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Nutrition Sensitivity in Ethiopia's Productive Safety Net Programme: Tracing the Movement of an Idea in Ethiopia's Development Landscape
Author(s) -
Warren Andrea M.,
Frongillo Edward A.,
Gillespie Stuart
Publication year - 2016
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.30.1_supplement.274.3
Subject(s) - operationalization , government (linguistics) , flexibility (engineering) , context (archaeology) , negotiation , qualitative research , focus group , economic growth , political science , business , public relations , sociology , marketing , economics , geography , social science , management , philosophy , linguistics , archaeology , epistemology
Background Nutrition sensitivity has emerged over the past 5–10 years as an influential idea in international development programming. The Ethiopian government has subscribed to the health and economic potential of a focus on nutrition and nutrition sensitivity more recently, as evidenced by the 2013 introduction of their comprehensive, multi‐sectoral National Nutrition Programme. In one of the first moves of its kind at this scale, the government explicitly “sensitized” the 2015 fourth iteration of their well‐known social protection scheme, the Productive Safety Net Programme (PSNP). Objective The objective of this qualitative study was to investigate how understandings of and negotiations toward the operationalization of the idea of nutrition sensitivity developed during the early phases of “sensitizing” a large social protection scheme to nutrition. Methods Sixty in‐depth, qualitative interviews were conducted with stakeholders at the international, federal, district, subdistrict, village, and household levels over a period of 18 months. Interviews were recorded or detailed notes were taken. They were coded to identify, compare, and contrast themes within and across levels. Relevant program documents were also collected and analyzed. Results In the Ethiopian context, the inherent flexibility within the idea of nutrition sensitivity, which allows for its key characteristic of adaptability, prevented intended audiences from being confident in their understanding of how to implement this concept. Stakeholders at all levels anticipated that pre‐existing systemic constraints around implementation capacity of both national health and agriculture programs would significantly inhibit successful implementation of nutrition‐sensitive programming within the PSNP. Despite potential implementation barriers, stakeholders indicated that the powerful, government‐backed momentum around the idea would continue, ideally leading to positive impacts on nutritional outcomes within the next decade. Conclusions This study provides evidence of 1) how understandings around the operationalization of nutrition sensitivity take shape and begin to materialize at multiple levels of operation and within multiple sectors, and 2) the contextual factors that influence the design and uptake of nutrition‐sensitive programming. Recommendations derived from this study are relevant for stakeholders engaged in the design, dissemination, and implementation of multi‐level and multi‐sectoral approaches to nutrition. Support or Funding Information This work is supported through Transform Nutrition funded by UK aid from the UK government, through the CGIAR Agriculture for Nutrition and Health Programme and through the Stories of Change Project from the Children's Investment Fund Foundation.