An assessment of the causes of malnutrition in Ethiopia: A ...

Figure 4.4: Breastfeeding as a package of care addressing the three underlying
causes of malnutrition
Child growth,
development
and survival
Food and
Nutrition
Security
Care
Health Care
and
Hygiene
BREAST-
FEEDING
As shown in the framework presented in Figure 4.4, hitherto breastfeeding has been
regarded as an act that fulfills all three underlying conditions of nutritional security —food,
health, and care. It is estimated that 14 percent of HIV/AIDS infections occur through
breastfeeding, and this tends to paralyze the promotion, protection, and support of
breastfeeding. Thus HIV has a crippling impact on caring practices, caring capacity,
household food security and provision of basic services including health services—all
essential practices for nutritional security. Studies have shown a close association between
compromised nutrition status and HIV/AIDS (Gillespie et al. 2001).
HIV/AIDS and poverty (a large part of which relates to food insecurity) interact in a
vicious cycle. Poverty increases the exposure to, as well as the impact of HIV. Poverty also
increases the radius of impact of HIV on family and friends for the poor, informal coping
mechanisms that are more dependent on family and friends and less so on insurance
companies and the state (EngenderHealth 2004).
HIV/AIDS in turn strips assets and exposes families to poverty and poor caring
practices. The mother has invariably been regarded as the primary caregiver, but this is not
the case anymore as more and more children lose their mothers to HIV/AIDS. It is common to
find young children taking care of their younger siblings. These children are themselves in
need of care and often lack the skills to provide adequate care for their siblings. Due to
HIV/AIDS, adult members of the family cannot engage in productive action. Those still
healthy members may have to focus their attention on the sick, which includes use of limited
household resources to provide medical care (Jonsson 1995; Gillespie et al. 2001).
4.2.5.1. Nutritional care for people living with HIV/AIDS
Owing to a frequent illness due to opportunistic infections, nutrient requirements of
people living with HIV/AIDS are higher. No single food contains all the nutrients that our
bodies need, except for breast milk for babies up to the age of six months.
Eating a variety of different foods will supply the nutrients that are essential for our
bodies. By carefully choosing foods that are in season and locally available, eating can be
enjoyable, healthy, and affordable.
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