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USAID/Empowering New Generations to Improve Nutrition

and Economic opportunities (ENGINE)

A program of the US Global Health and Feed the Future Initiatives

ENGINE Team

Implementing Agency

Role in ENGINE

Save the Children USA

- Prime- Overall program management- Technical lead on MNCHN, HIV/AIDS, in-service training, community mobilization and capacity building of HEWs and community volunteers.

Tufts University -Lead IR 4: -development of a cohesive, relevant research strategy and documentation and publication/dissemination contributing to the program’s learning agenda.- lead the design of a rigorous Monitoring and Evaluation system;

Valid International Lead design and implementation of studies under the research theme related to CMAM/SAM. Lead implementation and adaptation of Impact study , the Simple Spatial Survey Method (S3M) and SQUEAC assessments

Jhpiego Technical lead pre-service component

JHU CCP Technical lead on behavior change communication (BCC) and the development of an integrated demand generation strategy.

Land O Lakes Technical lead on livelihoods and economic strengthening activities

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FTF Nutrition Interventions

• Stand-alone nutrition project (ENGINE)

• Wrap-around Nutrition Activities

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IR 1IR1: Capacity for and institutionalization of

nutrition programs and policies

1R2: Quality and delivery of

nutrition and health care

services improved

IR3: Prevention of undernutrition

through community-based

nutrition care practices improved

Strategic ObjectiveImproved nutritional status of women

and young children through sustainable, comprehensive,

coordinated, and evidence-based interventions

IR4: Rigorous and innovative learning agenda adopted

Target Region

Regional Breakdown by YearRegion Total Target Year 1 Year 2Amhara 22 11 16Oromiya 34 17 26SNNPR 19 9 14Tigray 8 4 3Not AGP woredas 17 (16)*Total ENGINE woredas 100 41 59

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Region Zones Woredas

Amhara W Gojjiam Bahirdar Zuria, Debube Achefer, Jabi-tehnane, Semin Achefer, Jabi-tehnane, Semin Achefer, and Wenebrema

Awi Anikasha (Ankasha) , Danegela (Dangila)E Gojam Enmaye, DejeneN Gondar Alefa, Taqusa

Oromia W Arsi Dodola, KofleArsi Lemu na Bilbilo, ShirkaBale Agarfa, SinanaFinfine surrounding Special Zone Welmera/sebetaW Shoa Ambo, Dendi, Toko KutayuE Welega Guto Gida, Wayu TuqaS W Shoa Weliso, Becho (Tulu Bolo)Horo/G/Wolega Horo, Horo(Jimma Geneti), Guduru

SNNP Gedeo Bule, GedebSidama Wondo Genet, Gorche (Shebedino)Gurage Azernet Berbere, Enemor enerSilti Merab AzernetKeffa Decha, Chena

Tigray N W Tigray Tahtay AdiaboW Tigray Qfta humraS Tigray Endamehone, Ofla

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Direct beneficiaries• Under five children esp under two years• Pregnant and lactating women• women of reproductive age • Vulnerable households

Target sectors or institutions Intervention areas

MOH and its decentralized structure at Regional, and Woreda level, especially HEP

Policy and preventive and direct nutrition interventions

MOA at Federal especially the extension program and AGP unit and its decentralized structure –AEWs/DAs

Livelihood and Economic strengthening interventions of vulnerable households

Nutrition education for AEWs and AGP community groups

Hawassa, Gondar, Haromia, and Jimma University and Regional health and agriculture colleges

Pre-service integration of nutrition

Ethiopian Health and Nutrition Institute (EHNRI), and Hawassa and Jimma University

Operational Research/Phd and MSc support

Program Components/ work plan

IR1: Capacity for and institutionalization of nutrition programs and policies

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IR1.1:strengthened policy environment 

Strengthening existing Nutrition Multi-sectoral coordination 

Support revitalization of NNC (multi-sectoral coordination)

Revise and update nutrition PROFILEs Advocacy tool

Support nutrition policies, guidelines and standards 

Provide support to revision of NNP

Harmonize national IYCF training manuals

IR1.2: Pre-service and in-service nutrition training for health care and agricultural agents strengthened   

Pre-service education for health care providers and agricultural agents  

Conduct PSE sites readiness and baseline assessment

Develop standards and competencies of nutrition education for health and agriculture cadres

Enhance faculty’s/preceptors' instructional capacity and create an enabling environment for nutrition education

In-service capacity building for program mangers and existing health care providers  

Develop training package on training skill and nutrition program Mx for Program managers

Provide training skills course (ToT) for national nutrition trainers

Conduct coaching and mentoring of trainers

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...Program Components/ work plan

1R2: Quality and delivery of nutrition and health care services improved

IR2.1: Quality of nutrition services strengthened Facilitate the integration of quality improvement processes 

Support adaptation/development of minimum service standards for nutrition

Improve coaching/mentoring process and skills

Support development/adaptation of coaching/mentoring tools and guides

Conducting training on coaching and mentoring HEWs supervisors, and woreda level managers

Improve supportive supervision

Build the capacity of health facility staff and frontline workers to provide high quality services 

Provide training to Program managers, health workers and Health Extension Workers

Support Integrated Refresher Training for regional, zonal, and woreda program managers and HEWS

Provide support to HDAs trainings and logistics problems to 20 woredas

Train program mangers from zonal and Woreda health and Agriculture offices

Support training of AEWs and DAs on nutrition topics at woreda levels

Improve tools used by frontline health and agriculture workers to promote nutrition

Support utilization of health and nutrition data for decision making

Support review meetings, experience sharing forums, and promotion best practices

...Program Components/ work plan

IR 2.2 Health and nutrition service seeking behaviours increased

Mobilize communities to seek health and nutrition services 

Formative research for health-seeing behaviours

Conduct community conversations and identify key community groups and change agents

IR2.3: Increased access to health and nutrition services 

Strengthen referral system and access to essential supplies of maternal & child health services:(Vitamin A, Deworming, Zinc/ORS, iron-folate supplementation, breast feeding and complementary feeding counselling, iodized salt utilization etc.)

Establish 21 CMAM sites in collaboration with UNICEF

Link with existing programs and partners

Strengthen integration of Nutrition in to HIV/AIDS services  and livelihood interventions 11

1R2: Quality and delivery of nutrition and health care services improved

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…...Program Components/ work plan

IR3: Prevention of undernutrition through community-based nutrition care practices improved

IR 3.1: improved maternal and IYCF knowledge and practices   Develop the social and behaviour change communications strategy

Determine knowledge and research gaps, collect primary data of the formative research

Develop SBCC and Advocacy strategy through consultative process

Promote optimal nutrition practices through dynamic communication channels  

Disseminate nutrition messages through animated role model named Sister Asnakech

Work with local celebrities and leaders to become ambassadors for nutrition

Work with communities to promote model households.

Develop messages that can be incorporated into materials and community mobilization efforts of model households and HDAsDrive to scale through mass media programming

IR 3.2 Access to food and economic strengthening opportunities Apply economic strengthening (ES) interventions to meet households’ needs

Identify and map economic activities to address specific household vulnerabilitiesEstablish linkage and coordination with AGP under MOA, AGP-VCE under ACDI/VOCA, GRADS and AGP-LGP

Match economic opportunities with household needs and capabilitiesDevelop diagnostic tool to conduct household vulnerability analysis & set targeting criteria Set up and Orient targeting committee including all concerned partnersIdentify women beneficiaries & organize women groups on common needs using AGP innovative group modality

Promote demonstration plots and school demonstration gardensSupport demonstration of agricultural technologies on FTCs and school GardensTrain School teachers (preferably women) on gardening and food preparation(cooking)Provide printed teaching aids on nutrition and farming technology to schools

Facilitate effective approaches to small scale horticulture and animal production to most vulnerable households

Promote and support homestead gardening/productionTrain targeted most vulnerable households on homestead production of horticultural cropsProvide inputs such as improved seed, fertilizer and hand tools

Promote farming technology package and livestock at household levelTrain targeted most vulnerable households on animal husbandry (dairy, poultry, & goat rearing)Provide productive livestock (improved/local breed of heifer, Goat and commercial layers of chicken

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…Program Components/ work plan

IR4: Rigorous and innovative learning agenda adopted : it is cross-cutting for all IRs

Design and Delivery of Research strategy Multi-stakeholder national level research meeting and finalize research strategy/questions and roles/responsibilitiesEstablish research group(s) including PI/Co-PI for each study prioritised

Identify PhD/MSc programs in Ethiopia for partnerships with ENGINE

Develop study design/protocol for 2-5 phase 1 studies by individual research groups

Develop and manage an innovative documentation and dissemination strategy Conduct Baseline and Impact survey

Barriers-to-access analysis (SQUEAC survey) to nutrition and health services in select woredas

Facility-based quality-of-service survey

Establish program monitoring system

Support and provide technical assistance to the MOH with the integration of nutrition indicators into the HMIS.

Conduct quarterly supportive supervision at facility and community levels in NIS/HMIS

Document best practices in M and E at all levels

 Gender and ENGINE

Conduct gender audit assessment at all levels and gender analysisGender mainstreaming in ENGINE program

People with Disabilities (PWD) and ENGINE Conduct preliminary assessment of PWD and nutrition programs using disability assessment tool

Capacity Building and Analytical studies planned

• Capacity Building– Frontline workers- HEWs, health workers, MSGs, AEWs/DAs, women groups,

School teachers– Regional and Woreda health and agriculture program mangers– Federal MOH policy support– Health facilities and health posts, Farmer training Centers– Universities and EHNRI: researchers and students, nutrition course

improvement

• Analytical studies planned– ENGINE baseline and impact survey– Operational research on nutrition policy/governance, prevention of

undernutrition, linking nutrition and agriculture, and CMAM– Barriers-to-access analysis (SQUEAC survey) to nutrition and health services– Facility-based quality-of-service survey– Pre-service baseline assessment of 12 health and agriculture universities

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Implementation Modalities

• Community Based components – HEP with HDA– Agricultural Extension Program– Program management: MOH decentralized health

administration system– Local NGOs for BCC– Innovative modalities that complement the gov’t

structure

• Research– EHNRI and Universities (Jimma and Hawassa)

• SCUS sub-offices provide TA to their respective regions

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