USAID/Empowering New Generations to
Improve Nutrition and Economic
opportunities (ENGINE)
A program of the US Global Health and Feed the Future
Initiatives
1
ENGINE Team
Implementing Agency
Role in ENGINE
Save the Children USA
- Prime
- Overall program management
- Technical lead on MNCHN, HIV/AIDS, in-service training, community
HEWs and community volunteers.
Tufts University
-Lead IR 4:
-development of a cohesive, relevant research strategy and documentation
contributing to the program’s learning agenda.
- lead the design of a rigorous Monitoring and Evaluation system;
Valid International
Lead design and implementation of studies under the research theme
Lead implementation and adaptation of Impact study , the Simple Spatial
assessments
Jhpiego
Technical lead pre-service component
JHU CCP
Technical lead on behavior change communication (BCC) and the
strategy.
Land O Lakes
Technical lead on livelihoods and economic strengthening activities
2
FTF Nutrition Interventions
• Stand-alone nutrition project
(ENGINE)
• Wrap-around Nutrition Activities
3
Strategic Objective
Improved nutritional status of women and young children through
sustainable, comprehensive, coordinated, and evidence-based interventions
IR 1
IR1: Capacity for and institutionalization
of nutrition programs and policies
1R2: Quality and delivery of
nutrition and health care services
improved
IR3: Prevention of undernutrition
through community-based
nutrition care practices improved
IR4: Rigorous and innovative learning agenda adopted
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Target Region
Regional Breakdown by Year
Region
Total Target
Year 1
Amhara
22
11
Oromiya
34
17
SNNPR
19
9
Tigray
8
4
Not AGP woredas
17
Total ENGINE
woredas
100
41
Year 2
16
26
14
3
(16)*
59
5
Region
Amhara
Oromia
SNNP
Zones
W Gojjiam
Bahirdar Zuria, Debube Achefer, Jabi-tehnane, Semin
Achefer, Jabi-tehnane, Semin Achefer, and Wenebrema
Awi
Anikasha (Ankasha) , Danegela (Dangila)
E Gojam
Enmaye, Dejene
N Gondar
Alefa, Taqusa
W Arsi
Dodola, Kofle
Arsi
Lemu na Bilbilo, Shirka
Bale
Agarfa, Sinana
Finfine surrounding Special Zone Welmera/sebeta
W Shoa
Ambo, Dendi, Toko Kutayu
E Welega
Guto Gida, Wayu Tuqa
S W Shoa
Weliso, Becho (Tulu Bolo)
Horo/G/Wolega
Horo, Horo(Jimma Geneti), Guduru
Gedeo
Bule, Gedeb
Sidama
Wondo Genet, Gorche (Shebedino)
Gurage
Silti
Keffa
Tigray
Woredas
N W Tigray
W Tigray
S Tigray
Azernet Berbere, Enemor ener
Merab Azernet
Decha, Chena
Tahtay Adiabo
Qfta humra
Endamehone, Ofla
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Direct beneficiaries
• Under five children esp under two years
• Pregnant and lactating women
• women of reproductive age
• Vulnerable households
Target sectors or institutions
Intervention areas
MOH and its decentralized structure at Regional,
and Woreda level, especially HEP
Policy and preventive and direct nutrition
interventions
MOA at Federal especially the extension program
and AGP unit and its decentralized structure –
AEWs/DAs
Livelihood and Economic strengthening
interventions of vulnerable households
Nutrition education for AEWs and AGP
community groups
Hawassa, Gondar, Haromia, and Jimma
University and Regional health and agriculture
colleges
Pre-service integration of nutrition
Ethiopian Health and Nutrition Institute (EHNRI),
and Hawassa and Jimma University
Operational Research/Phd and MSc
support
8
Program Components/ work plan
IR1: Capacity for and institutionalization of nutrition programs and policies
IR1.1:strengthened policy environment
Strengthening existing Nutrition Multi-sectoral coordination
Support revitalization of NNC (multi-sectoral coordination)
Revise and update nutrition PROFILEs Advocacy tool
Support nutrition policies, guidelines and standards
Provide support to revision of NNP
Harmonize national IYCF training manuals
IR1.2: Pre-service and in-service nutrition training for health care and agricultural agents strengthened
Pre-service education for health care providers and agricultural agents
Conduct PSE sites readiness and baseline assessment
Develop standards and competencies of nutrition education for health and agriculture cadres
Enhance faculty’s/preceptors' instructional capacity and create an enabling environment for nutrition education
In-service capacity building for program mangers and existing health care providers
Develop training package on training skill and nutrition program Mx for Program managers
Provide training skills course (ToT) for national nutrition trainers
Conduct coaching and mentoring of trainers
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...Program Components/ work plan
1R2: Quality and delivery of nutrition and health care services improved
IR2.1: Quality of nutrition services strengthened
Facilitate the integration of quality improvement processes
Support adaptation/development of minimum service standards for nutrition
Improve coaching/mentoring process and skills
Support development/adaptation of coaching/mentoring tools and guides
Conducting training on coaching and mentoring HEWs supervisors, and woreda level managers
Improve supportive supervision
Build the capacity of health facility staff and frontline workers to provide high quality services
Provide training to Program managers, health workers and Health Extension Workers
Support Integrated Refresher Training for regional, zonal, and woreda program managers and HEWS
Provide support to HDAs trainings and logistics problems to 20 woredas
Train program mangers from zonal and Woreda health and Agriculture offices
Support training of AEWs and DAs on nutrition topics at woreda levels
Improve tools used by frontline health and agriculture workers to promote nutrition
Support utilization of health and nutrition data for decision making
Support review meetings, experience sharing forums, and promotion best practices
10
...Program Components/ work plan
1R2: Quality and delivery of nutrition and health care services improved
IR 2.2 Health and nutrition service seeking behaviours increased
Mobilize communities to seek health and nutrition services
Formative research for health-seeing behaviours
Conduct community conversations and identify key community groups and change agents
IR2.3: Increased access to health and nutrition services
Strengthen referral system and access to essential supplies of maternal & child health services:
(Vitamin A, Deworming, Zinc/ORS, iron-folate supplementation, breast feeding and
complementary feeding counselling, iodized salt utilization etc.)
Establish 21 CMAM sites in collaboration with UNICEF
Link with existing programs and partners
Strengthen integration of Nutrition in to HIV/AIDS services and livelihood interventions
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…...Program Components/ work plan
IR3: Prevention of undernutrition through community-based
nutrition care practices improved
IR 3.1: improved maternal and IYCF knowledge and practices
Develop the social and behaviour change communications strategy
Determine knowledge and research gaps, collect primary data of the formative research
Develop SBCC and Advocacy strategy through consultative process
Promote optimal nutrition practices through dynamic communication channels
Disseminate nutrition messages through animated role model named Sister Asnakech
Work with local celebrities and leaders to become ambassadors for nutrition
Work with communities to promote model households.
Develop messages that can be incorporated into materials and community mobilization efforts of
model households and HDAs
Drive to scale through mass media programming
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IR 3.2 Access to food and economic strengthening opportunities
Apply economic strengthening (ES) interventions to meet households’ needs
Identify and map economic activities to address specific household vulnerabilities
Establish linkage and coordination with AGP under MOA, AGP-VCE under ACDI/VOCA, GRADS and AGP-LGP
Match economic opportunities with household needs and capabilities
Develop diagnostic tool to conduct household vulnerability analysis & set targeting criteria
Set up and Orient targeting committee including all concerned partners
Identify women beneficiaries & organize women groups on common needs using AGP innovative group modality
Promote demonstration plots and school demonstration gardens
Support demonstration of agricultural technologies on FTCs and school Gardens
Train School teachers (preferably women) on gardening and food preparation(cooking)
Provide printed teaching aids on nutrition and farming technology to schools
Facilitate effective approaches to small scale horticulture and animal production to most vulnerable
households
Promote and support homestead gardening/production
Train targeted most vulnerable households on homestead production of horticultural crops
Provide inputs such as improved seed, fertilizer and hand tools
Promote farming technology package and livestock at household level
Train targeted most vulnerable households on animal husbandry (dairy, poultry, & goat rearing)
Provide productive livestock (improved/local breed of heifer, Goat and commercial layers of chicken
13
…Program Components/ work plan
IR4: Rigorous and innovative learning agenda adopted : it is cross-cutting for all IRs
Design and Delivery of Research strategy
Multi-stakeholder national level research meeting and finalize research strategy/questions and
roles/responsibilities
Establish research group(s) including PI/Co-PI for each study prioritised
Identify PhD/MSc programs in Ethiopia for partnerships with ENGINE
Develop study design/protocol for 2-5 phase 1 studies by individual research groups
Develop and manage an innovative documentation and dissemination strategy
Conduct Baseline and Impact survey
Barriers-to-access analysis (SQUEAC survey) to nutrition and health services in select woredas
Facility-based quality-of-service survey
Establish program monitoring system
Support and provide technical assistance to the MOH with the integration of nutrition indicators into the HMIS.
Conduct quarterly supportive supervision at facility and community levels in NIS/HMIS
Document best practices in M and E at all levels
Gender and ENGINE
Conduct gender audit assessment at all levels and gender analysis
Gender mainstreaming in ENGINE program
People with Disabilities (PWD) and ENGINE
Conduct preliminary assessment of PWD and nutrition programs using disability assessment tool
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Capacity Building and Analytical
studies planned
• Capacity Building
– Frontline workers- HEWs, health workers, MSGs, AEWs/DAs, women groups, School
teachers
– Regional and Woreda health and agriculture program mangers
– Federal MOH policy support
– Health facilities and health posts, Farmer training Centers
– Universities and EHNRI: researchers and students, nutrition course improvement
• Analytical studies planned
– ENGINE baseline and impact survey
– Operational research on nutrition policy/governance, prevention of undernutrition,
linking nutrition and agriculture, and CMAM
– Barriers-to-access analysis (SQUEAC survey) to nutrition and health services
– Facility-based quality-of-service survey
– Pre-service baseline assessment of 12 health and agriculture universities and
colleges
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Implementation Modalities
• Community Based components
– HEP with HDA
– Agricultural Extension Program
– Program management: MOH decentralized health
administration system
– Local NGOs for BCC
– Innovative modalities that complement the gov’t structure
• Research
– EHNRI and Universities (Jimma and Hawassa)
• SCUS sub-offices provide TA to their respective regions
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