Theme:
Health
Project Title: Better child health and growth through nutrition sensitive agriculture
1. Description of the project context
Background for malnutrition
Childhood malnutrition is a major public health problem estimated to affect 55 million (10%) of under-five children in
developing countries. As an underlying cause, it is responsible for 15% of the total under-five death burden each year
(Black et al 2008). Ethiopia is one of the countries with the highest prevalence of malnutrition in under-five children. During
the DHS-2011, 10% of under-five children in the country were wasted, and 3% were severely wasted (DHS, 2011), which
declined to 9%(DHS, 2014). Acute malnutrition (Wasting) is estimated to be contributing factors in over 50% of child
deaths in Ethiopia (Caulfield et al 2004). However the prevalence stunting (chronic malnutrition) has remained pervasively
high with 40% of under five years old children in Ethiopia being studented (DHS, 2014). This is a very high magnitude
according to WHO making Ethiopia one of the ‘scaling up nutrition (SUN) movement’ countries.
The genesis of stunting goes back to early life and ensuring adequate nutrition during the first “1000 days window of
opportunity” starting from intrauterine life to 24 months after delivery, therefore, is critical in preventing long-term and
irreversible damage to children’s health and cognitive and physical development. The government of Ethiopia has planned
an accelerated stunting reduction program and deployed health development army(HAD) together with the health extension workers(HEW).
WHO recommended that child feeding programmes need to be linked to and operationalized through the service delivery
platforms of multiple relevant sectors, including agriculture, to optimise impact (WHO , 20087). The multi-sectoral
approach of the revised national nutrition program of Ethiopia calls for nutrition sensitive sectoral performance using the
concept of ‘Nutrition Lens’, which is a nutrition related criteria for reviewing each sectors’ performance.
Nutrition sensitive agriculture is one of the multispectral strategies of making agriculture not only be involved in food
production, but also work towards ways of improving access to and intake of essential nutrients by the vulnerable groups.
The agriculture extension platform is of key importance in Ethiopia, not only because it is one of the best-developed large
scale service delivery platforms outside of the health extension platform, but because dietary diversity has been identified
as one of the key limiting factors to the improvement of child feeding practices ( Aemro, 2013).
Under the National Nutrition Plan (2013-2015), sector-specific responsibilities for nutrition have been increasingly
recognised by the agriculture sector, including the hiring of nutritionists and providing for nutrition-sensitive trainings
developed by a range of partners. Some of these trainings have been given to agriculture extension workers with focus on
targeting vulnerable populations with messages on both the production and purchase of diversified foods, and improved
child feeding practices including consumption of diverse foods ( Davidson, 2015, USAID, 2014).
Integrated, multi-sectoral Infant and Young child feeding(IYCF) behaviour change interventions may also provide
additional opportunities for repetition of key child feeding messages and improve caregiver recall ( Low, 2007). However,
to date, such efforts have not been implemented and evaluated at large scale. Diversified and sustainable production of
food including fruit, vegetables and animal source foods as well as diversified consumption of foods especially with more
focus on animal sources foods is critical for reducing the prevalence of malnutrition among Ethiopian children. At
household level can be achieved through implementing “fruit trees per a family” and “permanent homestead vegetable
garden” approaches. Developing food products with enhanced nutrition (enriched with macro and micro nutrients) with the
use of locally available food ingredients, food processing techniques, particularly targeting the most vulnerable part of the
population, namely women and children is a critical issue to avert the problem of malnutrition.
1.1.
Background of the project
Original idea and steps undertaken to elaborate the idea.
Although there are several efforts in reducing childhood malnutrition, stunting had become pervasively high in
Ethiopia. Evidences show that improving the diet of children including complementary food through multi-sectoral
action such nutrition sensitive agriculture is advocated globally. The revised national nutrition program also
advocates this idea. One of the ways of doing this is through increasing nutrient density and dietary quality
through both diversification of production using nutrition sensitive agriculture and encouraging diversified consumption.
Given the growing capacity of the University, it logical to think more at the country level and fit into the VLIR’s
country program to have more a resonance/spinoff effect of the capacity building at Jimma University at the
national level. To materialize this objective, creating networking and partnership with key actors from the different
locations of the country is a necessity for a number of reasons: (1) To be able to reach out the research and
capacity building activities to areas that are more in need (2) to be able to undertake further study that can assist
the improvement of child nutrition in Ethiopia given the ecological diversity and locational advantages of the
NETWORK Programme Call 2015
Annex 1: Format for the concept note South
1/5
partner institution; (3) to have sustainability of the links these institutions already had with the VLIR project (4) To
engage partner institutions in the joint venture PhD and MSc training programs and build their capacity through
effective in-country south-to-south collaboration.
The initiative requires additional funding or own funding as the initial IUC collaboration is phasing out and there is
a need to sustain the program and reach it out to a wider scale to have a reverberation effect. There is also a
strategic shift in the VLIR programs as a whole to country program level. This entails thinking at scale level to fit
into this program and contribute to the country level initiatives. The establishment of south-to-south network will
enhance the research and academic capacity of not only Jimma university but also the partner institutions. This
could happen through recruitment of MSc and PhD students from the partner institutions, conducting multicenter
research in the areas of the partner institutions and involving the staff of these institutions in the research undertaking and short term capacity building trainings. These activities require additional funding.
History of the collaboration / antecedents
The IUC program between Jimma University and many Flemish universities has been going for the last many
years. One of the major projects areas is child health and nutrition, Ecology and soil and animal health. A critical
mass of highly qualified professional has been built. There have been a number of research outputs in the areas
of child health and nutrition. In addition to the PhD graduates and ones that are on the way of graduating, the
establishment of psychosocial stimulation center(Child play Centre) for children with severe acute malnutrition
attached to the paediatric ward is one of the capacity building outputs from the project. This capacity building has
also given rise to the initiation of both MSc and PhD programs in human nutrition in Jimma University. Currently
there 14 MSc students and 12 have already graduated and 18 PhD students following their trainings.
1.2.
Presentation of the project partners
Local project partners
Local project team
(Involved staff next to
the project lead and
involved focal points
and academics …..
Partner Institutions are Ambo University, Debrezeit Faculty of verterinary medicine,
Hawassa University, Mekele university/Hyder Hospital.

Jimma University (Prof.Dr.Tefera Belachew(MD, MSc, PhD,Dr.Amsalu
Nebiyu(PhD, Assistant professor), Soil Science, Fikremariam Geda(phD
scholar, Lecturer), in Aquaculture
Hawassa University

Dr. Kebede Abegaz (PhD, Assistant Professor), in Food Microbiology

Dr. Abebe Haile (PhD, Assistant Professor), in food Science and Nutrition
Capacities and
strategic interest (as
they relate to the
project)




Experience (academic, ….
Jimma University-has strong capacity in human resource and laboratory infrastructure in human Nutrition and soil science and aquaculture that has been built through
the IUC program. It has capacity to serve as a nucleus for coordinating multicenter
studies and carry out research on nutrition, soil science and aquaculture. For instance, questions like does adding zinc into fertilizer increase the solid zinc content? Zinc content in the plant? Does it increase the zinc intake of the child from
food? Bioavailability issues? Does it promote linear growth of the child and reduce
stunting?
Hawassa University has strong human capacity and laboratory infrastructure in food
science and nutrition and it has close location to the lake which enables the project
to undertake the study on effect of promoting fish consumption/aquaculture in complementary foods on child health, growth and wellbeing. Eg. What is the level of
consumption of fish by children? Does addition of fresh water fish preparations in
any form to the complementary food improve the growth? cognitive performance?
Debrezeit Faculty of Veterinary Medicine – Is interested in animal health studies
and can contribute to the promotion of animal source food production and consumption to reduce stunting and under nutrition among children. For instance how can a
household develop small poultry for supply egg to the child?
Ambo University- Is interested in agricultural research more on a highland areas. It
will contribute to the production of fruits and vegetables and in the promotion of horticulture and backyard gardening such as one fruit tree for per child. E.g. How can
we improve the backyard gardening practices? Does this it make a difference on
micronutrient intake of children? Health and growth of children?
The promoter (Project PI) has an experience of leading an international collaborative
research project and extensive research and teaching experience (see CV). Currently
NETWORK Programme Call 2015
Annex 1: Format for the concept note South
2/5
he is the major promoter of 18 PhD students.
Links to other relevant national and
international collaborating institutes
(name, nature) and
society in a broader
sense (government,
NGO, etc.)
The Federal Ministry of Health: the federal ministry of health has set an accelerated
stunting reduction plan in the revised national nutrition program (FMOH, 2013). Due to
the pervasive nature of stunting rate of 40% and above (DHS, 2014) the country is also
labelled by WHO as “very high stunting country” and targeted by the SUN movement.
There are other nongovernmental organizations such as Alive and Thrive and UNICEF
highly concerned about child nutritional problems and working towards its solution. The
evidence generated from such studies will give directions to tackle the problem in an
informed and practical manner. Research in the above areas is highly related to the
activity and goal of the Ethiopian public Health Institute (EPHI), the research arm of the
federal Ministry of Heath which is also one of our partner.
Other involved actors (if applicable)
Name and function of
the actor
Federal Ministry of Agriculture
Major (project related)
activities
Nutrition sensitive agriculture
Capacities and strategic interest (as they
relate to the project)
Multi-sectoral approach to nutrition intervention is one of the major strategies of the
revised national nutrition program. The Ministry of agriculture is highly interested in
making agriculture sensitive to nutrition. The ministry of agriculture with its research
arm “Ethiopian Agricultural research institute (EARI)” has strong capacity in promoting
nutrition sensitive agriculture which will be strong collaborator in the research of the
project.
Reasons for which the
actor is involved in the
project
The projects aims to promote better health through enhancing nutrition sensitive
agriculture which addresses the underlying cause of malnutrition and this exactly
aligns with the sector’s objectives. There is also a strong technical capacity in the
sector to be tapped for the realization of the project aims.
1.3.
Link with the VLIR-UOS country strategy
Description of the link with the VLIR-UOS country specific strategic guidelines that have been elaborated for the country
concerned, and how can it achieve national impact. (see background documents)
This network program application caters for spreading capacity and producing a resonance effect of the previously built
capacity through the VLIR assistance, which is exactly in alignment with the VLIR country strategy. This project addresses
one of the thematic areas identified by the VLIR as a priority country strategy for Ethiopia, “The Health”. It is also in accord
with the national strategic direction of creating south-to-south collaboration between universities in the country.
1.4.
Link with other initiatives (complementarity /synergy)
Link with initiatives taken in the same domain by other organisations (local, regional, Belgian, etc.) and in other VLIR-UOS
activities.
This project has strong synergy with other initiatives taken in the health domain such as the infectious diseases and the
ecology as it addresses the most vulnerable population i.e. children. Improving the nutritional situation of children will definitely improve their health status including susceptibility to infectious diseases. It highly complements the effects of the other
interventions within the health domain.
1.5.
Beneficiaries / target group
Description of the direct beneficiaries (specific objective) and indirect beneficiaries and stakeholders (external groups that are
affected by the implementation of the project), their interest, attitude and possible role.
The direct beneficiaries will be children less than 2 years and pregnant and lactating women. Targeting the first 1000 days
(from intrauterine life to the first 2 years after birth). Indirect beneficiaries are households and household members including
males. Stakeholders that are positively affected by the implementation of the project are: the community, the Ministry of
Health, the Ministry of Agriculture, NGOs (Alive and thrive) and UN Agencies (eg.UNICEF, WFP).
1.6.
Problem analysis
General and national presentation of the sector / development problem treated in the project, as well as the political lines
(development problem related to the sector analysis)
NETWORK Programme Call 2015
Annex 1: Format for the concept note South
3/5
Despite a number intervention efforts targeting immediate causes of malnutrition such as nutrient supplementation and
dewarming and bed net distribution. The problem of childhood malnutrition such as stunting remained pervasively high in
Ethiopian indicating the need for a more integrated and multispectral interventions addressing the underlying causes. The
government of Ethiopia has a plan for accelerated stunting reduction. For this reason, the Federal MOH had deployed
health development army to support the pre-existing health extension workers. Similarly, the ministry of agriculture has a
plan for making agricultural production nutrition sensitive through the various frontline cadres including the development
agents (DAs). The missing piece in the whole intervention is the failure to diversify the diet of children during the first 1000
days and increase its nutrient density. The question is how can we increase the dietary diversity? Nutrient density? Consumption of nutrient dense food by the vulnerable? Does this really change the status quo in the growth, health and survival of children? What indigenous knowledge of food processing can be improvised and optimized to serve the purpose of
addressing this problem? What is the model for bringing the different sectors together to address this problem at the community level? Answer to all these questions needs the concerted efforts of the various sectors including MOA, MOH, NGOs
and Universities in the network and an evidence to be generated from the research endeavours.
Analysis of the capacity constraints the partners are confronted with (academic problem)
Although the above problems require research based evidence to be answered properly, there is a limitation in the capacity
of scientists in the areas of nutrition and other related fields to respond to this need. There is also lack of budget and
laboratory facilities especially in some areas of especially the network institutions. Therefore, this project aims at building
the capacity of both for Jimma University and the network institutions through training high capacity professionals (PhD
level) and collaborative research endeavours. This can be realized through the integration of research with PhD level
training and service (Technology transfer). The research outputs of the PhD graduates will be changed into policy briefs for
policy consumption and innovations will be changed products through university industry linkages. The new formulations
(food products) will be linked to food industries to manufacturing. Efforts will also be made to deliver the out of and innovations of research such as optimized food products and other services through small scale and micro enterprises of women
using indigenous (local) food processing techniques.
2. Description of the project
Description of the specific objective(s) of the proposed project as also the expected results
Summary (max 15 lines)
1.
Improving dietary diversity and Nutrient density through promotion of nutrition sensitive agriculture and
aquaculture.

Soil and plant zinc content and zinc status of children

Growth highland fruits and backyard vegetable gardening and consumption enhancement on child health
and nutritional status

Effect of promotion of fish /other animal source food complementary food on child health and growth
2. Effect of optimizing indigenous(Local) processing techniques processing foods (fermentation, germination,
blending…) to enhance nutrient bioavailability
3. Examining the effect of local production of optimized nutrient dense complementary foods and its commercialization through the small scale and micro enterprises of women on their
4. Evaluation of Addition of zinc into fertilizer + consumption enhancement on the morbidity and linear growth
of children
The expected outcomes of these projects are enhancing Child health, growth / Child development and Survival.
For research activities, please elaborate the proposed research methodology and process .
Longitudinal studies and cluster randomized community trials conducted as multicenter studies involving the
network partners will be used to answer the above questions. The details the methods will be developed later.
Describe the developmental relevance of the project.
The project is highly relevant to the growth and transformation plan (GTP) of the country as well as the Millennium development goals post 2015 as well as to the global SUN movement to reduce stunting in Ethiopia. It is also
aligns with the revised national nutrition Program of accelerated stunting reduction and child mortality. In additions, it is also in accord with the agricultural policy and the goals of NGOs like alive and thrive and UNICEF and
WFP among others.
3. Needs assessment and sustainability
Describe in detail the capacity of the different local units, preconditions and major problems that could be encountered as also potential external influencing factors (feasibility).
NETWORK Programme Call 2015
Annex 1: Format for the concept note South
4/5
Human nutrition Unit is involved in research activities related to the following themes identified by the college of
health sciences as it’s center of excellence: Nutrient intake, deficiency disorders, metabolic syndrome and
intervention strategies food security, feeding, growth, development and wellbeing. The unit has qualified personnel who can support the development of capacity in the network institutions (see Annex I). Human nutrition unit
has been handling large collaborative research projects including the IUC budget, Brown University budget, the
Engine Tufts university budget, which had lead to several(over 50) scientific publications in peer reviewed
journals and over 36 policy briefs coming out of the research out puts. In addition training of MSc and PhD
students is another major activity the unit is undertaking.
Both human nutrition Unit and soil science Department have collaborations with different Universities with institutions in Ethiopia as well as with international institutions. For instance nationally, it has collaboration with Hawassa University School of nutrition, food science and technology and with Ethiopian Public Health Institute.
Internationally, it has linkages with Ghent University, Brown and Copenhagen University. All these collaborations
ha lead to PhD level training en scientific publications as outputs. For instance two of the PhDs students in
human nutrition are from Hawassa University while the other three are from Ethiopian Public Health Institute
which are both in the network partnership.
The most important problems facing the unit are research budget constraint and inability to accommodate the
huge demand of PhD enrolment. This can be solved through pooling of available staff for advisership through the
networks partnership and involving qualified staff in the partner institutions to be co-promoters to students from
their institutions.
The scope of the south to south linkage will be focusing on research capacity building and training and technoogy transfer.
Describe the opportunities and challenges for the sustainability of benefits (capacity retention, continuation of
research activities, etc.)
Opportunity
There are several opportunities that the project can exploit to maximize the achievement of its objectives. There
are highly qualified, experienced and competent academic staffs of Jimma University with the expertise to
significantly increase the training and research. In addition, Jimma University is also a leading university in the
country with a top rank for the last five consecutive years in a row and has firm good will to strengthen the
university’s academic programs. Good laboratory infrastructure
The other opportunity is the fact that there is a strong connection with the local community through its unique
Philosophy of community based Education CBE) . Similarly, a strong international connection with an arrangement of a double degree of PhD programs which enables attraction of students and internationalization.
The unit also enjoys an institution the unit to achieve its objectives. In the same vein, there is an excellent
project budget management system (equipped project budget management system and personnel). The other
opportunity is the presence of strong ICT system built through VLIR support, which facilitates research and
training activities.
Challenges
Despite the presence of the aforementioned opportunities, there are threats that the projects indentifies to be
stumbling blocks of its progress towards the achievement of its articulated objectives. Extremely inadequate
funding for research especially for PhD and MSc Trainings. Some of the challenges included: weak interdisciplinary programs among the various faculties, departments, schools, institutes and units; shortage of the necessary
resources to perform to its full potential; dependence on government for its for research and traini9ng because
of not soliciting sufficient research grants from non- treasury sources. This needs to be addressed through strong
capacity building on competitive grant writing to tap resources from funding agencies.
Poor marketing of the teaching and research work of the University is another challenge which if addressed
could be changed into an opportunity. For instance, strengthening technology transfer and university-industry link
will enable the university to generate finance for further research activities. By the same token, marketing of the
training programs such short term and in-service training programs will enable to generate funds for research.
NETWORK Programme Call 2015
Annex 1: Format for the concept note South
5/5