Background Understanding the student’s perspective of their clinical learning environment (CLE) might assist todiscover solutions to improve the learning process and increase engagement. However, there is a lack of informationon this issue, particularly in Ethiopia. The purpose of this study was to assess the satisfaction of undergraduatemedical and health science students with their clinical learning environment, as well as to identify the factors thataffect it.Methods Institutional-based cross-sectional study was conducted using a self-administered questionnaire among412 medical and health science students from Debre Markos University in 2023 through a simple random samplingtechnique. Mean, median, frequencies, and percentages were used to describe the data. A multivariate logisticregression model was fitted to test the association of dependent and independent variables. The Hosmer-Lemeshowgoodness-of-fit test was used to check the fitness of the model. Variables with a p-value < 0.05 with a 95% confidenceinterval were considered statistically significant.Results The questionnaire was completed by 394 individuals in total, generating a response rate of 95.63%.Approximately half (49.7%) of the participants were satisfied with their CLE. Age (AOR = 1.12; 95%CI = 1.02, 1.22),university positive perceptions (AOR = 1.60; 95%CI = 1.04, 2.43) and curriculum positive perception (AOR = 2.70;95%CI = 1.73, 4.10) were all positively associated with CLE satisfaction.Conclusion In this study, approximately half of the respondents were satisfied with their CLE. Age, positiveperceptions of the university and positive perceptions of the curriculum were all positively associated with CLEsatisfaction. The university and clinical facilitators should work together to improve infrastructure, and the facilities

This study aimed to determine the seasonality, feed balance, and copying mechanisms oflivestock feed in the east Gojjam Zone of northwestern ethiopia. to collect the data, the zonedivided into three agroecologies (lowland, midland, and highland) and randomly selected twodistricts from each agroecology to represent appropriate agroecologies. the study involved540 respondents – 45 from each peasant association – and utilized key informant interviews,focus groups, questionnaires, and direct observations for data collection. According to thefindings, the study reveals that feed availability in all agroecologies fluctuates seasonally. thetotal dry matter and crude protein supplies per household per year in highland, midland, andlowland agroecologies were 8.69, 15.49, and 14.94 tons, and 0.05, 0.91, and 0.90 tons,respectively. the yearly dry matter and crude protein requirements for livestock in highland,midland, and lowland agroecologies were 11.9, 22.2, and 19.5 t/hh/yr, and 1.4, 2.6, and 2.5 t/hh/yr, respectively. the total amounts of dry matter and crude protein produced in the studyareas satisfied only 73.3, 69.7, and 76.6%, and 32.1, 35.5, and 36.3% of the livestockrequirements in the highland, midland, and lowland agroecologies, respectively. Producers inthe study areas employ strategies such as purchasing feed, preserving crop residue, andreducing herd sizes to address livestock shortages of dry matter and crude protein. to addressthe issue, a new strategy should be employed, including managing natural pastures, increasingforage crop cultivation, providing protein-rich feed, and improving crop residue quality usingeffective microorganisms.

Introduction: The magnitude of poor sleep quality among people with asthma is widespread and has detrimental consequences, including a higher chance of having poor work performance, an increase in the frequency of asthma attacks, an increase in the need for overnight hospitalization, and a worse health related quality of life. However, it has not been well studied, especially in low-income countries like Ethiopia. This study's objective was to assess the degree of sleep quality and related factors among people with asthma who had follow-up visits at public hospitals in the East Gojjam Zone.
Methods: An institutional-based cross-sectional study design was conducted among 406 people with asthma through consecutive sampling techniques at public hospitals in East Gojjam Zone from June 6 to July 1, 2022. Sleep quality was measured by the Pittsburgh Sleep Quality Index through a face-to-face interview, and the collected data were entered into Epi Data version 4.4.2 and exported to SPSS version 25 for analysis. Logistic regression was fitted to assess the association between dependent and independent variables. Variables with a P-value

This paper addresses the smart management and control of an independent hybrid system based onrenewable energies. The suggested system comprises a photovoltaic system (PVS), a wind energyconversion system (WECS), a battery storage system (BSS), and electronic power devices that arecontrolled to enhance the efficiency of the generated energy. Regarding the load side, the systemcomprises AC loads, DC loads, and a water pump. An Adaptive Neuro-Fuzzy Inference System (ANFIS)-based MPPT technique is suggested to enhance the efficiency of the PVS and WECS. This technologyprovided good performance compared with the Perturb and Observe (P&O) algorithm and MPPT-basedfuzzy logic controller (FLC). The use of the ANFIS-PI proposed to control the bidirectional converteraccomplished voltage stabilization for the DC bus. This work also came with a fuzzy logic-basedalgorithm to manage the load side that depends on battery charge ratio, solar radiation, and windspeed. According to results obtained in the MATLAB/Simulink environment, the proposed technologieswere found to have performed well. The goal we were also pursuing was achieved through the fulluse of the energy generated by the proposed algorithm. The proposed study holds great potential forremote regions.Index terms: Renewable energy, Hybrid system, MPPT, ANFIS controller, Management

Background: Despite progress in reducing neonatal mortality rates in Ethiopia, the country still has a high neonatal mortality rate compared with the global average. Primary hospitals are critical in delivering basic neonatal care, particularly in rural areas. However, data on neonatal mortality and contributing factors in these settings are scarce. This study aimed to determine the survival status and predictors of neonatal mortality among neonates admitted to Bichena Primary Hospital, Northwest Ethiopia.
Methods: A retrospective cohort study was conducted among 638 neonates admitted to the Bichena Primary Hospital neonatal intensive care unit from January 1, 2021, to April 30, 2023. Neonates were selected via a consecutive sampling method. Data were collected from medical records using a pretested checklist. A Kaplan-Meier survival curve was used to estimate the neonatal survival time, and a Cox proportional hazard regression model was used to identify independent predictors of neonatal mortality.
Results: Of the 638 neonates followed, 21.5% died during the study period. The overall incidence rate of death was 66.69 per 1,000 neonate days. Hypothermia, birth injury, perinatal asphyxia, preterm birth, maternal history of abortion, low birth weight, and neonatal hypoglycemia were independent predictors of neonatal mortality.
Conclusion and recommendation: The study found a high rate of neonatal mortality, exceeding rates reported in other regions of Ethiopia. Most predictors were preventable and treatable. Therefore, early identification of obstetric complications, immediate interventions and postnatal care are crucial to reduce neonatal mortality and enhance overall neonatal outcomes.
Keywords: Ethiopia; neonate; predictors; primary hospitals; survival status.

Sweet potato (Ipomoea batatas L.) holds significant promise in addressing economic challenges and malnutrition issues. However, various factorsin Ethiopia impede its production and consumption. This review investigates sweet potato potential as a versatile solution for nutritionalchallenges in Ethiopia. Although the global yield of sweet potato reaches 14 tons/ha, in Ethiopia, it stands at approximately 8.1 tons/ha. In Africa,sweet potato is known as the 'poor person’s crop' and is primarily grown on a small scale by women for subsistence. Sweet potatoes are rich inessential nutrients such as vitamins C and E, B vitamins, iron, zinc, potassium, and fiber. Additionally, in Ethiopia, sweet potato leaves are utilizedas food, animal feed, and traditional medicine. Notably, they contain high levels of lutein (ranging from 38-51 mg/100 g), surpassing those foundin kale (38 mg/100 g) and spinach (12 mg/100 g). Leaves encompass protein (25%−37%), carbohydrate (42%−61%), crude fat (2%−5%), fiber(23%−38%), ascorbic acid (60−200 mg/100 g), and carotene (60−120 mg/100g). Malnutrition is continued as a major hurdle for millions ofEthiopians. Currently, stunting, wasting, and vitamin A deficiency (VAD) stand as the primary factors contributing to premature mortality inEthiopia. Despite the country's considerable potential for sweet potato cultivation and utilization, both yields and consumption remainremarkably low. Lack of clean planting materials, pests and diseases, knowledge gap, and poor market system are the key challenges of sweetpotato production in Ethiopia. Hence, to ease the malnutrition problems in Ethiopia, sweet potato production and utilization should be adept in abroader range.

Abstract Background: Hospitals usually encounter human, capital, and financial resource constraints which alerts the efficient use of allocated resources more than ever. Health system managers are required to identify inefficient hospitals and the drivers of the inefficiencies. Although there are multiple studies examining the efficiency of public hospitals in East Africa, their findings are often variable and inconsistent. Therefore, this study aimed to review published articles on technical efficiency of public hospitals in East African countries. Methods: A systematic search of published articles on the technical efficiency of public hospitals was employed using Pubmed, Cochrane library, and google scholar and thirteen studies were included to this review. The studies were described in terms of their publication year, sample size, inputs and outputs used in the efficiency analysis, and the technical efficiency levels. Finally, we assessed their quality and estimate the mean technical efficiency using meta-analysis. Results: The technical efficiency score of public hospitals varied across countries in east Africa which ranged from 0.64 ± 0.34 in Tanzania to 0.99 ± 0.03 in Ethiopia. The mean technical efficiency was 0.82 (95% CI = 0.56, 1.07) for primary hospitals and 0.88 (95% CI = 0.82, 0.95) for secondary level hospitals. Technical efficiency of public hospitals was negatively correlated with the number of hospitals (the sample size) and positively correlated with the number of inputs and outputs included in the efficiency analysis. Conclusions: This review revealed that the technical efficiency of public hospitals in east Africa requires an improvement. To enable effective and efficient hospital management and improvement in hospital efficiency, health man-agers and policymakers must identify the drivers of hospital inefficiency. Systematic reviews on public hospital efficiency, which are currently rare in Africa, should be conducted on a much larger scale in order to create more, and validated information for use in policy-making. Trial registration: This review protocol was registered and approved by the international prospective register of systematic reviews with a Protocol ID: CRD42023444729. Keywords: Technical efficiency, Hospitals, Data envelopment analysis, East Africa, Systematic review

ntroduction: Cognitive impairment is a medical condition caused by neurodegeneration, marked by a gradualdecline in neurological, motor, psychological, and cognitive domain functions, as well as daily activities. Itprimarily affects individuals with conditions such as Alzheimer’s disease, stroke, HIV/AIDS, diabetes mellitus,cancer, epilepsy, dementia, and other chronic illnesses, as well as older adults. While some individual studieshave explored the effects of cognitive impairment, there is a lack of nationwide research to provide a compre-hensive understanding of its burden among individuals with chronic diseases.Objective: To assess the pooled prevalence of cognitive impairment and its associated factors among individualswith chronic diseases in Ethiopia.Methods: Several databases were examined to find available articles. The data were extracted and sorted inMicrosoft Excel before being exported to STATA/MP 17.0 for analysis. A random-effects Der Simonian-Lairdmodel with a 95 % confidence interval was used to pool the data. Cochrane I2 statistics and Egger’s test wereused to evaluate heterogeneity and publication bias, respectively. To determine the cause of heterogeneity,subgroup analysis was performed. A log-odds ratio was utilized to illustrate the association between cognitiveimpairment and its associated factors. P-values less than 0.05 were considered statistically significant.Result: This study included 22 individual articles comprising a total of 6818 participants. The overall prevalenceof cognitive impairment among individuals with chronic diseases was 44.43 % (95 % CI: 37.76–51.10). Studiesconducted in Addis Ababa reported a higher prevalence of 50.89 % (95 % CI: 34.59–67.19). Similarly, researchfocusing on older adults indicated the highest prevalence, at 57.58 % (95 % CI: 28.78–86.39). Participants whoare unable to read and write were 3.82 times more likely to experience cognitive impairment compared to thosewho had completed primary education (AOR = 3.82; 95 % CI: 2.97–4.91).Conclusion: This review found a high prevalence of cognitive impairment among Ethiopians with chronic dis-eases, especially in older adults and those in Addis Ababa. Illiteracy significantly increased the risk. Thesefindings highlight the need for targeted cognitive screening and integration of cognitive care into chronic diseasemanagement.
Keywords: Cognition, Cognitive impairment, Associated factors, Ethiopia

EXECUTIVE SUMMARY Agricultural financing plays a critical role in enhancing crop productivity and fostering rural development, particularly in agrarian economies. This study aims to empirically investigate the impact of agricultural financing on the crop productivity of smallholder farmers and assess its implications on income inequality. To achieve this objective, a mixed research approach was adopted, integrating both qualitative and quantitative methodologies. An explanatory research design was employed to explore the causal relationship between access to agricultural financing and crop output. Primary data were collected from a sample of 800 crop-producing households using structured questionnaires, interview schedules, and focus group discussions, selected through simple random sampling. Secondary data were obtained through document reviews from relevant institutional sources. The data were analysed using descriptive statistics and econometric modelling techniques, specifically Propensity Score Matching (PSM), to estimate the Average Treatment Effect on the Treated (ATT). A binary logit model was used to identify the determinants of access to agricultural financing. The results revealed that age, seed cost, labor cost, tractor access (as a proxy for infrastructure), education level, and farming experience significantly influenced whether a household received agricultural financing. Conversely, variables such as plant protection, fertilizer use, and landholding size were found to have an insignificant effect. The covariate balancing indicators and balance plots confirmed that the matching algorithms were successful in reducing selection bias, with mean standardized bias decreasing by up to 77.5% and pseudo R² values dropping significantly post-matching. The common support condition was also satisfied, ensuring the reliability of the PSM estimates. The PSM results confirmed that agricultural financing had a statistically significant and positive impact on crop productivity. On average, farmers with access to financing produced ETB 3,942.53 to ETB 6,251.01 more per season compared to those without access, depending on the matching algorithm used (NNM-1, NNM-5, and KBM). The study concludes that agricultural financing significantly enhances crop productivity but may unintentionally exacerbate income inequality. It recommends targeted financial inclusion strategies to ensure equitable access to credit. Furthermore, it advocates for practical, hands-on training programs tailored to farmers‘ realworld needs, rather than theoretical lectures. Such capacity-building initiatives should focus on improving technical expertise, efficient input utilization, and financial literacy, thereby maximizing the benefits of agricultural financing for sustainable rural development. Keywords: Agricultural Financing, Crop Productivity, Propensity Score Matching, Logit, Gini

In the absence of a recommended optimal seed rate and nitrogen-phosphorous (NP) fertilizers application for a spe-cific area, achieving maximum bread wheat productivity becomes challenging. To address this issue, this field experi-ment was conducted to evaluate the effect of seed and NP fertilizer rates on growth, yield, and yield components ofbread wheat (Triticum aestivum L.). Factorial combinations of four levels of seed rates of bread wheat (100, 120, 150, and200 kg ha−1 ) and four levels of NP fertilizers rates (64–46, 87–46, 96–69, and 119–69 kg ha−1 of N and P 2 O 5 ) werelaid down in randomized complete block design with three replications. The remaining necessary agronomic practicesand crop management activities were undertaken uniformly. The data presented in this dataset article includes pheno-logical, growth, yield, and yield component parameters that were collected timely following their standard methods andprocedures. All the collected data were subjected to analysis of variance (ANOVA) which was carried out using theSAS version 9.0 software computer program’s General Linear Model (GLM) procedure [1]. the residuals were evalu-ated, as described in Montgomery [2], to confirm the normal distribution and homogeneous variance model assump-tions on the error terms for each response variable. The independence assumption is upheld due to the randomization ofthe sixteen (16) treatment combinations within each block. In cases where a treatment effect was found to be significant,a multiple means comparison was conducted at a 5% significance level using Fisher’s LSD method to create letter group-ings. Additionally, correlation analysis was carried out using the Pearson correlation procedure in SAS. This dataset articleprovides insights into how seed rate and NP fertilizer rates impact bread wheat productivity, as well as the economic viability of optimal seed rate and NP fertilizer rates on bread wheat productivity. The information presented can serve as a valuable resource for researchers looking to examine thesupplementary data and methods in detail, potentially lead ing to new research avenues. Furthermore, it has the potential to foster collaborations and enhance the credibility of the current research data within the scientific community, making it accessible for wider use.
Keywords: Bread wheat, Burie district, Dataset, Grain yield, Seed rate, NP fertilizers, Partial budget analysis