Nutrition, Early Childhood Development, and women empowerment through an Integrated Children’s center for lower-income families of Addis Ababa

Background Nutrition 4 Education and Development (N4ED) is an Ethiopian civil society organization whose mission is to improve children’s nutrition, especially in the first 1000 days, to ensure their full cognitive and physical development. It’s driven by the belief that investing in child nutrition will lead to a sustainable poverty reduction because future generations will acquire their full potential enabling them to learn & thrive. Without proper nutrition, children will be affected by stunting. It is a form of malnutrition that deprives children of reaching their full physical and cognitive development; thus leading to an impairment of the human capital of the community and the country. The COHA (Cost Of Hunger in Africa) estimates that the total economic impact of child under-nutrition in Ethiopia is the equivalent of 16.5% of its GDP. Through different projects, it empowers mothers so that they can autonomously provide nutritious foods to their children while keeping them in a clean and stimulating environment. This is done by giving mothers knowledge about economically suitable nutritious foods and by enabling them to be economically independent through employment, entrepreneurship, and skill development. Based on its field experience and with the desire to provide an integrated and sustainable response to the challenges met by marginalized communities, N4ED is currently determined to develop a community child care, child health, and training center. This center aims to respond to several goals at once: nutrition and early childhood development of preschool children, better quality health services, socio-economic empowerment of mothers, and serve as a community continuous learning center. The establishment and operationalization of the center require strong partners as well as human and financial resources to make it sustainable. Strong partnerships have been established with the Nifas Silk Lafto Sub-city woreda 12 health center as an implementing partner and the Rotary Club of Central Mella as a host rotary club of the project as well as other partners as listed below.

Justification Problem statement Investments in integrated Early Childhood Development (ECD) are believed to be critical in forming the foundation for lifelong developmental stage monitoring, early learning and providing children with the opportunity to reach their full potential. This is because early childhood is a crucial phase of physical growth as well as cognitive and educational development, which will influence outcomes across the entire course of an individual’s life. The first six years of life are the fastest period of human growth and development as 90 percent of a person’s brain development occurs by the age of five to six. Investing in the early years helps to break the cycle of poverty, address inequality, and boost productivity. Most importantly, in a growing economy like Ethiopia’s and with an exponentially growing population, making sure that the population becomes human capital is essential in reaching its goals. In fact, the Addis Ababa city Administration Mayor office and AACA Health Bureau have recognized this and have launched a series of initiatives to make ECD accessible to all. On the other hand, Nifas Silk Lafto Sub-city woreda 12 health center, which is the implementing partner of this project, is giving service in Five ECD Touch points: childhood health care services IMNCI, growth monitoring, nutrition, EPI, and other services such as health education in a disintegrated way, in different rooms and this results in poor service quality. Due to the load and lack of suitable service rooms, children and their parents are not getting appropriate attention and it affects preventive services like micronutrient supplementation, health education, and growth monitoring. It is known that good health is one of the five main components to ensure optimal ECD. Moreover, private childcare centers are financially and physically inaccessible for low-income communities. Government-owned daycares are mostly for civil servants and although new ones that focus on marginalized communities are being currently created, the demand is still much higher than the available daycares. This leaves many marginalized mothers in poor communities with no other choice but to stay at home to care for their children despite their motivation to work and improve their income. According to our assessments in low-income households, more than 1 mother out of 2 is currently without any paid job or is planning to stop working soon. For 86% of them, the reason is related to the fact that they have become mothers or because they are expecting a new child in the family. Moreover, out of 76 mothers we interviewed, 55 of them (72%) declared that it’s challenging to be employed and earn income when they have small children. For those who already have children, when asked if they have ever used daycare services, only 10% of them answered yes. 56% of them said that the reason why they don’t use child care centers is that they are too expensive or too far from their area. Finally, N4ED currently conducts community-based workshops to educate mothers on child feeding, breastfeeding, child care, maternal nutrition, family planning and hygiene. But community-based education doesn’t allow optimal learning environments: homes are too small to accommodate many mothers and communal areas are not stable or not well equipped for cooking. To support the government’s initiative to increase the accessibility of the ECD programs and with the desire of addressing all these needs, N4ED, and its partners have planned: to support the establishment of an Integrated Child Care, Child Health, and Training Center in the compound of Nifas Silk Lafto Sub-city woreda 12 health center. conduct multiple activities to improve awareness and practice in integrated early childhood development including nutrition, health, early stimulation, security and safety as well as responsive care.

Priority needs This project will address 6 priority needs that have been reflected by the beneficiaries of our previous projects and a general landscape analysis: Lack of sufficient affordable child care services Lack of early stimulation and learning opportunities Lack of access to child-focused quality health services Lack of access to nutritious and balanced diets Lack of sufficient income Lack of knowledge of parents on children's nutrition, health, development, early stimulation, and overall early childhood development

Area justification In all the communities where we have intervened so far, across 3 different sub-cities, the need to address the above priority needs is apparent. Any area in Addis Ababa where vulnerable households are present can benefit from this project's activities. Moreover, this project is designed as a pilot to test a model that can be replicated in other areas if it’s efficient and sustainable in order to support the AA city administration’s effort to provide quality and sustainable ECD programs to all children in Addis Ababa. Hence, the choice of the area is based on factors that will influence its feasibility, success, sustainability, and scalability. The pilot center is planned to be located in a peri-urban area of Addis Ababa, in the Lafto area near the community of Kosta Sefer. It will be built and hosted inside the compound of Nifas Silk Lafto sub-city, woreda 12 health center: Feasibility: this health center has enough space to accommodate a new children’s center, Success: a key factor to success is commitment and a clear understanding of the need. The commitment of the health centers’ leadership team to make this pilot project successful is remarkable and that kind of momentum is important for such a pilot project to be successful and reach its goal. Moreover, 14 team members of this center have already been trained in ECD by AACAHB in collaboration with Path Ethiopia. So they are fully able to support the implementation of the project's activities Sustainability: health is one of the 5 main components of nurturing care, the fact that the health center can fully and naturally implement the health component as its mainstream activity is a key factor of sustainability for an ECD program. Scalability: there are already health centers in every woredas across the city. Creating a model that works jointly with health centers will enable to replicate it easily. Project objective

General objective The general objective of the project is to enhance the nutrition, health, and holistic early childhood development of children under five in marginalized communities while also creating awareness on nutrition and ECD and solving one of the main obstacles to women's economic empowerment which is the lack of affordable child care services by proving such services in the Integrated Child Development Center built during phase 1 of the project.

The Integrated Child Development Center will be able to provide service to the children and families of the area for a long time even after the end of the project. Its aim is also to pilot a sustainable and scalable model of an integrated service that will offer equal opportunities for all children and women and that in the long run the model is replicated in other health centers across the city and all over Ethiopia.

Specific Objectives The specific objectives of the project are: To improve service quality and train staffs in the center for 3 years to address all the domains of nurturing care to children which are child health, nutrition, security and safety, responsive care, as well as early stimulation and learning, To empower 75 mothers and their families through different programs such as saving, micro loan, IGA, nutrition and health education as well as gender and GBV training for themselves and their husbands over a period of 3 years. To raise awareness on nutrition and early childhood development in schools and by using different media tools such as radio and social media over a period of 3 years.