BACKGROUND:
Malnutrition remains a major public-health challenge in Ethiopia, with low dietary diversity among young children, especially in rural and underserved areas. Social and Behavior Change Communication (SBCC) is widely used to improve infant and young child feeding (IYCF), but effectiveness across regions is unclear. This systematic review and meta-analysis assessed the impact of region-specific SBCC on Minimum Dietary Diversity (MDD), Dietary Diversity Score (DDS), and child weight gain.

METHODS:
We searched PubMed, Scopus, Hinari, and Google Scholar for Ethiopian studies evaluating SBCC. Eligible studies were screened, and data on MDD, DDS, and weight gain were extracted. Pooled risk ratios (RR) and mean differences (MD) were estimated using random-effects models; heterogeneity and regional subgroup analyses were conducted.

RESULTS:
Thirty-three studies met inclusion criteria. SBCC significantly improved all three outcomes. Children exposed to SBCC were 67% more likely to achieve MDD (RR 1.67; 95% CI 1.42–1.96). DDS increased (MD 0.80; 95% CI 0.50–1.11), and weight gain improved (MD 1.32; 95% CI 0.49–2.15), though heterogeneity was high (I² = 99.64%). Regional analyses showed the strongest effects in urban settings, including Addis Ababa (RR 1.78 for MDD; MD 1.39 for DDS). SNNPR demonstrated consistent gains with the highest weight increase (MD 2.01). Oromia and Amhara recorded moderate improvements, with some non-significant estimates, likely reflecting differences in local food systems, implementation fidelity, and structural constraints.

CONCLUSIONS:
SBCC interventions in Ethiopia are associated with higher dietary diversity and improved child growth, but impact varies by context. Tailoring SBCC to local cultural and environmental realities and integrating it with measures that strengthen food security, enhance health-service delivery, and address structural barriers may yield greater and more equitable benefits.