Background Sixty percent of the Ethiopia population is at risk of malaria, with the highest prevalence reported in Gambella (6%) and Benishangul-Gumuz (3%) regions. Within these regions are large agricultural developments with high numbers of seasonal migrant workers. The migrant workers are believed to be at increased risk for malaria infection due to their poor living conditions and outdoor activities, but there is little information on their specific behaviours and health risks. This study was conducted to address this gap. Methods Quantitative observations were conducted from September to December 2017 in the Benishangul-Gumuz Region. The nightly routines of mobile migrant workers were observed every month for 4 consecutive months. The study team collected quantitative data including nocturnal behavioural observations of worker living conditions, malaria prevention efforts, and work activities and surveys of worker representatives. Qualitative data was collected from migrant workers, farm managers and local health providers using focus group discussions and semi-structured interviews. Results Migrant workers arrived in the study area during the peak malaria transmission season and the workers in focus groups reported repeated cases of malaria during their stay on the farms. Overall, less than a quarter of the migrant workers were sleeping under a mosquito net by midnight in all 4 observation months. Some work activities also took place outdoors at night. The study additionally found a lack of access to malaria prevention and treatment at the farms and challenges in utilizing local public health facilities. Conclusions There is a need to better address malaria prevention and treatment needs among migrant workers in Ethiopia through outreach from existing healthcare infrastructure and within the farms themselves. This will help prevent malaria transmission both within this population and prevent transmission of malaria back to home communities in lower burden areas in Ethiopia.

Introduction In August 2014, WHO declared that Ebola outbreak ravaging West Africa including Liberia had become a Public Health Emergency of International Concern (PHEIC). Infection prevention and control (IPC) among healthcare workers was pivotal in reducing healthcare worker infection and containing the recent EVD outbreak. Hard to reach areas (HTRA) presents peculiar challenges in public health emergencies. We present the result of IPC capacity building strategies deployed in Gbarpolu County: an HTRA of Liberia. Methods Between April to October 2015, we conducted IPC training and mentorship at the county, district and facility levels in a selected HTRA of Liberia using the keep Safe, Keep Serving manual and the WHO core components of infection control. Serial follow-up assessments and mentoring using the Liberian Minimum standard tool for safe care in Liberian health facilities (MST) were done. Results 180 (100%) facility based healthcare workers were trained: including 59 clinicians (32%) and 121 (67%) non-clinicians. 100% of the healthcare workers in four selected very HTRAs were trained and underwent facility based-mentorship. Compliance with IPC practice increased: the MST score increased from 75% to 90% and for the MST score for waste management and isolation increased 60% to 87%. Conclusion Strengthening the capacity of healthcare workers for IPC was instrumental for containing the EVD epidemic but also critical for routine safe and quality services. A culture of IPC among healthcare workers in HTRA can be implemented through capacity building and training.

Background: Sixty percent of the Ethiopia population is at risk of malaria, with the highest prevalence reported in Gambella (6%) and Benishangul-Gumuz (3%) regions. Within these regions are large agricultural developments with high numbers of seasonal migrant workers. The migrant workers are believed to be at increased risk for malaria infection due to their poor living conditions and outdoor activities, but there is little information on their specific behaviors and health risks. This study was conducted to address this gap. Methods: Quantitative observations were conducted from September to December 2017 in the Benishangul-Gumuz Region. The nightly routines of mobile migrant workers were observed every month for four consecutive months. The study team collected quantitative data including nocturnal behavioral observations of worker living conditions, malaria prevention efforts, and work activities and surveys of worker representatives. Qualitative data was collected from migrant workers, farm managers and local health providers using focus group discussions and semi-structured interviews. Results: Migrant farmers arrived in the study area during the peak malaria transmission season and the workers in focus groups reported repeated cases of malaria during their stay on the farms. Overall, less than a quarter of the migrant workers were sleeping under a mosquito net by midnight in all four observation months. Some work activities also took place outdoors at night. The study additionally found a lack of access to malaria prevention and treatment at the farms and challenges in utilizing local public health facilities. Conclusions: There is a need to better address malaria prevention and treatment needs among migrant workers in Ethiopia through outreach from existing healthcare infrastructure and within the farms themselves. This will help prevent malaria transmission both within this population and prevent transmission of malaria back to home communities in lower burden areas in Ethiopia.

Background A board member was an important bridge to accelerate a day-to-day health care quality in a routine clinical activity at health institutions. They are significant in planning and examine integrated governance systems that encourage quality of care and accountability. So, the current research was planned to identify the level of engagement of the board members in health care quality and factors associated. Methods A facility-based cross-sectional study was implemented among 250 board members and data were collected by self-administered questionnaire at selected governing health centers in Addis Ababa, Ethiopia from May 1 to 30, 2018. A simple random sampling technique was used to reach the study participants. Data were entered using EpiData 3.1 software and analysis was done using SPSS 23. Adjusted odds ratio with 95% confidence interval and p-value < 0.05 was used to declare statistical significance. The level of board members’ engagement was found to be low which implies that the board members do not give appropriate attention to the quality of care. Results Good level of engagement of board members was (50.9%) [AOR=7.11, 95% CI (3.07–16.47)]. Most of the governing board members did not engage in the quality of health care activities. Uses quality data as a basis for recognition [AOR=7.11, 95% CI (3.07–16.47)], review a quality scorecard or dashboard [AOR=10.83, 95% CI (3.75–31.29)], establishing goals relating to staff satisfaction [AOR=15.42, 95% CI (6.14–38.75)] and receiving formal training [AOR=3.42, 95% CI (1.35 −8.62)], having a strategy relating to communication with clients [AOR= 4.95, 95% CI (2.02–12.15)] and spending more than 20% [AOR=11.96, 95% CI (3.27–43.83)], received training on healthcare disparities [AOR=3.81, 95% CI (1.40–10.36)], and having a plan on quality [AOR=16.38 95% CI (5.39–49.72)] were found to be significant predictors of level of board member engagement. Conclusion Collectively, most of the governing board members did not engage in the quality of health care activities. Stakeholders should work on capacity building for board members using training and further follow-up. Encouraging them to put quality health services at the forefront of their agenda during their involvement at their respective facilities.