Food insecurity and poor nutritional status remain widespread problems in the Horn of Africa (HOA). A multi-pronged nutrition-sensitive approach to development has been shown to be the best route for sustained reductions in undernutrition. One of the objectives of this report was to review Food and Nutrition Security (FNS) coordination mechanisms at the subregional and national levels. The study analyses trends and key FNS indicators in the region including reliance on imported food, net exports and trends of undernourishment. It describes challenges, opportunities and gaps that need to be addressed to reduce hunger in the six countries and proposes and a strengthened subregional and national FNS coordination mechanism.