February 2011 Issue 40 ISSN 1743-5080 (print) Special 40th issue: focus on Ethiopia View of the audience of a drama held during a Productive Safety Net Programme (PSNP) pay day session in Tigray-Hintalo Wajirat, Ethiopia Credit: P Fracassi, Ethiopia, 2010 Credit: P Fracassi, 1 Contents Tigray Beneshangul Administrative Gumuz Afar Amhara Dire Dawa Harari Field Articles Regions and Zones Addis Ababa 7 Enhanced Outreach Strategy/Targeted Supplementary Feeding for of Ethiopia Oromia Somali Child Survival in Ethiopia (EOS/TSF) Gambella SNNPR 11 Can the Nutrition Information System be ‘trusted’ to build on available data sources? 13 Oxfam’s Somaliland-Ethiopia Cross Border Drought Preparedness Project 17 Emergency Food Security and Livelihoods Project in Amhara and Oromia regions 22 The RAIN programme 25 Emergency Food Security and Livelihoods Project in Amhara and Oromia regions 31 Beyond the indicators: Assessing project impact on children’s lives 35 The experience of multi-storey gardens in Ethiopian refugee camps 38 Decentralisation and scale up of outpatient management of SAM in Ethiopia (2008-2010) 43 History of nutritional status and Concern's response in Dessie Zuria woreda, Ethiopia 48 Rapid response and long-term solutions: Christian Aid and food security in Ethiopia 49 Completing the Jigsaw Puzzle: Joint Assessment Missions (JAM) Adapted from graphic produced by UN Emergencies Unit for Ethiopia, March 2000, ©Reliefweb. produced by UN Emergencies Unit for Ethiopia, March 2000, ©Reliefweb. Adapted from graphic 2010. All rights reserved. Programme Food Adapted from ©United Nations World 52 World Vision programme for severe acute malnutrition in SNNPR 56 Market-led Livelihood Recovery and Enhancement Programme and News integrating ENAs 79 Standardised training package on SMART methodology 58 An overview of REST’s implementation of the Productive Safety released by ACF Canada Net Programme 79 Treatment of severe malnutrition now a core competency in 61 Maintaining GOAL’s capacity to support surveillance in Ethiopia health 65 Joint Emergency Operation Plan: NGO response to emergency food 80 Building national capacity in HIV and Nutrition needs in Ethiopia 80 Scale up Nutrition (SUN): a new global movement 68 Integrating OTP into routine health services – CONCERN’s 80 Regional CMAM meeting in Ethiopia 2011 experiences 81 Training and workshop to integrate IYCF in CMAM 75 The Targeted Supplementary Feeding Programme (TSF) 82 Updated HTP resource material for nutrition in emergencies 78 Value chain approach to increase production of RUTF/CSB training Agency Profile Research 21 Profile and overview of the church’s role in emergency response 82 Early stages of a ‘Food by Prescription’ programme for HIV infected adults 45 EHNRI: profile and role in the National Nutrition Programme 84 Emotional Stimulation for acutely and severely malnourished 55 School of Nursing and Midwifery & Pre-Service Training on children in SNNPR Nutrition, Hawassa University, Ethiopia 85 Critical analysis of MICAH programme 74 The Ethiopian Orthodox Church Development and Inter-Church Aid Commission 87 Linking PSNP and NNP: experiences and challenges Programme Profile 89 Post-drought restocking: Can its impact be sustainable? 91 Food insecurity and mental health among community health 32 The Emergency Nutrition Coordination Unit of Ethiopia: roles, volunteers in Ethiopia responsibilities and achievements 64 The Evolution of Ethiopian Government’s Early Warning System 92 Acronyms Invite to submit material to Field Exchange Many people underestimate the value of their individual field experiences should contribute, pass this on – especially to government staff and and how sharing them can benefit others working in the field. At ENN, we local NGOs who are underrepresented in our coverage. are keen to broaden the scope of individuals and agencies that contribute Send this and your contact details to: material for publication and to continue to reflect current field activities and Marie McGrath, Sub-editor/Field Exchange, experiences in emergency nutrition. email: [email protected] Many of the articles you see in Field Exchange begin as a few lines in an email Mail to: ENN, 32 Leopold Street, Oxford, OX4 1TW, UK. or an idea shared with us. Sometimes they exist as an internal report that Tel: +44 (0)1865 324996 Fax: +44 (0)1865 324997 hasn’t been shared outside an agency. The editorial team at Field Exchange Visit www.ennonline.net to update your mailing details, to make sure can support you in write-up and help shape your article for publication. you get your copy of Field Exchange. To get started, just drop us a line. Ideally, send us (in less than 500 words) your If you are not the named recipient of this Field Exchange copy, keep it ideas for an article for Field Exchange, and any supporting material, e.g. an or pass it on to someone who you think will use it. We’d appreciate if agency report. Tell us why you think your field article would be of particular you could let us know of the failed delivery by email: interest to Field Exchange readers. If you know of others who you think [email protected] or by phone/post at the address above. 2 Foreword A Simons/FH Ethiopia, 2009 ver twenty five years on from the famine of the 1980s which resulted in many thousands of deaths and devastated livelihoods, Ethiopia today is a country that has placed nutrition and food security concerns at the heart of its development. The launch of the first Ethiopian National Nutrition Strategy and implementation of the National Nutrition Programme are testament to the national drive to Osignificantly improve the population’s nutritional status and to manage the threats to people’s nutrition and food security posed by recurrent emergencies. This special issue of Field Exchange focuses on Ethiopia, 25 years on from the devastating famine of the 1980s. It brings together articles written by many highly experienced Government and non-government actors about the country’s large-scale programmes aimed at preventing and treating acute malnutrition, reducing food insecurity, tackling childhood sickness and improving people’s livelihoods. The wealth of experience contained in these articles reflects the results of many years of lesson learning both within Ethiopia and internationally. Challenges remain with to-scale programming and these are outlined, as are the potential solutions. Smaller scale projects, research initiatives and key national nutrition and coordinating institutions are also profiled in this publication. Overall, this issue of Field Exchange provides a unique and comprehensive picture of Ethiopia’s nutrition and food security programming. It is of value, not only as a resource for those of us in Ethiopia who are working in a complex nutrition and food security environment, but also to others in emergency prone and food insecure countries which are scaling up programmes to address undernutrition. Ethiopia has come a very long way in 25 years. The work being undertaken by Government in partnership with many UN, NGO, church and community based organisations, academic institutions and coordinating bodies as documented here is undoubtedly saving countless lives and, whilst much still needs to be done to tackle food insecurity and undernutrition, these endeavours are providing a better tomorrow for millions of Ethiopians. H. E Dr Kesetebirhan Admassu, State Minister of Health Dr Ferew Lemma, Senior Nutrition Advisor From the Editor thiopia is a diverse country where a signifi- years on from the mid-1980s crisis. It contains six cant proportion of the population live on or agency/programming profiles and twenty field arti- below the poverty line, where food insecurity cles written by national and international actors is widespread and rates of acute malnutrition about nutrition and food security related program- E ming. The profiles and articles provide insights into are often at or above the international threshold that Simon Rolph, Ethiopia Simon Rolph, defines an emergency situation. Levels of chronic some of the key nutrition and food security/liveli- malnutrition are also high. Food and nutrition crises hoods related structures and programmes in arising from the effects of drought, floods, market Ethiopia, covering early warning, response, recovery fluctuations and, at times, political instability are and longer-term programming. frequently faced. The challenges today are enormous Government agencies and structures but over the past 25 years, the Government of The first profile is on the government’s Early Warning Ethiopia (GoE), with the technical support and budg- System (EWS). Written by Kassahun Bedada Beyi, it etary assistance of many donors, UN agencies, plots the EWS evolution from an ad-hoc system in the non-governmental organisations and institutions has 1970s, to a highly centralised, somewhat cumber- developed an impressive array of national nutrition, some system with minimal community involvement food security, livelihoods and health related policies, in the 1980s to the current system which is highly programmes and systems. These are driving nutrition decentralised and takes account of local early warn- and food security improvements and should ensure ing knowledge. Ethiopia’s EWS, as with many that the massive loss of lives and livelihoods seen at emergency prone country experiences, is not with- the height of the famine in the mid-1980s, doesn’t out its problems. It will no doubt continue to evolve arise again. as it manages complex data and strives