重计划,轻实施:埃塞俄比亚营养政策的结构性失败。

IF 2.6 2区 医学 Q3 NUTRITION & DIETETICS
Taddese Zerfu
{"title":"重计划,轻实施:埃塞俄比亚营养政策的结构性失败。","authors":"Taddese Zerfu","doi":"10.1111/mcn.70073","DOIUrl":null,"url":null,"abstract":"<p>Ethiopia's development ambitions rest on the foundation of a healthy population, yet its nutrition sector remains stalled despite decades of planning and investment. Nearly 38% of children under five are stunted, and food insecurity continues to affect millions. Landmark initiatives like the National Food and Nutrition Policy and the Seqota Declaration demonstrate strong political will—but implementation and scale-up falters due to entrenched structural failures. At the core of this breakdown is an overstretched and under-resourced frontline workforce. Health Extension Workers, while committed, are burdened with wide-ranging responsibilities, and lack the specialized training needed for effective nutrition service delivery. As a result, national strategies often collapse at the community level, where change is most urgently needed. This is further compounded by fragmented coordination. Despite the multisectoral nature of malnutrition—spanning health, agriculture, education, and social protection—ministries and partners frequently work in silos, sending conflicting messages to the same households. Meanwhile, valuable research and data remain disconnected from policy and program implementation, limiting the system's responsiveness and accountability. The path forward requires more than incremental fixes. Ethiopia needs specialized community nutrition workers to bridge the last-mile gap, a high-level coordination mechanism to align sectoral actions, and agile policies grounded in real-time evidence. Without these structural reforms, the burden of malnutrition will continue to erode the country's human capital and economic potential. This is not just a health crisis—it is a critical bottleneck to national progress. The time for structural transformation is now.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 4","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.70073","citationCount":"0","resultStr":"{\"title\":\"Heavy on Plans, Light on Delivery: The Structural Failures of Ethiopia's Nutrition Policies\",\"authors\":\"Taddese Zerfu\",\"doi\":\"10.1111/mcn.70073\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>Ethiopia's development ambitions rest on the foundation of a healthy population, yet its nutrition sector remains stalled despite decades of planning and investment. Nearly 38% of children under five are stunted, and food insecurity continues to affect millions. Landmark initiatives like the National Food and Nutrition Policy and the Seqota Declaration demonstrate strong political will—but implementation and scale-up falters due to entrenched structural failures. At the core of this breakdown is an overstretched and under-resourced frontline workforce. Health Extension Workers, while committed, are burdened with wide-ranging responsibilities, and lack the specialized training needed for effective nutrition service delivery. As a result, national strategies often collapse at the community level, where change is most urgently needed. This is further compounded by fragmented coordination. Despite the multisectoral nature of malnutrition—spanning health, agriculture, education, and social protection—ministries and partners frequently work in silos, sending conflicting messages to the same households. Meanwhile, valuable research and data remain disconnected from policy and program implementation, limiting the system's responsiveness and accountability. The path forward requires more than incremental fixes. Ethiopia needs specialized community nutrition workers to bridge the last-mile gap, a high-level coordination mechanism to align sectoral actions, and agile policies grounded in real-time evidence. Without these structural reforms, the burden of malnutrition will continue to erode the country's human capital and economic potential. This is not just a health crisis—it is a critical bottleneck to national progress. The time for structural transformation is now.</p>\",\"PeriodicalId\":51112,\"journal\":{\"name\":\"Maternal and Child Nutrition\",\"volume\":\"21 4\",\"pages\":\"\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-08-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.70073\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Maternal and Child Nutrition\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/mcn.70073\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"NUTRITION & DIETETICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Maternal and Child Nutrition","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/mcn.70073","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
引用次数: 0

摘要

埃塞俄比亚的发展雄心建立在健康人口的基础上,然而,尽管经过数十年的规划和投资,其营养部门仍然停滞不前。近38%的五岁以下儿童发育迟缓,数百万人继续受到粮食不安全的影响。《国家粮食和营养政策》和《配额宣言》等具有里程碑意义的举措表明了强烈的政治意愿,但由于根深蒂固的结构性失败,实施和扩大力度受到阻碍。这种崩溃的核心是一线劳动力过度紧张和资源不足。卫生推广工作者虽然恪尽职守,但承担着广泛的责任,而且缺乏有效提供营养服务所需的专门培训。结果,国家战略往往在最迫切需要变革的社区一级失败。分散的协调进一步加剧了这种情况。尽管营养不良问题具有多部门性质(涉及卫生、农业、教育和社会保护),但各部委和合作伙伴往往各行其是,向同一家庭传递相互矛盾的信息。与此同时,有价值的研究和数据仍然与政策和计划实施脱节,限制了系统的响应能力和问责制。前进的道路需要的不仅仅是增量修复。埃塞俄比亚需要专门的社区营养工作者来弥合最后一英里的差距,需要一个高级别协调机制来协调部门行动,以及基于实时证据的灵活政策。如果不进行这些结构性改革,营养不良的负担将继续侵蚀该国的人力资本和经济潜力。这不仅是一场健康危机,也是国家进步的关键瓶颈。现在是进行结构转型的时候了。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Heavy on Plans, Light on Delivery: The Structural Failures of Ethiopia's Nutrition Policies

Ethiopia's development ambitions rest on the foundation of a healthy population, yet its nutrition sector remains stalled despite decades of planning and investment. Nearly 38% of children under five are stunted, and food insecurity continues to affect millions. Landmark initiatives like the National Food and Nutrition Policy and the Seqota Declaration demonstrate strong political will—but implementation and scale-up falters due to entrenched structural failures. At the core of this breakdown is an overstretched and under-resourced frontline workforce. Health Extension Workers, while committed, are burdened with wide-ranging responsibilities, and lack the specialized training needed for effective nutrition service delivery. As a result, national strategies often collapse at the community level, where change is most urgently needed. This is further compounded by fragmented coordination. Despite the multisectoral nature of malnutrition—spanning health, agriculture, education, and social protection—ministries and partners frequently work in silos, sending conflicting messages to the same households. Meanwhile, valuable research and data remain disconnected from policy and program implementation, limiting the system's responsiveness and accountability. The path forward requires more than incremental fixes. Ethiopia needs specialized community nutrition workers to bridge the last-mile gap, a high-level coordination mechanism to align sectoral actions, and agile policies grounded in real-time evidence. Without these structural reforms, the burden of malnutrition will continue to erode the country's human capital and economic potential. This is not just a health crisis—it is a critical bottleneck to national progress. The time for structural transformation is now.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Maternal and Child Nutrition
Maternal and Child Nutrition 医学-小儿科
CiteScore
7.70
自引率
8.80%
发文量
144
审稿时长
6-12 weeks
期刊介绍: Maternal & Child Nutrition addresses fundamental aspects of nutrition and its outcomes in women and their children, both in early and later life, and keeps its audience fully informed about new initiatives, the latest research findings and innovative ways of responding to changes in public attitudes and policy. Drawing from global sources, the Journal provides an invaluable source of up to date information for health professionals, academics and service users with interests in maternal and child nutrition. Its scope includes pre-conception, antenatal and postnatal maternal nutrition, women''s nutrition throughout their reproductive years, and fetal, neonatal, infant, child and adolescent nutrition and their effects throughout life.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信