Poor dietary quality is a significant risk factor for stunting and micronutrient deficiencies among young children and globally one of the leading causes of premature death and disease (Arimond & Ruel, 2004; Forouzanfar et al., 2015). Dietary quality is typically proxied by diversity of the consumed diet. Foods with similar nutritional qualities are first grouped together and dietary diversity is measured by the number of different food groups consumed in a certain time interval. For example, the World Health Organization recommends that children 6-23 months consume at least from four food groups (out of seven) every day. Based on this metric, Ethiopian children in this age range consume one of the least diversified diets in sub-Saharan Africa (Hirvonen, 2016) with only 14 percent meeting the WHO recommendation (CSA & ICF, 2016). Recent analysis of the timing of growth faltering of young children suggests that poor complementary feeding practices, including poor dietary quality, is an important risk factor for stunting in Ethiopia (Hirvonen, Headey, Golan, & Hoddinott, 2019). The available evidence suggests that diets are monotonous also at the household level. For example, in 2011, the average Ethiopian household consumed only 42 kg of fruits and vegetables in a year per adult equivalent (Hassen Worku, Dereje, Minten, & Hirvonen, 2017) – far below the World Health Organization’s recommendation of 146 kg per year (Hall, Moore, Harper, & Lynch, 2009). This report is structured as follows. In the subsequent section, we describe the data used in this report. In section 3, we assess the consumption of nutritious foods among vulnerable groups: young children and mothers. In section 4, we assess the production of nutritious foods in the region. In section 5, we study the availability of nutritious foods in rural markets. In section 6, we assess the affordability of nutritious foods in the region. Section 7 concludes and summarizes the findings.

Poor dietary quality is a significant risk factor for stunting and micronutrient deficiencies among young children and globally one of the leading causes of premature death and disease (Arimond & Ruel, 2004; Forouzanfar et al., 2015). Dietary quality is typically proxied by diversity of the consumed diet. Foods with similar nutritional qualities are first grouped together and dietary diversity is measured by the number of different food groups consumed in a certain time interval. For example, the World Health Organization recommends that children 6-23 months consume at least from four food groups (out of seven) every day. Based on this metric, Ethiopian children in this age range consume one of the least diversified diets in sub-Saharan Africa (Hirvonen, 2016) with only 14 percent meeting the WHO recommendation (CSA & ICF, 2016). Recent analysis of the timing of growth faltering of young children suggests that poor complementary feeding practices, including poor dietary quality, is an important risk factor for stunting in Ethiopia (Hirvonen, Headey, Golan, & Hoddinott, 2019). The available evidence suggests that diets are monotonous also at the household level. For example, in 2011, the average Ethiopian household consumed only 42 kg of fruits and vegetables in a year per adult equivalent (Hassen Worku, Dereje, Minten, & Hirvonen, 2017) – far below the World Health Organization’s recommendation of 146 kg per year (Hall, Moore, Harper, & Lynch, 2009). This report is structured as follows. In the subsequent section we describe the data used in this report. In section 3, we assess the consumption of nutritious foods among vulnerable groups: young children and mothers. In section 4, we assess the production of nutritious foods in the region. In section 5, we study the availability of nutritious foods in rural markets. In section 6, we assess the affordability of nutritious foods in the region. Section 7 concludes and summarizes the findings.

Poor dietary quality is a significant risk factor for stunting and micronutrient deficiencies among young children and globally one of the leading causes of premature death and disease (Arimond & Ruel, 2004; Forouzanfar et al., 2015). Dietary quality is typically proxied by diversity of the consumed diet. Foods with similar nutritional qualities are first grouped together and dietary diversity is measured by the number of different food groups consumed in a certain time interval. For example, the World Health Organization recommends that children 6-23 months consume at least from four food groups (out of seven) every day. Based on this metric, Ethiopian children in this age range consume one of the least diversified diets in sub-Saharan Africa (Hirvonen, 2016) with only 14 percent meeting the WHO recommendation (CSA & ICF, 2016). Recent analysis of the timing of growth faltering of young children suggests that poor complementary feeding practices, including poor dietary quality, is an important risk factor for stunting in Ethiopia (Hirvonen, Headey, Golan, & Hoddinott, 2019). The available evidence suggests that diets are monotonous also at the household level. For example, in 2011, the average Ethiopian household consumed only 42 kg of fruits and vegetables in a year per adult equivalent (Hassen Worku, Dereje, Minten, & Hirvonen, 2017) – far below the World Health Organization’s recommendation of 146 kg per year (Hall, Moore, Harper, & Lynch, 2009). This report is structured as follows. In the subsequent section, we describe the data used in this report. In section 3, we assess the consumption of nutritious foods among vulnerable groups: young children and mothers. In section 4, we assess the production of nutritious foods in the region. In section 5, we study the availability of nutritious foods in rural markets. In section 6, we assess the affordability of nutritious foods in the region. Section 7 concludes and summarizes the findings.

Poor dietary quality is a significant risk factor for stunting and micronutrient deficiencies among young children and globally one of the leading causes of premature death and disease (Arimond & Ruel, 2004; Forouzanfar et al., 2015). Dietary quality is typically proxied by diversity of the consumed diet. Foods with similar nutritional qualities are first grouped together and dietary diversity is measured by the number of different food groups consumed in a certain time interval. For example, the World Health Organization recommends that children 6-23 months consume at least four food groups (out of seven) every day. Based on this metric, Ethiopian children in this age range consume one of the least diversified diets in sub-Saharan Africa (Hirvonen, 2016) with only 14 percent meeting the WHO recommendation (CSA & ICF, 2016). Recent analysis of the timing of growth faltering of young children suggests that poor complementary feeding practices, including poor dietary quality, is an important risk factor for stunting in Ethiopia (Hirvonen, Headey, Golan, & Hoddinott, 2019). The available evidence suggests that diets are monotonous also at the household level. For example, in 2011, the average Ethiopian household consumed only 42 kg of fruits and vegetables in a year per adult equivalent (Hassen Worku, Dereje, Minten, & Hirvonen, 2017) – far below the World Health Organization’s recommendation of 146 kg per year (Hall, Moore, Harper, & Lynch, 2009). This report is structured as follows. In the subsequent section, we describe the data used in this report. In section 3, we assess the consumption of nutritious foods among young children and also carry out a similar assessment at the household level. In section 4, we study the production of nutritious foods in the region. In section 5, we examine the availability of nutritious foods in rural markets. In section 6, we assess the affordability of nutritious foods in the region. Section 7 concludes and summarizes the findings.

Ethiopia has witnessed significant reductions in child mortality, undernutrition, and communicable diseases, but more substantial and faster progress is still needed. The rise in obesity and in noncommunicable diseases, particularly in urban areas, is alarming and requires urgent policy and programmatic attention. Unhealthy diets drive both undernutrition and obesity and are the underlying cause of significant proportion of both communicable and non-communicable diseases. Maintaining the relatively high breastfeeding practices and increasing the diversity of diets will be critical to improving nutrition in Ethiopia. Implementation of effective nutrition messaging that shapes consumer behavior to adopt healthy dietary patterns, while bridging gaps in both the reach and the quality of such messaging is warranted. The health extension program, which is the cornerstone of the transformation of the health sector, may need to be redesigned in a way that improves its reach and the quality of the services it provides and minimizes the risk of burnout of frontline health workers. Interventions focusing on making healthy diets available, affordable, and accessible are urgently needed.

New evidence this year corroborates the rise in world hunger observed in this report last year, sending a warning that more action is needed if we aspire to end world hunger and malnutrition in all its forms by 2030. Updated estimates show the number of people who suffer from hunger has been growing over the past three years, returning to prevailing levels from almost a decade ago. Although progress continues to be made in reducing child stunting, over 22 percent of children under five years of age are still affected. Other forms of malnutrition are also growing: adult obesity continues to increase in countries irrespective of their income levels, and many countries are coping with multiple forms of malnutrition at the same time – overweight and obesity, as well as anaemia in women, and child stunting and wasting.

We assess the impact of Ethiopia’s flagship social protection program, the Productive Safety Net Program (PSNP) on the adverse impacts of the COVID-19 pandemic on food and nutrition security of households, mothers, and children. We use both pre-pandemic in-person household survey data and a post-pandemic phone survey. Two thirds of our respondents reported that their incomes had fallen after the pandemic began and almost half reported that their ability to satisfy their food needs had worsened. Employing a household fixed effects difference-in-difference approach, we find that the household food insecurity increased by 11.7 percentage points and the size of the food gap by 0.47 months in the aftermath of the onset of the pandemic. Participation in the PSNP offsets virtually all of this adverse change; the likelihood of becoming food insecure increased by only 2.4 percentage points for PSNP households and the duration of the food gap increased by only 0.13 months. The protective role of PSNP is greater for poorer households and those living in remote areas. Results are robust to definitions of PSNP participation, different estimators and how we account for the non-randomness of mobile phone ownership. PSNP households were less likely to reduce expenditures on health and education by 7.7 percentage points and were less likely to reduce expenditures on agricultural inputs by 13 percentage points. By contrast, mothers’ and children’s diets changed little, despite some changes in the composition of diets with consumption of animal source foods declining significantly.

The perception of Ethiopia projected in the media is often one of chronic poverty and hunger, but this bleak assessment does not accurately reflect most of the country today. Ethiopia encompasses a wide variety of agroecologies and peoples. Its agriculture sector, economy, and food security status are equally complex. In fact, since 2001 the per capita income in certain rural areas has risen by more than 50 percent, and crop yields and availability have also increased. Higher investments in roads and mobile phone technology have led to improved infrastructure and thereby greater access to markets, commodities, services, and information. In Food and Agriculture in Ethiopia: Progress and Policy Challenges, Paul Dorosh and Shahidur Rashid, along with other experts, tell the story of Ethiopia's political, economic, and agricultural transformation. The book is designed to provide empirical evidence to shed light on the complexities of agricultural and food policy in today's Ethiopia, highlight major policies and interventions of the past decade, and provide insights into building resilience to natural disasters and food crises. It examines the key issues, constraints, and opportunities that are likely to shape a food-secure future in Ethiopia, focusing on land quality, crop production, adoption of high-quality seed and fertilizer, and household income. Students, researchers, policy analysts, and decisionmakers will find this book a useful overview of Ethiopia's political, economic, and agricultural transformation as well as a resource for major food policy issues in Ethiopia. Contributors: Dawit Alemu, Guush Berhane, Jordan Chamberlin, Sarah Coll-Black, Paul Dorosh, Berhanu Gebremedhin, Sinafikeh Asrat Gemessa, Daniel O. Gilligan, John Graham, Kibrom Tafere Hirfrfot, John Hoddinott, Adam Kennedy, Neha Kumar, Mehrab Malek, Linden McBride, Dawit Kelemework Mekonnen, Asfaw Negassa, Shahidur Rashid, Emily Schmidt, David Spielman, Alemayehu Seyoum Taffesse, Seneshaw Tamiru, James Thurlow, William Wiseman.

A growing number of governments, donor agencies, and development organizations are committed to supporting nutrition-sensitive agriculture (NSA) to achieve their development goals. Although consensus exists on pathways through which agriculture may influence nutrition-related outcomes, empirical evidence on agriculture’s contribution to nutrition and how it can be enhanced is still weak. This paper reviews recent empirical evidence (since 2014), including findings from impact evaluations of a variety of NSA programs using experimental designs as well as observational studies that document linkages between agriculture, women’s empowerment, and nutrition. It summarizes existing knowledge regarding not only impacts but also pathways, mechanisms, and contextual factors that affect where and how agriculture may improve nutrition outcomes. The paper concludes with reflections on implications for agricultural programs, policies, and investments, and highlights future research priorities.