Feed the Future Ethiopia Growth Through Nutrition

Enhanced Community Conversation (ECC) Registe

Region: Oromiya Zone: West Shewa Woreda: Bako Tibe Kebele: Gudina Alo Name of Local NGO/Code: 3

Group Name (Tick √): √ Mothers' group __Fathers' group ___Mother-in-laws __MVHH Saving Group Establishment/Enrollment Da

Community Change Agent (CCA) Name: Adanu Negeri Megersa CCA Phone Number: 0937752408 ECC Session Facilitated on (DD/MM/YYYY): ______

Note: One ECC Register should be completed per ECC Session *NA = Not Applicable ** Use Comma
C1 C2 C3 C4 C5 C6 C7 C8

Sex: Educational
Grand Occupation
Participant ID Participant Name Father Name 1- Male Age Status
Father Name (See code)
2 - Female (See code)

Algitu Nugus Fereja

301093775240801 2 36 2 2
Zebura Kebeda Mamo

301093775240802 2 41 1 2
Emebet Fite Tamiru

301093775240803 2 29 2 2
Mesay Dhufera Gerbaba

301093775240804 2 36 2 2
Tuba Weyessa Gemechu

301093775240805 2 39 2 2
Kedija Abdi Olana

301093775240806 2 42 1 2
Mesay Keno Tolera

301093775240807 2 35 3 2
Tolashe Degu Bedhasa

301093775240808 2 43 2 2
Ayinama Mengesha Mereba

301093775240809 2 27 2 2
Kedija Benti Gerbaba

301093775240810 2 39 2 2
Abeba Olkeba Beri

301093775240811 2 35 2 2
Mulu Kasa Yadessa

301093775240812 2 25 2 2
 Amina Bel'ina Mokonin

301093775240813 2 28 1 2
Rehmat Werkisa Tesfaye

301093775240814 2 32 2 2
Shebire Edessa Kasa

301093775240815 2 31 2 2
Mestawot Dhaba Beyena

301093775240816 2 36 1 2
Dinke Tolesa Gobena

301093775240817 2 38 1 2
Misire Abdu Mosisa

301093775240818 2 29 2 2

C7 - Educational Status: C8 - Occupation:

1. Illiterate 1. House wife
2. Adult education 2. Farmer
3. Primary (grade 1-4 and grade 5-8) 3. Government Employee
4. Secondary (grade 9-10 and grade 11-12) 4. Self-employed (small business)
5. TVET/ATVET 5. Private employee
6. University/college 6. Student
7. Unemployed
wth Through Nutrition Activity
nversation (ECC) Register

de: 3

Establishment/Enrollment Date(DD/MM/YYYY): 23/12/2020

ilitated on (DD/MM/YYYY): ______________________

** Use Comma to separate more than one response

C9 C10 C11 C12 C13 C14 C15 C16 C17 C18

If C11 =1, Age of the child (tick Ö under appropriate

If C9 = 2 or Are you a age group)
Have you If C17=1,
Are you 3, Is there parent
received Type of
pregnanat? pregnant /grandparent
Session Title SBCC SBCC
1 - Yes mother in of U2
Sprout Big Bud (See code) materials? materials
2 - No your home? children? Little Bud Flower
children (0- children (7- 1- Yes received
3 - NA* 1 - Yes 1- Yes children (6-7 children (12-
6 months 12 months 2 - No (See code) **
2 - No 2 - No months old) 24)
old) old)

1 2 2

1 2 2

1 2 2

1 2 2

1 2 2

2 2 1 √

2 2 1 √

2 2 1 √

2 2 1 √

2 2 1 √

2 2 1 √

2 2 1 √
 2 2 1 √

2 2 1 √

2 2 1 √

2 2 1 √

2 2 1 √

2 2 1 √

C16 - Session Title: C18 - Type of SBCC materials received:

1. Overview of the 1st 1000 days 1. 1000 day poster
2. Early pregnancy 2. IFA reminder calendar poster
3. Late pregnancy 3. Maternal menu planning poster
4. Exclusive breast feeding (0-6 months) 4. WASH poster
5. WASH 5. Little bud poster
6. Readiness for Bud 6. Big bud poster
7. Little Bud (6-7 months) 7. Flower poster
8. Big Bud (7-12 months) 8. Family reminder calendar
9. Flower (12-24 months)
10. Wrap-up and pledge
 Feed the Future Ethiopia Growth Through Nutrition
Enhanced Community Conversation (ECC) Register

Region: Oromiya Zone: West Shewa Woreda: Bako Tibe Kebele: Gudina Alo Name of Local NGO/Code: 3

Group Name (Tick √): Mothers' group √ Fathers' group ___Mother-in-laws __MVHH Saving Group Establishment/Enrollment Date

Community Change Agent (CCA) Name: Lemesa Shuma Bacha CCA Phone Number: 0920422568 ECC Session Facilitated on (DD/MM/YYYY): ________

Note: One ECC Register should be completed per ECC Session *NA = Not Applicable ** Use Comma
C1 C2 C3 C4 C5 C6 C7 C8

Sex: Educational
Participant Grand Occupation
Participant ID Father Name 1- Male Age Status
Name Father Name (See code)
2 - Female (See code)

Shibiru Diriba Kebede

301092042256801 1 27 3 2
Deti Desalegn Geneti
301092042256802 1 32 2 2
Mokonin Getu Birhanu
301092042256803 1 31 3 2
Kenasa Shibiru Abdisa
301092042256804 1 36 2 2
301092042256805 Chefa Husein Tola 1 39 2 2
Gashaw Ali Jirata
301092042256806 1 24 2 2
Asefa Getu Wakuma
301092042256807 1 25 3 2
Kore Adamu Tolasa
301092042256808 1 26 1 2
Ahmed Shibiru Shibiru
301092042256809 1 28 2 2
Kore Lelisa Debela
301092042256810 1 21 3 2
Wedajo Teferi Ganfure
301092042256811 1 23 1 2
Kore Abdu Biru
301092042256812 1 26 2 2
Wakesa Ashewari Mamo
301092042256813 1 32 1 2
Kenasa Mehammed Wako
301092042256814 1 30 3 2
Ahmed Ahmed Tamirat
301092042256815 1 34 1 2
Werkisa Yesuf Kenesa
301092042256816 1 26 2 2
Kebeda Jebessa Hundesa

301092042256817 1 29 2 2
Kebeda Segn Ashebir

301092042256818 1 25 3 2
 C7 - Educational Status: C8 - Occupation:
1. Illiterate 1. House wife
2. Adult education 2. Farmer
3. Primary (grade 1-4 and grade 5-8) 3. Government Employee
4. Secondary (grade 9-10 and grade 11-12) 4. Self-employed (small business)
5. TVET/ATVET 5. Private employee
6. University/college 6. Student
7. Unemployed
owth Through Nutrition Activity
Conversation (ECC) Register

O/Code: 3

oup Establishment/Enrollment Date(DD/MM/YYYY): 23/12/2020

Facilitated on (DD/MM/YYYY): ______________________

le ** Use Comma to separate more than one response

C9 C10 C11 C12 C13 C14 C15 C16 C17 C18

If C11 =1, Age of the child (tick Ö under appropriate

age group)
If C9 = 2 or Are you a
Have you If C17=1,
Are you 3, Is there parent
received Type of
pregnanat? pregnant /grandparent
Session Title SBCC SBCC
1 - Yes mother in of U2
Sprout Big Bud (See code) materials? materials
2 - No your home? children? Little Bud Flower
children (0- children (7- 1- Yes received
3 - NA* 1 - Yes 1- Yes children (6-7 children (12-
6 months 12 months 2 - No (See code) **
2 - No 2 - No months old) 24)
old) old)

2 1 2

2 1 2
2 1 2

2 1 2
2 1 2

2 2 1 √

2 2 1 √

2 2 1 √

2 2 1 √
2 2 1 √
2 2 1 √
2 2 1 √

2 2 1 √

2 2 1 √
2 2 1 √

2 2 1 √

2 2 1 √

2 2 1 √
 C16 - Session Title: C18 - Type of SBCC materials received:
1. Overview of the 1st 1000 days 1. 1000 day poster
2. Early pregnancy 2. IFA reminder calendar poster
3. Late pregnancy 3. Maternal menu planning poster
4. Exclusive breast feeding (0-6 months) 4. WASH poster
5. WASH 5. Little bud poster
6. Readiness for Bud 6. Big bud poster
7. Little Bud (6-7 months) 7. Flower poster
8. Big Bud (7-12 months) 8. Family reminder calendar
9. Flower (12-24 months)
10. Wrap-up and pledge
 Feed the Future Ethiopia Growth Through Nutrit
Enhanced Community Conversation (ECC) Regi

Region: Oromiya Zone: West Shewa Woreda: Bako Tibe Kebele: Gudina Welkite Name of Local NGO/Code: 3

Group Name (Tick √): √ Mothers' group __Fathers' group ___Mother-in-laws __MVHH Saving Group Establishment/Enrollment Da

Community Change Agent (CCA) Name: Korani Sori Regasa CCA Phone Number: 0918681458 ECC Session Facilitated on (DD/MM/YYYY): _________

Note: One ECC Register should be completed per ECC Session *NA = Not Applicable ** Use Comma
C1 C2 C3 C4 C5 C6 C7

Sex: Educational
Participant Grand
Participant ID Father Name 1- Male Age Status
Name Father Name
2 - Female (See code)

301091868145801
Dagitu Desisa Hunduma 2 30 1

301091868145802
Tsehay Fikadu Kusa 2 35 1

301091868145803
Damote Dhiba Tolera 2 25 1

301091868145804
Birhane Motuma Desta 2 28 1

301091868145805
Turune Moroda Ebisa 2 28 1

301091868145806
Ebeshi Takela Getachew 2 24 1

301091868145807
Amarech Tesema Gemeda 2 25 1

301091868145808
Kuleni Miressa Tola 2 22 1

301091868145809
Dawite Bekela Birhanu 2 27 1

301091868145810
Werke Wakjira Raji 2 25 1

301091868145811
Addisu Asfaw Boru 2 27 1

301091868145812
Shito Denusa Akewak 2 27 1
 301091868145813
Lubaba Abdurehman Kedir 2 28 1

301091868145814
Burtukan Gabisa Amenu 2 29 1

301091868145815
Dhibe Wakweya Oluma 2 30 1

301091868145816
Desta Taye Duresa 2 27 1

301091868145817
Aberash Tesfaye Garbi 2 30 1

301091868145818
Chaltu Bekela Buli 2 31 1

C7 - Educational Status: C8 - Occupation:

1. Illiterate 1. House wife
2. Adult education 2. Farmer
3. Primary (grade 1-4 and grade 5-8) 3. Government Employee
4. Secondary (grade 9-10 and grade 11-12) 4. Self-employed (small business)
5. TVET/ATVET 5. Private employee
6. University/college 6. Student
7. Unemployed
a Growth Through Nutrition Activity
nity Conversation (ECC) Register

al NGO/Code: 3

Group Establishment/Enrollment Date(DD/MM/YYYY): 23/12/2020

n Facilitated on (DD/MM/YYYY): ______________________

able ** Use Comma to separate more than one response

C8 C9 C10 C11 C12 C13 C14 C15 C16 C17

If C11 =1, Age of the child (tick Ö under appropriate

age group)
If C9 = 2 or Are you a
Have you
Are you 3, Is there parent
received
pregnanat? pregnant /grandparent
Occupation Session Title SBCC
1 - Yes mother in of U2
(See code) Sprout Big Bud (See code) materials?
2 - No your home? children? Little Bud Flower
children (0- children (7- 1- Yes
3 - NA* 1 - Yes 1- Yes children (6-7 children (12-
6 months 12 months 2 - No
2 - No 2 - No months old) 24)
old) old)

1 1 2 2

1 1 2 2

1 1 2 2

1 1 2 2

1 1 2 2

1 2 2 1 √

1 2 2 1 √

1 2 2 1 √

1 2 2 1 √

1 2 2 1 √

1 2 2 1 √

1 2 2 1 √
1 2 2 1 √

1 2 2 1 √

1 2 2 1 √

1 2 2 1 √

1 2 2 1 √

1 2 2 1 √

C16 - Session Title: C18 - Type of SBCC materials received:

1. Overview of the 1st 1000 days 1. 1000 day poster
2. Early pregnancy 2. IFA reminder calendar poster
3. Late pregnancy 3. Maternal menu planning poster
4. Exclusive breast feeding (0-6 months) 4. WASH poster
5. WASH 5. Little bud poster
6. Readiness for Bud 6. Big bud poster
7. Little Bud (6-7 months) 7. Flower poster
8. Big Bud (7-12 months) 8. Family reminder calendar
9. Flower (12-24 months)
10. Wrap-up and pledge
 C18

If C17=1,
Type of
SBCC
materials
received
(See code) **
 Feed the Future Ethiopia Growth Through Nutritio
Enhanced Community Conversation (ECC) Regis

Region: Oromiya Zone: West Shewa Woreda: Bako Tibe Kebele: Gudina Welkite Name of Local NGO/Code: 3

Group Name (Tick √): Mothers' group √ Fathers' group ___Mother-in-laws __MVHH Saving Group Establishment/Enrollment Date

Community Change Agent (CCA) Name: Dereje Kumsa Ayana CCA Phone Number:0920423867 ECC Session Facilitated on (DD/MM/YYYY): _______

Note: One ECC Register should be completed per ECC Session *NA = Not Applicable ** Use Comma
C1 C2 C3 C4 C5 C6 C7 C8

Sex: Educational
Grand Father Occupation
Participant ID Participant Name Father Name 1- Male Age Status
Name (See code)
2 - Female (See code)

301092042386701 Mulu Tolera Gemechu 1 34 1 1

301092042386702 Bekela Gadisa Chimdi 1 36 1 1

301092042386703 Daniel Getachew Kasa 1 29 1 1

301092042386704 Asfaw Teshoma Aboma 1 30 1 1

301092042386705 Chimdesa Motuma Hunde 1 31 1 1

301092042386706 Weyesa Adugna Boru 1 28 1 1

301092042386707 Alemayew Tolera Ameyu 1 35 1 1

301092042386708 Giduma Wakuma Fufa 1 29 1 1

301092042386709 Mokonin Takela Shifera 1 30 1 1

301092042386710 Shibiru Gidisa Oluma 1 32 1 1

301092042386711 Takilu Gerbaba Gari 1 31 1 1

301092042386712 Debela Negasa Motuma 1 35 1 1

 301092042386713 Tola Bersisa Getu 1 34 1 1

301092042386714 Fikadu Chala Tadesa 1 32 1 1

301092042386715 Feyera Chala Tadesa 1 28 1 1

301092042386716 Ayale Alemu Hailu 1 30 1 1

301092042386717 Girma Hunde Sori 1 35 1 1

301092042386718 Amente Gurmu Feyisa 1 26 1 1

C7 - Educational Status: C8 - Occupation:

1. Illiterate 1. House wife
2. Adult education 2. Farmer
3. Primary (grade 1-4 and grade 5-8) 3. Government Employee
4. Secondary (grade 9-10 and grade 11-12) 4. Self-employed (small business)
5. TVET/ATVET 5. Private employee
6. University/college 6. Student
7. Unemployed
th Through Nutrition Activity
versation (ECC) Register

de: 3

Establishment/Enrollment Date(DD/MM/YYYY): 23/12/2020

ed on (DD/MM/YYYY): ______________________

** Use Comma to separate more than one response

C9 C10 C11 C12 C13 C14 C15 C16 C17 C18

If C11 =1, Age of the child (tick Ö under appropriate

age group)
If C9 = 2 or Are you a
Have you If C17=1,
Are you 3, Is there parent
received Type of
pregnanat? pregnant /grandparent
Session Title SBCC SBCC
1 - Yes mother in of U2
Sprout Big Bud (See code) materials? materials
2 - No your home? children? Little Bud Flower
children (0- children (7- 1- Yes received
3 - NA* 1 - Yes 1- Yes children (6-7 children (12-
6 months 12 months 2 - No (See code) **
2 - No 2 - No months old) 24)
old) old)

2 1 2

2 1 2

2 1 2

2 1 2

2 1 2

2 2 1 √

2 2 1 √

2 2 1 √

2 2 1 √

2 2 1 √

2 2 1 √

2 2 1 √
 2 2 1 √

2 2 1 √

2 2 1 √

2 2 1 √

2 2 1 √

2 2 1 √

C16 - Session Title: C18 - Type of SBCC materials received:

1. Overview of the 1st 1000 days 1. 1000 day poster
2. Early pregnancy 2. IFA reminder calendar poster
3. Late pregnancy 3. Maternal menu planning poster
4. Exclusive breast feeding (0-6 months) 4. WASH poster
5. WASH 5. Little bud poster
6. Readiness for Bud 6. Big bud poster
7. Little Bud (6-7 months) 7. Flower poster
8. Big Bud (7-12 months) 8. Family reminder calendar
9. Flower (12-24 months)
10. Wrap-up and pledge
 Feed the Future Ethiopia Growth Through Nutrition A
Enhanced Community Conversation (ECC) Register
Region: Oromiya Zone: West Shewa Woreda: Bako Tibe Kebele: Oda Korma Name of Local NGO/Code: 3

Group Name (Tick √): √ Mothers' group __Fathers' group ___Mother-in-laws __MVHH Saving Group Establishment/Enrollment Da

Community Change Agent (CCA) Name: Amarech Gerbaba Chimdesa CCA Phone Number: 0917083675 ECC Session Facilitated on (DD/MM/YY

Note: One ECC Register should be completed per ECC Session *NA = Not Applicable ** Use Comma
C1 C2 C3 C4 C5 C6 C7 C8 C9

Are you
Sex: Educational pregnanat?
Participant Father Grand Father Occupation
Participant ID 1- Male Age Status 1 - Yes
Name Name Name (See code)
2 - Female (See code) 2 - No
3 - NA*

301091708367501 Takelu Mulu Tadesa 2 25 3 2 1

301091708367502 Werke Neme Furgea 2 30 3 2 1
301091708367503 Hinsene Mosisa Fufa 2 35 3 2 1
301091708367504 Mesare Teresa Bersisa 2 25 1 2 1
301091708367505 Meseret Taku Alamato 2 35 1 1 1
301091708367506 Hawine Wegari Ayala 2 30 3 2 2
301091708367507 Tigist Wegari Ayala 2 25 3 1 2
301091708367508 Abebeu Keno Feyera 2 35 3 2 2
301091708367509 Martha Dhugasa Tadesa 2 27 3 2 2

301091708367510 Dhibeshi Adugna Megersa 2 30 3 2 2

301091708367511 Shibire Tefera Tadesa 2 30 3 2 2
301091708367512 Shito Shifera Neme 2 28 3 2 2
301091708367513 Chaltu Teshoma Gutu 2 30 3 2 2

301091708367514 Komane Tesema Kursu 2 30 1 2 2

301091708367515 Shintayew Eticha Debisa 2 25 3 2 2

301091708367516 Shume Wegari Fakata 2 25 3 2 2
301091708367517 Diribe Doba Bonja 2 35 1 2 2
301091708367518 Hawine Dereje Likasa 2 30 3 2 2

C7 - Educational Status: C8 - Occupation: C16 - Session

1. Illiterate 1. House wife 1. Overview of the 1st 1000 days
2. Adult education 2. Farmer 2. Early pregnancy
3. Primary (grade 1-4 and grade 5-8) 3. Government Employee 3. Late pregnancy
4. Secondary (grade 9-10 and grade 11-12) 4. Self-employed (small business)
5. TVET/ATVET 5. Private employee
6. University/college 6. Student
7. Unemployed
4. Exclusive breast feeding (0-6 m
5. WASH
6. Readiness for Bud
7. Little Bud (6-7 months)
8. Big Bud (7-12 months)
9. Flower (12-24 months)
10. Wrap-up and pledge
hrough Nutrition Activity
ation (ECC) Register
e: 3

Establishment/Enrollment Date(DD/MM/YYYY): 23/12/2020

ession Facilitated on (DD/MM/YYYY): ______________________

** Use Comma to separate more than one response

C10 C11 C12 C13 C14 C15 C16 C17 C18

If C11 =1, Age of the child (tick Ö under appropriate

If C9 = 2 or Are you a age group)
Have you If C17=1,
3, Is there parent
received Type of
pregnant /grandparent
Session Title SBCC SBCC
mother in of U2
Sprout Big Bud (See code) materials? materials
your home? children? Little Bud Flower
children (0- children (7- 1- Yes received
1 - Yes 1- Yes children (6-7 children (12-
6 months 12 months 2 - No (See code) **
2 - No 2 - No months old) 24)
old) old)

2 2
2 2
2 2
2 2
2 2
2 1 √
2 1 √
2 1 √
2 1 √

2 1 √
2 1 √
2 1 √
2 1 √

2 1 √

2 1 √
2 1 √
2 1 √
2 1 √

C16 - Session Title: C18 - Type of SBCC materials received:

1. Overview of the 1st 1000 days 1. 1000 day poster
2. Early pregnancy 2. IFA reminder calendar poster
3. Late pregnancy 3. Maternal menu planning poster
4. Exclusive breast feeding (0-6 months) 4. WASH poster
5. WASH 5. Little bud poster
6. Readiness for Bud 6. Big bud poster
7. Little Bud (6-7 months) 7. Flower poster
8. Big Bud (7-12 months) 8. Family reminder calendar
9. Flower (12-24 months)
10. Wrap-up and pledge
 Feed the Future Ethiopia Growth Through Nutrit
Enhanced Community Conversation (ECC) Regi

Region: Oromiya Zone: West Shewa Woreda: Bako Tibe Kebele: Oda Korma Name of Local NGO/Code: 3

Group Name (Tick √): Mothers' group √ Fathers' group ___Mother-in-laws __MVHH Saving Group Establishment/Enrollment Date

Community Change Agent (CCA) Name: Wakuma Boja Dano CCA Phone Number: 0917440539 ECC Session Facilitated on (DD/MM/YYYY

Note: One ECC Register should be completed per ECC Session *NA = Not Applicable ** Use Comma
C1 C2 C3 C4 C5 C6 C7 C8

Sex: Educational
Participant Grand Father Occupation
Participant ID Father Name 1- Male Age Status
Name Name (See code)
2 - Female (See code)

301091744053901 Hachalu Etefa Megersa 1 25 2 1

301091744053902 Doctore Abera Chemeda 1 30 2 1

301091744053903 Temesgen Abdi Nemera 1 35 2 1

301091744053904 Shelema Adugna Nurgi 1 30 2 1

301091744053905 Deso Ereti Adugna 1 28 2 1

301091744053906 Lemma Abera Chemeda 1 32 2 1

301091744053907 Dereje Biri Shuge 1 32 2 1

301091744053908 Bekela Kebeda Chemeda 1 35 2 1

301091744053909 Dereje Tususha Nenera 1 36 2 1

301091744053910 Misgana Sura Abdeta 1 25 2 1

301091744053911 Gemechu Midhegsa Shuge 1 30 2 1

301091744053912 Takela Kebeda Chando 1 29 2 1

301091744053913 Tesfaye Chala Fite 1 30 4 1

301091744053914 Taye Chala Gutama 1 28 2 1

301091744053915 Fikadu Abera Chemeda 1 38 2 1

301091744053916 Werkisa Etefa Megersa 1 32 2 1

301091744053917 Gidisa Sura Abdeta 1 36 2 1

301091744053918 Mengesha Adugna Nurgi 1 33 2 1

 C7 - Educational Status: C8 - Occupation:
1. Illiterate 1. House wife
2. Adult education 2. Farmer
3. Primary (grade 1-4 and grade 5-8) 3. Government Employee
4. Secondary (grade 9-10 and grade 11-12) 4. Self-employed (small business)
5. TVET/ATVET 5. Private employee
6. University/college 6. Student
7. Unemployed
h Through Nutrition Activity
ersation (ECC) Register

stablishment/Enrollment Date(DD/MM/YYYY): 23/12/2020

Facilitated on (DD/MM/YYYY): ______________________

** Use Comma to separate more than one response

C9 C10 C11 C12 C13 C14 C15 C16 C17 C18

If C11 =1, Age of the child (tick Ö under appropriate

If C9 = 2 or Are you a age group)
Have you If C17=1,
Are you 3, Is there parent
received Type of
pregnanat? pregnant /grandparent
Session Title SBCC SBCC
1 - Yes mother in of U2
Sprout Big Bud (See code) materials? materials
2 - No your home? children? Little Bud Flower
children (0- children (7- 1- Yes received
3 - NA* 1 - Yes 1- Yes children (6-7 children (12-
6 months 12 months 2 - No (See code) **
2 - No 2 - No months old) 24)
old) old)

2 1 2

2 1 2

2 1 2

2 1 2

2 1 2

2 2 1 √

2 2 1 √

2 2 1 √

2 2 1 √

2 2 1 √

2 2 1 √

2 2 1 √

2 2 1 √

2 2 1 √

2 2 1 √

2 2 1 √

2 2 1 √

2 2 1 √
 C16 - Session Title: C18 - Type of SBCC materials received:
1. Overview of the 1st 1000 days 1. 1000 day poster
2. Early pregnancy 2. IFA reminder calendar poster
3. Late pregnancy 3. Maternal menu planning poster
4. Exclusive breast feeding (0-6 months) 4. WASH poster
5. WASH 5. Little bud poster
6. Readiness for Bud 6. Big bud poster
7. Little Bud (6-7 months) 7. Flower poster
8. Big Bud (7-12 months) 8. Family reminder calendar
9. Flower (12-24 months)
10. Wrap-up and pledge
 Feed the Future Ethiopia Growth Through Nutrition Ac
Enhanced Community Conversation (ECC) Register

Region: Oromiya Zone: West Shewa Woreda: Bako Tibe Kebele: Amerti Gibe Name of Local NGO/Code: 3

Group Name (Tick √): √ Mothers' group __Fathers' group ___Mother-in-laws __MVHH Saving Group Establishment/Enrollment Da

Community Change Agent (CCA) Name: Shitaye Hinsermu Geneti CCA Phone Number: 0917816088 ECC Session Facilitated on (DD/MM/YYYY): _

Note: One ECC Register should be completed per ECC Session *NA = Not Applicable ** Use Comma
C1 C2 C3 C4 C5 C6 C7 C8 C9

Are you
Sex: Educational pregnanat?
Participant Grand Occupation
Participant ID Father Name 1- Male Age Status 1 - Yes
Name Father Name (See code)
2 - Female (See code) 2 - No
3 - NA*

301091781608801 Birhane Ushunga Keno 2 25 1 1 1

301091781608802 Martha Takela Wakjira 2 27 1 1 1

301091781608803 Turu Desta Hailu 2 29 1 1 1

301091781608804 Birhane Takela Gari 2 30 1 1 1

301091781608805 Fechu Adugna Tolesa 2 28 1 1 1

301091781608806 Yadeshi Takela Mokonin 2 27 1 1 2

301091781608807 Martha Deso Kebeda 2 29 1 1 2

301091781608808 Kume Mirkana Tujuba 2 27 1 1 2

301091781608809 Fechu Chala Birhanu 2 30 1 1 2

301091781608810 Aberu Negasa Biru 2 30 1 1 2

301091781608811 Gebaynesh Miressa Tola 2 27 1 1 2

301091781608812 Kumeshi Misgana Kenesa 2 28 1 1 2

301091781608813 Birhane Guteta Abebe 2 30 1 1 2

 301091781608814 Hana Gudina Gadisa 2 31 1 1 2

301091781608815 Weyitu Mosisa Belay 2 29 1 1 2

301091781608816 Ababu Chala Turuneh 2 27 1 1 2

301091781608817 Birhane Sime Daksa 2 28 1 1 2

301091781608818 Shage Tesema Kuma 2 29 1 1 2

C7 - Educational Status: C8 - Occupation: C16 - Session Tit

1. Illiterate 1. House wife 1. Overview of the 1st 1000 days
2. Adult education 2. Farmer 2. Early pregnancy
3. Primary (grade 1-4 and grade 5-8) 3. Government Employee 3. Late pregnancy
4. Secondary (grade 9-10 and grade 11-12) 4. Self-employed (small business) 4. Exclusive breast feeding (0-6 mon
5. TVET/ATVET 5. Private employee 5. WASH
6. University/college 6. Student 6. Readiness for Bud
7. Unemployed 7. Little Bud (6-7 months)
8. Big Bud (7-12 months)
9. Flower (12-24 months)
10. Wrap-up and pledge
Through Nutrition Activity
ation (ECC) Register

Code: 3

Establishment/Enrollment Date(DD/MM/YYYY): 23/12/2020

n Facilitated on (DD/MM/YYYY): ______________________

** Use Comma to separate more than one response

C10 C11 C12 C13 C14 C15 C16 C17 C18

If C11 =1, Age of the child (tick Ö under appropriate

age group)
If C9 = 2 or Are you a
Have you If C17=1,
3, Is there parent
received Type of
pregnant /grandparent
Session Title SBCC SBCC
mother in of U2
Sprout Big Bud (See code) materials? materials
your home? children? Little Bud Flower
children (0- children (7- 1- Yes received
1 - Yes 1- Yes children (6-7 children (12-
6 months 12 months 2 - No (See code) **
2 - No 2 - No months old) 24)
old) old)

2 2

2 2

2 2

2 2

2 2

2 1 √

2 1 √

2 1 √

2 1 √

2 1 √

2 1 √

2 1 √

2 1 √
 2 1 √

2 1 √

2 1 √

2 1 √

2 1 √

C16 - Session Title: C18 - Type of SBCC materials received:

1. Overview of the 1st 1000 days 1. 1000 day poster
2. Early pregnancy 2. IFA reminder calendar poster
3. Late pregnancy 3. Maternal menu planning poster
4. Exclusive breast feeding (0-6 months) 4. WASH poster
5. WASH 5. Little bud poster
6. Readiness for Bud 6. Big bud poster
7. Little Bud (6-7 months) 7. Flower poster
8. Big Bud (7-12 months) 8. Family reminder calendar
9. Flower (12-24 months)
10. Wrap-up and pledge
 Feed the Future Ethiopia Growth Through Nutrition Ac
Enhanced Community Conversation (ECC) Register

Region: Oromiya Zone: West Shewa Woreda: Bako Tibe Kebele: Amerti Gibe Name of Local NGO/Code: 3

Group Name (Tick √): Mothers' group √ Fathers' group ___Mother-in-laws __MVHH Saving Group Establishment/Enrollment Date

Community Change Agent (CCA) Name: Shelema Mebiru Belete CCA Phone Number: 0920423867 ECC Session Facilitated on (DD/MM/YYYY): __

Note: One ECC Register should be completed per ECC Session *NA = Not Applicable ** Use Comma
C1 C2 C3 C4 C5 C6 C7 C8 C9

Are you
Sex: Educational pregnanat?
Participant Grand Occupation
Participant ID Father Name 1- Male Age Status 1 - Yes
Name Father Name (See code)
2 - Female (See code) 2 - No
3 - NA*

Guluma Birhanu Kasa

301092042386701 1 27 3 2 2
Aga Abdisa Lemi
301092042386702 1 32 2 2 2
Biru Tola Desalegn
301092042386703 1 31 3 2 2
Hailu Jirata Suleman
301092042386704 1 36 2 2 2
Gerbaba Wakuma Tilahun
301092042386705 1 39 2 2 2
301092042386706 Ayana Tolasa Misganu 1 24 2 2 2
301092042386707 Fufa Shibiru Takele 1 25 3 2 2
Gemeda Debela Edosa
301092042386708 1 26 1 2 2
Keno Ganfure Tesfaye
301092042386709 1 28 2 2 2
Jebena Biru Dereje
301092042386710 1 21 3 2 2
Biru Mamo Taressa
301092042386711 1 23 1 2 2
Zeleke Wako Mitiku
301092042386712 1 26 2 2 2
Jaleta Tamirat Ketema
301092042386713 1 32 1 2 2
Gidisa Kenesa Bacha
301092042386714 1 30 3 2 2
Gadisa Hundesa Shambel

301092042386715 1 34 1 2 2
Keno Ashebir Agucho

301092042386716 1 26 2 2 2
Erati Kemal Getu

301092042386717 1 29 2 2 2
 Chimdi Geleta Gidisa

301092042386718 1 25 3 2 2

C7 - Educational Status: C8 - Occupation: C16 - Session Title

1. Illiterate 1. House wife 1. Overview of the 1st 1000 days
2. Adult education 2. Farmer 2. Early pregnancy
3. Primary (grade 1-4 and grade 5-8) 3. Government Employee 3. Late pregnancy
4. Secondary (grade 9-10 and grade 11-12) 4. Self-employed (small business) 4. Exclusive breast feeding (0-6 month
5. TVET/ATVET 5. Private employee 5. WASH
6. University/college 6. Student 6. Readiness for Bud
7. Unemployed 7. Little Bud (6-7 months)
8. Big Bud (7-12 months)
9. Flower (12-24 months)
10. Wrap-up and pledge
Through Nutrition Activity
sation (ECC) Register

O/Code: 3

Establishment/Enrollment Date(DD/MM/YYYY): 23/12/2020

n Facilitated on (DD/MM/YYYY): ______________________

** Use Comma to separate more than one response

C10 C11 C12 C13 C14 C15 C16 C17 C18

If C11 =1, Age of the child (tick Ö under appropriate

age group)
If C9 = 2 or Are you a
Have you If C17=1,
3, Is there parent
received Type of
pregnant /grandparent
Session Title SBCC SBCC
mother in of U2
Sprout Big Bud (See code) materials? materials
your home? children? Little Bud Flower
children (0- children (7- 1- Yes received
1 - Yes 1- Yes children (6-7 children (12-
6 months 12 months 2 - No (See code) **
2 - No 2 - No months old) 24)
old) old)

1 2

1 2

1 2

1 2

1 2
2 1 √
2 1 √

2 1 √
2 1 √
2 1 √

2 1 √

2 1 √

2 1 √

2 1 √

2 1 √

2 1 √

2 1 √
 2 1 √

C16 - Session Title: C18 - Type of SBCC materials received:

1. Overview of the 1st 1000 days 1. 1000 day poster
2. Early pregnancy 2. IFA reminder calendar poster
3. Late pregnancy 3. Maternal menu planning poster
4. Exclusive breast feeding (0-6 months) 4. WASH poster
5. WASH 5. Little bud poster
6. Readiness for Bud 6. Big bud poster
7. Little Bud (6-7 months) 7. Flower poster
8. Big Bud (7-12 months) 8. Family reminder calendar
9. Flower (12-24 months)
10. Wrap-up and pledge
 Feed the Future Ethiopia Growth Through Nutritio
Enhanced Community Conversation (ECC) Registe

Region: Oromiya Zone: West Shewa Woreda: Bako Tibe Kebele: Oda Gibe Name of Local NGO/Code: 3

Group Name (Tick √): √ Mothers' group __Fathers' group ___Mother-in-laws __MVHH Saving Group Establishment/Enrollment Da

Community Change Agent (CCA) Name: Tirfe Chimdesa Belisa CCA Phone Number: 0917567856 ECC Session Facilitated on (DD/MM/YYYY): ______

Note: One ECC Register should be completed per ECC Session *NA = Not Applicable ** Use Comma
C1 C2 C3 C4 C5 C6 C7 C8

Sex: Educational
Participant Grand Occupation
Participant ID Father Name 1- Male Age Status
Name Father Name (See code)
2 - Female (See code)

301091756785601 Shasho Shelema Merga 2 20 1 1

301091756785602 Tarike Tolessa Busha 2 22 1 1

301091756785603 Gadise Gelana Gadisa 2 30 1 1

301091756785604 Buzu Fikadu Busha 2 27 1 1

301091756785605 Martha Alemu Shifera 2 19 1 1

301091756785606 Belaynesh Gudisa Ayana 2 26 1 1

301091756785607 Shashitu Abera Jira 2 36 1 1

301091756785608 Edoshe Boressa Gutu 2 26 1 1

 301091756785609 Jebene Gutu Gemechu 2 20 1 1

301091756785610 Meseret Dereje Gemechu 2 38 1 1

301091756785611 Sise Getachew Abdi 2 25 1 1

301091756785612 Nuritu Tolessa Gurmessa 2 26 1 1

301091756785613 Chaltu Sufa Moroda 2 25 1 1

301091756785614 Belaynesh Fufa Chimdessa 2 28 1 1

301091756785615 Mimi Adugna Lejisa 2 24 1 1

301091756785616 Shume Hika Boru 2 35 1 1

301091756785617 Martha Gari Motuma 2 23 1 1

301091756785618 Shewaye Eressa Chimdi 2 28 1 1

C7 - Educational Status: C8 - Occupation:

1. Illiterate 1. House wife
2. Adult education 2. Farmer
3. Primary (grade 1-4 and grade 5-8) 3. Government Employee
4. Secondary (grade 9-10 and grade 11-12) 4. Self-employed (small business)
5. TVET/ATVET 5. Private employee
6. University/college 6. Student
7. Unemployed
wth Through Nutrition Activity
nversation (ECC) Register

Code: 3

Establishment/Enrollment Date(DD/MM/YYYY): 23/12/2020

ilitated on (DD/MM/YYYY): ______________________

** Use Comma to separate more than one response

C9 C10 C11 C12 C13 C14 C15 C16 C17 C18

If C11 =1, Age of the child (tick Ö under appropriate

age group)

If C9 = 2 or Are you a
Have you If C17=1,
Are you 3, Is there parent
received Type of
pregnanat? pregnant /grandparent
Session Title SBCC SBCC
1 - Yes mother in of U2
Sprout Big Bud (See code) materials? materials
2 - No your home? children? Little Bud Flower
children (0- children (7- 1- Yes received
3 - NA* 1 - Yes 1- Yes children (6-7 children (12-
6 months 12 months 2 - No (See code) **
2 - No 2 - No months old) 24)
old) old)

1 2 2

1 2 2

1 2 2

1 2 2

1 2 2

2 2 1 √

2 2 1 √

2 2 1 √
 2 2 1 √

2 2 1 √

2 2 1 √

2 2 1 √

2 2 1 √

2 2 1 √

2 2 1 √

2 2 1 √

2 2 1 √

2 2 1 √

C16 - Session Title: C18 - Type of SBCC materials received:

1. Overview of the 1st 1000 days 1. 1000 day poster
2. Early pregnancy 2. IFA reminder calendar poster
3. Late pregnancy 3. Maternal menu planning poster
4. Exclusive breast feeding (0-6 months) 4. WASH poster
5. WASH 5. Little bud poster
6. Readiness for Bud 6. Big bud poster
7. Little Bud (6-7 months) 7. Flower poster
8. Big Bud (7-12 months) 8. Family reminder calendar
9. Flower (12-24 months)
10. Wrap-up and pledge
 Feed the Future Ethiopia Growth Through Nutrition Ac
Enhanced Community Conversation (ECC) Register

Region: Oromiya Zone: West Shewa Woreda: Bako Tibe Kebele: Oda Gibe Name of Local NGO/Code: 3

Group Name (Tick √): Mothers' group √ Fathers' group ___Mother-in-laws __MVHH Saving Group Establishment/Enrollment Date

Community Change Agent (CCA) Name: Misgana Getahun Mosisa CCA Phone Number: 0921842885 ECC Session Facilitated on (DD/MM/YYYY): __

Note: One ECC Register should be completed per ECC Session *NA = Not Applicable ** Use Comma
C1 C2 C3 C4 C5 C6 C7 C8 C9

Are you
Sex: Educational pregnanat?
Participant Grand Occupation
Participant ID Father Name 1- Male Age Status 1 - Yes
Name Father Name (See code)
2 - Female (See code) 2 - No
3 - NA*

301092184288501 Kitessa Megersa Etana 1 37 1 1 2

301092184288502 Beresa Motuma Debelo 1 29 1 1 2

301092184288503 Dhiba Diribi Fituma 1 34 1 1 2

301092184288504 Chala Merga Sori 1 38 1 1 2

301092184288505 Dawit Biria Dheressa 1 35 1 1 2

301092184288506 Chala Lemma Biru 1 35 1 1 2

301092184288507 Likisa Bulti Gemeda 1 36 1 1 2

301092184288508 Gobena Keno Negeri 1 38 1 1 2

 301092184288509 Adana Shuma Belay 1 27 1 1 2

301092184288510 Girmaye Kebeda Mijena 1 40 1 1 2

301092184288511 Dhaba Takela Firisa 1 25 1 1 2

301092184288512 Rebuma Dhiba Fira 1 24 1 1 2

301092184288513 Tefera Birhanu Motuma 1 25 1 1 2

301092184288514 Dereje Gadisa Wakessa 1 30 1 1 2

301092184288515 Dereje Tafese Abebe 1 28 1 1 2

301092184288516 Adane Abera Jifar 1 25 1 1 2

301092184288517 Merga Fikadu Gurmessa 1 26 1 1 2

301092184288518 Adana Gudeta Gemechu 1 27 1 1 2

C7 - Educational Status: C8 - Occupation: C16 - Session Title

1. Illiterate 1. House wife 1. Overview of the 1st 1000 days
2. Adult education 2. Farmer 2. Early pregnancy
3. Primary (grade 1-4 and grade 5-8) 3. Government Employee 3. Late pregnancy
4. Secondary (grade 9-10 and grade 11-12) 4. Self-employed (small business) 4. Exclusive breast feeding (0-6 month
5. TVET/ATVET 5. Private employee 5. WASH
6. University/college 6. Student 6. Readiness for Bud
7. Unemployed 7. Little Bud (6-7 months)
8. Big Bud (7-12 months)
9. Flower (12-24 months)
10. Wrap-up and pledge
Through Nutrition Activity
sation (ECC) Register

:3

Establishment/Enrollment Date(DD/MM/YYYY): 23/12/2020

on Facilitated on (DD/MM/YYYY): ____________

** Use Comma to separate more than one response

C10 C11 C12 C13 C14 C15 C16 C17 C18

If C11 =1, Age of the child (tick Ö under appropriate

age group)

If C9 = 2 or Are you a
Have you If C17=1,
3, Is there parent
received Type of
pregnant /grandparent
Session Title SBCC SBCC
mother in of U2
Sprout Big Bud (See code) materials? materials
your home? children? Little Bud Flower
children (0- children (7- 1- Yes received
1 - Yes 1- Yes children (6-7 children (12-
6 months 12 months 2 - No (See code) **
2 - No 2 - No months old) 24)
old) old)

1 2

1 2

1 2

1 2

1 2

2 1 √

2 1 √

2 1 √
 2 1 √

2 1 √

2 1 √

2 1 √

2 1 √

2 1 √

2 1 √

2 1 √

2 1 √

2 1 √

C16 - Session Title: C18 - Type of SBCC materials received:

1. Overview of the 1st 1000 days 1. 1000 day poster
2. Early pregnancy 2. IFA reminder calendar poster
3. Late pregnancy 3. Maternal menu planning poster
4. Exclusive breast feeding (0-6 months) 4. WASH poster
5. WASH 5. Little bud poster
6. Readiness for Bud 6. Big bud poster
7. Little Bud (6-7 months) 7. Flower poster
8. Big Bud (7-12 months) 8. Family reminder calendar
9. Flower (12-24 months)
10. Wrap-up and pledge