This is a presentation given by Andrea Warren as part of the USAID/ ENGINE (Empowering New Generations to Improve Nutrition and Economic opportunities) research symposium on 27-28 June, 2016 at the Hilton hotel, Addis Ababa, Ethiopia.

1. Stories of Change in Nutrition:
Ethiopia
Andrea Warren, PhD candidate
June 28, 2016
Addis Ababa, Ethiopia

2. Introduction
• Stories of Change in
Nutrition
• Document
experiential learning
• Tracing an idea:
Linear cascading
case study

3. International  Federal  Zone  Woreda Kebele
Community
Federal/International: (largely) PSNP actors
Woreda and zone: PSNP, agriculture, and health personnel
Kebele: leaders
Community: Household experiences with health, agriculture,
and safety net programming

4. Study questions
• How is nutrition sensitivity becoming established across
sectors and levels and what does it take to make ‘nutrition
sensitivity’ operational?
• Questions of institutional structures, capacities,
practices, and attitudes
• The operating systems through which it will be
implemented
• The conditions and perspectives of the communities
that are meant to receive it.

5. Study design and methods
• Flexible and adaptive qualitative study
• Data sources:
o over 60 qualitative key informant interviews with
federal officials, international donors, NGOs, and
partners, subregional agriculture, health, and social
protection officials, kebele officials
o 30 household interviews
o Review of national strategies, program documents
and evaluations

6. International and Federal
• Multisectoral coordination, leadership, and commitment
• A progressive policy environment for nutrition
• How are ideas and interventions cascaded from federal
to kebele level?
• What are some of the real world challenges of
implementing nutrition-sensitive agendas?

7. Zone and Woreda
• Awareness of concepts and national strategies
• Coherence of perspectives on nutrition–causes and
outcomes
• Vagueness of roles of health, ag, and social protection
• Lack of enforced coordination mechanisms
• Day to day challenges
• Perceptions of frontline worker workloads
• Limits on implementation: the state of existing platforms

8. Household
• Engagement in
programming:
what are the
constraints
beyond
education?
• Environmental
barriers
• Complexity of risk

9. Implications
• Implications for implementation
• For consideration: Change the system or adapt the
programming?
• Stories of change really one of ongoing change—pieces of a
picture that begin to fit together when researching the uptake
and adaptation of an idea and the experiences of those
grappling with this idea in real time.

10. Acknowledgments
Study participants—federal to household
Eskinder Wolka
Kenaw Gebreselassie and the Transform Nutrition Team
ENGINE/USAID