Poor Adherence to the Integrated Community Case Management of Newborn and Child Illness Protocol in Rural Ethiopia.

Ethiopia has adopted the Integrated Community Case Management of Newborn and Child Illness (iCMNCI) strategy to expand access to neonatal and child health services. This study assessed compliance with the iCMNCI case management protocol at the primary care settings. A descriptive cross-sectional assessment was conducted in eight districts of Benishangul-Gumuz Region from April to December 2019, and 1,217 sick children aged 2 to 59 months and 43 sick young infants aged 0 to 2 months who sought clinical consultation at the 236 health posts were selected purposively. Trained supervisors reviewed the medical records of two most recent cases from each illness category to quantify the extent to which health workers correctly assessed, classified, treated, and followed up cases per the iCMNCI guidelines. A total of 32,981 children sought clinical consultation of whom 31,830 (96.5%) were aged 2 to 59 months, and 1,151 (3.5%) were young infants aged 0 to 2 months. Of the 1,217 selected children, 426 (35%) had pneumonia, 287 (23.6%) malaria, 501 (41.2%) diarrhea, and 3 (0.2%) had malnutrition. Nearly two-thirds 306 (72%) of pneumonia cases were correctly classified as having had the disease and 297 (70%) were correctly treated for pneumonia; 213 (74%) were correctly classified as having had malaria and 210 (73%) were correctly treated for malaria; and 393 (78%) were correctly classified as having had diarrhea and 297 (59%) were correctly treated for diarrhea. Generally, the current practices of child illness assessment, classification, and treatment have deviated from iCMNCI guidelines. Future interventions should support frontline health workers to comply strictly with case management protocols through training, mentorship, and supervision.

Estrus response and fertility of Menz and crossbred ewes to single prostaglandin injection protocol.

Natural lambing in sheep in Ethiopia occurs throughout the year in a scattered manner negatively affecting survival and growth rates of the lambs born during the unfavorable season of the year. Thus, controlling the time of mating artificially using exogenous source of hormones is considered as one of the ways to mitigated problems related to haphazard lambing. To this end, an experiment was conducted to evaluate efficacy of prostaglandin-based estrus synchronization protocol in local and crossbred ewes. A total of 160 ewes (80 local and 80 crossbreds) which lambed at least once and aged 3-5 years were used. Lutalyse® (dinoprost tromethamine sterile solution equivalent to 5 mg dinoprost per ml) and its analog, Synchromate® (cloprostenol sodium equivalent to 0.250 mg cloprostenol per ml), were tested at different doses. The treatments used were intramuscular injection of (1) 2.50 ml of Lutalyse® (12.5 mg dinoprost tromethamine), (2) 2 ml of Lutalyse® (10.0 mg dinoprost tromethamine), (3) 1 ml of Synchromate® (0.25 mg of cloprostenol Sodium), and (4) 0.8 ml of Synchromate® (0.20 mg of cloprostenol Sodium). Forty ewes (20 local and 20 crossbreds) were allocated per treatment. Following injection of the respective hormones, rams of known fertility were introduced into the flock for the duration of 96 h at the ratio of one ram to 10 ewes. All estrus synchronization protocols except treatment 4 (0.8 ml of Synchromate®) induced estrus (heat) in majority (55-65%) of local and crossbred ewes within 96 h post-hormone injection. The time interval from hormone administration to onset of estrus was also more or less similar for all treatment groups except for treatment group 4 which showed heat quicker. The highest lambing rate was recorded in local ewes (84.62% (11/13) treated with 2.5 ml of Lutalyse®, whereas the least was obtained in crossbreds (33.33% (3/9) treated with 0.8 ml Synchromate®. In conclusion, even though 2.5 ml and 2 ml of Lutalyse® or 1 ml of Synchromate® were able to induce heat in majority of local and crossbred ewes, the highest lambing percentage was obtained from ewes treated with 2.5 ml of Lutalyse®. Therefore, the use of 2.5 ml Lutalyse® is recommended to synchronize estrus in local and crossbred ewes under Ethiopian smallholder sheep production system for the benefit of improved lambing rate.