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Inadequate safe water supply and poor sanitation and hygiene continue to be important risk factors for diarrhoea and stunting globally. We used data from the four rounds of the Ethiopian Demographic and Health Survey and applied the new World Health Organization (WHO)/UNICEF Joint Monitoring Program (JMP) service standards to assess progress in water, sanitation and hygiene (WASH) coverage between 2000 and 2016. We also performed an age‐disaggregated pooled linear probability regression analysis followed by a decomposition analysis to determine whether changes in WASH practices have contributed to the changing prevalence of diarrhoea and stunting in children under 5 years of age. We observed a significant increase in the coverage of safe drinking water and adequate sanitation facilities over the period. At the national level, the use of a basic water source increased from 18% in 2000 to 50% in 2016. Open defecation declined from 82% to 32% over the same period. However, in 2016, only 6% of households had access to a basic sanitation facility, and 40% of households had no handwashing facilities. The reduction in surface water use between 2000 and 2016 explained 6% of the decline in diarrhoea observed among children aged 0–5 months. In children aged 6–59 months, between 7% and 9% of the reduction in stunting were attributable to the reduction in open defecation over this period. Despite progress, improvements are still needed to increase basic WASH coverage in Ethiopia. Our findings showed that improvements in water and sanitation only modestly explained reductions in diarrhoea and stunting.

High-quality data are vital for informed decision-making, enhancing population health, and achieving comprehensive insights. However, there is limited understanding of the consistency and reliability of routine Health Management Information System (HMIS) including nutrition data across diverse regions in Ethiopia. This study systematically reviewed the existing literature to address these knowledge gaps. We systematically searched PubMed, HINARI, and Google Scholar for studies published from 2015 onwards to assess HMIS, including nutrition data quality in Ethiopia. The evaluations focused on completeness, consistency, and timeliness metrics defined by the WHO. We included diverse regional studies without indicator restrictions, prioritized data quality metrics as primary outcomes, and explored qualitative reasons for poor data quality as secondary outcomes. Of the 1790 papers screened, 25 met the inclusion criteria. The completeness of reporting varied widely among studies (50%-100%), with only 21% (4 out of 19) exceeding 90%. The consistency ranged from 38.9% to 90.5%, with only 6% of studies reporting internal consistency above 90%. Other consistency issues included lack of external consistency, indicator discrepancies, and outliers. Timeliness ranged from 41.9% to 93.7%, with 54% of studies reporting below 80%. In addition to the lack of studies addressing nutrition data, the quality was no better than other components of HMIS. The major factors contributing to poor data quality were human resource shortages, insufficient capacity building, behavioural influences, and infrastructural deficits. The HMIS including nutrition data in Ethiopia, exhibited deficiencies in completeness, consistency, and timeliness, which were largely, attributed to capacity and resource constraints. Interventions should prioritize resource allocation, staff training, supervision, and feedback mechanisms to enhance data quality, thereby improving decision-making processes and population health outcomes.

The objective of our study was to reanalyse the Ethiopia STEPwise approach to Surveillance Noncommunicable Disease Risk Factors survey (NCD STEPS), using causal path diagrams constructed using expert subject matter knowledge in conjunction with graphical model theory to map the underlying causal network of modifiable factors associated with prediabetes/diabetes and hypertension. We used data from the 2015 Ethiopia NCD STEPS representative cross‐sectional survey (males; n = 3977 and females; n = 5823 aged 15–69 years) and performed directed acyclic graph‐informed logistic regression analyses. In both sexes, a 1‐unit higher in body mass index (BMI) and waist circumference (WC) were positively associated with prediabetes/diabetes (BMI: males: adjusted odds ratio [aOR]: 1.07 [95% confidence interval: 1.0, 1.1], females aOR: 1.03 [1.0, 1.1]; WC: males: aOR: 1.1 [0.9, 1.2], females: aOR: 1.2 [1.1, 1.3]) and hypertension (BMI: males: aOR: 1.2 [1.1, 1.2], females aOR: 1.1 [1.0, 1.1]; WC: males: aOR: 1.6 [1.4, 1.8], females: aOR: 1.3 [1.2, 1.5]). Although residing in urban settings was associated with higher odds of hypertension in both males (aOR: 1.79 [1.49, 2.16]) and females (aOR: 1.70 [1.49, 1.95]), it was only associated with prediabetes/diabetes in males (aOR: 1.56 [1.25, 1.96]). Males and females in pastoralist areas had lower odds of prediabetes/diabetes compared with their agrarian counterparts (males: aOR: 0.27 [0.14, 0.52], females: aOR: 0.31 [0.16, 0.58]). Physical activity was associated with lower odds of prediabetes/diabetes among females (aOR: 0.75 [0.58, 0.97]). Other diet‐related modifiable factors such as consumption of fruit and vegetable, alcohol or salt were not associated with either prediabetes/diabetes or hypertension. Our findings highlight the need to implement interventions that prevent overweight/obesity and nutrition‐related NCDs, particularly in urban areas. We provide empirical findings relating to the factors associated with hypertension and prediabetes/diabetes among Ethiopian males and females. Our findings highlight the need to implement interventions that promote healthy lifestyles to address the burden of overweight/obesity and Nutrition‐Related Noncommunicable Diseases, particularly in urban areas. Key messages Body mass index and waist circumference were positively associated with hypertension and prediabetes/diabetes for both sexes. Residing in urban settings was associated with increased odds of hypertension in both sexes, and with prediabetes/diabetes in males. Physical activity was associated with lower odds of prediabetes/diabetes among women. Diet‐related factors (consumption of fruit and vegetables, alcohol, and salt) were not associated with either hypertension or prediabetes/diabetes. There is a need for longitudinal, nationally representative dietary surveys, which enable the derivation of relevant indicators of the nutrition transition in Ethiopia.

ObjectiveUnhealthy diets resulting in overweight and obesity and diet-related non-communicable diseases are of increasing concern in Ethiopia, alongside persistent undernutrition, and have been linked to unhealthy food environments. Little is known about the policy response to unhealthy food environments in Ethiopia. The objective of this study was to assess how different food environment domains have been addressed in Ethiopian policy goals and action over time and how this compares with global good practice benchmarks.SettingEthiopia.Primary and secondary outcome measuresWe analysed intentions and plans of the government to act, using policy documents (outputs of decision-making in the form of published strategies, plans or policies) related to improving diets and nutritional status through healthy food environments in Ethiopia between 2008 and 2020. Our coding framework was guided by the policy component (n=7 domains) of the Healthy Food-Environment Policy Index, which was modified to include food quality and safety as an eighth domain.ResultsFrom the 127 policy outputs identified, 38 were retained, published by 9 different government ministries and institutions. Our results show that eight food environment domains have been addressed to some extent, but gaps remain compared with global best practice, especially in food promotion, processing, retail, price and trade. From 2018, policy began to embrace the wider food system, with more explicit food environment interventions becoming apparent.ConclusionsPolicy efforts achieved in food safety, food processing, marketing and labelling are important stepping stones to building future policy actions addressing the food environment domains of food retail, food provision and food trade. Benchmarking of food environment policy actions should also consider actions on food fortification, agro-processing and informal markets in the context of multiple forms of malnutrition.

APPROACHES TO CASE STUDIES In this study, we employed a case study methodology to evaluate the effectiveness of the National Information Platform for Nutrition (NiPN) in improving evidence-based policymaking in nutrition. Data collection Data collection was multi-faceted. For the second case study, we employed the Lives Saved Tool (LiST) modeling analysis to estimate various outcomes related to stunting. Detailed case study reports were prepared, including background information, implementation details, outcomes, and lessons learned.

Storage losses at the farm are often assumed to be an important contributor to presumed large postharvest losses in developing countries. However, reliable and representative data on these losses are often lacking. We study farmers’ storage decisions and self-reported storage losses for grain based on two recent large-scale household surveys conducted in major agricultural areas in Ethiopia. We show that a relatively large share of grain production is stored by farm households themselves, mainly for own consumption, and that storage technologies are rudimentary. We find that farmers’ self-reported storage losses amount to an average of 4 percent of all grain stored and 2 percent of the total harvest. These storage losses are shown to differ significantly by socio-economic variables and wealth, but also by crop and humidity. We further see strong spatial heterogeneity in storage losses, being significantly higher in the southwestern part of the country. Efforts to scale up the adoption of improved storage technologies to reduce storage losses at the farm level should take into consideration these characteristics.