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Elf Learners‟ Attitude and Practice of Learning Listening Skills and Factors Affecting Their Learning Grade 8 Students Dureso Donke Primary School in Focus
No full textThe main purpose of the study was to EFL learners’ attitude and practice learning listening skill
and factors affecting their learning Dureso Donke primary school focus on grade eight. The
researcher employed descriptive survey design to gather quantitative and qualitative data from
respondents. The population of the study was 104 grade eight students and 4 EFL teachers. The
researcher selected 30 student samples using systematic random sampling. For students, the
researcher used comprehensive sampling for the questionnaires. For interview and observation,
three sample teachers were used. Observation, questionnaires and interview were the main data
gathering instruments for this study. The findings of the study reveal that EFL learners’ attitude
and practice learning listening skill and factors affecting their learning; however, they practiced
the listening lessons activities presented in grade eight EFL textbook rarely. In addition, their
practices of listening skill lessons were low. Moreover, teachers’ interview data showed that
students and material related factors were the major problems hindering the teaching learning
of listening skill lessons in grade 8 EFL classes. The focus of this study was EFL learners’
attitude, practices and factors affecting learning listening skills they encounter: Dureso Donke
primary school, grade Eight in focus. Listening problems related to listener originated from
student’s poor English proficiency such as limited English vocabulary, lack of back ground
knowledge of spoken text, poor knowledge of grammar
Prevalence of Cesarean Section Delivery and Its Associated Factors among Mothers Who Gave Birth at Hargeisa Hospitals, Hargeisa, Somaliland, 2025 an Institution Based Cross Sectional Study
No full textBackground: Many countries have exceeded WHO recommended a population-level of C
section rate of 10–15%, leading to both health and economic implications to mothers around the
world. There is Knowledge and geographical gap about cesarean section (C/S) in Hargeisa,
Somaliland. Hence, this will fill the knowledge by finding the prevalence and associated factors
of cesarean section among mothers who gave birth in Hargeisa, Somaliland.
Objective: The study aims to assess the prevalence of cesarean section delivery and its
associated factors among mothers who gave birth at Hargeisa hospitals, Hargeisa, Somaliland,
2025.
Methods: An institution-based cross-sectional study design was employed among systematic
randomly selected 580 mothers who gave birth at Hargeisa hospitals, Hargeisa, Somaliland from
01-30 May, 2025. A kobo collect incorporated with structured questionnaire is used to collect
data. After data exploration, it was entered in STATA V.17. Descriptive statistics was employed
to estimate frequency and prevalence. Bivariable and multivariable logistic analyses is carried
out to identify independent associated factors of cesarean section. Model fitness and Multi
collinearity has been done.
Result: The prevalence of cesarean delivery among mothers was 35.0% (95% CI: 31.2%
38.9%). Factors associated with cesarean delivery included being housewife (AOR = 0.87, 95%
CI: 0.21–0.87), husband’s with primary education (AOR = 0.47; 95% CI: 0.26–0.86), had history
of previous cesarean section (AOR = 9.51; 95% CI: 6.07–14.89), multiple pregnancy (AOR =
2.00; 95% CI: 1.42–2.85), and being multi-parity (AOR = 0.53; 95% CI: 0.32–0.89).
Conclusion: Cesarean section delivery was high among mothers in Hargeisa. Key associated
factors included maternal occupation, husband’s education, previous cesarean section multiple
pregnancy, and parity. Targeted prenatal wellness programs, standardized cesarean counseling,
and specialized VBAC clinics should be implemented, alongside enhanced monitoring for
multiple pregnancies and structured support for first-time mothers are recommended to reduce
unnecessary cesarean sections and improve maternal and neonatal outcomes
Determinants of Multi-Drug-Resistant Tuberculosis among Tuberculosis Patients in Jimma Zone Southwest Ethiopia, 2025: A Case-Control Study
No full textBackground: Tuberculosis (TB), caused by Mycobacterium tuberculosis (MTB), remains the
leading infectious killer globally, with an estimated 10.6 million new cases and 1.25 million
deaths annually. Despite progress in TB control, Multi-drug-resistant tuberculosis (MDR-TB)
remains a major global public health challenge.However; there is limited evidence on the
determinants of MDR-TB in the study area.
Objective: To identify the determinants of multi-drug-resistant tuberculosis (MDR-TB)
among tuberculosis patients in Jimma Zone, Southwest Ethiopia, 2025
Methods: A facility-based unmatched case-control study was conducted among TB patients
attending Shenen Gibe and Limu Genet General Hospitals from March to May, 2025. A total
of 64 cases and 128 controls were selected using a simple random sampling method. Cases
were MDR TB patients, while controls were Drug susceptible TB patients. Data were
collected through a structured questionnaire using Kobo Toolbox and review of clinical
records, then analyzed using SPSS version 27. Bivariable and multivariable binary logistic
regression analyses were performed to identify determinants of MDR-TB. Adjusted odds
ratios (AORs) with 95% confidence intervals (CIs) were reported, with statistical significance
set at p < 0.05.
Results: A total of 192 participants (64 cases and 128 controls) were included in this study
with 100% response rate. Among the participants, 33 (51.6%) of the cases and 57 (44.5%) of
the controls were males. Daily laborers (AOR = 8.50; 95% CI: 3.10–24.38), rural residence
(AOR = 3.93; 95% CI: 1.45–10.63), history of contact with TB patients (AOR = 7.99; 95%
CI: 2.80–22.80), history of drug interruption (AOR = 4.36; 95% CI: 1.41–13.50), history of
previous TB treatment (AOR = 3.20; 95% CI: 1.16–8.89), and being underweight (AOR =
2.66; 95% CI: 1.02–6.90) were found to be determinants of MDR-TB.
Conclusion: MDR-TB was significantly associated with sociodemographic, clinical, and
behavioral factors. Targeted interventions focusing on daily laborers, rural residents, patients
with a history of TB contact or drug interruption, history of previous TB treatment and
underweight individuals are essential to reduce the burden of drug-resistant TB in the region
Effects of Stream Sediment and Water Quality on Macro invertebrate Abundance and Diversity in Gilgel Gibe Watershed, Southwestern Ethiopia F Stream Sediment and Water Quality on Macro Invertebrate Abundance and Diversity in Gilgel Gibe Watershed, Southwestern Ethiopia
No full textBackground: Freshwater ecosystems face intense anthropogenic pressure, threatening water
quality and biodiversity. Benthic macroinvertebrates are key bioindicators of ecosystem health,
yet their response to multiple stressors from water and sediment pollution in tropical watersheds
remains poorly understood. Study on sediment and water quality is helpful for integrated water
resource management. This study investigated the individual and combined effects of stream
sediment and water quality on macroinvertebrate abundance and diversity in the Gilgel Gibe
watershed, Southwestern Ethiopia, in 2024.
Methods: A cross-sectional study was conducted from October to November 2024 across 30
sampling sites in the Gilgel Gibe watershed. Macroinvertebrates were sampled using a
rectangular kicking net (15 × 25 × 40 cm) with a mesh size of 300 m and identified to the family
level with a stereomicroscope and standard guides. Physicochemical water quality parameters
were measured onsite and analyzed in the laboratory using standard methods. Sediment samples
were collected and their physicochemical quality was analyzed. Diversity indices (Shannon
Wiener, Simpson and Margalef) were calculated. Multivariate analysis; Canonical
Correspondence Analysis were applied to examine relationships between sediment and water
quality with macroinvertebrate assemblages. Variance Partitioning Analysis quantified the
relative contributions of water and sediment quality variables to community variation.
Results: A total of 3,370 macroinvertebrates belonging to 7 orders and 36 families were
collected; dominated by Ephemeroptera (34.12%), Trichoptera (27.24%), and Odonata
(13.73%). Collector-gatherers dominated functional feeding groups (26.47%). Principal
Component Analysis explained 37.08% of environmental variation differentiating urban, semi
urban and rural sites. Canonical correspondence Analysis showed Water pH, Water Electrical
Conductivity, Water Turbidity, Water depth, Sediment Electrical Conductivity, Sediment Organic
Carbon and Water width were significant variables which influence the macroinvertebrate
assemblage. Water Electrical Conductivity, Water depth, Biological Oxygen Depth5, Sediment
Electrical Conductivity, Water pH and Sediment Available Phosphorous were the significant
factors which influence the diversity of macroinvertebrates. Variance Partitioning Analysis
revealed shared water and sediment variables explained largest proportion of
macroinvertebrates assemblage variation. Water quality explained more the assemblage
variation than sediment quality.
Conclusion: The study revealed that macroinvertebrate abundance and diversity regulated
jointly by water and sediment quality, and their combined effect is larger than their individual
inputs. The shared effects of water and sediment variables explained a notable portion of
community variation; highlighting the need for integrated ecosystem assessment. Water exerted
a stronger separate influence on the assemblage than sediment quality. Therefore, effective
biomonitoring and conservation of such ecosystems need a concerted approach with a priority
for water quality management within the framework of sediment quality
Assessment of outcome of nosocomial infections and associated factors among pediatric patients admitted at JUMC, Ethiopia
No full textBackground: Nosocomial infections are infections that occur in patients during their hospital
stay and were not present or incubating at the time of admission. Typically, these infections
develop 48 hours after hospital admission and can appear up to seven days after discharge. NI
represent a significant threat to patient safety, often resulting in prolonged hospital stays, long
term health complications, increased resistance to antimicrobial drugs, and a greater risk of
mortality. Furthermore, they contribute to a substantial financial burden on healthcare systems
and impose significant emotional and economic stress on patients and their families. Globally,
hundreds of millions of people every year are affected by NIs, many of which are completely
avoidable. No country or health system, even the most developed or sophisticated, can claim to
be free of NIs.
Objective: To assess the outcome of nosocomial infections and associated factors among
pediatric patients admitted at JUMC, Jimma, Ethiopia
Methods: An institution-based longitudinal study design was conducted on pediatric patients
with nosocomial infections from Nov, 2024 to Nov , 2025.Data were collected by using
structured questionnaire the collected data was entered into Epi Data 3.1 and exported to SPSS
(statistical package for social sciences) version 25.0 for further analysis. Descriptive analysis as
well as bivariate and multi-variable logistic regression analyses was conducted. Statistical
significance was considered at p-values <0.05 and 95% Confidence Interval (CI). Results are
presented as narratives and using tables and figures.
Result: A total of 282 patients diagnosed with NI were included in the study. More than half of
them were male 158(56%), with mean age of 2.1 ± (SD=1.1years ) Most children were admitted
to the General Ward (41.7%) and the Oncology Ward (31.9%), followed by the Neonatal
Intensive Care Unit (NICU) (19.4%).Most common type of Nosocomial infection among
pediatric patient was blood stream infection observed in 208 (73.8%), and followed by
pneumonia in 42(14.95%). A majority of the children (68.2%) had co-morbid diseases and
266(94.3%) were non-reactive for Serostatus.A total of 165 clinical samples were taken for
culture and 40(24.4%) microorganism were identified. About 12(30%) organism were
pseudomonas and CONS 11(27.5%) were isolated and drug sensitivity was observed to
meropenium ,Vancomycin followed by Amikacin.Patients infected with Pseudomonas were
about two times more likely to have an unfavorable outcome compared to those infected with
other organisms(AOR=2.12;CI=1.07-4.02,P=0.032).
Conclusion and recommendation: The overall findings revealed that bloodstream infections
(clinical or bacteriological) were the predominant type of hospital-acquired infection and a
significant number of patients had underlying comorbidity.The most isolated organism are
Gram-negative organisms which is pseudomonas followed by CONS.Most children were
improved and discharged with the poorer out come associated with gram -negative
infections.The high resistance observed to commonly used antibiotics, particularly
cephalosporins, highlights the need for periodic review and updating of empirical treatment
protocol
Assessing Soil and Water Conservation Practices and Factors Affecting its Adoption in Soro District, Hadiya Zone Central Ethiopia Region
No full textSoil is the most important natural resources which support all fauna and flora of the world. The
whole creation depends on the soil which is the ultimate foundation of life existence. Soil erosion
is a global environmental problem causing the loss of fertile topsoil and reducing the productive
capacity of the land or soil and there by raises the risk of the global food security. Soil erosion
by water is one of the principal causes of land degradation, food insecurity and largely remains
a major constraint to agricultural development in developing countries. Soil and water
conservation practices help to control runoff and prevent loss of soil by soil erosion. The aim of
this study was to assess soil and water conservation practices and factors influencing its
adoption among rural households in Soro district, Hadiya Zone, Central Ethiopia Region. Both
primary and secondary data were used in this study. Descriptive analysis and binary logit
regression model were used to analyze the collected data. Descriptive analysis showed contour
plough, soil bund, fanyajuu and waterways were important physical soil and water conservation
practices whereas crop rotation, planting trees and mixed cropping were used as main
biological soil and water conservation methods used among smallholder farmers in the study
area. Using trash for gulley control and planting local trees species were preferable indigenous
soil and water conservation practices which were highly implemented in the study area.
Moreover, sex, education level, land size, extension contact, training on soil and water
conservation practices and household total income were significantly (p<0.05) and positively
affected households’ adoption of soil and water conservation practices. Based on the findings we
suggest that governmental organizations and non-governmental organizations in broad
spectrum should need to focus on promoting agricultural production and land productivity,
decreasing land degradation and soil erosion by adoption of soil and water conservation
practices through provision and strengthening farmers’ education, training on soil and water
conservation practices, provision and strengthening extension service among small holder
farmers in the study area
Ethnobotanical Study of Wild Edible Plants in Mulo District, North Shewa Zone, Oromia Regional State, Central Ethiopia.
No full textAn ethnobotanical study of wild edible plants was conducted in Mulo District, North Shewa Zone,
Oromia Regional State, Central Ethiopia, from October 2024 to February 2025. This study aimed
to assess and document indigenous knowledge concerning wild edible plants and their uses within
the study area. Data were collected from 123 informants across 3 villages using semi-structured
interviews, focus group discussions, guided field walks, and direct observation. A total of 22 wild
edible plant species from 18 genera and 17 families were identified in the study area. The results
revealed that these plant species serve multiple purposes, including food, medicine, fodder, and
construction. The majority of WEPs were eaten raw, while the remainders were eaten after being
cooked. 45.5% are trees, followed by shrubs (36.3%) and herbs (18.2%). The most consumed parts
of the wild edible plants in the study area were fruits (68.2%), followed by tuber/root (18.2%), leaf
and stem (4.55%), gum and bark (4.55%), and nectar (4.55%). The fruits of Syzgium guineense
sub sp afromontanum were the most preferred wild food fruit among the other documented wild
edible plants, according to preference ranking analysis. Syzgium guineenses sub sp macrocarpa,
Psidum guajava, Opuntia ficus-indica, and Rubus apetalus were following in order. However,
Wild Edible plants are threatened due to various human activities and natural causes. Therefore,
the conservation of these plant species and assessing as well as preserving indigenous knowledge
were the fundamental urgent issues
The Chemical Compsition Of Stars and Galaxies Based on SDSS Spectral Data
No full textThe objectives study of this thesis is the chemical composition of stars and galaxies based on
Sloan Digital Sky Survey (SDSS) spectral data. The Sloan Digital Sky Survey (SDSS) dataset
with its wealth of spectroscopic data offers valuable insights into the chemical composition
and stellar populations of galaxies and stars. The chemical composition of stats is largely
dominated by hydrogen and helium with trace amount of heavier elements that vary depending
on the star’s mass, age, and evolution as well as the overall chemical composition of galaxies
is determined by the stars, gas, dust, and interstellar material within them. Stellar population
models are curtail tools for understanding how these populations evolve over time, how they
influence galaxy formation, and how we can infer age, metallicity, and star formation of galaxy
Formulation and in vitro evalaution of solid dispersion tablets Containing dihydroarthemesinin
No full textDihydroartemisinin (DHA) is a semi synthetic derivative of artemisinin antimalarial drug. The
drug suffers from limited aqueous solubility, which hinders its bioavailability and clinical
effectiveness. Hence, improved solubility is crucial for enhancing drug absorption and
therapeutic efficacy. Solid dispersion is one of the promising approaches to enhance the
solubility of poorly soluble drugs. Therefore, this study aimed to prepare a solid dispersion to
enhance the solubility of DHA.
Methods: In this study, PEG-4000, PEG-6000, and PVP K30 were utilized as the dispersion
carriers to prepare solid dispersions by kneading and solvent evaporation methods. Drug
polymer ratios of 1:1, 1:3, and 1:9 were investigated. FTIR spectroscopy was used to
characterize drug-polymer interactions, while XRD, DSC, and SEM were used to characterized
solid dispersions. Formulations were then evaluated for solubility and drug release.
Results: Interaction study revealed there might not be drug-polymer interaction. Comparing the
solid dispersion to the pure drug, XRD studies revealed a decrease in crystallinity. The SEM
images of the solid dispersion particles, when compared to pure DHA, showed an amorphous
morphology, as evidenced by their puffy appearance.
Formulations with a 1:9 drug-to-PVP 30k ratio, prepared using the solvent evaporation method,
exhibited the highest drug release, achieving 93.99% compared to 69.5% for the pure drug. The
study on the flow properties of the solid dispersions demonstrated good flowability, with Carr's
index ranging from 11.11±0.26 to 16.36±0.27, Hausner's ratio consistently below 1.25, and the
angle of repose between 23.2±0.02 and 28.26±0.75.
Tablets formulated from both physical mixtures and solid dispersions demonstrated good
mechanical properties, with hardness values exceeding 4 kp. The tensile strength of these tablets
also fell within the acceptable range, further confirming their structural integrity. Through
systematic optimization, it was found that solid dispersions prepared via the solvent evaporation
method, using a drug-to-polymer ratio of 1:9 with PVP as the polymer, yielded the most
effective formulation.
IV
Conclusions: In general, solid dispersion of DHA utilizing the PVP30K, PEG-6000, and PEG
4000 were the best formulation to improve the solubility and in vitro release of the drug. Among
the preparations of DHA solid dispersion, solid dispersion of DHA with PVP produces a
formulation with optimal drug release.
Recommendations: To advance solid dispersion technology, future research should focus on
developing novel carriers, in vivo performance, stability study, and leveraging strategies to
preserve product quality during scale up should be investigated. Interdisciplinary collaboration
between academia, industry, and regulators is critical to translate research into clinically
effective and commercially viable drug products
Effect of Dietary Supplementation and High-Intensity Motor Learning on Nutritional Status, Body Composition, Muscle Strength, and Motor Skill-Related Physical Fitness in 5-7-Year-Old Children with Moderate Thinness in Ethiopia
No full textBackground: Despite global efforts, child malnutrition remains a persistent challenge, exacerbating
disparities and posing ongoing threats to children and adolescents in developing nations. Malnutrition
refers to an inadequate or imbalanced intake of essential nutrients, encompassing both
undernutrition and overnutrition. Undernutrition is characterized by an inadequate intake of essential
nutrients, resulting in deficiencies. Thinness has been recognized as a more suitable indicator of
recent nutritional deprivation, such as insufficient dietary intake of energy, protein, or various
micronutrients.
Undernutrition is characterized by stunting and thinness. Stunting refers to being short relative to
one's age, while underweight is defined in terms of grades of thinness (grades 1–3) and is
characterized by rapid weight loss or an inability to gain body mass. Both conditions are linked to
poor school attendance and academic performance in mathematics, reading, and writing skills.
Additionally, sick or undernourished children often face difficulties with motor function, concentration,
problem-solving, and memory recall, all of which contribute to poor academic performance.
Undernutrition among schoolchildren in developing countries is a critical global health challenge with
far-reaching consequences for their well-being and future opportunities. Nutritional deficiencies
during early childhood can lead to poor brain development. Long-term undernutrition can negatively
impact academic performance, leading to chronic disorders, hindering cognitive development, and
even causing premature death.
Addressing both undernutrition and overnutrition among children aged 5–7 presents a significant
challenge for the food and nutrition policies in developing countries like Ethiopia. This age group
represents a critical developmental stage marked by key growth and developmental milestones and
the development of motor skills. Catch-up growth is particularly important for children with moderate
thinness (MT), as they may face developmental delays that could impact their long-term health and
well-being. This age is also critical for motor skill interventions as it coincides with significant brain
development that is closely linked to cognitive and behavioral growth during preschool years. In
Ethiopia, however, MT children aged 5-7 are often overlooked due to the absence of specific
treatment guidelines for MT. To address this, the management of acute malnutrition should focus on
preventing the progression of MT to severe thinness (ST). To effectively manage MT and prevent its
progression to ST, appropriate dietary interventions are essential. This includes providing nutrient
rich supplementary food or lipid-based Ready-to-Use Supplementary Food (RUSF) tailored to meet
the needs of children with MT. In addition to proper nutrition, motor skill training (high-intensity
motor learning (HiML)) interventions significantly enhance motor skill development in typically
developing children. HiML is very intensive as it is performed daily over an extended period, requiring
a minimum of 30–40 hours of training. The focus is on maximizing time spent on the task during
training, with a training/rest ratio of at least 70–30%. Active play, which involves repetitive muscle
movements that help build strength, speed, and agility, contributes to the development of both gross
and fine motor skills. Furthermore, existing literature on active play or goal-oriented play among
preschoolers and early school-aged children demonstrates its positive impact on motor skills.
Activities such as ball play, balancing exercises, walking, running, and jumping, or hopping have
been shown to improve coordination and physical abilities, reinforcing the importance of integrating
both nutrition and physical activity in early childhood development programs.
Therefore, the main aim of this study was to evaluate the effect of RUSF with(out) HiML compared
to no intervention on various outcomes, including weight, height, body composition, muscle strength,
and motor skill-related physical fitness of children with MT age 5-7 living in Jimma, South-West
Ethiopia. A summary of each chapter of this dissertation is provided below.
Chapter 1 is an introduction providing an overview of malnutrition. It begins by defining
undernutrition and moderate thinness, discussing their common drivers and consequences. The
chapter also presents malnutrition's global, regional, and national status, highlighting its prevalence
x
and public health significance. Additionally, the chapter identifies gaps or areas that previous studies
had not adequately addressed concerning moderate thinness. By providing this comprehensive
introduction, the first chapter gives a context for the subsequent chapters of the dissertation, which
will dive deeper into specific aspects of moderate thinness and its implications.
Chapter 2 outlines the general methods used in the study, including the study design, period,
setting, and population, inclusion and exclusion criteria for participant selection, the sampling
strategy, and the sample size calculations. Furthermore, it elaborates on the data collection methods
and procedures, the specific tools or instruments used, data management procedures including data
entry, storage, and quality control measures, and information on statistical tests or analytical
techniques used to examine the study variables and assess the outcomes of interest. It also
elaborates on the intervention packages implemented in the study, providing an overview of the
specific interventions or treatments administered to the participants and key measures or indicators
used to assess the outcomes under investigation. Ethical considerations are emphasized in this
chapter, highlighting the steps taken to ensure the protection of participants' rights and well-being.
Chapter 3 presents the findings of a school-based comparative cross-sectional study carried out in
Jimma Town. The study compared the body composition of 5-7-year-old children with MT to that of
their well-nourished (WN) peers and identified associated factors. Data were collected from 388
children (194 with MT and 194 with WN). The finding showed that, on average, moderately thin
children had significantly lower fat mass and fat-free mass compared to well-nourished children,
indicating malnutrition-related loss in both compartments. Body mass index (BMI) for age, age, and
sex were significantly associated with both fat-free mass and fat mass.
Chapter 4 presents the findings of a study that investigated the relationship between MT and muscle
strength in children aged 5-7 years in Jimma Town, Southwest Ethiopia. Conducted as a school
based comparative cross-sectional study between June and July 2022, the study assessed children's
nutritional status (MT vs. WN) using BMI for age and sex. Muscle strength was evaluated by
measuring grip strength with a JAMAR device, and biceps, quadriceps, and gastrocnemius strength
were measured using Digital Handheld Dynamometry model (Hoggan MicroFET2™). The result
revealed that children with MT had significantly lower muscle strength compared to their WN peers,
highlighting the negative functional effect of wasting. These findings underscore the importance of
integrating strategies to improve muscle strength into routine health care for children with MT.
Chapter 5 presents the result of a systematic review and meta-analysis on the effectiveness of RUSF
compared to other dietary interventions or no intervention on functioning at different levels of the
International Classification of Functioning, Disability, and Health (ICF) among children with MT
between 2 -12 years old. Eight studies were included in the analysis. The use of RUSF intervention
shows promise in improving nutritional outcomes and recovery rates in children with MT compared
to other dietary interventions. However, the low level of evidence highlights the need for robust
randomized controlled trials in MT children to determine the true effect of RUSF.
Chapter 6 presents the findings of a cluster-randomized controlled trial that examined the effect of
Ready-to-Use Supplementary Food (RUSF), with or without high-intensity motor learning (HiML), on
weight, height, body composition, and muscle strength in 5–7-year-old children with MT in Jimma
Town, Ethiopia. The study found that RUSF was effective on its own, but when combined with HiML,
it had an even greater impact. Both the RUSF and RUSF+HiML interventions led to improvements in
body composition, height, weight, and muscle strength of malnourished children. These findings
suggest that using RUSF and combining it with HiML could help mitigate the negative effects of
malnutrition in Ethiopia. The researchers recommend further exploration of these interventions in a
larger community-based study.
Chapter 7 presents the results of a cluster-randomized controlled trial that assessed the effect of
RUSF with or without HiML on motor skill-related physical fitness in children with MT. A 12-week
combination of RUSF + HiML was proven to be safe in children with MT and caused clear
improvements in skill-related physical fitness. When the children received RUSF with HiML training