usaid growth through nutrition most vulnerable households ......table i: summary table for growth...

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USAID Growth through Nutrition

Most Vulnerable Households 2017 Baseline & 2018 Follow-Up Survey Results

November 2019

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Table of Contents

Contents Table of Contents ........................................................................................................................................ 2

Acronyms ..................................................................................................................................................... 4

Acknowledgements ................................................................................................................................. 5

Disclaimer ................................................................................................................................................ 5

Executive Summary ...................................................................................................................................... 5

Background .................................................................................................................................................. 8

Description of the MVHH Intervention .................................................................................................... 8

Eligibility Criteria .......................................................................................................................................... 8

Problem Statement ..................................................................................................................................... 9

Study Overview ............................................................................................................................................ 9

Objectives and Research Questions .......................................................................................................... 10

Approach and Methods ............................................................................................................................. 10

Sampling Procedure and Sample Size .................................................................................................... 11

Outcome Monitoring Among MVHHs .................................................................................................... 11

Data Collection and data assurance ...................................................................................................... 12

Ethical Considerations ........................................................................................................................... 13

Limitations ............................................................................................................................................. 13

Results ....................................................................................................................................................... 14

Household Characteristics ..................................................................................................................... 14

Respondent Characteristics ................................................................................................................... 14

Growth through Nutrition’s Interventions for MVHHs .......................................................................... 14

Livestock Support .............................................................................................................................. 15

Agriculture Tools Support ................................................................................................................. 15

Services and Trainings ....................................................................................................................... 16

Program exposure and change in practice among MVHHs ................................................................... 16

Household Level Outcomes ................................................................................................................... 19

Household Hunger ............................................................................................................................. 19

Adequacy of Household Food Provisioning ...................................................................................... 20

Household Income ............................................................................................................................. 20

Income from Sales of Own Production ............................................................................................. 21

Income from Non-Agriculture Activities ........................................................................................... 23

Income from Project Related Support .............................................................................................. 24

Overall Household Income ................................................................................................................ 25

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Household Expenditures Covered by Project-related Support ......................................................... 25

Asset Ownership ............................................................................................................................... 26

Sanitation and Hygiene .................................................................................................................... 26

Individual Level Outcomes ..................................................................................................................... 27

Children ............................................................................................................................................. 27

Women .............................................................................................................................................. 30

Summary and Conclusions ..................................................................................................................... 32

Annex 1: Additional Data Tables ................................................................................................................ 36

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Acronyms AEW Agriculture Extension Worker AGP Agriculture Growth Program CDDS Child Dietary Diversity Scores DA Development Agents EBF Exclusive Breastfeeding ENGINE Empowering New Generations to Improve Nutrition and Economic Opportunities GOE Government of Ethiopia HEW Health Extension Worker HH Households HHS Household Hunger Scale IYCF Infant and young child feeding LES Livelihood and economic opportunities MAD Minimum Acceptable Diet MCHN Maternal Child Health and Nutrition MDD Maternal Dietary Diversity MDG Millennium Development Goal M&E Monitoring and Evaluation MEAL Monitoring, Evaluation Accountability and Learning MMF Minimum Meal Frequency MVHHs Most Vulnerable Households SBCC Social and Behavior Change Communication SNNP Southern Nations, Nationalities and People’s Region SPSS Statistical Package for Social Sciences USAID United Nations International Children’s Education Fund WDDS Women’s Dietary Diversity Score

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Acknowledgements The survey team would like to express its gratitude to the Woreda Health, Agriculture, and Administration Offices for their facilitation and permission to conduct the survey in each woreda. Special thanks go to all participants who generously responded to the lengthy interviews. Without their kind participation, this study would not have been possible. The survey team would like to thank the Growth through Nutrition team for leading and coordinating the fieldwork in each region.

Disclaimer This report is made possible by the support of the American people through the U.S. Agency for International Development (USAID) under Agreement No AID-663-A-16-00007. The contents of this document are the sole responsibility of Save the Children and the Growth through Nutrition Activity and do not necessarily reflect the views of USAID or the United States Government.

Executive Summary Growth through Nutrition Activity Household-Level Outcomes and Impact Indicators at Baseline (2017) and 1-Year Follow-up (2018). Feed the Future Ethiopia Growth through Nutrition Activity, United States Agency for International Development’s (USAID’s) flagship multi-sectoral nutrition and Water, Sanitation and Hygiene (WASH) project is implemented in 102 woredas in four regions (Amhara, Oromia, Southern Nations, Nationalities, and Peoples Region (SNNPR) and Tigray) of Ethiopia. The primary objective of this five-year (2016-2021) project is to improve the nutritional status of women and young children in Ethiopia’s four productive regions, focusing on the first 1000 days (from the start of pregnancy until the child’s second birthday).

In the course of implementation, Growth through Nutrition plans to conduct annual surveys among supported Most Vulnerable Households (MVHH) to assess the changes brought about by the interventions targeting MVHHs, to provide information to inform project implementation and to allow tracking of changes in households over time.

In Oct-Nov 2017, the baseline MVHH assessment was conducted among a cohort of 386 Growth through Nutrition MVHHs found in targeted 25 woredas in Amhara, Oromia, SNNP and Tigray regions. In Oct 2018, a one-year follow-up survey was conducted among the same cohort of MVHH.

As presented in the table 1 below, in 2017, 11% of these households reported no income declining to 2% in 2018. Substantial increase over these two years was noted in income from the sale of agriculture production support by the Growth through Nutrition project which increased from almost none reported in 2017 to 64% of households in 2018. Similarly, income obtained by MVHHs from sales of produce from project support is significantly (p=0.001) higher in 2018 (191,240 birr) than in 2017 (15,310 birr).

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Household having a handwashing facility at home significantly (p=0.004) increased from 2% in 2017 to 14% in 2018. For these households, the most frequent household facility was a water basin with jug. Slightly more than half (55.1%) of the households reported practicing hand washing with soap / ash and water most of the time in 2017, which increased significantly (p=0.006) 61.1% in 2018. On the contrary, percent of households practiced all five critical hand-washing moments decreased slightly between the two assessment years.

Among children aged 6−23 months, proportion of those who consumed a minimum of four-food groups or more out of seven per day thus fulfilled minimum dietary diversity, increased significantly from 12.4% in 2017 to 14.2% in 2018 (p=0.004).

Women of reproductive age group who had adequate dietary diversity, consuming five or more of the 10 food groups were 2.4% in 2017 and this slightly decreased to 2.0%, though this was statistically insignificant (p=0.8), in 2018. Subsequent qualitative assessment will look for possible factors contributing to this finding.

The prevalence of Iron and Folic Acid supplementation intake for at least three months among women who were pregnant in the past 2 years prior to the assessment was 32.5% and this increased to 40.6% in 2018 follow up survey (p=0.041).

Table I: Summary Table for Growth through Nutrition Most Vulnerable Households 2017 Baseline & 2018 Follow-Up Survey output / outcome level Indicators

Child Level Outcomes 2017 2018 Change Level of Sig (p-value)

% of household reporting no income in past year 11.7 (45/386)

2.2 (8/357)

- 8.9%pts -

Total income for all MVHHs from project support 15,310 birr (7)

191,240 birr (229)

+ 1,150%

Percentage earning income from production supported by project

1.8 (7/386)

64.1 (229/357)

-

Percent of MVHHs having hand washing facility at home

2% 14% +12% 0.004

Percentage of washing hands with soap / ash/’endod’ and water most of the time

55.1% (211/383)

61.1% (218/357)

+6.0% 0.006

Percent of MVHHs washing hands with water only (most of the time)

44.9 (172/384)

38.9 (139/357)

-6.0% NS

Percent of MVHHs having hand washing facility at home

2% (8/386) 14% (51/357) +12% 0.004

Percent who practice all 5 critical hand washing moments

17.6 (68/386)

15.8 (61/357)

-1.8% -

Mean # of food groups from a maximum of 7 food groups for children 6 to 23 months of age

2.2 food grps (201)

2.2 food grps (140)

0.0 NS

Child minimum dietary diversity (4 food groups or more for children 6 to 23 months)

12.4% 14.2% + 1.8%pts

0.004

Minimal Acceptable Diet (minimum dietary diversity and minimum meal frequency they are

fed during the day or night)

Note: this indicator is undergoing additional analysis before reporting.

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Mean # food groups consumed by women from 10 food groups

2.5 food grps (386)

2.6 food grps (354)

+ 0.1 NS

Minimum Dietary Diversity – Women (MDD-Women) (5 food groups or more)

2.4% (9/386)

2.0% (7/354)

- 0.4%pts

Proportion of women receiving iron and folic acid (IFA) supplementation for at least 3 months during

pregnancy

32.5% 68/209

40.6% 52/128

+7.9% 0.041

NS = statistically not significant Overall, the findings from these baseline and follow up survey disclose that livelihood intervention combined with SBCC activities and a resilient exposure to program activities have affirmative effect on some of the key individual and household level nutritional outcomes. On the other hand, change in practice based on health and nutrition information obtained from project-supported sources seems limited in some cases a year after base line survey, 2018. This may depict the presence of limited coaching & mentoring service to targeted HHs to change their practices. The relevance of strengthened and continued mentoring support is strongly suggested.

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Background Save the Children (SCI) in collaboration with the Government of Ethiopia (GOE) leads the implementation of Growth through Nutrition Activity, multi-sectoral nutrition and WASH project funded by the U.S. Agency for International Development (USAID). Growth through Nutrition supports country-led policies, programs, strategies, and institutions building the capacity of local partners. Activities are implemented at the woreda and kebele levels and target 102 woredas that are home to an estimated 14 million people in the regions of Amhara, Oromia, Tigray, and Southern Nations, Nationalities, and People (SNNP) in Ethiopia. The Growth through Nutrition activity emanates from the Empowering New Generations to Improve Nutrition and Economic opportunities (ENGINE) project to improve the nutritional status of women and young children, with the core initiative of preventing undernutrition during the first 1,000 days, from the start of pregnancy until the child’s second birthday. Growth through Nutrition invests in agriculture, health and WASH activities to address gaps in the availability of nutritious and productive varieties of vegetables, fruits, legumes, bio-fortified crops and small livestock, increase nutrition specific intervention utilization and support better use of inputs and cultivation practices, to increase market availability of diverse foods, and the supply of WASH products and services needed to reduce and prevent stunting. Primarily the government frontline agriculture extension workers through the agricultural extension system at the grassroots level implement activities.

Description of the MVHH Intervention Most vulnerable households (MVHHs) are defined by the Activity as the “poorest of the poor households who encounter difficulties in obtaining the basic supplies required to meet basic needs due to insufficient resources and or other livelihood conditions.” Growth through Nutrition aims to enhancing the nutritional status of children and women by improving dietary diversity of women and ensuring a minimum acceptable diet for children at household level. It places emphasis on the production, postharvest handling, promotion and consumption of nutrient-dense vegetables, fruits, animal source foods, and improved agricultural practices. Over the life of the project, 28,000 most vulnerable households (MVHHs) will be reached with direct support in acquiring startup inputs of packages of nutrition sensitive agriculture. To date the project has provided package of livelihood support for 17,852 MVHHs in all implementation regions.

The nutrition-sensitive livelihood strengthening approach enables the poor to save money & access credit and leads to increased household food production and income generation that ultimately aims to increase diversified food availability, access to markets, and asset accumulation. This further enables MVHHs to diversify their diets through increased purchase of diversified foods throughout the year, and to invest more in their livelihoods, ensuring the long-term sustainability of diversified food production and consumption. There is evidence that agricultural diversification can enhance dietary diversity – both directly through consumption of foods produced, and indirectly, by increasing the purchasing power of poor households through increased incomes (Canadian_Journal_of_development_studies 35(2):211-227 May 2014).

Eligibility Criteria The table below lists the criteria used in Growth through Nutrition to identify the MVHHs “poorest of the poor households” at kebele (lowest administrative unit in Ethiopia) levels who encounter difficulties in obtaining the basic supplies required to meet basic needs due to insufficient resources and or other

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conditions. If a household within Growth through Nutrition Activity’s target area met one or more of these criteria, they were included in the MVHH cohort study. Table 2. Targeting criteria for MVHHs.

Targeting Criteria Household should be member of the community/kebele* Female headed household (receive priority) Economically Poor household with above three months of food gap* Households with children less than 2 years of age* Pregnant woman and lactating mother* Household who do have plot of land for on-farm activities. For homestead gardening and grazing land for animals Disabled person who do have family labor Willing to be organized in a saving group, regularly save and attend enhanced community conversation (ECC) Landless households willing to engage in off-farm activities Physically able to do on-farm activities, and willing to construct separate room for animals and have the capacity to manage animals Household who did not receive support from INGOs/NGO/donor

*mandatory criteria to qualify for project support.

Problem Statement Most people suffering from chronic malnutrition in developing countries including Ethiopia are poorest of the poor and lack access to dietary diversity and food rich in micronutrient in a regular basis (FAO, 2013). They largely depend on high amounts of cheaper staple starchy foods that do not provide the required amounts of macro- and micronutrients needed for good health and development (HarvestPlus, 2012). Evidence for the past revealed that low dietary diversity is associated with stunting (Black et al. 2008). ENGINE’s and Growth through Nutrition surveys in Amhara, Oromia, SNNP and Tigray regions also portrayed that fruit, vegetable and animal source food consumption, is the least among rural community in project operation areas in Ethiopia. Vegetables are, however, excellent sources for overcoming micronutrient deficiencies as well as providing smallholder farmers with much higher income and more jobs per hectare than staple crops (Englberger et al., 2010). It is with this rational that Growth through Nutrition invests and promotes the agriculture and WASH activities to address gaps in the availability of nutritious and productive varieties of vegetables, fruits, legumes and small livestock, and support for better use of intervention package and agriculture cultivation practices.

Study Overview The purpose of these MVHH surveys (2017 baseline and 2018 follow-up studies) were to assess selected process and outcome indicators on a regular basis, to provide information on project implementation and to allow tracking of changes in households over time. In 2017, the baseline MVHH assessment was conducted among a cohort of 386 Growth through Nutrition MVHHs found in targeted 25 woredas in Amhara, Oromia, SNNP and Tigray regions. In 2018, a one-year follow-up survey was conducted among this cohort MVHH and will be repeated annually and the data will be analyzed and investigated further, triangulated with routine data and qualitative studies, to identify the factors leading to or preventing successful adoption of key behaviors and outcomes. The data collected during the

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MVHH surveys is supplementary to data collected through the project’s baseline survey, existing M&E tools and systems, additional qualitative case studies, and the planned end line survey of the Growth through Nutrition activity. The data collected in these two events was analyzed, to identify the factors leading to or preventing successful adoption of key outcome indicators.

The study therefore, was conducted with the following objectives:

Objectives and Research Questions Assess which MVHHs have benefited or not benefited from interventions on key program output and outcome level indicators after participating in USAID’s Growth through Nutrition project for one year. Specific objectives

1. Assess nutrition practices and asset building among participants / MVHHs of Growth through Nutrition project activities

2. Investigate proportional association of improvements in nutrition practices as the result of exposure or participation in Growth through Nutrition project activities

3. Examine the relationship between gains in household income and nutrition practices (income and expenditure)

Research Questions: The MVHH surveys aims to answer:

1. Does participation in the Growth through Nutrition Activity interventions lead to improved nutrition practices among MVHHs?

2. To what degree is exposure or participation in Growth through Nutrition Activity interventions associated with improvements in nutrition and WASH practices?

3. What is the relationship between gains in MVHH’s income and nutrition practices? 4. To what degree do household-level outputs and outcomes improve over a 1-year period

and, if so, how much and for which MVHHs? 5. To what degree do individual-level outputs and outcomes improve over a 1-year period and,

if so, how much and for which MVHH individuals?

Approach and Methods

A cohort panel study was conducted among rural MVHHs participating in the Growth through Nutrition project in targeted woredas. Participating households were assigned a unique identification number for the duration of the study. The study controlled for seasonal effects by conducting the MVHH surveys at the same time of year. The same MVHH were interviewed each year and, as much as possible, enumerators interviewed the same respondent in each MVHH during each year of data collection. The goal of this method is to monitor the same household each year and, as much possible, interview the same respondent each year as well.

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Sampling Procedure and Sample Size Since this is a household study, the sampling frame includes the total population of 4000 MVHHs in 250 kebeles, where each Kebele has 16 MVHHs. To obtain a sample with 95% level of confidence and +/- 5% margin of error, a sample of 400 MVHHs were selected and they were selected to be proportional to their representation in the number of kebeles in each of the four regions of Amhara, Oromia, SNNP, and Tigray. Due to logistical and budget constraints, MVHHs from only 25 of the kebeles (one kebele from each woreda except Debre Elias and Diga where two kebeles were selected from each woreda) were enrolled in the 2017 baseline study. The 2018 study included the same 25 kebeles, however, data were not collect among 1 or more MVHHs in 10 of the 25 kebeles, with the largest lost (14) of the MVHH cohort occurring in Gedeb kebele, in the SNNP region, due to security issues, as shown in Table 1. Table 3. Sample Size of MVHHs by Region, Woreda, % of Sample and Population in Growth through Nutrition Project Area.

Regional Representation Woreda Representation Study Representation

Region Baseline # Oct – Nov

2017

Follow-Up # Oct – Nov

2018

Woreda Baseline # Oct – Nov

2017

Follow-Up # Oct – Nov

2018

Baseline Oct – Nov

2017 (N=386)

Follow-Up Oct – Nov

2018 (N=357)

% of MVHH population (N=4000)

Amhara 94 88

Alefa 16 16

24.4% 24.7% 24% Ankasha 16 16 Debre Elias 30 26 Dejen 16 15 Takusa 16 15

Oromia 150 144

Agarfa 14 14

38.9% 40.3% 40%

Becho 16 16 Diga 32 32 Gasara 16 14 Girar Jarso 11 9 Horo 16 16 Wara Jarso 14 12 Wonchi 16 16 Yaya Gulale 15 15

SNNP 94 77

Bulle 16 16

24.4% 21.6% 24%

Gedeb 16 2 Gumer 15 14 Malga 15 14 Misrak Azerenet 16 16 South Ari 16 15

Tigray 48 48 Asgede Tsimbia 16 16

12.3% 13.4% 12% Enda Moheni 16 16 Tahtay Koraro 16 16

Total 386 357 25 386 357 100.0% 100% 100%

Outcome Monitoring Among MVHHs Three levels of outcomes were monitored and tracked among the MVHH cohort over the years: 1) household, 2) child, and 3) women. Within each of these levels, a set of primary outcomes were monitored and tracked. Household-Level Outcomes – primarily, three household level outcomes were monitored and tracked:

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1. Household income – this is measure by a) the percentage of households reporting an income from one or more sources, b) the total income amount from all sources, c) the mean household income for those household reporting an income, and d) the percentage of total household income accounted for by sales of project related inputs.

2. Households applying proper hand washing: this is based on interview and observation by enumerators - measurement on the presence of hand washing station in the household, the presence of water and soap/any other detergent and household hand washing practice at critical times (After toilet use/ defecation/ urination, After cleaning child following defecation, Before preparing the food, Before eating, and Before feeding a child).

Child-Level Outcomes – primarily, four child-level outcome will be monitored and tracked: 1. Mean number of food groups consumed from 7 food groups (children from 6 – 23 months of age) –

this is measured using USAID’s “Indicators for assessing infant and young child feeding practices, PART II Measurement” (2010) in which mothers report whether her child has consumed 17 different types of foods in the previous day that are then aggregated into seven (7) broad food groups.

2. Minimum diet diversity – this is measured on whether children 6 – 23 months have consumed from 4 or more food groups in the previous day.

3. Minimum meal frequency – for breastfed children 6–23 months of age this is measured by mothers reporting whether her child received solid, semi-solid or soft foods too. For non-breastfed children 6–23 months of age this is measured by mothers reporting whether her child consumed solid, semi-solid or soft foods or milk feeds the minimum number of times or more during the previous day.

4. Minimal acceptable diet – for breastfed children 6–23 months of age this is measured by mothers reporting whether her child consumed at least the minimum dietary diversity and the minimum meal frequency during the previous day and for non-breastfed children 6–23 months of age this is measured by mothers reporting whether her child consumed at least 2 milk feedings and had at least the minimum dietary diversity not including milk feeds and the minimum meal frequency during the previous day.

Women-Level Outcomes – primarily, two (2) women-level outcomes will be monitored and tracked: 1. Mean food groups consumed from 10 food groups – this is measured using USAID’s FANTA III (2016)

Minimum Diet Diversity for Women. Women report whether they have consumed 19 different types of foods in the previous day. These foods are then aggregated into 10 food groups.

2. Minimum diet diversity (consuming 5 of 10 food groups) – this is measured by whether or not the woman consumed 5 or more food groups in the previous day.

3. Iron and folic acid supplementation: This indicator measures women who took iron and folic acid for more than 3 months during pregnancy, who confirmed to have been pregnant in the past two years

Data Collection and data assurance Standard and pre-tested questionnaires (attached) was used to collect data at the household level. For both baseline and follow-up surveys, experienced and trained data collectors and supervisors (two data collectors and one supervisor) deployed in each region, collected data in the language preferred by the respondents, by walking from house to house with the assistance of a community guide. Data collectors

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entered the data using tablets directly during household interviews. During data collection, supervisors and regional MEAL managers closely monitored the data collection team to ensure their adherence to the study protocol. Besides, the country office MEAL team checked all the data submissions from the field on a weekly basis. SCI’s MEAL developed a data entry template using KoBo Toolkit. ODK software was used to design data entry template and data management system installed in all tables. This method of data collection, enable consistency check for data collection, skip logics were built in, and allows frequent uploading of collected data, ensures continuous data quality review and allows for timely solution if a problem arises. Growth through Nutrition MEAL team supervised data entry and cleaning prior to analysis. SCUS’s Senior Advisor, Research, M&E conducted the data analysis using SPSS. Data Entry and Analysis Growth through Nutrition’s MEAL team supervised data entry and cleaning prior to analysis. SCUS’s Senior Advisor, Research, M&E conducted the data analysis using SPSS and report writing in collaboration with Growth through Nutrition senior advisor, MEAL. The analysis used descriptive techniques and, statistical (bivariate statistical and t-tests) tests to assess level of significance in changes for some of the nutritional outcome indicators between baseline and follow-up assessments, thus, all findings are reported in percentages, means, ranges, sum-totals and p-values for some of the outcome indicators.

Ethical Considerations Ethical approval was obtained from SCUS’ Ethics Review Committee. Prior to data collection, data collection team did briefing to woreda authorities and respective kebele and village leaders on the objectives of the study and request oral consent to perform the survey in each locality. Data collectors informed respondents about the objectives of the survey, content, and duration of the assessment. Data collectors assured respondents of confidentiality and informed respondents that participation is voluntary. Survey team explained about the consent form, participants’ right to refuse to participate in all or part of the interview, and that non-participation will not affect future support. Consent from respondents was obtained verbally and data were registered and stored anonymously, and the questionnaire was administered in a confidential way.

Limitations The baseline survey was conducted during October and November, a time that is considered a lean season / pre-harvest, which may affect the results regarding dietary diversity, meal frequency, and household hunger. It is also possible that the results related to income and expenditure would be affected by the survey timing, as households may have made atypical choices in terms of available assets. Bias may occur if there is overlap between households interviewed during the Growth through Nutrition project baseline survey and the MVHH baseline survey (assuming the same households are selected for both surveys) -- households may be able to anticipate the questions and offer an alternate answer. This can be tracked by including question in the survey questionnaire to identify those MVHHs who are also included in Growth through Nutrition project baseline survey and can be controlled for during round three data analysis. Recall bias may affect data pertaining to the previous day and year. Lastly, caution should be exercised in generalizing survey results to woredas that are outside the Growth through Nutrition intervention areas. Among under two years, children with age greater than one year at the time of baseline survey were not in the measurement, because they have already graduated a year after baseline survey. This caused reduced sample size of cohort / under two children. Similarly, measurement in all exclusive breast-feeding children was not done in a cohort but in the new born, as they were already out of age limit in 2018.

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Results

Household Characteristics

In 2017 a total of 386 MVHH households were surveyed for the Baseline study. The same households were contacted in 2018, but 29 households were not available and thus 357 of these same households were surveyed for the Follow-up survey.

On average, these households had slightly more than five members with the vast majority of them (85%) being a married couple with children. The percentage of households with pregnant or lactating women decreased from 83% at the Baseline to 66% at the Follow-up. In addition, the percentage of households with children less than 2 years of age declined from 72% at the Baseline to 49% at the Follow-up study.

Almost all (90%) households live in houses with walls made of mud and wood, with roofing made of either corrugate iron sheets (55%) or thatch made from grass or leaves (40%).

The vast majority of these households, 91% at the Baseline and 97% at the Follow-up, own a plot of land for on-farm activities, with the vast majority of them growing grains and vegetables. Approximately one-half (41% in 2017 and 50% in 2018) have livestock, which are primarily chickens, cows, oxen as well as some sheep. For these households, farming is the main source of their income. Almost 2 of every 5 households (40%) own a separate structure for keeping livestock. Among the households that do not own a plot of land, they are involved in petty trade (73% of 19 in 2017 and 67% of 8 in 2018).

When asked if the household could cover its food consumption from their own production or income, 65% in were unable to 2017 increasing to 72% in 2018. For these households, the number of months they experienced a food gap was, on average, 3.2 months in 2017 and slightly increasing to 3.4 months in 2018. The months in which the most of the households experienced a food gap for the two years were August (72% - 73%), September (52% - 64%), and July (63% - 58%). The months with the smallest percentage of households experience a food gap were December (4% and 7%) and January (6% and 7%).

Respondent Characteristics

In both the 2017 baseline and 2018 follow-up studies, the vast majority (99%) were women who ranged from 18 to 52 years of age, with a mean age of 30.8 years in 2017 and 31.6 in 2018. The majority (80%) were married to the head of the household, with no education (66%), and most of the women (97%) responded that they were physically able to do physical labor.

Growth through Nutrition’s Interventions for MVHHs

During project implementation period, Growth through Nutrition, targeted to reach out 28,000 MVHHs in five regions/ sub- with a package of livelihood support to improve intake of nutritious foods and dietary diversity at household level. The support consists provision of productive animals such as sheep, goats, and poultry; seeds of specified vegetables and fruit seedlings which are selected based on their

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nutritional values; and basic hand tools for cultivation of homestead gardening. The primary aim of the package is to address household dietary diversity of women and ensuring a minimum acceptable diet for children through consumption, and income generated from the sale of surplus that would create a prospect to access nutritious food items from the local market. The livelihood support provided to MVHHs was accompanied by technical capacity building for production, consumption, and promotion of nutrient-dense vegetables, fruits, animal source foods, and improved nutrition sensitive agricultural practices at household levels. The household management of support provided by the project and nutritional effect of intervention was assessed and results are given in below subsequent sections. Livestock Support Chickens – in 2017 and 2018, about 30% of MVHHs owned chicken from their own means; However, in 2018 about 90% of these households owned chickens due to the Growth through Nutrition project support. Overall, the sum total these households reported receiving from Growth through Nutrition was 2100 chickens or about six chicken per household. At the time of the survey (Oct/Nov), however, only 1644 remained, which means that most likely MVHHs sold them since the food recall question indicated a very low proportion of mothers or children consuming chicken meat while there was an increase in household income from sale of project inputs. The number of chicken reduction could also be attributed to death associated to many factors such as feed shortage during the rainy season, disease outbreak and predators.

Sheep - In both 2017 and 2018, approximately 15% of households owned sheep that was not from the Growth through Nutrition project. However, in 2017 and 2018, close to 85% of the households reported receiving two or more sheep from the Growth through Nutrition project. These households reported receiving 981 sheep in 2017 and 739 sheep in 2018, which is about, two on average per household, 3 sheep in 2017 and 2 sheep in 2018 from the Growth through Nutrition project. Sheep provide not only meat for the MVHHs but also milk in some woredas and non-food products, such as manure and skin , which can be sold to generate income.

Goats – In both 2017 and 2018, the Growth through Nutrition distributed few goats to MVHHs depending on their preference of goats than sheep; that is, about 11% of these household received two or more goats. One of the benefits of goats is the milk they provide.

Agriculture Tools Support To support household’ gardens for food production, the project provided households with various agricultural tools appropriate for growing vegetable on small plot of land. Spades – a spade is a small shovel for digging and turning soil to prepare seedbed for planting. The project distributed 287 spades in 2017 and 215 spades distributed in 2018, or about 1 spade per household.

Pickaxes – a pickaxe is a tool, with pointed and sharpened edges, used to break hard, dry soil to prepare it for turning with a spade. These households reported 329 pickaxes were distributed in 2017 and 200 pickaxes distributed in 2018. This means that all households have at least one pickaxe from the Growth through Nutrition project for home gardening. Forks and Hoes – Forks are used for breaking hard, dry soil and a hoe is used for weeding and soil softening. The project distributed forks and hoes to slightly less than one-third (30%) of all households in

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2017 and 2018, which means that about 60% of all MVHHs have not received forks and hoes for home gardening.

Services and Trainings The vast majority of households (95% in 2017 and 92% in 2018) received services related to livestock as well as vegetable seeds and seedlings management in each year. The next two services in which many MVHHs participate in were Savings Groups (64% in 2017 increasing to 79% in 2018) and participation in ECC Sessions (0% in 2017 to 55% in 2018). These households attended from 1 to 10 sessions, for an average of 4 sessions attended per household. The percentage of households attending various ECC sessions in 2018 were: a) WASH poster (72%), b) 1000-day poster (58%), c) IFA Reminder Calendar (56%), and d) Bug Bud poster (55%).

Program exposure and change in practice among MVHHs Households with a woman currently pregnant or was pregnant in the last six months in the household – Among these households, 74% of them in 2017 received information about taking care of a pregnant mother during pregnancy declining to 47% in 2018. Thus, over the two years, all these households received this information from one or more sources. Among Growth through Nutrition interventions, in 2017, 76% and in 2018, 89% of these households reported receiving this information from HEW, with few to none reporting in 2017 receiving this information from ECC sessions or Savings Groups. However, by 2018, 13% reported receiving this information from Savings Groups and 41% from attending ECC sessions. When asked which practices they changed due to this information, close to all (100%), when combining the percentage of women in 2017 and 2018 who adopted practices, were “Taking Additional Meals” (64% and 41%), “Diversified Food Intake During Pregnancy” (59% and 54% respectively), and “Take Iron Folate During Pregnancy” (42% and 44% respectively). The practice adopted by the lowest percentage of women were “Use of Improved Latrine” (13% and 15% respectively) and “Treat Household Water” (11% and 20% respectively). This may demand strong engagement of private sector wash marketing.

Households with children 6 – 23 months of age residing in the household – Among these households, most received information on dietary diversity for children in 2017 (90%) and in 2018 (66%), thus all these households received this information over the two years from one or more sources. Among project related interventions, most of these households received this information from ECC sessions only in 2018 (54%) or Savings Group meetings (18%). The highest, (68% in 2017 and 85% in 2018) source of this information was health extension workers. There were four practices that the majority of women, when combining the percentage of women in 2017 and 2018, changed from this information, which were “Feeding Child Diversified Food” “73% in 2017 and 66% in 2018), “Giving Children Older than 6 Months Animal Source Food” (72% in 2017and 46% in 2018), “Feeding Thick Porridge” (51% in 2017and 57% in 2018), and “Increase Frequency of Feeding” (58% and 38%).

Households with children under 2 years’ old children residing in the household – Among these households, 55% of them received information about breastfeeding in 2017 and this was increased to 58% in 2018, thus all MVHHs received this information over the two years from one or more sources. From project interventions, most women received this information from ECC sessions in 2018 (42%) and Savings Groups (27%). When considering the combined percentage of women over the two years, most women changed the following practices due to this information: “Continued BF” (77% in 2017 and 70% in 2018), “Exclusive Breast Feeding for 6 Months Children” (73% in 2017 and 43% in 2018), and “Initiating Breastfeeding Within 1 Hour” (42% in 2017 and 21% in 2018). A lower percentage of these

17

household’s report practicing “Avoid Bottle Feeding” (12% in 2017 and 9% in 2018) and “Giving Colostrum” (21% in 2017 and 18% in 2018).

Households with children under 5 years of age residing in the household – Among these households, 57% of them received information about treating a child’s diarrhea in 2017 and 37% of them receiving this information in 2018, which means that almost all (94%) these households received the information over the two years. From Growth through Nutrition interventions, the largest proportion of these households received this information only in 2018 from ECC sessions (36%) and Savings Groups (28%). Combined over the two years, about 95% of women in these households began practicing “Taking Child to Health Facility” (58% in 2017 and 38% in 2018), with about 70% “and Increasing Meal Frequency” (42% in 2017 and 32% in 2018). A lower percentage of these households report practicing “Rehydrate the Child” (31% in 2017 and 11% in 2018) and “Giving ORS and Zinc” (28% in 2017 and 32% in 2018).

Households with children under 5 years’ of age residing in the household - Among these households, most (78% in 2017 and 67% in 2018) received information on hand washing with soap at critical times. The main source of information (76% in 2017 and 80% in 2018) was health extension workers in both years. Similarly, in 2018 from project interventions, most women received this information from ECC sessions (48%) and Savings Groups meetings (18%). Majority, 97% in 2017 and 89% in 2018-changed hand wash practice with water and soap or ash at critical times as the result of this information. Table 4. Source of information for maternal and child health, and nutrition among MVHH

Did you or anyone in household receive information in the following topics in the past six months?

Baseline Oct – Nov 2017

Follow-up Oct – Nov 2018

% (n) % (n) Households with a woman currently pregnant or was pregnant in the last six months in the household 59.6 (230/386) 27.5 (98/357)

Receive information on taking care of pregnant mother during pregnancy? Yes 74.3 (171/230) 46.9(46/98)

Source

Health Worker 43.9 (75/171) 21.7 (10/46) Health Extension Worker 76.0 (130/171) 89.1(41/46) AEWs 37.4 (64/171) 50.0 (23/46) HAD/WDA 9.4 (16/171) 0.0 (0/46) Enhanced Community Conversation 0.0 (0/171) 41.3 (19/46) Cooking Demonstration 21.1 (36/171) 0.0 (0/46) MVHHs or Saving Group Meetings 2.3 (4/171) 13.0 (6/46) Social/Religious Group Meetings 0.6 (1/171) 0.0 (0/46) Radio 0.0 (0/171) 2.2 (1/46) Mobile Phone 0.0 (0/171) 0.0 (0/46) Poster/Flyers/Leaflets 0.0 (0/171) 2.2 (1/46) D/K 1.8 (3/171) 0.0 (0/46)

Practices changed

Take Additional Meals, especially snacks during pregnancy 64.3 (110/171) 41.3 (19/46) Diversified food intake during pregnancy 58.5 (100/171) 54.3 (25/46) Take iron folate during pregnancy 41.5 (71/171) 43.5 (20/46) Take deworming tablets during pregnancy 18.1 (31/171) 15.2 (7/46) Wash hands with water and soap or ash at critical times 44.4 (76/171) 28.3 (13/46) Treat household water 11.1 (19/171) 19.6 (9/46) Use improved latrine 12.9 (22/171) 15.2 (7/46) Take adequate rest 17.5 (30/171) 19.6 (9/46) Giving Colostrum 24.6 (42/171) 15.2 (7/46) Not Practices 15.8 (27/171) 32.6 (15/46)

Households with children under 5 years of age residing in the household. 93.8 (362/386) 92.4 (330/357)

Receive information on treating your children’s diarrhea 58.6 (212/362) 37.3 (133/330)

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Source

Health Worker 41.5 (88/212) 6.8 (9/133) Health Extension Worker 77.8 (165/212) 91.7 (122/133) AEWs 42.9 (91/212) 33.8 (45/133) HAD/WDA 12.7 (27/212) 2.3 (3/133) Enhanced Community Conversation 0.0 (0/212) 36.1 (48/133) Cooking Demonstration 15.1 (32/212) 1.5 (2/133) MVHHs or Saving Group Meetings 3.3 (7/212) 27.8 (37/133) Social/Religious Group Meetings 0.9 (2/212) 0.0 (0/133) Radio 0.9 (2/212) 1.5 (2/133) D/K 1.9 (4/212) 0.0 (0/133)

Practices changed

Increase frequency of BF 43.4 (85/212) 27.8 (37/133) Increase Meal Frequency 42.3 (83/212) 31.6 (42/133) Rehydrate the Child 30.6 (60/212) 10.5 (14/133) Took the child to nearby health facility 58.2 (114/212) 37.6 (50/133) Giving ORS and Zinc 28.1 (55/212) 32.3 (43/133) Not Practiced 15.3 (30/212) 35.3 (47/133) N/A 0.5 (1/212) 1.5 (2/133)

Households with children under 2 years’ old children residing in the household. 69.4 (268/386) 48.5 (173/357) Receive information on breastfeeding 54.9 (189/268) 58.4 (101/173)

Source

Health Worker 43.9 (83/189) 5.9 (6/101) Health Extension Worker 75.7 (143/189) 90.1 (91/101) AEWs 49.17 (94/189) 35.6 (36/101) HAD/WDA 11.6 (22/189) 1.0 (1/101) Enhanced Community Conversation 0.0 (0/189) 41.6 (42/101) Cooking Demonstration 10.1 (19/189) 1.0 (1/101) MVHHs or Saving Group Meetings 4.8 (9/189) 26.7 (27/101) Poster/Flyers/Leaflets 0.5 (1/189) 2.0 (2/101) D/K 1.4 (3/189) 0.0 (0/101)

Practices changed

Initiate BF within 1 Hour 42.3 (80/189) 20.8 (21/101) Exclusive BF for 6 months 72.5 (137/189) 42.6 (43/101) Continued BF 77.2 (146/189) 70.3 (76/101) Avoiding bottle feeding 12.1 (23/189) 8.9 (9/101) Giving Colostrum 20.6 (39/189) 17.8 (18/101) Not Practiced 2.6 (5/189) 14.9 (15/101)

Households with children 6 – 23 months’ of age residing in the household. 66.1 (201/386) 41.5 (148/357) Anyone in household receive information on dietary diversity for children 6-23 months? 89.6 (180/201) 65.5 (97/148)

Source

Health Worker 34.4 (62/180) 7.2 (7/97) Health Extension Worker 68.3 (123/180) 84.5 (82/97) AEWs 61.1 (110/180) 34.0 (33/97) HAD/WDA 12.8 (23/180) 2.1 (2/97) Enhanced Community Conversation 0.0 (0/180) 53.6 (52/97) Cooking Demonstration 6.7 (12/180) 5.2 (5/97) MVHHs or Saving Group Meetings 7.8 (14/180) 17.5 (17/97) D/K 1.7 (3/180) 0.0 (0/97)

Practices changed

Feeding your child diversified foods (4+ groups) 72.8 (166/180) 66.0 (64/97) Give children >6 months animal sourced foods 72.2 (130/180) 46.1 (53/97) Increase frequency of feeding 58.3 (105/180) 38.1 (37/97) Thick Porridge 50.6 (91/180) 56.7 (55/97) Not Practiced 8.9 (16/180) 11.3 (11/97)

Households with children under 5 years’ of age residing in the household. 93.8 (362/386) 91.6 (327/357) Anyone in household receive information on hand washing with soap at critical times 78.0 (301/362) 66.6 (218/327)

Source Health Worker 31.5 (95/301) 4.6 (10/218) Health Extension Worker 73.5 (222/301) 79.8 (174/218) AEWs 47.4 (143/301) 30.7(67/218)

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HAD/WDA 7.6 (23/301) 2.3 (5/218) Enhanced Community Conversation 0.0 (0/301) 47.7 (104/218) Cooking Demonstration 13.2 (40/301) 5.0 (11/218) MVHHs or Saving Group Meetings 7.6 (23/301) 17.9 (39/218) Social/Religious Group Meetings 0.7 (2/301) 0.0 (0/218) Radio 0.3 (1/301) 1.4(3/218) Poster/Flyers/Leaflets 0.0 (0/301) 1.4 (3/218) D/K 1.0 (3/301) 0.0 (0/218)

Practices changed

Wash hands with water and soap or ash at critical times 97.0 (293/301) 89.4 (195/218) Not Practiced 3.0 (9/301) 10.6 (23/218)

In some cases, change in practice based on nutrition information obtained from frontline workers is limited a year after base line survey, 2018. This may depict the presence of limited coaching & mentoring service to targeted HHs to change their practices. The relevance of continued mentoring support is highly suggested.

Household Level Outcomes MVHHs received livelihood supports such as six chicken, two goats or sheep, legumes, root crops, vegetables, fruit seedlings and farm tools. They also received NSA training in order to establish home garden and be able to produce and consume diversified food in a small plot of land and initial capital. They are also organized in to saving group and started saving to solve their financial problem. Household Hunger Using FANTA’s Household Hunger Scale (2011), the table 5 below presents the percentage of households that experience different levels of hunger in the past month. Also, this measurement is sensitive to the time of year. Households reported earlier that the peak months they experience a food gap are July, August, and September. The 2017 and 2018 assessments were conducted in October and November when the food gap household face decreases. Therefore, if the Household Hunger Scale was used in August there would be, most likely, a larger percentage of households in the moderate to severe hunger categories. As presented in the table 5 below, the percentage of households experiencing little to no hunger, there is statistically significant (P<0.001) decrease between the two years (that is decreased from 62% in 2017 to 51% in 2018). This could be a result of a greater percentage of households reporting that their monthly food gap extended a little longer in 2018 than in 2017, into October and November, as presented in the below Figure 1. The basic change in household hunger categories was movement of households who experienced little to no hunger category to the category of experiencing moderate hunger (23.3% in 2017 and 34.2% in 2018). This is statistically significant increase (p<0.001) in the percentage reporting “Moderate” level of hunger in the previous 30 days between baseline and follow up years. There was no change in the proportion of households experiencing severe hunger (15% both years). Table:5. Percentage of MVHHs by Household Hunger Categories.

Household Hunger Scale 2017 (n=386)

2018 (n=357)

P-value

Little to no hunger in the past month 61.7% (238/386)

51.3% (183/357)

0.000

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Moderate hunger in the past month 23.3% (90/386)

34.2% (122/357)

0.000

Severe hunger in the past month 15.0% (58/386)

14.6% (52/357)

-

Adequacy of Household Food Provisioning Households were asked if they were able to cover their household’s food consumption need from their own income or production in the last year. In 2017, 35% reported they could, which declined to 28% of these same households in 2018. Of the households reporting that they could not cover their household’s food needs, they were asked to identify which months they experienced food gaps. The graph below presents the percentage of households who could not cover their household’s food needs in the previous year by each month they experience a monthly food gap. Clearly, in both 2017 and 2018, August is when the vast majority of these households experience a food gap. Also, the graph illustrates that in 2018, compared to 2017, a larger percentage of these households experienced monthly food gaps from September to October. For these households, the average number of months per year they experienced a food gap slightly increased from 3.2 months in 2017 to 3.4 months in 2018.

Figure 1. Food Gap Months Reported by MVHHs. Household Income For the large majority of MVHHs, in 2017 and 2018, they obtained income from primarily two sources, farming (82% and 74% respectively) and daily labor (11% and 20% respectively). The drop in the percentage of household’s primary income from farming and the increase in the percentage of household’s primary income from daily labor over this period of time indicates the challenges to earning an income from agriculture production. In each year, households were asked to report if they have income from three different sources, which were 1) sale of agriculture production from support by Growth through Nutrition project, 2) income

6.4 6.8 5.6

15.227.2

41.2

63.272.4

52.4

22.8

6.8 47

11.7 914.1 17.6

32

58.6

72.7 64.1

34.4

10.9 7

0102030405060708090

100

January

Febru

ary

March AprilMay

JuneJuly

August

September

October

November

December

Food Gap Months for Households Unable to Cover Household Food Needs

2017 (n=250) 2018 (n=256)

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from sales of their own agricultural production, and 3) any sources other than agricultural activities, such as daily labor and if they did, how much they earned in the past year. As presented in the table 6 below, in both years about 60% of these MVHHs earned income from the sale of their own agricultural production. In 2017, 60% of these households earned income from sources other than agriculture, which increased substantially to 82% in 2018. Another substantial increase over these two years was that in 2017 close to none of these households reported income from the sale of agriculture production support by the Growth through Nutrition project increasing to 64% in 2018. Another substantial increase was in the percentage of households reporting additional sources of income over these two years. For example, 11% of these households reported no income declining to 2% in 2018 and from 0% of household having income from all 3 sources in 2017 to 28% in 2018. Thus, in 2017 these MVHHs earned income from, on average, 1.2 sources increasing to 2.0 sources in 2018, which was due primarily to these households earning income from Growth through Nutrition project support. Table 6. Sources of Income for MVHHs.

Sources of Income Baseline

2017 Follow-up

2018 % (N) % (N)

Percentage earning income from own production 59.3 (229/386)

58.3 (208/357)

Percentage earning income from sources other than agriculture 60.1 (232/386)

81.5 (291/357)

Percentage earning income from production supported by project 1.8 (7/386)

64.1 (229/357)

Percentage of households with income from:

0 sources 11.7 (45/386)

2.2 (8/357)

Only 1 source 55.4 (214/386)

19.0 (68/357)

2 sources 32.9 (127/386)

51.3 (183/357)

All 3 sources 0.0 (0/386)

27.5 (98/357)

Mean # of sources 1.2 (386)

2.0 (357)

Income from Sales of Own Production The table 7 below is a summary of the income earned by these MVHHs in the previous year from their own production. The largest percentage of these households, and the largest amount earned, came from the sales vegetables in both 2017 but this declined substantially in 2018. Table 7. Types of MVHH Income from Own Production

Income from Own Production Baseline

2017 Follow-up

2018 % (N) % (N)

Sale of animal products Total 18,517 birr (23)

15,460 birr (10)

22

HH Mean 805 birr (23)

546 birr (10)

Sale of cash crops Total 0 birr

(0) 73,908 birr

(28)

HH Mean --- 2640 birr (28)

Sale of grain by-products Total 0 birr

(0) 4010 birr

(8)

HH Mean --- 501 birr (8)

Sale of grain Total 107,055 birr

(32) 619,802

(132)


4696 birr (132)

Sale of live animals Total 139,833 birr

(53) 72,460 birr

(28)


2588 birr (28)

Income from sales of other agricultural products (wood, herbs, spices, fishery, renting land)

Total 57,705 birr (12)

44,735 birr (28)


1598 birr (28)

Sale of vegetable products Total 758,665 birr

(181) 79,730 birr

(69)


1156 birr (69)

Total Total 1,081,775 birr

(229) 900,105 birr

(208)


4327 birr (208)

Sale of Animal products – In 2017 and 2018, very few households earned income from the sale of animal products (10% and 5% respectively). In 2017, sale amounts ranged from 20 birr to 3400 birr for an average of 805 birr ($28), and a total of 18,517 birr ($650) earned. In 2018, sale amounts ranged from 120 birr to 2000 birr for an average of 546 birr ($19), and a total of 15,460 birr ($540) earned. Thus, from 2017 to 2018 there was a decrease in the percentage of households selling their own animal products as well as a decrease in the average amount earned per household. This is possibly attributed to the behavioral change because of NSA training & ECC session on the importance of ASF for health. Sale of cash crops – In 2017, no households reported sales from cash crops increasing to 14% (or 28 of the 229 households with own sales). The 2018 sale amounts of cash crops ranged from 100 birr to 19,200 birr, for an average of 2640 birr ($90) per household and a total of 73,908 birr ($2600) earned. Sale of grain by products – In 2017, no households reported sales from cash crops increasing very little to 4% (or 8 of the 229 households with own sales). The 2018 sale amounts of cash crops ranged from 50 birr to 2000 birr, for an average of 501 birr ($18) per household and a total of 4010 birr ($140) earned. Sale of grain – In 2017 very few households earned income from the sale of grain (14% or 32 households) increasing to 64% (or 132 households) in 2018. In 2017, sale amounts of grain ranged from 400 birr to 8600 birr for an average of 3346 birr ($117), and a total of 107,055 birr ($3700) earned. In

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2018, sale amounts ranged from 160 birr to 27,500 birr for an average of 4696 birr ($164), and a total of 619,802 birr ($21,600) earned. Thus, from 2017 to 2018 there was a very large increase in the percentage of households selling their own grain as well as an increase (40%) in the average amount earned per household. Sale of live animals – In 2017 about one of every five households earned income from the sale of live animals (23% or 53 households) decreasing to 14% (or 28 households) in 2018. In 2017, sale amounts of live animals ranged from 8 birr to 11,000 birr for an average of 2638 birr ($90), and a total of 139,833 birr ($4900) earned. In 2018, sale amounts ranged from 100 birr to 8400 birr for an average of 2588 birr ($90), and a total of 72,460 birr ($2500) earned. Thus, from 2017 to 2018 there was a decrease in the percentage of households selling their live animals with little change in the average amount earned per household. In normal circumstances, smallholder farmers’ sale their livestock when they face critical challenges such as hunger, pay debt or buy agricultural inputs etc. Consequently, the decrease in sales of livestock in 2018 is possibly associated with the MVHHs who fulfilled their financial requirements not from sales of livestock but from outputs of Growth through Nutrition support unlike in the case of the baseline year. Sale of other types of agricultural products (wood, herbs, spices, fishery, renting land) – In 2017, very few households, 5% (or 12) had sales of other agricultural products increasing to 14% (or 28) in 2018. Because of so few households, only data from 2018 is analyzed. The sale amount of other agricultural products, in 2018, ranged from 80 birr – 7000 birr for an average of 1598 birr ($56) per household and a total of 44,735 ($1500) birr earned. Sale of vegetables – In 2017, a large majority of households (79% or 181) sold vegetables, which drastically reduced to only 33% (or 69) households selling vegetables in 2018. In 2017, sale amounts of live vegetables ranged from 50 birr to 25,000 birr for an average of 4192 birr ($146), and a total of 758,665 birr ($26,400) earned. In 2018, sale amounts ranged from 24 birr to 1000 birr for an average of 1156 birr ($40), and a total of 79,730 birr ($2800) earned. Thus, from 2017 to 2018 there was a large decrease in the percentage of households selling vegetables and a large decrease (- 73%) in the average amount earned per household. The decrease in sells of vegetable in 2018 could be attributed to the effects of NSA training and SBCC sessions on the health benefits of eating vegetables. Income from Non-Agriculture Activities In 2017 almost one-third (60% or 232) households had earned income from non-agriculture related products increasing to 82% (or 291) of households in 2018. In 2017, sale amounts of non-agriculture products ranged from 100 birr to 25,000 birr for an average of 4546 birr ($160), and a total of 1,054,720 birr ($36,700) earned. In 2018, sale amounts ranged from 60 birr to 26,400 birr for an average of 3389 birr ($118) per household, and a total of 966,333 birr ($33,700) earned. Table 8. Income Earned by MVHHs from Non-Agricultural Activities

Income from non-agriculture activities

Baseline 2017

Follow-up 2018

% (N)

% (N)

Income earned Total 1,054,720 birr

(232) 966,333 birr

(291)


3321 birr (291)

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Income from Project Related Support Of all households, very few of households in 2017 earned income from project related inputs increasing to 64% (or 229) of households in 2018. Because the number of households that earned some income from project related inputs in 2017, the discussion below only focuses on 2018. Table 9. MVHHs Income from Growth through Nutrition Project Support

Income from Growth through Nutrition Project Support Baseline

2017 Follow-up

2018 % (N) % (N)

Sale of animal products Total 500 birr

(1) 13,680 birr

(91)

HH mean 500 birr (1)

150 birr (91)

Sale of live animal Total 2250 birr

(2) 151,871 birr

(116)


1309 birr (116)

Sale of vegetables Total 12,560 birr

(6) 25,690 birr

(97)


265 birr (97)

Total Total 15,310 birr

(7) 191,240 birr

(229)


835 birr (229)

Sale of animal products – Of the 229 households that reported earning an income from project related inputs in 2018, 91 (or 40%) of these household earned it from the sale of animal products. Sale amounts ranged from 1 birr to 2500 birr, for an average of 150 birr ($5 USD) from these sales. The total income earned by all these households, for sale of project related animal products, was 13,680 birr ($500 USD). Sale of live animal – Of the 229 households that reported earning an income from project related inputs in 2018, 116 (or 51%) of these household earned it from the sale of live animals, such as goats and chickens. Sale amounts ranged from 1 birr to 6000 birr, for an average of 1309 birr ($46 USD) from these sales. The total income earned by all these households, for sale of project related animal, was 151,871 birr ($5300 USD). Sale of vegetable products – Of the 229 households that reported earning an income from project related inputs in 2018, 97 (or 42%) of these household earned it from the sale of vegetable products. Sale amounts ranged from 20 birr 1400 birr, for an average of 265 birr ($9 USD) from these sales. The total income earned by all these households, for sale of project related products, was 25,690 birr ($900 USD).

25

Overall Household Income The table 10 below present a summary of household income in 2017 and 2018 from project related inputs and overall household income. From 2017 to 2018, project related income increased by 1200% and represented in 2018 6% of the overall household income. However, overall household income significantly (p<0.001) decreased (by 4.4%) from 2017 and 2018. This shows that without Growth through Nutrition project inputs for income, the decline in household income in 2018 would have been even greater. Table 10. Percentage Change in MVHHs Income from 2017 to 2018

Income Sources 2017 (n=386)

2018 (n=357) % change P-value

From project related inputs 15,310 birr (7)

191,241 birr (229) + 1200 0.000

Total income from all sources 2,151,805 birr (341)

2,057,678 birr (349) - 4.4 0.000

Household average 6,310 birr (341)

5896 birr (349) - 6.6 0.000

% of total hh income from project inputs/activities 0.1 6.3 0.000

Household Expenditures Covered by Project-related Support In 2017, only 7 (2% of 386) households had income from project-related inputs and activities; however, in 2018, 229 (or 64% of 357) households did and, thus, the following analysis will only include household expenditures either partly or fully covered by project related income in 2018. The table below presents, in rank order, the percentage of households using project related income for specific household expenditures. Slightly more than one-half (53%) of the households who had income from project related inputs and activities used the income to purchase food. A far distant second expenditure was contributing to savings (22%), purchasing clothing (20%), the purchase of animals (14%) followed by Cleaning/sanitation (12%). Table 11. MVHHs Expenditures Using Income Generated from Growth through Nutrition’s Inputs and Activities.

Household Expenditures Using Project Related Income 2018 (n=357)

% households with income from project related inputs and/or activities 229 Expenditures from project related income (in rank order by % of households) % Food purchase 53 Savings 22 Clothing 20 Animal purchase 14 Cleaning/sanitation 12 Health/health related 9 Education 6 Cooking/light (kerosene) 4 Payment of debt 3 Agriculture inputs 3

26

Animal care 2 House improvement 1 Vegetable seeds 1 Farm tools 0

Asset Ownership In this study, households were asked about changes in five assets: 1) the number of radios owned, 2) the number of mobile phones owned, 3) their house’s roofing material, 4) their house’s wall material, and 5) if they owned a separate live building for keeping livestock. The largest increase, though quite small, from 2017 to 2018 was for roofing material; from 53% having corrugated iron sheets in 2017 to 58% in 2018. The percentage of households owning radios remained unchanged between 2017 and 2018 (89%), however, there was a decrease in the percentage of households owning mobile phones over these two years (44% in 2017 decreasing to 38% in 2018). Livestock represent a household asset too. Some of the largest increases from 2017 to 2018 were for a) chickens – 360 owned by 29% of households in 2017 increasing to 1644 owned by 90% of households in 2018 and b) beehives- 36 owned by 4% of households in 2017 increasing to 98 by 4% in 2018. Sanitation and Hygiene Given the sanitation and hygiene messages and trainings, the table 12 below shows the percentage of household respondents who washed their hands yesterday, the moments in which they washed, and what they washed with. When asked if the household had a handwashing facility at home, in 2017 on 2% (or 8) households did increasing to 14% (or 51) household in 2018. For these households, the most frequent household facility was a water basin with jug (69%). Hand washing primarily involved the use of water and soap or just water. In 2017 and 2018, all respondents reported washing their hands yesterday. The most frequent moments consistently for both years were 1) before eating (87%) and 2) before preparing food (mid 80%) with the least frequency in both years being 1) after cleaning child following defecation (40% in 2017 and 30% in 2018) and 2) before feeding a child (37% in 2017 and 44% in 2018). Less than one of every woman (18% in 2017 and 16% in 2018) washed their hands during all five critical hand washing moments (*highlighted in bold). Table 12. MVHHs Sanitation and Hygiene Practices

Sanitation and Hygiene 2017 2018 P-Value

Yesterday, did you wash your hands 99.5 (284/386)

100.0 (357/357

If YES, tell all moments you did wash hands

Dirt is visible 49.5 (190/384)

56.3 (201/357)

*After toilet use/ defecation/ urination

62.2 (239/384)

70.6 (252/357)

*After cleaning child following defecation

39.8 (153/384)

30.0 (107/357)

*Before preparing the food 87.2 (335/384)

84.0 (300/357)

27

Before serving a meal 55.2 (212/384)

53.5 (191/357)

*Before eating 87.2 (335/384)

87.7 (313/357)

After eating 71.6 (275/384)

61.1 (218/357)

*Before feeding a child 37.2 (143/384)

44.3 (158/357)

When I am reminded to do so 1.3 (5/384)

3.9 (14/357)

*Percent who practice all five critical hand washing moments (highlighted in bold above)

17.6 (68/386)

15.8 (61/357)

What do you use to wash your hands most of the time?

Water Only 44.9 (172/384)

38.9 (139/357)

Water and Soap 52.7 (202/384)

53.5 (191/357)

Water and Ash/Endod 2.3 (9/384)

7.6 (27/357)

Percentage of washing hands with soap / ash/endod and water most of the time

55.1% (211/383)

61.1% (218/357)

0.006

Handwashing facility at home 2% (8/386) 14%

(51/357) 0.001

Individual Level Outcomes Children Infant and Young Child Feeding (IYCF) The WHO recommends a specific set of appropriate infant and young child feeding (IYCF) practices include exclusive breastfeeding in the first 6 months of life, continued breastfeeding through age 2 years, introduction of solid and semisolid foods at age 6 months, etc (WHO 2008, 2010a). It also suggests that young children to consume diet from different food groups, including animal source foods that satisfy children’s growing micronutrient needs. For this study, indicators on breastfeeding (early initiation of breastfeeding, exclusive breast-feeding), dietary diversity, and meal frequency were focused on. Breastfeeding Early Initiation of Breastfeeding – Early initiation breastfeeding behaviors has its contribution to overall child health and nutrition as it contains colostrum, which is highly nutritious and has antibodies that protect the newborn from diseases. It is recommended that children be put to the breast immediately or within 1 hour after birth and that pre-lacteal feeding is highly discouraged for mother not to practice. Seventy-three percent of children began breastfeeding within 1 hour of birth in 2017 and this was 63% in 2018. The rest, 20.9% in 2017 and 37.5% in 2018 put in breast within one day of birth. The prevalence of early initiation in this report for both years is by far less than Growth through Nutrition baseline survey results. This is may be because, Growth through Nutrition baseline survey was conducted in a general population who relatively has better knowledge and capacity to give birth at health facilities, where they can be advised or assisted to initiate breast-feeding within one hour after birth. The MVHHs have relatively less capacity and access to deliver at health facility, because of their low economic and

28

social status. Hence, the project SBCC activities give more emphasis on tailored approaches to promote healthy IYCF related behaviors among MVHHs through saving group platforms, 1000 days radio program etc. Exclusive Breastfeeding – Breast milk contains all the nutrients needed by children in the first 6 months of life, is an uncontaminated nutritional source, and reduces the risk of morbidity and mortality due to diarrhea and pneumonia. It is recommended that children should be only breastfed during the first 6 months of their life; this means that they should be given nothing but breast milk. More than 95% of children under age 6 months were exclusively breastfed in both 2017 and 2018. Food Groups Consumption – From 2017 to 2018, there was an increase in the percentage of children 6 to 23 months consuming eggs (14% to 36%), legumes and nuts (47% to 52%, vegetables and fruits (25% to 31%), and grains, roots, and tubers (90% to 97%). Poultry, legumes, tubers and vegetable seeds are some of the supports provided to MVHHs by the project and hence increase in these food sources are directly attributed to project intervention. During this same time, however, the percentage of children consuming dairy products decreased from 18% in 2017 to 9% in 2018. Cattle is the primary source of milk in most of the Growth through Nutrition intervention areas and Growth through Nutrition did not provide cattle to MVHHs. In addition, traditionally milk is not sold in rural areas. Therefore, MVHHs will not have access to milk both from own production or market to feed their kids. In both years, few children consumed flesh foods as the number of livestock owned by Most MVHHs are very few to slaughter and feed their kids. In addition, there is no meat selling shops/ butcher houses in rural areas. As a result, because of both less market access as well as their economic status, MVHHs have less likely to provide flesh foods to their kids every day or regularly.

Figure 2. Consumption of Seven Food Groups by Children in MVHHs Minimum Diet Diversity among Children

90

47.3

18.4

2.513.9

25.9 24.9

97.1

52.1

9.32.9

35.725.7 31.4

0

20

40

60

80

100

Grains, roots,tubers

Legume, nuts Dairy products Flesh foods Eggs Vitamin A foods Otherfruits/vegetables

C O N S U M P T I O N O F 7 F O O D G R O U P S B Y C H I L D R E N 6 - 2 3 M O N T H S

29

Children are achieving minimum dietary diversity if they have consumed foods coming from at least four out of seven food groups. The minimum dietary diversity of an infant or young child assesses micronutrient sufficiency (World Health Organization 2010b). Table 13 below indicates, in 2017 the percentage of children who consumed 4 out of seven food groups were 12.4%. This was significantly (p=0.004) increased to 14.2% in 2018. These results are in line with the increase of egg and vegetable consumption in figure 2 above, as egg and vegetable are part of seven food groups counted in children dietary diversity. Minimum Meal Frequency – Minimum meal frequency is the minimum amount of energy intake required by an infant or young child from foods other than breastmilk in a day. The minimum Meal frequency requirements for infant or young child’s in a day are determined by their age and whether or not they are breastfed. The infants age 6 to 8 months breast feeding are expected to have at least 2 meals per day while breastfed children age 9 to 23 months are recommended to have at least 3 meals per day. Non-breastfed children age 6 to 23 months are suggested to eat at least 4 times a day (World Health Organization 2010b). Among the children who were breastfed, children who met the required criteria; that is, four or more food groups out of seven was 70.3% and 73.6% in 2017 for age group 6 to 8 months and 9 to 23 months respectively. These was increased to 96.2% and 93.9% for the same age group in 2018 respectively. Minimum Acceptable Diet (MAD) – Minimum acceptable diet is a composite indicator combining the dimensions of dietary diversity and meal frequency. MAD is used to assess the proportion of children age 6-23 months who meet minimum criteria with respect to infant and young child feeding practices. The minimum acceptable diet (MAD) among breastfed children is met if the child consumes four or more food groups from the standard seven food groups and is fed the minimum number of times or more per day. Minimum dietary diversity for the non- breastfed child is defined as four or more feedings of solid, semi-solid, soft food, or milk feeds for children 6−23 months. For non-breastfed children to receive a minimum acceptable diet (MAD), at least two of these feedings must be milk feeds. This indicator is undergoing additional data analysis before reporting. Table 13. Child-Level Outcomes at Baseline (2017) and 1-Year Follow-up (2018).

Child Level Outcomes 2017 2018 (P-value) Early initiation of breastfeeding under six months 73.1% (49/67) 62.5% (5/8)

Exclusive breastfeeding under six months 98.5% (66/67) 95.7% (22/23) NS

Mean # of food groups from a maximum of 7 food groups for children 6 to 23 months of age

2.2 food grps (201)

2.2 food grps (140)

NS

Child minimum dietary diversity (4 food groups or more for children 6 to 23 months) 12.4% (25/201) 14.2% (21/140) 0.004

Minimum Meal Frequency (Child receives solid, semi-solid, or soft foods (but also includes milk for non-breastfed children) the minimum number of times or more over the previous day)

6 to 8 months breastfed 70.3% (26/37) 96.2% (25/26) NS 9 to 23 months breastfed 73.6% (106/144) 93.9% (77/82) NS

6 to 23 months non-breastfed 45.0% (9/20) 90.6% (29/32) NS

6 to 23 months (all) 70.1 (141/201) 93.5 (131/140)

Minimal Acceptable Diet (minimum dietary diversity and minimum meal frequency they are fed during the day or night)

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Women Mother’s dietary diversity, is a qualitative measure to reflect the mother’s access to a variety of foods or nutrition adequacy of the mother. It is a dichotomous indicator of whether or not women 15–49 years of age have consumed at least five out of ten defined food groups the previous day or night. Food Groups Consumed – From 2017 to 2018, there were few overall changes in the percentage of women consuming different food groups. One change, however, was the decline in women consuming dark green vegetables, 36% in 2017 declining to 23% in 2018. The two increases were in the consumption of other vegetables (29% to 40%) and pulses (56% to 60%).

Figure 3. Consumption of 10 Food Groups by Women in MVHHs Minimum Diet Diversity – Women (MDD-W) - Women of reproductive age (15−49 years) are at risk of multiple micronutrient deficiencies, which can endanger their health and ability to care out day-to-day routine activities including care for their children and to partake in income- generating activities. A woman of reproductive age is considered to meet a minimum dietary diversity if she consumed at least five of 10 specific food groups within the previous 24 hours. Table 14 presents the rates of the dietary diversity for each baseline and follow up years, based on the cut-offs defined above. The percentage of women who consumed at least five out of 10 food groups was 2.4% in 2017. This was decreased to 2.0% in the second round assessment, in year 2018. This might imply that child-favoring intra-household food distribution and thus improving maternal feeding may require a different support or scale in MVHHs. Pregnant women Iron folate supplementation was also measured in both years of assessment.

99

56

0.38.8

4.1 0.5

35.5

13.5

28.5

3.4

99.4

59.7

05.3 4.5 8.1

22.714.3

40.3

3.4

0102030405060708090

100

Grains, roots,

tubers

Pulses (

beens,peas,le

ntils)

Nuts & se

edsDair

y

Meat,poultr

y,fish Eggs

Dark gr

een vegetables

Other VitA

fruits

,veg

Other vegetables

Other fruits

C O N S U M P T I O N O F 1 0 F O O D G R O U P S B Y W O M E N

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Proportion of women received iron and folic acid (IFA) supplementation for at least 3 months during pregnancy was 32.5% during baseline. 2017 and significantly increased (p=0.041), to 40.6% in 2018 follow up assessment period. Table 14. Diet Diversity among Women in MVHHs,

Women Level Outcomes 2017 2018

Mean # food groups consumed from 10 food groups 2.5 food grps (386)

2.6 food grps (354)

Level of sig (P-value)

Minimum dietary diversity (5 food groups or more)

Inadequate: 4 food groups or less 97.6 (377/386)

98.0 (347/354)

Adequate: 5 food groups or more 2.4% (9/386)

2.0% (7/354)

NS

Proportion of pregnant women who took Iron folate supplement at least once (pregnant in last 2 years)

70.8% (209/295)

70.7% (128/181)

NS

Proportion of women received iron and folic acid (IFA) supplementation for at least 3 months during pregnancy

32.5% 68/209

40.6% 52/128

0.041

Women’s Work Load – When asked how many hours, on average, spent on work that generates an income for the household, in 2017 women reported working an average of 4.8 hours increasing by one hour on average in 2018 (5.8 hrs). Table 15. Work Load of Women in MVHHs

Women’s Work Load 2017 2018

Number of hours each day, on average, of work to generate income either in cash or in kind?

Range 0 – 11 hrs (386)

0 – 12 hrs (357)

Mean 4.8 hrs (386)

5.8 hrs (357)

Number of hours each day, on average, worked related to the household, especially on food preparation, serving and child/self-care

<2 hrs 13.5 (52/386)

3.4 (12/354)

2-4 hrs 45.1 (174/386)

48.3 (171/354)

5-6 hrs 28.2 (109/386)

36.7 (130/354)

7-8 hrs 11.1 (43/386)

9.9 (35/354)

9-10 hrs 1.8 (7/386)

0.8 (3/354)

>10 hrs 0.3 (1/386)

0.9 (3/354)

Number of hours spent each day, on average, on non-food and non-child care related household chores such as water fetching, firewood collection, cleaning, procurement of food items, marketing and others?

<2 hrs 14.2 (55/386)

18.6 (66/354)

2-4 hrs 49.2 (190/386)

43.5 (154/354)

5-6 hrs 33.2 (128/386)

30.5 (108/354)

7-8 hrs 3.4 (13/386)

7.3 (26/354)

9-10 hrs 0.0 (0/386)

0.0 (0/354)

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>10 hrs 0.0 (0/386)

0.0 (0/354)

Number of months in a year spent working to generate income either in cash or in kind?

Range Not asked 0 – 11

months (357)

Mean Not asked 6.2 months (357)

A large majority (~80%) of women work from 2 – 6 hours, on average, in household related work as well as for non-food and non-child care chores, such as fetching water and firewood, cleaning and so forth. Thus, it was not unusual for many women in 2017 and 2018 to have a work load ranging from a low of 9 hours to a high of almost 17 hours each day. This may be one of the convincing factors for the project to strengthen introduction of time and labor saving technologies in its implementation areas. Women’s Decision-Making – In 2017, in slightly more than one-half (55%) of households, decisions on expenditures were jointly decided by the woman and husband increasing to 62% in 2018 with most of this increase due to the decrease in husbands solely making the decisions (12% in 2017 decreasing to 4% in 2018). In both 2017 and 2018, in almost two-thirds (62%) of the households the woman makes the decision on the types of food purchased with about one-third involving both the woman and husband deciding food purchases. Decisions about the type of food consumed was primarily made solely by the woman in the majority of households (75%) in 2017 decreasing to 52% of households in 2018. This decline in women solely making the decision about food consumed was due to the increase of the decision being made jointly with the husband (21% in 2017 increasing to 43% in 2018). When deciding about the husband’s and wife’s income, in both 2017 and 2018, in slightly more than one-half (52% to 55%) of households’ decisions are jointly made by the woman and husband.

Summary and Conclusions The Growth through Nutrition package of support to MVHHs includes agriculture, health, SBCC and WASH. The investments are aimed to increase utilization of nutrition specific and nutrition sensitive interventions which are ultimately meant to improve nutritional status of women and children in project implementation regions. In the course of implementation, the project designed and conducted annual MVHH baseline and follow-up surveys to evaluate project interventions targeting MVHHs, to elucidate the project’s influence in improving key selected process and outcome level indicators. It is also aimed to systematically generate evidence on project implementation and to allow tracking changes in households over time that is expected to contribute to the improvement of nutrition and dietary diversification practices for children, pregnant and lactating women, with a focus on the first 1000 days (from the start of pregnancy until the child’s second birthday).

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The baseline and follow-up study presents change in rates of maternal and child nutrition, WASH, program exposure, household income and expenditure, and household decision making between baseline and follow up survey. Most of the key output or outcome level indicators exhibited improvement between baseline and follow-up surveys, across three categories indicated below. Key indicators clustered into three levels (household, child, and women) that were assessed among the MVHH cohort over the years. Household level outcomes: Income: At the baseline, in 2017, 60% of these households got income from sources other than agriculture, which increased substantially to 82% in 2018. Another considerable increase over these two years was that in 2017 close to none of the MVHHs reported income from the sale of agriculture produces supported by the project, while in 2018 the figure increased to 64%. Generally, from 2017 to 2018, project related income increased by 1200% and income from sales generated from project inputs in 2018, represented 6% of the overall household income. However, overall household income significantly decreased (by 4.4%, p<0.001) in 2018 compared to 2017. This shows that without Growth through Nutrition project inputs, the decline in household income noticed in 2018 would have been even greater. In terms of sales of crops by MVHHs, between 2017 and 2018, there was a large decrease in the percentage of households selling vegetables and average amount earned per household from their sale, unlike the sale of grains and cash crop. The decrease in sale of vegetable in 2018 could be attributed to the effects of NSA training and SBCC sessions on the health benefits of consuming vegetables. HH Hunger: Among assessed HHs, there was a significant increase in the percentage of experiencing moderate or severe hunger between the two years. Similarly, the proportion of households who reported capacity to cover food consumption need of their households from their own income or production declined from 35% in 2017 to 28% in 2018. Factors contributing to this situation need further investigation including through the upcoming qualitative component of projects’ MVHH assessment. This decline in HH hunger score might have also contributed to the slight decrease in the dietary diversity of women between the baseline and the follow-up assessments and if such trend continues, it is likely to affect positive changes reported in dietary diversity among children too. WASH: Growth through Nutrition household level WASH interventions are aimed to reduce the prevalence of diarrheal disease among children as disease is one of the immediate causes of undernutrition. In the current study, handwashing practices are assessed, focusing on prevalence of washing with soap, mainly during five critical hand washing circumstances and presence of hand washing facilities at home. The percentage of households having hand-washing facility at home and practicing hand washing with soap and or Endod (local herbal detergent) increased significantly ( having facility p=0.001) and (practicing handwashing p=0.006) respectively increased between baseline and

34

follow up surveys. The household participation in project ECC at community level, and receiving information through multiple channels about the importance of WASH might have contributed to the observed changes. However, washing hand at all critical times, has decreased between the two assessment periods, and least frequency of hand washing in both years being 1) after cleaning child following defecation (40% in 2017 and 30% in 2018) and 2) before feeding a child (37% in 2017 and 44% in 2018) This needs adequate emphasis on awareness creation among community members using existing platforms including SBCC session about the importance of hand washing. Child-level outcome: Child dietary diversity (children consuming four or more food groups out of seven) has significantly (p=0.004) increased between the two assessments. This is clearly attributed to livelihood, and SBCC supports provided by the project to MVHHs because it is in line with the increased egg, and vegetable consumption. Prevalence of exclusive breast-feeding remained higher than both the national average and the overall project baseline (75.8% EBF on GTN Baseline), while early initiation of breastfeeding declined between the two surveys, the sample size in the second survey was too small to draw any significant conclusion. Continued focus on antenatal nutrition counselling is important to increase early initiation of breastfeeding. Women-level outcome: Women dietary diversity (percentage of women consuming five or more out of ten food groups) has decreased between the two assessments. On the other hand, CDD significantly (p= 0.004) increased between the two assessment periods. This might imply child-favoring within household food distribution and thus improving maternal dietary diversity requirement may require additional focus among MVHHs. Overall, the findings from these two assessments disclose that livelihood interventions with SBCC activities and a strong exposure to program activities have an increasing positive effect, particularly on child-related dietary indicators, despite decline in household food security status. Additional income from the project for households improved the provision of diverse foods and the opportunity for households to allocate income for food purchase. Food purchase is the highest expenditures category of households from project related income (table 11) The study reflects the crucial role, the frontline workers particularly the health extension workers are playing to share information with the community and bringing change in the practices there after. As it has been portrayed in table 4 above, HEW workers are main source of all maternal and child health, and nutrition related information among MVHH. The HEW’s being source of information for all types of information has consistently increased between baseline follow up assessments. The role of frontline workers needs to be further strengthen, as they are vital in reaching out the community. It is paramount to build the capacity of frontline workers and other community level social networks such as Saving Group Meetings, Enhanced

35

Community Conversation etc. to push optimal nutrition practices for mothers and children at community and HH levels. Reference

1. Black R.E., Allen L.H., Bhutta Z.A., Caulfield L.E., de Onis M., Ezzati M. et al. (2008) Maternal and child undernutrition: global and regional exposures and health consequences. Lancet 371, 243–260.

2. Crop diversification, dietary diversity and agricultural income: Empirical evidence from eight developing countries. Canadian_journal_of_development_studies 35(2):211-227 · May 2014

3. Englberger L, Kuhnlein HV, Lorens A et al. (2010) Pohnpei, FSM case study in a global health project documents its local food resources and successfully promotes local food for health. Pac Health Dialog 16, 129–136.

4. FAO (2013) Food-based dietary guidelines. Rome. Available from: http://www.fao.org/ag/humannutrition/nutritioneducation/fbdg/en/

5. Feed the Future Ethiopia, SC/Growth through Nutrition Activity, Baseline Survey Report, Nov, 2017

6. HarvestPlus (2012) Disseminating Orange-Fleshed Sweet Potato: Findings from a HarvestPlus Project in Mozambique and Uganda. Washington, D.C.

7. Save the Children Ethiopia. Baseline Survey of Most Vulnerable Households in 10 ENGINE Model Woredas. April 2015

8. USAID, UNICEF, WHO 2008, Indicators for assessing Infant and Young Child Feeding (IYCF) practices , part one definition.

9. USAID, UNICEF, WHO 2010, Indicators for assessing Infant and Young Child Feeding (IYCF). Part Two measurement

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Annex 1: Additional Data Tables Table : Background Characteristics of Household Respondents

Respondent Characteristics


Follow-Up Oct – Nov 2018

Remark

% (n)

% (n)

Gender

Female 100 (386/386)

99.2 (354/357)

Male 0.0 (0/386)

0.8 (3/357)

Age in Years

Mean 30.8 yrs (386)

31.6 yrs (357)

Median 31.0 yrs (386)

31.0 yrs (357)

Range 18 – 50 yrs (386)

18 – 52 yrs (357)

Age Group

<15 yrs 0.0 (0/386)

0.0 (0/357)

15 – 19 yrs

2.1 (8/386)

1.4 (5/357)

20 – 50 yrs

97.9 (378/386)

98.3 (351/357)

>50 yrs 0.0 (0/386)

0.3 (1/357)

Relation to Head of Household

Head of household

15.5 (60/386)

15.2 (54/357)

Wife/ husband

81.1 (313/386)

80.6 (287/357)

Son/ daughter

2.6 (10/386)

3.4 (12/357)

Grand parent

0.3 (1/386)

0.3 (1/357)

Brother/ sister

0.5 (2/386)

0.3 (1/357)

Not related

0.0 (0/386)

0.3 (1/357)

Marital status

Never married

0.5 (2/386)

1.7 (6/357)

Married/ living together

85.0 (328/386)

84.0 (300/357)

Divorced 5.2 (20/386)

5.9 (21/357)

Separated

3.4 (13/386)

3.9 (14/357)

Widow 6.0 (23/386)

4.5 (16/357)

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Level of Education

No education

65.8% (254/386)

66.4 (n=237)

Adult education/literate

1.6% (6/386)

0.6 (n=2)

Preschool 0.3% (1/386)

0.3 (1/357)

Primary 27.5% (106/386)

26.9 (96/357)

Secondary

4.4% (17/386)

5.9 (21/357)

Technical/vocational

0.5% (2/386)

0.0 (0/357)

Physically able to manage farm activities/ tend to livestock

Yes 97.2% (n375)

97.5 (348/357)

No 2.3% (n=9)

2.5 (9/357)

D/K 0.5% (n=2)

0.0 (0/357)

Table : Household Characteristics of panel households interviewed

Household Characteristics Number in HH


(N=386)

Follow-up Oct – Nov

2018 (N=357)

% (n)

% (n)

Remark

Size of household

1 0.0 (0/386)

0.3 (1/357)

2 1.8 (7/386)

2.5 (9/357)

3 12.7 (49/386)

10.6 (38/357)

4 18.9 (73/386)

19.9 (68/357)

5 20.7 (80/386)

20.2 (72/357)

6 17.4 (67/386)

18.2 (65/357)

7 16.6 (64/386)

15.7 (56/357)

8 8.5 (33/386)

9.0 (32/357)

9 2.8 (11/386)

2.8 (10/357)

10 0.5 (2/386)

1.7 (6/357)

>10 0.0 (0/386)

0.0 (0/357)

Mean hh size: 5.4 5.5

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(386) (357)

Median hh size: 5.0 (386)

5.0 (357)

Range of hh sizes: 1-10 (386)

1 – 10 (357)

Household Demographic

301 Demographic type of household

Adult Female & No Adult Male

17.1 (66/386)

15.1 (54/357)

Adult Male & No Adult Female

0.3 (1/386)

0.3 (1/357)

Male and Female Adults

82.6 (319/386)

84.6 (302/357)

307 Pregnant or lactating woman in household

Yes 83.2 (321/386)

66.9 (237/354)

No 16.8 (65/386)

33.1 (117/357)

308 Children less than 2 years of age

Yes

71.8 (277/386)

48.5 (173/357)

Some of the children age greater than two years were not in the measurement, a year after baseline survey because they have already graduated.

No 28.2 (109/386)

51.5 (184/357)

Table : Household Hunger & Food Insecurity

Hunger and Food Insecurity


2017 % (n)


2018 % (n)

Remark

(Q303) Household was able to cover food consumption last year

Yes 35.2 (136/386)

28.3 (101/357)

The prevailed weather conditions of the two years cropping season and peace and security situations in the study areas. Moreover, Growth through Nutrition interventions were tailored to increasing dietary diversity not on increasing availability and access to staples.

No 63.8 (250/386)

71.7 (256/357)

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(Q304) If NO, # of months food gap

Mean 3.2 months (250)

3.4 months (256)

Median 3 months (250)

3 months (256)

Range 1 – 8 months (n=250)

1 – 12 (n=256)

Q305 Months of food gap

January 6.4 (250)

7.0 (256)

February 6.8 (250)

11.7 (256)

March 5.6 (250)

9.0 (256)

April 15.2 (250)

14.1 (256)

May 27.2 (250)

17.6 (256)

June 41.2 (250)

32.0 (256)

July 63.2 (250)

58.6 (256)

August 72.4 (250)

72.7 (256)

September 52.4 (250)

64.1 (256)

October 22.8 (250)

34.4 (256)

November 6.8 (250)

10.9 (256)

December 4.0 (250)

7.0 (256)

Q501 Household Hunger Categories

Little to no hunger

61.7 (238/386)

51.3 (183/357)

Moderate Hunger

23.3 (90/386)

34.2 (122/357)

Severe Hunger 15.0 (58/386)

14.6 (52/357)

Key Indicator: Minimum Diet Diversity (MDD) for Mothers at least 5 of the 10 food groups

Inadequate: 4 food groups or less

94.8 (366/386)

94.0 (363/357)

Adequate: 5 food groups or more

Q706 Iron and Folic Acid Supplementation for mothers are currently pregnant or was pregnant with her youngest child in the last two years.

Yes 70.8 (209/295)

69.6 (128/184)

No or Don’t Know

29.2 (86/295)

30.4 (56/184)

Table : Child Diet Diversity Child Diet Diversity (6 – 23 months of age) # of Food groups %

(n) % (n)

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Diet Diversity children (6-23 months) Child 1

Boys

0 1.0 (0/102)

0.0 (0/74)

1 12.7 (13/102)

6.8 (5/74)

2 37.3 (38/102)

41.9 (31/74)

3 36.3 (37/102)

32.4 (24/74)

4 11.8 (12/102)

14.9 (11/74)

5 1.0 (1/102)

2.7 (2/74)

6 0.0 (0/102)

0.0 (0/74)

7 0.0 (0/102)

1.4 (1/74)

Mean 2.5 (102)

2.7 (74)

Girls

1 9.1 (9/99)

8.1 (6/74)

2 43.4 (43/99)

40.5 (30/74)

3 33.3 (33/99)

37.8 (28/74)

4 13.1 (13/99)

12.2 (9/74)

5 1.0 (1/99)

0.0 (0/74)

6 0.0 (0/99)

1.4 (1/74)

Mean 2.5 (99)

2.6 (74)

Total (n=201 in 2017 and n=148 in 2018)

0 0.5 (1/201)

0.0 (0/148)

1 10.9 (22/201)

7.4 (11/148)

2 40.3 (81/201)

42.1 (61/148)

3 34.8 (70/201)

35.1 (52/148)

4 12.4 (25/201)

13.5 (20/148)

5 1.0 (2/201)

1.4 (2/148)

6 0.0 (0/201)

0.7 (1/148)

7 0.0 (0/201)

0.7 (1/148)

Mean 2.5 (201)

2.7 (148)

41 | P a g e

Table : Ownership of land, off farm activities, and beneficiary selection criteria among MVHH

Land, farm, and beneficiary selection criteria



% (n)

% (n)

309 Household owns plot of land for on-farm activities Yes 91.2

(352/386) 96.6

(345/357)

No 8.8 (34/386)

3.4 (12/357)

310 If household owns plot, what do you produce on your land

Vegetables 79.8 (281/352)

89.9 (310/345)

Fruit 29.0 (102/352)

38.8 (134/345)

Grains 92.9 (327/352)

91.0 (314/345)

Livestock 41.2 (145/352)

49.6 (171/345)

Crops 9.4 (33/352)

18.3 (63/345)

Spices 0.6 (21/352)

5.8 (20/345)

311 If household does not own plot is your household willing to engage in off-farm activities

Yes 76.5 (26/34)

100.0 (12/12)

No 23.5 (8/34)

0 (0/12)

312 Did household have off-farm activities? Yes 6.7

(26/386) 3.4

(12/357)

No 93.3 (360/386)

96.6 (345/357

If yes, what activities?

Church leader 4.0 (1/26)

0 (0/12)

Day laborer 4.0 (1/26)

0 (0/12)

Mining 8.0 (2/26)

0 (0/12)

Petty trade 73.0 (19/26)

66.7 (8/12)

Shop (kiosk) 4.0 (1/26)

25.0 (3/12)

Weaver 8.0 (2/26)

8.3 (1/12)

302 Main source of income

Farming 82.4 (318/386)

73.9 (264/357)

Daily labor 11.4 (44/386)

19.9 (71/357)

Food assistance/ Safety net

1.0 (4/386)

0.0 (0/357)

Petty trade/”Gullet”

3.4 (13/386)

3.9 (14/357)

Weaver 0.3 (1/386)

0.0 (0/357)

Shop (kiosk) 0.3 0.3

42 | P a g e

(1/386) (1/357)

Remittance 0.3 (1/386)

0.6 (2/357)

Mining 0.8 (3/386)

0.6 (2) /357

Trading 0.3 (1/386)

0.0 (0/357)

Other 0.0 (0/386)

0.8 (3/357)

303 Able to cover HH food consumption from own income / production last year

Yes 35.2 (136/386)

28.3 (101/357)

No 64.8 (250/386)

71.7 (256/357)

304 If no, how many months with food gap

Mean 3.2 months (250)

3.4 months (256)

Median 3.0 months (250)

3.0 months (256)

Range 1 to 8 months (250)

1 – 12 (256)

305 Which months do you experience food gaps

January 6.4 (250)

7.0 (256)

February 6.8 (250)

11.7 (256)

March 5.6 (250)

9.0 (256)

April 15.2 (250)

14.1 (256)

May 27.2 (250)

17.6 (256)

June 41.2 (250)

32.0 (256)

July 63.2 (250)

58.6 (256)

August 72.4 (250)

72.7 (256)

September 52.4 (250)

64.1 (256)

October 22.8 (250)

34.4 (256)

November 6.8 (250)

10.9 (256)

December 4.0 (250)

7.0 (256)

306 Has you household receive food or agricultural inputs other than SC (n=386 in 2017 and n= 356 in 2018)

Yes 12.7 (49/386)

28.0 (100/357)

No 87.3 (337/386)

72.0 (257/357)

313 Why do you think you received agriculture / livelihood support (n=386 in 2017 and n=356 in 2018)

Poor/not enough income/assets

77.5 (299/386)

83.8 (299/357)

Food gap greater than 3 months

17.9 (69/386)

11.8 (42/357)

43 | P a g e

Have children under 5 years of age

46.6 (180/386)

41.7 (149/357)

Disabled 1.6 (6/386)

3.1 (11/357)

Pregnant and/or lactating member

28.8 (111/386)

24.4 (87/357)

Model women/active participation in kebele

0.3 (1/386)

1.4 (5/357)

D/K 3.1 (8/386)

2.0 (7/357)

314 Beneficiary selection criteria were clearly communicated to you, community, beneficiaries

Yes 75.1 (290/386)

89.4 (319/357)

No 22.3 (86/386)

3.6 (13/357)

D/K 2.6 (10/386)

7.0 (25/357)

Table . Livestock owned by the MVHHs

Q401 Livestock Ownership



% (n)

% (n)

Remark

Sheep

% of households with own sheep 18.4 (71/386)

12.9 (46/357)

% of households obtained sheep from project 85.0 (328/386)

83.5 (298/357)

This means the remaining targeted HHs-received goat. But, most targeted HHs received sheep compared to goat.

Total number of sheep so far / currently 981 739 / 1007

Increased and indicates the relevance or adaptation of this support to improve the livelihood of targeted HHs.

Goats

% of households with own goats 7.8 (30/386)

6.7 (24/357)

% of households obtained goats from project 10.6 (41/386)

11.8 (42/357)

44 | P a g e

Total number of goats so far from project / currently have 196 185 / 146

Chickens

% of households with own chickens 28.5 (110/386)

28.3 (101/357)

% of households chickens obtained from project 0.0 (0/386)

89.4 (319/357)

Total number of chickens so far from project / currently have 360 2101 / 1644

Calves

% of households with own calves 20.7 (80/386)

18.8 (67/357)

% of households calves obtained from project 0.0 (0/386)

0.0 (0/357)

Total number of calves so far from project / currently have 98 0 / 77

Cows

% of households with own cows 23.1 (89/386)

21.6 (77/357)

% of households cows obtained from project 0.0 (0/386)

0.3 (1/357)

Total number of cows so far from project / currently have 120 1 / 98

Heifer

% of households with own heifers 9.1 (35/386)

8.1 (29/357)

% of households heifers obtained from project 0.0 (0/386)

0.0 (0/357)

Total number of heifers from project / currently have 42 0 / 43 Bull

% of households with own bulls 5.7 (22/386)

7.6 (27/357)

% of households with bulls obtained from project 0.0 (0/386)

0.0 (0/357)

Total number of bulls so far from project / currently have 28 0 / 35

Oxen

% of households with own oxen 22.3 (86/386)

20.4 (73/357)

% of households with oxen obtained from project 0.0 (0/386)

0.0 (0/357)

Total number of oxen so far from project / currently have 121 0 / 116

Mules

% of households with own mules 0.5 (3/386)

0.6 (4/357)

% of households with mules obtained from project 0.0 (0/386)

0.0 (0/357)

Total number of mules so far from project / currently have 3 0 / 4

Horses

45 | P a g e

% of households with own horses 3.4 (13/386)

3.4 (12/357)

% of households with horses obtained from project 0.0 (0/386)

0.0 (0/357)

Total number of horses so far from project / currently have 16 0 / 14

Donkeys

% of households with no donkeys 14.8 (57/386)

17.4 (62/357)

% of households with donkeys obtained from project 0.0 (0/386)

0.0 (0/357)

Total number of donkeys so far from project / currently have 71 0 / 78

Bee hive

% of households with no bee hives 4.4 (17/386)

3.4 (12/357)

% of households with bee hives obtained from project 0.0 (0/386)

0.0 (0/357)

Total number of bee hives so far from project / currently have 36 0 / 98

Table . Agricultural tools owned by the MVHHs by source

Q402 Agricultural Tools



% (n)

% (n)

Yolk or harness

% of households with own yolk 40.7 (157/386)

37.0 (132/357)

% of households with yolks obtained from project 0.0 (0/386)

0.8 (3/357)

Total # of yolks so far from project / currently have 167 0 / 158 Local plow

% of households with own local plow 43.3 (167/386)

38.7 (138/357)

% of households with plow obtained from project 0 (0/386)

1.1 (4/357)

Total number of plows so far from project / currently have 194 3 / 168 Hoes

% of households with own hoes 32.1 (124/386)

24.4 (87/357)

% of households with hoes obtained from project 23.6 (91/386)

27.8 (99/357)

Total number of hoes so far from project / currently have 286 101 / 220 Pickaxes

% of households with own pickaxes 29.3 (111/386)

12.3 (44/357)

% of households with pickaxes obtained from project 51.3 (198/386)

58.3 (208/357)

Total number of pickaxes so far from project / currently have 329 203 / 252

46 | P a g e

Forks

% of households with own forks 28.8 (111/386)

17.1 (61/357)

% of households with forks obtained from project 29.8 (115/386)

27.5 (98/357)

Total number of forks so far from project / currently have 277 101 / 173 Rakes

% of households with own rakes 5.4 (21/386)

0.3 (1/357)

% of households with rakes obtained from project 0.0 (0/386)

2.0 (7/357)

Total number of rakes so far from project / currently have 23 8 / 8 Spades

% of households with ow spades 21.0 (81/386)

15.7 (56/357)

% of households with spades obtained from project 52.6 (203/386)

64.7 (231/357)

Total number of spades so far from project / currently have 287 215 / 289 Watering cans

% of households with own watering cans 3.9 (15/386)

2.8 (10/357)

% of households with watering cans obtained from project 0.0 (0/386)

6.7 (24/357)

Total number of watering cans so far from project / currently have 26 23 / 34 Machetes

% of households with own machetes 16.1 (61/386)

5.3 (19/357)

% of households with machetes obtained from project 0.0 (0/386)

0.0 (0/357)

Total number of machetes so far from project / currently have 78 0 / 19 Bucket

% of households with own bucket 19.3 (76/386)

29.8 (106/357)

% of households with bucket obtained from project 0.0 (0/386)

0.3 (1/357)

Total number of buckets so far from project / currently have 93 0 / 122 Nylon rope

% of households with own nylon rope 2.6 (10/386)

2.5 (9/357)

% of households with nylon rope obtained from project 0.0 (0/386)

0.0 (0/357)

Total number of nylon rope so far from project / currently have 22 16 Sickle

% of households with own sickle 64.0 (247/386)

60.8 (217/357)

% of households with sickle obtained from project 0.0 (0/386)

0.9 (3/357)

Total number of sickles so far from project / currently have 423 0 / 352 Table . Ownership of Selected Household Assets

47 | P a g e

Q403 Home Assets & House Structure



% (n)

% (n)

Radio

No Radios 89.9 (347/386)

89.6 (320/357)

1 9.6 (37/386)

10.1 (36/357)

2 0.5 (2/386)

0.3 (1/357)

Mobile Phone

No Mobile Phones 55.7 (215/386)

62.2 (222/357)

1 41.7 (161/386)

33.3 (119/357)

2 2.1 (8/386)

4.5 (16/357)

3 0.5 (2/386)

0.0 (0/357)

Residential house roofing material

Grass/Leaf Thatched Roof 43.8 (169/386)

39.5 (141/357)

Corrugated Iron Sheets Roof

52.8 (204/386)

58.0 (207/357)

Wood with Mud & Stone 1.0 (4/386)

1.1 (4/357)

Wood & Plastic 0.8 (3/386)

0.6 (2/357)

Bamboo 1.6 (6/386)

0.8 (3/357)

Residential house wall

Mud & Wood 87.3 (337/386)

91.0 (325/357)

Mud & Stone 5.7 (22/386)

3.9 (14/357)

Mud Bricks or Burned Bricks

0 (0/386)

1.1 (4/357)

Wood 2.1 (8/386)

0.0 (0/357)

Grass or Bamboo 2.6 (10/386)

2.5 (9/357)

Concrete Bricks 2.1 (8/386)

1.1 (4/357)

Plastic 0.3 (1/386)

0.3 (1/357)

Own separate animal house Yes 36.0 (139/386)

38.7 (138/357)

Table . Household income by source in the past year

Sources of Income



% (N)

% (N)

Remark

48 | P a g e

404b Earned from production supported by project

Yes 1.8 (n=7/386)

64.1 (229/357)

No 98.2 (379/386)

35.9 (128/357)

If YES, Sale of animal products (in Birr)

% with income from sale of animal products

14.3 (1/7)

39.7% (91/229)

Mean 500 birr (1)

150 birr (91)

StdDev --- 284 birr (91)

Median 500 birr (1)

80 birr (91)

Range 500 birr (n=1)

10 – 2500 birr (91)

Sum for all hhs 500 birr (1)

13,680 birr (91)

Sale of live animal (in Birr)

% with income from sale of live animal

28.6 (2/7)

50.7 (116/229)

Mean 1125 birr (2)

1,309 birr (116)

StdDev 318 birr (2)

880 birr (116)

Median 1125 birr (2)

1,050 birr (116)

Range 900 – 1350 birr (2)

1 – 6000 birr (116)

Sum for all hhs 2250 birr (2)

151,871 birr (116)

Sale of vegetable products (in Birr)

% with income from sale of vegetable products

85.7 (6/7)

42.4 (97/229)

This could be considered as positive result, since NSA training and SBCC interventions enhanced vegetable consumption and reduced sale.

Mean 2093 birr (6)

265 birr (97)

StdDev 4805 birr (6)

250 birr (97)

Median 150 birr (6)

180 birr (97)

Range 20 – 11,900 birr (6)

20 – 1400 birr (97)

Sum for all hhs 12,560 birr (6)

25,690 birr (97)

Total birr from project support 15,310 birr ($535 USD)

(7)

191,241 birr ($6700 USD)

(229)

404c Income from own production

Yes 59.3 (229/386)

58.3 (208/357)

No 40.7 (157/386)

41.7 (149/357)

49 | P a g e

Income from Sale of animal products (in Birr)

% with income from sale of animal products

10.0 (23/229)

4.8 (10/208)

Mean 805 birr (23)

546 birr (10)


641 birr (10)


270 birr (10)

Range 20 – 3400 birr (23)

120 – 2000 birr (10)


15,460 birr (10)

Income from Sale of cash crops

% with income from sale of cash crops

0.0 (0/229)

13.5 (28/208)

Mean --- 2640 birr (28)


Median --- 950 birr (28)

Range --- 100 – 19,200

birr (28)

Sum for all hhs --- 73,908 birr (28)

Income from sale of grain by products

% with income from sale of grain products

0.0 (0/229)

3.9 (8/208)

Mean --- 501 birr (8)


Median --- 300 birr (8)

Range --- 50 – 2000 birr (8)

Sum for all hhs --- 4,010 birr (8)

Income from sale of grain

% with income from sale of grain

14.0 (32/229)

63.5 (132/208)

Mean 3346 birr (32)

4696 birr (132)


4910 birr (132)


3000 birr (132)

Range 400 – 8600 birr

(32) 160 – 27,500

birr (132)


619,802 birr (132)

Sale_of_live_animals % with income from sale of live animal

23.1 (53/229)

13.5 (28/208)

50 | P a g e

Mean 2638 birr (53)

2588 birr (28)


2342 birr (28)


2125 birr (28)

Range 8 – 11,000 birr (53)

100 – 8400 birr (28)


72,460 birr (28)

Q404C Income from Other Sales of other agricultural products (wood, herbs, spices, fishery, renting land)

% with income from sale of other agricultural products

5.2 (12/229)

13.5 (28/208)

Mean 4809 birr (12)

1598 birr (28)


1837 birr (28)


900 birr (28)

Range 300 – 15,100

birr (12)

80 – 7000 birr (28)


44,735 birr (28)

Income from sale Own vegetable products

% with income from sale of own vegetable products

79.0 (181/229)

33.2 (69)

This could be considered as positive result, since NSA training and SBCC interventions enhanced vegetable consumption and reduced sale.

Mean 4192 birr (181)

1156 birr (69)


1664 birr (69)


700 birr (69)

Range 50 – 25,000 birr (181)

24 – 1000 birr (69)


79,730 birr (69)

Income from any other source other than agricultural activities in the last one year?

Yes 60.1 (232/386)

81.5 (291/357)

No 39.9 (154/386)

18.5 (66/357)

If yes, amount earned in birr?

Mean 4546 birr (232)

3321 birr (291)


3289 birr (291)


2400 birr (291)

Range 100 – 25,000 birr

60 – 26,400 birr (291)

51 | P a g e

(232)

Sum for all hhs 1,054,720 birr (232)

966,333 birr (291)

Total HH Income from all sources 2,151,805 birr ($77,858 USD)

(341)

2,057,678 birr ($105,507 USD)

(349)

Average income per household for those reporting income

6,310 birr ($223) (343)

5,896 birr ($302) (349)

% of total hh income from project 0.1 (343)

6.3 (349)

Q1001A_How many hours on average do you spend on work that generate income either in cash or in kind?

Mean 4.8 hrs (386)

5.8 hrs (357)

Median 5.0 hrs (386)

6.0 hrs (357)

StdDev 2.5 (386)

2.4 hrs (357)

Range 0 – 11 hrs (386)

0 – 12 hrs (357)

% of households with reporting “0” hours 10.6 (41/386)

7.8% (28/357)

Q1001_How many months in a year do you spend on work that generate income either in cash or in kind? Not Asked

Mean --- 6.2 months (357)

Median --- 6.0 months (357)

StdDev --- 3.1 months (357)

Range --- 0 – 11 months (357)

% of households with reporting “0” months --- 7.8% (28/357)

52 | P a g e

Table . Household expenditure – how HHs utilized income obtained from all sources in the past year

Q408 HH Expenditures



% (n)

% (n)

Q404B % of hhs with income from project sources 1.8 (7/386)

64.1 (229/357)

Q404C % of hhs with income from own ag production 59.3 (229/386)

58.3 (208/357)

Q405 % of hhs with income other than agriculture 60.1 (232/386)

81.5 (291/357)

% of hhs with income from one or more sources 88.3 (343/386)

97.8 (349/357)

Repayment of debt

Project support 0.0 (0/343)

3.2 (11/349)

Other than project sources 25.7 (88/343)

15.2 (53/349)

Savings


22.3 (51/349)


67.6 (236/349)

Education


6.0 (21/349)


57.0 (199/349)

Food purchase


52.7 (184/349)


93.4 (326/349)

Kerosene purchase for cooking and light


3.7 (13/349)


50.1 (175/349)

Health and health related expenses


8.9 (31/349)


48.1 (168/349)

Cleaning and sanitation supplies purchase


11.7 (41/349)


65.0 (227/349)

Clothing/ shoes


20.3 (71/349)

53 | P a g e


69.1 (241/349)

House improvement


0.9 (3/349)


6.3 (22/349)

Farm tools purchase


0.0 (0/349)


1.7 (6/349)

Vegetable seeds purchase


0.6 (2/349)


0.9 (3/349)

Agricultural inputs purchase (other than vegetable seeds – pesticide, fertilizer, etc)


3.2 (11/349)


32.1 (112/349)

Animal purchase


14.3 (50/349)


7.4 (26/349)

Animal care/ feeding


2.3 (8/349)


8.2 (28/349)

54 | P a g e

Table . MVHHs received support from the project by type of support

Services and Support Received Baseline Oct – Nov 2017


409. What services or support have you received from the project in the last one-year period?

% (n)

% (n)

Livestock support

Received support 94.8 (366/386)

91.9 (328/357)

Was helpful/relevant

Yes 99.5 (364/366)

87.5 (287/328)

If no, main complaints

Animals died Chickens have

not started laying eggs

Farm tools


19.0 (68/357)

Was helpful/relevant 97.5 (278/285)

94.1 (66/68)

Seed/Seedling


86.3 (308/357)

Was helpful/relevant

Yes 94.1 (305/324)

88.6 (273/308)

If no, main complaints

Vegetables died due to disease; Seeds arrive after planning season Not correct seed for land

Participated in training


30.0 (107/357)


96.3 (103/107)

Technical support on agricultural activities


13.4 (48/357)


100.0 (48/48)

Organized in Saving groups


78.2 (279/357)


92.5 (258/279)

Participated in ECC Sessions


54.9 (196/357)

Was helpful/relevant --- 96.9 (190/196)

55 | P a g e

Received nutrition counselling


29.2 (104/357)

Was helpful/relevant 99.6 (259)

95.3 (101/104)

Access to basic drinking water


2.8 (10/357)


Access to basic sanitation services


19.9 (71/357)


Vaccination


1.4 (5/357)


Table . Household Hunger Scale

HH Hunger Scale


2017


2017

% (n)

% (n)

Remark

501 In the past one month, was there ever no food to eat of any kind in your house because of lack of resources to get food?

Yes 49.2 (190/386)

60.5 (216/357)

Could be attributed to the variation in weather condition during the cropping season and peace and security during the two years

If YES, 502 How many times did this happen in the past month?

Rarely (once or twice in past 30 days)

34.7 (66/190)

34.3 (74/216)

Sometimes (3-10 times in the past 30 days)

54.2 (103/190)

62.0 (134/216)

Often (more than 10 times in the past 30 days)

11.1 (21/190)

3.7 (8/216)

503 In the past month, did you or any household member go to sleep at night hungry because there was not enough food?

Yes 26.9 (104/386)

34.5 (123/357)

Same justification

If YES , Rarely (once or twice in past 30 days)

53.8 (56/104)

56.9 (70/123)

56 | P a g e

504 How often did this happen in that past month?


41.3 (43/104)

41.5 (51/123)


4.8 (5/104)

1.6 (2/123)

505 In the past month, did you or any household member go a whole day and night without eating anything at all because there was not enough food?

Yes 7.0 (27/386)

5.6 (20/357)

If YES , 506 How many times did this happen in the past month?

Rarely (once or twice in past 30 days)

63.0 (17/27)

70.0 (14/20)


33.3 (9/27)

30.0 (6/20)


3.7 (1/27)

0.0 (0/20)

57 | P a g e

Table . Source of selected information for maternal, child health, and nutrition among MVHH

Did you or anyone in household receive information in the following topics in the past six months?



2018

% (n)

% (n)

Remark

Households with a woman currently pregnant or was pregnant in the last six months in the household

59.6 (230/386)

27.5 (98/357)

601 Receive information on taking care of pregnant mother during pregnancy?

Yes

74.3 (171/230)

46.9 (46/98)

Source

Health Worker 43.9 (75/171)

21.7 (10/46)

Extension Worker 76.0 (130/171)

89.1 (41/46)

AEWs 37.4 (64/171)

50.0 (23/46)

HAD/WDA 9.4 (16/171)

0.0 (0/46)

Enhanced Community Conversation

0.0 (0/171)

41.3 (19/46)

Cooking Demonstration 21.1 (36/171)

0.0 (0/46)

MVHHs or Saving Group Meetings

2.3 (4/171)

13.0 (6/46)

Social/Religious Group Meetings

0.6 (1/171)

0.0 (0/46)

Radio 0.0 (0/171)

2.2 (1/46)

Mobile Phone 0.0 (0/171)

0.0 (0/46)

Poster/Flyers/Leaflets 0.0 (0/171)

2.2 (1/46)

D/K 1.8 (3/171)

0.0 (0/46)

Practices changed

Take Additional Meals, especially snacks during pregnancy

64.3 (110/171)

41.3 (19/46)

Diversified food intake during pregnancy

58.5 (100/171)

54.3 (25/46)

Take iron folate during pregnancy

41.5 (71/171)

43.5 (20/46)

Take deworming tablets during pregnancy

18.1 (31/171)

15.2 (7/46)

Wash hands with water and soap or ash at critical times

44.4 (76/171)

28.3 (13/46)

Treat household water 11.1 (19/171)

19.6 (9/46)

Use improved latrine 12.9 (22/171)

15.2 (7/46)

Take adequate rest 17.5 (30/171)

19.6 (9/46)

Giving Colostrum 24.6 15.2

58 | P a g e

(42/171) (7/46)

Not Practices 15.8 (27/171)

32.6 (15/46)

Other 0.0 (0/171)

0.0 (0/46)

Don’t know 0.0 (0/171)

0.0 (0/46)

N/A 0.0 (0/171)

0.0 (0/46)

Households with children under 5 years of age residing in the household.

93.8 (362/386)

92.4 (330/357)

602 Receive information on treating your children’s diarrhea

58.6 (212/362)

37.3 (133/330)

Source


6.8 (9/133)


91.7 (122/133)

AEWs 42.9 (91/212)

33.8 (45/133)

HAD/WDA 12.7 (27/212)

2.3 (3/133)


0.0 (0/212)

36.1 (48/133)


1.5 (2/133)


3.3 (7/212)

27.8 (37/133)


0.9 (2/212)

0.0 (0/133)

Radio 0.9 (2/212)

1.5 (2/133)


0.0 (0/133)


0.0 (0/133)

D/K 1.9 (4/212)

0.0 (0/133)

Practices changed

Increase frequency of BF 43.4 (85/212)

27.8 (37/133)

Increase Meal Frequency 42.3 (83/212)

31.6 (42/133)

Rehydrate the Child 30.6 (60/212)

10.5 (14/133)

Took the child to nearby health facility

58.2 (114/212)

37.6 (50/133)

Giving ORS and Zinc 28.1 (55/212)

32.3 (43/133)

Not Practiced 15.3 (30/212)

35.3 (47/133)

Other 0.0 (0/212)

0.0 (0/133)

Don’t Know 0.0 (0/212)

0.0 (0/133)

59 | P a g e

N/A 0.5 (1/212)

1.5 (2/133)

Households with children under 2 years’ old children residing in the household.

69.4 (268/386)

48.5 (173/357)

603 Receive information on breastfeeding 54.9 (189/268)

58.4 (101/173)

Source


5.9 (6/101)


90.1 (91/101)

AEWs 49.17 (94/189)

35.6 (36/101)

HAD/WDA 11.6 (22/189)

1.0 (1/101)


0.0 (0/189)

41.6 (42/101)


1.0 (1/101)


4.8 (9/189)

26.7 (27/101)


0.0 (0/189)

0.0 (0/101)

Radio 0.0 (0/189)

1.0 (1/101)


0.0 (0/101)


2.0 (2/101)

D/K 1.4 (3/189)

0.0 (0/101)

Practices changed

Initiate BF within 1 Hour 42.3 (80/189)

20.8 (21/101)

Exclusive BF for 6 months 72.5 (137/189)

42.6 (43/101)

Continued BF 77.2 (146/189)

70.3 (76/101)

Avoiding bottle feeding 12.1 (23/189)

8.9 (9/101)

Giving Colostrum 20.6 (39/189)

17.8 (18/101)


14.9 (15/101)

Other 0.0 (0/189)

0.0 (0/101)

D/K 0.0 (0/189)

0.9 (1/101)

N/A 0.0 (0/189)

0.9 (1/101)

Households with children 6 – 23 months’ of age residing in the household.

66.1 (201/386)

41.5 (148/357)

604 Did you or anyone in household receive information on dietary diversity for children 6-23 months?

89.6 (180/201)

65.5 (97/148)

Source Health Worker 34.4 7.2

60 | P a g e

(62/180) (7/97)


84.5 (82/97)

AEWs 61.1 (110/180)

34.0 (33/97)

HAD/WDA 12.8 (23/180)

2.1 (2/97)


0.0 (0/180)

53.6 (52/97)


5.2 (5/97)


7.8 (14/180)

17.5 (17/97)


1.1 (2/180)

0.0 (0/97)

Radio 0.0 (0/180)

1.0 (1/97)


0.0 (0/97)


1.0 (1/97)

D/K 1.7 (3/180)

0.0 (0/97)

Reported practices changed

Feeding your child diversified foods (4+ groups)

72.8 (166/180)

66.0 (64/97)

Give children >6 months animal sourced foods

72.2 (130/180)

46.1 (53/97)

Increase frequency of feeding 58.3 (105/180)

38.1 (37/97)

Thick Porridge 50.6 (91/180)

56.7 (55/97)


11.3 (11/97)

Other 0.0 (0/180)

0.0 (0/97)

D/K 0.0 (0/180)

0.0 (0/97)

N/A 0.0 (0/180)

0.0 (0/97)

Households with children under 5 years’ of age residing in the household.

93.8 (362/386)

91.6 (327/357)

605 Did you or anyone in household receive information on hand washing with soap at critical times

78.0 (301/362)

66.6 (218/327)

Source


4.6 (10/218)


79.8 (174/218)

AEWs 47.4 (143/301)

30.7 (67/218)

HAD/WDA 7.6 (23/301)

2.3 (5/218)


0.0 (0/301)

47.7 (104/218)

61 | P a g e


5.0 (11/218)


7.6 (23/301)

17.9 (39/218)


0.7 (2/301)

0.0 (0/218)

Radio 0.3 (1/301)

1.4 (3/218)


0.0 (0/218)


1.4 (3/218)

D/K 1.0 (3/301)

0.0 (0/218)

Practices changed

Wash hands with water and soap or ash at critical times

97.0 (293/301)

89.4 (195/218)


10.6 (23/218)

Other 0.0 (0/301)

0.0 (0/218)

D/K 0.0 (0/301)

0.0 (0/218)

606 Did you or anyone in your household participated in Enhanced Community Conversations conducted by local NGOs in the past six months?

Yes 0.0 (0/386)

59.4 (212/357)

No 99.5 (384/386)

39.2 (140/357)

D/K or No Answer 0.5 (2/386)

1.4 (5/357)

Q607_1 1000 day poster

Yes --- 58.0

(123/212)

No --- 42.0 (89/212)

Q607_1 Big bud poster

Yes --- 54.7

(116/212)

No --- 45.3 (96/212)

Q607_1 Family reminder calendar

Yes --- 41.5

(88/212)

No --- 58.5 (124/212)

Q607_1 Flower poster

Yes --- 42.9

(91/212)

No --- 57.1 (121/212)

62 | P a g e

Q607_1 IFA reminder calendar poster

Yes --- 55.7

(118/212)

No --- 44.3 (94/212)

Q607_1 Little bud poster

Yes --- 36.3

(77/212)

No --- 63.7 (135/212)

Q607_1 Maternal menu planning poster

Yes --- 40.6

(86/212)

No --- 59.4 (126/212)

Q607_1 WASH poster

Yes --- 72.2

(153/212)

No --- 27.8 (59/212)

Q608_How many times did you or anyone in the household participate in the ECC?

Mean --- 4.4

sessions (212)

Median --- 5.0

sessions (212)

StdDev --- 1.8

sessions (212)

Range --- 1 – 10

sessions (212)

Q609_Who_usually_participates

Mother --- 98.1 (208/212)

Father --- 0.5 (1/212)

Daughter --- 0.5 (1/212)

Sone --- 0.5 (1/212)

Other --- 0.5 (1/212)

610. Did you or anyone in your household participated in cooking demonstration (at FTC or school or health facility) in the past six months?

Yes 54.1 27.2

63 | P a g e

(209/386) (97/357)

No 45.3 (175/386)

72.3 (258/357)

D/K or No Answer 0.5 (2/386)

0.6 (2/357)

Q611_How many times did you or anyone in the household participate in the cooking demonstration?

Mean 1.6 sessions (209)

1.3 sessions

(97)

Median 1.0 sessions (209)

1.0 sessions

(97)

StdDev 0.9 sessions (209)

0.6 sessions

(97)

Range 1 – 4 sessions (209)

1 – 4 sessions

(97)


Mother 97.1 (203/209)

97.9 (95/97)

Father 2.9 (6/209)

0.0 (0/97)

Fathers are not included in cooking demonstration but have to be involved to enhance husbands support in child care or feeding practices

Daughter 0.0 (0/209)

1.0 (1/97)

Son 0.0 (0/209)

1.0 (1/97)

Q613_Did you or anyone in your household Participated in homestead gardening demonstration?

Yes 55.4 (214/386)

22.4 (80/357)

No 42.7 (165/386)

76.2 (272/357)

Don’t know 1.8 (7/386)

1.4 (5/357)

Q614 How many times did you participate? Number of times


1.3 sessions

(80)

Median 1.0 sessions 214)

1.0 sessions

(80)

64 | P a g e


0.6 sessions

(80)


1 – 4 sessions

(80)


Mother 95.3 (204/214)

97.5 (78/80)

Father 4.7 (10/214)

0.0 (0/80)


1.3 (1/80)

Son 0.0 (0/214)

1.3 (1/80)

Q616_Did you or anyone in your household Participated in women’s saving group in the past six months?

Yes 81.6 (315/386)

86.8 (310/357)

No 17.9 (69/386)

13.2 (47/357)

Don’t know 0.5 (2/386)

0.0 (0/357)

Q617_How many times did you or anyone in the household participate the saving group?


5.4 sessions

(310)

Median 3.0 sessions (315)

6.0 sessions

(310)


1.5 sessions

(310)


1 – 12 sessions

(310)

Q618_Who usually Participate?

Mother 97.8 (308/315)

97.7 (303/310)

Father 1.3 (4/315)

0.3 (1/310)


0.6 (2/310)

Son 0.0 (0/315)

1.0 (3/310)

Other 0.3 (1/315)

0.3 (1/310)

Table . Women consuming iron Folate during most recent pregnancy

Reproductive Health Baseline Follow-up

65 | P a g e

Oct – Nov 2017 Oct – Nov 2017 % (n)

% (n)

Q704 % households with women 15 – 49 years old mothers. Have you been pregnant in the last two years?

76.6 (295/385)

52.1 (184/353)

702. Women’s Age (in completed year)

Mean 30.6 yrs (295)

30.7 yrs (184)

Median 31.0 yrs (295)

30.0 yrs (184)

StdDev 5.5 yrs (295)

5.6 yrs (184)

Range: 18 – 47 yrs (295)

18 – 46 yrs (184)

705. Are you currently pregnant? 8.8 (26/295)

12.5 yrs (23/184)

706. During your last pregnancy (in the last 2 years), were you given or did you buy and Iron and Folic Acid tablets?

70.8 (209/295)

69.6 (129/184)

707. During the whole last pregnancy (in the last 2 years) for how many days did you take the IFA tablets?

Mean 62.3 days (209)

69.0 days (129)

Median 60.0 days (209)

60.0 days (129)

StdDev 39.2 days (209)

36.6 (129)

Range 2 – 183 days (209)

2 – 180 days (129)

Table . Food groups consumed by women among MVHHS

Maternal Dietary Diversity



% (n)

% (n)

708. Bread, biscuits, porridge, Enjera, noodles (Indomin), rice, or other foods made from grains such as Teff, corn, millet (dagusa), sorghum, wheat, oats, barley?

Yes 85.7 (330/385)

88.7 (313/353)

No 13.5 (52/385)

11.3 (40/353)

D/K 0.8 (3/385)

0.0 (0/353)

709. Pumpkin, carrots, squash, sweet potatoes or any other dark yellow or orange fleshed roots, tubers and vegetables?

Yes 13.0 (50/385)

14.4 (51/353)

No 86.2 (332/385)

85.6 (302/353)

D/K 0.8 (3/385)

0.0 (0/353)

710. White potatoes, potato chips, white yams, cassava, bulla, kocho, manioc, or any other foods made from roots?

Yes 41.6 (160/385)

44.8 (158/353)

No 57.7 (222/385)

55.2 (195/353)

D/K 0.8 (3/385)

0.0 (0/353)

66 | P a g e

711. Any dark green leafy vegetables such as spinach, pumpkin leaves, kale, mustard leaves or moringa?

Yes 35.6 (137/385)

22.9 (81/353)

No 63.4 (244/385)

77.1 (272/353)

D/K 1.0 (4/385)

0.0 (0/353)

712. Any other vegetables like green beans, tomatoes, cauliflower, cabbage, broccoli, eggplant, etc?

Yes 28.6 (110/385)

40.5 (143/353)

No 70.6 (272/385)

59.5 (210/353)

D/K 0.8 (3/385)

0.0 (0/353)

713. Ripe mangos, ripe papaya or other fruits that are dark yellow or orange inside?

Yes 0.5 (2/385)

0.0 (0/353)

No 98.7 (380/385)

100 (184/353)

D/K 0.8 (3/385)

0.0 (0/353)

714. Any other fruits like bananas, apples, avocados, guava, pineapple, plum, orange, any berries, etc.?

Yes 3.4 (13/385)

3.4 (12/353)

No 95.8 (369/385)

96.6 (341/353)

D/K 0.8 (3/385)

0.0 (0/353)

715. Any liver, kidney, heart, or other organ meats from domesticated animals such as beef, pork, lamb, goat, chicken, or duck?

Yes 0.3 (1/385)

0.0 (0/353)

No 98.7 (380/385)

100 (353/353)

D/K 1.0 (4/385)

0.0 (0/353)

716. Any meat from domesticated animals, such as beef, pork, lamb, goat, chicken, or duck?

Yes 2.9 (11/385)

3.7 (13/353)

No 96.1 (370/385)

96.3 (340/353)

D/K 1.0 (4/385)

0.0 (0/353)

717. Any organs from wild animals, such as birds, wild pigeons, guinea fowl, deer, wild boar, wild goat?

Yes 0.3 (1/385)

0.3 (1/353)

No 99.0 (381/385)

99.7 (352/353)

D/K 0.8 (3/385)

0.0 (0/353)

718. Any flesh from wild animals, such as birds, wild pigeons, guinea fowl, deer, wild boar, wild goat?

Yes 0.0 (0/385)

0.0 (0/353)

No 99.2 (382/385)

100 (353/353)

D/K 0.8 (3/385)

0.0 (0/353)

719. Eggs?

Yes 0.5 (2/385)

8.2 (29/353)

No 98.7 (380/385)

91.8 (324/353)

D/K 0.8 0.0

67 | P a g e

(3/385) (0/353)

720. Fresh or dried fish, shellfish?

Yes 0.8 (3/385)

0.6 (2/353)

No 98.4 (379/385)

99.4 (351/353)

D/K 0.8 (3/385)

0.0 (0/353)

721. Any foods made from beans, peas, lentils, peanuts or other legumes?

Yes 56.1 (216/385)

59.8 (211/353)

No 43.1 (166/385)

40.2 (142/353)

D/K 0.8 (3/385)

0.0 (0/353)

722. Any foods made from nuts and seeds such as pumpkin seeds?

Yes 0.3 (1/385)

0.0 (0/353)

No 98.7 (380/385)

100 (353/353)

D/K 1.0 (4/385)

0.0 (0/353)

723. Milk, cheese, yogurt, skim milk (arera), whey (aguat), cottage-cheese, or other milk products?

Yes 8.8 (34/385)

5.4 (19/353)

No 90.4 (348/385)

94.6 (334/353)

D/K 0.8 (3/385)

0.0 (0/353)

724. Any oils, fats, butter, ghee, or foods made with any of these?

Yes 76.6 (295/385)

81.3 (287/353)

No 22.6 (87/385)

18.7 (66/353)

D/K 0.8 (3/385)

0.0 (0/353)

725. Any sugary foods such as chocolates, sweets (halawa, mushebek), candies, doughnuts, cakes, honey?

Yes 13.2 (51/385)

12.7 (45/353)

No 86.0 (331/385)

87.3 (308/353)

D/K 0.8 (3/385)

0.0 (0/353)

726. Condiments for flavor, such as chilies, spices, herbs, or fennel grain, coriander, cumin, ginger, turmeric, garlic, cardamom?

Yes 62.3 (240/385)

62.6 (221/353)

No 36.9 (142/385)

37.4 (132/353)

D/K 0.8 (3/385)

0.0 (0/353)

Table . Infant and Young Child Feeding Practices

IYCF Practices Baseline Oct – Nov 2017


68 | P a g e

% (n)

% (n)

802. % of households with children 0-24 months of age 69.4 (268/386)

48.5 (173/357)

Age of infants – Child 1

Mean age 11.0 months (268)

11.1 months (173)


11 months (173)

Range 0 – 23 months (268)

1 – 24 months (173)

Age of infants – Child 28

Mean age 9.9 months (15)

10.8 months (11)


11.0 months (11)


2 – 20 (11)

% HHs with infant 0-5 months 17.4 (67/386)

6.4 (23/357)

804. Has the child ever been breastfeed? 100.0 (67/67)

34.8 (8/23)

805. How long after birth did you first put the child to the breast?

Immediately/Less than an hour

74.6 (50/67)

62.5 (5/8)

Within 24 hours 20.9 (14/67)

37.5 (3/8)

After a day/24+ hrs 7.5 (5/67)

0.0 (0/8)

806. In the first three days after delivery, was the child given anything to drink other than breastmilk? Yes 0.0

(0/67) 4.3

(1/23)

807. What was the child given to drink?

Milk 0.0 (0/1) ---

Plain Water 0.0 (0/1) ---

Sugar/Glucose 0.0 (0/1) ---

Water 0.0 (0/1) ---

Gripe Water 0.0 (0/1) ---

Sugar-Salt-Water Solution

0.0 (0/1) ---

Fruit Juice 0.0 (0/1) ---

Tea/Infusions 0.0 (0/1) ---

Honey 0.0 (0/1) ---

Fresh Butter 0.0 (0/1)

100.0 (1/23)

Fenugreek 0.0 (0/1) ---

Other 0.0 (0/1) ---

69 | P a g e

808. Was the child breastfed yesterday during the day or at night? Yes 66 missing

cases 87.5 (7/8)

810. Was the child given any vitamin drops or other medicines as drops yesterday during the day or at night?

Yes 66 missing cases

0.0 (0/8)

811. Did the child consume any semisolid foods or liquids like water, formula milk, porridge, cow/goat milk, juice, etc, yesterday during the day or at night?

Yes 66 missing cases

12.5 (1/8)

Continued Breastfeeding, Dietary Diversity, and Meal Frequency (for children 6-23 months)

% of hhs with children 6 – 23 months 52.1 (201/386)

41.5 (n=148 of 357)

812. Are you still breastfeeding the child? Yes 94.5 (190/201)

90.3% (112 of 124)

24 missing cases 813. Bread, biscuits, porridge, Enjera, noodles (Indomin), rice or other foods made from grains such as Teff, corn, millet, sorghum, wheat, oats, barley?

Yes 81.6 (164/201)

83.8 (124/148)

814. Pumpkin, carrots, squash, sweet potatoes or or any other dark yellow or orange fleshed roots, tubers and vegetables?

Yes 7.0 (14/201)

15.5 (23/148)

815. White potatoes, potato chips, white yams, cassava, bulla, kocho, manioc, or any other foods made from roots?

Yes 33.3 (67/201)

37.2 (55/148)

816. Any dark green leafy veg (spinach, lettuce with dark green leaves, moringa leaves, sama) Yes 14.9

(30/201) 0.0

(0/148) 817.Orange/yellow colored fruit like ripe mangoes, ripe papaya (NO ORANGES) Yes 1.0

(2/201) 1.4

(2/148) 818. Any dark green leafy vegetables such as spinach, pumpkin leaves, kale, mustard leaves, moringa? Yes 5.0

(10/201) 8.8

(13/148) 819. Any other vegetables, like green beans, tomatoes, cauliflower, cabbage, broccoli, eggplant, etc.? Yes 23.9

(48/201) 27.0

(40/148) 820. Ripe mangoes, ripe papaya, or other fruits that are dark yellow or orange inside? Yes 1.5

(3/201) 0.0

(0/148) 821. Any other fruits like bananas, apples, avocados, guava, pineapple, plum, orange, any berries, etc.? Yes 3.0

(6/201) 4.7

(7/148) 822. Any liver, kidney, heart, or other organ meats from domesticated animals such as beef, pork, lamb, goat, chicken, or duck?

Yes 0.0 (0/201)

0.0 (0/148)

823. Any meat from domesticated animals, such as beef, pork, lamb, goat, chicken, or duck? Yes 2.0

(4/201) 2.0

(3/148) 824. Any organs from wild animals, such as birds, wild pigeons, guinea fowl, deer, wild boar, wild goat? Yes 0.0

(0/201) 0.0

(0/148) 825. Any flesh from wild animals, such as birds, wild pigeons, guinea fowl, deer, wild boar, wild goat? Yes 0.0

(0/201) 0.0

(0/148)

826. Eggs? Yes 13.9 (28/201)

33.8 (50/148)

827. Fresh or dried fish, shellfish? Yes 0.5 (1/201)

0.7 (1/148)

828. Any foods made from beans, peas, lentils, peanuts or other legumes? Yes 46.8

(94/201) 49.3

(73/148)

70 | P a g e

829. Any foods made from nuts and seeds such as pumpkin seeds? Yes 1.0

(2/201) 0.0

(0/148) 830. Cheese, yogurt, skim milk (alera), whey (aguat), cottage-cheese, or other milk products? Yes 18.4

(37/201) 8.8

(13/148) 831. Any oils, fats, butter, ghee, or foods made with any of these? Yes 64.7

(130/201) 73.0

(108/148) 832. Any sugary foods such as chocolates, sweets (halawa, mushebek), candies, doughnuts, cakes, honey?

Yes 18.9 (38/201)

12.2 (18/148)

833. Condiments for flavor, such as chilies, spices, herbs, or fennel grain, coriander, cumin, ginger, turmeric, garlic, cardamom?

Yes 37.8 (76/201)

46.6 (69/148)

Table . Household participation in economic strengthening activities, income generation, and utilization

Women’s Workload/ Decision making



% (n)

% (n)

1001. How many hours on average do you spend on work that generate income either in cash or in kind?

Mean 4.8 hrs (386)

5.8 hrs (354)

StdDev 2.5 hrs (386)

2.4 hrs (354)

Range 0-11 hrs (386)

0 – 12 hrs (354)

Q1001_How many months in a year do you spend on work that generate income either in cash or in kind?

Mean

Not asked

6.2 months (354)

StdDev 3.1 months (354)


1002. The average time spent (in hours) on household related work especially on food preparation, serving and child/self-care

<2 hrs 13.5 (52/386)

3.4 (12/354)

2-4 hrs 45.1 (174/386)

48.3 (171/354)

5-6 hrs 28.2 (109/386)

36.7 (130/354)

7-8 hrs 11.1 (43/386)

9.9 (35/354)

9-10 hrs 1.8 (7/386)

0.8 (3/354)

>10 hrs 0.3 (1/386)

0.9 (3/354)

1003. What is the average time spent daily (in hours) on non-food and non-child care related household chores such as water fetching, firewood collection, cleaning, procurement of food items, marketing and others?

<2 hrs 14.2 (55/386)

18.6 (66/354)

2-4 hrs 49.2 (190/386)

43.5 (154/354)

5-6 hrs 33.2 (128/386)

30.5 (108/354)

7-8 hrs 3.4 7.3

71 | P a g e

(13/386) (26/354)

9-10 hrs 0.0 (0/386)

0.0 (0/354)

>10 hrs 0.0 (0/386)

0.0 (0/354)

Women’s access to and control over resources (decision-making)

1004. Most of the time who decides on household income expenditure?

Self 27.5 (106/386)

26.6 (95/354)

Jointly with Husband

55.2 (213/386)

61.9 (219/354)

Jointly with other family members

2.3 (9/386)

2.8 (10/354)

Head of Household

2.8 (11/386)

5.1 (18/354)

Husband 12.2 (47/386)

3.7 (13/354)

1005. Most of the time who makes decisions on what type of food to purchase?

Self 62.2 (240/386)

61.9 (219/354)


32.4 (125/386)

33.9 (120/354)


2.1 (8/386)

2.3 (8/354)

Head of Household

1.0 (4/386)

1.4 (5/354)

Husband 2.3 (9/386)

0.6 (2/354)

1006. Most of the time who makes decisions on the type of food consumed?

Self 75.4 (291/386)

51.7 (183/354)


21.2 (82/386)

43.2 (153/354)


1.6 (6/386)

2.3 (8/354)

Head of Household

1.0 (4/386)

1.1 (4/354)

Husband 0.8 (3/386)

1.7 (6/354)

1007. Who gets to decide on husband’s income most of the time?

Self 1.9 (42/386)

2.8 (10/354)


52.1 (201/386)

55.1 (195/354)


1.3 (5/386)

0.8 (3/354)

Head of Household

1.8 (7/386)

6.5 (23/354)

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Husband 25.4 (98/386)

19.2 (68/354)

I have no husband

8.5 (33/386)

15.5 (55/354)

1008. Who gets to decide on wife’s income most of the time?

Self 40.9 (158/386)

38.4 (136/354)


51.6 (199/386)

53.7 (190/354)


1.8 (7/386)

2.0 (7/354)

Head of Household

1.0 (4/386)

0.6 (2/354)

Husband 4.4 (17/386)

1.4 (5/354)

Others 0.3 (1/386)

4.0 (14/354)

Man’s work within a day (please ask a man alone)

Is there a man in the house Yes 57.8

(223/386) 60.5

(215/357)

No 42.2 (163/386)

39.8 (142/357)

1009. How many hours on average do you spend on work that generate income either in cash or in kind?

Mean 7.6 hrs (223)

7.8 hrs (215)

St. Dev 2.3 hrs (223)

2.1 hrs (215)

Range 0-12 hrs (223)

0 – 12 hrs (215)

1010. The average time spent (in hours) on household related work especially on food preparation, serving and child/self-care)?

0 hrs 38.6 (86/223)

42.3 (91/215)

<2 hrs 51.6 (115/223)

41.4 (89/215)

2-4 hrs 9.4 (21/223)

15.3 (33/215)

5-6 hrs 0.4 (1/223)

1.0 (2/215)

1011. What is the average time spent daily (in hours) on non-food and non-child care related household chores such as water fetching, firewood collection, cleaning, procurement of food items, marketing and others?

0 hrs 16.6 (37/223)

30.7 (66/215)

<2 hrs 46.6 (104/223)

42.8 (92/215)

2-4 hrs 33.6 (75/223)

21.9 (47/215)

5-6 hrs 2.7 (6/223)

4.7 (10/215)

7-8 hrs 0.4 (1/223)

0.0 (0/215)

Man’s access to and control over resources (decision-making)

1012. Most of the time who decides on household income expenditure?

Self 23.7 (53/223)

8.4 (18/215)

Jointly with wife

69.1 (154/223)

81.9 (176/215)

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1.3 (3/223)

1.4 (3/215)

Head of Household

0.9 (2/223)

1.9 (4/215)

Wife 4.9 (11/223)

6.0 (13/215)

D/K 0.0 (0/223)

0.5 (1/215)

1013. Most of the time who makes decisions on what type of food to purchase?

Self 8.5 (19/223)

1.9 (4/215)

Jointly with wife

43.5 (97/223)

50.7 (109/215)


0.4 (1/223)

0.9 (2/215)

Head of Household

0.4 (1/223)

1.9 (4/215)

Wife 47.1 (105/223)

44.2 (95/215)

D/K 0.0 (0/223)

0.5 (1/215)

1014. Most of the time who makes decisions on the type of food consumed?

Self 9.0 (20/223)

0.5 (1/215)

Jointly with wife

25.1 (56/223)

40.0 (86/215)


0.4 (1/223)

1.4 (3/215)

Head of Household

0.0 (0/223)

0.9 (2/215)

Wife 65.5 (146/223)

56.7 (122/215)

D/K 0.0 (0/223)

0.5 (1/215)

1015. Who gets to decide on husband’s income most of the time?

Self 28.3 (63/223)

18.6 (40/215)

Jointly with wife

67.3 (150/223)

76.3 (164/215)


1.3 (3/223)

0.5 (1/215)

Head of Household

0.4 (1/223)

0.9 (2/215)

Wife 2.7 (6/223)

1.4 (3/215)

D/K 0.0 (0/223)

2.3 (5/215)

1016. Who gets to decide on wife’s income most of the time? Self 6.7 1.4

74 | P a g e

(15/223) (3/215)

Jointly with wife

69.2 (155/223)

72.1 (155/215)


0.4 (1/223)

0.5 (1/215)

Head of household

0.4 (1/223)

0.5 (1/215)

Wife 22.8 (51/223)

20.9 (45/215)

No response

0.4 (1/223)

4.7 (10/215)

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Table . Water, Sanitation, and Hygiene Practices

Water, Sanitation, Health (WASH)



% (n)

% (n)

901. Yesterday, did you wash your hands? 99.5 (384/386)

100 (357/357)

902. What are all the moments that you washed your hands?

When dirt is visible 49.5 (190/384)

56.3 (201/357)

After toilet use/ defecation/ urination

62.2 (239/384)

70.6 (252/357)

After cleaning child following defecation

39.8 (153/384)

30.0 (107/357)

Before preparing the food 87.2 (335/384)

84.0 (300/357)

Before serving a meal 55.2 (212/384)

53.5 (191/357)

Before eating 87.2 (335/384)

87.7 (313/357)

After eating 71.6 (275/384)

61.1 (218/357)

Before feeding a child 37.2 (143/384)

44.3 (158/357)

When I am reminded to do so 1.3 (5/384)

3.9 (14/357)

903. What do you use to wash your hands most of the time?

Water Only 44.9 (172/384)

38.9 (139/357)

Water and Soap 52.7 (202/384)

53.5 (191/357)

Water and Ash/Endod 2.3 (9/384)

7.6 (27/357)

904. Does the HH have a handwashing facility at home? 2.1 (8/386)

14.3 (51/51)

905. If yes, what type is it?

Tippy Tap 12.5 (1/8)

29.4 (15/51)

Water basin with jug 87.5 (7/8)

68.6 (35/51)

An improved handwashing facility with tap

0.0 (0/8)

0.0 (0/51)

Others 0.0 (0/8)

0.0 (0/51)

Not observed 0.0 (0/8)

2.0 (1/51)

906. If yes, where is it located?

In the house corner/food cooking place

25.0 (2/8)

60.8 (31/51)

Near the latrine 25.0 (2/8)

23.5 (12/51)

In the house other than food cooking place

37.5 (3/8)

5.9 (3/51)

Outside of the house 12.5 (1/8)

9.8 (5/51)

Q910_OBSERVATION ONLY: If HH has handwashing facility at home observe presence of water at the place for handwashing

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Water is available Yes Not asked 42.0

(21/51)

No Not asked 58.8 (30/51)

Q911_OBSERVATION ONLY: Observe presence of soap, detergent, or other cleansing agent at the place for handwashing_

Soap or detergent (bar, liquid, powder, paste) Not asked 40.0

(20/51)

Ash, mud, sand Not asked 12.0 (6/21)

None Not asked 48.0 (25/51)

907. Does the HH practice point of use water treatment? 7.5 (29/386)

2.5 (9/357)

908. What type of water treatment does the HH use? (check all that apply)

Boiling 44.8 (13/29)

0.0 (0/9)

Water treatment chemicals 48.3 (14/29)

77.8 (7/9)

Household water filter (sawyer or tulip)

20.7 (6/29)

33.3 (3/9)

909. If chemicals or water filter, what is the source?

Growth through Nutrition project

0.0 (0/29)

11.1 (1/9)

Health Facility 55.2 (16/29)

77.8 (7/9)

NGOs 3.4 (1/29)

0.0 (0/9)

Own Source 17.2 (5/29)

22.2 (2/9)

usaid growth through nutrition most vulnerable households ......table i: summary table for growth...

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