Improving adolescent girls' nutrition in Ethiopia: Formative research findings from ENGINE (Empowering New Generations in Improved Nutrition and Economic Opportunities)

background: Around 1.2 billion adolescents (age 10-19) make up nearly 20% of today’s global population. Yet, the needs of adolescents around the world have gone largely unmet. Nutrition programs, policies, and strategies often fail to include adolescents. In particular, there is a dearth of research on the special nutritional needs of adolescent girls in developing countries. ENGINE (Empowering New Generations in Improved Nutrition and Economic Opportunities) is an integrated nutrition program designed to improve the nutritional status of women, adolescents, and young children in Ethiopia.

objective: To understand knowledge, attitudes, self-efficacy, norms, and actions pertaining to optimal adolescent nutrition practices, in addition to barriers and motivators to such practices in order to inform the design of ENGINE. 

methods: This mixed methods study undertook 32 in-depth interviews, 16 focus group discussions, and household and market day observations in 27 households with adolescents age 15-18. Qualitative data was analyzed thematically keeping the social ecological model in mind. Univariate and bivariate analyses were utilized to examine the availability of food and food purchases.

results: Adolescent diets are not varied or balanced enough. Poverty, food inaccessibility, and gendered norms emerged as the greatest barriers to optimal nutrition. Culturally defined conceptions of nutrition, a desire to eat healthier, and trust in local health workers are some facilitating factors upon which interventions can be based.

conclusions: Programs and policies must take into account the current needs of adolescents, as well as their prospective needs so as to ensure the health and well-being of future generations.