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

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4.3.6.2. Time demands of urban caregivers Although urban women will take advantage of opportunities for informal, temporary work, lack of preparation for work opportunities and the inability to plan causes disruption in child-care patterns for those women in the informal economy. Opportunities for wage labor take priority over the needs of infants and young children. Mothers cannot plan for these occasions; they never know when work will be available. If they are able to obtain work for a few days, the pay is too low and the occasion too brief to employ household help. In this situation, infants are left in the care of neighbors or relatives. For the majority of the urban poor, regular salaried employment is rare. Only monthly salaried workers receive either maternity leave or maternity entitlements of any kind. More often, women workers are fired when their pregnancy becomes obvious. Another factor affecting women's capacity to care for their infants and young children is scheduling. Unpredictable shift changes, night work, and lack of control over work schedules make child care difficult. In addition, the patterns of feeding for infants and young children may change significantly from the beginning to the middle or end of the month or pay period, depending on available income (AED/Linkages 2004). 4.3.6.3. Models of good care In agrarian societies with high fertility and high mortality, parents are usually guided by cultural modes, the goal of which is to maximize the number of surviving offspring, but not to optimize the growth and development of each one. It can be pointed out that societies in which the concept of child spacing has not been adopted simply may not have the time, knowledge, or motivation to deal with growth and development. These models for parental behavior are themselves adaptations, culturally evolved over the centuries to conditions of labor-intensive family agricultural production and natural fertility. The first condition creates a demand for child labor in the home: the more children, the more land can be cultivated and the more work distributed (Engle 1992b). However, caregivers usually learn good caregiving practices from what they observe in their surroundings. Neighboring mothers with positive deviance success stories will serve as a role model for good caring practices. The other models of child caring in the Ethiopian context are grandmothers and elderly women. Particularly young women learn many caring practices, like breastfeeding, complementary feeding, and child washing and caring during illness, from their own mothers. This implies that involving grandmothers and other elderly women who have successfully reared their own children in community support groups will have beneficial effect in improving caring practices at the household level throughout the community. 4.4. Care-focused Initiatives in Ethiopia by Government Sectors and NGOs 4.4.1. Assessment of care focused initiatives in Ethiopia In Ethiopia there are different care focused in itiatives that are being implemented or planned to be implemented both by governmental and non-governmental organizations. In Table 4.3 below the activities of different care focused initiatives in Ethiopia are reviewed. The purpose of this analysis is to examine the aspects of care for the vulnerable people they are addressing and the activities they do in order to build upon their experiences during the development of the National Nutrition Strategy (NNS). During consultative meetings with funding agencies, NGOs, regional food security bureaus, and ministries for the preparation of national nutrition strategy, it was observed that care, which is the link between food availability and nutritional status, is the weakest point of all interventions. 110
Table 4.3: Care focused initiatives in Ethiopia Care focused initiatives in Ethiopia • Essential nutrition actions approach • Integrated management of childhood illness (IMCI), both community and clinical • Enhanced outreach service (EOS) • Essential health service Ethiopia (ESHE) • Community therapeutic care • Preventive health care programs (Antenatal care, delivery care, postnatal care, family planning and immunization, growth monitoring and promotion) • Child Growth promotion (CGP) • Agricultural home economic agents Components of caring practice addressed • Three micronutrients (Vitamin A, Iodine, Iron), Sick child feeding, EBF, CF, Maternal nutrition, BCC, PMTCT, community support groups. • Breastfeeding, Complementary feeding, maternal nutrition, micronutrients, Health seeking behavior, hygiene, BCC, HIV/AIDS. • Micro-nutrient deficiency (Vitamin A and iron). • Screening for malnutrition. • Preventive health care (measles vaccine). • IEC on hand washing and HIV/AIDS. • IEC and health promotion. • Breastfeeding. • Complementary feeding. • Hygiene (hand washing & water sanitation). • Nutritional care (energy, vitamin A, folic acid, deworming). • Health care. • Breastfeeding. • Immunization. • IEC. • Family planning. • Ante-natal care, delivery care. • Growth monitoring. • Growth monitoring at the community level (weight & height measurements) connected to food security program. • Counseling of mothers on child nutrition. • Educate household about food preparation, • Backyard gardening. • Child and maternal feeding practices. Components not very well addressed (Gaps) • Institutional arrangements (supplies). • Capacity only for promotive efforts. • Institutional arrangements (supplies). • Gaps in the referral system • Maternal nutrition • Maternal nutrition. • Breastfeeding, complementary feeding. • Food hygiene (complementary food). • Other micronutrients (iodine). • Sick child feeding. • Maternal nutrition. • Micronutrients. • Sick child feeding. • BCC on child feeding & caring practices is poor. • Breastfeeding, hygiene, complementary feeding. • Iodine for the family. • Micronutrients. • No BCC. • Growth monitoring weak; no promotion activities (counseling). • Sick child feeding. • Health care settings not baby friendly. • Coordination and integration with the other governmental and NGOs care activities. • Intervention only counseling. • These agents exist only in Tigray region. • BCC on caring practices (BF and CF) is poor. • Integration with other sectors needs to be meticulously worked out. 111
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An assessment of the causes of maln
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• Bantirgu Hailemariam coordinate
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3.4. National and Regional Trends:
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LIST OF TABLES Table 2.1: Child stu
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LIST OF ACRONYMS ADLI AGOA AIDS BCC
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Figure 1.1: Stunting among children
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these underlying determinants of th
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experimental body of evidence that
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water can have significant impact o
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2.1. Introduction In the early 1960
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violating the basic tenets presente
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Table 2.3: Regional profile of stun
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A rich food through popularization
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key tenet in the process of identif
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Basic Causes Major Features High im
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commodity trading is the most signi
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Table 2.9: Gross primary enrollment
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following and in alliance with the
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• Accept that agricultural develo
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the other practices that need to be
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CHAPTER 3: FOOD SECURITY AND MALNUT
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Afar in 2000 was 12.6 percent and 5
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3.1. Introduction The economic grow
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In a more technical way, it is diff
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differently, it is important to acc
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households will not be as difficult
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the drought prone areas, the rain f
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insecure, these activities will als
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viewed as a proxy for household foo
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Figure 3.3: Per capita food product
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Intermediate means of transport suc
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educated, environmentally conscious
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1995-96 revealed that ‘the greate
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made by NGOs for the affected child
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CHAPTER 6: INSTITUTIONAL FRAMEWORK
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interventions in Ethiopia, includin
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6.2. Challenges and Lessons Learnt
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Training Post-secondary training is
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Table 6.6: (continued) Agency Inter
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Achievements Challenges Sustainabil
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Berhane G. 1995. Nutrition surveill
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Ethiopian PROFILES Team & AED/Linka
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Middlebrook, P. 2002. Social protec
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Raisin, J. 2001b. Improving food se
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Yamano, T., H. Alderman, & L. Chris
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