Participatory Nutrition Capacity Assessment and Capacity Development in Six Regions of Ethiopia

Abstract

Abstract Objectives The multi-faceted causes of malnutrition make capacity development in nutrition complex. Defining capacity development actions requires an understanding of the landscape actors utilize to address the determinants. Thus, six regional health bureaus (RHB) in Ethiopia, in collaboration with Alive & Thrive (A&T), conducted participatory capacity assessments to identify capacity strengths and gaps, and co-developed appropriate maternal, infant, and young child nutrition (MIYCN) capacity development plans linked to achieving targets outlined in the national nutrition program. Methods From April to June 2019, 143 nutrition practitioners in six regions of Ethiopia conducted rapid participatory assessments of their respective regional capacity. They used an adapted assessment tool based on WHO's six system building blocks, and a four-level scoring guide to identify MIYCN capacity strengths and gaps on 87 statements of excellence. Validated by RHB's leadership, the assessors and A&T co-developed region-specific MIYCN capacity development plans for areas rated ‘poor’ and ‘fair’. Results An aggregate assessment score for six regions revealed presence of adequate MIYCN implementation capacity – excellent (25.3%), moderate capacity with basic ones in place or in use – good (37.9%), low capacity needing attention – ‘fair’ (23.6%), and no capacity or critical capacity limitation needing urgent attention – ‘poor’ (9.4%). Using a prioritization matrix, MIYCN-focused performance strengthening plans were designed, tailored to each region's context. Beginning in July 2019, the six RHBs incorporated key MIYCN improvement action items targeted towards ‘poor’ and ‘fair’ performance areas with relevant indicators into their annual plans, budget structure, and M&E framework. A&T and other partners provided technical assistance and coordinated their efforts with RHBs to spirally build regional MIYCN implementation capacities. Conclusions The participatory capacity assessment served to establish a baseline of existing MIYCN implementation capability; and create a strong and shared commitment within the health sector identifying areas for improvement that can be addressed by the government, with little or no external assistance. Funding Sources The Bill & Melinda Gates Foundation.