Program Targets Research Articles

Reducing dropout rates in cardiac rehabilitation among cardiac patients in a vulnerable situation: systematic development and feasibility testing of the Heart Priority Programme

BackgroundDespite advancements in reducing cardiovascular disease, it remains a major health concern. Cardiac rehabilitation (CR) has a positive impact on morbidity, mortality, and functioning, but faces high dropout rates especially among vulnerable patients, due to social inequalities and insufficiently tailored interventions. To address this, we developed the Heart Priority Programme targeting and supporting cardiac patients at risk of dropout. This study outlines the development of the Heart Priority Programme and share findings from a feasibility test.MethodsAn iterative three-stage process involving cardiac patients and healthcare professionals from three community healthcare services, guided the development of the programme. Stage 1 included reviewing evidence, consulting stakeholders, and observing practice. In stage 2, a project-group of researchers and healthcare professionals was established to co-produce the programme. Stage 3 included field-testing and local adaptions. Subsequently, the programme was feasibility tested in a single-arm follow-up study across two community healthcare services. Over six months, process data on implementation, acceptability, and mechanism of impact were gathered.ResultsThe Heart Priority Programme was development from January 2023 to June 2023, comprising two main parts: 1) an evidence-based identification form with 13 risk factors to identify patients at risk of dropout (referred to as priority patients), and 2) an add-on intervention targeted these patients with three core elements—assigning a contact person, systematic communication, and follow-up. During a six-month feasibility phase, 260 patients were included. Of these, 91 (35%) were identified as priority patients. CR teams found that the programme was relevant, easy to integrate into daily workflow, and applicable in practice. Patient consultations yielded positive feedback on the three core elements of the add-on intervention.ConclusionsThis paper outlines the development and feasibility test of the Heart Priority Programme, co-produced to identify, and support priority patients. The programme, developed through a three-stage iterative co-production process, was found relevant and easy to implement in community healthcare services. CR teams valued its structured approach to supporting priority patients, and patients found it aligned with their needs. Although initial results are promising, further research is needed to evaluate the programme's effectiveness and suitability for widespread implementation.Trial registrationClinicalTrials.gov NCT06575764, registered retrospectively on 28 August 2024.

The Ethical Paradox of Informed Consent in HPV Vaccination: Examining the Legal Boundaries and Ethical Considerations of Parental Consent, Public Health, and Individual Rights

Background and Objective: Effective communication is crucial in medical procedures, and informed consent is a key example of this. However, informed consent may face unique circumstances, such as in life support situations or government health programs. The Human Papillomavirus (HPV) vaccination, as part of a government initiative, raises the question of whether informed consent is still required. The study aims to explore whether informed consent is still necessary for the HPV vaccination and to analyze the legal implications if a citizen refuses to receive the vaccine. Patients have the right to refuse medical actions, making it essential to understand the legal consequences of rejecting the HPV vaccination. Methods: This study adopts a normative juridical approach with an analytic descriptive specification. Secondary data was gathered from primary, secondary, and tertiary legal sources through literature reviews, document studies, and archival research. The collected data was then analyzed qualitatively and presented in a descriptive format. Results: The study found that there are exceptions to the requirement for informed consent for vaccinations included in government programs. Specifically, informed consent is not necessary for individuals within the target age group of the government’s HPV vaccination program. In Indonesia, this program targets girls aged 9 to 14. Additionally, there are currently no legal penalties for individuals who refuse the HPV vaccination. Conclusion: Informed consent is not required for individuals within the targeted age group of the government’s HPV vaccination program in Indonesia. Furthermore, there are no legal penalties for rejecting the vaccination.

Identification of genomic regions affecting nitrogen excretion intensity in Brown Swiss dairy cows

Dairy cows with a lower nitrogen excretion intensity (Nexi) excrete less nitrogen, ammonia (NH3) and nitrous oxide (N2O), a highly potent greenhouse gas (GHG), per kg of milk produced and therefore represent a lower environmental impact while maintaining food security. To date, the genomics background of Nexi is unknown. Here we performed a genetic association study, overlap analysis and functional enrichment analysis for Nexi in 875 genotyped dairy cows with 2,147 lactations from 200 herds. We identified 1456 single nucleotide polymorphisms (SNPs) that significantly affect Nexi. We found 140 SNPs overlapping with 148 protein-coding genes. The MAN1A1 gene is a strong candidate gene for Nexi. Genotype CC of rs42786248, the most significantly associated SNP located in the MAN1A1 gene, had higher Nexi than genotypes AA (p < 0.001) and AC (p < 0.001). We identified 33 genes involved in biological processes related to nitrogen metabolism. Our results form the basis for further research on the genomics background of Nexi. The identified SNPs serve as potential targets for selective breeding programs, aimed at reducing Nexi and associated NH3 and N2O emissions in cattle production, thus contributing to more environmentally sustainable milk production.

Advancing pharmacometrics in Africa-Transition from capacity development toward job creation.

Trained pharmacometricians remain scarce in Africa due to limited training opportunities, lack of a pharmaceutical product development ecosystem, and emigration to high-income countries. The Applied Pharmacometrics Training (APT) fellowship program was established to address these gaps and specifically foster job creation for talent retention. We review the APT program's progress over 3 years and encourage collaboration to enhance local clinical data analysis in Africa. Initiated in 2021 by Pharmacometrics Africa, a non-profit educational entity, with support from partners including the Bill & Melinda Gates Foundation and Certara, the APT program targets African doctoral-level scientists and clinicians. This 6-month program is jointly managed by partners, with Pharmacometrics Africa handling logistics and sponsor liaison. Job creation initiatives include inviting fellows to join consulting teams or local research centers. Over the 3 year reporting period, 177 applications were received, with 27 individuals (41% female, median age 35 years) from nine African countries selected into and completing the full program. The fellows worked on 13 data analysis projects, with six so far being presented at international conferences and/or submitted for publication in peer-reviewed journals. Nine fellows have joined consulting teams or research centers working from offices in Africa. Currently, in the 3rd year, the APT program has demonstrated success in skills development, job creation, and fostering a critical mass of African pharmacometricians. Collaboration is essential for the sustainable advancement of model-informed drug development in Africa.

Adolescents' Wellbeing at School: What Helps and What Hinders From Feeling Safe and Satisfied?

The aim of this qualitative study was to identify the main factors that help and hinder adolescents' wellbeing at school using their perspectives and experiences. We used data from 45 adolescents in the first year of high school in Slovakia (mean age = 14.98; 22.2% boys). We obtained the data using 11 semi-structured group interviews conducted in 2020/2021. Participants were selected from three types of high school with regard to graduation system. Data was analysed using consensual qualitative research and thematic analysis. We identified three main themes of factors contributing to their wellbeing at school: 1. School (atmosphere and organisation of life at school, physical environment, threats and the ability of school to deal with issues); 2. Relationships (with peers and teachers, and teachers' behaviour towards them); 3. Myself (own perceived obstacles and resilience resources). The organisation of life at school, surroundings, threats and dealing with issues importantly affect adolescents' wellbeing. Therefore, adjustment of physical environment and interpersonal competences of teachers, supporting of resilience resources of adolescents should be targets for interventions and prevention programmes at schools.

Determinants of an unfavorable treatment outcome among tuberculosis patients in the Jimma Zone, Southwest Ethiopia.

Tuberculosis (TB) is a major public health challenge in Ethiopia. TB treatment outcomes were suboptimal compared to the expected target of the national TB control Program. The provision of standard anti-TB treatment is the primary component of the directly observed treatment, short-course strategy. The aim of this study was to assess the TB treatment outcomes and the determinants of an unfavorable treatment outcome. The study used a cross-sectional study design at baseline and record review to identify treatment outcomes. A total of 1,161TB patients were recruited from eight randomly selected districts and one town administration in the Jimma Zone, Ethiopia. Treatment outcomes were grouped into favorable and unfavorable. Of the total participants, 86.9% had a favorable treatment outcome, and 5.7% an unfavorable treatment outcome. The rest were transferred out and not recorded cases. Women were more likely to experience an unfavorable treatment outcome [adjusted odds ratio (AOR) = 1.96, 95% CI 1.06, 3.64]. Patients who were perceived to not be stigmatized were less likely to have an unfavorable treatment outcome (AOR = 0.32, 95% CI 0.15, 0.73). Patients who had a monthly income of > 3,500 Ethiopian birr were less likely to have an unfavorable outcome than patients who did not have a regular income (AOR = 0.04, 95% CI 0.01, 0.45). The observed treatment success rate is lower than the World Health Organization's target of successfully treating > 90% of detected TB cases. It is imperative to ensure that information, education and communication/behavior change communication strategies consider the needs of women and patients with perceived TB stigma. Furthermore, designing locally acceptable and affordable interventions may help to address the financial challenges of TB treatment adherence.

Efficacy and safety of albendazole alone versus albendazole in combination with ivermectin for the treatment of Trichuris trichiura infections: An open-label, randomized controlled superiority trial in south-western Uganda.

Trichuris trichiura, a soil-transmitted helminth (STH), often persists after a single dose of anthelminthic treatment. To overcome limited efficacy against T. trichiura of benzimidazoles (albendazole or mebendazole), the primary drugs used in mass drug administration (MDA) campaigns, the World Health Organization endorses the use of a combination of ivermectin and albendazole as a more effective treatment to be used for preventive chemotherapy. Given observed considerable differences in efficacy of the combination therapy over albendazole monotherapy, between different settings, it is necessary to evaluate the performance of the combination before introducing it on a larger scale. This open-label, randomized controlled superiority trial in two Ugandan primary schools enrolled eligible 6- to 12-year-olds positive for T. trichiura. Participants were randomized 1:1 to receive either a single dose of albendazole alone or co-administered albendazole and ivermectin. Adverse events were monitored at three and 24h post-treatment. Follow-up samples were collected 14 to 21 days post-treatment for efficacy assessment. The combination of albendazole with ivermectin showed superior efficacy against T. trichiura compared to albendazole alone, both in terms of cure rates (31.3% versus 12.3%, difference 18.9%-points, 95% CI 6.2-31.2, p < 0.004) and in terms of egg reduction rates (ERRs; 91.4% versus 52.7%). A higher cure rate against co-infecting Ascaris lumbricoides was observed in the combination compared to the albendazole monotherapy arm (100% versus 83.9%). Both therapies showed an excellent safety profile with few and only mild and transient treatment emergent adverse events observed in the albendazole monotherapy and albendazole plus ivermectin arm (total of 22 and 19 events, respectively). In conclusion, the efficacy of the combination therapy against T. trichiura in Uganda is superior to that of albendazole alone. Given the high ERRs observed albendazole-ivermectin might aid in eliminating morbidity, an important target of STH control programs. Trial registration (clinicaltrials.gov): NCT06037876.

Pengelolaan Anggaran Desa di Desa Warawatung, Kecamatan Nagawutun, Kabupaten Lembata

Village budget management is the process of planning, allocating, using and supervising funds owned by a village. Good village budget management aims to improve the welfare of village communities through targeted and efficient development. The method of implementing work programs is through socialization and interviews by program implementers. work and work program targets. Good Village Budget Management can bring Warawatung Village to a prosperous, developing and advanced village,

Refugees Labor Market Integration in Kenya

We analyze labor market outcomes among refugees in Kenya during the COVID-19 pandemic. The analyses are based on eight waves of the COVID-19 Rapid Response Phone Surveys dataset. We employ static panel regression, and test for robustness of the results in a staggered difference-in-difference regression. Findings suggest that employment rate, hours worked, and labor income differed across the waves. Employment rate rose in the last four waves relative to the first four waves of the pandemic. Average hours worked declined relative to the level at the onset of the pandemic. Whereas gender insignificantly affected employment rate, females worked fewer hours compared to males. The higher the educational attainment, the likelier the refugee was employed. College graduates earned higher incomes compared to refugees without formal education. Males and females had similar labor market outcomes for the same level of education. In terms of coping actions, adopters were less likely to be employed in waves 5-8, worked fewer hours, and had lower labor incomes compared to non-adopters. In line with the findings, we recommend, among other things, the implementation of job interventions that target refugees, and proper targeting of social protection and education programs to incentivize work, and raise refugees’ human capital.

CAPACITY BUILDING IN JOB SUSTAINABILITY FOR PERMAI MEMBERS IN PULAU PINANG, MALAYSIA

This Community Service Program (PPM) aims to improve the self-actualization, competitiveness, and adaptability of Indonesian migrant workers in Malaysia, particularly members of the PERMAI organization in Penang. The challenges posed by regional labor competition, especially after the implementation of the ASEAN Economic Community (AEC), include low productivity, limited education, and insufficient skills among Indonesian workers. To address these issues, the program offers psychoeducation, training, and the introduction of new competencies such as digital literacy, sustainability-focused green skills, and an entrepreneurial mindset. These skills are designed to better prepare participants for the global job market, ensuring long-term employment sustainability and economic contribution. The program targets 50-100 PERMAI members from diverse professional backgrounds, including factory workers, lecturers, and data analysts. Through lectures, discussions, and interactive workshops, the initiative aims to boost self-efficacy in career and business planning while enhancing both hard and soft skills. The integration of digital competencies and environmental awareness aligns with global trends in sustainable work practices, contributing to the development of technology-driven and environmentally responsible workers. The anticipated outcomes include improved career planning, entrepreneurial development, and green job practices. The findings are expected to add theoretical value to sustainable human resource development and digital upskilling.

Identifying and overcoming challenges in the EMA's qualification of novel methodologies: a two-year review.

The EMA Qualification of Novel Methodologies procedure qualifies methods, technologies and methodologies within a well-defined context of use in a pharma R&D context based on the evaluation of the presented scientific rationale and submitted data. This policy brief analyses QoNM submissions providing policy messages and recommendations to stakeholders on how to better prepare qualification applications in this regard. The recommendations include: 1. Grounding validation strategy using a current standard measure or a distribution technique. 2. Accurately represent pertinent subgroups via accurate inclusion and exclusion criteria. 3. Establish a well-defined and specific CoU with clear descriptions of the use within a development program target population and disease stage. Lastly, it emphasizes role of the QoNM procedure in advancing medicine development methodologies within the EU.

Countermeasures and follow-up actions in response to information on thyroid cancer, which possibly provoked misunderstanding and unfounded rumour, issued by five former Japanese prime ministers.

This study summarises the responses to information on thyroid cancer, which possibly provoked misunderstanding and unfounded rumour, described in a letter issued by five former Japanese Prime Ministers on 27 January, 2022. Fukushima Medical University (FMU) implemented countermeasures and follow-up in three phases in response to the letter. In Phase 1, FMU shared scientific facts on the relationship between radiation exposure and thyroid cancer, as well as the response of FMU towards those who read the letter and were concerned about the description. Furthermore, FMU organised lectures and workshops to facilitate peer support among medical and non-medical staff, which were publicised through a newspaper article. In Phase 2, the peer support programme targeting patients with thyroid cancer was launched. In Phase 3, FMU participated in a TV programme to explain the medical aspects of thyroid cancer and the importance of providing peer support to patients with cancer, featuring individuals with experiences as medical staff and survivors.

A Proposal for a Best-evidence Model of Care and Program Logic for Supported Accommodation for People Released From Prison.

This paper describes the development of a proposed best-evidence model of care (MoC) and program logic (PL) for supported accommodation (SA) for people released from prison. Evidence from a systematic review, interviews with clients of SA, and consultation with service providers were synthesized to develop a draft MoC that was embedded into a PL. The MoC and PL were refined in a workshop with researchers and SA providers. The MoC comprised five best-evidence core components to be standardized across any SA, operationalized by flexible activities that need to be determined by services to suit their circumstances. The PL comprised client needs that the program targets, a rationale for why core components would be effective and appropriate process and outcome measures. The development and uptake of a best-evidence MoC and clearly defined PL will help engender a larger and more rigorous SA evidence-base, and improve outcomes for people released from prison.

Caregiving Challenges from Persistent Pain Among Family Caregivers to People with Dementia.

Many family caregivers to people with dementia experience persistent physical pain. Though caregivers' pain is associated with poor caregiving outcomes, there is little research on how pain challenges caregiving to yield poor outcomes. This study developed a typology of caregiving challenges from pain among family caregivers to people with dementia. We conducted semi-structured, in-depth interviews with 25 family caregivers living with persistent pain and caring for people with dementia. We inductively analyzed data via a thematic analysis approach, wherein we identified and categorized caregiving challenges stemming from caregivers' pain. We then analyzed how challenges were related to one another and their consequences for caregiving outcomes. Analysis revealed three interrelated categories of caregiving challenges from living with pain: 1) physical (e.g., difficulty lifting care recipient), 2) psychological/emotional (e.g., worry about future care if their pain condition worsens), and 3) familial/relational (e.g., resentment towards family without pain for not helping with care). Caregivers reported that these challenges compounded one another in ways that made both caregiving and pain management more difficult. Moreover, challenges led to caregivers delaying or skipping care tasks. The nature of challenges and their connection to caregiving outcomes were dependent on various supporting factors, such as whether caregivers reported benefits from their own pain (e.g., greater empathy). The resulting typology informs a conceptual model to guide future translational research on caregivers' pain, including illuminating promising intervention targets of pain self-management programs for family caregivers to people with dementia.

A standard area diagram for Fusarium yellows rating in sugar beet (Beta vulgaris)

AbstractMembers of the Fusarium oxysporum species complex are pathogens of sugar beet causing Fusarium yellows. Fusarium yellows can reduce plant stand, yield and extractable sugar. Improving host plant resistance against Fusarium‐induced diseases, like Fusarium yellows, represents an important long‐term breeding target in sugar beet breeding programmes. Current methods for rating Fusarium yellows disease severity rely on an ordinal scale, which limits precision for intermediate phenotypes. In this study, we aimed to improve the accuracy and precision of rating Fusarium yellows by developing a standard area diagram (SAD). Two SAD versions were created using images of sugar beets infected with Fusarium oxysporum strain F19. Each version was tested using inexperienced raters. Version 1 and the improved version 2 SAD showed no statistical differences in Lin's concordance correlation coefficient (LCC) values, which was used to assess accuracy and precision between the two versions (Cb = 0.99 for both versions, c = 0.97 and 0.96 for version 1 and 2, respectively). In addition, five naïve Bayesian machine‐learning models that used pixel classification to determine disease score were tested for congruency to human estimates in SAD version 2. Root mean square error was lowest compared to the ‘true’ values for the unweighted model and a model where necrotic tissue was given a 2× weight (12.4 and 12.6, respectively). The creation of this SAD enables breeding programmes to make consistent, accurate disease ratings regardless of personnel's previous experience with Fusarium yellows. Additionally, more iterations of pixel quantification equations may overcome accuracy issues for rating Fusarium yellows.

COMMUNITY SERVICE IN IMPROVING HEALTH-BASED WELFARE IN GUNUNG BUNDER 2 VILLAGE

In order to improve health in Gunung Bunder 2 Village, Pamijahan, Bogor, leactures of Budi Luhur University collaboration with Cibening Community Health Center held an activity namely health day. The health day implementation program is an activity to educate the public on issues related to health, the environment and waste management. Community involvement in the health sector has become a major focus in recent decades. This is driven by the understanding that active community involvement can increase the effectiveness and sustainability of health programs. Apart from that, 70% of public health comes from community participation. The main target of health programs, must be empowered so that they are willing and able to maintain their health. Currently in the Gunung Bunder 2 Village environment there is no waste collection, the waste is thrown into the river, landfilled or burned. This is not very good for health. The aim of health day activities is to encourage people to play an active role in maintaining a clean environment. Implementation of activities in Gunung Bunder 2 Village is carried out in stages per RW starting with the RW closest to the Village Hall where the activities are carried out.

Efektivitas Sistem Administrasi Kependudukan Berbasis Teknologi Informasi (SAKTI) di Kota Kediri

The Population and Civil Registration Service of the City of Kediri is one of the regional government agencies of the City of Kediri that implements acceleration of the quality of public services by presenting an innovation in public services in the field of population administration. One of the innovations is SAKTI (Information Technology Based Population Administration System), a website application that makes it easier for the people of Kediri City to manage population administration. The presence of the SAKTI Application does not necessarily replace face-to-face services at the Kediri City Population and Civil Registration Office. Some people prefer face-to-face services at the Kediri City Population and Civil Registration Office rather than online services via the SAKTI application. This research aims to determine and analyze the effectiveness of the Information Technology Based Population Administration System (SAKTI) at the Kediri City Population and Civil Registration Service. This type of research is qualitative research with a descriptive approach. Data collection techniques through observation, interviews and documentation. The theory used in this research is the theory of program effectiveness according to Budiani in Maulana &amp; Adam (2021) with four focuses, namely accuracy of program targets, program socialization, program objectives, program monitoring. The research results show that the effectiveness of the SAKTI Application is still less effective. This is because there are still people who have not used the SAKTI Application to process population documents. Apart from that, there are still several problems with the SAKTI application.

Implementasi Digitalisasi Kurikulum Merdeka Di SD Negeri 3 Tenggeles Kudus Dengan Media Canva Sebagai Pengabdian Kuliah Kerja Nyata

One of the villages in Kudus Regency's Mejobo District, Tenggeles, is seeing an increase in its productive generation. Equipped with this insight, the team responsible for implementing the activity decided to promote the potential of the community in the field of education, particularly at SD Negeri 3 Tenggeles. Student empowerment at SD Negeri 3 Tenggeles will be carried out through the deployment of Independent Curriculum digitalization with Canva media. This program's primary goal is to raise awareness of the value of digital technology proficiency for future acquisition of other soft skills. The sixth graders at SD Negeri 3 Tenggeles are the program's target audience; they can be thought of as a high class that is prepared to advance to the next grade level by receiving further knowledge. Training and accompanying strategies are used in the implementation of this program. The procedure begins with the introduction of Canva and the material presentation. Next, the design team collaborates with the team implementing the activity, and finally, the work is presented in front of the class. As a result of this program's adoption, kids' creativity is being encouraged and their teamwork skills are improving.

MANAJEMEN TRANSFORMASI DIGITAL PENDIDIKAN SEKOLAH DASAR DI KABUPATEN SINTANG

The independent curriculum as one of the digital development products developed through the independent learning platform has become a challenge for the education field, including in Sintang Regency. This study aims to describe the management of digital transformation of education in the Implementation of the Independent Curriculum (IKM) in Sintang Regency. The research method used is case study research. Data collection techniques aimed of mapping the readiness of schools, teachers, students, parents in utilizing ICT, the Independent Teaching Platform. The results show that digital transformation management of education has been implemented at Elementary Schools in Sintang Regency. In the planning aspect, it is done by mapping priorities in the short, medium and long term. Assessing and analyzing capabilities, requirements, challenges and opportunities related to digital transformation. Building steps and synergy with various related parties to achieve goals. Socializing the program and setting achievement targets in digital transformation management. In terms of implementation, it is to apply the entire series of planning by directing, playing an active role from structural and functional to influence and strive for all stakeholders to be able to implement the digital transformation program in the Implementation of the Independent Curriculum effectively and efficiently. Meanwhile, monitoring or evaluation of the digital transformation program is the result of the achievement of the planning and implementation process, namely 65.35% of IKM achievement so that it can be used as a benchmark for success or as a follow-up effort for the program at Elementary Schools in Sintang Regency.

Rethinking Food and Nutrition Security: Why Income Alone Isn’t Enough in Coffee-Producing Areas of Ethiopia.

Background Coffee-growing communities in Yayu, Southwestern Ethiopia, are perceived to be food secure due to income from coffee production. However, while income ensures caloric sufficiency, it does not necessarily translate into complete food security, especially in terms of nutrient intake. Our study assessed the food and nutrition security of smallholder farm households in Yayu, with a particular focus on dietary diversity and hidden hunger. We found significant gaps in nutritional intake, especially for vulnerable groups such as women and children under five. Policy and Implications Ethiopia’s Productive Safety Net Program (PSNP) targets food-insecure areas based on economic status, assuming that income ensures food security. However, our findings suggest that this approach may be flawed, as households in coffee-growing regions are often labeled food secure despite significant deficiencies in essential nutrients such as heme iron. This calls for a re-evaluation of food security policies in cash-crop-dominated areas to address not only income but also access to diverse and nutrient-rich foods. Recommendations 1. Enhance Nutritional Education: Implement targeted educational programs focusing on the importance of dietary diversity, particularly in coffee-producing areas. 2. Diversify Agriculture: Encourage smallholder farmers to diversify crops, integrating nutrient-dense foods alongside coffee cultivation. 3. Improve Market Access: Strengthen local markets to ensure that nutrient-rich foods are available and affordable during both surplus and shortage seasons. 4. Revise PSNP Criteria: Use localized food and nutrition data rather than income alone to identify food insecurity in cash-crop regions. Conclusion Income from coffee production in Yayu improves caloric sufficiency but does not guarantee nutritional adequacy. To combat hidden hunger, policies must move beyond income-based indicators of food security and prioritize access to diverse, nutrient-rich foods. This will ensure a more comprehensive approach to food and nutrition security in Ethiopia’s coffee-growing regions.