Resilience to Nutrition/health USAID/ENGINE field experience Habtamu Fekadu, ENGINE COP

ENGINE- a multi-sector nutrition project 83 Productive/Food secure woredas - 5-15%- poorest of the poor 17 Food Insecure/PSNP woredas 16 dry land woredas in Somali region The presentation focus in the high lands

In-service: MOH and MOA Capacity building In-service: MOH and MOA Pre-service: Universities and Regional health and Agriculture colleges Facility and Community Services Direct Nutrition services Quality of Services Nutrition sensitive Livelihoods and ES Milk matters for Somali SBCC WASH Gender Drought response Policy and partnerships Multi-sectoral-coordination NNP and Guidelines Create partnership: Nutrition and AGP partnership Improved nutritional status of women and young children (1000 days) Operational Research & Documentation - This 4 key elements were presented before and are summarized on this slide: # The first one forming partnerships at all levels, from the community up to the national level, so a united front is promoting nutritional improvements, - The second. carrying out skills-based training, both in-service as well as pre-service. - The third, promoting community action to disseminate messages and based on negotiation with mothers and family members to adopt new improved practices, and - Fourth, using Behaviors change communication approach using support and mass media to reinforce those messages and actions

Resilience framework- improved health and nutrition Contributes to resilience goals Skill and Education Improved access to Nutrition and heath services Improved Nutritional practices All other resilience activities

What have we learned Targeting vulnerable households with nutrition is only is not enough Poor households targeted by some form of resilience activities have better nutritional outcomes if : resilience activities and nutritional interventions are integrated from design to outcome level The intensity of program participation by poor households is key to improve nutritional practices Linking quality of nutrition services with the livelihood activities/programs

Nutrition in resilience is not only SBCC Nutrition in resilience is not only SBCC. It is also looking each component of resilience activities from nutrition lens or outcomes Developmental nutrition projects or activities will prevent gains in nutritional outcomes if crisis modifier is built in the design Analyzed and targeted layering is key for nutritional outcomes- Trying in Ethiopia

Nutritional Outcomes Indicators Survey Nov-Dec 2014 Survey Sept 2015   Survey Nov-Dec 2014 Survey Sept 2015 Early initiation of breastfeeding 55.2% 61.4% Exclusive breastfeeding 78.9% 90% Mean Maternal Dietary diversity score 2.9 Child Minimum Dietary Diversity 13.8% 26.1% The increase in child dietary diversity scores is very positive, especially since the Sept 2015 data collection was during what is typically considered the lean season and during worsening drought in much of Ethiopia.

Challenges Household and resilience/ nutrition projects aspiration/priority differs The link between resilience activities and nutrition is weak The financial capital and land endowment of most saving groups/ SHG is limited to protect to diversify their incomes and nutritional outcomes during significant stress or shocks How to do effective layering/convergence at implementation level We want households to save money, accumulate asset, and spend money on good nutrition. Households prioritize their immediate needs such as building a big house or change their roof, pay pack their huge debt, paying for child education

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