Poor dietary quality is a significant risk factor for stunting and micronutrient deficiencies among young children and globally one of the leading causes of premature death and disease (Arimond & Ruel, 2004; Forouzanfar et al., 2015). Dietary quality is typically proxied by diversity of the consumed diet. Foods with similar nutritional qualities are first grouped together and dietary diversity is measured by the number of different food groups consumed in a certain time interval. For example, the World Health Organization recommends that children 6-23 months consume at least four food groups (out of seven) every day. Based on this metric, Ethiopian children in this age range consume one of the least diversified diets in sub-Saharan Africa (Hirvonen, 2016) with only 14 percent meeting the WHO recommendation (CSA & ICF, 2016). Recent analysis of the timing of growth faltering of young children suggests that poor complementary feeding practices, including poor dietary quality, is an important risk factor for stunting in Ethiopia (Hirvonen, Headey, Golan, & Hoddinott, 2019). The available evidence suggests that diets are monotonous also at the household level. For example, in 2011, the average Ethiopian household consumed only 42 kg of fruits and vegetables in a year per adult equivalent (Hassen Worku, Dereje, Minten, & Hirvonen, 2017) – far below the World Health Organization’s recommendation of 146 kg per year (Hall, Moore, Harper, & Lynch, 2009). This report is structured as follows. In the subsequent section, we describe the data used in this report. In section 3, we assess the consumption of nutritious foods among young children and also carry out a similar assessment at the household level. In section 4, we study the production of nutritious foods in the region. In section 5, we examine the availability of nutritious foods in rural markets. In section 6, we assess the affordability of nutritious foods in the region. Section 7 concludes and summarizes the findings.

Poor dietary quality is a significant risk factor for stunting and micronutrient deficiencies among young children and globally one of the leading causes of premature death and disease (Arimond & Ruel, 2004; Forouzanfar et al., 2015). Dietary quality is typically proxied by diversity of the consumed diet. Foods with similar nutritional qualities are first grouped together and dietary diversity is measured by the number of different food groups consumed in a certain time interval. For example, the World Health Organization recommends that children 6-23 months consume at least from four food groups (out of seven) every day. Based on this metric, Ethiopian children in this age range consume one of the least diversified diets in sub-Saharan Africa (Hirvonen, 2016) with only 14 percent meeting the WHO recommendation (CSA & ICF, 2016). Recent analysis of the timing of growth faltering of young children suggests that poor complementary feeding practices, including poor dietary quality, is an important risk factor for stunting in Ethiopia (Hirvonen, Headey, Golan, & Hoddinott, 2019). The available evidence suggests that diets are monotonous also at the household level. For example, in 2011, the average Ethiopian household consumed only 42 kg of fruits and vegetables in a year per adult equivalent (Hassen Worku, Dereje, Minten, & Hirvonen, 2017) – far below the World Health Organization’s recommendation of 146 kg per year (Hall, Moore, Harper, & Lynch, 2009). This report is structured as follows. In the subsequent section we describe the data used this report. In section 3, we assess the consumption of nutritious foods among vulnerable groups: young children and mothers. In section 4, we assess the production of nutritious foods in the region. In section 5, we study the availability of nutritious foods in rural markets. In section 6, we assess the affordability of nutritious foods in the region. Section 7 concludes and summarizes the findings.

Poor dietary quality is a significant risk factor for stunting and micronutrient deficiencies among young children and globally one of the leading causes of premature death and disease (Arimond & Ruel, 2004; Forouzanfar et al., 2015). Dietary quality is typically proxied by diversity of the consumed diet. Foods with similar nutritional qualities are first grouped together and dietary diversity is measured by the number of different food groups consumed in a certain time interval. For example, the World Health Organization recommends that children 6-23 months consume at least from four food groups (out of seven) every day. Based on this metric, Ethiopian children in this age range consume one of the least diversified diets in sub-Saharan Africa (Hirvonen, 2016) with only 14 percent meeting the WHO recommendation (CSA & ICF, 2016). Recent analysis of the timing of growth faltering of young children suggests that poor complementary feeding practices, including poor dietary quality, is an important risk factor for stunting in Ethiopia (Hirvonen, Headey, Golan, & Hoddinott, 2019). The available evidence suggests that diets are monotonous also at the household level. For example, in 2011, the average Ethiopian household consumed only 42 kg of fruits and vegetables in a year per adult equivalent (Hassen Worku, Dereje, Minten, & Hirvonen, 2017) – far below the World Health Organization’s recommendation of 146 kg per year (Hall, Moore, Harper, & Lynch, 2009). This report is structured as follows. In the subsequent section, we describe the data used in this report. In section 3, we assess the consumption of nutritious foods among vulnerable groups: young children and mothers. In section 4, we assess the production of nutritious foods in the region. In section 5, we study the availability of nutritious foods in rural markets. In section 6, we assess the affordability of nutritious foods in the region. Section 7 concludes and summarizes the findings.

Poor dietary quality is a significant risk factor for stunting and micronutrient deficiencies among young children and globally one of the leading causes of premature death and disease (Arimond & Ruel, 2004; Forouzanfar et al., 2015). Dietary quality is typically proxied by diversity of the consumed diet. Foods with similar nutritional qualities are first grouped together and dietary diversity is measured by the number of different food groups consumed in a certain time interval. For example, the World Health Organization recommends that children 6-23 months consume at least from four food groups (out of seven) every day. Based on this metric, Ethiopian children in this age range consume one of the least diversified diets in sub-Saharan Africa (Hirvonen, 2016) with only 14 percent meeting the WHO recommendation (CSA & ICF, 2016). Recent analysis of the timing of growth faltering of young children suggests that poor complementary feeding practices, including poor dietary quality, is an important risk factor for stunting in Ethiopia (Hirvonen, Headey, Golan, & Hoddinott, 2019). The available evidence suggests that diets are monotonous also at the household level. For example, in 2011, the average Ethiopian household consumed only 42 kg of fruits and vegetables in a year per adult equivalent (Hassen Worku, Dereje, Minten, & Hirvonen, 2017) – far below the World Health Organization’s recommendation of 146 kg per year (Hall, Moore, Harper, & Lynch, 2009). This report is structured as follows. In the subsequent section, we describe the data used in this report. In section 3, we assess the consumption of nutritious foods among vulnerable groups: young children and mothers. In section 4, we assess the production of nutritious foods in the region. In section 5, we study the availability of nutritious foods in rural markets. In section 6, we assess the affordability of nutritious foods in the region. Section 7 concludes and summarizes the findings.

Poor dietary quality is a significant risk factor for stunting and micronutrient deficiencies among young children and globally one of the leading causes of premature death and disease (Arimond & Ruel, 2004; Forouzanfar et al., 2015). Dietary quality is typically proxied by diversity of the consumed diet. Foods with similar nutritional qualities are first grouped together and dietary diversity is measured by the number of different food groups consumed in a certain time interval. For example, the World Health Organization recommends that children 6-23 months consume at least from four food groups (out of seven) every day. Based on this metric, Ethiopian children in this age range consume one of the least diversified diets in sub-Saharan Africa (Hirvonen, 2016) with only 14 percent meeting the WHO recommendation (CSA & ICF, 2016). Recent analysis of the timing of growth faltering of young children suggests that poor complementary feeding practices, including poor dietary quality, is an important risk factor for stunting in Ethiopia (Hirvonen, Headey, Golan, & Hoddinott, 2019). The available evidence suggests that diets are monotonous also at the household level. For example, in 2011, the average Ethiopian household consumed only 42 kg of fruits and vegetables in a year per adult equivalent (Hassen Worku, Dereje, Minten, & Hirvonen, 2017) – far below the World Health Organization’s recommendation of 146 kg per year (Hall, Moore, Harper, & Lynch, 2009). This report is structured as follows. In the subsequent section we describe the data used in this report. In section 3, we assess the consumption of nutritious foods among vulnerable groups: young children and mothers. In section 4, we assess the production of nutritious foods in the region. In section 5, we study the availability of nutritious foods in rural markets. In section 6, we assess the affordability of nutritious foods in the region. Section 7 concludes and summarizes the findings.

Ethiopia has witnessed significant reductions in child mortality, undernutrition, and communicable diseases, but more substantial and faster progress is still needed. The rise in obesity and in noncommunicable diseases, particularly in urban areas, is alarming and requires urgent policy and programmatic attention. Unhealthy diets drive both undernutrition and obesity and are the underlying cause of significant proportion of both communicable and non-communicable diseases. Maintaining the relatively high breastfeeding practices and increasing the diversity of diets will be critical to improving nutrition in Ethiopia. Implementation of effective nutrition messaging that shapes consumer behavior to adopt healthy dietary patterns, while bridging gaps in both the reach and the quality of such messaging is warranted. The health extension program, which is the cornerstone of the transformation of the health sector, may need to be redesigned in a way that improves its reach and the quality of the services it provides and minimizes the risk of burnout of frontline health workers. Interventions focusing on making healthy diets available, affordable, and accessible are urgently needed.

Updates for many countries have made it possible to estimate hunger in the world with greater accuracy this year. In particular, newly accessible data enabled the revision of the entire series of undernourishment estimates for China back to 2000, resulting in a substantial downward shift of the series of the number of undernourished in the world. Nevertheless, the revision confirms the trend reported in past editions: the number of people affected by hunger globally has been slowly on the rise since 2014. The report also shows that the burden of malnutrition in all its forms continues to be a challenge. There has been some progress for child stunting, low birthweight and exclusive breastfeeding, but at a pace that is still too slow. Childhood overweight is not improving and adult obesity is on the rise in all regions. The report complements the usual assessment of food security and nutrition with projections of what the world may look like in 2030, if trends of the last decade continue. Projections show that the world is not on track to achieve Zero Hunger by 2030 and, despite some progress, most indicators are also not on track to meet global nutrition targets. The food security and nutritional status of the most vulnerable population groups is likely to deteriorate further due to the health and socio economic impacts of the COVID-19 pandemic. The report puts a spotlight on diet quality as a critical link between food security and nutrition. Meeting SDG 2 targets will only be possible if people have enough food to eat and if what they are eating is nutritious and affordable. The report also introduces new analysis of the cost and affordability of healthy diets around the world, by region and in different development contexts. It presents valuations of the health and climate-change costs associated with current food consumption patterns, as well as the potential cost savings if food consumption patterns were to shift towards healthy diets that include sustainability considerations. The report then concludes with a discussion of the policies and strategies to transform food systems to ensure affordable healthy diets, as part of the required efforts to end both hunger and all forms of malnutrition.