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Social Protection and Nutrition-Sensitive Agriculture Synergies for Maternal and Child Nutrition Security in Northwest Ethiopia

Tafere Z, Regassa N, Ashenafi M · 7 Jul 2026

Abstract

Abstract Background Maternal and child undernutrition remains a problem in Ethiopia, worsened by socioeconomic shocks. While the Productive Safety Net Program (PSNP) helps address long-term food insecurity, its effect on diet quality is limited. The Seqota Declaration encourages combining PSNP with Nutrition-Sensitive Agriculture (NSA) to create synergistic benefits, but evidence on this combined approach is limited. The study examined the synergistic effects of integrated PSNP and NSA interventions on household food security and maternal and child nutritional status in Northwest Ethiopia. Methods A cross-sectional, mixed-methods design was employed to compare an intervention woreda(district) (PSNP + NSA) with a non-intervention control woreda. The target population included 586 mothers and primary caregivers along with their children aged 6–23 months. Child nutritional status was assessed using Height-for-Age (HAZ), Weight-for-Height (WHZ), Weight-for-Age (WAZ), and the Composite Index of Anthropometric Failure (CIAF), while maternal nutritional status measured using mid-upper arm circumference (MUAC) and Body Mass Index (BMI). Ordinal logistic regression was used to identify predictors of maternal and child nutritional status. Results Nearly half of children (47.1%) experienced at least one anthropometric failure. Integrated PSNP + NSA households were five times more likely to achieve better wasting outcomes (AOR = 4.90, p = 0.003), while NSA-only support reduced stunting risk (AOR = 0.60, p = 0.037). Antenatal care (AOR = 6.53, p = 0.011), maternal group membership (AOR = 0.53, p = 0.037), and paternal literacy (AOR = 5.01, p = 0.025) were protective, whereas poor hygiene knowledge (AOR = 4.16, p = 0.019) and low income (< 10,000 ETB) worsened outcomes. Landholding size and women’s group participation also predicted maternal nutrition. Conclusion Integrated PSNP + NSA interventions significantly reduce acute malnutrition and improve maternal nutrition, while NSA-specific support is particularly effective against chronic stunting. Scaling up layered, multisectoral approaches is essential to address both acute and chronic undernutrition and strengthen behavioral determinants.