Food and Nutritional Security, Strategies and

programs

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• Food security exists
– When all people, at all times, have physical, social
and economic access to sufficient, safe and
nutritious food which meets their dietary needs
and food preferences for an active and healthy life
• Food insecurity exists
– When people do not have adequate physical,
social or economic access to food as defined
above

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Food security vs. Food Self Sufficiency
• Food security
– Being able to get adequate and sufficient food, regardless
of where it comes from
– These days, it comes from all over the world. We are able
to buy food from all over the world because we have the
money to purchase the food
• Food self-sufficiency
– In contrast , food self-sufficiency is defined as being able
to meet consumption needs (particularly for staple food
crops) from own production rather than by buying
or importing
– Is when we grow all the food we need, right here at home

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• Nutrition security
– Access of all people at all times to sufficient food, including
adequate utilization and absorption, in order to be able to
live a healthy and active life
– A household achieves nutrition security when it has secure
access to food coupled with a sanitary environment,
adequate health services and knowledgeable care to ensure a
healthy life for all household members

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The Conceptual Framework of Food Security

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• Two determinants influence the framework:
– Physical determinant
– Temporal determinant
• Physical determinant is the food flow
– Availability → Accessibility → Utilization
– Availability is achieved if adequate food is ready to have at
people’s disposal
– Access is ensured when all households and all individuals
within those households have sufficient resources to obtain
appropriate foods (through production, purchase or donation)
for a nutritious diet
– Adequate Utilization refers to the ability of the human body to
ingest and metabolize food

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• The temporal determinant
– Stability refers to the temporal determinant of FNS and
affects all three physical elements
• Chronic food and nutrition insecurity due to
– Repeated food shortages before harvest
“seasonality”
– Lack of caring during harvest
• Transitory food and nutrition insecurity due to
– Natural disasters
– Man made disasters

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Conceptual frame work of nutrition security

• This conceptual framework for nutritional status emphasizes

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 Conceptual framework of food security
and nutritional status at household level

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• The two most commonly used conceptual frameworks show
significant differences
– The food security framework emphasizes an economic
approach in which food as a commodity is a central focus
– The nutrition security framework adopts a biological
approach in which the human being is the starting point

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The three characteristics of a FNS Program
• FNS program has to meet three requirements.
– The most nutritional vulnerable people are addressed
(adequate targeting)
• FNS program must be targeted to reach the most
nutritional vulnerable population groups
• Malnutrition is most prevalent in the poorest segment of
society
• However, FNS is not identical to poverty alleviation since
poverty is far more comprehensive than malnutrition
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– Proper design

• The selected interventions are based on the identified

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– High effectiveness and efficiency
• The interventions can improve and secure the
nutritional situation of the malnourished target group
at the lowest costs
• The program must ensure that the interventions lead to
an improved nutritional situation and to increased FNS
• As a result, FNS programs require routine monitoring
and critical evaluations that validate high program
effectiveness

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Food and nutrition security situation in Africa

– In one-third of African countries, the mean daily calorie

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– More than a third of African children are stunted in their
growth and must face a range of physical and cognitive
challenges not faced by their better-fed peers
– An estimated 200 million people on the continent are
undernourished or unable to meet their dietary energy
requirement
– Undernutrition of various sorts is the major risk factor
underlying more than 28 percent of all deaths in Africa
(some 2.9 million deaths annually)

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Interventions for FNS
• Suggested interventions to increase food security include
– Providing credit and inputs for farming such as agricultural
starter packs;
– Making available low-interest loans for farmer support program
– Developing irrigation schemes
– Improving management of natural resources and the
environment
– Providing community grain storage, processing facilities, and
access to community agricultural transport services
– Improve access to household water and sanitation
– Increasing access to land and land tenure
– Implementing price controls and subsidies for food.

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– Improve access to
• Antiretroviral vaccines, as well as treatment of other
communicable diseases
• Health facilities
• Enriched feeding schemes for infants, pregnant women
and the elderly
• Training in areas like food preparation, hygiene, child
care, water and sanitation, and diet diversity
– Consolidating access to social grants, especially for child
support and old age
– Providing food subsidies in chronic need situations

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National Nutrition Strategy
• In February 2008, the Government of Ethiopia formulated
and launched its first ever National Nutrition Strategy (NNS)
thereby achieving a major step forward in its efforts to tackle
persistent malnutrition in the country.
– To address the broad multi‐sectoral factors contributing to
malnutrition
• Before NNS, focus has been placed on addressing food
security as the primary means to address nutritional
insecurity.
• Although nutrition is recognized in the NNS as being multi‐
sectoral, the overall responsibility for coordinating the
strategy has been given to the Federal Ministry of Health
(FMOH)

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• Progress has been made in Ethiopia to reduce child
malnutrition
– Underweight prevalence has decreased by approximately
0.5 percentage points between 2000 and 2005
– However, the proportion of underweight children in the
country would need to reduce by more than 2 percentage
points per year to achieve MDG 1 by 2015
– Malnutrition in Ethiopia is the underlying cause of 57% of
child deaths and thus failing to address this problem will
also hold back progress towards reaching MDG 4 to reduce
child mortality

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• The overall Goal of the Ethiopia National Nutrition Strategy
– Is to ensure that all Ethiopians attain adequate nutritional status in a
sustainable manner, which is an essential requirement for a healthy
and productive life
• Specific objectives are to:
– Provide due attention to malnutrition of vulnerable groups of the
society, particularly under 5 children and pregnant and lactating
women
– Ensure the citizens are free from malnutrition related health problems;
– Protect the society from unhealthy dietary patterns and unhealthy
lifestyles that may affect their health and
– Coordinate and support nutrition activities of all sectors, government,
nongovernmental organizations and individuals working to alleviate
nutritional problems.

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• Progress in Implementing the National Nutrition Strategy
– The National Nutrition Program (NNP) was developed in
order to implement the NNS
– The National Nutrition Program (NNP) translates the
strategies of the National Nutrition Strategy into program
actions

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• The Federal Ministry of Health in collaboration with relevant
government sectors and partners developed the National
Nutrition Program (NNP) in order to guide the
implementation of the NNS
– NNP is a long‐term program that will be implemented in
two phases over 10 years starting 2008, with each phase
lasting five years

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– The NNP I, for the first five years (2008/2009‐2012/2013),
was finalized and approved by the National Nutrition
Coordination Committee in December 2008
– NNP targets the most vulnerable groups as mentioned
above and also gives priority to the rural population
while recognizing that significant malnutrition exists in
low income urban areas

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• The NNP has primary impact, outcome and intermediate
objectives
– The primary impact objectives include:
• Reduce the prevalence of underweight (W/A <‐2 z‐
scores) from 38% to 30% by 2013
• Reduce the prevalence of stunting (H/A <‐2 z‐scores)
from 46% to 40% by 2013
• Reduce the prevalence of wasting (W/H <‐2 z‐scores)
from 11% to 5% by 2013

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• The NNP seeks to address/achieve the above objectives using
eight strategies that are grouped into two main components
– Nutrition Service Delivery component
– Institutional Strengthening component to support the
service delivery

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• The Nutrition Service Delivery component has four sub‐
components:
– a) Sustaining Enhanced Outreach Strategy (EOS) with
Targeted Supplementary Food (TSF) and Transitioning of
EOS into HEP
– b) Health Facility Nutrition Services (Management of severe
malnutrition, nutrition and HIV, Infant and Young Child
feeding (IYCF), women nutrition and Baby Friendly Hospital
Initiative (BFHI)

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– c) Community Based Nutrition (CBN)
• It is preventive community‐based nutrition program
which empowers the community to assess, analyze and
take action to improve children’s and women’s
nutritional status through
– Community conversation
– Under two years children community GMP
– Pregnancy weight monitoring
– Individual and group counseling on child care and
feeding (ENA) and maternal nutrition
– Community based screening and management of
malnutrition
– Linkages to community based food security, water
and sanitation, productive safety net programs
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– d) Micronutrient Interventions
• It focuses on
– Universal Salt iodization (USI) as the main intervention for
control and prevention Iodine Deficiency Disorder (IDD)
– Prevention and control of
» Iron Deficiency Anemia (IDA)
» Vitamin A Deficiency (VAD)
» Zinc deficiency

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• The Institutional Strengthening for Nutrition Policy and
Program Implementation has four sub‐components.
– a) Strengthening Human Resources and Capacity Building
– b) Advocacy, Social Mobilization and Program
Communication
– c) Nutrition Information System/Surveillance, Monitoring
and Evaluation and Operation Research
– d) Strengthening Multi‐Sectoral Nutrition Linkages

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Thank you!

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