The First 1,000 Day’s Plus Public Movement for Social and Behavior Change Guideline

Abstract

Malnutrition refers to deficiencies, excesses or imbalances in a person’s intake of energy and/or nutrients (WHO 2020). It is also defined as both under-nutrition and over nutrition, which includes micronutrient and macronutrient deficiencies and negatively impacts both individuals and populations. Under-nutrition inhibits the body’s immune system from fighting disease and impedes cognitive, social-emotional, and motor development. Under-nutrition contributed to 3.1 million (45 percent of) child deaths worldwide in 2011. In Ethiopia nearly 1 out of every 4 reported deaths of children is associated with under nutrition (EPHI, COHA, 2009). Under nutrition not only increases the frequency and severity of common infections and the risk of dying from them, but it also has long-term consequences on growth and development. Malnutrition is associated with impaired cognitive ability, reduced school and work performance, and increased risk of non-communicable diseases later in life (UNICEF Annual Report, 2016.) Cost of hunger study done in Ethiopia indicated that Ethiopia losses ETB 55.5 billion (16.5 %) of GDP in 2009 due to malnutrition. If we reduce underweight to 5% and stunting to 10%, it can reduce losses by ETB 148 billion by 2025. Globally, millions of people suffer from different forms of malnutrition. According to global malnutrition estimates, the prevalence of child stunting in 2019 was 21.3 per cent, or 144 million children. Although there has been some progress, rates of stunting reduction are far below the level needed to reach the World Health Assembly (WHA) target for 2025 and the SDG target for 2030. In Ethiopia, despite some improved trends in all three nutrition indices over the last 14 years (2005 to 2019), with decline in stunting from 51 percent to 37 percent, underweight from 33 percent to 21 percent and wasting from 12 percent to 7 percent, Ethiopia remains in a precarious situation. There are wide regional differences in nutrition indicators, with regions, such as Amhara and Tigray, having the highest percentages of stunting despite the fact that they have good agricultural yields. The Government of Ethiopia has continued its commitment to nutrition by developing the National Nutrition Program i.e., NNP II (2016 – 2020), Food and Nutrition Policy and Food and Nutrition strategy (2021-2030), and the Seqota Declaration (SD) which is a high-level commitment declared in July 2015. Seqota Declaration is the Ethiopian government commitment to end stunting by 2030. A fifteen-year roadmap (2016 – 2030) outlining key strategic goal, objectives and implementation phases of the SD was developed jointly by Implementing sector ministries namely Health, Agriculture, Irrigation and Low land areas development, Water and Energy, Education, Women and Social Affair, Finance, Transport and Logistics, and Science and Innovation sectors.