Nutrition case team

National Nutrition Program

Introduction 

Ethiopia has witnessed encouraging progress in reducing malnutrition over the past decade. However, baseline levels of malnutrition remain so high that Ethiopia still needs to continue significant investment in nutrition. 

The Nutrition case team was established with the aim of coordinating and guiding nutrition specific interventions being implemented by the decentralized FMOH structures and supporting the coordination of nutrition sensitive interventions being implemented by National Nutrition Programme (NNP) implementing sectors to effectively and efficiently utilize the resource and to best coordinate and comprehensively address the health and nutrition related problems of the county. Nutrition is a cross cutting issue that needs a multisectoral approach and a strong integration with all stakeholders. With this regard the case team works closely with other case teams within the MCH directorate, other directorates and agencies, other sectors, private institutions and with different partners and donors. 

Nutrition trends in Ethiopia: The 2019 mini EDHS estimated the national prevalence of stunting among children at 37 percent, the prevalence of underweight at 21 percent and wasting at 7 percent. Between 2005 and 2019 the prevalence of all the three child under nutrition declined as indicated in the figure below. 

Percentage of children under age 5 who are malnourished


National food and nutrition policy (FNP)
The national food and nutrition policy endorsed by the council of ministers in 2018. The policy is based on the global conceptual framework for nutrition security as a change model to address the existing causes of nutrition insecurity at various levels. The policy framework focuses on short, medium and long-term strategies in an integrated way to address the different layers of nutrition problems.

Vision, Mission, Goal and objectives

Vision: To see all Ethiopians with optimal nutritional status, quality of life, productivity and longevity of life.

Mission: We strive to ensure food and nutrition security through coordinated implementation of nutrition specific and nutrition sensitive interventions.

Goal: To attain optimal nutritional status at all stages of life at a level that is consistent with a high quality of life, productivity and longevity of life.

Objectives
By creating an enabling policy environment, the food and nutrition policy objectives will: 

  1.  Ensure the availability and accessibility of adequate food to all Ethiopians at all times. 
  2.  Improve accessibility, and quality of nutrition and nutrition smart health services at all stages of the life span in an equitable manner. Food and Nutrition Policy 6 We shall strive to create food and nutrition self-reliant Ethiopia 
  3.  Improve consumption and utilization of a diversified and nutritious diet that ensures a citizen’s optimal heath throughout their life cycle. 
  4. Improve the safety and quality of food throughout the value chain. 
  5. Reduce food and nutrient losses along the value chain. 
  6. Improve food and nutrition emergency risk management, preparedness and resilience systems. 
  7.  Improve food and nutrition literacy of all Ethiopians.

Hence, with the objective of ensuring optimal nutritional status of the population along the life cycle, the team works on the following initiatives 

  • Optimal nutrition through the first 1000 days plus 
  • Emergency Nutrition Response and Management of Acute malnutrition 
  • Comprehensive community and facility based nutrition intervention 
  • Strengthening National Food fortification initiative 
  • Multi-sectoral Nutrition Coordination and Linkage 

Multisectoral Nutrition Coordination
To ensure the multi-sectoral coordination for nutrition, the National Nutrition Coordinating Body (NNCB) and National Nutrition Technical Committee (NNTC) were established to efficiently coordinate multi-sectorality and lead the implementation of National Nutrition Program (NNP) in all NNP implementing sectors.

Aim: To improve the national nutrition program implementation by creating a multisectoral platform and build the capacity of the coordination structures at different levels.

NNCB: The NNCB is composed of signatory government sectors as well as non-signatory development partners, civil society organizations, academia, and the private sector. And the high nutrition governing body so far. MOH is chair and MOA and MOE are co-chairs.

NNTC: The NNTC operate under the auspices of the NNCB. The committee is responsible for handling the technical work related to the implementation of NNP.

Members:

  •  Ministry of Health
  •  Ministry of Agriculture
  •  Ministry of Education
  •  Ministry of Trade and Industry 
  • Ministry of Labour and Social Affairs
  • Ministry of Water, Irrigation and Electricit
  • Ministry of Finance 
  • Ministry of Women, Children and youth 
  • The Disaster Risk Management Coordination Commission
  • Ethiopia Food and  Drug Authority (EFDA)
  • Ethiopia Pharmaceuticals Supply Agency (EPSA)
  • Ethiopia public health institiute(EPHI)
  • Ethiopia institute of agriculture(EIAR)
  • Development Partners and donors, UN agencies and CSOs
  • Ethiopia Chamber of Commerce 
  • Academic Representatives (Mekelle and Jimma Universities)

The Nutrition case team lead the overall national nutrition specific interventions in the country and has been engaged in coordinating the other sector implementation to enhance the nutritional status of the population focusing on the prevention of public health importance nutritional problems, promotion and advocacy on optimal nutrition through the life cycle approach. 

On top of coordinating other nutrition implementing sectors the team is performing the following tasks:

Developmental Nutrition: Promote optimal nutrition to all age group through the life cycle approach with special focus to the first 1000 Days plus nutrition (from conception to second year of a child and adolescent nutrition). Provision of GMP service, VAS, IFA and Weekly Iron folic Acid Supplementations, etc has been implementing.

Emergency nutrition response and management of Acute malnutrition : Ensuring emergency nutrition preparedness and response at all-time whenever there is crisis, IDP (internal displacement of population), drought and famine in the country by coordinating and mobilizing relevant stakeholders to provide acute malnutrition management, IYCF-E counseling, nutrition education and rehabilitation services.

Multi-sectoral coordination: Through the coordination and collaboration of the relevant sectors to address both nutrition specific and nutrition sensitive interventions, since nutrition is a cross cutting issue and health intervention alone would not overcome the nutritional problems, the health sector taking the lead, much efforts has been done to coordinate and organize the relevant sectors in order to come together and work for better outcome.

Targets:

  • Decrease stunting prevalence in children aged less than 5 years from 38% to 27% (2024) and 19% (2029) 
  •  Decrease wasting prevalence in children aged less than 5 years from 7% to 5% (2024) and 3%(2029) 
  • Increase proportion of pregnant women who received iron & folic acid supplements at least 90 plus from 11% to 50% (2024) and 90% (2029)
  • Decrease prevalence of anemia in women of child bearing age from 24% to 18% (2024) and 12% (2029) 
  • Increase exclusive breast feeding in the first six months from 59% to 90% (2024) and 95% (2029)

Projects and programs

SURE
The SURE program, supported by the Children’s Investment Fund Foundation (CIFF), is the first Government-led integrated health and agriculture sector program for improving practices in complementary feeding and dietary diversity among young children. The program has been implemented in 50 woredas across the four agrarian regions.

Seqota Declaration  

Seqota Declaration (SD) is a high-level commitment of the Government of Ethiopia to end stunting in children under two years by 2030. The SD was launched in July 2015 Addis Ababa and has a 15 years roadmap builds on and accelerates implementation of the National Nutrition Program and currently the National Food and Nutrition Policy. The SD is being implemented in three phases. The first phase called an Innovation Phase (2016-2020), where innovative approaches are being tested in 40 woredas of Amhara and Tigray national regional states. The second phase is the Expansion phase (2021-2025) where preparation is being undertaken to expand promising practices and lessons learning during the innovation phase. The final phase is the national scale-up phase (2026-2030) where full-blown implementation of evidence-based multi-sectoral interventions will be undertaken throughout the country. 

National Level policy and program documents:

  • Food and Nutrition Policy of Ethiopia, 2018
  • National Food and Nutrition Strategy, 
  •  Food and Nutrition Council and Agency establishment Proclamation, 
  • Seqota declaration road map and innovative phase plan, 2015

Guidelines and Training manuals: 

  • Adolescent, Maternal, Infant and Young Child Nutrition Guideline, 2016
  • Guidelines for The Prevention and Control of Micronutrient Deficiencies in Ethiopia, 2016
  • National Guideline for the Management of Acute Malnutrition in Ethiopia, 2019 
  • National Nutrition Program Multi-sectoral Implementation Guide, 2016
  • Blended Integrated Nutrition Learning Module (BINLM)
  • IYCF/NSA materials (job aids, training materials, ADA/HAD materials for SBCC
  • Pastoralist and Agro-pastorlaist CINS guidelines and packages, 2020
  • Nutrition leadership facilitators guide and participants manual
  • Acute malnutrition management training manuals, 2019