Journal Articles

Estimating multidimensional development resilience

Existing measures of resilience are typically based on a single well-being indicator. This is problematic in contexts where households face deprivations across multiple dimensions. We develop a multidimensional resilience measure, integrating probabilistic moment-based resilience measurement approaches with multidimensional poverty measurement methods. Applying these to household panel data from Ethiopia, we show that univariate and multidimensional resilience measures based on expenditure-based poverty, dietary diversity, and livestock asset holdings can yield varied inferences on the ranking of households as well as potential impact of development interventions. Univariate resilience measures constructed using consumption expenditure, dietary diversity and livestock asset holdings show distinct temporal and spatial distributional patterns. But while univariate measures are weakly correlated with one another and with different well-being metrics, multivariate measures exhibit much stronger rank correlations. When we contrast univariate measures of resilience to multidimensional measures of resilience, we find that the latter vary less over the study period; multidimensional resilience measures seem to capture more “persistent or structural” vulnerability and associated capacity of households. We also demonstrate the differences in these univariate and multivariate measures, including the potential of the composite multidimensional resilience measures for supporting targeting processes.

Does small-scale irrigation affect women’s time allocation? Insights from Ethiopia

Small-scale irrigation (SSI) interventions have received increasing attention as a potential pathway for women’s empowerment in sub-Saharan Africa. One key aspect of women’s empowerment that SSI can influence is women’s time burden. Hypothesized benefits of SSI for women are less energy exertion and reduced labor in agriculture. Yet, these hypotheses have not been tested empirically. We explore how household adoption of different SSI technologies affects the time allocation of women in the household, using two rounds of intrahousehold panel survey data from Ethiopia. Two different approaches are used to address potential endogeneity issues related to time-constant and time-varying factors that may be correlated with both SSI and time use: an instrumental variables-correlated random effects approach and a fractional multinomial logit-correlated random effects with control function approach. The results suggest that household use of SSI in general is associated with an increase in women’s leisure time. The results further suggest that household use of motor pumps is associated with an increase in women’s leisure time and reductions in the time they spend on farming and personal care. Given that women often provide the labor for irrigation using manual, labor-intensive methods, such as watering cans, buckets, or hand- or foot-powered treadle pumps, the results suggest that SSI using motorized methods has the potential to free up women’s time in farming and enable more leisure time. These findings have broad implications for women’s empowerment and labor allocation. Future research using new and more comprehensive data could explore the mechanisms for the findings in this study and determine if SSI enables women to improve their ability to allocate their time to activities they prefer.

From data to decision: How the National Information Platform for Nutrition (NiPN) bridges the research-policy gap in Ethiopia's nutrition sector

Bridging the gap between research and policy continues to be a major challenge in Ethiopia, particularly in the nutrition sector, where evidence is often fragmented, inconsistently collected, and underutilized. Traditional research-to-policy approaches are frequently misaligned with policymaking needs due to differences in timelines, priorities, and communication practices. While these challenges are not unique to Ethiopia—and indeed, numerous global efforts have attempted to address them with varying degrees of success—examples from other settings offer useful insights for strengthening the interface between evidence and action. In the Ethiopian context, the National Information Platform for Nutrition (NiPN) represents an important shift toward a more responsive, demand-driven model that seeks to improve the relevance and uptake of evidence. Unlike conventional approaches that begin with research questions and proceed directly to data collection, Ethiopia's NiPN starts with policy question formulation, aligning evidence generation with real-time decision-making priorities. This approach emphasizes embedding research in institutional processes and tailoring outputs to policy needs. The paper explores how NiPN addresses structural barriers to nutrition governance—such as limited institutional capacity, fragmented coordination, and weak knowledge translation. It engages multiple sectors in mapping evidence, analyzing data, and supporting dialogue to inform actionable recommendations. Using examples like the Seqota Declaration and the School Feeding Programme, the paper demonstrates how NiPN has improved policy relevance, intervention targeting, and national ownership. The Ethiopian case offers transferable insights for other countries seeking to institutionalize evidence-informed policymaking in complex, multisectoral domains.

Rural income diversification in Ethiopia: Drivers and welfare impact

Diversification of rural households into the nonfarm economy is a key driver of economic growth and structural transformation in countries where agriculture remains the primary source of livelihood. This study examines trends and patterns of income diversification, its determinants, and its association with household welfare in rural Ethiopia. Our analysis indicates that rural households in Ethiopia continued to rely primarily on farming, with only marginal diversification of income sources during 2012–2019, despite the broader context of rapid economic growth. Crop production remains the main source of income, followed by livestock, while nonfarm activities contribute 17–24% of total household income. Factor endowments and local conditions, including rainfall, play a crucial role in shaping diversification decisions. In particular, the 2015–16 drought appears to have pushed households to increase engagement in nonfarm income-generating activities. Importantly, income diversification is associated with higher household consumption, improved dietary diversity, and better housing quality, highlighting the potential of expanding the rural nonfarm economy to enhance household welfare.

Exploring the barriers and facilitators of nutrition and dietary intake among school-aged children in the urban low-income setting of Addis Ababa

BACKGROUND/OBJECTIVES
Healthy eating supports mental clarity, physical development, and focus in the classroom. However, government policy, cultural customs, education, family income, and food access, influence children's nutrition, which in turn affects school-age children's growth, development, and academic achievement. This study aimed to explore the barriers and facilitators influencing the nutritional and dietary intake of school-age children in urban low-income settings in Addis Ababa, Ethiopia.

SUBJECTS/METHODS
A total of 10 schools (6 public and 4 private) from 2 subcities in Addis Ababa participated in a qualitative phenomenological study conducted in May 2024. Focus group discussions, key informant interviews (KIIs), and in-depth interviews (IDIs) with 92 participants were used to gather data. A total of 77 participants (41 male, 36 female) participated in 6 focus groups, 10 IDIs, and 5 KIIs from the Ministry of Agriculture, Ministry of Education, Save the Children, Water, Sanitation and Hygiene (WASH), and Ethiopian Public Health Institute (EPHI). Using MAXQDA software, native language data were transcribed, translated, and then thematically analyzed.

RESULTS
Two major themes emerged from the study's findings. The fisrt one is barriers to healthy nutrition and dietary intake in school-aged children, including lack of awareness, inadequate and unhealthy dietary practices, financial hardship and time constraints within households, parental lack of awareness, food accessibility issues, poor infrastructure, and inconsistent policies. These factors were described as potential contributors to challenges in children's nutrition. The second one is facilitators, which include school meal programs, community engagement, family support, physical activity, and policy support for healthy eating, all of which are seen as promoting healthier dietary behaviors and possibly improving children's focus and participation in school activities.

CONCLUSION
Several factors influence children's diet and nutrition. Improving children's nutritional and general well-being requires focused nutrition education, policy interventions, and the utilization of coordinators.

A comparative study of the legal and regulatory dimension of seed sector development in Sub-Saharan Africa using regulatory systems maps: The case of Ethiopia, Rwanda, and Uganda

Modeling the economywide effects of water and energy interventions in the face of climate shocks in Ethiopia

The Ethiopian economy relies heavily on rainfed agriculture for income generation, export earnings, and rural livelihoods. However, projections from climate scenarios predict high frequency and intense extreme agro-climatic events, posing significant and growing risks to Ethiopia’s agri-food system and overall economy. This study evaluates the economic impacts of recurrent climate shocks on Ethiopia through 2040 and assesses the contribution of alternative investment options in lessening some of these impacts. Findings reveal that recurrent climate shocks could reduce Ethiopia's cumulative GDP by up to 17 percent (or approximately US$ 534.3 billion) by 2040 compared to a “no climate change” baseline. These economic losses are predominantly concentrated in the agricultural sector, disproportionately affecting rural households and poorer urban populations. Strategic investments in irrigation infrastructure and hydroelectricity generation emerge as effective measures to mitigate some of the adverse effects of recurrent climate variability, underscoring the importance of proactive and targeted climate adaptation strategies for Ethiopia's economic resilience. Results further indicate that significantly mitigating the socio-economic impacts of climate and weather shocks requires scaling up investments and diversifying adaptation strategies. The insights derived from this analysis can be informative to economies with similar structures.

Determinants of household food security and maternal dietary diversity in rural Gedeo zone, southern Ethiopia: Results from a cross-sectional study

Background: In Ethiopia, food insecurity and poor dietary diversity continue to affect maternal and child health, particularly in rural regions.

Objective: We examined the status and determinants of household food security and maternal dietary diversity in rural Gedeo zone, southern Ethiopia.

Methods: A cross-sectional study was conducted among randomly selected 422 households, and household food insecurity and women’s dietary diversity was measured. We conducted bivariable and multivariable logistic regression.

Results: In this study, 65.5% of mothers (95% CI: 60.7–70.0%) and 27.9% (95% CI: 23.7–32.5%) of households had adequate dietary diversity and food security, respectively. Severe or moderate food insecurity predispose to inadequate dietary diversity, whereas, higher wealth status increased the odds of adequate dietary diversity. Maternal education increased the odds of adequate dietary diversity. Regarding household food insecurity, the size of the household having a member of 5–7 and 8–12 were 78 and 76% less likely to be food insecure among households compared to 1–4 members size [OR = 0.22 (95%CI: 0.07, 0.70)] and [OR = 0.24 (95% CI: 0.07, 0.83)] respectively. Those household having high in women’s dietary diversity were 83% less likely to have to food insecure among households compared to the lowest women’s dietary diversity [AOR = 0.17 (95% CI: 0.10, 0.31)].

Conclusion: Household wealth status, maternal education, household food security status, pregnancy status were factors affected maternal dietary diversity. Family size and dietary diversity affected household food security status. Interventions should focus on maternal literacy, empowering women on income, assuring food security to increase maternal dietary diversity.

Contributions of District Health Information Software 2 (DHIS2) to maternal and child health service performance in Ethiopia: An interrupted time series mixed-methods study

Background
The District Health Information Software 2 (DHIS2) is the primary digital platform for health management information systems (HMIS) in Ethiopia, aligning with the nation’s digitization strategy. Despite widespread implementation, its effectiveness on key health service indicators, particularly maternal and child health (MCH) services, remain unclear.

Objective
This study aimed to evaluate the contribution of DHIS2 on data use and the performance of selected MCH indicators in Ethiopia, comparing data before and after the implementation of DHIS2.

Methods
We analysed data from primary health care units (PHUs) across five diverse regions of Ethiopia, encompassing urban, agrarian, and pastoralist settings. A mixed-methods approach was employed, combining quantitative and qualitative methods to provide a comprehensive understanding of the data. The quantitative component involved examining performance reports of selected maternal and child health (MCH) indicators from 2013 to 2022 to assess changes before and after the implementation of the District Health Information System 2 (DHIS2). Data were collected electronically and analysed using descriptive statistics and interrupted time series (ITS) analyses to identify trends and patterns. The qualitative component included interviews and focus group discussions with health workers and stakeholders to explore contextual factors influencing MCH service utilization and performance. The data were analysed thematically using OpenCode 4.1 software.

Results
The implementation of DHIS2 significantly contributed to the enhancement of MCH data utilization within PHU facilities. This improvement supported decision-making processes in various aspects of maternal and child healthcare delivery, including target setting, resource allocation, program monitoring, and clinical service provision. Specifically, DHIS2 led to increased monthly mean performance of key indicators such as antenatal care visits, skilled birth attendance, and immunization rates. Notable improvements in service delivery were observed, with significant increases in institutional delivery rates over time.

Conclusions
The study highlights DHIS2’s significant contribution to improving MCH services in Ethiopia, with increased institutional delivery rates and ANC coverage reflecting enhanced data-driven decision-making. Most facilities relied on DHIS2 for resource allocation and program monitoring, though challenges like offline usage and accessibility persist. To maximize impact, improving offline data management, training staff, leveraging real-time reporting, and addressing accessibility through connectivity investments are recommended.

Using a list experiment to measure intimate partner violence: Cautionary evidence from Ethiopia

While indirect response methods are increasingly used in surveys to measure sensitive behaviours such as intimate partner violence, important questions persist around how respondents understand and react to these methods. This article presents evidence from a list experiment measuring multiple forms of intimate partner violence in rural Ethiopia. We find that the list experiment does not generate estimates of intimate partner violence that are higher than direct response questions; rather, prevalence estimates using the list experiment are lower vis-à-vis prevalence estimates using the direct reports, and are sometimes even negative. We provide suggestive evidence that this pattern may reflect ‘fleeing’ behaviour by respondents who do not wish to be associated with statements indicating their exposure to intimate partner violence.

Farm size and agricultural productivity of nutritious foods: Evidence from Ethiopia

Agri-food systems are transforming quickly in Africa. An important issue in the transformation process of agricultural production is the role of small farms. While many authors have looked at this question, one aspect that has received little attention is the role of small farms in the production of nutritious foods, an important topic given the low availability and relatively high prices of nutritious foods and the consequent low level of nutrition security in the continent. Using a unique large-scale dataset from Ethiopia—one of the largest countries in Africa that has been transforming rapidly—we look at the production of vegetables and dairy products. We find a strong association between farm size and partial productivity measured in terms of output, value of outputs and profit per hectare/cow, with productivity twice to four times as high for larger farms. These farms have substantially higher input expenditures as well as differences in farm technologies compared to small ones. Our findings have important implications for the debate on the role of small farms and nutritional improvements in the continent.

JEL Classification: O13, Q12, Q18

Rural institutions and the technical efficiency of teff production in Ethiopia

We examine the effect of rural institutions on plot-level technical efficiency of teff production. We account for differences in production technology, access to the market, plot characteristics, and weather shocks across plots and investigate the robustness of the effects of rural institutions on technical efficiency across various specifications. Using a large and detailed cross-section of teff plots, we find that teff output could be increased by approximately 25 percent with the available inputs and technology through improved technical efficiency. The magnitude of technical inefficiency is robust to alternative functional forms and variable specifications. Community discussion groups and distance to the nearest agricultural co-operative have a positive relationship with technical efficiency, highlighting their potential to enhance agricultural productivity. However, we find limited evidence on the relationship between co-operative membership, visits with extension and technical efficiency of teff producers. Our results show that when studying the impact of new programs and policies in agriculture, it is important to look beyond just whether farmers are members of co-operatives. We might consider other factors, such as how much access they have to co-operative services. It is crucial for policymakers to consider implementing targeted interventions to share information on best management practices and agricultural technologies in order to address the efficiency gap in teff production.

JEL classification: D02, D24, C54, P13, N57

Climate information services enhance farmers’ resilience to climate change: Impacts on agricultural productivity

Ethiopia is a climate “hotspot” where the variable and changing climate periodically threatens agricultural production, food security, and human well-being. Using two-rounds of Feed the Future program survey data that cover 3,799 farming households in five major regions in Ethiopia, and employing panel data estimation methods, we analyze the potential impact of weather and climate services (WCS) on agricultural productivity and farmers’ resilience in Ethiopia. We found that access to WCS increases the productivity of maize and wheat crops by 27 % and 17 %, respectively. These estimates are comparable to or higher than conventional yield-increasing production technologies such as fertilizer and improved seeds. Despite such a strong productivity effect, access to WCS is limited to only 18 % of the surveyed farmers. This study adds to the existing body of evidence on the significant positive impact of WCS, and affirms the importance of weather and climate information service products to enhance farmers’ resilience to climate risk. Further analyses are needed to estimate the value to Ethiopia’s smallholder farmers, especially those who are most vulnerable to climate-related hazards, of increasing investment in improving seasonal climate forecasts, mainstreaming weather and climate services in the agricultural extension system, including through National Framework for Climate Services (NFCS), and supporting farmer decision-making with climate-informed digital advisory tools and training.

Maize yield responsiveness and profitability of fertilizer: New survey evidence from six African countries

Enhancing maize productivity growth is pivotal for revolutionizing the agrifood system in Africa, with inorganic fertilizer serving as a fundamental input for catalyzing this progress. However, concerns are mounting about the low and decreasing yield response and profitability of inorganic fertilizer use, particularly in Sub-Saharan Africa. This study aims to refine yield response and profitability models by incorporating recent data from nationally representative and panel datasets spanning six countries. Most countries exhibited low nitrogen yield responsiveness (4–7 kg), while Ghana and Uganda showed higher responsiveness (15–20 kg) per additional 1 kg of nitrogen. Analysis of fertilizer-to-maize price ratios from 2010 to 2023 showed a downward trend, with spikes in 2022 in Ghana, Malawi, Nigeria, and Tanzania. Overall, except for those years, the data suggest a trend of increasingly favorable price incentives for fertilizer use. Ethiopia, Tanzania, and Uganda experienced declines in the fertilizer-to-maize price ratio. Increasing inorganic fertilizer use would be profitable in Ethiopia, Ghana, Nigeria, and Uganda at current market prices, but not in Malawi or Tanzania. Subsidies in Malawi and Tanzania have boosted profitability, but these may not be necessary in Ghana, Nigeria, or Uganda, which already have favorable price incentives; Malawi could benefit by substantially reducing its 80 percent subsidy while maintaining decent price incentives and farm profits. The paper proposes policy options based on factors influencing yield responsiveness and potential improvements drawn from new modeling and synthesis of the literature.

Storage management practices and mycotoxin contamination of sorghum (Sorghum bicolor) in northwest Ethiopia

Mycotoxins are toxic metabolites produced by certain fungal species that affect animal and human health. Data on the relationships between specific traditional storage management practices of sorghum and mycotoxin contamination are rarely available in Ethiopia. The aim of this study was to investigate current sorghum storage management practices in major sorghum producer locations in Northwest Ethiopia and their relationships with mycotoxin contamination. Sorghum storage management practices of 120 farmers were surveyed, the occurrence of multiple mycotoxins in samples from their stored sorghum was determined, and potential relationships between the traditional storage management practices and mycotoxin contamination were analyzed. Samples were analyzed using UPLC-MS/MS for 33 different mycotoxins. About 88% of the samples were contaminated with at least one mycotoxin. The detected mycotoxins belong to one of the four mycotoxin categories, produced by Aspergillus spp, Fusarium spp, Penicillium spp, and Alternaria spp. From the total, 3%, 7%, and 3% of the samples were contaminated with aflatoxins, ochratoxin A, and zearalenone, respectively, above the EU regulatory limits. The measured concentrations that bypassed EU regulatory limits were 9.14, 18.34 and 29.13 (μg/kg) for total aflatoxins, 5.31, 12.50, 14.94, 15.77, 32.94, 56.81, 58.07 and 112.59 (μg/kg) for Ochratoxin A, and 123.48, 238.43 and 431.78 (μg/kg) for Zearalenone, respectively. Logistic regression showed relationships between the traditional storage management practices with mycotoxin contamination. The age and the experience of the Main Person Responsible for Storage management (MPRS), the placement of the storage structure, and the insecticide application showed negative relationships with multi-mycotoxin contamination. On the other hand, the educational status of the MPRS and the type of storage structure showed positive relationships with mycotoxin contamination. Therefore, it is recommended that farmers receive training in proper sorghum storage management to further reduce the mycotoxin contamination in the grain.

Fertilizer demand and profitability amid global fuel-food-fertilizer crisis: Evidence from Ethiopia

We assess fertilizer demand and profitability in Ethiopia in the face of the recent global fuel–food–fertilizer price crisis and other domestic shocks. We first examine farmers’ response to changes in both fertilizer and food prices by estimating price elasticity of demand. We then evaluate the profitability of fertilizer by computing average value–cost ratios (AVCRs) associated with fertilizer application before and after these crises. We use detailed longitudinal household survey data collected in three rounds, covering both pre-crisis (2016 and 2019) and post-crisis (2023) production periods, focusing on three main staple crops in Ethiopia (maize, teff, and wheat). Our analysis shows that fertilizer adoption, and yield levels were increasing until the recent crises, but these trends have been halted by these crises. We also find slightly larger fertilizer price elasticity of demand estimates than previous estimates, ranging between −0.40 and −1.12, which vary across crops. We find that farmers are more responsive to fertilizer prices than to output prices. Farmers’ response to increases in staple prices was statistically insignificant and hence not as strong as theoretically perceived. Households with smaller farm sizes are relatively more responsive to changes in fertilizer prices. Finally, we show important dynamics in the profitability of chemical fertilizer. While the AVCRs show profitable trends for most crops, the share of farmers with profitable AVCRs declined following the fertilizer price surges. Our findings offer important insights for policy focusing on mitigating the adverse effects of fertilizer price shocks.

Africa's manufacturing puzzle: Evidence from Tanzanian and Ethiopian firms

Recent growth accelerations in Africa are characterized by declining shares of the labor force employed in agriculture, increasing labor productivity in agriculture, and declining labor productivity in modern sectors such as manufacturing. To shed light on this puzzle, this study disaggregates firms in the manufacturing sector by average size, using two newly created firm-level panels covering Tanzania (2008–2016) and Ethiopia (1996–2017). The analysis identifies a dichotomy between larger firms with superior productivity performance that do not expand employment and small firms that absorb employment but do not experience much productivity growth. Large, more productive firms use highly capital-intensive techniques, in line with global technology trends but significantly greater than what would be expected based on these countries’ income levels or relative factor endowments.

Estimating the direct and indirect effects of improved seed adoption on yields: Evidence from DNA-fingerprinting, crop cuts, and self-reporting in Ethiopia

Farmers' adoption of improved crop varieties could increase yields in low-income countries. However, the presence of measurement error in household surveys poses a challenge to estimating true returns. Using the 2018/19 Ethiopia Socio-economic Survey, we analyze the impacts of how three sources of measurement error: misperceptions of seed varieties, land area, and quantities harvested affect maize yields and input use. These data include DNA-fingerprinting of seed, GPS plot size information, and crop cuts that we compare to farmers’ self-reported estimates of these measures. Results indicate that the measurement error in self-reported seed variety adoption, especially from farmers who did not know they were using improved maize varieties, attenuates their estimated yield gains by 25 percentage points on average. The enhanced genetics of improved seed varieties accounts for a 41-percentage point yield increase over non-improved varieties, and increased input use accounts for a 30-percentage point gain for improved varieties on average.

JEL classification: D13, O13, N57, Q12, Q16

Developing a food safety consumer experience scale: Qualitative insights from Bangladesh, Ethiopia, and Vietnam

Objectives: Unsafe food contributes to 600 million cases of foodborne illness and 420,000 deaths annually. Existing methods used to evaluate food safety risks overlook consumers’ perspectives coming from their everyday experiences that influence their food choices. Our objective was to develop a cross-culturally appropriate and user-friendly scale to assess consumers’ experiences related to food safety in low- and middle-income countries. This study identified the constructs that constitute the experiences of food safety that the scale should reflect.

Methods: In-depth interviews were conducted with urban households in Bangladesh (n=51), Ethiopia (n=50), and Vietnam (n=41). Eligible households had children aged 2–5 years and members serving as primary food purchasers, preparers, and caregivers. Interviews explored attitudes, perceptions, and lived experiences related to food safety. Data were analyzed using a constant comparative method.

Results: Respondents expressed awareness of biological and chemical contaminants in foods. Concerns about chemical additives and food adulteration were common, fueled by beliefs that these hazards cause chronic illnesses. Personal and familial experiences with foodborne illness reinforced caution when buying foods. Religious and cultural beliefs shaped how respondents explained and responded to food safety concerns, with some attributing illness symptoms to spiritual causes. Trust in food vendors was rooted in reputation, visible cleanliness, and willingness to rectify issues (e.g., exchange items). Respondents differentiated their extent of scrutinizing safety based on food type: staples such as rice and pulses were assessed more by vendor credibility, whereas perishables such as fish and meat underwent direct, detailed inspections. Low transparency in food sourcing and how vendors prepared foods were persistent concerns.

Conclusions: Trust, perceived transparency, risk perceptions, and past incidents shaped consumers’ mental representations and behaviors related to food safety. Interviews underscored the centrality of context and sensory-based quality indicators, suggesting that scenario-based assessments are more appropriate than generic risk-reduction items.

Inclusive and gender-transformative seed systems: Concepts and applications

CONTEXT
Seed is vital to the nutrition and livelihoods of millions of women and men small-scale farmers in low- and middle-income countries. Seed systems interventions can significantly enhance food security and nutrition by accelerating the adoption of improved varieties and the use of quality seed, which in turn increase the rate of genetic gain, productivity, and household welfare. These interventions can be particularly effective when advancing gender equality by supporting women's empowerment and addressing discriminatory gender norms. However, there is relatively little evidence on the ways in which seed systems can be an entry point for advancing gender equality by transforming discriminatory gender norms.
OBJECTIVES
We develop and illustrate a gender transformative approach applied to seed sector development. Our first objective is to provide a framework to better understand how seed systems interventions can contribute to gender equality by (1) integrating gender-accommodative and gender-transformative approaches; and (2) assessing their gendered impacts. Our second objective is to apply this framework to a particular innovation – gender messaging via information and communications technologies (ICTs) – and explore how seed system interventions can be made more gender-transformative.
METHODS
We first reviewed the existing literature to develop a framework that defines gender-transformative and accommodative seed system interventions and their impacts. We then synthesized lessons learned from the application of this framework to case studies from Ethiopia, Kenya, Tanzania, and Uganda that used ICTs that contained gendered components.
RESULTS AND CONCLUSION
We discuss how a gender-accommodative approach aims for gender considerations to improve seed systems, while a gender-transformative approach flips the goal around by aiming at progress toward gender equality through seed systems. We find growing evidence on the potential of gender-transformative seed systems interventions to influence positively the empowerment of women and also men, and to create more conducive gender norms, as shown by three case studies on ICT enablers. These case studies also show that accommodative and transformative approaches are often complementary.
SIGNIFICANCE
We introduce research questions that research and development practitioners can ask to develop accommodative or transformative approaches in seed system interventions, and show the potential of both approaches to progress toward gender equality. The case studies indicate the feasibility of gender-transformative, ICT-enabled seed system interventions, with clear indications of the potential for low-cost adaptation at scale. However, the transformative potential of these interventions requires careful consideration of messaging content, format, and context, as well as strategic public investment and strong political will.

Scalable nutrition interventions in a graduation model program: Experimental evidence from Ethiopia

Shocks and stability of risk and time preferences among poor rural households in Ethiopia

This paper examines the effects of shocks on temporal stability of risk and time preferences of rural households within a developing country context characterized by frequent droughts, chronic food insecurity, and low levels of education. Leveraging a three-wave large and diverse household panel data that elicits preferences every two years for more than 6,500 individuals from over 5,600 sample rural households in Ethiopia, we analyze the effects of droughts (self-reported) and rainfall shortfalls on household risk and time preferences. Our findings show that households become more risk-averse and impatient after experiencing drought and rainfall shocks; the change in risk preferences is more notable among households that experience recurrent droughts and multiple covariate shocks during the same period.

Quality of routine health and nutrition data in Ethiopia: A systematic review

Background
High-quality data are vital for informed decision-making, enhancing population health, and achieving comprehensive insights. However, there is limited understanding of the consistency and reliability of routine Health Management Information System (HMIS) including nutrition data across diverse regions in Ethiopia. This study systematically reviewed the existing literature to address these knowledge gaps.

Methods
We systematically searched PubMed, HINARI, and Google Scholar for studies published from 2015 onwards to assess HMIS, including nutrition data quality in Ethiopia. The evaluations focused on completeness, consistency, and timeliness metrics defined by the WHO. We included diverse regional studies without indicator restrictions, prioritized data quality metrics as primary outcomes, and explored qualitative reasons for poor data quality as secondary outcomes.

Results
Of the 1790 papers screened, 25 met the inclusion criteria. The completeness of reporting varied widely among studies (50%–100%), with only 21% (4 out of 19) exceeding 90%. The consistency ranged from 38.9% to 90.5%, with only 6% of studies reporting internal consistency above 90%. Other consistency issues included lack of external consistency, indicator discrepancies, and outliers. Timeliness ranged from 41.9% to 93.7%, with 54% of studies reporting below 80%. In addition to the lack of studies addressing nutrition data, the quality was no better than other components of HMIS. The major factors contributing to poor data quality were human resource shortages, insufficient capacity building, behavioural influences, and infrastructural deficits.

Conclusion
The HMIS including nutrition data in Ethiopia, exhibited deficiencies in completeness, consistency, and timeliness, which were largely, attributed to capacity and resource constraints. Interventions should prioritize resource allocation, staff training, supervision, and feedback mechanisms to enhance data quality, thereby improving decision-making processes and population health outcomes.

Building Ethiopia’s food security resilience to climate and hydrological change

Historically Ethiopia's food security has been sensitive to climatic variability, but changes in future weather and climate could lead to overall reductions and increased variability in agricultural production, without further adaptation. We present an integrated modelling assessment framework which combines climate, crop, and hydrological modelling to quantify future risks to Ethiopia's food security. We explore the impacts of 2°C and higher climate change scenarios on water availability and crop yields and simulate how future climate shocks may impact Ethiopia's food. We consider three adaptations to agricultural management practices (improved seed varieties, increased use of nitrogen fertilizer and supplementary irrigation) and quantify their effectiveness in enhancing the resilience of Ethiopia's food system to climate and hydrological change by 2050. Results show that, without policy intervention, climate change creates a risk of declining Meher season crop yields across Ethiopia. Under the worst climate change scenario, teff (−12.0%), barley (−6.7%), and wheat (−4.4%) are projected to have the largest decline in average yields, whilst maize (−0.1%) and sorghum (+0.9%) yields are less impacted thanks to more favourable growing conditions. However, the results also indicate that the adaptation options have a bigger beneficial effect than the climate impact. Of the policies evaluated, improved seeds have a relatively greater effect than increased fertilizer use. Supplementary irrigation could help to mitigate increases in crop water requirements under warmer climate conditions and is most effective in drought prone basins and for drought-vulnerable crops. Overall, the results show that locally relevant agricultural policies are necessary to build Ethiopia's food system resilience to climate and hydrological change by the mid-century.

Enhanced quality of nutrition services during antenatal care through interventions to improve maternal nutrition in Bangladesh, Burkina Faso, Ethiopia, and India

Background
Quality antenatal care (ANC) services are critical for maternal health and nutrition. Information on the quality of nutrition interventions during ANC is scarce in low- and middle-income countries. We examined the effects of intensified maternal nutrition interventions during ANC on service readiness, provision of care, and experience of care and assessed the inter-relationships between the dimensions of quality.

Methods
We used data from impact evaluations of maternal nutrition interventions in Bangladesh, Burkina Faso, Ethiopia, and India. We calculated the quality of nutrition services during ANC using information from health facility assessments, health care provider interviews, ANC observations, and client exit interviews. We used structural equation models to examine relationships between the dimensions of quality.

Results
Health facilities in all four countries had a high service readiness component in terms of basic amenities, equipment and supplies, medicines and commodities, and guidelines (mean (x̄) = 8–10 in Bangladesh and Burkina Faso, x̄ = 7–9 in Ethiopia, and x̄ = 6–8 in India). Scores for provision of care were low across the countries but higher in intervention compared to control areas in Bangladesh (5.2 vs. 2.9) and Burkina Faso (5.6 vs. 4.8), but not significantly different in Ethiopia (range = 4.7–5.0) and India (range = 2.6–3.5). For experience of care, client satisfaction scores were high and similar between intervention and control areas in all countries (range = 8.3–9.7), but client experience scores were lower with statistically significant differences observed only in Bangladesh (x̄ = 8.2 in intervention vs. x̄ = 7.1 in control areas). The interventions had significant direct effects on service readiness in Bangladesh (β = 0.07), Burkina Faso (β = 1.20), and Ethiopia (β = 1.0), on the provision of care in Bangladesh (β = 2.27), Burkina Faso (β = 1.27), and India (β = 0.96), and experience of care in Bangladesh (β = 0.21).

Conclusions
In this study, we provided evidence on various dimensions of service quality that may be improved by interventions to strengthen nutrition services during ANC in diverse low- and middle-income countries.

Association between wasting and inadequate breastfeeding practices among infants under six months in SNNPR and Somali regions of Ethiopia: A multilevel cross-sectional study

Background
Wasting is a severe threat to children’s survival and development. Attaining optimal breastfeeding practices for infants under six months of age remains a significant challenge in low-income countries. This study assessed the association between wasting and breastfeeding practices among infants under six months of age in the SNNPR and Somali regions of Ethiopia.

Methods
The study used data from a large feasibility study conducted in the SNNPR and Somali regions of Ethiopia, from August-September 2021. This study involved 895 infants under six months of age with their mothers. The Poisson regression model with robust variance estimation was used to produce adjusted prevalence ratios (APRs) with 95% confidence intervals (CIs).

Results
The prevalence of wasting was 16.5% (95% CI: 14.2, 19.2) among infants under six months of age. Non-exclusive breastfeeding (APR = 1.50; 95% CI:1.02, 2.21), delayed initiation of breastfeeding (APR = 1.52; CI:1.00, 2.30), being male infants (APR = 1.50; 95% CI:1.09, 2.07), and mothers who attained primary level (APR = 0.62; 95% CI: 0.40, 0.95) or secondary level education (APR = 0.30; 95% CI: 0.09, 0.99) were independently associated with wasting in the multivariable analysis.

Conclusion
This study indicates a high prevalence of wasting among infants under six months of age. Non-exclusive breastfeeding and delayed initiation of breastfeeding were the modifiable factors significantly linked to infant wasting. Strengthening breastfeeding promotion and support may help reduce wasting in infants under six months.

Basis risk, social comparison, perceptions of fairness, and demand for insurance: A field experiment in Ethiopia

Index insurance lowers agricultural risk but covers only covariate risks. Since farmers do not have complete insurance, they may develop mistrust of insurance when experiencing crop losses and not receiving payouts. Although recent innovations in remote sensing enable the provision of more complete insurance including coverage for idiosyncratic risks, such insurance introduces differences in payouts within social networks, which might be considered unfair, introduce jealousy, and depress insurance demand. We conduct a lab-in-the-field experiment with farmers in Ethiopia to examine whether providing complete insurance coverage affects perceived fairness and insurance demand. We also examine effects of informing farmers about neighbors' payout experiences. We find that such social comparison increases perceived fairness of index insurance. Providing complete crop insurance increases perceived fairness of outcomes and willingness to pay for insurance, without introducing jealousy over neighbors receiving different payouts. These results are concentrated among men and those with little insurance knowledge.

Modeling crop-livestock interactions in semi-subsistence economies

Climate and weather shocks pose significant threats to crop and livestock systems, leading to economic losses and humanitarian crises. Utilizing a modeling framework that innovatively integrates the crop and livestock production systems in semi-subsistence economies, this study examines the interactions and dynamic adjustments within these systems following weather shocks, using Ethiopia as a case study. We also evaluate the effectiveness of various adaptation strategies in sustaining farm incomes, food security, and welfare. Results show unique effects on the crop and livestock sectors resulting from a joint shock on the two systems. While food crops experience a strong and immediate growth effect (12.4%) that fades quickly, the livestock sector faces the full impact of the shock a year later (13.7%), with the effect persisting to some degree. We also find diverging economic and livestock system adjustment trajectories from separate shocks to the crop and livestock systems. Further, the intervention options analyzed show contrasting impacts on various outcome indicators, with only the resilient crop intervention causing sector-indifferent impacts. Our findings emphasize the importance of proactive measures to enhance the resilience of crop-livestock systems, with implications for policy and practice aimed at safeguarding food security and livelihoods in semi-subsistence economies.

JEL Classification: C68, Q18, Q54, I32, O55

Buyers' response to third-party quality certification: Theory and evidence from Ethiopian wheat traders

When quality attributes of a product are not directly observable, third-party certification (TPC) enables buyers to distinguish between quality levels and reward sellers accordingly. We study the adoption of TPC by traders in smallholder-based agricultural value chains in low-income countries, where traders aggregate products from many small-scale producers before selling in bulk to downstream processors. In this context, the introduction of TPC services has oftentimes failed. We develop a theoretical model identifying how different market conditions affect traders' choice to purchase certified output from farmers. Next, using a novel lab-in-the-field experiment with Ethiopian wheat traders, we examine the model's predictions. Traders’ willingness to specialize in certified output increases with the share of certified wheat in the market, and this effect is stronger in larger markets. However, we find that traders do not optimally respond to variation in the quality of uncertified wheat in the market. We also analyze conditions where traders deviate from optimal behavior and discuss implications for research and policy making to promote TPC in smallholder-based value-chains.

JEL Codes: Q13; D22; O13; C93

Men can cook: Effectiveness of a men’s engagement intervention to change attitudes and behaviors in rural Ethiopia

Graduation model interventions seek to address multiple barriers constraining households’ exit from poverty, however, few explicitly target restrictive gender norms. Using a randomized controlled trial design, combined with three rounds of data, we investigate the impacts on gender equitable attitudes and behaviors of a graduation program that seeks to address multiple constraints for those in poverty and improve restrictive gender norms in Ethiopia. We find that at 1-year follow-up all treatment arms lead to improvements in men’s gender equitable attitudes and their engagement in household domestic tasks as reported by both men and women; but at 3-year follow-up, impacts are only sustained in the treatment arms that introduced men’s engagement groups after the 1-year follow-up survey to further promote improvements in equitable gender norms.

Low awareness and affordability are major drivers of low consumption of animal‐source foods among children in Northern Ethiopia: A mixed‐methods study

Animal-source foods (ASFs), contain high amounts of essential nutrients that are readily absorbed by the body. However, children in resource-constrained settings often have limited access to these nutritious foods. This study aimed to investigate the reasons for the low consumption of ASFs among children in the Amhara region of Ethiopia. A community-based mixed-methods study was conducted, using exploratory qualitative methods supplemented by the analysis of secondary data from the Ethiopian Demographic and Health Survey (EDHS). The qualitative study employed a multiphase stepwise design and the maximum variation purposive sampling technique, enroling a diverse range of participants such as mothers and/or caregivers, household heads, religious and community leaders, health and nutrition experts, and others. The qualitative data were analysed using a thematic framework analysis method, while the quantitative data were analysed using SPSS v22 statistical software. Multivariable logistic regression analysis was performed to identify the predictors of ASFs among children under 5 years of age in the region. Despite the large and diverse livestock populations available, only 13.2% of children consumed at least one animal-source food (ASF) in the prior day. The most consumed ASFs were dairy and eggs, whereas beef, organ meat, and seafood were the least consumed. Household demographics such as residence, literacy level, paternal age, and household wealth quintiles influenced the overall consumption of ASFs. The main reasons for the low consumption of ASFs among children were unaffordability and poor awareness among caregivers. In addition, religious misconceptions, price hikes, limited availability during certain seasons, low productivity, insufficient support from health professionals, and time constraints for caregivers were also mentioned as significant barriers to ASF consumption in the area. The consumption of ASFs among children in Ethiopia, particularly in the Amhara region, remains very low. This is mainly due to the caregivers' levels of awareness and unaffordability of ASFs. It is recommended that behavioural and sociocultural interventions be implemented that target caregivers to improve the consumption of ASFs among children.

Evaluating large-scale government investments in fertilizer adoption: The Ethiopian experience

We evaluate the impact of a large Government of Ethiopia intervention to raise fertilizer supply by establishing five fertilizer blending facilities supplying fertilizers tailored to local soil nutrient profiles. We rely on the phased geographic rollout of blending facility establishment to identify the causal effect on fertilizer use, application rates, crop yields, gross crop revenue, and household consumption. Combining effects of multiple treatment periods, each estimated using a doubly robust difference-in-difference model, we find that the blending facilities increased the probability that farmers adopt the new blended fertilizers by 22 percentage points and increased application rates by 17 kg/ha (baseline adoption was zero). The facilities mostly induced farmers who previously used DAP to switch to NPS, and we find large decreases in DAP adoption (by 22 percentage points, 47% of the control group base mean) and application rates (16 kg/ha, 52% of the control group base mean) yet no impact on overall fertilizer adoption or application rates. Though the new blended fertilizers were expected to perform better, there is no evidence they improved crop yields, crop gross revenue, or household consumption. The effect of the intervention was more pronounced (with larger increases in NPS use and larger decreases in DAP use) for farms located near demonstration plots, which the Government used to train farmers about the agronomic response to the new fertilizers. We confirm results using three large-scale longitudinal datasets and show that they are robust to choices of specification, treatment definition, and inference assumptions.

JEL classification: O12, O13, Q16, Q18

The linkages between water supply, sanitation and hygiene and small-scale irrigation: Insights from rural Ethiopia

While small-scale irrigation is largely designed and developed for agricultural production, irrigation water is used for multiple other purposes in rural low- and middle-income settings where dedicated water, sanitation, and hygiene services (WASH) are not available. Therefore, expanding access to irrigation can potentially improve the WASH environment leading to health and nutrition benefits. This study examines the linkages between irrigation, use of irrigation water sources for multiple purposes, and WASH and health outcomes. We find that irrigation is associated with better household access to water and improved sanitation facilities. This relationship is driven by households that use groundwater for both irrigation and domestic uses. Moreover, our results show that hygiene practices and health outcomes are not influenced by irrigation or multiple uses of the same water source. To strengthen hygiene behavior, behavioral change communication will be important. For small-scale irrigation to effectively support WASH and, thus, to strengthen nutrition and health outcomes, systems would need to be co-designed by irrigation and health specialists, and women farmers who are largely responsible for providing WASH services at the household level would need to be empowered to participate in the design and management of these dual-purpose systems.

Climate and weather services can enhance Ethiopian farmers’ resilience to climate change: Economy-wide impact analysis

Weather and climate services (WCS) are particularly important in Sub-Saharan Africa, where weather-dependent agriculture is the main source of livelihood, and where erratic weather patterns and extreme weather events have major impacts on rural livelihoods and food security. However, despite their importance, their effects on the agriculture sector and the overall economy are not well understood. For the case of Ethiopia, we use a computable general equilibrium modeling approach with the latest Ethiopian social accounting matrix data to estimate the potential contribution of WCS to macroeconomic variables, including growth in gross domestic product nationally and by sector. The analysis incorporates results of a separate econometric analysis of household survey data from five major regions in Ethiopia, which showed WCS use is associated with increased agricultural productivity. We estimate that increased agricultural productivity associated with WCS contributes to overall economic growth of more than 6 %, with a likely positive effect on farmers’ resilience to climate variability and change. The positive impact of WCS on agricultural productivity propagate to the overall economy, as evidenced by the considerable positive effect on GDP especially from the more climate sensitive sectors such as agriculture.

Suboptimal nutritional status of school-age children in Addis Ababa: evidence from the analysis of socioeconomic, environmental, and behavioral factors

Background: School-aged children (6–14 years old) are susceptible to malnutrition and micronutrient deficiencies. Environmental and behavioral factors greatly influence their nutritional status. This study aimed to examine the association between dietary factors and the nutritional status of school-aged children attending public and private schools in Addis Ababa.

Methods: A community-based cross-sectional study design was employed from March to August 2023. A total of 309 study participants were randomly selected from 10 schools. Data were entered into Epidata version 3.1 and exported to SPSS version 23.0 for analysis. WHO Anthro Plus 1.0.4 was used to assess the measurements of weight-for-age (WAZ), height-for-age (HAZ), and BMI-for-age (BAZ) for overweight, stunting, and underweight, while wasting was assessed using MUAC. A Poisson regression model was used to determine the association between predictor variables and stunting, wasting, underweight, and overweight, with adjusted prevalence ratios (APR). APR and 95% CI were used to identify statistically significant variables.

Results: Findings revealed the prevalence of wasting (15%), stunting (24%), underweight (36%), and overweight (19%) among school-aged children. Factors influencing stunting include marital status, house ownership, education level of parents/caregivers, child sex, and meal skipping. Wasting was linked to wealth index, child age, dietary diversity, dietary habits, water access, and toilet facilities. Underweight predictors include parent/caregiver age, marital status, and meal frequency. Moreover, school type appeared as a significant factor for overweight.

Conclusions: The overall nutritional status of school-aged children is suboptimal, influenced by sociodemographic, environmental, and behavioral factors. Addressing these factors through targeted interventions is crucial, particularly for the most vulnerable groups.

A system readiness approach to support the packaging and scaling of innovation bundles for farming systems transformation

CONTEXT: A newly established ‘systemic approach to technology packaging’ for improved scaling has emerged in the literature. This approach suggests that core transformative innovations can be scaled more effectively through scaling readiness, which helps identify complementary innovations that support and facilitate the scalability of the core innovation. Since these packaging approaches start with single core innovations, we propose that they can benefit from the broader literature on sustainable agricultural systems transformation and readiness.
OBJECTIVE: The objective of this paper is to advocate for a more comprehensive packaging of innovations for sustainable agricultural system transformations by better understanding gaps in the agricultural system – and its capacity for change. This approach provides a stronger rationale for the selection of relevant innovations to be packaged together. We introduce the concept of agricultural ‘system readiness’ as a possible framework for guiding such bundles.
METHODS: The paper begins with a comprehensive literature review that identifies the current gaps in tools and methods to guide system transformation. It also focuses on the specific literature on innovation packaging for scaling and builds on the gaps of existing approaches as a rationale for introducing the concept of system readiness (mostly used in infrastructure engineering) and adapting it to agricultural science. We also use illustrative hypothetical examples from mixed crop-livestock systems in the drylands to show how two approaches – ‘packaging for scaling’ and ‘packaging for transformation’ – can lead to different innovation packages.
RESULTS AND CONCLUSIONS: The concept of system readiness is introduced, defined and advocated. We show that it can help identify performance gaps in agricultural systems and guide better planning for system strengthening and integration. We conclude with possible complementarities between the two approaches of scaling and system readiness. SIGNIFICANCE: The agricultural system readiness approach, as outlined in this paper, would be particularly beneficial for agricultural research-for-development, as well as other agricultural investment programs that seek to identify strategies for fostering sustainable transition in farming systems. Such programs would typically entail complexity-aware theories of change that focus on stimulating sustainable transformation pathways related to key target areas, such as agroecology, sustainable intensification, and system integration (e.g., crop-livestock integration and integrated pest management). The system readiness approach can support such programs through the identification, prioritization, targeting, and empowerment of the most significant (and transformative) system components by identifying respective innovations to be packaged.

Revolutionising multi-sectoral nutrition policy: Insights from the Ethiopian National Information Platform for Nutrition (NiPN) approach

The global nutrition and food security crisis, characterised by troubling trends in various forms of malnutrition ranging from hunger to obesity, has significantly worsened [1,2]. In 2021 and 2022, nearly one-third of the global population faced moderate to severe food insecurity, underscoring a persistent challenge in accessing healthy and sustainable diets [1,3]. This decline in diet quality has led to a surge in malnutrition, with obesity and diet-related noncommunicable diseases (NCDs) reaching epidemic proportions [4–6].

Despite the implementation of numerous nutrition policies and interventions, many low- and middle-income countries (LMICs) continue to grapple with food and nutrition security issues, posing a significant threat to vulnerable populations [3,7]. Food insecurity is particularly evident among the poor, with women and children in rural areas being the most affected [1,2,8]. In 2022 alone, an alarming 230 million children under the age of five experienced some form of malnutrition. Specifically, 148 million (22.3%) were stunted, 45 million (6.8%) were wasted, and 37 million (5.6%) were overweight [1,9,10]. Stunting and wasting were more prevalent in rural areas, while overweight was somewhat more common in urban settings. In Ethiopia, the latest national survey showed that 37% of children under five were stunted, 11% were wasted, and 22% were underweight [11].

Evidence-based approaches and effective programming are essential in tackling these persistent nutrition challenges and improving outcomes. These methods address policy gaps and are cost-effective in resource-poor settings. Recognising the importance of evidence-based policy, driven by political and accountability demands, helps raise awareness and guide decision-making through multisectoral collaboration. However, more evidence does not always mean better policies, as cognitive and institutional factors can hinder effective use. Emphasising knowledge translation in nutrition research is crucial [12], yet many studies focus only on policy formulation, neglecting the systematic analysis of implementation. This highlights the need to address the impact of research on policy and programme execution.

Analysis of alternative national development pathways for the cattle system in Ethiopia: Linked economic and animal systems (LEAS) model

The livestock sector is undergoing rapid changes, and governments are designing sector development plans to account for this transition. However, the fundamental assumptions behind the medium- to long-term growth strategies of the sector should be looked at from the perspective of the dynamics in the domestic and global economy, and uncertainties around the driving forces of the transition.This study used the case of Ethiopia to provide a scenario-based analysis of alternative national development trajectories, focusing on the prospects of growth performance, urbanisation, and their potential implications on the cattle system within the country.We employed a newly developed linked economic and animal systems (LEAS) model where the livestock, economy-wide, and microsimulation subsystems are linked either way through flows of information.Our findings suggested that demand for animal-source food (ASF) is highly dependent on economic-demographic changes and that income growth is the primary driver of overall livestock-system expansion. Additionally, urbanisation shifts the outputs of the livestock systems towards processed ASF products.The analysis showed that livestock development plans should reflect the economic reality and potential risks facing the economic system. Herd offtake and livestock sector output vary considerably with assumptions about future growth and urbanisation trajectories.In addition to relevant findings about the implications of the interplays between the economic and demographic variables, the study generated insights into the role of integrating economy-wide and livestock-system models to provide a risk-based approach to the prospects of the livestock sector.

Aspiring to more? New evidence on the effect of light-touch aspirations interventions in rural Ethiopia

A growing literature in economics has analysed the effects of psychological interventions designed to boost individual aspirations as a strategy to increase households’ propensity to make long-term investments and thus reduce poverty. This paper reports on a randomised controlled trial evaluating a short video-based intervention designed to increase aspirations of adults in poor rural Ethiopian households who are beneficiaries of the Productive Safety Net Program, the main government safety net program in Ethiopia. Evidence from a sample of 5,258 adults from 3,220 households is consistent with the hypothesis that there are no significant effects of the intervention on self-reported aspirations for the household, educational investment in children, or savings nine months post-treatment. This suggests that the effect of light-touch aspirations treatments for extremely poor adults may be limited in this context.

Monitoring the cost and affordability of a healthy diet within Countries: Building systems in Ethiopia, Ghana, Malawi, Nigeria, Pakistan, Tanzania, and Viet Nam

Background
Governments around the world collect food price data on a frequent basis, often monthly, for the purpose of monitoring inflation. These routine economic data can be used with a nutrition-sensitive lens for understanding economic access to a healthy diet. The United Nations Food and Agriculture Organization has adopted the cost and affordability of a healthy diet (CoAHD) for annual tracking alongside other food security indicators. This indicator is relevant in many countries for informed decision-making and accountability toward food systems summit pathways. National governments may wish to include this indicator in their own monitoring systems, using existing subnational price and income data.
Objectives
We describe emerging systems in several countries for monitoring CoAHD and analytical tools that facilitate the calculation of CoAHD. We discuss reasons why the indicator may differ when calculated using subnational data compared with the global monitoring system and how to interpret differences.
Methods
Between June 2016 and February 2024, 19 workshops were held in 7 countries (Ethiopia, Ghana, Malawi, Nigeria, Pakistan, Tanzania, and Viet Nam), where stakeholder discussions covered sources of food price data, institutions involved, policy uses, and direct training in calculation of CoAHD. Food price data collected by national organizations were used to calculate CoAHD in partnership with government agencies.
Results
Calculating CoAHD using subnational data uses the same methods across settings, but the mechanisms for monitoring and dissemination are different in each country, illustrating heterogeneity in how the metric can most effectively be incorporated within existing structures. Results from national and global monitoring systems have expected differences based on data sources, healthy diet standards, and affordability standards.
Conclusions
CoAHD can be calculated with existing data and resources, facilitated by new software tools and user tutorials. In the future, it can be further streamlined, leveraging technical assistance from global institutions and aligning national and global monitoring systems.

Toward integrated dam assessment: Evaluating multi-dimensional impacts of the Grand Ethiopian Renaissance Dam on Sudan

The Grand Ethiopian Renaissance Dam (GERD) on the Nile is expected to influence many ecosystem services, such as flood regulation, hydro-electricity production, food supply, and habitat provision, among others. Understanding these impacts (positive and negative) requires a comprehensive evaluation framework. This study develops and applies an integrated simulation framework for assessing the impacts of the GERD on Sudan, focusing on the simultaneous economywide effects of riverine flood hazards, irrigation water supply, hydropower generation, and floodplain-dependent industries, namely traditional fired clay brick production. The simulation framework incorporates three models: a river infrastructure system model, a flood model, and a Computable General Equilibrium Model. Results indicate positive impacts for hydropower generation and flood control, marginal benefits for water supply to existing irrigation, and negative consequences for brick production and the construction sector. Assuming that the GERD starts its long-term operation in 2025, we find an overall positive economic impact on Sudan's Gross Domestic Product in 2025, with an increase of up to just over 0.1%, subject to river flow conditions. Recognizing the differences in impacts across sectors and income groups, the study emphasizes the need for interventions that ameliorate negative effects. While the study captures several impacts, other effects on the environment, recession agriculture, and soil fertility require further investigation. Still, our findings underscore the importance of adopting an integrated simulation approach to dam evaluation, acknowledging the interconnected nature of water and related sectors in national economies.

Irrigation technologies and management and their environmental consequences: Empirical evidence from Ethiopia

The main objective of this study is to understand the interlinkages between different irrigation technologies and management systems and environmental outcomes. We use a unique and comprehensive household and plot-level dataset covering ten districts of Ethiopia complemented with remotely sensed data and qualitative information collected from the study sites. The econometric results show that compared to open-access plots equipped with pump irrigation, other irrigated configurations, and especially private groundwater-based systems, have higher vegetation cover and show less susceptibility to the most common environmental concerns mentioned in the survey regions: water logging, soil salinity, and erosion externalities.

Hybrid performance and grain yield stability for advanced provitamin A and quality protein maize hybrids evaluated in Ethiopia

Studying inclusive innovation with the right data: An empirical illustration from Ethiopia

CONTEXT
Agricultural innovations are inclusive when they are used by any member of society who wants to use them. Conversely, agricultural innovations that can only be used by a specific privileged group within society can be characterized as “exclusive”.

OBJECTIVE
The first objective of this paper is to examine the inclusivity of agricultural innovations in Ethiopia, using national representative data and considering a wide portfolio of innovations resulting from the collaborative research between CGIAR and its national partners. Second, we also examine how measurement error may affect how we characterize the inclusivity of agricultural innovations.

METHODS
We use nationally-representative survey data from Ethiopia (collected in 2018/19) in which best-practice measures of the adoption of a large number of agricultural innovations were embedded, including the adoption of CGIAR-related improved maize varieties measured using two different approaches: subjective, self-reported survey data; and objective DNA fingerprinting of crop samples taken from the same farmers' plots. A rich set of household variables is also collected in the survey, which allows characterizing the types of farmers that are adopting different innovations, and the extent to which conclusions regarding the inclusivity of innovations depends on the measurement of the latter.

RESULTS AND CONCLUSIONS
Many innovations are not disproportionately more likely to be adopted by male, larger, richer, or more connected farmers. When using self-reported data on adoption of improved maize varieties, adoption appears positively correlated with having larger landholdings and households with lower female participation in agriculture, and negatively correlated with poorer households (being among the bottom 40% of consumption distribution). Substituting survey responses with the results of DNA fingerprinting these correlations disappear, with farm size, gender and poverty status no longer predictive of adoption.

SIGNIFICANCE
The results suggest the potential value of offering a menu of innovations to farmers to increase inclusivity, as it allows each farmer to be a critical consumer of potential innovations and select those that best correspond to their own needs and constraints. We also highlight how important data quality is in ensuring we have correct information about inclusive innovation.

Emerging outsource agricultural services enable farmer adaptation in agrifood value chains: A product cycle perspective

Outsource agricultural service enterprises emerged a century ago in high-income countries and in the past several decades in developing regions. We contribute by analyzing and illustrating the emergence of these services from the perspective of phases of the Product Cycle. These services help farmers adapt to international and domestic agrifood value chains: (1) in the commoditization phase, e.g., with rice combine harvesting services in China and Myanmar for domestic and export markets; (2) in the early product differentiation phase into quality traits, e.g., with horticultural services to Ethiopian and Indonesian farmers for urban wholesale markets; (3) in the advanced product differentiation phase into environmental traits, e.g., with A-Z services to help French farmers grow eco-labeled vegetables for supermarkets. These services addressed farmers’ shortfalls in information, skills, labor, and equipment. The services are supplied by medium/large farmers with excess capacity say of a combine; by wholesalers who want to reduce search costs and risks; by input “agro-dealers”; and by agribusinesses servicing their outgrowers. In new cases shown in France, outsource firms partner with farm input companies such as Bayer or with robot/drone companies. Governments have – and can do much more to – support the emergence of these services such as in developing regions today through: (1) promotion of a business ecosystem, based on policies of investment in hard and soft infrastructure, favoring the coadaptation of these firms with farmers’ needs; (2) policies facilitating access, such as through import liberalization, of equipment and seeds and chemicals.

Sustained underweight in rural areas and emergence of overweight in urban Ethiopian women: A multivariate analysis of EDHS data 2000–2016

A growing body of evidence indicates the emergence of overweight/obesity in developing countries before the battle against undernutrition has been won. We conducted this study to quantify the reduction of underweight and the emergence of overweight among Ethiopian women from 2000 to 2016 and evaluate factors explaining the progress. We used the four Ethiopian Demographic and Health Surveys (2000–2016) to analyze body mass index (BMI) trends among women. Data from 43,815 non-pregnant, non-puerperal reproductive-age women was used to evaluate the linear change in BMI and changes in the percentage of overweight and underweight over time. Using multivariate decomposition analysis of change in underweight and overweight percentages, we identified sources of change in BMI in the past 16 years of the survey periods. The BMI of Ethiopian reproductive-age women increased by 0.88 kg/m2 from 2000 to 2016. The increment was pronounced in urban areas with 1.46 kg/m2. There has been a significant reduction in underweight women since 2000 (p-value < 0.001), and 87.62% of the changes were attributed to behavioral changes toward weight management. And there was a significant upswing in overweight women from 2000 to 2016 (p-value < 0.001) as well. A compositional change of factors including region, women’s age, women’s educational status, religion, type of place of residence, and use of contraceptives contributed to 57.51% of the observed increment in the percentage of overweight women. A relatively slow decrease in underweight and an increment in overweight have been observed. This progress can be disaggregated into persistent underweight in the rural and poorest, and swift development of overweight in the urban and richest communities. Targeted nutrition interventions for both underweight and overweight women are mandatory. Nutritional interventions in Ethiopia should focus on behavioral change to reduce hunger and malnutrition as well as to avert the emergence of overweight or obesity in the affected communities.

Progress in Water, Sanitation and Hygiene (WASH) coverage and potential contribution to the decline in diarrhea and stunting in Ethiopia

Inadequate safe water supply and poor sanitation and hygiene continue to be important risk factors for diarrhoea and stunting globally. We used data from the four rounds of the Ethiopian Demographic and Health Survey and applied the new World Health Organization (WHO)/UNICEF Joint Monitoring Program (JMP) service standards to assess progress in water, sanitation and hygiene (WASH) coverage between 2000 and 2016. We also performed an age-disaggregated pooled linear probability regression analysis followed by a decomposition analysis to determine whether changes in WASH practices have contributed to the changing prevalence of diarrhoea and stunting in children under 5 years of age. We observed a significant increase in the coverage of safe drinking water and adequate sanitation facilities over the period. At the national level, the use of a basic water source increased from 18% in 2000 to 50% in 2016. Open defecation declined from 82% to 32% over the same period. However, in 2016, only 6% of households had access to a basic sanitation facility, and 40% of households had no handwashing facilities. The reduction in surface water use between 2000 and 2016 explained 6% of the decline in diarrhoea observed among children aged 0–5 months. In children aged 6–59 months, between 7% and 9% of the reduction in stunting were attributable to the reduction in open defecation over this period. Despite progress, improvements are still needed to increase basic WASH coverage in Ethiopia. Our findings showed that improvements in water and sanitation only modestly explained reductions in diarrhoea and stunting.

The impact of large-scale agricultural investments in low-income economies

Recent years have witnessed an increasing interest in large-scale agricultural land acquisitions in developing countries. The accompanying socio-economic implications have been areas of debate among politicians, policymakers and development agents. This paper argues that the traditional way of simulating the impacts of these investments in developing countries is misleading as the approach implies that the new investments are identical to the semi-subsistence way of farming that dominates agricultural practices in the host countries. In this study, we incorporate the peculiarity of large-scale agro-investments into an existing database for economy-wide models, i.e., social accounting matrix (SAM), and capture welfare and distributional outcomes properly. SAM-based multiplier models applied to Ethiopian data justify the need to account for the peculiarity of the investments in terms of production technology and their geographic distribution.

Drivers of change in weight-for-height among children under 5 years of age in Ethiopia: Risk factors and data gaps to identify risk factors

The prevention of wasting should be a public health priority as the global burden of acute malnutrition is still high. Gaps still exist in our understanding of context-specific risk factors and interventions that can be implemented to prevent acute malnutrition. We used data from the four rounds of the Ethiopia Demographic and Health Survey (2000–2016) to identify risk factors that have contributed to the change in weight-for-height z-score (WHZ) among children under 5 years of age. We performed a pooled linear regression analysis followed by a decomposition analysis to identify relevant risk factors and their relative contribution to the change in WHZ. Modest improvements in WHZ were seen between 2000 and 2016. The sharpest decrease in mean WHZ occurred from birth to 6 months of age. Perceived low weight at birth and recent diarrhoea predicted a decline in WHZ among children aged 0–5, 6–23 and 23–59 months. Less than 50% of the change in WHZ was accounted for by the change in risk factors included in our regression decomposition analysis. This finding highlights data gaps to identify context-specific wasting risk factors. The decline in the prevalence of recent diarrhoea (15% of the improvement), decline in low birth size (7%–9%), and an increase in wealth (15%–30%) were the main risk factors that accounted for the explained change in WHZ. Our findings emphasize the importance of interventions to reduce low birthweight, diarrhoea and interventions that address income inequities to prevent acute malnutrition.

Understanding delays in the introduction of complementary foods in rural Ethiopia

Age-appropriate breastfeeding and introduction to complementary foods can shape child feeding practices, ensure adequate energy and nutrient intake and prevent linear growth faltering. This study aimed to assess mothers' and health workers' knowledge of timely introduction to complementary foods and evaluate the relationship between delays in complementary feeding and subsequent linear growth. We conducted two rounds of surveys (March/August 2017) among 249 health workers (n = 249) and caregivers (n = 2635) of children 6–23 months of age. We collected information about socio-demographic characteristics, knowledge and practice related to timely introduction to complementary foods. The study was conducted in households from the Productive Safety Net Programme (PSNP) districts, in four highland regions of Ethiopia. Delays in the introduction to complementary feeding were widespread with 53% of children 6–8 months of age not consuming solid, semisolid or soft foods in the past 24 h. After controlling for child, caregiver and household characteristics, children not introduced to complementary foods by 6–8 months had a 0.48 SD lower length-for-age z-score at 12–15 months. Caregivers' knowledge was strongly and inversely correlated with untimely introduction of complementary foods in logistic regressions (OR = 0.55, p < 0.01). In turn, local health extension worker's knowledge was strongly correlated with caregiver's knowledge. Consequently, frequent and timely visits by health extension workers emphasising not only on what to feed but also when and how to feed a child are needed. Innovative ways of increasing reach, intensity and frequency of nutrition messaging by using the PSNP interactions as an additional point of contact would need to be explored further.

Child growth faltering dynamics in food insecure districts in rural Ethiopia

Child undernutrition disproportionally affects children in low- and middle-income countries. In Ethiopia, both wasting and stunting are serious public health concerns, with high human and economic costs. Understanding the dynamics in ponderal and linear growth faltering is critical to inform the design of innovative interventions that can prevent both wasting and stunting in poor and complex settings. Using two longitudinal studies conducted in 2017 and 2019 in four highland regions of Ethiopia, we evaluated the dynamics and drivers of child growth faltering in children 6–23 months of age (N = 5003). Child wasting prevalence peaked during the first 6 months of life, whereas stunting increased significantly after 6 months of age. Male sex, child illnesses (i.e., diarrhoea or fever) and low consumption of fruits and vegetables were associated with higher odds of acute undernutrition (P < 0.05). The consumption of animal source foods (ASF) was associated with increases (β: 95% CI) in weight-for-length Z-score (WLZ; 0.12: 0.0002; 0.242), whereas fruit or vegetables consumption was associated with increases in midupper arm circumference (MUAC; 0.11 cm: 0.003; 0.209). Only consumption of ASF was the statistically significant predictor of future linear growth (0.14: 0.029; 0.251). Distinct trends in WLZ and MUAC were observed by child sex and age. Improving diet quality through improved nutrition knowledge and increased access and affordability of ASFs, along with effective infection prevention/control measures could prevent both child wasting and stunting concurrently.

Predictors of prediabetes/diabetes and hypertension in Ethiopia: Reanalysis of the 2015 NCD STEPS survey using causal path diagrams

The objective of our study was to reanalyse the Ethiopia STEPwise approach to Surveillance Noncommunicable Disease Risk Factors survey (NCD STEPS), using causal path diagrams constructed using expert subject matter knowledge in conjunction with graphical model theory to map the underlying causal network of modifiable factors associated with prediabetes/diabetes and hypertension. We used data from the 2015 Ethiopia NCD STEPS representative cross-sectional survey (males; n = 3977 and females; n = 5823 aged 15–69 years) and performed directed acyclic graph-informed logistic regression analyses. In both sexes, a 1-unit higher in body mass index (BMI) and waist circumference (WC) were positively associated with prediabetes/diabetes (BMI: males: adjusted odds ratio [aOR]: 1.07 [95% confidence interval: 1.0, 1.1], females aOR: 1.03 [1.0, 1.1]; WC: males: aOR: 1.1 [0.9, 1.2], females: aOR: 1.2 [1.1, 1.3]) and hypertension (BMI: males: aOR: 1.2 [1.1, 1.2], females aOR: 1.1 [1.0, 1.1]; WC: males: aOR: 1.6 [1.4, 1.8], females: aOR: 1.3 [1.2, 1.5]). Although residing in urban settings was associated with higher odds of hypertension in both males (aOR: 1.79 [1.49, 2.16]) and females (aOR: 1.70 [1.49, 1.95]), it was only associated with prediabetes/diabetes in males (aOR: 1.56 [1.25, 1.96]). Males and females in pastoralist areas had lower odds of prediabetes/diabetes compared with their agrarian counterparts (males: aOR: 0.27 [0.14, 0.52], females: aOR: 0.31 [0.16, 0.58]). Physical activity was associated with lower odds of prediabetes/diabetes among females (aOR: 0.75 [0.58, 0.97]). Other diet-related modifiable factors such as consumption of fruit and vegetable, alcohol or salt were not associated with either prediabetes/diabetes or hypertension. Our findings highlight the need to implement interventions that prevent overweight/obesity and nutrition-related NCDs, particularly in urban areas.

Child feeding practices in rural Ethiopia show increasing consumption of unhealthy foods

The quality of complementary feeding can have both short- and long-term health impacts by delaying or promoting child growth and establishing taste preferences and feeding behaviours. We aimed to assess the healthy and unhealthy feeding practices of infants and young children in rural Ethiopia. We conducted two rounds of surveys in December 2017/18 in Habru district, North Wello, rural Ethiopia among caregivers of infants and young children (N = 574). We characterised the consumption of infants and young children using non-quantitative 24 h recall and the World Health Organization infant and young child feeding indicators. Sociodemographic characteristics, anthropometry and haemoglobin concentrations were assessed. Breastfeeding was a norm as 82% and 67% were breastfed in the first and second rounds. Between the two rounds, dietary diversity increased from 5% to 17% (p < 0.05), but more pronounced increases were observed in the consumption of ultra-processed food (UPFs). Up to one-in-five (22%) of the children consumed UFPs. With an average of only three food groups consumed, the consumption of nutrient-dense foods like animal source foods, fruits and vegetables was very low particularly among younger children. UPFs are an additional risk factor that contributes to poor quality diets. Behavioural Change Communication interventions, including those in rural areas, should explicitly discourage the consumption of UPFs. Future studies should aim to quantify the amount of UPFs consumed and evaluate how this is associated with diet adequacy and nutritional outcomes.

Feed handling practices, aflatoxin awareness and children's milk consumption in the Sidama region of southern Ethiopia

Consumption of milk is linked to improved nutrient intake and reduced risk of child malnutrition in low and middle-income countries. However, these benefits are contingent on the safety and quality of the milk. Milk consumption may alleviate the widespread risk of malnutrition in rural Ethiopia, but milk-borne contaminants may also compromise child health. We aimed to: i) identify the types of dairy feeds used, their storage conditions, and potential risk of aflatoxin contamination; ii) assess stakeholders' knowledge about aflatoxin contamination along the value chain; and iii) assess parental practices on feeding milk to infants and young children. This qualitative study was conducted in the Sidama region, southern Ethiopia. In-depth interviews (n = 12) and key-informant interviews (n = 18) were conducted with actors along the dairy value chain. Focus-group discussions were conducted with farmers (9FGD/n = 129) and child caregivers (9FGD/n = 122). Study participants were selected to represent a rural-urban gradient, as well as low- and high- dairy cow holdings. We found that while animal-feed processors and their distribution agents had relatively good knowledge about aflatoxin, farmers and retailers did not. Feed storage conditions were poor. Many respondents linked moldy feeds to animal health but not to human health. Farmers' feed choice was influenced by cost, seasonality, and herd size. Small-holding farmers had limited access to commercial feed. Children's consumption of milk was limited to skim milk, as butter was extracted and sold for income. The high cost of dairy products also led some parents to dilute skim milk with water before feeding children, compromising the nutritional value and safety of the milk. Our findings underscore the need to address the gaps in aflatoxin and food safety knowledge, improve storage conditions, and ensure the availability of quality feed to increase the sector's productivity, but most importantly to protect consumers' health and well-being, especially infants and young children.

African domestic supply booms in value chains of fruits, vegetables, and animal products fueled by spontaneous clusters of SMEs

There is an international consensus that Africans consume less fruits and vegetables (FV), and animal products (AP) than they need for adequate nutrition, and that production and supply chains of these products are constrained. Yet, in this paper, we show that despite these problems, there is a lot of dynamism in demand and supply of these nutrient-dense products in Africa: (1) macro evidence of “domestic supply booms"—with supply growing as fast as or faster than in Asia and Latin America; (2) only 2–4% of FV, and 10% of AP consumption in Africa is imported, and only about 1–2% of the output of FV and AP is exported: the supply booms have thus been overwhelming domestically sourced, not imported; (3) micro evidence of substantial shares of consumption of FV and AP in total food consumption, similar to Asia's; (4) evidence of rapid development of spontaneous clusters of farms and off-farm SMEs (output wholesalers, logistics, processors, and agro-dealers supporting farmers). These clusters are important in fueling the supply booms. Illustrative cases from Ethiopia, Nigeria, Tanzania, and Zambia are presented. We recommend that African governments and international partners: (1) internalize the fact that these spontaneous clusters are forming and already fueling supply booms; (2) note that important drivers of the booms have been government investments in wholesale markets, roads, and other infrastructure like electrification, and agricultural research/extension; (3) leverage and support existing spontaneous clusters and help new ones to form by greatly increasing those three types of public investments.

JEL Codes: O20, Q13, Q18

Land as a binding constraint to cluster-based development in Ethiopia: To cluster or not to cluster?

As one of the agglomeration models targeting cluster-based rural development, cluster farming has been promoted in Ethiopia and it is already reported to have significant welfare implications, but participation rates are not as high as expected. This study examines the role of land as a constraint to the development of cluster-based development in Ethiopia both using extensive and intensive measures of cluster farming. The study further disaggregates farm households based on their farm size to better understand potential heterogeneities in the relationship between farm size and cluster farming. The paper also documents other household socio-economic and network characteristics that may matter in cluster farming.
Methods
We use a large-scale farm household data from 3,969 households coupled with some expert insights on cluster farming in Ethiopia. Households in the study areas grow major staples such as maize, wheat, teff, malt barley, and sesame in four main regions of Ethiopia. We employ a double hurdle model to examine both the decision to participate and the extent to which households participate in cluster farming. By extent of participation, we refer to the amount of land and share of land farm households contribute to cluster farming. For robustness purposes, we also estimate the Tobit and Linear Probability Models.
Results
We show a positive association between farm size and cluster farming both at the extensive and intensive margins. This relationship turns negative for large amounts of land. This shows that cluster farming increases with farm size up to a threshold beyond which it declines. We also find suggestive evidence that participation rates are lower for small-scale farms, but also declines for large-scale farms. In addition, we show that access to information and network characteristics also matter in enabling cluster farming.
Conclusion
The findings of this study are relevant in the framework of plans to upscale the cluster-based development initiative in Ethiopia. Attention to landholding issues is key and may be an important area where policy action can be geared to boost cluster farming. Moreover, our results inform potential targeting plans that aim to increase the participation of small-scale farmers who are usually the intended targets of such programs.

Study protocol to assess aflatoxin M1 health risks versus benefits of dairy consumption in Ethiopian children: An epidemiological trial and risk-benefit analysis

Introduction In Sidama, Ethiopia, animal-source foods can be difficult to access. Milk has important nutrients for child growth, but carries the risk of aflatoxin M1 (AFM1) contamination. AFM1 is a metabolite of the mycotoxin aflatoxin B1 (AFB1) in dairy feed; cows secrete AFM1 in milk when their feed contains AFB1 produced by Aspergillus fungi in maize, nuts and oilseeds. It is unknown whether AFM1 compromises child growth and health.

Methods and analysis This protocol paper describes our study in Sidama to determine the impact of milk consumption and AFM1 on child growth in the first 18 months of life. We will collect baseline and end-line data on dairy production, socioeconomic and nutritional factors of 1000 dairy-owning households with children ages 6–18 months at baseline; and gather samples of milk and dairy feed and child anthropometrics. We will conduct phone interviews every 6 months to ascertain changes in practices or child health. Dairy feed will be tested for AFB1; milk for AFM1, pathogens and nutrients. Controlling for herd size, socioeconomic, nutritional and behavioural factors, we will determine the association between child anthropometrics and milk consumption, as well as AFM1 exposure. We will examine whether AFM1 exposure affects child growth in the first 18 months of life, and weigh the benefits and risks of milk consumption.

Ethics and dissemination The protocol is approved by the Institutional Review Boards of the Ethiopian Public Health Institute (EPHI-IRB-481–2022), Michigan State University (STUDY00007996) and International Food Policy Research Institute (DSGD-23–0102). Written informed consent will be obtained from all participants, who may withdraw from the study at any time. Confidentiality of collected data will be given high priority during each stage of data handling. The study’s findings will be disseminated through stakeholder workshops, local and international conferences, journal articles and technical reports.

Revisiting the size–productivity relationship with imperfect measures of production and plot size

Monitoring smallholder agricultural productivity growth, one of the targets of the Sustainable Development Goals, rests on accurate measures of crop production and land area. Existing methods and protocols for measuring smallholder production and plot size are prone to various sources and forms of mismeasurement. Inaccuracies in production and land area measurement are likely to distort descriptive and predictive inferences. We examine the sensitivity of empirical assessments of the relationship between agricultural productivity and land area to alternative measurement protocols. We implement six production and six land area measurement protocols, and show that most of these protocols differ systematically in their accuracy. We find that an apparent inverse size–productivity relationship in our data is fully explained by measurement error in both production and plot size. Moreover, we show that some of the previously used “gold standard” measures are themselves prone to nonclassical measurement error, and hence can generate spurious inverse size–productivity findings. Our results also show that slight improvements in the precision of objective measures significantly reduce the inferential bias associated with the size–productivity relationship.

The importance and determinants of purchases in rural food consumption in Africa: implications for food security strategies

We analyze rural households’ purchases of food (cereals and non-cereals) in Sub-Saharan Africa using nationally representative data with 65,000 observations covering 7 countries over a decade. We distinguish between three strata of countries: lower stratum in income and urbanization, middle stratum, and upper stratum. The paper breaks ground by the breadth and time length of the sample. We find that purchases form the majority of rural food consumption whether in favorable or unfavorable agroecological zones and over country and income strata and for most food products. Rural nonfarm employment (as a cash source) plays an important role in household food purchases across all study countries and food products. Policy implications include the importance of food purchase markets and supply chains to and in rural areas as well as nonfarm employment.

Variation in women’s attitudes toward intimate partner violence across the rural–urban continuum in Ethiopia

Little is known about the effects of urbanization on women’s attitudes toward intimate partner violence (IPV). The scarcity of empirical studies on this relationship can be partly attributed to the lack of an objective measure of urbanization levels. In this study, we investigate the effects of urbanization on Ethiopian women’s attitudes toward IPV using four continuous measures of urbanization: nightlight intensity, distance to urban areas, total urban area within a 10-km radius, and an urbanization index. These measures are defined from satellite-based nighttime light intensity and multispectral sensor data. We find that despite a generally strong positive association between urbanization and progressive attitudes among women toward IPV, some stages of urbanization show a more significant association than others. The heterogeneities in the effect of all urbanization measures on women’s attitudes toward intimate partner violence further show that the effects of urbanization measures are sharply heterogeneous across wealth indicator terciles. While we find that urbanization measures are associated with an overall decrease in the justification of IPV, the effects are higher and stronger for women in the upper and middle wealth terciles compared to the lowest wealth tercile. Initially less-privileged women gain little from urbanization in the attitudes toward IPV, resulting in increased inequality in women’s empowerment in the short and medium term.

The effect of price support policies under productivity shocks: Evidence from an economywide model

Agricultural mechanisation and gendered labour activities across sectors: Micro-evidence from multi-country farm household data

The gender difference in employment across sectors is a critical element of gender inequality in rural livelihoods and welfare in developing countries. The role of production technologies, including agricultural mechanisation, in addressing gender inequality is increasingly explored. Knowledge gaps remain, however, including how agricultural mechanisation differentially affects labour engagements across sectors. This study aims to partly fill these knowledge gaps through micro‐evidence from seven countries (Ethiopia, Ghana, Nigeria, Tanzania, India, Nepal and Vietnam), using several nationally representative panel data and supplementary data and applying correlated random effects double‐hurdle models with instrumental variables. We find that the use of tractors and/or combine harvesters by the household induces a greater shift from farm activities to non‐farm activities by female members than by male members. While statistical significance varies, these patterns generally hold consistently across all seven countries studied. These patterns also hold across different farm sizes. While these are short‐term relations, agricultural mechanisation proxied by tractors and/or combine harvesters is one of the crucial contributors to gendered rural livelihood. Future studies should more closely investigate these patterns' underlying mechanisms and implications.

Does access to improved grain storage technology increase farmers' welfare? Experimental evidence from maize farming in Ethiopia

Seasonal price variability for cereals is two to three times higher in Africa than on the international reference market. Seasonality is even more pronounced when access to appropriate storage and opportunities for price arbitrage are limited. As smallholder farmers typically sell their production after harvest, when prices are low, this leads to lower incomes as well as higher food insecurity during the lean season, when prices are high. One solution to reduce seasonal stress is the use of improved storage technologies. Using data from a randomised controlled trial, in a major maize-growing region of Western Ethiopia, we study the impact of hermetic bags, a technology that protects stored grain against insect pests, so that the grain can be stored longer. Despite considerable price seasonality—maize prices in the lean season are 36% higher than after harvesting—we find no evidence that hermetic bags improve welfare, except that access to these bags allowed for a marginally longer storage period of maize intended for sale by 2 weeks. But this did not translate into measurable welfare gains as we found no changes in any of our welfare outcome indicators. This ‘near-null’ effect is due to the fact that maize storage losses in our study region are relatively lower than previous studies suggested—around 10% of the quantity stored—likely because of the widespread use of an alternative to protect maize during storage, for example a cheap but highly toxic fumigant. These findings are important for policies that seek to promote improved storage technologies in these settings.

Getting ahead of the game: Experiential learning for groundwater governance in Ethiopia

Groundwater management is highly complex, with many users sharing the same resource often with limited understanding of their interconnectedness. Behavioral experiments (games) that simulate real-life common-pool resource use have shown promise as an experiential learning tool for improving resource governance. This study pilots an experiential learning intervention in Ethiopia using a groundwater game to help raise awareness of groundwater over-extraction and improve understanding of the importance of collective action in governance. In the Meki River catchment in Ethiopia, small-scale irrigation is expanding, but overextraction and competition over groundwater have not yet reached alarming levels. The groundwater game, adapted from India and including the addition of a rule-making round, was played in 15 villages with 30 groups. The game was accompanied by subsequent community-wide debriefing in each village to reflect on the experience and lessons learned, which stimulated discussions about groundwater governance. We surveyed participants to capture individual mental models regarding groundwater use and management, as well as any immediate learning effects. Focus group discussions in each village prior to the intervention and again six months after the intervention assessed possible lasting effects. The findings indicate cognitive, normative and relational learning, including increased understanding of groundwater dynamics (such as the joint effect of diverse water uses and users), the importance of collective action in resource management, and the benefits of communication. We find gendered differences in decision-making about resource extraction in the game and development of group-level resource management, confirming the need for gender-responsive approach to sustainable groundwater management interventions. We discuss community-wide learning and institution-building, and considerations for future intervention designs. We recommend embedding experiential learning, facilitated by local extension officers and other practitioners, in intervention packages that include both technical assistance on water-conserving technologies and groundwater management approaches and support in building communities’ institutional capacity.

Barriers to appropriate complementary feeding and the use of ultra‐processed foods: A formative qualitative study from rural Oromia, Ethiopia

Children's consumption of ultra-processed foods (UPF) is increasing in Ethiopia, but relatively little is known about the specific feeding practices that underlie this pattern. The objective of this study was to explore patterns of consumption of UPF by infants and young children within a broader context of inappropriate complementary feeding practices in extremely poor households in rural Oromia, Eastern Ethiopia. A formative qualitative study was conducted using semistructured interview questionnaires developed drawing on a socioecological model. A total of 16 focus group discussions with mothers (45 respondents), fathers (21 respondents) and grandmothers (23 respondents) of children aged 6–23 months in households that were beneficiaries of the Productive Safety Net Program were conducted, along with four key informant interviews with health workers. Qualitative transcripts were complemented with field notes before qualitative content analysis was applied. The key findings suggest that UPF were widely provided to infants and young children as part of a pattern of suboptimal complementary feeding, including both early and late initiation of complementary foods. In particular, UPF (including juice, biscuits and lipid-based nutrient supplements) were diluted with or dissolved in water and fed to infants via bottle, often before the recommended age of initiation of 6 months. Mothers and caregivers reported that they perceived the products to be affordably priced and packaged, ready to use and convenient given their time constraints. The level of consumption of UPF and its effects on infant and young child feeding feeding practices and children's nutritional status in rural Ethiopia should be further explored.

Evaluating the impacts of watershed rehabilitation and irrigation interventions on vegetation greenness and soil erosion using remote sensing and biophysical modelling in Feresmay watershed in Ethiopia

Soil erosion and subsequent land degradation undermine efforts to ensure food security and environmental sustainability in Ethiopia. The government of Ethiopia has implemented extensive soil and water conservation (SWC) programs in severely degraded and food-insecure areas of the country, in some cases integrated with subsequent or parallel irrigation development. However, the effectiveness of these interventions has not been extensively evaluated. This study, therefore, evaluates the performance and impacts of SWC practices in terms of improving vegetation greenness and reducing soil erosion in Feresmay watershed in Ethiopia. Long-term Landsat-based Normalised Difference Vegetation Index (NDVI), Revised Universal Soil Loss Equation (RUSLE), and Soil and Water Assessment Tool (SWAT) were used for change-detection analysis before and after the implementation of various SWC interventions. The results revealed the positive impacts of SWC interventions in improving the vegetation greenness and soil erosion reduction although the outcome varied by intervention. Increased vegetation greenness was observed largely in areas where area closure with catchment treatment (ACCT) and impacts of irrigation (IRR) interventions are dominant, while relatively little impact was observed at the watershed level analysis. Although these interventions helped to reduce soil loss, the results highlighted the need for more SWC interventions to minimise further soil loss.

Smallholder maize yield estimation using satellite data and machine learning in Ethiopia

The lack of timely, high-resolution data on agricultural production is a major challenge in developing countries where such information can guide the allocation of scarce resources for food security, agricultural investment and other objectives. While much research has suggested that remote sensing can potentially help to address these gaps, few studies have indicated the immediate potential for large-scale estimations over both time and space. In this study we described a machine learning approach to estimate smallholder maize yield in Ethiopia, using well-measured and broadly distributed ground truth data and freely available spatiotemporal covariates from remote sensing. A neural networks model outperforms other algorithms in our study. Importantly, our work indicates that a model developed and calibrated on a previous year’s data can be used to reasonably estimate maize yield in the subsequent year. Our study suggests the feasibility of developing national programs for the routine generation of broad-scale, high-resolution estimates of smallholder maize yield, including seasonal forecasts, on the basis of machine learning algorithms and well-measured ground control data and currently existing time series satellite data.

Synergies and trade-offs between agricultural export promotion and food security: Evidence from African economies

Several countries across the developing world have designed and implemented agricultural export incentives. However, little is known about the effects of these policies on various aspects of domestic food security. This study utilizes economywide models linked top-down with microsimulation modules to analyze the impacts of increased agricultural export promotion on the four dimensions of food security – availability, access, utilization, and stability – in three structurally food-insecure economies of Ethiopia, Kenya, and Uganda. We find that agro-export promotion adversely affects all four aspects of food security in urban areas and at the national level due to significant increases in food prices domestically. However, it generally benefits households in rural areas. The food security effects are stronger in Ethiopia and Kenya. We also find that risks associated with the volatility in international markets and declines in domestic productivity can lead to further deterioration in access to food when countries implement outward-oriented agricultural policies

Challenges and experience of the Ethiopian rural health extension program: Implications for reform and revitalization

Background Despite remarkable gains over the past decade, mounting evidence suggests that Ethiopia’s rural health extension program (HEP) is facing serious implementation challenges. We investigated the current and potential future program design and implementation challenges of Ethiopia’s rural HEP based on the lived experiences of health extension workers (HEW) implementing the program at the grassroots level. Methods We employed a longitudinal qualitative exploration linked to a larger cluster-randomized trial (RCT) which was implemented in 282 villages randomly selected from 18 Kebeles of the Gedeo zone, southern Ethiopia. Data were collected using in-depth interviews with key informants, focus group discussion, and passive observation of program implementation. The data were analyzed manually using a thematic framework analysis approach. Themes and sub-themes were generated by condensing, summarizing, and synthesizing data collected in the field in the form of extended notes and field observation checklists. Findings Despite considerable gains in availing basic health services to the rural population, HEP seems to suffer serious design and implementation flaws that demand thoughtful and immediate adjustment. The design constraints span from the number and type of intervention packages to the means of dissemination (vehicle) as well as the target population emphasized. As such, some low-cost high-impact interventions that were strongly desired by the community were overlooked, while others were inappropriately packed. The means of distribution - female health extension workers trained with basic prevention skills, were lacking essential skills. They also had high burnout rates and with little engagement with men, were repeatedly mentioned flaws of the program demanding revitalization. Furthermore, the sheer structure of HEP precluded adult and adolescent men, non-reproductive women, and the elderly. Conclusion Despite significant gains over the last couple of months, Ethiopia’s rural HEP appears to have reached a tipping point that requires a comprehensive revamp of the program package, means of distribution, and target beneficiaries rather than the “usual” tweaks to reap maximum benefits.

Access to water, sanitation and hygiene (WASH) services and drinking water contamination risk levels in households of Bishoftu Town, Ethiopia: A cross-sectional study

Background and Aims
Access to safe drinking water, sanitation, and hygiene is a fundamental human right and essential to control infectious diseases. However, many countries, including Ethiopia, do not have adequate data to report on basic water, sanitation, and hygiene (WASH) services. Although contaminated drinking water spreads diseases like cholera, diarrhea, typhoid, and dysentery, studies on drinking water contamination risk levels in households are limited in Ethiopia. Therefore, closing this gap needs investigation.

Methods
A community-based cross-sectional study was conducted. A total of 5350 households were included. A systematic, simple random sampling technique was used to select the participants. The information was gathered through in-person interviews using a standardized questionnaire. Furthermore, 1070 drinking water samples were collected from household water storage.

Results
This investigation revealed that 9.8%, 83.9%, and 4.9% of households used limited, basic, and safely managed drinking water services, respectively. Besides, 10.2%, 15.7% and 59.3% of households used safely managed, basic and limited sanitation services, respectively. Yet, 10.6% and 4.2% of households used unimproved sanitation facilities and open defecation practices. Also, 40.5% and 19.4% of households used limited and basic hygiene services. On the other hand, 40.1% of households lacked functional handwashing facilities. In this study, 12.1%, 26.3%, and 42% of households’ drinking water samples were positive for Escherichia coli, fecal coliforms, and total coliforms, respectively. Also, 5.1% and 4.5% of households’ drinking water samples had very high and high contamination risk levels for E. coli, respectively. We found that 2.5% and 11.5% of households and water distributors had unacceptable fluoride concentrations, respectively.

Conclusion
The majority of households in Bishoftu town lack access to safely managed sanitation, drinking water, and basic hygiene services. Many households’ water samples had very high and high health risk levels. Hence, the government and partner organizations should implement water and sanitation safety plans.

The new normal? Cluster farming and smallholder commercialization in Ethiopia

Cluster farming is increasingly recognized as a viable means of improving smallholder economic integration and commercialization in many developing countries. However, little is known about its impact on smallholder welfare and livelihoods. We examine the relationship between cluster farming and smallholder commercialization using a large-scale survey of 3969 farm households in Ethiopia cultivating high-acreage crops such as teff, wheat, maize, barley, and sesame. Using switching regressions and instrumental variable estimators, we show that cluster farming is associated with commercialization measured as commercialization index, market surplus value, and market price. To further deal with endogeneity concerns, we also employ some pseudo-panel models where we observe similar insights. Beyond this, we account for heterogeneities by disaggregating households based on farm scales and crops cultivated. Our findings show that cluster farming is positively associated with commercialization for all farms and crop types despite this disaggregation. However, the related gains are higher among medium and large farms and vary per crop type. These findings imply that cluster farming is crucial in improving smallholder commercialization and may be a critical entry and leveraging point for policy. We thus lend support to initiatives and plans that seek to upscale cluster farming as they can potentially improve smallholder commercialization with ensuing impacts on rural livelihoods and welfare.

Developing feasible healthy diets for Ethiopian women of reproductive age: A linear goal programming approach

Objective:
To develop a healthy diet for Ethiopian women closely resembling their current diet and taking fasting periods into account while tracking the cost difference.

Design:
Linear goal programming models were built for three scenarios (non-fasting, continuous fasting and intermittent fasting). Each model minimised a function of deviations from nutrient reference values for eleven nutrients (protein, Ca, Fe, Zn, folate, and the vitamins A, B1, B2, B3, B6, and B12). The energy intake in optimised diets could only deviate 5 % from the current diet.

Settings:
Five regions are included in the urban and rural areas of Ethiopia.

Participants:
Two non-consecutive 24-h dietary recalls (24HDR) were collected from 494 Ethiopian women of reproductive age from November to December 2019.

Results:
Women’s mean energy intake was well above 2000 kcal across all socio-demographic subgroups. Compared to the current diet, the estimated intake of several food groups was considerably higher in the optimised modelled diets, that is, milk and dairy foods (396 v. 30 g/d), nuts and seeds (20 v. 1 g/d) and fruits (200 v. 7 g/d). Except for Ca and vitamin B12 intake in the continuous fasting diet, the proposed diets provide an adequate intake of the targeted micronutrients. The proposed diets had a maximum cost of 120 Ethiopian birrs ($3·5) per d, twice the current diet’s cost.

Conclusion:
The modelled diets may be feasible for women of reproductive age as they are close to their current diets and fulfil their energy and nutrient demands. However, the costs may be a barrier to implementation.

Food safety and incipient modern value chains: Evidence from milk in Ethiopia

Modern marketing arrangements are increasingly being implemented to assure improved food quality and safety. However, it is not well known how these modern marketing arrangements perform in early stages of roll-out. We study this issue in the case of rural–urban milk value chains in Ethiopia, where modern processing companies—selling branded pasteurized milk—and modern retail have expanded rapidly in recent years. We find overall that the adoption levels of hygienic practices and practices leading to safer milk by dairy producers in Ethiopia are low and that there are no significant improvements in the incipient modern milk value chains compared to traditional ones. While suppliers to modern processing companies are associated with more formal milk testing, they do not obtain price premiums for the adoption of improved practices, nor do they obtain higher prices overall. At the urban retail level, we find there are only small price differences between pasteurized and raw milk and that modern retailers sell pasteurized milk at lower prices, ceteris paribus. Modern value chains to better reward hygiene and food safety in these settings are therefore called for.

Feasibility and impact of school-based nutrition education interventions on the diets of adolescent girls in Ethiopia: a non-masked, cluster-randomised, controlled trial

Background Adolescence is a critical period of physical and psychological development, especially for girls, because poor nutrition can affect their wellbeing as well as that of their children. We aimed to assess the feasibility and impact of a package of nutrition education interventions delivered through public primary schools on the diets of adolescent girls in Ethiopia. Methods In this non-masked, cluster-randomised, controlled trial, primary schools (clusters) in the Southern Nations, Nationalities, and People's Region and Somali region of Ethiopia were randomly allocated to the intervention group (nutrition information provided during flag ceremonies, classroom lessons, school club meetings, peer group mentoring, BMI measurement and counselling, and parent–teacher meetings) or the control group (standard academic curriculum on health and nutrition) by use of computer-generated pseudo-random numbers. Duration of the school-based interventions was 4 months, and the key messages were related to dietary diversity (eating a variety of foods), energy adequacy (eating breakfast and healthy snacks), and healthy food choices (avoiding junk foods). Adolescent girls were eligible for participation if aged 10–14 years and enrolled in grades 4–8 in a study school. Data were collected with two independent cross-sectional surveys: baseline before the start of implementation and endline 1·5 years later. The primary outcome of impact was dietary diversity score, defined as the number of food groups (out of ten) consumed over the previous 24 h using a list-based method, and minimum dietary diversity, defined as the proportion of girls who consumed foods from at least five of the ten food groups, in the intention-to-treat population. We also assessed intervention exposure as a measure of feasibility. We estimated intervention effects using linear regression models for mean differences at endline, with SEs clustered at the school level, and controlled for adolescent age, region, household food security, and wealth. The trial is registered with ClinicalTrials.Gov, NCT04121559, and is complete. Findings 27 primary schools were randomly allocated to the intervention group and 27 to the control group. Between March 22 and April 29, 2021, 536 adolescent girls participated in the endline survey (270 in the intervention group and 266 in the control group), with median age of 13·3 years (IQR 12·1–14·0). At endline, the dietary diversity score was 5·37 (SD 1·66) food groups in the intervention group and 3·98 (1·43) food groups in the control group (adjusted mean difference 1·33, 95% CI 0·90–1·75, p<0·0001). Increased minimum dietary diversity was also associated with the intervention (182 [67%] of 270 in the intervention group vs 76 [29%] of 266 in the control group; adjusted odds ratio 5·37 [95% CI 3·04–9·50], p<0·0001). 256 (95%) of 270 adolescent girls in the intervention group were exposed to at least one of the five in-school intervention components. Interpretation Integrating nutrition interventions into primary schools in Ethiopia was feasible and increased dietary diversity incrementally among adolescent girls, but could be limited in changing other food choice behaviours, such as junk food consumption, based on nutrition education alone.

Biofortification in Ethiopia: Opportunities and challenges

Children younger than 5 years and women of reproductive age often suffer from micronutrient deficiencies. Biofortification, which involves enriching staple crops with micronutrients, is a nutritional intervention focused on addressing micronutrient deficiencies. It is equitable, sustainable, and costs less than other nutritional interventions.This study investigates biofortification in Ethiopia, considering 6 globally biofortified crops, 5 of which are currently being biofortified in Ethiopia. However, only 2 of these crops are important in the consumption baskets of most Ethiopians. Therefore, efforts to mainstream biofortification should begin with studies to identify crops that have larger impacts in reducing local micronutrient deficiencies and their cost-effectiveness.Literature was searched between July and December 2021 using Google Scholar to provide insights into the state of biofortification in Ethiopia. Key-informant interviews were conducted to gain insights into the state of biofortification in Ethiopia and to identify bottlenecks for scaling up the production and consumption of biofortified foods. Furthermore, Annual Agriculture Sample Survey and 2015/16 Ethiopian Household Consumption and Expenditure Survey data were used to describe the area under production of biofortifiable crops and their importance in total consumption, respectively.Mainstreaming biofortification in Ethiopia faces several challenges. Policy documents appear to be inconsistent, regressive, and vague regarding biofortification. Critically, there is no specific institution to oversee and/or coordinate biofortification-related activities.Overall, the success of biofortification depends upon a strong coordination body with clear mandates from detailed policies; adequate funding for research and development; and robust monitoring and evaluation of the identified production, adoption, and consumption issues.

Water stress dominates the projected maize yield changes in Ethiopia

Comprehensive approach for improving adherence to prenatal Iron and folic acid supplements based on intervention studies in Bangladesh, Burkina Faso, Ethiopia, and India

The World Health Organization recommends daily iron and folic acid (IFA) supplementation during pregnancy, but consumption remains low, and high prevalence of anemia among pregnant women (PW) persists.This study aims to (1) examine factors at the health system, community, and individual levels, which influence adherence to IFA supplements; and (2) describe a comprehensive approach for designing interventions to improve adherence based on lessons learned from 4 country experiences.We conducted literature search, formative research, and baseline surveys in Bangladesh, Burkina Faso, Ethiopia, and India and applied health systems strengthening and social and behavior change principles to design interventions. The interventions addressed underlying barriers at the individual, community, and health system levels. Interventions were further adapted for integration into existing large-scale antenatal care programs through continuous monitoring.Key factors related to low adherence were lack of operational protocols to implement policies, supply chain bottlenecks, low capacity to counsel women, negative social norms, and individual cognitive barriers. We reinforced antenatal care services and linked them with community workers and families to address knowledge, beliefs, self-efficacy, and perceived social norms. Evaluations showed that adherence improved in all countries. Based on implementation lessons, we developed a program pathway and details of interventions for mobilizing health systems and community platforms for improving adherence.A proven process for designing interventions to address IFA supplement adherence will contribute to achieving global nutrition targets for anemia reduction in PW. This evidence-based comprehensive approach may be applied in other countries with high anemia prevalence and low IFA adherence.

Ownership of small livestock species, but not aggregate livestock, is associated with an increased risk of anemia among children in Ethiopia: A propensity score matching analysis

Consumption of animal source foods, through livestock production, improves children's growth and micronutrient status. However, research on the relationship between livestock ownership and childhood anemia has produced conflicting results. The current study used robust analytical approaches to examine the effect of household livestock ownership on children's anemia using the most recent secondary data from the national demographic and health survey. We followed a 1:1 closest neighborhood propensity score matching analysis. A propensity score was generated using the binary logistic regression model to compute the probability of owning livestock. From a total of 18,008 households enrolled in the latest Ethiopian Demographic and Health Survey (EDHS 2016), data of 721 index children aged 6–59 months from households owning livestock were matched with a comparable number (721) of children from households without livestock. The paired and independent t-test, matched relative risk (RR), and standardized mean differences were used to compare the distributions of hemoglobin concentration and anemia risks between treatment and control groups. Anemia was found in more than half (54.1% and 58.8%) of children aged 6–59 months from livestock-owning and nonowning families, respectively (p > .05). Aggregate ownership of livestock was not associated with hemoglobin concentration or anemia status (RR = 0.95, 95% confidence interval [95% CI] [0.87–1.04]). Species-wise, poultry was associated with a lower (RR = 0.88, 95% CI [0.84–0.95]) anemia risk, while ownership of goat/sheep was associated with higher (RR = 1.10, 95% CI [1.03–1.17]) risk. In conclusion, ownership of small livestock species (sheep/goats and poultry), but not aggregate livestock ownership, was associated with the risk of anemia among children in Ethiopia. Therefore, agriculture-sensitive nutrition, with a One Health lens approach, is recommended to mitigate the high burden of anemia among children in Ethiopia. In the future, a well-controlled interventional study with more extended periods may be required to fully understand the effects of livestock production and highlight the differences seen across livestock species.

Near-real-time welfare and livelihood impacts of an active war: Evidence from Ethiopia

Ethiopia recently experienced a large-scale war that lasted for more than two years. Using unique High-Frequency Phone Survey (HFPS) data, which span several months before and after the outbreak of the war, this paper provides evidence on the immediate impacts of the conflict on households’ food security. We also assess potential mechanisms and evaluate impacts on proximate outcomes, including on livelihood activities and access to food markets. We use difference-in-differences and two-way fixed effects estimation to compare trends across affected and unaffected regions (households) and before and after the outbreak of the war. Seven months into the conflict, we find that the war was associated with a 37 percentage points increase in the probability of moderate to severe food insecurity. Using the Armed Conflict Location and Event Data (ACLED), we show that exposure to an additional battle leads to a 1 percentage point increase in the probability of moderate or severe food insecurity. The conflict was associated with significant reduction in access to food through supply chain disruptions and by curtailing non-farm livelihood activities. Non-farm and wage related activities were affected the most, whereas farming activities were relatively more resilient. Our estimates, which likely underestimate the true average effects on the population, constitute novel evidence on the near-real-time impacts of large-scale conflict. Our work highlights the potential of HFPS to monitor active and large-scale conflicts, especially in contexts where conventional data sources are not immediately available.

Towards understanding vegetable and fruit markets for improved consumption and nutrition: The case of Ethiopia

Dietary recommendations for Ethiopians on the basis of priority diet-related diseases and causes of death in Ethiopia: An umbrella review

Food-based dietary guidelines (FBDG) need to be evidence-based. As part of the development of Ethiopian FBDG, we conducted an umbrella review to develop dietary recommendations. Protein-energy malnutrition (PEM), deficiencies of vitamin A, zinc, calcium, or folate, cardiovascular diseases (CVD), and type 2 diabetes mellitus (T2DM) were selected as a priority. Systematic reviews were eligible if they investigated the impact of foods, food groups, diet, or dietary patterns on priority diseases. After a search, 1513 articles were identified in PubMed, Scopus, and Google Scholar published from January 2014 to December 2021. The results showed that 19 out of 164 systematic reviews reported the impact of diet on PEM or micronutrient deficiencies. Daily 30–90 g whole-grain consumption reduces risk of CVD and T2DM. Pulses improve protein status, and consuming 50–150 g/d is associated with a reduced incidence of CVD and T2DM. Nuts are a good source of minerals, and consuming 15–35 g/d improves antioxidant status and is inversely associated with CVD risk. A daily intake of 200–300 mL of milk and dairy foods is a good source of calcium and contributes to bone mineral density. Limiting processed meat intake to <50 g/d reduces CVD risk. Fruits and vegetables are good sources of vitamins A and C. CVD and T2DM risks are reduced by consuming 200–300 g of vegetables plus fruits daily. Daily sugar consumption should be below 10% of total energy to lower risk of obesity, CVD, and T2DM. Plant-based fat has favorable nutrient profiles and modest saturated fat content. The association of saturated fatty acids with CVD and T2DM is inconclusive, but intake should be limited because of the low-density lipoprotein cholesterol-raising effect. Plant-based diets lower risk of CVD and T2DM but reduce micronutrient bioavailability. The review concludes with 9 key dietary recommendations proposed to be implemented in the Ethiopian FBDG. This review was registered at PROSPERO (CRD42019125490).

Associations of WHO/UNICEF Joint Monitoring Program (JMP) Water, Sanitation and Hygiene (WASH) Service Ladder service levels and sociodemographic factors with diarrhoeal disease among children under 5 years in Bishoftu town, Ethiopia: a cross-sectional study

Objective: To determine the associations of WHO/UNICEF Joint Monitoring Program Water, Sanitation and Hygiene (WASH) Service Ladder service levels and sociodemographic factors with diarrhoeal disease among children under 5 years in Bishoftu town, Ethiopia.

Design: A community-based cross-sectional study.

Setting: Bishoftu town, Ethiopia, January–February 2022.

Participants: A total of 1807 mothers with at least one child under 5 years were included. Sociodemographic and WASH variables were collected using a structured questionnaire. 378 drinking water samples were collected.

Outcome: The response variable was diarrhoeal disease among children under 5 years.

Results: The 2-week prevalence of diarrhoeal disease among children under 5 years was 14.8%. Illiteracy (adjusted OR 3.15; 95% CI 1.54 to 6.47), occupation (0.35; 0.20 to 0.62), mother’s age (1.63; 1.15 to 2.31), family size (2.38; 1.68 to 3.39), wealth index (5.91; 3.01 to 11.59), residence type (1.98; 1.35 to 2.90), sex of the child (1.62; 1.17 to 2.24), child’s age (3.52; 2.51 to 4.93), breastfeeding status (2.83; 1.74 to 4.59), food storage practice (3.49; 1.74 to 8.26), unimproved drinking water source (8.16; 1.69 to 39.46), limited drinking water service (4.68; 1.47 to 14.95), open defecation practice (5.17; 1.95 to 13.70), unimproved sanitation service (2.74; 1.60 to 4.67), limited sanitation service (1.71; 1.10 to 2.65), no hygiene service (3.43; 1.91 to 6.16) and limited hygiene service (2.13; 1.17 to 3.86) were significantly associated with diarrhoeal disease.

Conclusion: In this study, diarrhoea among children is a significant health issue. Child’s age, drinking water service, residence type and hygiene service were the largest contributors with respect to the prevalence of diarrhoeal disease. This investigation provides information that could help to inform interventions to reduce childhood diarrhoea. The findings suggest that state authorities should initiate robust WASH strategies to achieve the Sustainable Development Goal 3 agenda.

Toward a better understanding of the environmental impacts of expanding farmer-led irrigation in Sub-Saharan Africa: An exploratory assessment of irrigation-induced risk of nutrient water pollution in Ethiopia

Irrigation, and especially farmer-led irrigation, is considered to be a promising option for enhancing agricultural productivity in Sub-Saharan Africa. However, there is a lack of thorough understanding of the impacts of irrigation development on environment. Past discussions are mainly limited to the water depletion and hydrological regime change effect of irrigation. This paper presents a study to narrow the knowledge gap by assessing nutrient water pollution risk induced by the expansion of farmer-led irrigation in Ethiopia. Using household survey data collected from four woredas in Ethiopia where irrigated crop production currently concentrates, we first evaluate the impact of irrigation on cropping intensity and annual consumption level of fertilizers and then use the findings of the household survey data analysis to support conceptualization of a modeling framework for assessing agricultural nutrient water pollution risk from farmer-led irrigation development in Ethiopia at national scale. We project that overall farmer-led irrigation development in Ethiopia will lead to a gentle increase in national total of agricultural nutrient loadings. This result helps justify the endeavor of promoting farmer-led irrigation in Ethiopia. On the other hand, the projected nutrient flow and nutrient loading growth rate related to the farmer-led irrigation expansion are highly heterogeneous spatially, and risk of local water quality deterioration exists. There is still need to make investment to ensure the environmental sustainability of farmer-led irrigation development.

Assessing multicountry programs through a “Reach, Benefit, Empower, Transform” lens

The feasibility of implementing food-based dietary guidelines and food graphics in Ethiopia

This study aimed to test the acceptability, cultural appropriateness, consumers' understanding, and practicality of the Ethiopian food-based dietary guideline's messages, tips, and food graphics. A qualitative study design was applied with focus group discussions and key informant interviews. Four different participant groups were included: 40 consumers, 15 high-level nutrition experts, 30 frontline community health extension workers (HEWs), and 15 agriculture extension workers (AEWs) to incorporate different stakeholder perspectives. Data collection was conducted using 7 focus group discussions (FGDs) and 30 key informant interviews (KIIs). Collected data were coded and analyzed using QSR International NVivo V.11 software. Most of the study participants were highly interested in implementing the dietary guidelines once these guidelines are officially released. Based on the participants' views, most of the messages align with the current nutrition education materials implemented in the country except the messages about physical activity and alcohol intake. However, participants suggested defining technical terms such as ultra-processing, whole grain, safe and balanced diet in simpler terms for a better understanding. Practicality, affordability, availability, and access to the market were the major barriers reported for adherence to the guidelines. To be more inclusive of cultural and religious beliefs, findings show that the guideline should address fasting and traditional cooking methods. In conclusion, the dietary guidelines were well received by most stakeholders. They are thought to be feasible once feedback on wording, affordability, availability, and access is considered in the messages, tips, and graphic designs.

Video-based behavioral change communication to change consumption patterns: Experimental evidence from urban Ethiopia

Poor diet quality has been identified as a primary driver of malnutrition and increasing burden of noncommunicable diseases in low- and middle-income countries. Low fruit and vegetable consumption contributes to poor diet quality. We experimentally assess whether videos embedded messages about increasing fruit and vegetable consumption affect consumption. Four months after viewing either a basic video or a video that explains why fruits and vegetables can improve health and nutrition outcomes, average household consumption of fruits and vegetables increased by about 9% in both treatment groups relative to the control group, both in kilocalorie and consumption expenditure terms.

Assessing the application of gender perspectives in land restoration studies in Ethiopia using text mining

Restoration of degraded land is key to enhancing land productivity and farmers' wellbeing in sub-Saharan Africa. Evidence shows that the benefits of land restoration are tremendous, ranging from biophysical benefits in soil health, agricultural productivity, ecosystem services, to socio-economic dimensions such as improving farmers’ income and livelihoods. Yet one issue that is rarely considered is how the outcomes of restoration initiatives affect different social groups, specifically women, men, and the marginalized. Our study aims to understand the extent of gender and social inclusion in land restoration studies in Ethiopia. Through analyzing 314 peer-reviewed scientific articles on land restoration initiatives and studies for Ethiopia published between 1985 and 2020, we aimed to: i) develop a novel approach that would allow for the semi-automatization of analyzing gender aspects in a large set of scientific documents using machine learning techniques, ii) assessed the current evidence on gender integration in peer-reviewed studies related to RDL, and iii) identified what gender issues are discussed in RDL literature. We employed text mining techniques to analyze the literature for keywords and to classify articles into three main classes: gender blind, gender sensitive, and gender transformative, based on the extent to which gender and social inclusion keywords appeared in the studies. Our analysis showed that gender and social inclusion are rarely considered in landscape restoration studies in Ethiopia, as most studies and interventions are heavily focused on the biophysical and environmental aspects of restoration. Despite an exponential increase in the use of gender and social inclusion keywords after 2005, most of the research (58 percent of articles) remains gender blind. The most frequently used related terms remained generic, e.g. community, access, participatory, and tenure. Only 38% of the studies could be classified as gender sensitive to a certain degree, and a strikingly low number of articles (4 percent) ― which consider the systematic challenges women face ― could be defined as gender transformative. This implies that scientific evidence about how land restoration has benefited men and women, and to what extent it could transform gender and power dynamics, is lacking. Our findings demonstrate the urgent need to consider gender and social inclusion to ensure associated benefits of land restoration practices.

Cash plus programming and intimate partner violence: A qualitative evaluation of the benefits of group-based platforms for delivering activities in support of the Ethiopian government's Productive Safety Net Programme (PSNP)

Objectives: Intimate partner violence (IPV) is a public health challenge but there is evidence that cash and cash ‘plus’ interventions reduce IPV. An increasingly popular design feature of these kind of interventions is the group-based modality for delivering plus activities, however, evidence of the mechanisms through which this modality of delivery impacts IPV is limited. We explore how the group-based modality of delivering plus activities that complemented the Government of Ethiopia’s Productive Safety Net Programme contributed to modifying intermediate outcomes on the pathway to IPV. Design: Qualitative study using in-depth interviews and focus group discussions between February and March 2020. Data were analysed using a thematic content and gender lens approach. Findings were interpreted, refined and drafted in collaboration with our local research partners. Setting: Amhara and Oromia regions in Ethiopia. Participants: In total 115 men and women beneficiaries from the Strengthen PSNP4 Institutions and Resilience (SPIR) programme took part in the study. Fifty-eight were interviewed and 57 took part in 7 focus group discussions. Results: We found that Village Economic and Social Associations—through which SPIR activities were delivered—improved financial security and increased economic resilience against income shocks. The group-based delivery of plus activities to couples appeared to enhance individual agency, collective power and social networks, which in turn strengthened social support, gender relations and joint decision-making. Critical reflective dialogues provided a reference group to support the shift away from social norms that condone IPV. Finally, there appeared to be gender differences, with men highlighting the financial benefits and enhanced social status afforded by the groups, whereas women’s accounts focused primarily on strengthened social networks and social capital. Conclusion: Our study offers important insights into the mechanisms by which the group-based delivery of plus activities affects intermediate outcomes on the pathway to IPV. It underscores the importance of the modality of delivery in such programmes, and suggests that policy-makers should consider gender-specific needs as men and women might differentially benefit from interventions that enhance social capital to generate gender transformative impacts.

Antenatal care is associated with adherence to iron supplementation among pregnant women in selected low-middle-income-countries of Asia, Africa, and Latin America & the Caribbean regions: Insights from Demographic and Health Surveys

Anaemia is a global public health problem affecting 800 million women and children globally. Anaemia is associated with perinatal mortality, child morbidity and mortality, mental development, immune competence, susceptibility to lead poisoning and performance at work. The objective of this article is to identify whether antenatal care-seeking was associated with the uptake of iron supplementation among pregnant women, adjusting for a range of covariates. This article used data from the cross-sectional recent Demographic and Health Surveys (DHS) of 12 countries in Asia, Africa and Latin America & the Caribbean regions. The individual-level data from 273,144 women of reproductive age (15−49 years) were analysed from multi-country DHS. Multiple Logistic regression analyses were conducted using Predictive Analytics Software for Windows (PASW), Release 18.0. Receiving at least four antenatal care visits was significantly associated with the consumption of 90 or more iron-containing supplements in 12 low and middle income countries across three regions after adjusting for different household and respondent characteristics, while mass media exposure was found to be a significant predictor in India and Indonesia. Antenatal care seems to be the most important predictor of adherence to iron intake in the selected countries across Africa, Asia, Latin America and Caribbean regions.

Comparison of total body vitamin A stores using individual versus population 13C-natural abundance of serum retinol in preschool children and women residing in 6 diverse African countries

Background
Stable isotope techniques using 13C to assess vitamin A (VA) dietary sources, absorption, and total body VA stores (TBSs) require determination of baseline 13C abundance. 13C-natural abundance is approximately 1.1% total carbon, but varies with foods consumed, supplements taken, and food fortification with synthetic retinyl palmitate.

Objectives
We determined 13C variation from purified serum retinol and the resulting impact on TBSs using pooled data from preschool children in Burkina Faso, Cameroon, Ethiopia, South Africa, Tanzania, and Zambia and Zambian women.

Methods
Seven studies included children (n = 639; 56 ± 25 mo; 48% female) and one in women (n = 138; 29 ± 8.5 y). Serum retinol 13C-natural abundance was determined using GC-C-IRMS. TBSs were available in 7 studies that employed retinol isotope dilution (RID). Serum CRP and α1-acid-glycoprotein (AGP) were available from 6 studies in children. Multivariate mixed models assessed the impact of covariates on retinol 13C. Spearman correlations and Bland–Altman analysis compared serum and milk retinol 13C and evaluated the impact of using study- or global-retinol 13C estimates on calculated TBSs.

Results
13C-natural abundance (%, median [Q1, Q3]) differed among countries (low: Zambia, 1.0744 [1.0736, 1.0753]; high: South Africa, 1.0773 [1.0769, 1.0779]) and was associated with TBSs, CRP, and AGP in children and with TBSs in women. 13C-enrichment from serum and milk retinol were correlated (r = 0.52; P = 0.0001). RID in children and women using study and global estimates had low mean bias (range, −3.7% to 2.2%), but larger 95% limits of agreement (range, −23% to 37%).

Conclusions
13C-natural abundance is different among human cohorts in Africa. Collecting this information in subgroups is recommended for surveys using RID. When TBSs are needed on individuals in clinical applications, baseline 13C measures are important and should be measured in all enrolled subjects.

The gendered impacts of index-insurance on food-consumption: Evidence from southern Ethiopia

Index insurance has been promoted as an innovative strategy for enhancing long-term resilience to climate-related shocks and providing financial inclusion, particularly to poor women farmers in developing countries. In this paper, we evaluate the gendered impact of an index-based livestock insurance product on food consumption among pastoral households in southern Ethiopia. We exploit intertemporal variation in household risk exposure and insurance payouts to evaluate the ex ante and ex post insurance impacts and use randomly distributed discount coupons to instrument the insurance purchase variables. We find that during the pre-drought period, a previous season insurance purchase and the intensity of insurance coverage significantly and equally reduces food expenditure in male- and female-headed households. In the post-drought period, we find that an insurance payout significantly increases food expenditure per adult equivalent among female-headed households.

Price predictors in an extended hedonic regression framework: An application to wholesale cattle markets in Ethiopia

Livestock markets influence income generation for producers, but also accessibility and affordability of highly nutritious animal-sourced foods for consumers. Despite their importance, the functioning of livestock markets in lower-income countries is poorly understood and rarely studied compared to more developed countries. This study analyzes wholesale cattle markets in Ethiopia using a uniquely rich large-scale dataset covering both prices and cattle characteristics in 39 markets (in both highland and lowland areas) over a 10-year period, and hedonic regression models structured to understand both cattle price formation and seasonal and secular price dynamics. We show that cattle prices are influenced by a wide range of factors, including proxies for meat quality, religious fasting practices, climate-based seasonality but also climate shocks and availability of grazing land, competition from animal traction services, and rising consumer incomes. However, the implied effects of these factors are often significantly different in highland mixed crop-livestock areas compared to agro-pastoralist lowland areas, emphasizing the dualistic nature of cattle markets in Ethiopia. The analyses help inform the systemic challenges that Ethiopia will need to overcome to meet rising demand for beef products in the face of sustained income and population growth, as well as the adverse effects of climate change.

Measuring consumption over the phone: Evidence from a survey experiment in urban Ethiopia

The paucity of reliable, timely household consumption data in many low- and middle-income countries have made it difficult to assess how global poverty has evolved during the COVID-19 pandemic. Standard poverty measurement requires collecting household consumption data, which is rarely collected by phone. To test the feasibility of collecting consumption data over the phone, we conducted a survey experiment in urban Ethiopia, randomly assigning households to either phone or in-person interviews. In the phone survey, average per capita consumption is 23 percent lower and the estimated poverty headcount is twice as high than in the in-person survey. We observe evidence of survey fatigue occurring early in phone interviews but not in in-person interviews; the bias is correlated with household characteristics. While the phone survey mode provides comparable estimates when measuring diet-based food security, it is not amenable to measuring consumption using the ‘best practice’ approach originally devised for in-person surveys.

Are agro-clusters pro-poor? Evidence from Ethiopia

Governments and development agencies increasingly promote agro-clusters as a pathway to improving smallholder incomes and ensuring inclusive rural development through mitigating production and market risks. However, there is very limited empirical evidence to support this promise. We use a large farm household survey of about 4000 smallholder farmers in Ethiopia growing cereals like teff, maize, wheat, maltbarley and sesame to examine the relationship between agro-clusters and smallholder welfare and poverty. Using instrumental variable estimators, we establish a positive association between agro-clusters, household income and per capita income. Agro-clusters are also shown to reduce poverty and poverty gaps. Our results are robust over different agro-cluster proxies and alternative estimators, such as the augmented inverse probability weighting estimator. We also show that our findings are unlikely to be driven by omitted variable bias. Moving beyond average effects and in the interest of understanding heterogeneous effects, we use quantile regressions at different income levels. We find that agro-clusters are associated with welfare gains for all households. However, the most significant gains are observed for the wealthier households. Despite this regressive association, our findings suggest that agro-clusters may be useful in making farming more profitable with significant welfare implications.

Incorporating seasonality into an agroeconomic model of Ethiopia

Ethiopia’s agriculture-based economy generates highly seasonal outputs, with most production occurring during the long-rains Meher season and a lesser amount during the short-rains Belg season. Despite numerous studies detailing the economic impacts of Meher precipitation, there is relatively little consideration of other seasonal or subseasonal climate impacts in Ethiopia, with most economic models only considering aggregated annual-scale production to simulate the Ethiopian economy. This paper serves to address both seasonal and subseasonal effects of climate using a partial equilibrium agroeconomic model of Ethiopia. First, an annual-scale model is disaggregated into a seasonal time step, corresponding to the two major cropping seasons in Ethiopia. Second, the effect of yield gains from a subseasonal forecast–based planting strategy is considered in the updated model. We found that crop yields and corresponding economic indicators varied widely by season and location, and that subseasonal forecast–based management strategies can, on average, increase gross domestic product (GDP), per capita calorie consumption, and lead toward reduced poverty, warranting the inclusion of seasonal and subseasonal processes in economic models and agricultural planning.

Value addition and farmers: Evidence from coffee in Ethiopia

Local value-addition in developing countries is often aimed at for upgrading of agricultural value chains, since it is assumed that doing so will make farmers better off. However, transmission of the added value through the value chain and constraints to adoption of value-adding activities by farmers are not well understood. We look at this issue in the case of coffee in Ethiopia–the country’s most important export product–and value-addition in the coffee value-chain through ‘washing’ coffee, which is done in wet mills. Washed coffee is sold internationally with a significant premium compared to ‘natural’ coffee but the share of washed coffee in Ethiopia’s coffee exports has stagnated. Relying on a unique primary large-scale dataset and a combination of qualitative and quantitative methods, we examine the reasons for this puzzle. The reasons seemingly are twofold. First, labor productivity in producing red cherries, which wet mills require, is lower than for natural coffee, reducing incentives for adoption, especially for those farmers with higher opportunity costs of labor. Second, only impatient, often smaller, farmers sell red cherries, as more patient farmers use the storable dried coffee cherries as a rewarding savings instrument, given the negative real deposit rates in formal savings institutions.

Challenges to joint planning, monitoring, and evaluation for nutrition-sensitive agriculture in Ethiopia: an exploratory qualitative study

Background
Nutrition-sensitive agriculture is an effective multi-sectoral approach to address the underlying causes of malnutrition. However, successful implementation requires the involvement of different sectors to jointly plan, monitor, and evaluate key activities, which is often challenged by contextual barriers. Previous studies in Ethiopia have not adequately explored these contextual barriers. Hence, the current study aimed to qualitatively explore the challenges to joint planning, monitoring, and evaluation for nutrition-sensitive agriculture among sectors in Ethiopia.

Methods
A qualitative exploratory study was conducted in Tigray and Southern Nations, Nationalities, and Peoples (SNNP) of Ethiopia regional states in 2017. Ninety-four key informants were purposively selected from government agencies primarily in health and agriculture, from local (kebele) to national levels, and ranging from academic organizations, research institutions, and implementing partners. Researchers developed a semi-structured guide and conducted key informant interviews which were audiotaped, transcribed verbatim in local language, and translated to English. All transcriptions were imported into ATLAS.ti Version 7.5 software for coding and analysis. The data analysis followed an inductive approach. Transcriptions were coded line by line; then similar codes were grouped into categories. Subsequently, non-repetitive themes were identified from the categories using thematic analysis methodology.

Results
The following themes were identified as challenges that hinder joint planning, monitoring, and evaluation to link nutrition to agriculture: (1) limited capacity, (2) workload in home sector (agriculture or nutrition), (3) lack of attention to nutrition interventions, (4) inadequate supportive supervision, (5) problematic reporting system, and (6) weak technical coordinating committees.

Conclusions and recommendations
Gaps in human and technical resources, limited attention from different sectors, and absence of routine monitoring data hindered joint planning, monitoring, and evaluation activities for nutrition-sensitive agriculture in Ethiopia. Short-term and long-term training for experts and intensification of supportive supervision may address gaps in capacity. Future studies should address whether routine monitoring and surveillance in nutrition-sensitive multi-sectoral activities provides long-term improvement in outcomes.

Development of the Ethiopian Healthy Eating Index (Et-HEI) and evaluation in women of reproductive age

Ethiopia announced its first food-based dietary guidelines (FBDGs) on 15 March 2022. The present study aims to develop and evaluate the Ethiopian Healthy Eating Index (Et-HEI) based on the FBDG. Data were collected from 494 Ethiopian women of reproductive age sampled from households in five different regions. The Et-HEI consists of eleven components, and each component was scored between 0 and 10 points, the total score ranging from 0 to 110, with maximum adherence to the FBDG. The Et-HEI score was evaluated against the Minimum Dietary Diversity for Women (MDD-W) and the probability of nutrient adequacy. The average Et-HEI score for women of reproductive age was 49 out of 110. Adherence to the recommendations for grains, vegetables, legumes, fat and oils, salt, sugar and alcohol contributed the most to this score. Most women had low scores for fruits, nuts and seeds, and animal-sourced foods, indicating low intake. The Cronbach's alpha coefficient, indicating the reliability of the Et-HEI to assess its diet quality, was 0⋅53. The low mean Et-HEI score agreed with a low mean score of the MDD-W (3⋅5 out of 10). Also, low nutrient adequacies confirmed poor adherence to nutrient-dense components of the FBDG. The Et-HEI was not associated with the intake of vitamin B12, vitamin C and calcium in this study population. Women who completed secondary school and above had relatively lower Et-HEI scores. The newly developed Et-HEI is able to estimate nutrient adequacy while also assessing adherence to the Ethiopian FBDG though there is room for improvement.

Accelerating technical change through ICT: Evidence from a video-mediated extension experiment in Ethiopia

Despite enthusiasm around applications of information and communications technologies (ICTs) to smallholder agriculture in many lower-income countries, there are still many questions on the effectiveness of ICT-based approaches. This study assesses the impacts of video-mediated agricultural extension service provision on farmers’ adoption of improved agricultural technologies and practices in Ethiopia using data from a two-year randomized experiment. Our results show that the video-mediated extension approach significantly increases uptake of recommended technologies and practices by improving extension access and farmer knowledge. Specifically, we find that video-mediated extension reaches a wider audience than the government’s conventional extension approach and leads to higher levels of farmer understanding and uptake of the subject technologies in those locations randomly assigned to the program. While our results also point to greater extension access and greater knowledge among female spouses in locations where both male and female spouses were targeted by the program, we do not find clear evidence that a more inclusive approach translates into higher uptake of the subject technologies. Finally, we find that the video-mediated approach becomes less costly as the scale of operation increases.

The DQQ is a valid tool to collect population-level food group consumption data: A study among women in Ethiopia, Vietnam, and Solomon Islands

Background
The Diet Quality Questionnaire (DQQ) is a rapid dietary assessment tool designed to enable feasible measuring and monitoring of diet quality at population level in the general public.

Objectives
To evaluate validity of the DQQ for collecting population-level food group consumption data required for calculating diet quality indicators by comparing them with a multipass 24-h dietary recall (24hR) as the reference.

Methods
Cross-sectional data were collected among female participants aged 15–49 y in Ethiopia (n = 488), 18–49 y in Vietnam (n = 200), and 19–69 y in Solomon Islands (n = 65) to compare DQQ and 24hR data in proportional differences in food group consumption prevalence, percentage of participants achieving Minimum Dietary Diversity for Women (MDD-W), percent agreement, percentage misreporting food group consumption, and diet quality scores of Food Group Diversity Score (FGDS), noncommunicable disease (NCD)-Protect, NCD-Risk, and the Global Dietary Recommendation (GDR) score using a nonparametric analysis.

Results
The mean (standard deviation) percentage point difference between DQQ and 24hR in population prevalence of food group consumption was 0.6 (0.7), 2.4 (2.0), and 2.5 (2.7) in Ethiopia, Vietnam, and Solomon Islands, respectively. Percent agreement of food group consumption data ranged from 88.6% (10.1) in Solomon Islands to 96.3% (4.9) in Ethiopia. There was no significant difference between DQQ and 24hR in population prevalence of achieving MDD-W except for Ethiopia (DQQ 6.1 percentage points higher, P < 0.01). Median (25th–75th percentiles) scores of FGDS, NCD-Protect, NCD-Risk, and GDR score were comparable between the tools. Conclusions The DQQ is a suitable tool for collecting population-level food group consumption data for estimating diet quality with food group-based indicators such as the MDD-W, FGDS, NCD-Protect, NCD-Risk, and GDR score.