Evidence map›Paper›PMID 36197123›Full record

ArticleMaternal & child nutrition2023

Barriers and facilitators to the implementation of nutrition interventions at primary health care units of Ethiopia: A consolidated framework for implementation research.

Bilal Shikur Endris, Esete Fenta, Yalemwork Getnet, Mark Spigt, Geert-Jan Dinant, Seifu H Gebreyesus

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Maternal & child nutrition, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 4 pooled it
2.3field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 4 syntheses or guidelines pooled it, 22 citations in OpenAlex.

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  12. Implementation science in nutrition practice: A review of the Consolidated Framework for Implementation Research.Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 3 countries.

Bilal Shikur EndrisDepartment of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.ORCID 0000-0002-5321-1034
Esete FentaDepartment of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
Yalemwork GetnetDepartment of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
Mark SpigtSchool CAPHRI, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.
Geert-Jan DinantSchool CAPHRI, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.
Seifu H GebreyesusDepartment of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
Addis Ababa University · ETMaastricht University · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

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.

Indexed as

Health PersonnelPrimary Health CareChildEthiopiaHumansQualitative Research1000 days nutritionbarrier and facilitatorconsolidated frameworkimplementation researchprimary health care

Identifiers

PMID36197123
PMCPMC9749594
OpenAlexW4302004453

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.