Participatory Assessment of Factors Influencing Nutrition and Livelihoods in Rural Ethiopia: Implications for Measuring Impacts of Multisector Nutrition Programs.

Agricultural interventions more effectively improve nutrition when they are adapted to local contexts and engage multiple sectors. However, evidence is limited for how to design and measure the impacts of such interventions. We piloted a participatory methodology to collect community feedback to inform the design and selection of measures for a multisector nutrition intervention in Ethiopia. Study participants were purposively recruited from 6 rural districts in Tigray and the Southern Nations, Nationalities, and Peoples' regions. Qualitative data were collected from 12 focus group discussions with smallholder farmers (men and women) participating in a nutrition-sensitive agriculture intervention. The Sustainable Livelihoods Approach (SLA) combined with an ecological systems model informed the survey tool and analyses. Analyses revealed 3 key findings. First, there were regional differences in how communities defined assets important for nutrition. Second, when asked to prioritize which assets were most important, communities selected every SLA capital category; however, the types of assets within each category differed by region. Third, the most commonly reported barriers to good nutrition were traditional feeding behaviors (eg, men eating before women) and lack of nutrition knowledge. How households use assets to enhance nutrition is influenced by diverse and dynamic cultural, social, economic, and ecological factors. The participatory methods piloted in this study present a novel approach to identify contextually relevant household, community, and institutional assets used to support food and nutrition security.