Stronger evidence towards future scale up: Cluster Randomised Trial in Ethiopia
Collaborators: London School of Hygiene and Tropical Medicine (LSHTM), Jimma University (Ethiopia), GOAL, and the Emergency Nutrition Network (ENN)
Donors: Eleanor Crook Foundation (ECF)
Overview of research
This four year research programme (2019-2023) will test the MAMI care pathway as a community based approach to care for nutritionally at risk infants under six months in a randomised control trial (RCT) within existing services in two sites in Ethiopia (Jimma Zone and Deder Woreda).
The ultimate goal of this research is to effect national (Ethiopian) and international policy guidance change to ensure access to community based care for at risk infants and their mothers. Central to this is generating high quality evidence on an intervention that is feasible, effective, scalable and sustainable. At the heart of this research are partnerships at sub-national, national and international levels to truly co-create an integrated intervention that has real potential for scale.
Formative research in Phase 1 (2020 to mid-2021) is now underway to collect quantitative data on caseload at facilities and qualitative research on perceptions of malnutrition amongst health workers and families. An updated MAMI Care Pathway will be piloted in preparation for Phase 2. Phase 1 also includes secondary data analysis on anthropometric data from Ethiopia to inform enrolment criteria, and consultation with international policy makers, programmers and researchers to inform plans, share developments and nurture cross-country learning. National and international stakeholder mapping to identify communication tools and influencers in collaboration with SDG2AdvocacyHub is being used to inform opportunities for strategic and practical engagement on MAMI.
The randomised control trial is planned for Phase 2 (mid-2021-2024) due to commence mid-2021. Primary outcomes (improved weight-for-age and MUAC) will be assessed at age 6 months. Secondary outcomes include breastfeeding status, and episodes of severe illness. Maternal benefits will also be explored, such as wellbeing / perceptions of social support. Infant follow up is planned to 18-24 months. In addition, cost and cost-effectiveness will be examined as a core component. A process evaluation accompanies the formative phase and RCT for real time, responsive research and to generate evidence on pathways to sustainable scale.
The COVID-19 pandemic impacted on our scheduled RCT that is now planned for mid 2021. We adapted timings and methodologies for Phase 1 research and have used the extended formative phase to undertake the feasibility study of the MAMI Care Pathway. Adaptation has been greatly facilitated by a dedicated frontline research team in Jimma University, regular remote team and 1: 1 meetings between partners, and a flexible, engaged funding partner (ECF).
Presentation to the Ethiopian Nutrition Leaders Network Annual Meeting, 23rd November 2020.
Stakeholder meeting
In follow up to key stakeholder meetings held in October 2019, the research team hosted two virtual (zoom) update meetings on 14th December or 15th December 2020, 1400 – 1630 Ethiopia time. The meeting on 14th December focused on Jimma Zone and on the 15th December focused on Deder Woreda. Key developments and plans were presented by the research team and discussed with all. Click the links for the meeting report and recordings of the meetings in Deder and Jimma.
Meet the team
Our team
The research partnership comprises a strong team of experienced researchers and practitioners at London School of Hygiene and Tropical Medicine (LSHTM) (overall lead & coordinator), Jimma University (academic lead, Ethiopia), GOAL (operational) and ENN (process evaluation and learning).
LSHTMMarko Kerac, Principal investigator |
Jimma UniversityMelkamu Berhane, Principal investigator (Jimma and Deder) |
GOALHatty Barthorp, Research Advisor |
ENNMarie McGrath, Co-investigator |
AdditionalProf Jonathan Wells (UCL), Co-investigator/technical advisor |
More information
Stakeholder update meetings report, December 2020
Newsletter update 1.0, November 2020
Stakeholder meeting report, Addis Ababa, October 2019
Stakeholder meeting report, Jimma Zone, October 2019
Stakeholder meeting report, Deder Woreda, October 2019
Contacts
Carlos Grijalva-Eternod, LSHTM
Marie McGrath, ENN
Gallery
More like this
en-net: Invite to online update meeting on MAMI Ethiopia research programme
Stronger evidence towards future scale up of management of at risk mothers and infants under six months (MAMI): Cluster Randomised Trial in Ethiopia Monday 14th December or...
Video: Ethiopia and MAMI
This video is a presentation to the Ethiopian Nutrition Leaders Network Annual Meeting, 23rd November 2020 by Marie McGrath (ENN) and Carlos Grijalva Eternod (LSHTM). MAMI...
Resource: Stronger evidence towards future scale-up of management of at-risk mothers and infants under six months (MAMI): Cluster Randomised Trial in Ethiopia Report on stakeholder update meetings
Meeting overview Two meetings were held virtually in December 2020 to provide stakeholders in the upcoming cluster randomised control trial (RCT), Stronger evidence towards...
MAMI Ethiopia Stakeholder Update Meetings December 2020
Two stakeholder update meetings on the MAMI RCT in Ethiopia were hosted in December 2020 by Jimma University, LSHTM, GOAL and ENN. Read the report here.
Resource: Stronger evidence towards future scale up via a cluster RCT in Ethiopia. Key stakeholder meeting, Jimma, Ethiopia.
Summary A one-day meeting of key stakeholders in the upcoming research on community management of at-risk mothers and infants under six months (cMAMI) in Ethiopia was held at...
MAMI Global Network Coordination and Governance
MAMI Global Network Coordination and Governance The MAMI Global Network Strategy for 2021-2025 is now available here. An overview of the Network's governance structures and...
Resource: Stronger evidence towards future scale up via a cluster RCT in Ethiopia. Key stakeholder meeting, Harar, Ethiopia.
Summary A one-day meeting of key stakeholders in the upcoming research on community management of at-risk mothers and infants under six months (cMAMI) in Ethiopia was held...
Resource: Stronger evidence towards future scale up: Cluster Randomised Trial in Ethiopia - Update 1.0, November 2020
Overview We are a consortium of two universities - Jimma University and the London School of Hygiene and Tropical Medicine a technical charity - the Emergency Nutrition...
Resource: Stronger evidence towards future scale up via a cluster RCT in Ethiopia. Key stakeholder meeting, Addis, Ethiopia.
Summary A one-day meeting of key stakeholders in the upcoming research on community management of at-risk mothers and infants under six months (cMAMI) in Ethiopia was held in...
ENN Latest
Small Vulnerable Newborns contribute to the burden of underweight, wasted & stunted infants and children worldwide. Health and nutrition communities need to join forces. Our...
FEX: Management of At-risk Mothers and Infants under six months (MAMI): Update and direction
View this article as a pdf Summary of meeting report1 A two-day meeting of the MAMI Special Interest Group (SIG)2 was held on 12-13 December 2019, organised by Emergency...
Blog post: MAMI reflections on the Lancet Small Vulnerable Newborns series
The recently launched Lancet Small Vulnerable Newborns (SVN) Series comprised three hearty papers of evidence and analyses and a call for action to prevent babies being born...
FEX: The Lancet ‘Small Vulnerable Newborns’ series: Reflections from a ‘MAMI’ perspective
View this article as a pdf Marie McGrath is a Technical Director at ENN and co-Chair of the MAMI Global Network What we know: This year's Lancet series on small vulnerable...
Blog post: MAMI and the new 2023 WHO recommendations on ‘at-risk’ infants under 6 months: we’re talking the same talk!
Lisez cet blog en français ici The much-anticipated 2023 WHO guideline on the prevention and management of wasting and nutritional oedema (acute malnutrition) in...
Our team
Nigel Tricks ENN Chief Executive Officer Nigel is a British humanitarian who has led international aid agencies in Africa and Asia for the last 30 years. He has overseen...
FEX: Carers’ and health workers’ perspectives on malnutrition in infants aged under six months in rural Ethiopia: A qualitative study
View this article as a pdf This is a summary of the following paper: Jibat N, Rana R, Negesse A et al (2022) Carers' and health workers' perspectives on malnutrition in...
Resource: Facilitator’s guide & presentation: orientation workshop on the management of small and nutritionally at-risk infants under six months and their mothers (MAMI)
This facilitator's guide and presentation for an orientation workshop on the management of small and nutritionally at-risk infants under six months and their mothers (MAMI)...
FEX: Adapting the MAMI Care Pathway Package in India: Progress and direction
View this article as a pdf Praveen Kumar is Director Professor at Lady Hardinge Medical College and associated Kalawati Saran Children's Hospital, New Delhi, India, and Deputy...
MAMI Evidence
MAMI Evidence There are a range of ongoing research activities by the MAMI Global Network and its partners. See below for a list of peer-reviewed publications. Upcoming...
MAMI News and Events
MAMI News If you would like to receive MAMI Global Network's monthly updates please subscribe here. Past issues of the newsletter can be viewed here. If you would like to...
Reference this page
Stronger evidence towards future scale up: Cluster Randomised Trial in Ethiopia. www.ennonline.net/ourwork/research/mamiriseethiopia
(ENN_6860)