Expanding Implementation Research for Maternal and Child Health in Ethiopia: Opportunities, Gaps and Recommendations

Abstract Evidence-based interventions to improve maternal and child health (MCH), a national priority, are not consistently implemented in Ethiopia. We assessed MCH-related implementation research (IR) in Ethiopia using a concurrent mixed-methods approach, comprised of a scoping review and key informant interviews, guided by PRISMA-ScR, Nilsen’s taxonomy, and the CFIR frameworks. Half of identified studies focused on determinants while half addressed process or evaluation. Only 42% applied an explicit theory, model, or framework; 17% used co-design; none examined dissemination. Barriers in the Inner Setting included limited training, reliance on external expertise, scarce funding, competing priorities, and limited evidence-use culture. In the Outer Setting, limited internal collaboration and dependence on external partners constrained IR. Facilitators included university IR centers, locally led initiatives, and strong interest in capacity building. Priority areas for action include establishing a national IR network, expanding training and mentorship, strengthening institutional systems, and tailoring IR frameworks for local use.