Abstract:
Ethiopia has made a remarkable progress against child undernutrition in the past fifteen years; however, child stunting remains a serious challenge. According to Ethiopian Demographic and Health Survey, the national prevalence of stunting declined from 58% in 2000 to 38% in 2016, an average reduction of
more than 1 percentage point per year. However, progress has been inconsistent across regions. In 2016 15% of children under 5 in Addis Ababa were stunted compared to 46% in Amhara and 39% in Tigray (1).
The government of Ethiopia is committed to dramatically accelerating progress in fighting child malnutrition to reach zero childhood stunting and zero household food insecurity by 2030. These are two of eight nutrition and food security goals set in the July 2015 Seqota Declaration (SD) (2). Under the SD Implementation Plan, years 1-3 are designated as the “Innovation Phase” during which intensive
efforts will be focused in 33 pilot woredas (27 in Amhara and 6 in Tigray). The SD plan was informed by the 2013 update of the UNICEF nutrition framework (3). The SD framework (Figure 1), designates three paths to reducing malnutrition through nutrition specific, nutrition-smart, and infrastructure interventions across multiple sectors including health, agriculture, water, education, and social
protection. All interventions are supported by cross-cutting social behavior change communication (SBCC) strategies.
Seqota Declaration investments support cross-sectoral intervention scale-up by 1) strengthening multi-sectoral coordination through the creation and operation of three Program Delivery Units (PDU) – one at the federal level, and two at regional levels, 2) using the Community Lab approach to foster innovative
and integrated approaches to addressing challenges that can be scaled up in future phases. Community development lab (CDL) is SD’s innovative approach engaging the community itself to solve the challenging nature of malnutrition in SD areas that cannot be solved by traditional methods and approaches (2), and 3) advocating for full funding of SD implementation plans with government and
development partners. Each PDU is headed by a senior public health professional and comprised of sectoral experts.
The Ethiopian Public Health Institute (EPHI), with technical assistance from the Johns Hopkins University Bloomberg School of Public Health (JHSPH) is leading impact evaluation of the three-year innovation
phase of the SD initiative in select woredas in Tigray and Amhara regions.