{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T03:25:16Z","timestamp":1781839516193,"version":"3.54.5"},"reference-count":51,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"vor","delay-in-days":38,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"crossref","award":["NIHR 131996"],"award-info":[{"award-number":["NIHR 131996"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"crossref","award":["NIHR 131996"],"award-info":[{"award-number":["NIHR 131996"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Prim. Care"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The profound impact of wounds on the quality of life of those affected is often underestimated. Chronic wounds impose substantial burdens on individuals and communities in terms of disability, mental distress, stigma, and economic productivity losses. To effectively address these challenges, an integrated and comprehensive approach to primary healthcare-based chronic wound care prevention and management is essential. This implementation research study aims to assess the integration and scale-up of a comprehensive package of primary healthcare-based wound care and psychosocial support for persons affected by chronic wounds caused by NTDs and other conditions in selected districts in Ethiopia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study will be implemented in Central Ethiopia and Amhara Regions in three stages, utilizing a mixed-methods approach to co-develop a comprehensive care package and progressively implement the care package building on learnings from successive stages of implementation. Stage 1 will encompass the co-development of a holistic wound care package and strategies for its integration into routine primary health services. Stage 2 will involve a pilot study in one sub-district, to establish the care package\u2019s adoption, feasibility, acceptability, fidelity, potential effectiveness, readiness for scale-up, and costs. Stage 3 will involve the scale-up of the wound care package and its evaluation in several districts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This implementation research on integration and scale up of chronic wound care within primary health services will substantially improve access to care and support for affected persons in Ethiopia. It will also have critical contribution to the national wound care and integrated early detection, management and reporting of chronic wound due to skin-NTDs and other chronic health conditions government initiative in the primary health care system of Ethiopia. The finding from this embedded implementation research will be disseminated to relevant stakeholders using a variety of channels to inform policymaking and program design. Persons affected by chronic wounds and their family, healthcare providers, and program planners will benefit from this study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12875-026-03259-9","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T13:29:35Z","timestamp":1773062975000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Integration and scale-up of a primary healthcare-based chronic wound care package for persons affected by skin-neglected tropical diseases and other conditions in Ethiopia: a protocol for an implementation research study"],"prefix":"10.1186","volume":"27","author":[{"given":"Mersha","family":"Kinfe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maya","family":"Semrau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asrat","family":"Mengiste","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oumer","family":"Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tigest","family":"Ajeme","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Bremner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Hounsome","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasso","family":"Anagnostopoulou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malcolm","family":"Brewster","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence","family":"Rugema","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eiman Siddig","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agumasie","family":"Semahegn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abebaw","family":"Fekadu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gail","family":"Davey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"issue":"4","key":"3259_CR1","doi-asserted-by":"publisher","first-page":"e0004385","DOI":"10.1371\/journal.pntd.0004385","volume":"10","author":"L Toutous Trellu","year":"2016","unstructured":"Toutous Trellu L, Nkemenang P, Comte E, Ehounou G, Atangana P, Mboua DJ, et al. Differential Diagnosis of Skin Ulcers in a Mycobacterium ulcerans Endemic Area: Data from a Prospective Study in Cameroon. PLoS Negl Trop Dis. 2016;10(4):e0004385.","journal-title":"PLoS Negl Trop Dis"},{"key":"3259_CR2","doi-asserted-by":"publisher","first-page":"1233","DOI":"10.1111\/j.1365-4632.2006.02671.x","volume":"45","author":"T Ryan","year":"2006","unstructured":"Ryan T. Public health dermatology: Regeneration and repair of the skin in the developed transitional and developing world. Int J Dermatol. 2006;45:1233\u20137.","journal-title":"Int J Dermatol"},{"issue":"9","key":"3259_CR3","doi-asserted-by":"publisher","first-page":"695","DOI":"10.2471\/BLT.06.037184","volume":"85","author":"R Norman","year":"2007","unstructured":"Norman R, Matzopoulos R, Groenewald P, Bradshaw D. The high burden of injuries in South Africa. Bull World Health Organ. 2007;85(9):695\u2013702.","journal-title":"Bull World Health Organ"},{"key":"3259_CR4","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1007\/978-3-319-61672-8_8","volume-title":"Towards a Sociology of Health Discourse in Africa","author":"J Amzat","year":"2018","unstructured":"Amzat J, Razum O. Rural Health in Africa. In: Amzat J, Razum O, editors. Towards a Sociology of Health Discourse in Africa. Cham: Springer International Publishing; 2018. pp. 109\u201324."},{"issue":"3","key":"3259_CR5","doi-asserted-by":"publisher","first-page":"651","DOI":"10.2337\/dc13-2176","volume":"37","author":"JB Rice","year":"2014","unstructured":"Rice JB, Desai U, Cummings AK, Birnbaum HG, Skornicki M, Parsons NB. Burden of diabetic foot ulcers for medicare and private insurers. Diabetes Care. 2014;37(3):651\u20138.","journal-title":"Diabetes Care"},{"issue":"11","key":"3259_CR6","doi-asserted-by":"publisher","first-page":"e05552","DOI":"10.1016\/j.heliyon.2020.e05552","volume":"6","author":"TW Abate","year":"2020","unstructured":"Abate TW, Enyew A, Gebrie F, Bayuh H. Nurses\u2019 knowledge and attitude towards diabetes foot care in Bahir Dar, North West Ethiopia. Heliyon. 2020;6(11):e05552.","journal-title":"Heliyon"},{"issue":"8","key":"3259_CR7","doi-asserted-by":"publisher","first-page":"974","DOI":"10.1001\/jama.296.8.974","volume":"296","author":"M Reddy","year":"2006","unstructured":"Reddy M, Gill SS, Rochon PA. Preventing pressure ulcers: a systematic review. JAMA. 2006;296(8):974\u201384.","journal-title":"JAMA"},{"issue":"1","key":"3259_CR8","first-page":"1","volume":"66","author":"W Bekri","year":"1998","unstructured":"Bekri W, Gebre S, Mengiste A, Saunderson PR, Zewge S. Delay in presentation and start of treatment in leprosy patients: a case-control study of disabled and non-disabled patients in three different settings in Ethiopia. Int J Lepr other Mycobact diseases: official organ Int Lepr Association. 1998;66(1):1\u20139.","journal-title":"Int J Lepr other Mycobact diseases: official organ Int Lepr Association"},{"issue":"1","key":"3259_CR9","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1093\/inthealth\/ihu043","volume":"7","author":"E Mousley","year":"2015","unstructured":"Mousley E, Deribe K, Tamiru A, Tomczyk S, Hanlon C, Davey G. Mental distress and podoconiosis in Northern Ethiopia: a comparative cross-sectional study. Int health. 2015;7(1):16\u201325.","journal-title":"Int health"},{"issue":"2","key":"3259_CR10","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1093\/inthealth\/ihv037","volume":"8","author":"J Bartlett","year":"2016","unstructured":"Bartlett J, Deribe K, Tamiru A, Amberbir T, Medhin G, Malik M, et al. Depression and disability in people with podoconiosis: a comparative cross-sectional study in rural Northern Ethiopia. Int health. 2016;8(2):124\u201331.","journal-title":"Int health"},{"issue":"Suppl 1","key":"3259_CR11","doi-asserted-by":"publisher","first-page":"i53","DOI":"10.1093\/inthealth\/ihv071","volume":"8","author":"K Hofstraat","year":"2016","unstructured":"Hofstraat K, van Brakel WH. Social stigma towards neglected tropical diseases: a systematic review. Int health. 2016;8(Suppl 1):i53\u201370.","journal-title":"Int health"},{"issue":"3","key":"3259_CR12","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1016\/j.inhe.2011.06.006","volume":"3","author":"A Tora","year":"2011","unstructured":"Tora A, Davey G, Tadele G. A qualitative study on stigma and coping strategies of patients with podoconiosis in Wolaita zone, Southern Ethiopia. Int health. 2011;3(3):176\u201381.","journal-title":"Int health"},{"key":"3259_CR13","doi-asserted-by":"publisher","first-page":"647","DOI":"10.1186\/2193-1801-3-647","volume":"3","author":"A Tora","year":"2014","unstructured":"Tora A, Franklin H, Deribe K, Reda AA, Davey G. Extent of podoconiosis-related stigma in Wolaita Zone, Southern Ethiopia: a cross-sectional study. SpringerPlus. 2014;3:647.","journal-title":"SpringerPlus"},{"issue":"1","key":"3259_CR14","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1016\/j.socscimed.2008.09.040","volume":"68","author":"B Person","year":"2009","unstructured":"Person B, Bartholomew LK, Gyapong M, Addiss DG, van den Borne B. Health-related stigma among women with lymphatic filariasis from the Dominican Republic and Ghana. Soc Sci Med. 2009;68(1):30\u20138.","journal-title":"Soc Sci Med"},{"issue":"7","key":"3259_CR15","doi-asserted-by":"publisher","first-page":"1136","DOI":"10.1111\/j.1365-3156.2006.01658.x","volume":"11","author":"F Tekola","year":"2006","unstructured":"Tekola F, Mariam DH, Davey G. Economic costs of endemic non-filarial elephantiasis in Wolaita Zone, Ethiopia. Trop Med Int health: TM IH. 2006;11(7):1136\u201344.","journal-title":"Trop Med Int health: TM IH"},{"issue":"2","key":"3259_CR16","doi-asserted-by":"publisher","first-page":"e128","DOI":"10.1371\/journal.pntd.0000128","volume":"1","author":"M Perera","year":"2007","unstructured":"Perera M, Whitehead M, Molyneux D, Weerasooriya M, Gunatilleke G. Neglected patients with a neglected disease? A qualitative study of lymphatic filariasis. PLoS Negl Trop Dis. 2007;1(2):e128.","journal-title":"PLoS Negl Trop Dis"},{"issue":"12","key":"3259_CR17","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1093\/trstmh\/tru154","volume":"108","author":"S Martindale","year":"2014","unstructured":"Martindale S, Mkwanda SZ, Smith E, Molyneux D, Stanton MC, Kelly-Hope LA. Quantifying the physical and socio-economic burden of filarial lymphoedema in Chikwawa District, Malawi. Trans R Soc Trop Med Hyg. 2014;108(12):759\u201367.","journal-title":"Trans R Soc Trop Med Hyg"},{"issue":"12","key":"3259_CR18","doi-asserted-by":"publisher","first-page":"1432","DOI":"10.1111\/ijd.13785","volume":"56","author":"A Effah","year":"2017","unstructured":"Effah A, Ersser SJ, Hemingway A. Support needs of people living with Mycobacterium ulcerans (Buruli ulcer) disease in a Ghana rural community: a grounded theory study. Int J Dermatol. 2017;56(12):1432\u20137.","journal-title":"Int J Dermatol"},{"issue":"9","key":"3259_CR19","doi-asserted-by":"publisher","first-page":"566","DOI":"10.1093\/trstmh\/trt054","volume":"107","author":"SR Narahari","year":"2013","unstructured":"Narahari SR, Bose KS, Aggithaya MG, Swamy GK, Ryan TJ, Unnikrishnan B, et al. Community level morbidity control of lymphoedema using self care and integrative treatment in two lymphatic filariasis endemic districts of South India: a non randomized interventional study. Trans R Soc Trop Med Hyg. 2013;107(9):566\u201377.","journal-title":"Trans R Soc Trop Med Hyg"},{"issue":"5","key":"3259_CR20","doi-asserted-by":"publisher","first-page":"e0006391","DOI":"10.1371\/journal.pntd.0006391","volume":"12","author":"SM Bakhiet","year":"2018","unstructured":"Bakhiet SM, Fahal AH, Musa AM, Mohamed ESW, Omer RF, Ahmed ES, et al. A holistic approach to the mycetoma management. PLoS Negl Trop Dis. 2018;12(5):e0006391.","journal-title":"PLoS Negl Trop Dis"},{"issue":"1","key":"3259_CR21","doi-asserted-by":"publisher","first-page":"e0005939","DOI":"10.1371\/journal.pntd.0005939","volume":"12","author":"S Wiese","year":"2018","unstructured":"Wiese S, Elson L, Feldmeier H. Tungiasis-related life quality impairment in children living in rural Kenya. PLoS Negl Trop Dis. 2018;12(1):e0005939.","journal-title":"PLoS Negl Trop Dis"},{"issue":"8","key":"3259_CR22","doi-asserted-by":"publisher","first-page":"e0005808","DOI":"10.1371\/journal.pntd.0005808","volume":"11","author":"SL Walker","year":"2017","unstructured":"Walker SL, Lebas E, De Sario V, Deyasso Z, Doni SN, Marks M, et al. The prevalence and association with health-related quality of life of tungiasis and scabies in schoolchildren in southern Ethiopia. PLoS Negl Trop Dis. 2017;11(8):e0005808.","journal-title":"PLoS Negl Trop Dis"},{"issue":"2","key":"3259_CR23","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1111\/iwj.12603","volume":"14","author":"JF Guest","year":"2017","unstructured":"Guest JF, Ayoub N, McIlwraith T, Uchegbu I, Gerrish A, Weidlich D, et al. Health economic burden that different wound types impose on the UK\u2019s National Health Service. Int Wound J. 2017;14(2):322\u201330.","journal-title":"Int Wound J"},{"issue":"2","key":"3259_CR24","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1016\/j.ando.2017.11.005","volume":"79","author":"H Tchero","year":"2018","unstructured":"Tchero H, Kangambega P, Lin L, Mukisi-Mukaza M, Brunet-Houdard S, Briatte C, et al. Cost of diabetic foot in France, Spain, Italy, Germany and United Kingdom: A systematic review. Ann Endocrinol. 2018;79(2):67\u201374.","journal-title":"Ann Endocrinol"},{"issue":"2","key":"3259_CR25","doi-asserted-by":"publisher","first-page":"313","DOI":"10.4269\/ajtmh.13-0255","volume":"91","author":"K Velding","year":"2014","unstructured":"Velding K, Klis SA, Abass KM, Tuah W, Stienstra Y, van der Werf T. Wound care in Buruli ulcer disease in Ghana and Benin. Am J Trop Med Hyg. 2014;91(2):313\u20138.","journal-title":"Am J Trop Med Hyg"},{"key":"3259_CR26","doi-asserted-by":"crossref","unstructured":"desta m, Tenaw M, Ayalew E. Level of Knowledge and Wound Care Practice at a Tertiary Referral Hospital in Ethiopia: A Survey in 180 Nurses. 2020.","DOI":"10.21203\/rs.3.rs-110089\/v1"},{"issue":"1","key":"3259_CR27","doi-asserted-by":"publisher","first-page":"1","DOI":"10.47276\/lr.86.1.1","volume":"86","author":"DS Walsh","year":"2015","unstructured":"Walsh DS, De Jong BC, Meyers WM, Portaels F. Leprosy and Buruli ulcer: similarities suggest combining control and prevention of disability strategies in countries endemic for both diseases. Lepr Rev. 2015;86(1):1\u20135.","journal-title":"Lepr Rev"},{"issue":"9","key":"3259_CR28","doi-asserted-by":"publisher","first-page":"652","DOI":"10.2471\/BLT.16.189399","volume":"95","author":"K Deribe","year":"2017","unstructured":"Deribe K, Kebede B, Tamiru M, Mengistu B, Kebede F, Martindale S, et al. Integrated morbidity management for lymphatic filariasis and podoconiosis, Ethiopia. Bull World Health Organ. 2017;95(9):652\u20136.","journal-title":"Bull World Health Organ"},{"key":"3259_CR29","unstructured":"WHO. Ending the neglect to attain the Sustainable Development Goals A road map for neglected tropical diseases 2021\u20132030."},{"key":"3259_CR30","doi-asserted-by":"crossref","unstructured":"Mieras LF, Taal AT, Post EB, Ndeve AGZ, van Hees CLM. The Development of a Mobile Application to Support Peripheral Health Workers to Diagnose and Treat People with Skin Diseases in Resource-Poor Settings. Trop Med Infect disease. 2018;3(3).","DOI":"10.3390\/tropicalmed3030102"},{"issue":"3","key":"3259_CR31","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1071\/AH09794","volume":"34","author":"JJ Moffatt","year":"2010","unstructured":"Moffatt JJ, Eley DS. The reported benefits of telehealth for rural Australians. Australian health review: publication Australian Hosp Association. 2010;34(3):276\u201381.","journal-title":"Australian health review: publication Australian Hosp Association"},{"issue":"3","key":"3259_CR32","first-page":"242","volume":"28","author":"H Jia","year":"2012","unstructured":"Jia H, Cowper DC, Tang Y, Litt E, Wilson L. Postacute stroke rehabilitation utilization: are there differences between rural-urban patients and taxonomies? JRural Health. 2012;28(3):242\u20137.","journal-title":"JRural Health"},{"issue":"20","key":"3259_CR33","doi-asserted-by":"publisher","first-page":"3629","DOI":"10.1002\/cncr.28275","volume":"119","author":"TA Skolarus","year":"2013","unstructured":"Skolarus TA, Chan S, Shelton JB, Antonio AL, Sales AE, Malin JL, et al. Quality of prostate cancer care among rural men in the Veterans Health Administration. Cancer. 2013;119(20):3629\u201335.","journal-title":"Cancer"},{"issue":"Suppl 2","key":"3259_CR34","doi-asserted-by":"publisher","first-page":"648","DOI":"10.1007\/s11606-011-1762-1","volume":"26","author":"C Buzza","year":"2011","unstructured":"Buzza C, Ono SS, Turvey C, Wittrock S, Noble M, Reddy G, et al. Distance is relative: unpacking a principal barrier in rural healthcare. J Gen Intern Med. 2011;26(Suppl 2):648\u201354.","journal-title":"J Gen Intern Med"},{"issue":"5","key":"3259_CR35","doi-asserted-by":"publisher","first-page":"651","DOI":"10.1111\/j.1742-481X.2008.00478.x","volume":"5","author":"C Chanussot-Deprez","year":"2008","unstructured":"Chanussot-Deprez C, Contreras-Ruiz J. Telemedicine in wound care. Int Wound J. 2008;5(5):651\u20134.","journal-title":"Int Wound J"},{"key":"3259_CR36","volume-title":"AHRQ Comparative Effectiveness Reviews. Chronic Venous Ulcers: A Comparative Effectiveness Review of Treatment Modalities","author":"J Zenilman","year":"2013","unstructured":"Zenilman J, Valle MF, Malas MB, Maruthur N, Qazi U, Suh Y, et al. AHRQ Comparative Effectiveness Reviews. Chronic Venous Ulcers: A Comparative Effectiveness Review of Treatment Modalities. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013."},{"issue":"4","key":"3259_CR37","doi-asserted-by":"publisher","first-page":"623","DOI":"10.4269\/ajtmh.2012.12-0204","volume":"87","author":"D Ayode","year":"2012","unstructured":"Ayode D, McBride CM, de Heer H, Watanabe E, Gebreyesus T, Tadele G, et al. The association of beliefs about heredity with preventive and interpersonal behaviors in communities affected by podoconiosis in rural Ethiopia. Am J Trop Med Hyg. 2012;87(4):623\u201330.","journal-title":"Am J Trop Med Hyg"},{"key":"3259_CR38","unstructured":"Keast DH. World Alliance for Wound and Lymphedema Care. 2020."},{"key":"3259_CR39","unstructured":"David H, Peters NTT, Taghreed Adam. Implementation Research in Health: A Practical Guide. 2013."},{"key":"3259_CR40","first-page":"a1655","volume":"337","author":"P Craig","year":"2008","unstructured":"Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ (Clinical Res ed). 2008;337:a1655.","journal-title":"BMJ (Clinical Res ed)"},{"key":"3259_CR41","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1186\/1745-6215-15-267","volume":"15","author":"MJ De Silva","year":"2014","unstructured":"De Silva MJ, Breuer E, Lee L, Asher L, Chowdhary N, Lund C, et al. Theory of Change: a theory-driven approach to enhance the Medical Research Council\u2019s framework for complex interventions. Trials. 2014;15:267.","journal-title":"Trials"},{"key":"3259_CR42","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1186\/1752-4458-8-15","volume":"8","author":"E Breuer","year":"2014","unstructured":"Breuer E, De Silva MJ, Fekadu A, Luitel NP, Murhar V, Nakku J, et al. Using workshops to develop theories of change in five low and middle income countries: lessons from the programme for improving mental health care (PRIME). Int J mental health Syst. 2014;8:15.","journal-title":"Int J mental health Syst"},{"key":"3259_CR43","unstructured":"Commission(OPCC) OotPC. The 2007 Population and Housing Census of Ethiopia."},{"key":"3259_CR44","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1186\/1745-6215-15-264","volume":"15","author":"MD Teare","year":"2014","unstructured":"Teare MD, Dimairo M, Shephard N, Hayman A, Whitehead A, Walters SJ. Sample size requirements to estimate key design parameters from external pilot randomised controlled trials: a simulation study. Trials. 2014;15:264.","journal-title":"Trials"},{"issue":"10","key":"3259_CR45","doi-asserted-by":"publisher","first-page":"e037675","DOI":"10.1136\/bmjopen-2020-037675","volume":"10","author":"M Semrau","year":"2020","unstructured":"Semrau M, Ali O, Deribe K, Mengiste A, Tesfaye A, Kinfe M, et al. EnDPoINT: protocol for an implementation research study to integrate a holistic package of physical health, mental health and psychosocial care for podoconiosis, lymphatic filariasis and leprosy into routine health services in Ethiopia. BMJ open. 2020;10(10):e037675.","journal-title":"BMJ open"},{"key":"3259_CR46","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1186\/1745-6215-15-267","volume":"15","author":"M De Silva","year":"2014","unstructured":"De Silva M, Breuer E, Lee L, Asher L, Chowdhary N, Lund C, et al. Theory of Change: a theory-driven approach to enhance the Medical Research Council\u2019s framework for complex interventions. Trials. 2014;15:267.","journal-title":"Trials"},{"key":"3259_CR47","unstructured":"Keast DH. Wound and Lymphoedema Management 2nd Edition Focus on Resource-limited Settings. 2020."},{"key":"3259_CR48","first-page":"i5239","volume":"355","author":"SM Eldridge","year":"2016","unstructured":"Eldridge SM, Chan CL, Campbell MJ, Bond CM, Hopewell S, Thabane L, et al. CONSORT 2010 statement: extension to randomised pilot and feasibility trials. BMJ (Clinical Res ed). 2016;355:i5239.","journal-title":"BMJ (Clinical Res ed)"},{"key":"3259_CR49","unstructured":"The National NTD roadmap as policy pieces. https:\/\/espen.afro.who.int\/system\/files\/content\/resources\/Third%20NTD%20national%20Strategic%20Plan%202021-2025.pdf."},{"key":"3259_CR50","unstructured":"WHO a strategic framework for integrated control. and management of skin-related neglected tropical diseases."},{"key":"3259_CR51","doi-asserted-by":"publisher","first-page":"e016650","DOI":"10.1136\/bmjgh-2024-016650","volume":"10","author":"M Kaba","year":"2025","unstructured":"Kaba M, Hailemichael Y, Alemu AY, et al. Understanding experiences of neglected tropical diseases of the skin: a mixed-methods study to inform intervention development in Ethiopia. BMJ Glob Health. 2025;10:e016650. https:\/\/doi.org\/10.1136\/bmjgh-2024-016650.","journal-title":"BMJ Glob Health"}],"container-title":["BMC Primary Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12875-026-03259-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12875-026-03259-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12875-026-03259-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T19:39:01Z","timestamp":1781638741000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12875-026-03259-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,9]]},"references-count":51,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["3259"],"URL":"https:\/\/doi.org\/10.1186\/s12875-026-03259-9","relation":{},"ISSN":["2731-4553"],"issn-type":[{"value":"2731-4553","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,9]]},"assertion":[{"value":"20 March 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical approval for the study has been obtained from the Brighton and Sussex Medical School Research Governance and Ethics Committee (BSMS RGEC) in the UK (Stage 1 ref: ER\/BSMS9D79\/6; Stage 2 ref: ER\/BSMS9D79\/7) and the Institutional Review Board of the College of Health Sciences at Addis Ababa University in Ethiopia (013\/23\/CDT). All participants, who must be over 18 years of age, will be provided with a participant information sheet. Those who choose not to participate will be excluded from the study. Participants retain the right to withdraw from the study at any time until data have been aggregated without providing a reason or facing any negative consequences, including those related to their care, treatment, or employment.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"A publication plan has been developed outlining the dissemination of study findings through various channels. The plan encompasses the publication of multiple peer-reviewed articles in scientific journals.Maintaining the confidentiality and anonymity of participant data is paramount throughout the study, encompassing data collection, storage, analysis, and publication. Multi-layered safeguards will be meticulously implemented to protect the sensitive nature of the information collected and preserve the anonymity of participants. Personal identifiers will be utilized in-stead of names, and identifying data will be securely stored separately from the correspond-ing codes used on the data collection sheets and databases. Only pseudonymised data will be subjected to data analyses. All data will be securely stored in a restricted OneDrive folder, accessible solely to authorized members of the research team. The study participants will be asked to give their consent for the publication of the findings.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"140"}}