Dr. Brikti Masresha Fiseha is a physician and public health nutritionist born and raised in Addis Ababa, Ethiopia. She currently serves as a program officer, lecturer, and nutrition practitioner, actively engaged in advancing both academic learning and community health. Her deep passion lies in clinical care and its integration with public health solutions. She is committed to contributing meaningfully to the well-being of her fellow Ethiopians.
As a social entrepreneur, she works on innovative and practical solutions that address the health challenges faced by underserved populations. In her spare time, she enjoys writing and reading, both of which inspire her advocacy work. She strongly believes that real change in Ethiopia must come from within, led by Ethiopians who understand and love their country. Dr. Brikti is a proud Ethiopian and deeply dedicated to being part of that change.
The Ethiopian Herald had the opportunity to have a short stay with Brikti Masresha (MD) to shed light on the powerful connection between women’s empowerment and nutrition.
Enjoy reading!
Some say women’s empowerment and nutrition are inseparable; that one cannot thrive without the other. How do you see this relationship and its impact on individuals and communities?
The intersection between women’s empowerment and nutrition is not just a correlation; it’s a cycle of mutual reinforcement. These two forces feed into one another, shaping both individual lives and society at large. Empowered women, those with education, financial independence, and decision-making power, are better able to prioritize families’ health, secure nutritious food and serve as model for resilience for the next generation. This creates a ripple effect that benefits entire communities.
At the same time, a well-nourished woman is more likely to be physically strong, mentally focused and emotionally resilient to pursue education, engage in the workforce, and contribute meaningfully to her community. Nutrition is the invisible fuel behind her vision, productivity and leadership.
That’s why we must treat women’s nutrition not as a separate health concern; but as a cornerstone of empowerment. We cannot speak of reducing any disease such as anemia, which affects nearly one in three Ethiopian women, without addressing the systems that deny women access to education, income, healthcare, and autonomy. Simply put, we can’t build empowered communities without well-nourished women at the heart of them. Empowerment and nutrition, therefore, are two sides of the same coin. One cannot thrive without the other. To truly move forward, Ethiopia must commit to nourishing its women both in body and in opportunity.
In your view, which stage of life should be prioritized for nutrition interventions, particularly in the context of adolescent girls who often face early marriage and pregnancy? Additionally, how can empowering individuals at each stage of life contribute to achieving national goals such as the Home-Grown Economic Reform Agenda?
This is such a beautiful and fundamental question. As a nutritionist, I believe that no single life stage should be prioritized in isolation. We must target nutrition holistically throughout the entire lifecycle. This is not just a health issue, but a profound pillar of national development. A country that recognizes and leads with a life-course approach to nutrition is not only addressing health, but laying the groundwork for long-term economic and social progress.
However, if strategic prioritization is a must, adolescence should come first, because it is the foundation-building stage. During this period, nutritional deficiencies, particularly iron and folate, significantly increase the risks of complications in early pregnancy, which remains common in Ethiopia. Thus, supporting adolescent health sets the stage for healthier pregnancies and births, reduces maternal and infant mortality, and helps break the intergenerational cycle of malnutrition.
When we link this stage to Ethiopia’s broader development goals, especially the Home- Grown Economic Reform Agenda, investing in adolescent girls builds human capital as healthier girls are more likely to further their education, join the labor market, and raise healthier children ultimately contributing to creating a more productive population. Furthermore, it enhances community resilience. When women are empowered, they engage actively in the economy and decision-making structures, driving community strength from within.
Addressing malnutrition early means fewer health complications later. In essence, prioritizing adolescent health reduces future healthcare costs, easing the burden on Ethiopia’s health system. Moreover, well-nourished and informed girls grow into empowered, influential women who foster sustainability, advocate for change, and nurture resilience across generations, thereby promoting intergenerational equity.
Micronutrient deficiencies—iron-deficiency anemia, iodine deficiency and emerging vitamin-D insufficiency— remain stubbornly high. Based on your clinical and public-health experience, what strategies (e.g., salt iodization, wheat-flour fortification, bio-fortified crops) are proving most effective in the Ethiopian context, and where are the policy gaps?
Micronutrient deficiencies—such as iron-deficiency anemia, iodine deficiency, and rising vitamin D insufficiency—remain major health concerns in Ethiopia. While public health strategies like salt iodization, wheat flour fortification, and biofortified crops are proven globally and have been adopted in Ethiopia, their impact is limited by weak implementation.
The country often performs well in policy drafting, but enforcement, supply chain quality, monitoring, and community outreach are inconsistent.
From a clinical nutrition perspective, these public health strategies are essential preventive tools but are not substitutes for clinical care.
Once a deficiency is detected in a patient, clinical nutrition follows a different approach involving proper assessment, diagnosis, individualized dietary plans, and therapeutic supplementation. This distinction is crucial, especially for vulnerable populations with complex needs.
In many parts of rural Ethiopia, gender norms influence women’s access to nutritious food. How do gender norms in such areas affect women’s access to nutritious food and what culturally sensitive approaches have proven effective in shifting that power imbalance?
In some parts of rural Ethiopia, gender norms often place men in control of food-related decisions, limiting women’s access to nutritious options. Although I don’t have specific data from those areas, a common thread across Ethiopian society is the strong influence of culture, religion, and social structure.
However, one impactful and culturally respectful tactic to shift this imbalance has been the involvement of religious leaders. Their influence and respected positions within communities allow them to convince and promote gender equity in nutrition-related decisions. When their guidance is combined with scientific behavior change strategies, like community discussions and participatory learning, it yields meaningful progress while valuing local values.
In short, integrating a scientific approach with faith-based leadership creates a powerful framework for addressing gender norms and improving women’s access to nutrition.
Studies show that Ethiopian women with secondary education are far less likely to have undernourished children. What are the biological and behavioral pathways through which girls’ education leads to improved nutrition outcomes?
Education is a powerful force, especially in the life of a woman. When a girl is educated, the benefit extends far beyond her personal life. Both biologically and behaviorally, education equips women with the knowledge and skills to not only nourish themselves but also those around them.
Just to elaborate, from the biological perspective, an educated woman is more likely to understand her nutritional needs throughout different life stages— adolescence, pregnancy, lactation, and motherhood. This awareness enables her to seek timely healthcare services, take essential supplements like iron and folic acid, practice birth spacing, and maintain adequate nutrition during pregnancy. These biological investments translate directly into healthier pregnancies and better birth outcomes—reducing the risks of low birth weight, stunting, and wasting.
Coming to the behavioral pathways, education fosters self-esteem, confidence, and decision-making abilities. An educated woman is more likely to earn an income, delay early marriage, make informed food choices, and seek medical care for herself and her children when needed. She is also more likely to adopt proper hygiene practices, exercise healthy child nutrition guidelines, and resist harmful traditional practices that negatively affect health.
Overall, I would say educating a girl is one of the most powerful way to build healthier families and communities because when you educate a girl, you build a healthier more nourished nation.
In your clinical practice—perhaps at a referral hospital in Addis Ababa or other parts of the country, what nutrition-related conditions do you most encounter among women, and how do determinants such as heavy household labor, limited land rights and seasonal food shortages exacerbate these conditions?
In my practice, one of the most common nutrition-related conditions I encounter among women is micronutrient deficiencies, particularly Vitamin D, Vitamin B12, and iron. These often present with fatigue, weakness, mood changes, menstrual irregularities, and sometimes neurological symptoms. Management often goes beyond treating a single deficiency; it involves layered symptom-based support and long-term nutritional planning.
As for the underlying determinants, heavy household labor, limited land ownership, and seasonal food insecurity consistently emerge as driving factors. These restrict women’s access to diverse and sufficient nutrition, especially when coupled with social expectations that deprioritize their own dietary needs.
As both a clinician and a public health professional, I find myself not just treating nutritional deficiencies, but also addressing the deeper systemic issues that leave women nutritionally vulnerable—often placing them at the end of their household’s food chain. I believe supporting women’s health requires us to tackle these social barriers just as urgently as the clinical symptoms.
Ethiopia is currently facing a double burden of malnutrition—child stunting in rural areas and increasing rates of overweight and gestational diabetes in urban centers. How can empowerment programs be designed to address both challenges at once?
A great and a very timely question. I’ve actually touched on this in one of my recent articles, particularly when discussing the Seqota Declaration, which was strategically designed to combat child stunting. While it is an excellent step, I’ve also emphasized the urgent need for a parallel strategy that addresses the growing challenge of urban malnutrition, particularly conditions like obesity, gestational diabetes, and other features of metabolic syndrome.
To be clear, I don’t necessarily view stunting and urban obesity as two unrelated extremes. Rather, I believe they are interconnected outcomes of a broader nutrition transition—and in some cases, even part of the same cycle. If you consider Barker’s hypothesis, it becomes evident that early life undernutrition (as seen in stunting) may predispose individuals to metabolic disorders later in life, particularly when exposed to poor-quality diets and sedentary lifestyles in adulthood.
Micronutrient deficiencies play a key role here. Hidden hunger—often present in both rural and urban settings—can silently contribute to poor metabolic health. So, when we see obesity and diabetes in urban women, especially during pregnancy, we must also investigate underlying deficiencies in iron, magnesium, vitamin D, and others.
Empowerment programs, therefore, must be holistic and life-cycle based. They should integrate nutrition education and behavior change communication tailored to the distinct realities of both rural and urban populations.
Involving a multidisciplinary team, including public health nutritionists, clinical dietitians, health coaches, educators, and community leaders should be actively involved to ensure contextual relevance and impact. These efforts should be anchored at the health center level, with clear monitoring and evaluation mechanisms to track the progress. Equally important, they should address food systems by promoting both availability and affordability of nutritious foods, not just calories.
Only through such an integrated, community-anchored, and biologically informed approach can we begin to shift the trend and address both undernutrition and overnutrition effectively.
Antenatal care (ANC) visit is often women’s first interaction with the formal health system. How can Ethiopia’s Heath Extension Program integrate stronger nutrition counseling such as iron-folate supplementation, dietary diversity counseling, while also boosting women’s autonomy over their own bodies and food choices?
If it’s a Health Extension Program, then it must go beyond the clinic walls. Waiting for women to come for ANC is not enough, especially in rural and culturally diverse regions. The program should be proactive and community-embedded, tailoring its approach to local cultural norms and starting preventive care early, even before pregnancy.
Stronger nutrition counseling, including iron-folate supplementation and dietary diversity education, should be integrated into home visits, women’s groups, and local gatherings. Most importantly, it should empower women by involving them in food decision-making, encouraging vertical gardening, and supporting income-generating activities that improve their autonomy over food and body-related choices.
That’s how we shift from reactive care to preventive, woman centered nutrition support.
Finally, if you could push through one policy reform or investment in the next five years to accelerate women’s empowerment through improved nutrition in Ethiopia, be it national wheat-flour fortification, cash transfers for adolescent girls, or scaling up the Urban Health Extension Program, which would you choose, and why is it your top priority?
This is a difficult choice because both wheat flour fortification and scaling up the Urban Health Extension Program (UHEP) are critical. However, I see UHEP as the backbone—an umbrella platform that can support and amplify the impact of other initiatives, including fortification and targeted interventions like cash transfers.
If we’re looking at a five-year window with measurable impact, wheat flour fortification may show faster results in reducing micronutrient deficiencies. But launching it alone comes with challenges—logistical, regulatory, and equity-related.
That’s why my recommendation is to integrate both: scale up UHEP as the delivery and education platform, and roll out national wheat flour fortification wherever large-scale milling is feasible. This dual strategy ensures both coverage and sustainability, while reinforcing women’s empowerment through improved nutrition and informed health choices.
I’m grateful for the opportunity to speak with you—thank you for your time!
Thank you
BY LEULSEGED WORKU
THE ETHIOPIAN HERALD SUNDAY EDITION 13, July 2025
