Despite recent progress, malnutrition remains a severe problem in Ethiopia, especially among young children. Many of them suffer lifelong consequences in terms of higher risk of mortality and future illness, impaired cognitive ability (including lower IQ) and educational attainment, and overall productivity loss. This report provides the findings from an in-depth data-based analysis of malnutrition in Ethiopia and its causes. It assesses various aspects of current nutrition programming in the country, noting the importance of Ethiopia's first National Nutrition Strategy and National Nutrition Program established in 2008. The report also examines key details including costs and benefits of a range of interventions against malnutrition in the country, including some that are not yet being implemented but could potentially be introduced. The analysis draws on data from household surveys, detailed program data and data from various sources on costs, impacts and potential coverage, among others. The report finds that contrary to what is commonly believed and traditionally used to guide policymaking, a substantial amount of the malnutrition in Ethiopia is due to factors other than food insecurity, pointing to the need for a multi-sectoral approach. Nutrition interventions in general are found to have high benefit-to-cost ratios - sometimes in the double or triple digits - with these ratios being especially high for micronutrient interventions, insecticide-treated bednets, deworming and community-based interventions. Among others, the report recommends the introduction of deworming for pregnant women in Ethiopia - which has the highest benefit-to-cost ratio among the interventions analysed - and scaling up community-based interventions. These include the Community-Based Nutrition program which shows impressive results in Ethiopia after just over two years of implementation. The report also recommends various ways of improving the effectiveness of nutrition programming including by improving program targeting, enhancing coordination and linkages among programs, and establishing an effective nutrition information and surveillance system.

Achieving Better Service Delivery Through Decentralization in Ethiopia examines the role decentralization has played in the improvement of human development indicators in Ethiopia. Ethiopia has made major strides in improving its human development indicators in the past 15 years, achieving significant increases in the coverage of basic education and health services in a short period of time. Improvements took place during a period of massive decentralization of fiscal resources, to the regions in 1994 and to woredas in 2002-03. The devolution of power and resources from the federal and regional governments to woredas appears to have improved the delivery of basic services. Surveys of beneficiaries reveal that they perceive that service coverage and quality have improved. Beneficiary satisfaction has increased markedly in education, and less conspicuously in water and health services. In the south, the decentralization to woredas in 2002-03 tended to narrow differences in per capita expenditures on education and health across woredas. Decentralization disproportionately favored woredas that are remote (more than 50 kilometers from a zonal capital), food-insecure, and pastoral, suggesting that decentralization has been pro-poor. Decentralization also narrowed the gap in educational outcomes between disadvantage and better-off woredas, especially in the south. Pastoral, food-insecure, and remote woredas gained in terms of the educational outcomes examined (gross enrollment rates, grade 8 examination pass rates, repetition rates, pupil-teacher ratios, and teacher-section ratios).