Since the Nutrition for Growth Initiative Summit (N4G) in 2013, Global Nutrition Report (GNR) annually tracks commitments of donors, governments, civil societies, UN and businesses to tackling malnutrition. Using projected data and the annual rate of reduction based on the latest data collected from multiple sources, the report gauges the progress of countries towards nine targets related to all forms of malnutrition. Targets related to undernutrition include reducing stunting by 40%, wasting to less than 5%, and reduction in anemia among women of reproductive age groups by 50%.
The targets set in the National Nutrition Program of Ethiopia (NNP, 2016-2020) as well as in the Seqota Declaration are more ambitious than the above global targets. Hence, paying attention to the portrayal of Ethiopia in these reports and deliberating on their recommendations helps add impetus to our national commitment. This blog thereby briefly highlights the nutrition situation in Ethiopia as depicted in the GNRs since the launching of NNP II, 2016, with a focus on MIYCN outcomes and progress forecast.
GNRs released since 2016 lauded the Ethiopian achievement in reducing stunting since 2000, preparation of nutrition-sensitive multisectoral programs, engagement of private sector to improve access to iodized salt, and development of national food and nutrition policy. Likewise, the 2018 report presented a success story from a multisectoral project implemented by Alive and Thrive that significantly improved dietary diversity and reduced stunting. Nonetheless, when it comes to interventions and practices that address MIYCN and forecasted progress towards achieving committed targets, the reports revealed a rather grim picture.
The 2016 and 2017 reports presented the situation of countries along 12 selected MIYCN interventions (Fig 1) and showed that Ethiopia had the lowest coverage rate in indicators of minimum dietary diversity and two IFA supplementation indicators among pregnant women. The 2017 report further highlighted Ethiopian vulnerability to food insecurity and droughts by placing it among six priority countries where food insecurity exacerbates malnutrition. This reminds us that we cannot afford attacking stunting, wasting or maternal anemia alone but need to act on all forms of undernutrition as also acknowledged in all three reports.
The 2018 GNR report did not present progress on the key MIYCN interventions, yet it warned that most of the countries are not on track to achieve committed targets in 2025. This report placed Ethiopia among 100 countries that are not on track to achieve any of the committed targets.
In general, the three GNRs witnessed good advancements in developing policies and programs to guide nutrition interventions in Ethiopia. The reports also shared commendable practices and success stories in some programmatic/geographic areas. However, without forgetting the time required for changes to take effect, translating policies/programs to impact and scaling-up of best practices remain big assignments for all stakeholders.
A few suggestions on lessons going forward: making findings from such global reports more visible and accessible, if possible by reinforcing them with local and up-to-date evidences compiled by EPHI (M&E Committee of the NNP) and/or producing annual National Nutrition Report may help to inform decision makers, influential groups and implementers at different levels. Local solutions to provide up-to-date data on dietary practices, mainly by engaging the Ministry of Agriculture and on adolescent nutrition by working closely with the Ministry of Education can help fill gaps in critical data. The very low IFA supplementation to pregnant women should also be a key and constant discussion agenda between both supply and demand side actors to bring about a sustainable solution. In the end, we all need to promote multi-sectoral, comprehensive and integrated delivery of nutrition services and avoid trying to combat malnutrition by acting on a single indicator.
By Lioul Berhanu
Lioul Berhanu serves as Nutrition Advisor for the Growth through Nutrition Activity