Top

Reproductive Health

Published in:

Open Access 01-12-2017 | Study protocol

Community based intervention to prevent domestic violence against women in the reproductive age in Northwestern Ethiopia: a protocol for quasi-experimental study

Authors: Agumasie Semahegn, Kwasi Torpey, Abubakar Manu, Nega Assefa, Augustine Ankomah

Published in: Reproductive Health | Issue 1/2017

Abstract

Background

Violence against women is a well understood devastating global pandemic, and human right violation. One in three women experienced intimate partner violence worldwide. In Ethiopia, the level of domestic violence against women is one of the highest in the world. However, Ethiopia is signatory for various conventions and incorporated in legal frameworks. Nevertheless, effective implementation of the existing policy documents, and engaging different stakeholders is very limited. Therefore, we aimed to pilot feasibility of implementing available research evidence and policy documents at community level to prevent domestic violence against women in Awi zone, northwestern Ethiopia.

Methods

A community-based quasi-experimental study design will be employed using mixed method. Multistage stratified systematic sampling and purposive sampling will be used to recruit quantitative and qualitative study participants, respectively. A total of 1,269 women will be participated in the intervention, active comparator and control groups. Pre and post-test quantitative data will be collected using face-to-face interview. Qualitative data will be collected through in-depth, key informant interview and focus group discussions. Intervention: advocacy meeting will be held to persuade local politicians and sustain the implementation of community based intervention to prevent domestic violence against women. Community representatives will be trained to enhance peer education to promote community awareness and engage stakeholders to transform the traditional gender norm within local context. Awareness creation and husband involvement will be made through integrating the intervention with community health extension program. Only husband involvement will not be promoted in the active comparator to test the role of husband involvement on the domestic violence prevention activities. Intervention progress will be monitored regularly. Gathered data will be entered in Epidata and exported to SPSS (23.0) software for analysis. Descriptive statistics, logistic regressions, intention to treat analysis and difference in differences will be computed. Qualitative data will be transcribed, color coded, thematically analyzed and arranged using Nvivo.

Discussion

This interventional study is aimed to design, pilot and translate proven research evidence, agreed conventions and country policy document to real setting implementation. We are expecting to initiate implementation of culturally acceptable intervention through engaging stakeholders. Policy makers, planners and any concerned bodies will be benefited.

Trial registration

ClinicalTrials.gov ID: NCT03265626

World Health Organization. Addressing violence against women and achieving the Millennium Development Goals [Internet]. Geneva: World Health Orgnization; 2005. Available from: http://www.who.int/gender/en

Population Reference Bureau TIGWG (IGWG). Gender-Based Violence and Reproductive Health & HIV/AIDS. Summary of technical update. [Internet]. Washington, DC 20009–5728; 2002. Available from: www.prb.org or www.igwg.org

USAID, IGWG P. Gender-based violence: impediment to reproductive health; 2010. p. 2.

Oxfam. Eending Violence Against Women; An Oxfam Guide. 2012.

WHO. Violence against women and HIV/AIDS: critical intersections intimate partner violence and HIV / AIDS. WHO bulletin Series. 2004;1:1–9. Available from: genderandhealth@who.int

UNIFEM AU. Domestic violence fact sheet. A 2010 Lenten study compiled by the world Council of Churches, the world student Christian Federation and the world YWCA. 2010. Available from: http://women.overcomingviolence.org.

World Health Organization. Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence [Internet]. Geneva: World Health Orgnization; 2013. Available from: www.who.int/reproductivehealth

Boldosser-Boesch A, Byrnes D, Carr C, Farid S, Lovell K, Minchew H, Omang J, Russell R, Warner A. Sexual and Reproductive Health and Rights (SRHR) and the Post- Development Agenda. Brief Cards. 2015.

Watts C, Zimmerman C. Violence against women I violence against women : global scope and magnitude. Lancet. 2002;359:1232–7.CrossRefPubMed

10.

Inge Baumgarten AE. Ending Violence against Women and Girls; Reduction and prevention of gender-based violence as contribution to the protection of human rights and to development. African Division. 2003.

11.

Ellsberg M, Jansen HAFM, Heise L, Watts CH, García-moreno C, Study WHOM. Intimate partner violence and women’s physical and mental health in the WHO multi-country study on women’s health and domestic violence: an observational study. Lancet. 2008;371:1165–72.CrossRefPubMed

12.

Jewkes RK, Levin JB, Penn-kekana LA. Gender inequalities, intimate partner violence and HIV preventive practices: findings of a south African cross-sectional study. Soc Sci Med. 2003;56:125–34.

13.

Koenig MA, Lutalo T, Zhao F, Nalugoda F, Wabwire-mangen F, Kiwanuka N, et al. Domestic violence in rural Uganda: evidence from a community-based study. Bull World Health Organ. 2003;81:53–60.PubMedPubMedCentral

14.

Kouyoumdjian FG, Findlay N, Schwandt M, Calzavara LM. A systematic review of the relationships between intimate partner violence and HIV / AIDS. PLoS One. 2013;8(11):e81044.CrossRefPubMedPubMedCentral

15.

Jamison DT, Summers LH, Alleyne G, Arrow KJ, Berkley S, Binagwaho A, et al. Global health 2035: a world converging within a generation. Lancet. 2014;382(9908):1898–955. Available from: https://doi.org/10.1016/S0140-6736(13)62105-4 CrossRef

16.

Union A. Mapto Plan of Action 2016–2030 for The Operationalization of The Continental Policy Framework for Sexual and Reproductive Health and Rights. In: Universal Access to Comprehensive Sexual and Reproductive Health Services In Africa MAPUTO [Internet]. Addis Ababa: The African Union Commission; 2016. Available from: www.au.int

17.

Remme M, Siapka M, Vassall A, Heise L, Jacobi J, Ahumada C, et al. Review article the cost and cost-effectiveness of gender-responsive interventions for HIV : a systematic review. J Int AIDS Soc. 2014;17:19228. Available from: http://www.jiasociety.org/index.php/jias/article/view/19228 | /link?doi=10.7448/IAS.17.1.19228

18.

Das S, Bapat U, More NS, Alcock G, Joshi W, Pantvaidya S, et al. Intimate partner violence against women during and after pregnancy: a cross-sectional study in Mumbai slums. BMC Public Health. 2013;13:817. Available from: BMC Public HealthCrossRefPubMedPubMedCentral

19.

Pallitto CC, Campo PO. Community level effects of gender inequality on intimate partner violence and unintended pregnancy in Colombia : testing the feminist perspective. Soc Sci Med. 2005;60:2205–16. Available from: www.elsevier.com/locate/socscimed CrossRefPubMed

20.

World Health Organization. Violence Against Women;Intimate Partner Violence and Sexual Violence.

21.

Agrawal A, Bloom SS, Suchindran C, Curtis S, Angeles G. Gender-based power and couples’ HIV risk in Uttar Pradesh and Uttarakhand, North India. HHS public access. Int Perspect Sex Reprod Health. 2015;40(4):196–205.CrossRef

22.

Laisser RM, Nyström L, Lugina HI, Emmelin M. Community perceptions of intimate partner violence - a qualitative study from urban Tanzania. BMC Womens Health. 2011;11:13. Available from: http://www.biomedcentral.com/1472-6874/11/13.

23.

Mukanangana F, Moyo S, Zvoushe A, Rusinga O. Gender based violence and its effects on women ’ s reproductive Health : the case of Hatcliffe , Harare , Zimbabwe. Afr J Reprod Health. 2014;18(1):110–22.PubMed

24.

Feder G, Howard LM, Trevillion K. Experiences of domestic violence and mental disorders: a systematic review and meta-analysis. PLoS One. 2012;7(12):e51740.CrossRefPubMedPubMedCentral

25.

Pico-alfonso MA. Psychological intimate partner violence: the major predictor of posttraumatic stress disorder in abused women. Neurosci Biobehav Rev. 2005;29:181–93.CrossRefPubMed

26.

Deyessa N, Berhane Y, Alem A, Ellsberg M, Emmelin M, Hogberg U, et al. Clinical practice and epidemiology intimate partner violence and depression among women in rural Ethiopia : a cross-sectional study. Clin Pract Epidemiol Ment Heal. 2009;5:8. Available from: http://www.cpementalhealth.com/content/5/1/8 CrossRef

27.

Yigzaw T, Yibrie A, Kebede Y. Domestic violence around Gondar in Northwest Ethiopia. Ethiop J Health Dev. 2004;18(3):133–9.

28.

Guruge S, Bender A, Aga F, Hyman I, Tamiru M, Hailemariam D, Kassa A, Refaie-Shirpak K. Towards a global interdisciplinary evidence-informed practice: intimate partner violence in the Ethiopian context. International Scholarly Research Network. ISRN Nursing Volume 2012, Article ID 307271.doi:10.5402/2012/307271.

29.

Abate BA, Wossen BA, Degfie TT. Determinants of intimate partner violence during pregnancy among married women in Abay Chomen district , western Ethiopia : a community based cross sectional study. BMC Womens Health. 2016;16:16. Available from: https://doi.org/10.1186/s12905-016-0294-6 CrossRef

30.

Dunkle KL, Jewkes RK, Brown HC, Gray GE, Mcintryre JA, Harlow SD. Gender-based violence, relationship power, and risk of HIV infection in women attending antenatal clinics in South Africa. Lancet. 2004;363:1415–21.CrossRefPubMed

31.

Shi C, Kouyoumdjian FG, Dushoff J. Intimate partner violence is associated with HIV infection in women in Kenya : a cross-sectional analysis. BMC Public Health. 2013;13:512. Available from: http://www.biomedcentral.com/1471-2458/13/512 CrossRefPubMedPubMedCentral

32.

Onsomu EO, Abuya BA, Okech IN, Rosen DL, Duren-Winfield V, Simmons AC. Association between domestic violence and HIV serostatus among married and formerly married women in Kenya. Heal Care Women Int. 2015;36(2):205–28.CrossRef

33.

Li Y, Marshall CM, Rees HC, Nunez A, Ezeanolue EE, Ehiri JE. Intimate partner violence and HIV infection among women: a systematic review and meta-analysis. J Int AIDS Soc. 2014;17(18845). Available from: http://www.jiasociety.org/index.php/jias/article/view/18845 | https://doi.org/10.7448/IAS.17.1.18845

34.

Harling G, Msisha W, Subramanian S V. No Association between HIV and Intimate Partner Violence among Women in 10 Developing Countries. 2010;5(12).

35.

Decker MR, Seage GR III, Hemenway D, Raj A, Saggurti N, Balaiah D, Silverman JG. Intimate partner violence functions as both a risk marker and risk factor for Women’s HIV infection: findings from Indian husband-wife dyads. J Acquir Immune Defic Syndr. 2009;51(5):593–600.CrossRefPubMedPubMedCentral

36.

Maman S, et al. Intersection of intimate partner violence and HIV in women. Soc Sci Med. 2000;50(4):459–78. Available from: www.cdc.gov/hiv and www.cdc.gov/violencepreventionCrossRefPubMed

37.

Berg-beckhoff G. Intimate partner violence (physical and sexual) and sexually transmitted infection: results from Nepal demographic health survey 2011. Int J Women’s Heal. 2014;6:75–82. Available from: https://doi.org/10.2147/IJWH.S54609

38.

Sigbeku OA, Fawole OI, Ogunniyan TB, Statistics M. Experiece of intimate partner violence as a predictor of sexually transmitted infections among married women Nigeria. Ann Ibd Pg Med. 2015;13(1):6–16.

39.

Pallitto CC, O’Campo P. And unintended pregnancy: analysis of a National Sample from Colombia. Int Fam Plan Perspect. 2004;30(4):165–73.PubMed

40.

Rahman M. Intimate partner violence and termination of pregnancy: a cross-sectional study of married Bangladeshi women. Reprod Health. 2015;12:102. Available from: https://doi.org/10.1186/s12978-015-0095-7 CrossRefPubMedPubMedCentral

41.

Nguyen PH, Van Nguyen S, Quang M, Nguyen NT, Keithly SC, Mai LT, et al. The association and a potential pathway between gender-based violence and induced abortion in Thai Nguyen province, Vietnam. Glob Health Action. 2012;5:19006. 11. Available from: https://doi.org/10.3402/gha.v5i0.19006 CrossRefPubMed

42.

Antai D, Adaji S. Community-level influences on women’s experience of intimate partner violence and terminated pregnancy in Nigeria: a multilevel analysis. BMC Pregnancy Childbirth. 2012;12:128. Available from: BMC Pregnancy and ChildbirthCrossRefPubMedPubMedCentral

43.

Rahman M, Nakamura K, Seino K, Kizuki M. Intimate partner violence and use of reproductive health services among married women : evidence from a national Bangladeshi sample. BMC Public Health. 2012;12:913. Available from: http://www.biomedcentral.com/1471-2458/12/913 CrossRefPubMedPubMedCentral

44.

Muralidharan, A., J. Fehringer, S. Pappa, E. Rottach, M. Das and M. Mandal. Transforming Gender Norms, Roles, and Power Dynmaics for Evidence from a Health Programs in Low and Middle Income Countries. Washington DC; 2015.

45.

Semahegn A, Mengistie B. Domestic violence against women and associated factors in Ethiopia; systematic review. Reprod Health. 2015;12:78. Available from: https://doi.org/10.1186/s12978-015-0072-1 CrossRefPubMedPubMedCentral

46.

FDRE. Constitution of The Federal Democratic Republic of Ethiopia Constitution of The Federal Democratic Republic of Ethiopia. Addis Ababa, Ethiopia; 1994.

47.

FDRE. The criminal code of the Federal Democratic Republic of Ethiopia 2004. Proclamation no.414/2004. Addis Ababa, Ethiopia: Federal Democratic Republic of Ethiopia; 2005.

48.

FDRE. The Revised Family Code Procalmation No.213/2000. Addis Ababa, Ethiopia; 2000. p. 96.

49.

FMOH. Standard Operation procedure for the response and prevention of sexual violence in Ethiopia: Federal Democratic Republic of Ethiopia Minstry of Health. Addis Ababa: Ministry of Health; 2016.

50.

Semahegn A, Belachew T, Abdulahi M. Domestic violence and its predictors among married women in reproductive age in Fagitalekoma Woreda , Awi zone , Amhara regional state , north western Ethiopia. Reprod Health. 2013;10:63. Available from: http://www.reproductive-health-journal.com/content/10/1/63 CrossRefPubMedPubMedCentral

51.

Zhong B. How to calculate sample size in randomized controlled Trial ? J Thorac Dis. 2009;1(1):51–4.PubMedPubMedCentral

52.

Abramsky T, Devries K, Kiss L, Nakuti J, Kyegombe N, Starmann E, et al. Findings from the SASA! Study: a cluster randomized controlled trial to assess the impact of a community mobilization intervention to prevent violence against women and reduce HIV risk in Kampala, Uganda. MBC Med. 2014;12:122. Available from: http://www.biomedcentral.com/1741-7015/12/122

53.

Central Statistical Agency (CSA). [Ethiopia] and ICF. 2016. Ethiopia Demographic and Health Survey 2016. Addis Ababa, Ethiopia, and Rockville, Maryland, USA: CSA and ICF. Addis Ababa, Ethiopia; 2016.

54.

Rahman M, Nakamura K, Seino K, Kizuki M. Does gender inequity increase the risk of intimate partner violence among Women ? Evidence from a National Bangladeshi Sample. PLoS One. 2013;8(12):e82423.CrossRefPubMedPubMedCentral

55.

Sapkota D, Bhattarai S, Baral D, Pokharel PK. Domestic violence and its associated factors among married women of a village development committee of rural Nepal. BMC Res Notes. 2016;9:178. Available from: "https://doi.org/10.1186/s13104-016-1986-6 CrossRefPubMedPubMedCentral

56.

Lamichhane P, Puri M, Tamang J, Dulal B. Women’s status and violence against young married women in rural Nepal. BMC Womens Health. 2011;11:19. Available from: http://www.biomedcentral.com/1472-6874/11/19 CrossRefPubMedPubMedCentral

57.

Dalal K, Wang S, Svanström L. Intimate partner violence against women in Nepal: an analysis through in- dividual, empowerment, family and societal level factors. J Res Heal Sci J. 2014;14(4):251–7.

58.

Uthman OA, Moradi T, Lawoko S. Are individual and community acceptance and witnessing of intimate partner violence related to its Occurrence ? Multilevel Structural Equation Model. PLoS One 2011;6(12):e27738.

59.

Shannon K, Leiter K, Phaladze N, Hlanze Z, Tsai AC, Iacopino V, et al. Gender inequity norms are associated with increased male-perpetrated rape and sexual risks for HIV infection in Botswana and Swaziland. PLoS One. 2012;7(1):e28739.CrossRefPubMedPubMedCentral

60.

Abramsky T, Watts CH, Garcia-moreno C, Devries K, Kiss L, Ellsberg M, et al. What factors are associated with recent intimate partner violence? Findings from the WHO multi-country study on women’s health and domestic violence. BMC Public Health. 2011;11:109. Available from: http://www.biomedcentral.com/1471-2458/11/109 CrossRefPubMedPubMedCentral

61.

Ismayilova L. Spousal violence in 5 transitional Countries : a population-based multilevel analysis of individual and contextual factors. Am J Public Heal. 2015;105:e12–22.CrossRef

62.

Hayati EN, Högberg U, Hakimi M, Ellsberg MC, Emmelin M. Behind the silence of harmony: risk factors for physical and sexual violence among women in rural Indonesia. BMC Womens Health. 2011;11:52. Available from: http://www.biomedcentral.com/1472-6874/11/52 CrossRefPubMedPubMedCentral

63.

Antai D. Traumatic physical health consequences of intimate partner violence against women: what is the role of community-level factors? BMC Womens Health. 2011;11:56. Available from: http://www.biomedcentral.com/1472-6874/11/56 CrossRefPubMedPubMedCentral

64.

Uthman OA, Lawoko S, Moradi T. Factors associated with attitudes towards intimate partner violence against women : a comparative analysis of 17 sub-Saharan countries. BMC Int Health Hum Rights. 2009;9:14. Available from: http://www.biomedcentral.com/1472-698X/9/14 CrossRefPubMedPubMedCentral

65.

Conroy AA. Gender, power, and intimate partner violence: a study on couples from rural Malawi. J Interpers Violence. 2014;29(5):866–88.CrossRefPubMed

66.

Heise L. Violence against women: an integrated, ecological framework. Violence Against Women. 1998;4(3):262–90. Available from: http://vaw.sagepub.com/cgi/content/abstract/4/3/262 CrossRefPubMed

67.

Ellsberg M, and Heise L. Researching Violence Against Women: A Practical Guide for Researchers and Activists. Washington DC, United States: World HealthOrganization, PATH; 2005.

68.

Central Statistics Agency [Ethiopia]. Ethiopian demographic aand Health survey 2016;Central Statistical Agency Addis Ababa, Ethiopia The DHS Program ICF Rockville, Maryland, USA. [Internet]. Addis Ababa, Ethiopia; 2016. Available from: www.DHSprogram.com

69.

Central Statistical Agency [Ethiopia]. Ethiopia Demographic and Health Survey 2005; Central Statistical Agency Addis Ababa, Ethiopia ORC Macro Calverton, Maryland, USA [Internet]. Addis Ababa, Ethiopia; 2006. Available from: http://www.measuredhs.com.

70.

Central Statistical Agency [Ethiopia]. Ethiopia Demographic and Health Survey 2011; Central Statistical Agency Addis Ababa, Ethiopia; ICF International Calverton, Maryland, USA. [Internet]. Addis Ababa, Ethiopia; 2012. Available from: http://www.measuredhs.com.

71.

Azmat SK, Hameed W, Hamza HB, Mustafa G, Ishaque M, Abbas G, et al. Engaging with community-based public and private mid-level providers for promoting the use of modern contraceptive methods in rural Pakistan : results from two innovative birth spacing interventions. Reprod Health. 2016;13:25. Available from: https://doi.org/10.1186/s12978-016-0145-9 CrossRefPubMedPubMedCentral

72.

Michaels-igbokwe C, Abramsky T, Devries K, Michau L, Musuya T, Watts C. Cost and cost-effectiveness analysis of a community mobilisation intervention to reduce intimate partner violence in. BMC Public Health [Internet]. 2016;16:196. Available from: https://doi.org/10.1186/s12889-016-2883-6

73.

Wagman JA, Gray RH, Campbell JC, Thoma M, Ssekasanvu J, Nalugoda F, et al. Effectiveness of an integrated intimate partner violence and HIV prevention intervention in Rakai, Uganda: analysis of an intervention in an existing cluster randomised cohort. Lancet Glob Heal. 2015;3(1):e23–33.CrossRef

74.

Kalichman SC, Simbayi LC, Cloete A, Clayford M, Mxoli M, Smith G, et al. Integrated gender-based violence and HIV risk reduction intervention for south African men: results of a quasi-experimental field trial. Prev Sci. 2011;10(3):260–9.CrossRef

75.

Pulerwitz J, Hughes L, Mehta M, Kidanu A, Verani F, Tewolde S. Changing gender norms and reducing intimate partner violence: results from a quasi-experimental intervention study with young men in Ethiopia. Am J Public Heal. 2015;105:132–7.CrossRef

76.

Green EP, Blattman C, Jamison J, Annan J. Social Science & Medicine Women’s entrepreneurship and intimate partner violence: a cluster randomized trial of microenterprise assistance and partner participation in post-con fl ict Uganda. Soc Sci Med. 2015;133:177–88. Available from: https://doi.org/10.1016/j.socscimed.2015.03.042 CrossRefPubMed

77.

Gupta J, Falb KL, Lehmann H, Kpebo D, Xuan Z, Hossain M, et al. Gender norms and economic empowerment intervention to reduce intimate partner violence against women in rural Côte d ’ Ivoire : a randomized controlled pilot study. BMC Int Health Hum Rights. 2013;13:46. Available from: http://www.biomedcentral.com/1472-698X/13/46 CrossRefPubMedPubMedCentral

78.

Falb KL, Annan J, Kpebo D, et al. Differential impacts of an intimate partner violence prevention program based on child marriage status in rural Côte d’Ivoire. J Adolesc Health. 2015;57(5):553–8. Available from: https://doi.org/10.1016/j.jadohealth.2015.08.001 CrossRefPubMed

79.

Krishnan S, Vohra D, De Walque D, Medlin C, Nathan R, Dow WH. Tanzanian couples ’ perspectives on gender equity, relationship power, and intimate partner violence: findings from the RESPECT study. AIDS Res Treat. 2012;2012:Article ID 187890.

80.

Abeid M, Muganyizi P, Mpembeni R, Darj E, Axemo P. A community-based intervention for improving health- seeking behavior among sexual violence survivors: a controlled before and after design study in rural Tanzania. Glob Health Action. 2015;8(28608):9. Available from: - https://doi.org/10.3402/gha.v8.28608

81.

Kim JC, Watts CH, Hargreaves JR, Ndhlovu LX, Phetla G, Morison LA, et al. Understanding the impact of a microfinance-based intervention on Women’s empowerment and the reduction of intimate partner violence in South Africa. Am J Public Heal. 2007;97(10):1794–802.CrossRef

82.

Jewkes RK, Dunkle K, Nduna M, Shai N. Intimate partner violence, relationship power inequity, and incidence of HIV infection in young women in South Africa: a cohort study. Lancet. 2010;376:41–8. Available from: https://doi.org/10.1016/S0140-6736(10)60548-X CrossRefPubMed

Title: Community based intervention to prevent domestic violence against women in the reproductive age in Northwestern Ethiopia: a protocol for quasi-experimental study
Authors: Agumasie Semahegn
Kwasi Torpey
Abubakar Manu
Nega Assefa
Augustine Ankomah
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: Reproductive Health / Issue 1/2017
Electronic ISSN: 1742-4755
DOI: https://doi.org/10.1186/s12978-017-0414-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Community based intervention to prevent domestic violence against women in the reproductive age in Northwestern Ethiopia: a protocol for quasi-experimental study

Abstract

Background

Methods

Discussion

Trial registration

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Discussion

Trial registration

Please log in to get access to this content

Other articles of this Issue 1/2017

Perspectives of urban Ghanaian women on vasectomy

Contraceptive practices among married women of reproductive age in Bangladesh: a review of the evidence

Determinants of modern contraceptive use among sexually active men in Kenya

Accuracy of gestational age estimation from last menstrual period among women seeking abortion in South Africa, with a view to task sharing: a mixed methods study

Moving from legality to reality: how medical abortion methods were introduced with implementation science in Zambia

Educational status as determinant of men’s knowledge about vasectomy in Dangila town administration, Amhara region, Northwest Ethiopia