Malnutrition is a profound and multifaceted challenge in Ethiopia. It affects a significant portion of the population, requiring comprehensive interventions.
The Landscape of Malnutrition in Ethiopia
Malnutrition in Ethiopia manifests in various forms. Stunting, also known as chronic malnutrition, is low height for age, indicating prolonged undernutrition. Wasting, or acute malnutrition, is low weight for height, reflecting recent and severe weight loss. The country also faces the “double burden of malnutrition,” where undernutrition coexists with overweight or obesity within households or individuals.
Recent 2023 data indicates that 39% of children under five in Ethiopia are stunted, and 11% are acutely malnourished or wasted. In 2019, 57.2% of all under-5 deaths in Ethiopia were attributed to malnutrition. The prevalence of wasting among children under five varies significantly by region, from 4% in Addis Ababa to 26% in the Afar region.
Vulnerable populations are particularly susceptible to malnutrition. Children under five are highly affected, with high rates of stunting and wasting across regions. Pregnant and lactating women also face elevated risks, with 4.4 million needing treatment for malnutrition. In 2019, 20.4% of women of reproductive age (15-49 years) in Ethiopia had anemia, further illustrating the widespread nature of nutritional deficiencies in this group.
The “double burden of malnutrition” is an increasing concern, with a pooled prevalence of 8.30% among mother-child pairs in Ethiopia. This involves overweight or obese mothers living alongside their undernourished children, reflecting rapid changes in global food systems and increasing urbanization. Factors such as residence, household size, and wealth index influence its prevalence.
Driving Factors of Malnutrition
Malnutrition in Ethiopia is driven by environmental, socio-economic, and public health factors. Recurrent droughts and climate change disrupt agricultural production and food access, leading to food insecurity for millions. The 2020-2023 drought, the longest on record, exacerbated food shortages. Flooding and mudslides, particularly between October and November 2023, also affected approximately 1.5 million people in regions like Somali, Oromia, Afar, and Gambella.
Socio-economic issues, including poverty, widespread food insecurity, and economic instability, contribute to the problem. In May 2023, 22.8 million people in Ethiopia faced food insecurity. The depreciation of the Ethiopian Birr has led to price surges in imported staple foods, fuel, and agricultural inputs, increasing pressure on producers and consumers. Female-headed households and those experiencing income loss are more likely to face food insecurity.
Conflict and displacement also exacerbate malnutrition. Millions have been forced from their homes due to conflict and extreme weather, losing productive assets and facing interrupted access to markets and clean water. Internally displaced persons (IDPs) and refugees are among the most vulnerable groups, often relying on aid and food assistance, with some reports indicating that 91.3% of surveyed refugee camps in 2018 presented global acute malnutrition.
Weaknesses in health, education, and Water, Sanitation, and Hygiene (WASH) systems compound the issue. Limited access to quality health and nutrition services, poor water and sanitation conditions, and inadequate maternal knowledge on feeding practices contribute to child stunting. Public health crises, such as the COVID-19 pandemic, have also worsened food insecurity, especially for vulnerable groups, disrupting food value chains and livelihoods.
National and International Responses
Addressing malnutrition in Ethiopia requires a comprehensive systems approach that integrates various sectors. This strategy focuses on aligning food security, health services, education, and WASH initiatives to create a more resilient and effective response. Progress in reducing child stunting, for instance, depends on large-scale programs that deliver evidence-based nutrition interventions across these interconnected systems.
Specific programs and interventions are being implemented to combat the different forms of malnutrition. Nutritional feeding programs, including treatment for severe acute malnutrition (SAM) integrated into routine health services, aim to provide immediate relief and recovery for affected individuals. The World Food Programme (WFP), for example, treated 740,000 children and pregnant or breastfeeding women for malnutrition in the first quarter of 2025, and provided 50,000 families with fresh food vouchers.
Agricultural support initiatives contribute to long-term food security by enhancing food production and diversifying diets. Efforts to improve access and affordability of animal-source foods, such as eggs and chicken, are considered important for sustainable nutritional improvement, moving beyond reliance on monotonous starchy diets. Early warning systems also play a role in anticipating and responding to potential food crises, allowing for more timely interventions.
Community-based health interventions, like the Community Based Nutrition (CBN) program, aim to improve the nutritional status of mothers and children through cost-effective and sustainable methods at the local level. The CBN program, integrated into the Health Extension Program (HEP), involves health extension workers and community volunteers in activities such as targeted counseling on infant and young child feeding, WASH practices, and maternal nutrition. These programs also include micronutrient deficiency control through vitamin A supplementation and deworming.
Collaborative efforts between the Ethiopian government, non-governmental organizations, and international bodies are crucial for effective implementation. The National Nutrition Program (NNP-II), developed in 2016, provides a national framework for coordinated nutritional interventions, focusing on reducing undernutrition and micronutrient deficiencies. The National Food and Nutrition Policy, endorsed in 2018, further addresses the immediate and underlying causes of malnutrition, emphasizing prevention and treatment. Despite these efforts, challenges such as funding shortfalls, ongoing violence, and limited access continue to hinder the full reach and sustainability of these responses.