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Despite the developments at the global level in the use of research evidence in the policymaking processes, linking research evidence to action is not an easy task. It becomes more challenging in LMICs where the resources are scarce and social problems are pressing. While research has highlighted the importance of relationships with decision-makers and networks of researchers, strategies that enhance EIDM mechanisms have received less attention, especially in resource-constrained settings. So, the objective of this scoping review will be to map and summarize the available evidence on strategies that enhance evidence-informed decision-making (EIDM) in low- and middle-income countries (LMICs).

This scoping study seeks to map the evidence relating to school feeding like coverage of school feeding, quality, nutritional impacts, funding issues, and its educational achievements among students in Ethiopia to inform policies, programs, future research, and offer insight related to school feeding in Ethiopia.

Insecticide based vector control intervention is threatening with the emergence and spread of resistant vectors. The development of other eco-friendly and cost effective vector control tools is required to alleviate this problem. In this study, five selected plant leaf extracts were evaluated for their larvicidal activities against 3rd instar An. arabiensis larvae at concentrations ranging from 50 to 300 ppm following the WHO protocol. The best performing extract was subjected to bioassay-guided column chromatographic fractionation and all fractions were tested separately for their larvicidal activities. All the plant extracts were found to have potential larvicidal activities against 3rd instar An. arabiensis larvae. Methanol crude extract of Calpurnia aurea achieved 100% larval mortality at 300 ppm with LC50 of 84.85 ppm while less activity was observed for methanol crude extract of Artemisia annua, 68% larval mortality at 300 ppm. Column chromatographic fractions F1and F3 of methanol extract of C. aurea caused 100% mortality at 250 and 300 ppm with LC50 of 62.51 and 82.33 ppm, respectively. The present study revealed that column chromatographic fractions F1 and F3 of methanol extract of C. aurea caused a remarkable larvicidal activity against An. arabiensis demonstrating a high potential for botanical mosquito insecticide development.

OBJECTIVE This systematic review will identify and synthesize evidence on the effectiveness of conditional cash transfers for the uptake and retention in prevention of mother-to-child transmission services in pregnant and/or breastfeeding women with HIV infection in low- and middle-income countries. INTRODUCTION Regardless of the effectiveness of prevention of mother-to-child transmission services, uptake and retention in such services remains poor in low- and middle-income countries. This review intends to evaluate the effectiveness of conditional cash transfers in improving uptake and retention in such services for pregnant and/or breastfeeding women with HIV infection. INCLUSION CRITERIA This review will consider studies that evaluate the impact of conditional cash transfers on uptake and retention in prevention of mother-to-child transmission services in pregnant and/or breastfeeding women with HIV. Studies will compare conditional cash transfers with no intervention or other interventions. Only studies carried out in low- and middle-income countries will be eligible for inclusion. METHODS Eight databases will be searched. Publication status will not be considered as a criterion for inclusion. Studies published in English since 2000 will be considered, because prevention of mother-to-child transmission services were first introduced in that year. Following the search, two independent reviewers will screen titles and abstracts against the inclusion criteria, critically appraise eligible studies for methodological quality using JBI critical appraisal tools, and extract data from included studies using a standardized data extraction tool. Where possible, quantitative data will be pooled using statistical meta-analysis. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42021236729.

Review question/objective:: The objective of this systematic review is to explore the impact of male partner involvement on modern contraceptive use among married or partnered women of reproductive age in developing countries. Specifically, does male partner involvement:Increase the rate of modern c

REVIEW QUESTION/OBJECTIVE The objective of this review is to assess the impact of conditional cash transfers on child nutritional outcomes among sub-Saharan African countries. More specifically, the objectives are to assess the impact of conditional cash transfers on child anthropometry, micro-nutrient, and improvement in dietary diversity of households.

Review question/objective:The objective of this review is to identify and synthesize the best available evidence on the effect of mobile health (mHealth) interventions in antenatal care utilization and skilled birth attendance in low- and middle-income countries.More specifically, the review questio

BACKGROUND: The influence of socio-cultural factors on institutional birth is not sufficiently documented in Ethiopia. Thus, this study explores socio-cultural beliefs and practices during childbirth and its influences on the utilization of institutional delivery services.METHODS: A qualitative study was conducted in three regions of Ethiopia through eight focus group discussions (with women) and thirty in-depth interviews with key informants which included health workers, community volunteers, and leaders. The data were analyzed thematically.RESULTS: The study identified six overarching socio-cultural factors influencing institutional birth in the study communities. The high preference for traditional birth attendants (TBAs) and home as it is intergenerational culture and suitable for privacy are among the factors. Correspondingly, culturally unacceptable birth practices at health facilities (such as birth position, physical assessment, delivery coach) and inconvenience of health facility setting to practice traditional birth rituals such as newborn welcoming ceremony made women avoid health facility birth. On the other hand, misperceptions and worries on medical interventions such as episiotomy, combined with mistreatment from health workers, and lack of parent engagement in delivery process discouraged women from seeking institutional birth. The provision of delivery service by male health workers was cited as a social taboo and against communities' belief system which prohibited women from giving birth at a health facility.CONCLUSIONS: Multiple socio-cultural factors and perceptions were generally affected utilization of institutional birth in study communities. Hence, culturally competent interventions through education, re-orientation, and adaptation of beneficial norms combined with women friendly care are essential to promote health facility birth.

An attempt was made to determine the infection rate of onchocerciasis in the resettled and indigenous communities of Asossa. A total of 931 persons consisting of 548 settlers and 383 indigenous population, aged five years and over were examined parasitologically for the presence of Onchocerca microfilaria in a skin snip, and 11.1% of the resettled population and 31.3% of the indigenous population were found infected with the parasite. The total mean number of microfilariae per mg of skin snip at the buttock was 15.3. The clinical manifestations recorded include skin atrophy, skin depigmentation, pruritus and presence of nodules at a rate of 15.5%, 20.4%,44.8%, and 1.7%, respectively, among the positives. No visual impairment difference between the positives and negatives was seen and blindness due to onchocerciasis was not detected. Blackfly collection and identification around the near-by rivers indicated the presence of the anthropophilic vector Simulium damnosum s.l. The results recorded for the resettled communities clearly indicated disease propagation in the resettled population who came from areas of the country non-endemic for onchocerciasis in 1984. [Ethiop. I. Health Dev. 1996;10(2):89-95]

Objective: The aim of this study was to investigate malaria elimination in Ethiopia. Ethiopia has planned to eliminate malaria by 2015 in areas of unstable malaria transmission and in the entire country by 2020. However, there is a shortage and maldistribution of the health workforce in general and malaria experts in particular. Training, motivating, and retaining the health workforce involved in malaria control is one strategy to address the shortage and maldistribution of the health workforce to achieve the goal of elimination.Methods: Policy options include the following: (i) in-service training (educational outreach visits, continuing education meetings and workshops, audit and feedback, tailored interventions, and guideline dissemination) may improve professional practice; (ii) recruiting and training malaria specialists together with academic support, career guidance, and social support may increase the number of malaria experts; and (iii) motivation and retention packages (such as financial, educational, personal, and professional support incentives) may help motivate and retain malaria professionals.Results: Implementation strategies include the following: (i) massive training of health personnel involved in malaria elimination and malaria experts (requiring special training) at different levels (national, sub-national, District & community levels), and (ii) recruiting highly qualified health personnel and retention and motivation mechanisms are needed.Conclusions: The lack of adequately trained human resources and personnel attrition are major challenges to effectively implement the planned multi-faceted malaria elimination by 2020 strategy in Ethiopia. Although a reduction in malaria incidence has been observed in the last 3-4 years, maintaining this success and achieving the malaria elimination goal with the present human resource profile will be impossible. A clear strategy for developing the capacity of the health workers in general, and malaria experts in particular, and retaining and motivating staff are crucial for malaria control and elimination.

OBJECTIVE To assess the susceptibility/resistance level of Anopheles gambiae s.l. to DDT, malathion, permethrin and deltamethrin in different parts of Ethiopia. METHODS Field collected female An.gambiae s.l. was exposed for 1 h to discriminating dosage of 4% DDT, 5% malathion, 0.75% permethrin and 0.05% deltamethrin using WHO insecticide susceptibility test kits and procedures. Knockdown and mortality rates were recorded at 10, 15, 20, 30, 40, 50 and 60 min and 24 h post-exposure respectively. RESULTS Anopheles gambiae s.l. was sensitive to DDT only in 2 of 16 localities where susceptibility studies were carried out in northern Ethiopia; it was resistant in 11 sites and potentially resistant in three. To malathion, the test population was sensitive in four of the six study sites in southern Ethiopia and potentially resistant in the other two sites. In northern Ethiopia, the population was resistant in five localities and sensitive in three. Of the six localities in northern Ethiopia where permethrin was tested, populations were sensitive in three, resistant in one and potentially resistant in two. In southern Ethiopia, the populations were resistant in five of the six sites. Against deltamethrin, the population was sensitive in five of 13 localities, three in northern and two in southern Ethiopia. It was resistant only in two localities, one in northern and one in southern Ethiopia, and potentially resistant in five localities. In eastern Ethiopia at Sabure, the population was sensitive to all insecticides but DDT to which it was potentially resistant. CONCLUSION The existence of high level of DDT and pyrethroid resistance with the possibility of cross-resistance to each other and other classes of agricultural pesticides could seriously jeopardise the efficacy of both ITNs and IRS in the country in the future. Insecticide resistance monitoring and surveillance systems as part of a malaria control programme are mandatory for proper management of resistance. The use of a mixture of unrelated insecticides for impregnating nets and rotational use of insecticides for IRS is suggested as a way forward.

Although Ethiopia is one of the countries worst affected by human onchocerciasis, the exact taxonomic identity of the blackflies acting as the main vectors in the endemic areas has never been determined. A cytotaxonomic analysis of Simulium damnosum s.l. collected from three endemic sites in south-western Ethiopia has now revealed the existence of the 'Kisiwani' form (a non-anthropophilic cytoform that is common in East Africa) and a newly recognized species, Simulium kaffaense. Simulium kaffaense sp. nov. is differentiated from other members of the S. damnosum complex by six fixed inversions and dozens of 'new' floating inversions. The rearing of egg batches from some of the biting adult females, to larvae or adults, indicated that the human-biting blackflies were all S. kaffaense. As S. kaffaense is not only highly anthropophilic but also, apparently, the only anthropophilic member of the S. damnosum complex present, it is likely to be the main (if not the only) vector of Onchocerca volvulus in the study area. The presence of inversion 1S-1 and a complex inversion possibly involving 1L-3 indicates that S. kaffaense either belongs or is close to the 'Nile' phylogenetic group of S. damnosum s. l. The karyotype frequencies of the inversions in the collections from the three study sites indicate that at least two forms of S. kaffaense, here designated 'Bebeka' and 'Jimma', were caught. The taxonomy and medical importance of S. kaffaense are discussed.

The repellent activity of essential oils of lemon eucalyptus (Eucalyptus maculata citrodion), rue (Ruta chalepensis), oleoresin of pyrethrum (Chrysanthemum cinerariaefolium) and neem (Azadiracta indica) have been field tested as 40%, 50% and 75% solutions in coconut oil against populations of mosquitoes consisting mainly of Mansonia in Gambella, western Ethiopia. A latin square design was used to randomize the test subjects for possible individual differences for mosquito attraction. Repellency was evaluated as the percentage protection. Deet was included in the study for comparison. All the plant products manifested repellency. At 50% concentration at which the highest repellency was recorded the protection was 91.6%, 87.0%, 96.0%, 97.9% for rue, neem, pyrethrum and deet, respectively. The essential oil of lemon eucalyptus was not tried at this concentration. At a 40% concentration deet, lemon eucalyptus and pyrethrum were significantly (p < 0.05) more effective than rue and neem. At a 50% concentration, deet and pyrethrum were significantly better (p < 0.05) than rue and neem. At a 75% concentration concentration, deet and lemon eucalypus performed significantly better (p < 0.05) than pyrethrum and neem. The difference between pyrethrum and neem was also significant (p < 0.01).

Human Resources for Health (HRH) constitute the most vital component of health systems. However, the HRH picture of Ethiopia has remained critically low and characterized by geographic mal-distribution. This brief aimed to show the major causes for poor health workforce distribution and to suggest possible policy options. We reviewed relevant evidence describing the problem and feasible options to address the problem, the barriers to implement those options, and implementation strategies to address these barriers. We searched electronic databases of systematic reviews and supplemented with local evidences. In our review, we found different options that help to improve health workforce distribution in the remote and rural areas of the country. Systematic reviews on impact of task shifting, clinical rotations in rural areas during studies and financial incentives have shown favourable results that may lead to increase the number of health workforce working in rural and underserved areas. But none of the studies assessed the costs and cost effectiveness of the suggested options. Therefore, given the limitations of the currently available evidence, there is a need for rigorous evaluative research on the cost effectiveness of each option prior to widespread implementation.

Indoor-resting blood-fed Anopheles gambiae s.l. were collected from selected localities in Ethiopia. Anopheles arabiensis was the only sibling species identified. Paracentric chromosomal inversion polymorphisms were observed on the 2R and 3R arms. A significant excess of heterozygotes was obtained in samples from Sille carrying the 3Ra inversion. Similarly, significant variation was seen in the frequencies of the 3Ra inversion between the study localities. The observed intraspecific inversion polymorphisms relative to indoor resting behaviour are discussed.

To assess the susceptibility/resistance level of Anopheles gambiae s.l. to DDT, malathion, permethrin and deltamethrin in different parts of Ethiopia.Field collected female An.gambiae s.l. was exposed for 1 h to discriminating dosage of 4% DDT, 5% malathion, 0.75% permethrin and 0.05% deltamethrin using WHO insecticide susceptibility test kits and procedures. Knockdown and mortality rates were recorded at 10, 15, 20, 30, 40, 50 and 60 min and 24 h post-exposure respectively.Anopheles gambiae s.l. was sensitive to DDT only in 2 of 16 localities where susceptibility studies were carried out in northern Ethiopia; it was resistant in 11 sites and potentially resistant in three. To malathion, the test population was sensitive in four of the six study sites in southern Ethiopia and potentially resistant in the other two sites. In northern Ethiopia, the population was resistant in five localities and sensitive in three. Of the six localities in northern Ethiopia where permethrin was tested, populations were sensitive in three, resistant in one and potentially resistant in two. In southern Ethiopia, the populations were resistant in five of the six sites. Against deltamethrin, the population was sensitive in five of 13 localities, three in northern and two in southern Ethiopia. It was resistant only in two localities, one in northern and one in southern Ethiopia, and potentially resistant in five localities. In eastern Ethiopia at Sabure, the population was sensitive to all insecticides but DDT to which it was potentially resistant.The existence of high level of DDT and pyrethroid resistance with the possibility of cross-resistance to each other and other classes of agricultural pesticides could seriously jeopardise the efficacy of both ITNs and IRS in the country in the future. Insecticide resistance monitoring and surveillance systems as part of a malaria control programme are mandatory for proper management of resistance. The use of a mixture of unrelated insecticides for impregnating nets and rotational use of insecticides for IRS is suggested as a way forward.

The effect of resettlement programmes and agricultural development projects on the tsetse population in Gambella were investigated. Adult tsetse were collected using biconical traps and moving vehicle catches. The species collected were Glossina pallidipes, G. fuscipes and G. tachinoides. G. pallidipes was the most frequently encountered species. G. morsitans which were reported to be abundant in the area (Balis and Bergeon, 1968; Hutchinson, 1971; Langridge, 1976) were not collected during the present survey. About 155,000 ha. of land, formerly reported as tsetse infested, is found to be tsetse free. The natural vegetation is being transformed into farmlands and villages, and the wildlife is being hunted out, remaining only in such areas as Demesaye and Gog forest. Under such circumstances tsetse hosts may change from wild mammals to man and his domestic animals and outbreaks of nagana and sleeping sickness are likely to occur throughout the region.

The man-biting behavior and Plasmodium infection rates of anopheline mosquitoes were investigated in Sille, a hyperendemic malarious area in southern Ethiopia. Seven Anopheles species were identified from all night landing collections, conducted from 18:00 to 06:00h between October 2001 and August 2002. The predominant species was Anopheles arabiensis (55.8%), followed by Anopheles coustani (31.5%), Anopheles pharoensis (9.5%), Anopheles funestus (2.2%), Anopheles nili (0.5%), Anopheles marshallii (0.4%) and Anopheles demeilloni (0.2%). Dissection of A. arabiensis showed an average parous rate of 73.2%. A large proportion of the parous mosquitoes were caught biting in the latter part of the night. Malaria sporozoite rates were determined by ELISA for A. arabiensis, with 0.5% (4/796) infective with Plasmodium falciparum and 1.76% (14/796) with Plasmodium vivax; there were no mixed infections. From our small sample of sporozoite positives we found no association between biting behavior and sporozoite infection status.

The host preference of indoor resting Anopheles arabiensis has been determined using a direct enzyme-linked immunosorbent assay. A total of 611 specimens, 258 from human dwellings, 179 from mixed dwellings, and 174 from cattle sheds, was examined. The proportion of human blood meals identified was highest from mosquitoes caught in human dwellings (91.5%), followed by those from mixed dwellings (20.2%) and cattle sheds (3.5%) (P < 0.0001). The smaller proportion of human blood meals from mixed dwellings suggests that cattle may protect humans from A. arabiensis.

The exact taxonomic identity of members of the Simulium damnosum Theobald complex in Ethiopia was not known until recently. A cytotaxonomic analysis of larval chromosomes from the Kulfo River area in southern Ethiopia, from where the ‘Kulfo’ form was reported, and from the Awash River at Sodere in central Ethiopia has revealed the existence of two newly recognized species, namely Simulium kulfoense and Simulium soderense. Although three fixed and 11 floating inversions in the chromosomes of the ‘Kulfo’ form were described in an idiogram, in the present study four fixed and 17 floating inversions were observed, out of which only seven floating inversions were the same as Dunbar's, indicating that the remaining 10 inversions were either missed or misinterpreted. Though both species share many inversions, S. kulfoense sp. nov. has a diagnostic inversion on chromosome II, IIL-E6, with no sex-linked chromosomal arrangement, while S. soderense sp. nov. has a sex-linked inversion, IIS-3, which warrants it as a distinct species. Both of these new species also share many inversions with the recently described new species from south-western Ethiopia, Simulium kaffaense, including the fixed inversions IIL-E1 and E3. Since both the study sites are known to be free of onchocerciasis, and the flies are not anthropophilic, both the species are not presumed to be vectors of human onchocerciasis. The presence of IS-1 and a complex inversion possibly involving IL-3 strongly indicates that the two species belong to the ‘Nile’ phylogenetic group of S. damnosum s.l.

Long term and wide use of indoor residual sprays augments the selection of insecticide resistance genes. The development of insecticide resistance in an insect population depends up on the volume and frequency of sprays against them and the inherent characteristics of the insect species. However, despite its use for decades, the effect of residual sprays on the status of insecticide resistance of malaria vectors is unknown in Ethiopia. The objective of this study was to assess the effect of bendiocarb 80% WP indoor residual spraying on insecticide resistance status of An. arabiensis in Bahir Dar Zuria District, Northwest Ethiopia. Susceptibility of An. arabiensis was examined against different insecticides using 2-3-day old female mosquitoes following WHO insecticide susceptibility test procedures. Test results were calculated according to WHO bioassay test protocol. Chi-square test was used to determine the significance level of differences between years and study sites. Susceptibility of An. arabiensis to fenitrothion, pirimiphosmethyl and propoxur was 100% in both study villages for three successive years. Resistance to bendiocarb was suspected after two years (2015) in Andassa, but not in Tikurit. Mortality and knock down due to DDT significantly increased from 2013 to 2015 at Tikurit (knock down: χ2 = 117.9, P