Expansion and Scale-up Phase of the Sequota Declaration

Abstract

Stunting in Ethiopia is still unacceptably high. Despite the steady decline of stunting over the past twenty years, the rate in children under five was 38% in 2019 and 28% in children under two (with wide regional variation). The Government of Ethiopia (GoE) has designed and implemented several pro-poor policies and strategies across different sectors in the last twenty years focused on multisectoral poverty reduction, food security, increased agricultural production, decentralized health systems, health extension programs, accelerated midlevel health care worker training, girls’ and parental education, maternal nutrition status, economic improvement, and a reduction in open defecation and general Water, Hygiene and Sanitation (WASH) practices. Impacts from the implementation of these policies and strategies collectively contributed to the stunting reduction achieved in Ethiopia over the last twenty years. Despite this progress, the gains are insufficient to achieve the country’s stunting reduction targets in either the short term (the national nutrition plan II NNP II1 target of reducing stunting in children under five to 26% by 2020) or long term (World Health Assembly target of 40% reduction by 2025 and Seqota Declaration target of zero stunting by 2030 in children under two). Gender inequality is highly associated with child malnutrition and child mortality. Women’s socio-economic empowerment in terms of access to education, information, media, and income-generating activities is strongly associated with lower rates of childhood stunting and wasting, and women’s decision-making power is positively associated with better health status for children. In July 2015, the Government of Ethiopia exemplified its commitment to nutrition by issuing the Seqota Declaration to eliminate child undernutrition and end stunting in Ethiopia by 2030. The 15-year Seqota Declaration Implementation Plan focuses on delivering high-impact nutrition-specific, nutrition-sensitive, and infrastructure interventions across multiple sectors. Recognizing that ending child malnutrition requires coordinated efforts from all stakeholders, the declaration’s implementation plan emphasizes improving adolescent, infant, and maternal nutrition; increasing access to nutrient-rich food all year round, improving access to water and hygienic services; building resilient social protection systems; supporting the economic empowerment of women; and improving access to education, especially for girls. The SD focuses on stunting because it is considered to be the best overall indicator of children’s well-being and social inequities globally. The SD is being implemented in three phases. The Innovation Phase was implemented from 2016 to 2020 to pilot innovative programs in 40 woredas along the Tekeze river basin in Amhara (27 woredas) and Tigray (13 woredas). Amhara and Tigray were targeted for the Innovation Phase because the stunting burden in both regions was consistently above the national average. The Expansion Phase will be implemented between 2021 and 2025 and seeks to expand these innovative pilot programs to additional vulnerable communities. The Scale-up Phase will take place from 2026 through 2030 and will scale these innovations nationally.