Roadside billboard erected by Mekelle University, Ethiopia

Supporting the Government of Ethiopia to end child undernutrition: Seqota Declaration

The Seqota Declaration is a bold commitment by the Government of Ethiopia to end child undernutrition in Ethiopia by 2030.  Big Win Philanthropy is partnering with the Deputy Prime Minister, two Regional Presidents and federal ministries that include health, water, agriculture, livestock, education, social protection and women to build leadership, enhance sector plans and position the program to deliver on its ambitious goal. This initiative will aim to double the speed of stunting reduction across the country, a rate never before seen in Africa.

40% of children under five are stunted
51% of child deaths are associated with undernutrition
$4.7bn cost to the Ethiopian economy in 2009 (16.5% of GDP)
20% earning shortfall for adults malnourished as children
2030 Government target date for eliminating child undernutrition

Background

The work is focused initially on 4 million people in the north of the country who face some of the greatest nutritional disadvantage in the world – child stunting in these areas averages around 50% and in some communities reaches 80%. The government plans to scale up the program from 2021 to reach the whole country. Ethiopia’s high population growth means that if the right investments are made now in the health and abilities of its children, they will grow up to become a powerhouse generation able to transform their country. But the window of opportunity for this demographic dividend will not last long, so the need for action is urgent.

Better nutrition is crucial for Ethiopia’s children and its economy. Children who lack key nutrients such as protein and vitamins during the period from conception to the age of two become “stunted” for the rest of their lives – shorter, weaker, more vulnerable to disease and cognitively impaired. In Ethiopia 40% of children under five are stunted. Child undernutrition is associated with half of all child deaths and costs the country 16% of its income. The program is named after the town of Seqota, which has historically been at the center of Ethiopia’s worst famines. This sends the message that the government is determined to tackle stunting even in the most challenging localities.

Undernutrition is caused not only by inadequate diet but also by indirect factors such as poor hygiene causing diseases which make the body actually lose nutrients. This means that “nutrition-smart” action by sectors such as water, sanitation, agriculture and education are needed as well as “nutrition-specific” action by the health sector.

Progress to date

Big Win’s support started in 2015 when the government had a roughly costed 15-year action plan. Big Win was asked to work with a broad coalition of Ethiopian leaders to upgrade plans to optimize returns on investment, and to help position them to secure new funding. By late 2017 detailed sector plans were complete and the total raised had reached $260m with funding from the government and a range of partners. In 2018 implementation began. Big Win’s involvement includes:

  • Funding for delivery units to drive performance across multiple sectors, and practical help in setting up these units. Three units with 17 staff are now established at federal and regional levels. They are engaging with the relevant ministries, as well as with sectors outside government such as religion and business.
  • Technical assistance to support the development of an optimal plan for water management. Much of Ethiopia is arid, and water is crucial for improving food production and hygiene, so better water management- for example to enable a big increase in irrigation – would transform people’s lives. As part of this work, two visits to Israel have been undertaken for officials and ministers for water, agriculture, livestock and health to learn from Israel’s success in managing water under arid conditions. One outcome of these visits is a plan to have access to clean water within 5km of every household.
  • Technical assistance to drive adoption at household level of behaviors that underpin better child nutrition. Family behavior makes a big difference to nutrition, so a social movement delivered via thousands of front-line workers will be key in promoting key behavior changes to one million households. These include changes to breastfeeding practices, more handwashing, a more varied diet for pregnant women and exempting young children from religious fasting practices.
  • Household surveys to establish accurate baseline and performance data to measure the impact of the program and enable ongoing monitoring of progress and upgrading of interventions as appropriate.