Operational Research

Water supply construction projects are implemented after a detailed feasibility study and design process to identify the source and scope of the construction. Accordingly, the feasibility studies accompanied by design of water supply schemes have been carried out in collaboration with the government water office and reviewed at different levels before execution. To date, the project has constructed or rehabilitated a total of 147 water supply schemes. The water schemes are designed to serve a total of 108,171 beneficiaries in 20 woredas of the four project targeted regions. 

For the water schemes constructed/rehabilitated and commissioned to address the need for safe water supply and thus play a positive role in the goal to reduce malnutrition in the targeted community, they must be functional and utilized by the target population. Therefore, this research is designed to assess the functionality, utilization and related determinants of the water supply schemes constructed/rehabilitated by the project. The data will generate evidence on the functionality of the water supply schemes, if access to safe water supply is improved, amount of time saved and how the beneficiaries are utilizing the water sources and for what kind of purposes. A qualitative study will also be conducted using key informant interviews to identify any hurdles or improvements in accessing and utilizing the water supply schemes.

Two studies, ENGINE (Empowering New Generations to Improve Nutrition and Economic opportunities) and Growth through Nutrition, were conducted in the same 4 regions of Ethiopia approximately 5 years apart. A similar protocol using a quantitative and qualitative survey of key informants at the subnational level was used to explore barriers and facilitators for implementation of the country’s national multisector nutrition plan. Noticeable differences were observed, including a change in the perception of the nutrition problems in pregnant women and preschool aged children and greater awareness of the multisector plan. Poor coordination and collaboration were still noted in both time periods. A key issue highlighted was the need to keep up the momentum for multisector approaches to improve nutrition in the policy agenda. Collaboration with the Ethiopian Public Health Institute (EPHI). 

The full impacts of COVID-19 and the restrictions adopted to mitigate the pandemic are yet to be seen. In low and middle-income countries (including Ethiopia), the impact of containment and preparedness policies on the health of the overall population and maternal and newborn health could be more pronounced. Even before the emergence of COVID-19, high-quality and timely healthcare services were unavailable, inaccessible or unaffordable for millions of individuals. The COVID-19 will have short and long-term impacts on Ethiopian agriculture and its extension systems, thereby affecting the food security. The probable short-term impacts of the COVID-19 on the Ethiopian extension system could be the disruption of the normal and major activities of the extension services (advice, training, input delivery etc.) due to restrictions on movement, gathering, and meetings. The objective of the current study is to assess the impact of the COVID-19 pandemic and mitigation strategies on key health and nutrition services at PHCUs and on agricultural activities in Growth through Nutrition-supported woredas during March-July 2020. 

The research aims at evaluating the barriers and facilitating factors that influence household nutrition practices and decision-making with regard to the production, consumption, utilization, sale and purchase of nutrient-rich foods. The study tries to understand the dynamics of household food production and dietary management in order to inform the project’s nutrition sensitive agricultural packages and SBCC strategy.The purpose of the study is to inform Growth through Nutrition activities that support and train rural farming households on consumption and marketing of nutrient-rich foods to better ensure that production investment, as well as other market-based strategies result in positive dietary benefits.

Improving key nutrition practices requires change at the individual, household, and community levels, and in services for mothers and families—all of which must be supported by an enabling environment. Growth through Nutrition Activity includes SBCC activities as part of its strategic approach to bring about significant and sustainable improvements in maternal dietary and infant and young child feeding practices. The project works to ensure that consistent, locally adapted, actionable messages are reinforced at each level for interventions to be more likely to result in significant improvements in the short term and sustainable progress in the long term. In addition to the existing SBCC approach under Growth through Nutrition, a new tool designed to complement the ECCs called the Virtual Facilitator (VF), a pre-recorded audio message with actors modelling the desired knowledge and behaviours, is anticipated to make the SBCC program more robust and scalable. Therefore, the objective of the study is to evaluate the added value of the virtual facilitator tool to the existing ECC program for improving IYCF practice and nutritional status of women and children in Ethiopia under the Growth through Nutrition Activity program.

The Government of Ethiopia has placed substantial emphasis on improving quality of health services. This has led to the adoption of a national policy on healthcare quality and the introduction of several initiatives that intend to improve quality of health services provided at all levels of the health system. Growth through Nutrition (GTN), a 5-year USAID Feed the Future nutrition project in Ethiopia, has been providing technical and financial support for quality improvement on nutrition interventions within Primary Health Care Units (PHCU), ensuring availability of nutrition commodities, and data use for evidence-based decision-making processes for program refinement. In August 2019, the project has progressively reached 551 PHCUs to support increased uptake of nutrition services by mothers and young children, out of which 101 model Health Centers (HC) and one Health Post (HP) under their respective catchment were selected and supported to apply QI models. This study intended to assess the role of quality improvement initiatives in improving nutrition interventions at PHCU level and identify challenges and facilitators of implementation to facilitate learning.

Assessing Multisectoral Coordination for Nutrition Policy Effectiveness:  Analysis of Facilitators, Constraints and Solutions for Effective Implementation at the Woreda Level

This new research conducted during the first year of Growth through Nutrition was designed to follow up on the support provided under ENGINE, especially to model woredas in supporting the establishment and ongoing implementation of the woreda multisectoral coordination bodies and nutrition technical committees and to ascertain the factors that have enabled and sustained effective multisectoral coordination.

The research aims at evaluating the barriers and facilitating factors that influence household nutrition practices and decision-making with regard to the production, consumption, utilization, sale and purchase of nutrient-rich foods. The study tries to understand the dynamics of household food production and dietary management in order to inform the project’s nutrition sensitive agricultural packages and SBCC strategy.The purpose of the study is to inform Growth through Nutrition activities that support and train rural farming households on consumption and marketing of nutrient-rich foods to better ensure that production investment, as well as other market-based strategies result in positive dietary benefits.

Improving key nutrition practices requires change at the individual, household, and community levels, and in services for mothers and families—all of which must be supported by an enabling environment. Growth through Nutrition Activity includes SBCC activities as part of its strategic approach to bring about significant and sustainable improvements in maternal dietary and infant and young child feeding practices. The project works to ensure that consistent, locally adapted, actionable messages are reinforced at each level for interventions to be more likely to result in significant improvements in the short term and sustainable progress in the long term. In addition to the existing SBCC approach under Growth through Nutrition, a new tool designed to complement the ECCs called the Virtual Facilitator (VF), a pre-recorded audio message with actors modelling the desired knowledge and behaviours, is anticipated to make the SBCC program more robust and scalable. Therefore, the objective of the study is to evaluate the added value of the virtual facilitator tool to the existing ECC program for improving IYCF practice and nutritional status of women and children in Ethiopia under the Growth through Nutrition Activity program.

The Government of Ethiopia has placed substantial emphasis on improving quality of health services. This has led to the adoption of a national policy on healthcare quality and the introduction of several initiatives that intend to improve quality of health services provided at all levels of the health system. Growth through Nutrition (GTN), a 5-year USAID Feed the Future nutrition project in Ethiopia, has been providing technical and financial support for quality improvement on nutrition interventions within Primary Health Care Units (PHCU), ensuring availability of nutrition commodities, and data use for evidence-based decision-making processes for program refinement. In August 2019, the project has progressively reached 551 PHCUs to support increased uptake of nutrition services by mothers and young children, out of which 101 model Health Centers (HC) and one Health Post (HP) under their respective catchment were selected and supported to apply QI models. This study intended to assess the role of quality improvement initiatives in improving nutrition interventions at PHCU level and identify challenges and facilitators of implementation to facilitate learning.

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