Moss Cami, Bekele Tesfaye Hailu, Salasibew Mihretab Melesse, Sturgess Joanna, Ayana Girmay, Kuche Desalegn, Eshetu Solomon, Abera Andinet, Allen Elizabeth, Dangour Alan D
Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK.
Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
BMJ Open. 2018 Jul 19;8(7):e022028. doi: 10.1136/bmjopen-2018-022028.
Improving complementary feeding in Ethiopia requires special focus on dietary diversity. The Sustainable Undernutrition Reduction in Ethiopia (SURE) programme is a government-led multisectoral intervention that aims to integrate the work of the health and agriculture sectors to deliver a complex multicomponent intervention to improve child feeding and reduce stunting. The Federal Ministries of Health and Agriculture and Natural Resources implement the intervention. The evaluation aims to assess a range of processes, outcomes and impacts.
The SURE evaluation study is a theory-based, mixed methods study comprising impact and process evaluations. We hypothesise that the package of SURE interventions, including integrated health and agriculture behaviour change communication for nutrition, systems strengthening and multisectoral coordination, will result in detectable differences in minimum acceptable diet in children 6-23 months and stunting in children 24-47 months between intervention and comparison groups. Repeated cross-sectional household surveys will be conducted at baseline and endline to assess impact. The process will be assessed using observations, key informant interviews and focus group discussions to investigate the fidelity and dose of programme implementation, behavioural pathways of impact and contextual factors interacting with the intervention. Pathways of impact will also be explored through statistical analyses.
The study has received ethics approval from the scientific and ethical review committees at the Ethiopian Public Health Institute and the London School of Hygiene and Tropical Medicine. The findings will be disseminated collaboratively with stakeholders at specified time points and through peer-reviewed publications and presentations.
改善埃塞俄比亚的辅食喂养需要特别关注饮食多样性。埃塞俄比亚可持续减少营养不良（SURE）计划是一项由政府主导的多部门干预措施，旨在整合卫生和农业部门的工作，实施一项复杂的多组分干预措施，以改善儿童喂养并减少发育迟缓。联邦卫生部、农业与自然资源部实施该干预措施。评估旨在评估一系列过程、结果和影响。
SURE评估研究是一项基于理论的混合方法研究，包括影响评估和过程评估。我们假设，SURE干预措施组合，包括针对营养的综合卫生与农业行为改变沟通、系统强化和多部门协调，将导致干预组和对照组之间6至23个月儿童的最低可接受饮食以及24至47个月儿童的发育迟缓出现可检测到的差异。将在基线和终线进行重复的横断面家庭调查以评估影响。将使用观察、关键信息提供者访谈和焦点小组讨论来评估过程，以调查项目实施的保真度和剂量、影响的行为途径以及与干预相互作用的背景因素。影响途径也将通过统计分析进行探索。
该研究已获得埃塞俄比亚公共卫生研究所和伦敦卫生与热带医学学院的科学与伦理审查委员会的伦理批准。研究结果将在特定时间点与利益相关者合作传播，并通过同行评审的出版物和报告进行传播。
