Much of Ethiopia's rural population lives in a state of chronic food insecurity. Recurrent drought, degradation of natural resources and rapid population growth are among the main causes of declining per capita food production. Average daily energy intake is estimated at 16 to 20 percent below the accepted minimum, while diseases due to deficiencies in vitamin A, iron and iodine are widespread. Several times over the past 30 years, Ethiopia's precarious food security has tipped over into full-blown famine.
Now the good news. In two of the country's most disadvantaged rural areas, northern Shoa and southern Tigray, a recently completed FAO project has achieved measurable improvements in the health and nutrition status of an estimated 26,000 people. Launched in 2001 with support from the Belgium Survival Fund, the project set itself an ambitious target - to resolve nutrition and household food security problems in 40 communities through interventions in agriculture, health, education, water and sanitation. Priority was given to assisting female-headed households, which accounted for 80% of all malnutrition cases and made up about 30% of the population in the project areas.
Community action plans. "We didn't go in with ready-made solutions," says Karel Callens, a nutrition officer in FAO's Nutrition and Consumer Protection Division. "The project was, ultimately, about people and their ability to acquire and utilize food they need, not about technologies and inputs. So, most of our interventions were in response to community action plans and micro-projects that groups of beneficiaries prepared for themselves, with technical assistance from government services and NGOs."
By July 2005, more than 100 micro-projects involving 3,600 households had been implemented. Among the most successful were for intensive fruit and vegetable production, a novelty in communities where less than six percent of households grew vegetables, and orchards were virtually non-existent. "Production of cash crops such as garlic and spices proved to be a viable income generating activity for farmers, especially landless households and small holders without oxen," project staff reported. Realizing the income potential of horticultural production, groups in northern Shoa submitted for funding micro-projects involving supply of seeds, tools and training for 800 households, creation of 10 school gardens and support for "nutrition clubs" benefiting more than 4,600 students.
To encourage conservation of natural resources, micro-projects were also approved for planting degraded communal grazing land with fuelwood trees, which is expected to create livelihoods for 100 landless families. The introduction of energy-efficient stoves was described as "an unqualified success", especially in northern Shoa, where more than 300 households have benefited. Stoves for another 500 households are "in the pipeline", and their use is spreading beyond the project area.
Another major objective of the FAO project was to promote health and prevent disease through improvements in diet, access to safe drinking water and sanitation. A baseline survey of almost 1,800 children aged six months to five years had found high rates of undernutrition in the target communities: 47% of children were stunted, 11% suffered wasting and 43% were underweight. In discussions with community health workers, project staff found an acute lack of education materials - for example, less than 16% of mothers in northern Shoa had access to information on breast-feeding, the importance of vitamin A and the care and nutrition of sick children.
To fill that gap, the project prepared nutrition fact sheets and promotional messages, and facilitated the printing and distribution to health offices of guidelines on emergency nutrition and acute malnutrition. As part of a health programme conducted in mid-2004 in northern Shoa, an estimated 85 percent of children aged 6 to 59 months received high doses of supplementary vitamin A, while close to 10 percent of children under three years were weighed (almost 10 percent of children were found to have body mass at least 60 percent below recommended levels). The project also provided training and equipment for traditional birth attendants in all the target villages.
The project reported high demand for hygiene and sanitation support. In one district, more than 600 households took training in construction of pit latrines. Since then, the use of latrines has grown from virtually zero to almost 5% of households. Meanwhile, schemes for drinking water and home garden irrigation have been completed for some 155 households, along with water collection points for 520 households, more than a quarter of them headed by women.
Working with rural Skills Training Centres (STCs), the project helped promote off-farm employment opportunities. Funds were provided for upgrading facilities used for training in blacksmithing, sewing, tailoring and weaving, and some 100 trainees took courses in making fibre and clothes. Since the communities have little or no access to micro-finance institutions, the project also used the STCs as vehicles for disbursing investment funds. In Southern Tigray, it provided a grant of $11,800 for saving and credit groups, along with training in credit management.
In a district of southern Tigray, an FAO evaluation found evidence that the project had made a measurable impact on health, nutrition and household food security. Health clinic data show a major reduction in diarrhoea cases among children, while results of a World Food Program nutrition assessment of 8,000 children aged under five indicate that incidence of acute malnutrition fell from 13.4% in 2003 to 9.5% in 2005. "This may reflect the project's positive achievements in the areas of water, hygiene and sanitation, and nutrition education," the evaluation found. Health education provided by traditional birth attendants is also expected to have contributed to lower prevalence of acute malnutrition.
Says Karel Callens: "What made this project different from many others is that it put people first - we listened and learned and then worked together with them to help them find solutions to their problems." FAO has now prepared for donor funding a four-year community development programme that will extend the methods and expertise generated by the project to some 250,000 people in northern Shoa and southern Tigray.
More about AGN's programmes on household food security and community nutrition
See also FAO's Special Programme for Food Security
Published February 2006