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

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

4. 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

5. 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

6. 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

7. 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

8. 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.

9. 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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