers in six European food supply chains. Results show that price risk management strategies in EU food chains are diverse and well beyond traditional instruments such as futures and forward contracts. We further find that deviations of prices by more than 10-15% from expected levels were perceived as price volatility by a majority of the chain actors. This study provides new insights on price risk management, a deeper understanding of price risk perceptions and highlights the interrelation of price risk management decisions with other business decisions.

BACKGROUND: Unwanted pregnancy followed by unsafe abortion is one of the major worldwide health problems, which has ma ny negative consequences on the health and well -being of women. Information about women's knowledge, attitude and practice of emergency contraceptives plays a major role in the reduc tion of unwanted pregnancy; however, there are no studies about this issue in the study area. This study assessed Adama University female students' knowledge, attitude and practice of emergency contraceptives. METHOD: A cross-sectional study design was employed from February 1 to 30/2009, on 660 regular undergraduate female students of Adama University. Data were entered and analyzed using SPSS for windows version 16.0. Logistic regression was used to identify the association between variables and emergen cy contraceptive knowledge, attitude and practice. P-value less than 0.05 at 95% CI was taken for statistical significance. RESULTS: Of the total, 660 respondents, 194(29.4%) were sexually active, 63(9.4%) had history of pregnancy and 49(7.4%) had history of abortion. About 309 (46.8%) of the students had heard about emergency contraceptives and from those who heard emergency contraceptives, 27.2% had good knowledge. Majority, four hundred fifteen (62.9%) of the students had positive attitude towards it. However, only 31(4.7%) had used emergency contraceptive methods. CONCLUSION: This study demonstrated lack of awareness, knowledge and utilization of emergency contraceptives among Adama University female students. Hence behavioral change strategies should be considered by responsible bodies to improve knowledge and bring attitudinal change on use of emergency contraception.