This study assesses progress in the implementation of the nutrition-sensitive interventions of the fourth phase of Ethiopia’s Productive Safety Net Programme (PSNP-4) and its impact on: (1) the pathways underpinning children’s nutritional status; and (2) the roles it plays in reducing the malign effect of seasonality on the nutritional status of women and pre-school children. The analysis is based on four rounds of household survey data, conducted in March and August 2017 (baseline) and March and August 2019 (endline). These surveys focused on households with a child less than 24 months of age (index child) and his/her mother (index mother). In 2017 and 2019, the survey teams visited more than 2,500 households in 264 kebeles in 88 PSNP woredas in the Amhara, Oromia, SNNP, and Tigray regions.

Improving household resilience is becoming one of the key focus and target of social protection programs in Africa. However, there is surprisingly little direct evidence of the impacts of social protection programs on household resilience measures. We use five rounds of panel data to examine rural households’ resilience outcomes associated with participation in Ethiopia’s Productive Safety Nets Program (PSNP). Following Cissé and Barrett (2018), we employ a probabilistic moment-based approach for measuring resilience and evaluate the role of PSNP transfers and duration of participation on households’ resilience. We document four important findings. First, although PSNP transfers are positively associated with resilience, PSNP transfers below the median are less likely to generate meaningful improvements in resilience. Second, continuous participation in the PSNP participation is associated with higher resilience. Third, combining safety nets with income generating or asset building initiatives may be particularly efficacious at building poor households’ resilience. Fourth, our evaluation of both short-term welfare outcomes and longer-term resilience suggests that these outcomes are likely to be driven by different factors, suggesting that optimizing intervention designs for improving short term welfare impacts may not necessarily improve households’ resilience, and vice versa. Together, our findings imply that effectively boosting household resilience may require significant transfers over multiple years. National safety nets programs that transfer small amounts to beneficiaries over limited time horizons may not be very effective.

The objective of this report is to present results from the baseline survey conducted as part of the Implementer-Led Evaluation and Learning (IMPEL) evaluation of SPIR II, a randomized controlled trial launched in 2022. The second phase of the Strengthen PSNP Institutions and Resilience (SPIR) Resilience Food Security Activity (RFSA) aims to enhance livelihoods, increase resilience to shocks, and improve food security and nutrition for rural households vulnerable to food insecurity in Ethiopia. The RFSA is situated within Ethiopia’s Productive Safety Net Program (PSNP), one of the largest safety net programs in Africa. Funded by USAID’s Bureau for Humanitarian Assistance (BHA), SPIR II is implemented by World Vision International (lead), CARE, and ORDA in the Amhara and Oromia regions of Ethiopia. The IMPEL SPIR II impact evaluation employs an experimental design with three arms, comparing two treatment combinations of livelihood and nutrition graduation model programming provided to PSNP beneficiaries relative to a control group receiving only PSNP transfers. The treatment assignment is randomized at kebele level in 234 kebeles. In the first arm (the control group), PSNP is implemented by the government with SPIR II support for the provision of cash and food transfers only (no supplemental programming). In the second arm, SPIR II programming is rolled out to PSNP beneficiary households in conjunction with nurturing care groups (NCGs) targeting enhanced infant and young child nutritional practices. In the third arm, PSNP beneficiary households receive SPIR II programming and NCGs, supplemented with additional targeted cash grants to pregnant and lactating women.

The objective of this report is to present results from the midline survey conducted as part of the IMPEL evaluation of SPIR-II, a randomized controlled trial launched in 2022. The second phase of the Strengthen PSNP Institutions and Resilience (SPIR-II) project aims to enhance livelihoods, increase resilience to shocks, and improve food security and nutrition for rural households vulnerable to food insecurity in Ethiopia. The project is situated within Ethiopia’s Productive Safety Net Program (PSNP), one of the largest safety net programs in Africa. Funded by USAID’s Bureau for Humanitarian Assistance (BHA), SPIR-II is implemented by World Vision International (lead), CARE, and ORDA in the Amhara and Oromia regions of Ethiopia. The IMPEL SPIR-II impact evaluation employs an experimental design with three arms comparing two treatment combinations of livelihood and nutrition graduation model programming provided to PSNP beneficiaries relative to a control group receiving only PSNP transfers. The treatment assignment is randomized at the kebele level in 234 kebeles. In the first arm (T1; the control group), PSNP is implemented by the government with SPIR II support for the provision of cash and food transfers only (no supplemental programming). In the second arm (T2), SPIR-II programming is rolled out to PSNP beneficiary households in conjunction with nurturing care groups targeting enhanced infant and young child nutritional practices. In the third arm (T3), PSNP beneficiary households receive SPIR-II programming and nurturing care groups (NCGs), supplemented with additional targeted cash transfers to pregnant and lactating women.

Eggs have high potential for improving nutrition outcomes in low-income countries, yet very few children in such settings consume eggs on a regular basis despite widespread poultry ownership. To redress this disconnect, a number of interventions have been implemented to improve household production of poultry products, as well as caregiver awareness of the nutritional benefits of eggs and other animal-sourced foods. However, very few of these interventions have tried to leverage food markets to improve nutrition, even though most rural people predominantly rely on markets for the majority of their non-staple food consumption. This study was implemented to better understand the constraints to purchasing eggs for consumption by young children in rural Ethiopia, with a view to informing the design of marketoriented interventions that might cost-effectively increase children’s egg consumption. To do so we analyzed secondary datasets on poultry ownership, household and child egg consumption, and retail egg prices to understand egg markets and the egg value chain in Tigray. Similar to other contexts in sub-Saharan Africa, we find that two-thirds of households own poultry, though only onequarter of young children consumed eggs in the past 24 hours. Although markets in Tigray are well integrated – likely because of the important role of egg aggregators – egg prices remain high. A modest consumption level of 2.5 eggs per person per week would cost around 10 percent of the total budget of households in the poorest quintile of households, even though eggs are more affordable than other animal-sourced foods. We find that egg consumption among young children is not constrained by fasting associated with Orthodox Christianity. High prices are likely the main constraint and are a function of low levels of intensification in egg production, which is dominated by backyard poultry systems characterized by high mortality rates and low productivity.

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.

We explore the impact of different models of scalable nutrition services embedded within a light-touch graduation program, implemented at scale in Ethiopia. The graduation program provided poor households enrolled in Ethiopia’s national safety net, the Protective Safety Net Program (PSNP), with additional livelihood programming including savings groups, business skills training and linkages to financial services. In addition, extremely poor households received a one-time livelihood grant on an experimental basis, as cash transfers or in-kind poultry grants, at a value much smaller than lump sum transfers in other graduation model programs in recent literature. The experiment compared a core nutrition model of nutrition information and sanitation and hygiene activities to an enhanced model that added more intensive nutrition messaging, supplementary feeding of malnourished children, mental health services, and a male engagement activity. Results show that interaction with health care workers and participation in community health activities increased significantly under the enhanced nutrition model, as did maternal nutritional knowledge. Nevertheless, neither nutrition model led to significant improvements in child dietary diversity or anthropometric outcomes on average. However, cash livelihood grants combined with the enhanced nutrition model reduced childhood stunting.

The COVID-19 pandemic has spurred interest in the use of remote data collection techniques, including phone surveys, in developing country contexts. This interest has sparked new methodological work focusing on the advantages and disadvantages of different forms of remote data collection, the use of incentives to increase response rates and how to address sample representativeness. By contrast, attention given to associated response fatigue and its implications remains limited. To assess this, we designed and implemented an experiment that randomized the placement of a survey module on women’s dietary diversity in the survey instrument. We also examine potential differential vulnerabilities to fatigue across food groups and respondents. We find that delaying the timing of mothers’ food consumption module by 15 minutes leads to 8-17 percent decrease in the dietary diversity score and a 28 percent decrease in the number of mothers who consumed a minimum of four dietary groups. This is driven by underreporting of infrequently consumed foods; the experimentally induced delay in the timing of mothers’ food consumption module led to a 40 and 11 percent decrease in the reporting of consumption of animal source foods, and fruits and vegetables, respectively. Our results are robust to changes in model specification and pass falsification tests. Responses by older and less educated mothers and those from larger households are more vulnerable to measurement error due to fatigue.

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.

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