Nutrition Sensitive Agriculture in Ethiopia: Political Economy Analysis

Review Article

Austin J Nutri Food Sci. 2021; 9(3): 1160.

Nutrition Sensitive Agriculture in Ethiopia: Political Economy Analysis

Alehegn MA¹* and Shibru A²

¹Candidate in Food Security and Development, Addis Ababa University, Addis Ababa, Ethiopia

²Associate Professor, College of Development Studies, Center for Food Security Studies, Addis Ababa University, Addis Ababa, Ethiopia

*Corresponding author: Matyas Atnafu Alehegn, Candidate in Food Security and Development, Addis Ababa University, Addis Ababa, Ethiopia

Received: November 15, 2021; Accepted: December 20, 2021; Published: December 15, 2021


Governments globally are stressing on nutrition interventions combined with nutrition sensitive policies and programs to combat malnutrition. Governance at all levels has been identified as a critical element in ensuring success of national nutrition plan. Ethiopia has an integrated approach to addressing food insecurity and malnutrition; however, there is little clarity about the wider impact of government policy on food and nutrition. Overall, there have been notable successes in nutrition policy in Ethiopia, but significant challenges remain unsolved. Multi-sectoral nutrition governance has been hailed as an effective mechanism to reduce undernutrition. Ethiopia has adopted many approaches and has been implementing nutrition programs with some success, but undernutrition remains high for a range of reasons. This political economy analysis of nutrition sensitive agriculture of Ethiopia will address challenges of nutrition program design, coordination, and implementation, and looks at root causes that remain less understood. If these challenges are to be met successfully, greater consideration of how to address rapidly changing food systems in Ethiopia is needed at national policy level. The focus of government policy needs to shift from food availability to broader issues of food acquisition and particularly food affordability, which is mediated through food prices and waged employment. Ethiopia as country tried to combat food insecurity and malnutrition through different approaches.

The country developed National Nutrition program, National food and Nutrition policy, National Nutrition sensitive agriculture strategy and the Seqota Declaration, which all are intended to eradicate poverty and reduce malnutrition. To attain the highest possible food security and nutritional benefits for the people of Ethiopia, it is essential that agriculture, nutrition, and health (ANH) sciences and their related research activities work together in an integrated manner.

Keywords: Ethiopia; National Nutrition Program; Food and Nutrition Policy


ADLI: Agricultural Development Led to Industrialization; AEW: Agricultural Extension Workers; AGP: Agricultural Growth Project; ANH: Agriculture, Nutrition and Health; BMI: Body Mass Index; EDHS: Ethiopian Demographic and Health Survey; ELMP: Ethiopian Livelihood Master Plan; FNP: Food and Nutrition Policy; GDP: Gross Domestic Product; GTP: Growth and Transformation Plan; HEW: Health Extension Workers; HH: Household; MOF: Ministry of Finance; MOH: Ministry of Health; NGO: Non-Governmental Organizations; NNCB: National Nutrition Coordination Body; NNCT: National Nutrition Technical Committee; NNP: National Nutrition Program; NSA: Nutrition Sensitive Agriculture; PASDEP: Plan for Accelerated and Sustainable Development to End Poverty; PIF: Policy Investment Frame; PNSP: Productive Safety Net Program; RRC: Relief and Rehabilitation Commission; SBC: Social and Behavioral Change; SDG: Sustainable Development goals; SUN: Scale-Up Nutrition; WASH: Water, Sanitation, and Hygiene


Ethiopia has made a high-level commitment in the past decade to reduce undernutrition1 and its associated socioeconomic costs. This commitment has been manifested in many ways, including the design of a national nutrition strategy and programs as well as National Nutrition sensitive agriculture strategy. A significant component of Ethiopia’s nutrition program is what has become known as the Seqota Declaration, which was launched in 2015 to eradicate poverty by 2030. In the past decades, the institutional landscape for nutrition policy and practice has also been changing. The adoption of the national Food and Nutrition Policy in 2018 and the formation of a multi-sectoral nutrition governance structure to coordinate program design and implementation could be manifestations of government focus on nutrition [1-4].

The national Food and Nutrition Policy (FNP), endorsed in November 2018, has comprehensively addressed food security, food safety, food quality and post-harvest management, as well as other system-level issues including multi-sectoral approaches and institutional arrangements for food and nutrition governance.

Ethiopia’s agriculture sector accounts significant contribution of the country’s Gross Domestic Product (GDP) and export earnings each year. Nutrition-sensitive interventions in key sectors such as agriculture can advance progress in nutrition by addressing the underlying determinants of malnutrition and enhancing the coverage of nutrition-specific interventions. Agriculture can impact nutrition through multiple pathways, including increased availability of food through household production; increased household incomes through agriculture- related activities; changes in women’s time use, empowerment, or status within the household; and environmental exposures because of agricultural activities [3,5,6].

To attain the highest possible food security and nutritional benefits for the people of Ethiopia, it is essential that agriculture, nutrition, and health (ANH) sciences and their related research activities work together in an integrated manner [6].

The main objective of Ethiopian National Food and Nutrition Policy is Ensuring the availability, accessibility, safety and quality consumption of nutritious foods at all times to all citizens is a prerequisite for the creation of a productive workforce, longevity of life, improved livelihood and innovative capacity that would lead to fast economic, social and sustainable development of a nation [7]. This can be realized when citizens across all ages of the life cycle enjoy a healthy life, have better knowledge of nutrient rich foods, practice improved utilization of foods, ensure food safety and quality along the food value chain, avoid food and nutrient losses, develop food and nutrition emergency preparedness and increase resilience capacity. Thus, the development of Food and Nutrition Policy can be taken as a key input towards ensuring food and nutrition security in the country.

Agriculture and nutrition are intrinsically interlinked. The government of Ethiopia is determined to build a nutritionally secure country. Nutrition security is expected to be attained through efforts made in the areas of household food security, child and maternal care, and healthy environment creation. Agricultural production is one of the most important means of achieving food and nutrition security. Increasing agricultural productivity has the potential to improve household food security and nutrition of the population. A healthier and well- nourished agricultural labor force is more productive, earns more income, and contributes to further economic growth and development. The contribution of nutrition to the increase of agricultural labor force productivity is enormous. Therefore, Ethiopia’s Nutrition Sensitive Agriculture (NSA) strategy focuses, among others, on the UNICEF 1990 causal relationship between household (HH) food security and malnutrition and death through inadequate dietary effect. This strategy, in addition to the dietary effect, also focuses on the low productivity of labor due to undernourishment on HH food security [8].

The government of Ethiopia is committed to accelerating the implementation of a multisectoral, harmonized National Nutrition Program to make a strong impact on nutrition and on the overall wellbeing of the nation. The national nutrition program (NNP) is designed to address both long-term and short-term nutrition goals in Ethiopia. The strategic plan outlines a package of proven, cost-effective nutrition interventions that will break the cycle of malnutrition and ensure child survival. Inadequate budget allocation, resource shortages, weak financial mobilization and low utilization have been the main challenges to implementing the National Nutrition Program through nutrition sensitive agriculture [9].

Ethiopia’s agriculture sector covers for approximately more than 35 percent of the country’s Gross Domestic Product (GDP) and around 75 percent of export earnings each year. Crop and livestock subsectors contributed a lot for the country economy in addition to the role of forestry and fishery. The agriculture sector is the major employer of more than 80 percent of the country’s labor force. Major crop production and productivity have reached more than 270 million quintal and 22 quintal per hectare respectively. The areas of land developed with modern small-scale irrigation schemes have increased a little bit. The productivity of smallholder farmers has improved by introducing and disseminating of modern agricultural technologies [8].

Many achievements have been achieved in agricultural sector because of government’s national policies, strategies, programs, and investments. Agricultural Development Led Industrialization (ADLI) has been the central strategy of the government since the early 1900s when it gave the highest priority to the transformation of agriculture from subsistence livelihood to a market-oriented economic sector. This strategy has been the driving force for accelerating the country’s economic growth and development. This strategy has been further elaborated through sector specific policies and strategies such as Rural Development Policy and Strategy, Strategies for Pastoral Areas, Ethiopia Livestock Master Plan (ELMP), Policy Investment Framework (PIF), Agricultural Growth Project (AGP) I and II, the Food Security Strategy and its major programs such as livelihood, safety net, resettlement and community investment. These policies and strategies were also further refined by successive five -year development plans such as the Sustainable Development and Poverty Reduction Program, A Plan for Accelerated and Sustained Development to End Poverty (PASDEP), and the Growth and Transformation Plans 1 and 2 [3,8].

In line with the policies, the agricultural objectives were set to increase productivity through increasing the capacity and extensive use of labor, proper utilization of agricultural land, linking specialization with diversification, integrating agricultural and rural development, and strengthening the agricultural marketing system. The AGP is another large initiative, focused on high agriculture potential areas, designed to support agricultural productivity and commercialization to further accelerate the economic growth and transformation of the country by addressing key bottlenecks for agricultural growth [8].

The Nutrition Situation in Ethiopia

Despite the tremendous achievements in food security and nutrition, the problem of food and nutrition security remains a key main health and development issue for the country. The prevalence of stunting among children 6 to 59 months old is 38 percent and the prevalence of wasting and underweight in children is 24 and 10 percent respectively. Undernutrition of women aged 15-49 year is measured by body mass-index (BMI) less than 18.5. Based on this criterion, though the proportion decreased, 22 per cent remained thin. Micronutrient deficiency is also pervasive and severe across the country. The household dietary diversity is also shown to be affected by the diversity of agricultural production. Though consumption of food from different food groups is good for optimum nutrition, the consumption of diverse diet is low in Ethiopia. For instance, consumption of minimum acceptable diet by children in Ethiopia is only less than 5 percent, which is very low compared to other sub Saharan countries (EDHS- 2016).

Dependency on rain-fed agriculture and subsistent farming system, low genetic potential of indigenous animals and poor animal husbandry practices, limited access to water and animal feed, the widespread influence of disease and parasites, low coverage, and quality of implementation of the agricultural extension system, low educational status of most farming households and pastoralists, land degradation, soil infertility, lack of gender sensitivity which is explained by low participation and benefit of women from agricultural technologies and interventions are among other factors contributing to the problem of under-nutrition [1,3,8,10,11]. Ethiopia’s undernutrition records are unacceptable and among the highest in sub-Saharan Africa and the world. Recognizing the magnitude of the challenge, nutrition-specific and nutrition-sensitive interventions are being practiced. Nutrition-specific interventions, such as those that enhance access to micronutrients, are set to be delivered within existing health service delivery platforms and health tiers, namely community health extension programs and health facilities; whereas nutrition-sensitive interventions are meant to deal with the different underlying determinants and causes of undernutrition, such as access to adequate food and sufficient health services [1,3,5,11].

Undernutrition manifests itself in different multi-sector arenas, and multi-stakeholder interventions are required to address them. Nutrition-sensitive agricultural interventions are now said to be essential components of the Productive Safety Net Program and the Agriculture Growth Program in Ethiopia [1,3,6,11].

The following are nutrition sensitive agriculture interventions:

• Mainstreaming Nutrition into Agriculture (nutritionsensitive agriculture initiatives)

• School Feeding Program

• Food safety and food processing; and Food Fortification

• Family planning: healthy timing and spacing of pregnancy

• Water, sanitation, and hygiene (WASH)

• Early childhood care and development

• Girls’ and women’s education, economic strengthening

• Livelihoods and social protection

Acceleration of progress in nutrition will require nutritionsensitive programming effectiveness, large-scale programs that address key underlying determinants of nutrition and enhance the coverage and effectiveness of nutrition-specific interventions. For nutrition- sensitive agriculture, the Ministry of Agriculture and Natural Resources has taken the initiative to mainstream nutrition into its overall sectoral plans and has established nutrition implementing structures [8,11].

The government of Ethiopia has also been implementing the Productive Safety Net Program (PSNP) since 2005. The PSNP began as a food “safety net” that would provide food or cash for food insecure households during the “hungry” seasons of the year in exchange for public works through the Ministry of Agriculture. Although it began as a household food security program it has, for all practical purposes, evolved into a broader package of social protection, now comprising four components: social protection, livelihoods, disaster risk management, nutrition and climate resilience/green economy [7,8,11].

Nutrition and Agriculture Pathways

Over the last few decades, the Government of Ethiopia, through its national policies, plans and programs, accorded high priority to the agricultural and rural development sector. Agricultural Development Led Industrialization (ADLI) has been the overarching policy and strategy of the government since the early 1900s and assigned the highest priority to the transformation of agriculture from a subsistence source of livelihood to market-oriented economic sector, so as to enable it to become a driving force for accelerating the country’s economic development.

There has been increased political commitment at the national level towards nutrition sensitive agriculture in Ethiopia over the past few years as evidenced by the existence of the National Nutrition Strategy, as well as the inclusion of nutrition in various government policy documents. There are numerous strategy documents and programs aimed at improving nutrition in Ethiopia, such as GTP, PASDEP, Agricultural Development Led Industrialization (ADLI), HSDP, National Nutrition Strategy and national nutrition program (NNP).

Food production

Household food production can be critically important to the diets and nutrition of individuals in smallholder farmer households. In general, however, it is not the primary objective of an agricultural livelihood to produce all the food a family needs; most poor rural families are net purchasers of food. However, for those with access to arable land, it is a combination of food produced for consumption, income, and local food availability and prices that determines the family’s food security. Food production can affect the type, quantity, and seasonality of food available in the household for consumption. At the same time, production may also influence the availability and prices of diverse food in local markets [3,6,12].

The decisions farmers make about crop and livestock production are affected by many factors, including potential market prices, relative costs and risks associated with each product, the assets, and endowments of land the household possesses, and family needs and preferences. If preferred foods or varieties are not consistently available, affordable, or conveniently accessible in markets, raising or growing them on the farm may be the most efficient way to obtain them. Substituting a more nutritious variety of a crop already grown for consumption may be an easy way to improve nutrition as part of the overall set of livelihood decisions. Nutrition knowledge and SBC are therefore essential to informing the range of decisions that farmers make about what they grow to consume, what they grow to sell, and what they decide to purchase with their income.

Agricultural income

The agriculture income pathway assumes that nutritious, diverse foods are available and affordable in local markets. Appropriate inputs to grow these diverse foods must also be available so local production can meet demand. Additionally, market and transportation systems must enable year-round and/or seasonal supplies based on consumer preferences and purchasing power. Local supply and demand may also be influenced not only by market prices but also by SBC, nutrition knowledge, and social marketing, which may help drive consumer preferences [1,3,12].

Household investments in health, including potable water sources and toilets, preventive care, and other necessities, are crucial to supporting good nutrition, especially for women and young children. All rural farm households must balance their spending decisions between farm production and marketing investments and the immediate purchases of food, health, and care necessities. The effect of income on nutrition is not direct or easily predictable; it is always modified by what is available, affordable, and convenient to purchase; who decides what is purchased; and the many other factors that drive that decision [1,3,7,12].

Women’s empowerment

Increasing the agricultural income that women can control strengthens the income pathway to nutrition. Women’s income enables expenditures on food and health care, affecting diet and health status. Research shows that in many places around the world, income controlled by women is more frequently used on food and health care for the family, particularly for children. Often, the best way for women to influence how household income is spent is by earning their own income. For women in rural areas, an agriculturerelated livelihood is the most common way a family makes a living. Women’s decision-making also affects what is produced on the farm and women’s control of income and assets can affect productivity based on their spending decisions and on the social networks and cultural norms that influence those decisions. Training female and male farmers in farm management and business skills can optimize the income earned with the available time, labor, assets, and capital [3,7,12].

Food market environment

Agriculture and food systems contribute greatly to the food market environment in how nutrition messages are conveyed to consumers. Labeling and social marketing, for example, are tools that have been used by the food marketing industry and other value chain actors to influence food purchase decisions and consumption habits. This type of marketing may influence what people eat more extensively than nutrition education. Purchase decisions are affected not only by the relative price of different foods, but also factors such as convenience of purchase and preparation, available information about foods, and related perceptions of quality and safety. The food environment therefore interacts with household decision-making and food purchases in many ways and has a significant influence on household and individual nutrition [1,12].

Natural resources environment

All pathways between agriculture and nutrition are affected by natural resources: water, soil, climate, and biodiversity Natural resource endowment affects agricultural production potential and, therefore, management strategies for income generation and food availability. Appropriate management of often scarce natural resources, such as sustainable harvesting, use and drainage of water, soil fertility management, and managing access to productive land, is critical to a successful farming business. Rainfall patterns directly impact production cycles of farms without access to irrigation; and water availability, often a cause of human conflict, determines the type of viable farming systems. Access to potable water is essential for human health and nutrition. Irrigation for agriculture can impact human health, especially in areas of intensive cultivation that use chemical inputs [6,12].

Health, water, and sanitation environment

Nutritional status is strongly influenced by the health, water, and sanitation environment and access to health services. Agricultural production interacts with the health, water, and sanitation environment. For instance, some agricultural practices may contaminate water available for household use and water management may contribute to waterborne diseases as well as exposure to zoonotic disease or agrochemicals poses risks to human health, particularly during pregnancy. Infants and young children may be at risk of illness when livestock or agricultural production diminishes household sanitary conditions. With compromised systems, children are unable to properly absorb the nutrients they are consuming, thus negating any potential positive nutrition outcomes from increases in agriculture production or income. A key component of nutritionsensitive agriculture therefore includes consideration of the activities’ potential effects on the health, water, and sanitation environment [1,6,12] (Figure 1).