Objective: This study evaluated the impact of the Addis Ababa SFP on educational outcomes. Design: Single-group repeated measurement/longitudinal study design and multistage stratified sampling design was followed. Effect sizes estimates, repeated measures ANOVA, Chi-square, Generalized Additive Mixed Model, and mixed effects negative binomial regression were used. Academic scores, attendance and dropout, and height and weight of schoolchildren were collected. Setting: School Feeding Programs in Addis Ababa, Ethiopia. Participants: Schoolchildren in primary schools, and school directors and teachers in 15 randomly selected schools for KII. Results: Anthropometric measurements of 4500 schoolchildren were taken from 50 schools. Academic scores of 3924 schoolchildren from 46 schools, class attendance records of 1584 schoolchildren from 18 schools, and annual enrollment records of 50 schools were gathered. School meals achieved a minimum to large scale effects on educational outcomes with effect sizes (η2) of academic scores (boys=0.023, girls=0.04), enrollment (girls=0.001, boys=0.05), and attendance (Cramer’s V=0.2). The average scores of girls were significantly higher than that of boys (p<0.0001). Height-for-age in all schoolchildren (p<0.01) and BMI-for-age Z-scores in adolescent girls of 15–19 years (p<0.0001) ever had significant positive relationship with average scores. Significant relation was observed between nutritional status and attendance (p=0.021). KIIs showed that SFP created convenient teaching-learning environment, reduced hunger in schools, while boosting enrollment, attendance, and academic performance among the schoolchildren. Conclusion: The Addis Ababa SFP has positively contributed to educational outcomes. Strengthening the program would enhance nutritional outcomes and diminish educational inequalities.

Background: Ethiopia has shown significant efforts to address the burden of TB/HIV comorbidity through the TB/ HIV collaborative program. However, these diseases are still the highest cause of death in the country. Therefore, this systematic review and meta-analysis evaluated this program by investigating the overall proportion of unknown HIV status among TB patients using published studies in Ethiopia. Methods: We conducted a systematic review and meta-analysis of published studies in Ethiopia. We identified the original studies using the databases MEDLINE/PubMed, and Google Scholar. The heterogeneity across studies was assessed using Cochran's Q test and I 2 statistics. The Begg's rank correlation and the Egger weighted regression tests were assessed for the publication bias. We estimated the pooled proportion of unknown HIV status among TB patients using the random-effects model. Results: Overall, we included 47 studies with 347,896 TB patients eligible for HIV test. The pooled proportion of unknown HIV status among TB patients was 27%(95% CI; 21-34%) and with a substantial heterogeneity (I 2 = 99.9%). In the subgroup analysis, the pooled proportion of unknown HIV status was 39% (95% CI; 25-54%) among children and 20% (95% CI; 11-30%) among adults. In the region based analysis, the highest pooled proportion of unknown HIV status was in Gambella, 38% (95% CI; 16-60%) followed by Addis Ababa, 34%(95% CI; 12-55%), Amhara, 30%(95% CI; 21-40%),and Oromia, 23%(95% CI; 9-38%). Regarding the study facilities, the pooled proportion of unknown HIV status was 33% (95% CI; 23-43%) in the health centers and 26%(95% CI; 17-35%) in the hospitals. We could not identify the high heterogeneity observed in this review and readers should interpret the results of the pooled proportion analysis with caution. Conclusion: In Ethiopia, about one-third of tuberculosis patients had unknown HIV status. This showed a gap to achieve the currently implemented 90-90-90 HIV/AIDS strategic plan in Ethiopia, by 2020. Therefore, Ethiopia should strengthen TB/HIV collaborative activities to mitigate the double burden of diseases.

No abstract

Background Ethiopia Population-based HIV Impact Assessment findings showed that in Addis Ababa, only 65.2% of people living with HIV (PLHIV) know their status. We present the enhanced HIV/AIDS data management and systematic monitoring experience in Addis Ababa City Administration Health Bureau (AACAHB). Methods AACAHB established a command-post with leadership and technical team members from the health bureau, 10 sub-city health offices, and non-governmental stakeholders. The command-post improved governance, standardized HIV program implementation, and established accountability mechanism. A web-based database was established at each health facility, sub-city, and AACAHB level. Performance was scored (green, ≥75%; yellow, 50–74%; red, < 50%). The command-post reviewed performance on weekly basis. A mentorship team provided a weekly site-level support at underperforming public and private health facilities. At facility level, quality of data on recording tools such as registers, and individual medical records were maintained through continued review, feedback mechanisms and regular consistency check of data. Percentage and 95% confidence interval were computed to compare the improvement in program performance over time. Results After 6 months of intervention period, the monthly New HIV case finding in 47 health facilities increased from 422 to 734 (1.7 times) and treatment initiation increased from 302 to 616 (2 times). After 6 months, the aggregate scoring for HIV testing at city level improved from yellow to green, HIV case finding improved from red to green, and treatment initiation improved from red to yellow. An increasing trend was noted in HIV positive case finding with statistically significant improvement from 43.4% [95% Confidence Interval: 40.23–46.59%] in May 2019 to 74.9% [95% Confidence Interval: 72.03–77.6%] in September 2019. Similarly, significant improvement was recorded for new HIV treatment from 30.9% [95% Confidence Interval: 28.01–33.94%] in May 2019 to 62.5% [95% Confidence Interval: 59.38–65.6%] in September 2019. Conclusions Regular data driven HIV program review was institutionalized at city, sub-city and health facility levels which further improved HIV program monitoring and performance. The performance of HIV case finding and treatment initiation improved significantly via using intensified monitoring, data driven performance review, targeted site-level support based on the gap, and standardized approaches.