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The ‘ENGINE’ Behind Improved Nutrition in Ethiopia

In a small mountaintop village in rural Ethiopia, the dinner menu has been changing in many households over the past few months.
“I enjoy all of the new foods we are now planting,” said Tirawork Ayele, a local resident and mother of four children. “I have been discussing recipes and new ways to prepare the different vegetables with my friends and neighbors.”
Zelekosh Engdawerk, a local resident and expectant mother with one daughter, said, “I have always liked to cook, but I am enjoying trying new recipes with the new food.”
Ayele, Engdawerk and many of their neighbors in the Debre Sine woreda(district) within Amhara, Ethiopia, are participants in the Empowering New Generations with Improved Nutrition and Economic Opportunity (ENGINE) program, USAID’s flagship nutrition program in Ethiopia and part of the U.S. Feed the Future Initiative to end hunger and malnutrition. USAID and Save the Children developed this five-year program, which ends in 2016, to improve the nutritional status of Ethiopia’s women and young children.
In Ethiopia, more than 40 percent of children suffer from stunting, a debilitating, lifelong condition that results when children are severely malnourished before their second birthday. Stunting not only affects children’s bodies, but also their cognitive development. That, in turn, has implications for them later in life and can seriously threaten their ability to maximize learning in school, to be a successful member of the work force as an adult, and to contribute fully to the economic development of their country. In addition, 29 percent of Ethiopian women are malnourished, meaning many children start life deficient of essential nutrients.
Ethiopia is rich in the fruits, vegetables and grains needed to promote healthy development, and the majority of the population are smallholder farmers. However, access to a variety of foods is unequal across the country and is often hampered by poor storage, lack of access to markets and weak infrastructure preventing the transport of produce. In addition, traditional meals use many of the same ingredients, resulting in a lack of dietary diversity; customary cooking practices like boiling often leach foods of nutrients; and poor sanitation habits can cause food to spoil and diseases to spread.
 
ENGINE provides young mothers from vulnerable, food insecure households with seeds for a variety of nutritious foods and teaches them techniques for planting and growing a homestead garden as well as ways to safely prepare the new produce. The program also supports improved livelihoods and increased access to sources of protein by providing women with poultry or small livestock. By diversifying the diet of pregnant and lactating mothers and their children, ENGINE aims to prevent undernutrition during the first 1,000 days of a child’s life and set children on a path to a healthy, productive future.
“Most other food security projects in Ethiopia only work in one area, but ENGINE works in three different sectors: agriculture, health and education,” said Dr. Habtamu Fekadu, ENGINE’s director and a staffer with Save the Children in Ethiopia. “Undernutrition has different causes that must be addressed by different sectors.”
With support from the presidential Feed the Future and Global Health Initiatives, ENGINE works in tandem with the Government of Ethiopia to implement its multi-sectorial 2013-2015 National Nutrition Program and increase the potential of market-based agricultural development to promote food security and sustainable livelihoods.
 
“This new type of comprehensive intervention to link growing more nutritious foods and nutrition education is already showing strong improvements. New data for the last three years show an estimated 160,000 fewer children are stunted, despite population growth. Food security isn’t just about the quantity of food but the nutritional quality of available food,” said Dennis Weller, mission director for USAID/Ethiopia.
Nutrition on the Menu
 
“With ENGINE, we have been able to bolster nutrition education,” said Fekadu. “We use existing government structures to build capacity for providing quality nutrition services. Before ENGINE, nutrition was never discussed in woreda agriculture trainings.”

ENGINE uses already established government outreach systems, such as local area staff and farmer training centers, to communicate nutrition messages. With this system, ENGINE has been able to provide services for women and their children in 100 woredas in the more populated Amhara, Oromia, Tigray and Southern Nations, Nationalities and People’s Regions.

Ayele, Engdawerk and other women in the Debre Sine woreda joined the program in the last year. Each woman’s household received seeds for a variety of nutritious produce not commonly found in the area, but that grow well in the local soil—for example, apples, carrots, Swiss chard, cabbage, mango and papaya. Each household also had the option to choose chickens, sheep or goats to raise as a food source and for economic gain. So far, participants have attended initial trainings to learn best practices for planting their homestead gardens and raising their chosen livestock.
“My family has learned technical information about farming, how to milk our new goats and how to prepare food for the children from the ENGINE trainings,” said Ayele.
“More than 85 percent of the participants trained implement the training,” said Lemma GebreMichael, Ministry of Agriculture representative for the Debre Sine woreda. “They also share their new knowledge with other farmers and become model citizens in the community.”
Progress and Challenges
In 2005, Amhara suffered from the highest stunting rates of any place in Ethiopia with 62.1 percent of children stunted. In 2014, the stunting rate had dropped to 42.4 percent. While this rate is still above the national average of 40.1 percent, it shows progress in improving nutrition for children in the region. Nationally, stunting rates have declined in just three years from 44 percent in 2011 to 40 percent in 2014.
However, challenges remain.
“Women’s empowerment is one of the biggest challenges in Amhara. Through surveying residents, we have found out women work longer hours than men, yet have very minimal decision-making power,” said Fekadu.
In a discussion about cooking and meals, expectant mother Engdawerk said, “I am a part of this family, so I must feed my husband and child before I can eat.”
With little to no voice in family decisions, Ayele, Engdawerk and their female neighbors are often unable to break traditional practices that can cause undernutrition before a child is even born.
“ENGINE is working on women’s self-lessons. Many women in this region think it is shameful to prepare food just to eat it themselves,” said Fekadu.
Despite obstacles that still remain, ENGINE participants are hopeful that being a part of this program will improve their fortunes and help their children thrive.
“I expect a big change when the goats grow, reproduce and we can sell the offspring,” said Ayele. “With the extra money, I know I’ll be able to keep my children in school. I can’t read or write, so I would like my children to know how to read and write.”
This article, by Lauren McCarty, originally appeared in USAID‘s Frontlines.

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