IR2. Promoting Optimal Nutrition, WASH, and Agriculture Behaviors

The goal is to improve maternal, adolescent and child nutrition by increasing the adoption of optimal nutrition, WASH, and agriculture behaviors using social and behavior change communication (SBCC). This approach addresses gaps and promotes alignment and consistency of SBCC activities across the country.

IR2 integrates programming related to nutrition-sensitive agriculture (IR1), nutrition-specific interventions through the health sector (IR3), and WASH (IR4). The targets are women and their family members, caretakers, and the most vulnerable households with children under two. The SBCC focus on women emphasizes equal distribution of responsibilities and decision-making in households for optimal family health and growth.

The following focus areas are identified under IR2:

  • Evidence-based SBCC approaches to improve nutrition, WASH, and agriculture-related behaviors
  • Frontline agriculture and health workers’ skills related to SBCC
  • Promotion and support of SBCC at community and household levels

Key Progress in Project Year II 

During the Project Year II, Growth through Nutrition availed key materials for all partners on an online SBCC Resource Bank as part of the knowledge management website. Reports on adolescent nutrition formative research and the maternal nutrition trial of improved practices (TIPs) research were finalized and SBCC strategy was formulated. The project started Enhanced Community Conversations (ECCs) via both LNGOs and MVHH saving group platforms to improve the adoption of maternal, infant, young child nutrition (MIYCN) practices, reaching a total of 13,155 individuals. The Ethiopian Orthodox Tewahedo Church – Development Association (EOTC-DICAC) also provided training for 247 clergies on laws and regulations related to fasting for pregnant and lactating women, and children under two in Amhara region.

Key Progress in Project Year III

Growth through Nutrition developed annotated descriptions for the set of seven new adolescent nutrition SBCC print materials for health clubs, teachers’ guide, and TOT module updated to the Growth through Nutrition’s online SBCC Resource Bank

Developed adolescent radio spot program for in-school girls:  In Year III, Growth through Nutrition supported twelve educational radio stations in Tigray, Amhara, Oromia, and SNNP Regions to produce and transmit 166 radio adolescent spot programs for in-school gitls and developed a set of new SBCC print materials for use with adolescents both in- and out-of-school. A rapid assessment was conducted in Quarter III to identify additional content to be transmitted as well as to verify the reach and quality of transmission. In depth interviews were conducted with radio program producers, teachers, and directors while focus group discussions were made with students in five selected schools from project Regions. 

Additionally, the project conducted a rapid assessment in Tigray and Amhara Regions and Ethiopian Orothodox Tewahedo Church head office in Addis Ababa to identify strengths and limitations of the current approach and recommend a more suitable approach to address harmful fasting norms. 

Key Progress in Project Year IV

During year IV the first 1,000-day radio program was aired in the Tigray and Oromia regions. Additionally a first 1,000 days assessment report, as well as Adolescent Nutrition SBCC document were produced during the year. Following the completion of transmissions in 2019, a rapid assessment and subsequent revision and development workshop was conducted to include anemia prevention during adolescence, early marriage, food frequency and diversity and other key topics. 

As a member of the National Health Communication and Promotifon Task Force, Growth through Nutrition provided support during 22 national and regional SBCC meetings in the year and also provided support for the development of the next Health Sector Transformation Plan. Following the COVID-19 outbreak, technical support in SBCC focused on preventative communication related to the Pandemic. In addition, more than 86,000 coronavirus risk communication promotion materials (posters and flyers) were distributed.

The SBCC arm of the project focused on improving the capacity of frontline agriculture and health workers during year IV, encouraging the utilization of practical tools such as training manuals and SBCC material package by extension workers.  Relevant SBCC materials were printed and distributed and the resource library of the learning website was also updated with the relevant SBCCs, strategies and learning documents. 

Consumption of animal source foods is negatively impacted by religious fasting of Orthodox Christian communities in Tigray and Amhara regions. Local and national religious leaders were therefore mobilized in a two-day training by the project to teach the importance of exempting children under 7 from fasting.


The added value of virtual facilitator as a Social and Behaviour Change Communication approaches to improve Infant and Young Child Feeding, women diet diversity, women empowerment and WASH practices:

Improving key nutrition practices requires change at the individual, household, and community levels, and in services for mothers and families—all of which must be supported by an enabling environment. In addition to the existing SBCC approach under Growth through Nutrition, a new tool designed to complement the ECCs called the Virtual Facilitator (VF), a pre-recorded audio message with actors modeling the desired knowledge and behaviors, is anticipated to make the SBCC program more robust and scalable.

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Webinar: The Role of Animal Source Foods in Nutrition Security, Growth and Early Child Development: Benefits, Opportunities and Challenges

Animal sourced foods (ASFs) are nutrient-dense foods that when consumed in small amounts provide quality protein, vitamins, minerals, and amino acids, and all nutrients critical for growth and early child development. In this webinar, Dr. Shibani Ghosh will examine the role of Animal Source Foods in improving the nutritional status of vulnerable populations, present multi-country analyses assessing the role of the type of ASF and the total number of ASFs, and contextualize the opportunities and challenges in supporting actions promoting its consumption.

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Transforming Food Systems Lessons Learned from Global and Local Experience - Summary Notes

On December 1, 2020 - Tufts University, in collaboration with Save the Children International  conducted a webinar  and discussed the core elements of food systems, external drivers, and poliitical economy issues that facilitate or impede important changes in food systems. It also covered critical gaps in knowledge regarding the tradeoffs embedded in the SDGs, as well as policies that could bring about dramatic changes in food systems.  the major lessons and paths forward in regards to improving food systems transformations to meet nutritional needs in a sustainable manner.

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Success Story - the husband and wife team working to change their nutrition future

Since Birke Abera's husband Yohanis received awareness about child feeding practices, he has gone out of his way to support his wife where he can and they have learned to discuss and agree on their family's activities. Empowered by this new knowledge, the duo has transformed the fate of their family from being nutritionally vulnerable to capable of providing a healthy and nutritious to their son consistently.

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Success Story - Setting an Example for Health Extension Workers Everywhere

In Debark Woreda of North Gondar, Bizuwork Zewdu, a Health Extension Worker, is just one of many who have felt the impact of Grant under Grant, a growth through nutrition initiative. Bizuwork engages actively in securing a better future for her community's nutrition, working with mothers to demonstrate best practices in Deber HEalth post, where she works. 

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Looking Back to Look Forward: Lessons Learned from ENGINE and Growth through Nutrition

The paper below is a summary of key research findings, lessons learned and program/policy recommendations from operation research studies conducted under the Growth through Nutrition and its predecessor ENGINE project. It also highlights some of the ways the project learning, research dissemination and capacity building activities have had a positive outcome of turning “research into action” and summarizes the way forward.

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