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Ethiopia

Ethiopia-family

Duration: Phase 1: July 2009 through April 2014 | Phase 2: mid 2014 to mid-2017

In phase 1, Alive & Thrive implemented a comprehensive program in Ethiopia to improve breastfeeding and complementary feeding practices and to reduce stunting. Read about the program approach and results in phase 1. In phase 2, Alive & Thrive is incorporating the lessons and best practices from phase 1 and operating across multiple sectors to tackle stunting. Read about phase 2 program activities.

Download the Ethiopia country profile brief.

Phase 1: Moving from nutrition crisis to nutrition security

July 2009 through April 2014 

Alive & Thrive worked in partnership with the Health Extension Program of the Federal Ministry of Health, regional and district health bureaus, a USAID-funded national integrated family health project, women’s associations, nongovernmental organizations, and faith-based organizations to improve infant and young child feeding (IYCF).

Program Approach

  • Advocacy at national and sub-national levels to increase attention to and resources for IYCF through participation in the National Nutrition Working Group, technical support to the Federal Ministry of Health for development of the National Nutrition Program, and stunting reduction workshops for health officials and staff, leaders of other sectors, journalists, and parliamentarians
  • Interpersonal communication and community mobilization in four regions (Tigray, Amhara, Oromia, and SNNPR) to strengthen the ability of the government’s Health Extension Program to provide quality IYCF counseling by anchoring the program with seven priority feeding actions, developing and distributing counseling tools, building the capacity of health extension workers (HEWs), and providing supportive supervision. Community conversations engaged the community and complemented home visits.
  • Mass communication (a radio and TV campaign designed primarily for men) focusing on seven feeding actions to strengthen and extend the impact of community interventions and reach those outside program areas
  • Strategic use of data from formative research, the baseline survey, process evaluations, and sentinel site surveys to guide program design, implementation, management, and advocacy

Results

  • About 2 million mothers of children under 2 reached by either interpersonal communication and/or radio. By mid-2012, 48 percent of mothers of children under 2 in the program areas remembered a message on infant and young child feeding delivered by a health extension worker or volunteer during a home visit. This represents about 1.5 million mothers across 295 intervention woredas (districts). During this same period, an estimated 960,000 women heard the program’s radio spots.
  • Improved practices. The 2009 baseline survey conducted in Tigray and SNNPR found relatively high rates of exclusive breastfeeding (72 percent). By the time of the 2013 process evaluation, the rate had increased to 80 percent. The rates of dietary diversity and minimum meal frequency, while still extremely low, had doubled, from 6 to 15 percent and 5 to 12 percent, respectively.
  • Wide adoption of tools to improve service delivery. The IYCF counseling tool and reminder card for families are being used in government health programs throughout the country and by numerous civil society organizations. More than 33,000 HEWs in Ethiopia have or will receive training on complementary feeding as part of the government’s integrated refresher training.
  • Policy shift toward prioritization of stunting. The 2008 National Nutrition Plan was revised in 2013 to focus on a lifecycle approach with emphasis on the first 1,000 days, stunting reduction, and a multisectoral approach. The new plan notes an improved policy landscape for nutrition since the 2008 plan with stunting reduction one of the goals of the country’s Growth and Transformation Plan.

Phase 2: Improving infant and young child feeding practices through multisectoral collaboration

Mid 2014 to mid 2017

Alive & Thrive’s program aligns with the multisectoral approach of the government’s National Nutrition Program and works at the federal and regional level (Amhara) in partnership with government ministries, UNICEF, Save the Children, Concern Worldwide, and civil society organizations.

Objectives

  • To sustain high rates of exclusive breastfeeding among children 0-5.9 months of age at over 70 percent in Alive & Thrive program areas in the Amhara region
  • To increase the proportion of children 6-23 months of age who receive a diverse diet and consume at least four different food groups by 10 percentage points in Alive & Thrive program areas
  • To increase the proportion of breastfed and non-breastfed children 6-23 months of age who receive solid, semi-solid, or soft foods at least the minimum number of times per day in Alive & Thrive program areas by 10 percentage points

Program Approach

  • Advocacy to strengthen a social and behavior change framework and communication strategy that will help unify multiple sectors and platforms in using approaches, messaging, and materials to improve feeding practices along with advocacy to increase regional and district funding for nutrition and IYCF services in Amhara
  • Interpersonal communication and community mobilization to support improved feeding practices in food secure and insecure areas and to change social norms. This involves building the capacity of health extension workers, members of the Health Development Army, and frontline workers of other sectors such as agriculture and WASH to provide timely and targeted counseling on IYCF. Community mobilization includes community conversations and meetings of women’s associations on nutrition and building on existing social networks to reach out to influential community and family members.
  • Mass communication, specifically radio, to inform and motivate targeted populations
  • Strategic use of data facilitated through development of an IYCF indicator tracking system for the National Nutrition Program, rapid assessments and operations research, and routine monitoring of coverage, scale, and quality of the program

Alive & Thrive
Generation 2


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