Exploring the challenges and opportunities of multisectoral nutrition programme in Ethiopia: A qualitative study on combating undernutrition during pregnancy

Background: Despite evidence of the benefits of multisectoral nutrition programmes in reducing undernutrition among vulnerable groups such as pregnant women, implementation is not as expected for reasons that are not well understood. This study aimed to explore the challenges, opportunities, and strategies of a multisectoral nutrition programme in improving undernutrition among pregnant women in Ethiopia. Methods: A phenomenological qualitative study was conducted in four rural districts of Sidama Region, Ethiopia, in 2023. Thirty-six in-depth interviews and four focus group discussions were conducted with programme coordinators, sector office leaders, and nutrition specialists from governmental and non-governmental organizations. Data were audio-recorded, transcribed, translated, and thematic analysis was carried out using qualitative data analysis software, MAXQDA version 2022. Results: The study identified key challenges and opportunities for a multisectoral nutrition programme aimed at addressing undernutrition among vulnerable groups such as pregnant women. Challenges include a lack of operational structure, poor integration of sectoral activities, inadequate budgeting, and low commitment from collaborators and staff. However, opportunities exist in the form of existing government structures, positive attention from global organizations, its principles and existance of community centers. Optimal strategies to strengthen the programme include improved coordination, integration, communication, innovative financing, advocacy, capacity building, and community engagement. Conclusion: Despite many challenges, the multisectoral nutrition programme is a promising start in addressing undernutrition in general and among pregnant women in particular, using existing government structures with greater community and partner involvement and integration.