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Accumulating evidence clearly shows poor implementation of nutrition interventions, in Ethiopia and other African countries, with many missed opportunities in the first 1000 days of life. Even though there are high‐impact interventions in this critical period, little is known about the barriers and facilitators influencing their implementation. This paper aims to explore barriers and facilitators for the implementation of nutrition services for small children with a focus on growth monitoring and promotion, iron‐folic acid supplementation and nutrition counselling. We conducted a qualitative study in four districts of Ethiopia. The data collection and analysis were guided by the consolidated framework for implementation research (CFIR). A total of 42 key informant interviews were conducted with key stakeholders and service providers. Interviews were transcribed verbatim and coded using CIFR constructs. We found that from 39 constructs of CFIR, 14 constructs influenced the implementation of nutrition interventions. Major barriers included lack of functional anthropometric equipment and high caseload (complexity), poor staff commitment and motivation (organisational incentive and reward), closed health posts (patient need and resource), false reporting (culture), lack of priority for nutrition service (relative priority), poor knowledge among service providers (knowledge and belief about the intervention) and lack of active involvement and support from leaders (leadership engagement). Adaptability and tension for change were the facilitators for the implementation of nutrition interventions. Effective implementation of nutrition interventions at primary health care units requires several actions such as improving the healthcare providers' motivation, improving leadership engagement, and creating a strong system for monitoring, supportive supervision and accountability. Key messages: Key barriers include lack of resources such as functional anthropometric equipment, high caseload, poor staff commitment and motivation, closed health posts, false reporting and lack of accountability, lack of priority for nutrition services, poor nutrition counselling, and poor leadership engagement and support.Improving implementation of nutrition services requires systematic identification of barriers and designing adaptable solutions.Our study highlights the need for separate growth monitoring and promotion (GMP) rooms and service providers. Service providers need adequate training to provide nutrition services. There is a need for improved monitoring supervision, leadership engagement and regular and improved carrier development and incentives. [ABSTRACT FROM AUTHOR]

Background: Wild edible plants (WEPs) are usually considered to constitute all plant resources that are neither cultivated nor domesticated but are used as nutritional supplements by local people. WEPs play a vital role in ensuring food and livelihood security for countless families and communities around the world. The objective of the study was to assess and document wild edible plants used by communities in the Arsi Robe district as food. Methods: Semi-structured interviews, market surveys, and guided field walks were employed as data collection tools. The data were analyzed using preference ranking, direct matrix ranking, and Jaccard's similarity index. Results: The present study revealed various types of wild edible plants consumed by local communities in the Arsi Robe district of the East Arsi Zone. This could be justified by the documentation of 36 different wild edible plants in the study area. These WEPs belong to 31 genera and 25 families. Most of the growth forms of the edible wild plants in the district were shrubs (16, 44.44%) and trees (14, 38.88%). Amaranthus caudatus and Bridelia micrantha are the most preferred WEPs in the study area. The finding of the study also revealed that Lepidotrichilia volkensii and Premna schimperi are among the novel WEPs that had not before been documented as food items in other areas. Olea europaea subsp. cuspidata, Ficus sycomorus, Cordia africana, and Ficus sur are species with multiple uses. Agricultural expansion, charcoal production, the construction of different materials, making agricultural tools, deforestation, and other factors were the top prioritized threats affecting the abundance and diversity of wild edible plants. Conclusion: Along with the sustainable utilization and conservation of the existing WEPs of the study district, priority should be given to the urgent collection, domestication, and cultivation of multiuse wild edible plant species such as Olea europaea subsp. cuspidata, Ficus sycomorus, Cordia africana, and Ficus sur in the study area. [ABSTRACT FROM AUTHOR]

Over the last two decades, great efforts and investments have been made in Ethiopia to ensure that all children have equal access to nutrition services in health facilities. While quality health systems are a prerequisite for quality nutrition services, little attention has been given to the evaluation of the supply and delivery services. The purpose of the study was to evaluate the coverage and quality of the nutrition‐specific interventions delivered through the health system. Using an end‐user monitoring (EUM) system, we monitored the delivery of nutrition‐specific interventions in 500 districts, having 2514 health facilities distributed throughout Ethiopia. Data were collected through third‐party monitors between August 2020 and 2021. Roughly 90% of health facilities were performing severe acute malnutrition management in line with the national guideline/protocol, and 2/3 of the assessed facilities were delivering iron and folic acid, vitamin A supplementation and deworming. A third of the messages on AMIYCN were retained by beneficiaries. Warehouse conditions were good in 64.3% of the facilities, but only 22% had good recording practices and about half had problems related to the quality and availability of nutrition supplies. Most beneficiaries were satisfied with the nutrition supplies and service delivered at the health facility level. This study also suggests the relevance of an EUM system to assess the quality of nutrition service delivery and its related supply management, as well as to improve the implementation of nutrition interventions as a decision‐making tool. Key messages: The main bottleneck identified in supply management was the recording system, while roughly 65% of warehouses are in good condition to store nutrition supplies at the health facility level.Roughly 90% of health facilities were performing severe acute malnutrition management in line with the national guideline, while 2/3 of the health facilities are delivering iron and folic acid, vitamin A supplementation and deworming.The knowledge and practices of the HW were above average and only a third of the messages delivered were retained by beneficiariesAlthough messages are being well delivered once counselling is implemented, many opportunities (contact points) are missed to deliver nutrition counselling. [ABSTRACT FROM AUTHOR]

Tef [Eragrostis tef (Zucc.) Trotter], an ancient cereal primarily grown in Ethiopia, is becoming increasingly popular worldwide due to its high iron content and gluten-free nature. However, it has been reported that injera produced only with tef flour lack certain vital nutrients. Therefore, this specific study was conducted to supplement tef injera with other food materials of better nutritional value and compensate its expensive market price with sorghum cereal flour. The effect of fermentation conditions, and the sorghum and carrot pulp blending ratio on the nutritional value and sensory quality of tef injera was investigated. The factorial approach of the experimental design was conducted considering the nutritional value and sensory quality of the injera made of three main blending ratios of tef, sorghum, and carrot (60% tef: 30% sorghum: 10% carrot pulp, 45% tef: 45% sorghum: 10% carrot pulp and 30% tef: 60% sorghum: 10% carrot pulp) as experiential variables. The raw materials and injera were characterised for their proximate composition, physicochemical property, mineral composition, microbial analysis, and sensory attributes, using standard methods. The results of the study show that fermentation conditions and blending ratios have a significant effect on the nutritional, anti-nutritional, mineral content, microbial quality, and sensory properties of blended injera products, where higher values of ash, crude protein, crude fat, Total titratable acidity (TTA), Fe, Zn, and Ca (2.30%, 11.34%, 2.62%, 3.53, 32.97 mg/100 g, 2.98 mg/100 g and 176.85 mg/100 g, respectively) were analyzed for the co-fermented injera sample. In addition, a lower microbial count was observed in co-fermented injera samples, whereas microbial counts in injera samples prepared from carrot pulp-supplemented dough after the co-fermentation of tef and sorghum flours were observed to be higher. The injera product made using blending ratio of 60% tef: 30%sorghum: 10% carrot co-fermented was found to be the optimum result due to its very good nutritional improvement (i.e., reduction of some anti-nutritional factors, microbial contents, pH and increased contents of some minerals, crude protein, crude fat, TTA and improved most of the sensory quality of the supplemented injera product). According to this study, sorghum and carrot supplementation on tef could improve the nutritional value of injera while also providing an instant remedy for the growing price of tef. [ABSTRACT FROM AUTHOR]

Antenatal care (ANC) is the largest health platform globally for delivering maternal nutrition interventions (MNIs) to pregnant women. Yet, large missed opportunities remain in nutrition service delivery. This paper examines how well evidence‐based MNIs were incorporated in national policies and programs in Bangladesh, Burkina Faso, Ethiopia and India. We compared the nutrition content of ANC protocols against global recommendations. We used survey data to elucidate the coverage of micronutrient supplementation, weight gain monitoring, dietary and breastfeeding counselling. We reviewed literature, formative research and program assessments to identify barriers and enabling factors of service provision and maternal nutrition practices. Nutrition information in national policies and protocols was often fragmented, incomplete and did not consistently follow global recommendations. Nationally representative data on MNIs in ANC was inadequate, except for iron and folic acid supplementation. Coverage data from subnational surveys showed similar patterns of strengths and weaknesses. MNI coverage was consistently lower than ANC coverage with the lowest coverage of weight gain monitoring and variable coverage of dietary and breastfeeding counselling. Key common factors associated with coverage were micronutrient supply disruptions; suboptimal counselling on maternal diet, weight gain, and breastfeeding; and limited or no record keeping. Adherence of women to micronutrient supplementation and dietary recommendations was low and associated with late and too few ANC contacts, poor maternal knowledge and self‐efficacy, and insufficient family and community support. Models of comprehensive nutrition protocols and health systems that deliver maternal nutrition services in ANC are urgently needed along with national data systems to track progress. Key points: Delivering nutrition services to all pregnant women is essential for maternal and child health outcomes but remains a challenge.Nutrition gaps in antenatal care (ANC) include lack of specificity in national guidelines and protocols, bottlenecks in micronutrient supplies, low ANC provider knowledge and skills, inadequate supervision to reinforce counseling, and not engaging families to encourage key practices.National protocols for ANC should be more specific for the four nutrition interventions (micronutrient supplements, weight gain monitoring, counseling on diets and counseling on breastfeeding) and assign accountability for coverage and quality.Country models are needed for improving provision and utilisation of nutrition interventions through ANC that are based on comprehensive policy frameworks. [ABSTRACT FROM AUTHOR]

Simple Summary: Nutritional flushing has the potential to increase reproduction in small ruminants. Utilization of locally available feed resources is imperative if smallholder farmers are to adopt improved nutritional strategies for flushing sustainably. The current experiment investigated the effect of four isonitrogenous (14.7% crude protein) rations formulated to supply low (Lo-ME) or high (Hi-ME) metabolizable energy based on enset leaf (Ensete ventricosum) and commercial concentrate and the effects on local Doyogena ewes in Ethiopia. The current finding indicated the supplementation of both enset leaf and concentrate enhanced the performance of local ewes. The objective of the study was to establish the effect of appropriate supplementation days (days -21 to +7) using four isonitrogenous (14.7% CP) diets balanced to provide low (Lo-ME) or high (Hi-ME) metabolizable energy on the body condition score (BCS), body weight (BW) change, and reproductive performances of sheep. Thirty-five Doyogena ewes (27.71 ± 2.87 kg, 2–5 years of age, BCS of 2.0–2.5) grazing on natural pasture were randomly assigned to supplementary treatments consisting of combinations of enset leaf (EL) and commercial concentrate (CC): T0 (control), T1 (250 g EL + 500 g CC: Lo-ME), T2 (400 g EL + 500 g CC; Hi-ME), T3 (500 g EL + 400 g CC; Hi-ME), and T4 (500 g EL + 250 g CC; Lo-ME). The estrous cycle was synchronized with one intramuscular injection, 5 mg PGF2α, prior to artificial insemination. The dry matter (DM) from the pasture provided 1.10–1.46 kg/day, which corresponds to the DM requirements of the ewes until late gestation. However, the pasture provided a protein content of 9.52%, which was insufficient for breeding, mid-gestation, and gestation, requiring minimums of 16.1%, 13.1%, and 14.8%, respectively. The pasture could only provide enough energy for breeding ewes with a BW of up to 30 kg. The energy provided by pasture was insufficient for ewes weighing > 30 kg at mid-gestation and gestation, providing 6.9–9.2 MJ/day, below the requirement of 11.92–16.32 MJ/day required for mid-gestation and gestation. The energy was not sufficient for large ewes weighing > 40 kg. Supplementary diets T1–T4 provided DM in the range of 1.7–2.29 kg/day. This was sufficient for AI, mid-gestation, and gestation phases. Dietary supplements increased (p < 0.01) BW during breeding and mid-gestation. During lambing, T2 and T3 increased BW (p < 0.05) compared to T4 and T1. T4 had a similar effect (p > 0.05) on BW during lambing. T1, T2, and T3 significantly increased BCS (p < 0.05). T2 and T3 increased (p < 0.05) BCS at mid-gestation, but only T2 significantly increased BCD (p < 0.05) during lambing. All dietary supplements resulted in a shorter (p < 0.05) time to the resumption of estrous and the length of estrous (p < 0.05). T1, T2, and T3 resulted in a stronger estrous response (p < 0.05). Dietary supplements enhanced (p < 0.05) the conception rate and fecundity rate. The conception rate was highest in T2 and T3 at 85.7% and 83.3%, respectively. T2 had the highest fecundity rate at 151.7% (p < 0.05). Dietary supplementation increased the rate of lambing (LR), litter size (LS), and weight of lambs at birth (LBW). The LR for treatments T2, T3, and T4 was 100% versus 66.7% in the control. T1 and T2 significantly increased (p < 0.05) LS, but T4 had a similar LS to the control. Dietary supplements T1, T3, and T4 tended to increase (p < 0.05) LBW, but T2 increased LBW significantly (p < 0.05). Supplementation (T2, T3) with 400 g enset + 500 g CC and 500 g enset + 400 g CC are promising feed supplements to increase the reproductive capacities of Doyogena ewes in Ethiopia. Energy is as important to ewe flushing as protein. [ABSTRACT FROM AUTHOR]

Background: Despite their paramount importance all over the globe in supporting food security, information about wild edible plants is generally patchy. In this study, we investigated the wild edible plants used by the local people in the Soro District of Hadiya Zone, southern Ethiopia. The main purpose of the study was to document and analyze the indigenous and local knowledge of the people on their abundance, diversity, use and management. Methods and materials: Purposive sampling and systematic random sampling were used to identify informants who can give information about the wild edible plants of the area. Data were collected by interviewing 26 purposively sampled key informants and 128 systematically randomly sampled general informants using semi-structured interviews. Guided observations and 13 focus group discussions (FGDs) consisting of 5–12 participants/discussants at each FGD session were also undertaken. Statistical analyses (mainly descriptive statistics approaches) and common analytical tools of ethnobotany including informant consensus, informant consensus factor, preference ranking, direct matrix ranking, paired comparison and index of fidelity level were applied to the data sets. Results: A total of 64 wild edible plant species belonging to 52 genera and 39 families were recorded. All of these species are indigenous, 16 are new additions to the database and seven of them, including Urtica simensis and Thymus schimperi, are endemic to Ethiopia. In about 82.81% of the species, the edible plant part is also used in the Ethiopian traditional herbal medicine. It is striking to see that almost all wild edible plants recorded from the study area are nutraceutical plant species, serving multiple roles as food and therapeutic sources for the local people. We recorded five growth habits of 34.38% trees, 32.81% herbs, 25% shrubs, 6.25% climbers, and 1.56% liana. We found the Flacourtiaceae, Solanaceae, and Moraceae to be families that represented more species (4 each), followed by Acanthaceae, Apocynaceae, Amaranthaceae, and Asteraceae, which accounted for 3 species each. Fruits (53.13%) and leaves (31.25%) were consumed in more proportions than other edible parts (15.63%); mostly the ripe, raw fruit is eaten upon simple processing, followed by leaves eaten after boiling, roasting and cooking. Conclusion: The frequency and intensity of consumption of these plants varied significantly (P < 0.05) with gender differences, key and general informants, and people's religious backgrounds. We postulate that priority setting for in situ and ex situ conservation of multipurpose wild edible plants in human-inhabited landscapes is essential to warrant sustainable use and conservation of the species as well as the use of new modes of application and valorization. [ABSTRACT FROM AUTHOR]

Previous attempts to increase the level of flaxseed in hens' diet for the production of n-3 polyunsaturated fatty acids (n-3 PUFAs)-enriched eggs have been commonly associated with undesirable effects on production efficiency, lipid health indices, and oxidative stability of eggs, requiring adequate research attention. This study investigated the effects of feeding a moderate level of flaxseed (FS) and plant polyphenol extracts (PPEs) on fatty acid content, oxidative stability, and lipid health indices in eggs of slow-growing Sasso T451A laying hens. One hundred and five hens were assigned to five groups (seven replicates of three) and fed on FS (75 g flaxseed and no antioxidants), VE8 (75 g flaxseed and 800 mg vitamin E), TS8 (75 g flaxseed and 800 mg Thymus schimperi), DA8 (75 g flaxseed and 800 mg Dodonaea angustifolia), and CD8 (75 g flaxseed and 800 mg Curcuma domestica) extract per kg diets. The egg yolk content of eicosapentaenoic acid (EPA, C20:5 n-3) in the DA8, TS8, and CD8 diets and docosahexaenoic acid (DHA, C22:6 n-3) in TS8 and CD8 diets significantly (p < 0.05) increased compared with the FS diet. The FS diet significantly increased the malondialdehyde (MDA) content in egg yolks, whereas the TS8 diet decreased it by 67% (p < 0.05). Little difference was observed in yolk fatty acid content between cooked and raw eggs. Production of n-3 PUFA-enriched eggs with favorable lipid health indices was possible through inclusion of PPEs extracted from local plant species grown in Ethiopia and a moderate dose of flaxseed in the diet of laying hens. [ABSTRACT FROM AUTHOR]

Background: Vitamin A is a nutrient that is required in a small amount for normal visual system function, growth and development, epithelia's cellular integrity, immune function, and reproduction. Vitamin A has a significant and clinically important effect since it has been associated with a reduction in all-cause and diarrhea mortality. The aim of this study was to determine factors associated with national vitamin A supplementation among children aged 6–35 months. Method: The data for this study was extracted from the 2019 Ethiopian Mini Demographic and Health Survey. A total weighted sample of 2242 women with children aged 6–35 months was included in the study. The analysis was performed using Stata version 14.2 software. Applying sampling weight for descriptive statistics and complex sample design for inferential statistics, a manual backward stepwise elimination approach was applied. Finally, statistical significance declared at the level of p value < 0.05. Result: The overall coverage of vitamin A supplementation among children aged 6–35 months for the survey included was 44.4 95% CI (40.15, 48.74). In the multivariable analysis, mothers who had four or more antenatal visits [AOR = 2.02 (95% CI: 1.34, 3.04)] were two times more likely to receive vitamin A capsules for their children than mothers who had no antenatal visits. Children from middle-wealth quintiles had higher odds of receiving vitamin A capsules in comparison to children from the poorest wealth quintile [AOR = 1.77 (95% CI: 1.14, 2.73)]. Older children had higher odds of receiving vitamin A capsules than the youngest ones. Other factors that were associated with vitamin A supplementation were mode of delivery and region. Conclusion: The coverage of vitamin A supplementation in Ethiopia remains low and it is strongly associated with antenatal visit, household wealth index and age of child. Expanding maternal health services like antenatal care visits should be prioritized. [ABSTRACT FROM AUTHOR]

A study was performed with the objective to assess nutrient biological performance and assess economic feasibility of Farta lambs fed wheat straw (WS) as a basal feed and supplemented with lentil screening (LS) in replacement for noug seed cake (NSC). The experimental sheep were blocked into five based on their initial body weight and randomly assigned to treatment diets within each block. The experimental design used for this study was randomized complete block design (RCBD) with five replications. Result indicated %CP contents of experimental feeds were 26.13, 25.00 and 5.66 for lentil screening, NSC and WS, respectively. There was significant difference in WS DM intake (p<0.05) in all treatment groups. The supplement DM intake increased significantly (p<0.001) as lentil screening level increased from 0, 29.4, 55.4, 78.8, and 100% from (T1-T5), respectively. Total DM intake was significantly different (p<0.01) among all treatment groups but CP intake was not significantly different among treatments (p>0.05). Average daily body weight gain (ADG) and feed conversion efficiency (FCE) were significantly different (p<0.01) among treatment groups. Among treatment groups, T5 had higher (p<0.01) daily body weight gain (76.44 g/d) as compared to T4 (72.1 g/d), T3 (69.8 g/d), T2 (62.89 g/d), T1 (58.28 g/d). T5 returned a higher net income (110.94 Ethiopian Birr (EB)/sheep) as compared to the other treatment groups. From biological performance and economic return T5 could be recommended as an alternative supplement for growing Farta sheep both in biological performance and better economic gain. [ABSTRACT FROM AUTHOR]

Background: Micronutrient (MN) deficiency among children is recognised as a major public health problem in Ethiopia. The scarcity of MNs in Ethiopia, particularly in pastoral communities, might be severe due to poor diets mitigated by poor healthcare access, drought, and poverty. To reduce MNs deficiency, foods rich in vitamin A (VA) and iron were promoted and programs like multiple micronutrient powder (MNP), iron and vitamin A supplements (VAS) and or deworming have been implemented. Nationally for children aged 6–23 months, consumption of four or more food groups from diet rich in iron and VA within the previous 24 hours, MNP and iron supplementation within seven days, and VAS and >75% of deworming within the last 6 months is recommend; however, empirical evidence is scarce. Therefore, this study aimed to assess the recommended MN intake status of children aged 6–23 months in the emerging regions of Ethiopia. Methods: Data from the Ethiopia Demographic and Health Survey 2016 were used. A two-stage stratified sampling technique was used to identify 1009 children aged 6–23 months. MN intake status was assessed using six options: food rich in VA or iron consumed within the previous 24 hours, MNP or iron supplementation with the previous seven days, VAS or deworming within six months. A multilevel mixed-effect logistic regression analysis was computed, and a p-value of < 0.05 and Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were used to identify the individual and community-level factors. Results: In this analysis, 37.3% (95% CI: 34.3–40.3) of children aged 6–23 months had not received any to the recommended MNs sources. The recommended MNs resulted; VAS (47.2%), iron supplementation (6.0%), diet rich in VA (27.7%), diet rich in iron (15.6%), MNP (7.5%), and deworming (7.1%). Antenatal care visit (AOR: 1.9, 95% CI: 1.4–2.8), work in the agriculture (AOR: 2.2, 95% CI: 1.3–3.8) and children aged 13 to 23 months (AOR: 1.7, 95% CI: 1.2–2.4) were the individual-level factors and also Benishangul (AOR: 2.2, 95% CI: 1.3–4.9) and Gambella regions (AOR: 1.9, 95% CI: 1.0–3.4) were the community-level factors that increased micronutrient intake whereas residence in rural (AOR: 0.4, 95% CI: 0.1–0.9) was the community-level factors that decrease micronutrient intake. Conclusions: Micronutrient intake among children aged 6–23 months in the pastoral community was low when compared to the national recommendation. After adjusting for individual and community level factors, women's occupational status, child's age, antenatal visits for recent pregnancy, residence and region were significantly associated with the MN intake status among children aged 6–23 months. [ABSTRACT FROM AUTHOR]