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

different parts of the country showed that women avoid eating nutritious foods (animal foods
and green vegetables) for fear that the baby will be large and labor will be difficult later (Save
the Children Fund (UK) 2003). Other cultural practices exposing women to malnutrition
include early marriage and teen-age pregnancy. Pregnancy in a growing girl is nutritionally
demanding and will put the young mother in a nutritionally insecure position. In all
circumstances, care of the child in the intrauterine period and after delivery will be affected
due to decreased nutrient transfer both via feto-maternal unit and via breast milk (Ethiopian
PROFILES Team & AED/Linkages 2005). About 30.1 percent of Ethiopian women suffer
from chronic energy deficiency with inter-regional variations reaching a maximum of 48.3
percent in Somali region.
4.3.5. Household hygiene practices
Household hygienic practices depend on the availability of water, on excreta disposal
systems, and on the knowledge of the caregiver and other household members about the
importance of hygiene. Access of the population to sanitation resources like water and waste
disposal facilities is very low in Ethiopia. This is even worse when it comes to the rural
population due to the low level of awareness of the community (FDRE et al. 2003).
4.3.5.1. Water and sanitation resources of the household
Adequate and safe water supply is a key factor for caring practices. Access to water
and safe excreta disposal are prerequisites for control of diarrhea and other diseases
influencing the nutrition status of children. The health condition that is achieved ultimately
depends on resources in the same way that food and care conditions do (4). Availability of
water enables maintenance of the hygienic condition of the environment, including food,
drinks, utensils, clothing, and the personal hygiene of the child and caregiver, particularly
proper hand washing practices. Hand washing prevents most of the communicable diseases
that result in diarrhea and then lead to malnutrition. Additionally, nearby availability of water
will allow the caregiver to spend more time giving care and saves her energy reserves, which
is care for the caregiver (Yared 2003; Levinson et al. 2002). A study in Ethiopia indicated that
hygienic care of children was poor. When asked why they did not wash their children more
often, most women replied that (i) they are too busy, (ii) this practice is not in their culture,
(iii) there is no point in washing children’s bodies and then putting on dirty clothes again, and
(iv) they cannot afford soap (van Esterik 1995). The findings indicate that there is a need for
stronger behavior change communication emphasizing the link between hygiene, sanitation,
infection, and malnutrition. When we look at the national situation, only 37.3 percent of the
population has access to a safe water supply. Safe human waste disposal is also a key element
in the prevention of occurrence of diarrhea that has strong bearing on the occurrence of
malnutrition. Only 28.9 percent of the population had access to excreta disposal facilities in
1996 (MOH 2003/2004).
4.3.5.2. Hand-washing practices.
Hand washing of the caregiver is a critically important to break the link between food
or drink intake and development of infection. Caregivers need to wash their hands with clean
water and soap before preparing the food, before feeding the baby and after going to a toilet
or disposing of the child feces. A study in Ethiopia showed that educated mothers are more
likely to know the causes of diarrhea, are better informed about the advantages of good
hygiene, and are more likely to prioritize soap use than are uneducated mothers. The use of
soap was associated independently with both household wealth and maternal educational
status (van Esterik 1995). The need for behavior change communications, to increase the
knowledge of mothers about hand washing as an important intervention to break the chain
disease transmission.
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