Leveraging Systems Approach for Healthier and Sustainable Diet Policy in Ethiopia
By Alebel Weldesilassie 16 June 2021
Location/s:
Ethiopia

Over the past two decades, Ethiopia, the second most populous country in Africa with about 110 million people, has achieved significant progress in improving Nutrition status. For instance, stunting was reduced from 58% in 2000 to 38% in 2016. Despite such improvement, a substantial share of its population remains chronically undernourished and suffers from micro-nutrient deficiencies[1]. For example, it is estimated that the number of adults with diabetes in the country will be double and become 2.7 million by 2030[2]. Poor diets are major cause of malnutrition, morbidity and mortality. Ethiopian government recognizes it, as demonstrated in the National Nutrition Program (NNP) in 2013 (revised in 2016) and its National Food and Nutrition Policy in 2017, along with its Seqota Declaration which commits the National Government to eradicate the underlying causes of chronic under-nutrition and ending stunting among children under 2 years old by 2030. The promotion of healthier diets is at the center of these initiatives to addressing the problems of under-nutrition, micro-nutrient deficiencies, obesity and emerging diet-related non communicable diseases. Embedded within these initiatives is the adoption of a sustainable food system approach. This will play an important role in the development of transformative and sustainable change. The effective implementation of these efforts requires, however, the cooperation of many actors in the overall food system including food producers and processors, storage and transportation operators, traders and consumers themselves. To facilitate this transformation there is an ongoing effort by the Ethiopian Public Health Institute (EPHI) to prepare a national food-based dietary guideline (FBDG). Although this is a laudable and worthwhile effort, other components of the food system need to be taken into account as well in order to reach a more general solution. In this context a panel of (inter)national researchers and other stakeholders recently analyzed the food system and identified a number of crucial research priorities in the Ethiopian context. One of the important conclusions was that there is a need for extensive diagnosis and research to characterize dietary gaps and dietary transitions as well as to anticipate which food system dynamics contribute positively or negatively to those trends[3]. The impact of the COVID pandemic also illustrates the urgent need to study changes in the food system and to evaluate what approaches may be used to improve and deliver healthy and sustainable diets. The proposed study, thus, seeks to build on the recommendations of the aforementioned panel and the various ongoing government initiatives. This will be done through systemic thinking in which the interactions between the different components of the food system will be considered and examined, and how overall change can be affected through a systems approach in which the various components will be seen as complementing one another and functioning in a network. Accordingly, it is proposed to significantly improve data not only on dietary quality and dietary pattern, but also to elucidate where there are major gaps in various components of the overall food system including: (i) the food supply system which includes food production, processing and transformation as well as marketing; (ii) consumer behavior, preference and food affordability; (iii) policy and institutional and socio-cultural conditions which influence people’s choices of various kinds of food and; (iv) drivers of transformation of the food system and dietary transition. While diet quality will be at the focus in the proposed study, consideration will also be given to: a) the trade-off between diet quality and the impact of the food system on the environment, social equity and vulnerable groups of society, including women and; b) the dynamic nature of the food system in terms of understanding the causal relationship and feedback loops between the different components and actors that drive the change.

Addressing gaps in the overall food system and the identified specific areas will be done in three stages, namely: understand, identify and inform. Each of these will be addressed through a set of specific objectives. (2.1) The first objective is to develop a methodological framework for consumer focused agri-food value chain in Ethiopia based on health, nutrition, social and environmental indicators. (2.2) The second objective is to identify healthier food items that are affordable and accessible to all including low – income group and vulnerable people including women and children with minimum environmental tradeoffs. (2.3) The third objective is to inform public policy that guide future practice by identifying the necessary conditions that can take the food systems approaches for healthier and sustainable diets in Ethiopia.

The project is a three - years collaborative project of Ethiopian Policy Studies Institute, Ethiopian Public Health Institute, McGill University and Wagningen University. The project is led by Dr. Alebel Bayrau from PSI, co-lead by Dr. Masresha from EPHI, Prof Inge Brouwer (WUR) and Prof Michael Ngadi, from McGill Unieveristy. The project is supported by IDRC. 

 

[1] Wordofa and Sassi (2020). Impact of agricultural interventions on food and nutrition security in Ethiopia: Uncovering pathways linking agriculture to improved nutrition. Cogent Food & Agriculture, 6:1

[2] Global Panel on Agriculture and Food Systems for Nutrition. 2016. Food systems and diets: Facing the challenges of the 21st century. London, UK.

[3] Mestawet Gebru, Roseline Remans, Inge Brouwer and others (2018), “Food Systems for Healthier Diets in Ethiopia: Toward a Research Agenda” IFPRI Discussion Paper 01720, April 2018.

[4] The availability of such system will enhance the ability of agencies to target their interventions and improve their efficacy in delivering food aid and improve nutrition.

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