Abstract
BACKGROUND: Quality research is essential to improving maternal, newborn, and child health (MNCH). Although Ethiopia has rapidly expanded academic and research institutions, duplication of studies, gaps in prioritisation and methods, and limited guidance on utilising evidence inhibit a coordinated approach to informing MNCH policy. We aim to address these challenges by characterising and prioritising the needs and opportunities of the MNCH research ecosystem in Ethiopia. METHODS: We purposively sampled experts for a three-stage Delphi study. Key informant interviews (KIIs) (n = 18) explored needs and challenges in capacity-strengthening, community engagement in research, operational infrastructure, collaborations, and funding. We thematically coded KII responses to generate 134 statements, which were then rated in an anonymous questionnaire (n = 34) on a Likert scale. We calculated average scores and percentage agreement for each statement. Finally, consensus-building discussions (n = 28) identified top priorities within each topic. RESULTS: Average percentage agreement across statements was 87% (range = 37-100). Highly endorsed priorities included strengthening inclusivity in research agenda-setting, prioritising research addressing key MNCH needs, enhancing research training by emphasising local experiences, cultivating intellectual curiosity, building skills in data analysis and translation, fostering research collaborations with greater multidisciplinary expertise, long-term mentorship, and capacity-building for local institutions, and engaging communities more effectively. CONCLUSIONS: Understanding challenges in the existing research environment will enable better-informed activities and stronger research networks that address local priorities. We characterised the MNCH research ecosystem across multiple dimensions, offering actionable opportunities to strengthen research capacities, infrastructure, and innovation design and evaluation through advocacy, organisational and system strengthening efforts, curricula development, and the implementation of principles to guide partnerships and agenda-setting for a variety of stakeholders. Future efforts should prioritise fostering a culture of evidence, collaborative prioritisation of research between policymakers and researchers, and sustained commitment to scaling evidence-based practices to advance MNCH outcomes.