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

4.3.1.2. Recognizing symptoms of illness and the appropriate response
Caregiver’s perception of the symptoms of illness is fundamental for healthcare
seeking behavior and utilization of the health care services. Especially in areas like Ethiopia
where there is high burden of both infectious communicable diseases and nutritional problems
and poor hygienic conditions, knowledge of symptoms of illness by caretakers are critically
important (Fasil et al. 2000). Findings of a study in Ethiopia on mothers’ knowledge of health
demonstrated that maternal nutritional knowledge, as proxied by the community’s ability to
diagnose faltering in the growth of young children, also plays an important role in
determining child malnutrition. It was recommended that, in addition to implementation of
actions to increase primary schooling, food security and income development, which are
Ethiopia’s development programs, community-based programs to enhance knowledge of
caregivers could reduce child malnutrition in Ethiopia by 31 percent (Christiaensen &
Alderman 2004).
4.3.2. Preventative health care
According to the global conceptual framework, health is an essential prerequisite for
good nutritional status and growth. Good nutritional status is both an outcome of good health
and an input to overall development in general and health status in particular. Utilization of
preventative health care services is one of the care giving practices. A study in Addis Ababa
indicated that utilization of maternal health care services is inadequate as clearly depicted by
the major maternal health care indicators (antenatal, delivery, and postnatal care services)
(FDRE et al. 2003). The situation is worst in the rural areas, where more than 80 percent of
the population resides. Recent reports of the Ministry of Health indicated that utilization of
preventive healthcare is low. Coverage of antenatal care, attendance of deliveries by a skilled
person, and postnatal care services were 40.8 percent, 9.5 percent, and 15.8 percent,
respectively (MOH 2003/2004).
All these health care services have a direct bearing on the nutritional care of children
and women. A study in Ethiopia showed that the odds of stunting were 1.5 times higher
among children whose mothers have had no prenatal care visit compared with children whose
mothers had five or more prenatal care visits. Children whose mothers had 1-4 prenatal care
visits were also at similar higher odds of stunting (Woldemariam & Timotiwos 2002).
4.3.2.1. Immunization
Immunization is one of the most importance preventive healthcare priorities that has a
very strong link with the nutritional status of children. Among the vaccine preventable
diseases, measles, tuberculosis, whooping cough are highly associated with childhood
malnutrition. Measles is particularly associated with diarrhea diseases, which lead to
malnutrition and back to diarrhea in a sort of vicious cycle. The recent immunization
coverage for Ethiopia is 60.78 percent and 52.61 percent, for DPT3 and measles, respectively
(MOH 2003/2004).
4.3.2.2. Vitamin A supplementation
Vitamin A supplementation and child survival and growth are highly linked.
Evidence indicates that vitamin A supplementation reduces child mortality by 23 to 35
percent (WHO et al. 1999). In Ethiopia, vitamin A supplementation is typically given through
the Expanded Programme on Immunization plus program or, at times, through national
campaigns. PROFILES 15 indicates that 298,000 child deaths in Ethiopia over 6-year period
(2000-2005) can be attributed to vitamin A deficiency (Ethiopian PROFILES Team &
AED/Linkages 2005). The national guideline for micronutrient intervention (MOH 2004b)
15 PROFILES is a computer model that quantifies functional consequences of malnutrition using scientific data.
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