{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T22:30:51Z","timestamp":1781821851031,"version":"3.54.5"},"reference-count":34,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2019,12,16]],"date-time":"2019-12-16T00:00:00Z","timestamp":1576454400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Despite some progress, stunting prevalence in many African countries including Ethiopia remains unacceptably high. This study aimed to identify key interventions that, if implemented at scale through the health sector in Ethiopia, can avert the highest number of stunting cases. Using the Lives Saved Tool (LiST), the number of stunting cases that would have been averted, if proven interventions were scaled-up to the highest wealth quintile or to an aspirational 90% coverage was considered. Stunting prevalence was highest among rural residents and households in the poorest wealth quintile. Coverage of breastfeeding promotion and vitamin A supplementation were relatively high (&gt;50%), whereas interventions targeting women were limited in number and had particularly low coverage. Universal coverage (90%) of optimal complementary feeding, preventive zinc supplementation, and water connection in homes could have each averted 380,000\u2013500,000 cases of stunting. Increasing coverage of water connection to homes to the level of the wealthiest quintile could have averted an estimated 168,000 cases of stunting. Increasing coverage of optimal complementary feeding, preventive zinc supplementation, and Water, Sanitation and Hygiene (WASH) services is critical. Innovations in program delivery and health systems governance are required to effectively reach women, remote areas, rural communities, and the poorest proportion of the population to accelerate stunting reduction.<\/jats:p>","DOI":"10.3390\/nu11123065","type":"journal-article","created":{"date-parts":[[2019,12,17]],"date-time":"2019-12-17T02:59:01Z","timestamp":1576551541000},"page":"3065","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Prioritizing the Scale-Up of Evidence-Based Nutrition and Health Interventions to Accelerate Stunting Reduction in Ethiopia"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7298-1096","authenticated-orcid":false,"given":"Kaleab","family":"Baye","sequence":"first","affiliation":[{"name":"Center for Food Science and Nutrition, College of Natural and Computational Sciences, Addis Ababa University, P.O. 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Child Nutr."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1080\/07853890701704683","article-title":"Nutrition, child growth, and chronic disease prevention","volume":"40","author":"Uauy","year":"2008","journal-title":"Ann. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1001\/archpediatrics.2012.199","article-title":"Nutrient supplementation and neurodevelopment: Timing is the key","volume":"166","author":"Cusick","year":"2012","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"ref_6","unstructured":"Central Statistical Agency\u2013CSA\/Ethiopia, and ICF (2017). Ethiopia Demographic and Health Survey 2016."},{"key":"ref_7","unstructured":"Golan, J., Headey, D., Hirvonen, K., and Hoddinott, J. (2019). Ethiopia, 2000\u20132016. The Oxford Handbook of the Ethiopian Economy, Oxford University Press."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Walker, N., Tam, Y., and Friberg, I.K. (2013). Overview of the lives saved tool (LiST). BMC Public Health.","DOI":"10.1186\/1471-2458-13-S3-S1"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2132S","DOI":"10.3945\/jn.116.243766","article-title":"Nutrition Interventions in the Lives Saved Tool (LiST)","volume":"147","author":"Clermont","year":"2017","journal-title":"J. Nutr."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Stegmuller, A.R., Self, A., Litvin, K., and Roberton, T. (2017). How is the Lives Saved Tool (LiST) used in the global health community? Results of a mixed-methods LiST user study. BMC Public Health, 17.","DOI":"10.1186\/s12889-017-4750-5"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2811","DOI":"10.1016\/S0140-6736(16)00738-8","article-title":"Reproductive, maternal, newborn, and child health: Key messages from Disease Control Priorities 3rd Edition","volume":"388","author":"Black","year":"2016","journal-title":"Lancet"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1016\/S0140-6736(13)60996-4","article-title":"Evidence-based interventions for improvement of maternal and child nutrition: What can be done and at what cost?","volume":"382","author":"Bhutta","year":"2013","journal-title":"Lancet"},{"key":"ref_13","unstructured":"Central Statistical Agency\u2013CSA\/Ethiopia, and ICF (2012). Ethiopia Demographic and Health Survey 2011."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Tam, Y., and Pearson, L. (2017). Using the missed opportunity tool as an application of the Lives Saved Tool (LiST) for intervention prioritization. BMC Public Health, 17.","DOI":"10.1186\/s12889-017-4736-3"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Clermont, A. (2017). The impact of eliminating within-country inequality in health coverage on maternal and child mortality: A Lives Saved Tool analysis. BMC Public Health, 17.","DOI":"10.1186\/s12889-017-4737-2"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e12440","DOI":"10.1111\/mcn.12440","article-title":"Social determinants of inequalities in child undernutrition in Bangladesh: A decomposition analysis","volume":"14","author":"Huda","year":"2018","journal-title":"Matern. Child Nutr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/s12887-017-0790-3","article-title":"Factors behind the success story of under-five stunting in Peru: A district ecological multilevel analysis","volume":"17","author":"Huicho","year":"2017","journal-title":"BMC Pediatr."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"121","DOI":"10.3945\/ajcn.116.136705","article-title":"Height in healthy children in low-and middle-income countries: An assessment","volume":"105","author":"Karra","year":"2016","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.worlddev.2017.02.031","article-title":"Children\u2019s diets, nutrition knowledge, and access to markets","volume":"95","author":"Hirvonen","year":"2017","journal-title":"World Dev."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1093\/ajae\/aaz032","article-title":"Rural food markets and child nutrition","volume":"101","author":"Headey","year":"2019","journal-title":"Am. J. Agric. Econ."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1111\/agec.12458","article-title":"Remoteness, urbanization, and child nutrition in sub-Saharan Africa","volume":"49","author":"Headey","year":"2018","journal-title":"Agric. Econ."},{"key":"ref_22","unstructured":"Bachewe, F., Hirvonen, K., Minten, B., and Yimer, F. (2017). The Rising Costs of Nutritious Foods in Ethiopia, IFPRI\u2013ESSP. IFPRI ESSP Research Note."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Baye, K., and Hirvonen, K. (2019). Seasonality: A missing link in preventing undernutrition. Lancet Child Adolesc. Health.","DOI":"10.1016\/S2352-4642(19)30343-8"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.nut.2017.02.012","article-title":"Energy and nutrient intake of infants and young children in pastoralist communities of Ethiopia","volume":"41","author":"Mengistu","year":"2017","journal-title":"Nutrition"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e12443","DOI":"10.1111\/mcn.12443","article-title":"Simulated effects of home fortification of complementary foods with micronutrient powders on risk of inadequate and excessive intakes in West Gojjam, Ethiopia","volume":"14","author":"Abebe","year":"2018","journal-title":"Matern. Child Nutr."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e473","DOI":"10.1542\/peds.2009-1519","article-title":"Worldwide timing of growth faltering: revisiting implications for interventions","volume":"125","author":"Victora","year":"2010","journal-title":"Pediatrics"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1177\/0379572116651209","article-title":"Health extension workers\u2019 knowledge and knowledge-sharing effectiveness of optimal infant and young child feeding are associated with mothers\u2019 knowledge and child stunting in Rural Ethiopia","volume":"37","author":"Abebe","year":"2016","journal-title":"Food Nutr. Bull."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/j.nut.2016.06.002","article-title":"Predictors of dietary diversity in children ages 6 to 23 mo in largely food-insecure area of South Wollo, Ethiopia","volume":"33","author":"Gebremedhin","year":"2017","journal-title":"Nutrition"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Baye, K., Hirvonen, K., Dereje, M., and Remans, R. (2019). Energy and nutrient production in Ethiopia, 2011\u20132015: Implications to supporting healthy diets and food systems. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0213182"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/s41043-016-0059-8","article-title":"Dietary habits, food taboos, and perceptions towards weight gain during pregnancy in Arsi, rural central Ethiopia: A qualitative cross-sectional study","volume":"35","author":"Zerfu","year":"2016","journal-title":"J. Health Popul. Nutr."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1482","DOI":"10.3945\/ajcn.115.116798","article-title":"Dietary diversity during pregnancy is associated with reduced risk of maternal anemia, preterm delivery, and low birth weight in a prospective cohort study in rural Ethiopia","volume":"103","author":"Zerfu","year":"2016","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1038\/s41387-018-0060-y","article-title":"Consumption of dairy, fruits and dark green leafy vegetables is associated with lower risk of adverse pregnancy outcomes (APO): A prospective cohort study in rural Ethiopia","volume":"8","author":"Zerfu","year":"2018","journal-title":"Nutr. Diabetes"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e1139","DOI":"10.1016\/S2214-109X(19)30268-2","article-title":"The WASH benefits and SHINE trials: Interpretation of WASH intervention effects on linear growth and diarrhoea","volume":"7","author":"Pickering","year":"2019","journal-title":"Lancet Glob. Health"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1093\/nutrit\/nuy068","article-title":"Environmental enteric dysfunction and child stunting","volume":"77","author":"Budge","year":"2019","journal-title":"Nutr. 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