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From various Ethiopian government food security strategies, the Productive Safety Net Program (PSNP) is one of the strategies to improve households’ consumption. As a result, the government needs to know the outcome of the program intervention for further decisions in similar poverty reduction strategies. This study examined the impact of Productive Safety Net Program intervention on food security of rural households in rural western Ethiopia. A cross-sectional survey data were gathered from a total of randomly selected 188 beneficiary and non-beneficiary sample households. Key informants interviews and focus group discussions were employed to triangulate household survey results. A Chi-square test was employed to compare the households’ food security status. The propensity score matching method was used to evaluate the impact of a Productive safety net on beneficiary households’ food security status. In this study, the Productive Safety net program has significantly increased households’ calorie intake. The beneficiaries’ households were more food secure than non-beneficiary households by 68% and54% respectively. The mean energy available for the beneficiary and non-beneficiary households is 2488.500 and 2153.394 kcal, respectively. Estimates of the average treatment effect of the treated indicated that a Productive safety net program can impact households food security by 2519.29348 kilocalories, higher in the kernel matching method. This is an encouraging indicator for Programme implementers and funding agents. Therefore, channeling further efforts on this indicator is important for a more pronounced impact of the Programme. Given a certain level of variations of different program impact studies, this study recommends further research with greater scope and at different locations on the impact of PSNP and related Food Security Programs on households’ food security status.

From various Ethiopian government food security strategies, the Productive Safety Net Program (PSNP) is one of the strategies to improve households' consumption. As a result, the government needs to know the outcome of the program intervention for further decisions in similar poverty reduction strategies. This study examined the impact of Productive Safety Net Program intervention on food security of rural households in rural western Ethiopia. A cross-sectional survey data were gathered from a total of randomly selected 188 beneficiary and non-beneficiary sample households. Key informants interviews and focus group discussions were employed to triangulate household survey results. A Chi-square test was employed to compare the households' food security status. The propensity score matching method was used to evaluate the impact of a Productive safety net on beneficiary households' food security status. In this study, the Productive Safety net program has significantly increased households' calorie intake. The beneficiaries' households were more food secure than non-beneficiary households by 68% and54% respectively. The mean energy available for the beneficiary and non-beneficiary households is 2488.500 and 2153.394 kcal, respectively. Estimates of the average treatment effect of the treated indicated that a Productive safety net program can impact households food security by 2519.29348 kilocalories, higher in the kernel matching method. This is an encouraging indicator for Programme implementers and funding agents. Therefore, channeling further efforts on this indicator is important for a more pronounced impact of the Programme. Given a certain level of variations of different program impact studies, this study recommends further research with greater scope and at different locations on the impact of PSNP and related Food Security Programs on households' food security status.

IntroductionEthiopia has made significant progress in reducing malnutrition in the past two decades. Despite such improvements, a substantial segment of the country’s population remains chronically undernourished and suffers from micronutrient deficiencies and from increasing diet-related non-communicable diseases such as diabetes, hypertension and cancer. This survey aims to assess anthropometric status, dietary intake and micronutrient status of Ethiopian children, women and adolescent girls. The study will also assess coverage of direct and indirect nutrition-related interventions and map agricultural soil nutrients. The survey will serve as a baseline for the recently developed Ethiopian Food System Transformation Plan and will inform the implementation of the National Food and Nutrition Strategy.Methods and analysisAs a population-based, cross-sectional survey, the study will collect data from the 10 regions and 2 city administrations of Ethiopia. The study population will be women of reproductive age, children aged 0–59 months, school-aged children and adolescent girls. A total of 16 596 households will be surveyed, allowing the generation of national and regional estimates. A two-stage stratified cluster sampling procedure will be used to select households. In the first stage, 639 enumeration areas (EAs) will be selected using probability-proportional-to-size allocation. In the second stage, 26 eligible households will be selected within each EA using systematic random selection. Primary outcomes include coverage of direct and indirect nutrition interventions, infant and young child feeding (IYCF) practices, food insecurity, dietary intakes, mental health, anthropometric status, micronutrient status and soil nutrient status.Ethics and disseminationThe protocol was fully reviewed and approved by the Institutional Review Board of the Ethiopian Public Health Institute (protocol no: EPHI-IRB-317–2020). The study is based on voluntary participation and written informed consent is required from study participants. The findings will be disseminated via forums and conferences and will be submitted for publication in peer-reviewed journals.

Background Anemia is still one of the major public health problems in many developing countries including Ethiopia. Thus, this study aimed to assess individual and contextual-level factors associated with iron-folic acid supplement intake during pregnancy in Ethiopia. Methods A secondary analysis was done on the 2019 mini-Ethiopian Demographic and Health Survey (EDHS) dataset. A total of 3,927 pregnant women who gave birth five years before the survey were included in the analysis. Multi-level mixed-effect logistic regression analysis was done by STATA/SE version 14.0 to identify individual and contextual-level factors. Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was used to show the strength and direction of the association. The level of statistical significance was declared at a P value less than 0.05. Results Those primary educated [AOR  =  1.83, 95% CI: (1.24, 2.74)], secondary educated [AOR  =  2.75, 95% CI: (1.57, 4.824)], women who had greater than 5 living children [AOR = 2.02, 95% CI: (1.25, 3.27)], women who had ANC visit [AOR = 21.26, 95% CI: (13.56, 33.32)] and women who lived in a cluster with high proportion of women had ANC visit [AOR = 1.72, 95% CI: (1.17, 2.54)] and women who lived in Somali [AOR = 0.44 0.73, 95% CI: (0.22, 0.87)] were significantly associated with iron-folic acid intake during pregnancy. Conclusions Both individual and contextual-level factors were significantly associated with iron-folic acid intake during pregnancy. From individual-level factors: education status of women, the total numbers of living children, and ANC follow-up are significant and from contextual-level factors: region and living in a high proportion of women who had ANC follow-up were found to have a statistically significant association. Promoting women’s education and maternal health services like ANC and intervention targeting the Somali region would be the recalled area of the government.

Large‐scale food fortification (LSFF) is an effective public health measure because it may reach a large number of populations at risk using current food delivery systems. The objective of the study was to assess coverage and consumption of fortifiable foods at the household level and to assess the potential impact of LSFF on child outcomes (stunting and survival) in Ethiopia. Cross‐sectional survey data on sociodemographic characteristics, dietary intake, and fortifiable food consumption were collected at the household level among 15,812 randomly selected households participating in the 2021–2024 National Food and Nutrition Strategy Baseline Survey at national and subnational levels. We modeled the impact of LSFF on child survival and stunting using the LiST approach. The overall national coverage of fortifiable edible oil, wheat flour, and salt was 89%, 29%, and 98%, respectively. Wealth was a significant predictor of the use of all fortifiable products ( p  < 0.001). Edible oil consumption varied significantly by education ( p  < 0.001), while wheat consumption varied by residence and wealth. Knowledge of fortification varied across residence, wealth, and education, highlighting a limitation in promoting current programs for fortified products. The LiST model estimates that in 2023, fortifying wheat flour with folate and zinc could save 161 and 1499 child lives, and prevent 302 and 406 cases of stunting, respectively. Increasing coverage by 10% annually from 2024 to 2029 could double these benefits. Zinc is effective at reducing both childhood deaths and stunting by improving child health in Ethiopia. Whereas folic acid is more effective at averting stunting. Still, fortification of wheat flour will have limited influence due to its low consumption, and its impact is likely to be limited to urban and peri‐urban settings. Alternative food vehicles or interventions that can reach rural areas may be needed. Wealth significantly influences the use of all fortifiable products, highlighting economic disparities in access to essential nutrients ( p  < 0.001). Edible oil consumption is notably linked to education levels, while wheat flour consumption varies by both residence and wealth, emphasizing the need for targeted educational campaigns. Due to its low consumption, the impact of wheat flour fortification is expected to be limited, especially in rural areas. Alternative strategies may be necessary to reach these populations. Due to limited access to fortifiable wheat flour, exploring double‐fortified salt as a more accessible and scalable strategy to address micronutrient deficiencies, particularly among rural populations, is a promising prospect. The high coverage of fortifiable edible oil and salt presents a significant opportunity to improve vitamin A and iodine status among the Ethiopian population.