A Multi-Sectoral Programme Evaluation: Assessing the Impact of Nutrition-Sensitive Agriculture on Child Stunting in the Ethiopian Highlands (2021–2026)

Child stunting remains a critical public health challenge in Ethiopia, demanding integrated, multi-sectoral solutions. This study protocol outlines a prospective evaluation of a large-scale nutrition-sensitive agriculture (NSA) programme on child linear growth in the Ethiopian Highlands. The programme integrates homestead food production, nutrition behaviour change communication, and gender-sensitive training. A longitudinal, quasi-experimental design will be employed, with repeated surveys in 2024 (baseline) and 2026 (endline) across four intervention districts and four matched control districts. A total of 1,200 households with children under five will be sampled at each round. Data will be collected on agricultural production diversity, women's dietary diversity, child feeding practices, and anthropometry. The primary outcome is the prevalence of stunting (height-for-age z-score < -2). The analysis plan utilises a difference-in-differences approach to estimate the programme's impact, controlling for socio-economic and maternal covariates. This design aims to provide robust evidence on the association between the NSA intervention and improved child growth outcomes. The findings are intended to inform policymakers on the potential of such multi-sectoral programmes as a component of broader strategies to combat malnutrition in Africa.