Date of Award


Document Type

Open Access Dissertation


Health Promotion, Education and Behavior


The Norman J. Arnold School of Public Health

First Advisor

Edward A. Frongillo


This research sought to understand the ways in which ideas and discourses in international development are adapted in a country context. Our particular focus was on how ideas at the international and national level become reality at the subnational and community levels. We primarily examined the sensitization of Ethiopia’s Productive Safety Net Program to nutrition across sectors and down levels of government as a way to understand how the global momentum around nutrition, particularly multisectoral or nutrition-sensitive initiatives, can be translated into action.

The first manuscript delves further into the operational realities of implementing multisectoral nutrition-sensitive programming among the neglected lower levels of government, or what we term the mid-level actors and their operating environments. We used key informant interviews with sub-district government implementers and households in a vulnerable agrarian community. The second manuscript frames the current narrative around nutrition in development. We identify and describe the frameworks, ideologies, and operational realities that both influence the conceptualization of nutrition-sensitive efforts at a global level and constrain their realization within a country context. We collected and analyzed data from Ethiopian national strategic frameworks and key informant interviews, and situated it within literature from development studies, nutrition, anthropology, and geography. All data were collected between June 2014 and March 2016.

We intend this work to serve as a practical guide for future research and programming on multisectoral nutrition. Our identification and discussion of insidious, constraining patterns within nutrition research and practice, in combination with those within development at-large and the operational constraints at the country-level will ideally influence current discourses in such a way that possibilities for addressing the overarching (and underlying) structural factors that impact nutrition can be better imagined. This work will help to move nutrition in development beyond the single-factor, individual-level focus that we observed within international nutrition practice.


© 2017, Andrea Marie Warren