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European Commission

Study for the Mainstreaming of Nutrition Outcomes in Agricultural Growth Programme (AGP 2) in Ethiopia

Final Report

14 January 2015

Project n°2014/343172/1

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|Study for the Mainstreaming of Nutrition Outcomes in Agricultural Growth Programme (AGP 2) in Ethiopia | | |

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|Request n° 2014/343172/1 | | |

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|Final Report | | |

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|14 January 2015 | | |

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|Team leader Expert in applied nutrition: Dr. Anne-Marie B. Mayer | | |

|Expert 2 in applied nutrition: Mr. Dawit Hagos Baheru | | |

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|DISCLAIMER |

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|This report has been prepared with the financial assistance of the European Commission. The views expressed herein are those of the |

|consultants and therefore in no way reflect the official opinion of the European Commission |

Acknowledgements

The Consultants would like to thank the Staff of the Ministry of Agriculture and Ministry of Health in Ethiopia for sharing their insights with us; the Nutrition Task Force of the Agriculture Growth Project that was formed to guide the process of the assignment and the AGP Federal Coordination Unit and Technical Committee of AGP for their feedback on the drafts and presentations; the Regional, Woreda and Kebele staff working on the AGP for their guidance and information shared, the communities in the kebeles visited for sharing their time for interviews.

Table of Contents

Acknowledgements 4

Table of Contents 5

Glossary of acronyms 7

Executive Summary 9

1. Introduction 12

1.1. Project objectives and purpose 12

1.2. Agricultural Growth Programme (2011-2015) 13

1.2.1. Beneficiaries 13

1.2.2. Allied programmes to AGP 14

In addition, three aligned projects of AGP1 have components related to nutrition outcomes: 14

1.2.3. AGP 2: the second phase of the Agriculture Growth Project 14

1.3. Situational analysis and synthesis 14

1.3.1. Diversity of agricultural production in AGP woredas 14

1.3.2. Nutrition situation nationally 14

1.3.3. Nutrition situation in AGP woredas 15

1.3.4. Consequences of undernutrition 15

1.4. Stakeholder and institutional analysis 16

1.4.1. National Nutrition Programme (NNP) 16

1.4.2. Mapping of existing nutrition related programmes and interventions in AGP woredas and gap analysis 17

1.5. Theory of Nutrition Mainstreaming 18

1.5.1. Definitions of Food and Nutrition Security 19

1.5.2. Multi-sectoral approaches to improve nutrition through agricultural programmes 19

1.5.3. Conceptual models for linking Agriculture and Nutrition 20

1.5.4. Key Recommendations for improving nutrition through Agriculture (FAO) 20

1.5.5. Value Chains for Nutrition 21

2. Methods 22

2.1. Overview of the Work Plan 22

2.2. Question guide 22

2.3. Case studies 22

3. Findings and Analysis 23

3.1. Analysis of Nutrition Sensitivity in AGP 23

3.1.1. Assessment of the context at the local level, to design appropriate activities to address the types and causes of malnutrition 23

3.1.2. Incorporation of explicit nutrition objectives and indicators into their design 23

3.1.3. Targeting the vulnerable and improving equity 24

3.1.4. Collaboration and coordination with other sectors 25

3.1.5. Maintaining or improving the natural resource base 26

3.1.6. Empowering women 26

3.1.7. Facilitating production diversification, and increasing production of nutrient-dense crops and small-scale livestock 27

3.1.8. Improving processing, storage and preservation 29

3.1.9. Expanding markets and market access for vulnerable groups, particularly for marketing nutritious foods incorporating Value Chains 30

3.1.10. Incorporating nutrition promotion and education 31

3.1.11. Capacity building for nutrition sensitivity 33

3.1.12. Extension Services for nutrition sensitivity 33

3.1.13. ‘Do no harm’ prevention of detrimental consequences and opportunity costs of AGP activities 34

3.1.14. Research 35

4. Intervention Proposals 37

4.1. Programme Development Objectives (PDO) & indicators for nutrition sensitivity, logical framework 37

4.1.1. Objectives for AGP 37

4.1.2. Objectives for Nutrition Mainstreaming in AGP 2 38

4.1.3. Monitoring and Evaluation for nutrition in AGP 2 39

4.1.4. Proposed Activities for Nutrition Mainstreaming in AGP 2 39

4.1.5. Implementation 40

4.1.6. Budgets for selected activities 48

4.1.7. Targeting for nutrition in AGP 48

4.1.8. Work plan for Mainstreaming Nutrition in the AGP 2 48

4.2. Conclusions 49

5. Annexes 50

5.1. Annex 1 AGP 2: Description of components and sub-components 50

5.2. Annex 2: Administration of the Assessment 51

5.3. Annex 3 Work plans of the Assessment 51

5.4. Annex 4 Detailed Schedule of the assessment visits 52

5.5. Annex 5 Question guide for Mainstreaming Nutrition into AGP 57

5.6. Annex 6 Suggested budgets for selected activities 58

Explanation of the budget estimation: 59

5.7. Annex 7 Terms of Reference 60

References 70

List of Tables

Table 1: Five pathways linking agriculture to nutrition from World Bank analysis: 19

Table 2: Logical framework for the AGP 2 project: 42

Table 3: Detailed Activities arranged by AGP component with Institutional Arrangements and links to the NNP and Mainstreaming objectives: 43

Table 4: Description of Institutional arrangements for AGP mainstreaming 46

Table 5: Summary Budgets for Selected Proposed Activities: 48

list of figures

Figure 1: USAID Ethiopia: Pathways from agriculture to nutrition: 20

Figure 2 Pathways for Nutrition mainstreaming in AGP 2 37

Figure 3: Overall and Specific Objectives for Mainstreaming Nutrition in AGP 2 38

list of BOXES

Box 1: Key guiding principles on agriculture programming for nutrition (FAO) 21

Box 2: Examples of nutrition related problems and opportunities observed during the field trips to woredas and kebeles in the four AGP Regions and suggested mitigations. 24

Box 3: Examples of Post Harvest Technologies 31

Box 4: Coordination and capacity building case study 33

Box 5: Case study on Legume Research at Hawassa University 36

Glossary of acronyms

|ACDI/VOCA |Agricultural Cooperative Development International/ Volunteers in Overseas Cooperative Assistance |

|ACF |Action Contre la Faim |

|AGP |Agricultural Growth Program |

|AGP CU |Agricultural Growth Program Coordinating Unit |

|AGP TC |Agricultural Growth Program Technical Committee |

|A&T |Alive & Thrive project |

|AMDe. |Agribusiness & Market Development |

|ATA |Ethiopian Agricultural Transformation Agency |

|BMI |Body Mass Index |

|BoA |Board of Agriculture |

|BoH |Board of Health |

|BCC |Behaviour Change Communication |

|CAADAP |Comprehensive Africa Agriculture Development Program |

|CASCAPE |Capacity Building for Scaling up of Evidence-based best Practices in Agricultural production in Ethiopia |

|CBN |Community Based Nutrition Programme |

|CBO |Community Based Organisation |

|CIDA |Canadian International Development Agency |

|CIG |Common Interest Group |

|CIMMYT |Centre for Wheat and Maize Improvement |

|CMAM |Community-based Management of Acute Malnutrition |

|CSA |Central Statistics Agency |

|DA |Development Agent |

|DHS |Demographic and Health Survey |

|EKN |Embassy of the Kingdom of the Netherlands |

|EIAR |Ethiopian Institute for Agriculture Research |

|ENGINE |Empowering New Generations to Improve Nutrition and Economic opportunities |

|EPHI |Ethiopian Institute for Public Health |

|EUD |European Union Delegation |

|FAO |Food and Agriculture Organisation |

|FTC |Farmers Training Centre |

|FtF |Feed the Future programme |

|GAFSP |Global Agricultural and Food Support Program |

|GDP |Gross Domestic Product |

|GMP |Growth Monitoring and Promotion |

|HEW |Health Extension Worker |

|HYV |High Yielding Variety |

|IDA |International Development Association |

|IEC |Information Education Communication |

|IFHP |Integrated Family Health Programme |

|IFPRI |International Food Policy Research Institute |

|IYCF |Infant and Young Child Feeding |

|LMD |Livestock Market Development |

|MoA |Ministry of Agriculture |

|M&E |Monitoring and Evaluation |

|MoH |Ministry of Health |

|NGO |Non- Governmental Organization |

|NNP |National Nutrition Program |

|NRM |Natural Resource Management |

|NTF |Nutrition Task Force |

|OFSP |Orange Fleshed Sweet Potato |

|OTP |Outpatient Therapeutic Programme |

|PDO |Programme Development Objective |

|PIF |Policy and Investment Framework |

|PLW |Pregnant and Lactating women |

|PSNP |Productive Safety Net Program |

|QPM |Quality Protein Maize |

|SBCC |Social Behaviour Change Communication |

|SMS |Subject Matter Specialist |

|SNNPR |Southern Nations, Nationalities, and Peoples' Region |

|SO |Specific Objective |

|SUN |Scaling Up Nutrition |

|ToRs |Terms of Reference |

|UNDP |United Nations Development Program |

|UNICEF |United Nations Children Fund |

|USAID |United States Agency for International Development |

|WASH |Water Sanitation and Hygiene |

|WDA |Women’s Development Army |

|WHO |World Health Organization |

Executive Summary

Within the frame of the preparation of the next phase of the Agricultural Growth Program (AGP 2) towards the programme embracing a nutrition sensitive approach, the mission team led a situation analysis of nutrition status of AGP 1 implementation and of existing nutrition relative interventions. Mainstreaming objectives and activities have been identified for AGP through the Consultants' discussions with stakeholders and through feedback on their recommendations at presentations,

Findings and Analysis: There was overall consensus that it is important for AGP to be more nutrition sensitive. For each of the FAO guiding principles the Consultants discussed opportunities and challenges for mainstreaming nutrition. There are many opportunities for Mainstreaming Nutrition in AGP:

▪ Ethiopia has many different agro-ecological zones and a heritage of bio-diversity (e.g. barley, teff, enset, coffee) and Ethiopian cuisine includes diversity of preparations including cereal, pulses, vegetables on fasting days & traditional processed foods, e.g. injera which is high in Fe.

▪ Support for Nutrition initiatives is strong in Ethiopia and The NNP is well-designed for mainstreaming nutrition in agriculture and offers a good opportunity for AGP since much of the design work is done, and coordination structures are in place or being developed.

▪ The new structure for Nutrition in Agriculture Extension is a good opportunity for Nutrition to be progressed in Agriculture sector at all levels.

▪ The women’s development army (WDA) is part of the kebele structure; a good opportunity to cascade information (1:5 structure). The AGP supports women and youth and inclusively is a high level Project Development Objective, for example in Common Interest Groups.

▪ ENGINE project is working on Nutrition Behaviour Change Communication and Capacity Building with particular focus on vulnerable women

▪ The FTCs have been established in each kebele with strong links to Development Agents (DAs). AGP supports Natural Resource Management activities at FTC such as soil and water conservation, composting skills, how to use farmyard manure, use of bio-fertiliser and crop rotations.

▪ Research Institutes are developing appropriate technologies that can be used to improve post harvest losses and save labour for women

The following challenges should be overcome:

▪ There is a lack of structure in AGP for nutrition and awareness about nutrition is poor. There is limited capacity for design of nutrition-related activities at all levels in Agriculture Sector.

▪ Poor coordination between AGP and the NNP: so far there are no formal links between AGP and the NNP.

▪ The main objective of AGP is increased production for commercial purposes rather than for local consumption. There is an assumption that in AGP woredas high production will mean assured food security and nutrition. This is not necessarily true and has resulted in few nutrition programmes implemented in AGP woredas.

▪ It is not clear what groups are benefiting from AGP activities to date and whether poor groups in particular benefit.

▪ Agricultural resources for diversification of production are not available, for example seeds and fruit tree seedlings. The crops targeted for Value Chain activities are limited to 5 crops nationally.

▪ Post-harvest practices are under-emphasised and there is limited capacity to support processing, storage, food preparation, through the FTCs.

▪ Unsustainable practices are promoted such as introduction of HYVs requiring high inputs, narrowing of genetic diversity. Agrochemical inputs used over the long term disrupt soil ecology and pesticides are a threat to pollinators such as bees.

▪ There are gaps in the link between agriculture research and extension services, e.g. appropriate technologies are not well disseminated.

▪ There is a lack of understanding about nutrition in the population and cultural barriers and belief systems around IYCF and nutrition mean that recommendations are not followed.

▪ Women’s lack of access to productive resources for agriculture, poor control over decisions related to nutrition.

Intervention Proposals: Through field visits, data analysis, and discussions with stakeholders, the Consultants have identified the following mainstreaming objectives and activities:

Overall objective: Improve consumption of diverse and nutrient-dense foods for the population of AGP woredas with particular emphasis on children under 2 and pregnant and lactating mothers to prevent malnutrition and with emphasis on improving the nutritional status of farmers.

Specific Objectives (SO):

▪ SO 1: Increase production of a range of diverse nutrient-dense foods: fruit vegetables, animal products, legumes, cereals.

▪ SO 2: Improve post harvest handling, preservation and processing to improve availability of good nutritional quality and safe foods to rural communities.

▪ SO 3: Improve income generating capacity of women through AGP activities.

▪ SO 4 to increase awareness of community members (e.g. farmers, women, adolescents community leaders) about nutrition.

▪ SO 5: Build capacity of staff in MoA at all levels (Federal, Regional, Woreda, Kebele) about nutrition mainstreaming.

▪ SO 6: Support the research and dissemination of technologies on post harvest handling processing and consumption for improved nutrition.

▪ SO 7: Support coordination across sectors to achieve synergies between nutrition-specific and nutrition sensitive interventions.

Recommended activities

▪ Production of Diversified foods by supporting the following interventions in component 1: Seed multiplication, FTC demonstrations, fruit nurseries, legume production, poultry promotion, dairy production, fisheries including hatcheries, apiculture, soil nutrient management. Horticulture production is supported by irrigation. CIGs supported to carry out production of nutrient dense crops.

▪ Post harvest handling and processing of all crops and animal foods to maintain nutritional quality and safety. Emphasis should be made on local and appropriate technologies for food preservation, storage, processing, and technology that improves nutrition whilst adding economic value promoted. These activities should be managed through CIG women and youth groups taking into consideration indigenous knowledge and new technologies. Local private sector industries in this area should be made aware of to the importance of targeting women cooperatives and youth groups into the use of their technologies.

▪ Behaviour Change Communication (BCC): Promotion of consumption of diversified foods using IEC (Information Education Communication) materials adapted to the local language, culture, nutrition barriers, and local food production system. Awareness raising activities delivered by BoA New Nutrition role at FTC on relevant topics such as nutrition, infant and young child feeding, processing, cooking demonstration, hygiene practices emphasizing use of local foods and prevention of nutrient loss (overcooking and over processing).

▪ Create capacity for nutrition mainstreaming at all levels: Support Federal, Regional, Woreda and Kebele capacity building to improve multi-sectoral coordination across sectors and within the agriculture sector through in-service training and institutional support. Recruit of a Nutritionist for the AGP FCU to follow nutrition mainstreaming. Develop of an implementation manual for nutrition mainstreaming in AGP to be disseminated and adapted for all levels in the structure. Provision of equipment for FTCs to enable cooking and processing demonstrations.

▪ Value Chain: Include nutrient dense crops in Value Chain activities. Discourage ultra processed food products through support to technologies that minimize nutrient loss in processing. Support to minimally processed foods (such as cracked wheat) for local consumption and sale. Structures built to protect perishable foods in markets to encourage purchase and consumption locally. Value chain activities to be encouraged for women’s CIGs to generate income controlled by women; this should also consider the work load and time costs for women to not adversely affect the time for child care.

▪ Research: to be supported on understanding variability in the nutrient content of food related to: breeding for nutritional quality, e.g. biofortified crops, soil fertility management for nutritional quality, post harvest nutrient losses including through storage, processing, preparation. Development and adoption of technology for post harvest handling and processing appropriate for women and to maintain the nutritional quality of the food. Support studies on food safety such as Aflatoxin testing in widely consumed staple foods and value chain crops to understand the magnitude and nature of the problems.

▪ Coordination: There is a need for AGP to coordinate with the National Nutrition Programme and across other sectors which includes many activities for nutrition sensitive agriculture with a wide geographical coverage. Coordination may be achieved through the New Nutrition role in Agriculture Extension Dept at all levels who may link to the NNP structures. Plans for AGP can then be aligned with NNP plans for Agriculture Sector at all levels. Collaboration between Heath Extension and DAs at kebele level would help to promote consumption of diversified foods.

The next steps are for the stakeholders to decide on priorities and implementation modalities for these activities. The serious nature of malnutrition in Ethiopia calls for urgent action. Mainstreaming nutrition should be prioritised in AGP 2.

Introduction

1 Project objectives and purpose

Global objective

The main objective of the assignment is to assist the Agricultural Growth Program Technical Committee (AGP TC) and the Agricultural Growth Program Coordinating Unit (AGP CU) with the preparation of the next phase of the Agricultural Growth Program (AGP 2) towards the programme embracing a nutrition sensitive approach.

Specific objectives

▪ (1) Problem analysis of nutrition status in sample Regions/ Woredas of ongoing and future AGP implementation (using MoA and CSA data as well);

▪ (2) Review and map-out the specifically nutrition-related emergency and development-oriented interventions that are being implemented by both government and non-governmental organizations in AGP operational areas;

▪ (3) Recommend how the next generation of AGP can achieve more impact on nutritional outcome/ status through adopting some of the activities recommended under the National Nutrition Program (NNP) Action Plan, or CAADP/PIF or other initiatives;

▪ (4) Identify the target group for these interventions;

▪ (5) Identify nutritional and consumption indicators relevant for the AGP with a view to their incorporation in AGP M&E;

▪ (6) Provide support for the design of nutrition sensitive interventions in AGP2.

Background

The Agricultural Growth Program, implemented in 96 woredas in four National Regional states (Oromiya, Amhara, SNNPR, Tigray) is a multi-donor financed program designed to increase productivity and market access for key crop and livestock products in targeted woredas with increased participation of women and youth.

AGP 2, the second phase of the Agriculture Growth Project will remain relatively unchanged but include cross-cutting themes of gender, nutrition youth development, climate smart agriculture mainstreaming, capacity development.

Chronic undernutrition in Ethiopia is 40% nationally in 2014 census and particularly high in 3 of the AGP regions (Tigray 44.4%; Amhara 42.4% and SNNPR 44.3%), In Oromia it is 37.5%. Malnutrition is not restricted to children but includes adolescents and adults with high levels of undernutrition assessed by BMI. The data point to a serious problem of chronic undernutrition in children and also adults and adolescents. Micronutrient deficiencies are serious concern for all groups. Also surveys carried out in the AGP woredas reveal that chronic malnutrition and poor dietary practices are also apparent in high productive woredas, thus bringing in to question the hypothesis that nutrition situation is less serious in AGP woredas than in food insecure woredas.

The National Nutrition Programme (2013-2015) lays out a programme of work to be undertaken by a multi-sectoral group of ministries, including Agriculture. During the course of this study the Consultants have interviewed stakeholders and discussed the ways in which the AGP can contribute to the NNP agenda.

The ENGINE program targets AGP woredas and aims at decreasing maternal, neonatal and child mortality by improving the nutritional status of women and children less than 5 years through sustainable, comprehensive and coordinated evidence-based interventions. Apart from ENGINE, other NGOs are not generally operational in AGP woredas working on nutrition interventions.

There is much current interest globally for ‘Nutrition-sensitive’ agriculture, and guidelines developed to assist programming in Agriculture to improve nutrition, notably by FAO. These are detailed in Box 1. The 10 guiding principles are:

1. Incorporate explicit nutrition objectives and indicators into their design, and track and mitigate potential harms;

2. Assess the context at the local level, to design appropriate activities to address the types and causes of malnutrition;

3. Target the vulnerable and improve equity;

4. Collaborate and coordinate with other sectors;

5. Maintain or improve the natural resource base;

6. Empower women;

7. Facilitate production diversification, and increase production of nutrient-dense crops and small-scale livestock;

8. Improve processing, storage and preservation;

9. Expand markets and market access for vulnerable groups, particularly for marketing;

10. Incorporate nutrition promotion and education. These guidelines have been used to develop the methods for this study to build question guides for interviewing stakeholders.

2 Agricultural Growth Programme (2011-2015)

The Agricultural Growth Program, implemented in 96 woredas in four National Regional states (Oromiya, Amhara, SNNPR, Tigray) is a multi-donor financed program designed to increase productivity and market access for key crop and livestock products in targeted woredas with increased participation of women and youth. The approach of the current phase ending in September 2015 is value-chain oriented, decentralized, participatory and integrated and focuses on key rural and agricultural development constraints. The current phase (AGP 1) is intended to address about 2.2 million households from 2423 Kebeles in the program area, providing support to the following three major components: (1) Agricultural Production and Commercialization; (2) Small-scale Rural Infrastructure Development and Management; (3) Program Management, and Monitoring & Evaluation.

Components of AGP 1:

▪ Component 1: Agricultural Production and Commercialization

- Sub component 1.1- Institutional Strengthening and Development

- Sub component 1.2 – Scaling up of Best Practices

- Subcomponent 1.3 – Market and Agribusiness Development

▪ Component 2: Small-scale Rural Infrastructure Development and Management

- Sub component 2.1- Small-scale Agricultural Water Development and Management

- Sub component 2.2- Small-scale Rural Market Infrastructure Development and

- Management

▪ Component 3: Program Management, and Monitoring & Evaluation

- Sub component 3.1 AGP management and coordination

- Sub component 3.2 Monitoring and Evaluation

The AGP is a multi-donor financed program that involves a wide range of stakeholders in the overall implementation process. For AGP 1 these include among others; the Canadian International Development Agency (CIDA), the United Nations Development Program (UNDP), the Embassy of the Kingdom of the Netherlands (EKN), the Spanish Agency for International Development (AECID), the United States Agency for International Development (USAID), the Global Agricultural and Food Support Program (GAFSP), the Ethiopian Agricultural Agency (ATA), AGP-AMDe, AGP-LMD and the World Bank (IDA/WB). The list of donors for AGP 2 is not yet finalised at the time of writing.

1 Beneficiaries

The intended beneficiaries of the AGP1 project include small and medium-scale farmers. The project is expected to achieve better livelihoods and quality of life through provision of enhanced agricultural extension services, small-scale irrigation and market infrastructure facilities that significantly reduce variability in agricultural production and enable smallholders take advantage of new and more productive opportunities. Other beneficiaries of the AGP are large commercial farms, farmer organizations, traders, agro-processors, and others. Common Interest Groups (CIG)s are targeted to women and youth.

In its current phase (AGP1 - terminating September 2015), the AGP doesn't have any explicit nutrition sensitive objectives and activities, but the current design offers many obvious and significant entry points for nutrition sensitive interventions (e.g. extension system, types of crops, value chain, behaviour change communication). The Consultants have recommended explicit nutrition objectives and indicators for the design of AGP 2 (see section 4.1.2 below and Table 2). The seven specific objectives described below will lead together to the overall objective of ‘improving consumption of diverse and nutrient-dense foods for the population of AGP woredas with particular emphasis for children under 2 and women to contribute to the prevention of malnutrition and adults to improve productivity’. With Nutrition Mainstreaming, the beneficiaries of AGP 2 could also include pregnant and lactating mothers and children under 5 although the nutrition mainstreaming activities should benefit the whole population. In addition, through the AGP2 project the wider community in Ethiopia, for example urban populations will benefit from improved quality of food production in the AGP Woredas.

2 Allied programmes to AGP

In addition, three aligned projects of AGP1 have components related to nutrition outcomes:

CASCAPE (EKN) program aiming at scaling-up best practices has a sub-component on nutrition. It has recently started a pilot project in Amhara region (Bahirdar University cluster of the project) in collaboration with Community Based Nutrition program of UNICEF (CBN-UNICEF) to have a better agricultural-nutrition linkage and improve the nutritional status of rural households especially of women and children. Following this pilot program, other University clusters are currently starting various nutrition sensitive agricultural activities in different regions of the project.

LMD program supported by USAID also targets AGP woredas and focuses on Livestock production and value chains and has integrated nutrition-sensitive activities in their programme

AMDe program supported by USAID also targets AGP woredas and focuses on the 5 selected Value Chains through support for production processing and marketing of wheat, maize, chickpea, sesame, honey and coffee and has integrated nutrition-sensitive activities in their programme.

4 AGP 2: the second phase of the Agriculture Growth Project

The Government of Ethiopia (GoE) and the main development partners (DPs) supporting the AGP have undertaken to design and implement a second phase of this program. The proposed components and subcomponents of AGP 2 are detailed in Annex 1. This is the list provided by the AGP formulation meeting in November 2014 and is still under review at the time of writing. For AGP 2 the number of woredas is planned to increase to 157 with continuation of activities in the original 96 woredas and including an extra 61 woredas in the new Regions of Benishangul Gumuz, Deredawa, Gambela and Harari. Ongoing discussions indicate that new approaches and themes will be included into the design, including cross-cutting themes of gender, nutrition, youth development, climate smart agriculture mainstreaming, capacity development. The notable addition is component 2 for Research which was not included in the first phase. The small scale irrigation activities and the agricultural marketing and agribusiness components have also been elaborated as separate components in AGP 2. Our study suggests nutrition objectives for AGP 2, in order to mainstream Nutrition into AGP 2. These ideas are currently under discussion for inclusion in AGP 2.

The Allied programmes for AGP 2 are not yet agreed nor the implementation modalities for all the components defined. There are still opportunities for parallel programming, such as the AMD, LMD and CASCAPE programmes that were allied to AGP 1.

3 Situational analysis and synthesis

1 Diversity of agricultural production in AGP woredas

The Feed the Future baseline survey[1] reports poor diversity of production in the sampled woreda: 77.5% of households produce cereals; 26.3 pulses; 6.8 Oilseeds; 3.7 Vegetables; 8.8 Root crops; 2.4 Fruit crops; 9.9 Coffee; 15.4 enset. These woredas include a sample of AGP woredas. The AGP baseline survey[2] does not present data in the same format for comparison.

2 Nutrition situation nationally

Various nutrition surveys have been undertaken in Ethiopia in recent years. The Demographic and Health Survey (DHS) is a nation-wide survey. The most recent full survey was carried out in 2011[3] with a mini survey update of stunting and wasting data in 2014[4]. It is important to note that the survey covered more woredas in each Region than the few that were included in AGP so these results may not be representative of the AGP woredas[5]. Data more specific to the AGP woredas are reported in section 1.3.3.

The 2011 survey highlights serious nutrition problems for children, adolescents, women and men with a level of stunting in under 5 children at 44% for the four AGP regions in 2011 were 41% in Oromia, 44% in SNNP, 51% in Tigray and 52% in Amhara in the EDHS 2011. Wasting-measured as General Acute Malnutrition (GAM) (moderate plus severe) was on average nationally 9.7% with 2.8% of that severely malnourished (SAM). In the 4 AGP Regions in 2011 GAM was 9.7% in Oromia; 7.6% in SNNPR; 10.3% in Tigray and 9.9% in Amhara.

By 2014 the national average of stunting had reduced to 40%. Stunting is particularly high in 3 of the AGP regions (Tigray 44.4%; Amhara, 42.4% and SNNPR 44.3%); In Oromia it is 37.5%. Acute malnutrition (GAM) was nationally 9% with 3% severely wasted (measured by weight for height) Acute malnutrition was lower than average in 2 Regions (Oromiya 6.9%; SNNPR 6.8% but higher in 2 Regions (Tigray 13.6%; Amhara 9.7%).

From 2011 DHS survey[6], twenty-seven percent of women are thin or undernourished (BMI less than 18.5 kg/m2) and 6% are overweight or obese (BMI 25 kg/m2 or above). Rural women (29.1%) also are more likely to be thin than urban women. Adolescents (age 15-19) are more likely to be thin (36 percent) than older women. Thirty seven percent of Ethiopian men age 15-49 are thin or undernourished (BMI less than 18.5 kg/m2), and 2 percent are overweight or obese (BMI 25 kg/m2 or above). Rural men are slightly more likely to be thin (39 percent) than urban men (32 percent).

Anaemia is one indicator of iron deficient diets and the DHS also reveals a serious problem particularly for women and children and particularly in rural areas. More than four in ten Ethiopian children (44 percent) are anaemic. Seventeen percent of Ethiopian women age 15-49 are anaemic. Anaemia prevalence also varies by urban and rural residence; a higher proportion of women in rural areas are anaemic (18 percent) than those in urban areas (11 percent). Nationally, 11 percent of men 15-49 are anaemic. Rural men are more likely to be anaemic than urban men (13 and 5 percent, respectively).

This highlights the need to improve the iron content of rural diets.

Dietary consumption

Only 4% of breastfed children 6-23 months consume an adequate diet according to internationally recognized IYCF recommendations. The main problem lies with dietary diversity where only 4% meet dietary diversity minimum score of 4 food groups per day. Only half meet meal frequency requirements (48%). 26 percent of youngest children age 6-23 months living with their mothers consumed foods rich in vitamin A. Urban children (38 percent) are more likely than rural children (24 percent) to consume foods rich in vitamin A[7].The data point to a serious problem of chronic undernutrition in children and also adults and adolescents. Micronutrient deficiencies are serious concern for all groups.

3 Nutrition situation in AGP woredas

The ENGINE programme commissioned a baseline survey that was conducted in 2012 to 2013 in 42 woredas in Amhara, SNNPR and Oromia with intervention and control woredas designed to assess the eventual impact of the ENGINE programme[8]. The woina dega agroecological zones were included for the survey from 3 of the 4 Regions of operation of ENGINE. Tigray was omitted from the survey. These are also the woredas targeted by AGP.

Nutrition and dietary data were poor in these woredas despite their classification as food secure. This suggests that factors beyond availability of food (as assessed by food security measures) were important in the causes of undernutrition.

Child stunting averaged 49.2%, 43.5% and 39.8% respectively in Amhara, Oromia and SNNPR regions. Child dietary practices were poor in the ENGINE woredas surveyed. Dietary adequacy was 6.3% 13.9% and 9.2% respectively in Amhara, Oromia and SNNPR for children 6-23 months. As the in the national figures, dietary diversity was poor with only 7.2%, 15.0% and 11.5% of children in the 3 regions meeting internationally recognized minimum of 4 food groups daily. The percentage of children meeting frequency requirements were 68.8%, 78.3% and 63.5% in the 3 regions.

The prevalence of undernourished women (BMI ................
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