An assessment of the causes of malnutrition in Ethiopia: A ...
An assessment of the causes of malnutrition in Ethiopia: A ... An assessment of the causes of malnutrition in Ethiopia: A ...
• Enhance the role of husbands and non-parental family caregivers in the provision of care for the vulnerable in the household. • Establish and strengthen partnerships between frontline health workers (facilitators) and community mobilizers (animators) for the promotion of better caring practices at the household level. • Conduct behavior change communication activities on better caring practices at household level through integration of community level development workers of the different sectors and the active involvement of the community. • Establish effective social security and institutional safety nets for the vulnerable segments of the population, with clear targeting indicators. • Strengthen caring practices & programs directed at vulnerable groups. • Nutrition care as part of a holistic program for PLWHA. • Develop national guideline for nutrition and HIV/AIDS and incorporate these guidelines into the Essential Nutrition Actions (ENA). • Update national HIV/AIDS home-based care handbook based on current knowledge. • Develop or adapt practical tools for local use in order to enhance nutrition support interventions. • Train health workers and community based care providers and counselors on nutrition and HIV/AIDS. • Advocate for the importance of good nutrition support & care for HIV infected individuals. • Expand training on infant feeding counseling for PMTCT and ENA. Integrate infant feeding messages into PMTCT behavior change communication strategies. • Support gender and orphan-focused credit and micro-enterprise development and agricultural extension training programs in rural areas. • Establish institutional mechanisms to protect, promote, and support optimal infant and young feeding practices in the general population. • Implement and enforce the International Code of Marketing of BMS. • Make hospitals and health centers baby friendly. • Improve duration of maternity leaves to enable exclusive breastfeeding for six months. • Arrange work schedules so that they do not counter the breastfeeding practice of a working mother, e.g., avoid assigning nursing mothers for night duties. • Make workplaces breastfeeding friendly for nursing mothers, e.g., breastfeeding corner. • Establish community support groups for caring practices such as breastfeeding and complementary feeding. • Mainstream better caring practices in each organization. • Conduct in-service trainings on essential nutrition actions for health professional and disseminate the National Strategy for Infant and Young Child Feeding. • Implement the incorporation of ENA in to the pre-service curriculum. 116
• Enhance women’s capacity for caring. • Increase women’s access to and autonomy to decide on use of household resources. • Promote the establishment of community support groups and linkages with food security programs. • Raise awareness of the importance of sharing the burden of caregiving by husbands and other non-parental members of the household (siblings and others) both at the community and household levels. • Increase female educational attainment through gendered awareness creation, affirmative action, and through informal education. • Raise women’s knowledge of child feeding and caring practices through home visit programs by integrated teams of kebele development workers. • Increase women’s income and employment status through raising micro credit schemes and entrepreneurship interventions at the community level. • Promote time saving technologies for women – grain mills, alternative fuel sources, water sources, improved stoves. • Establish community day care centers for both rural and urban women. • Promote maternal nutrition during pregnancy and lactation. • Promote health care utilization by the mother (antenatal care, delivery care, postnatal care, and family planning). • Include caring as one of the values presented in the Civics education syllabus at the primary and secondary schools. • Give special attention to the care of vulnerable segments of society (children, women, elderly people, and disabled) during emergency and crisis situations. • Make sure that essential caring practices – optimal breastfeeding, optimal complementary feeding – are not compromised due to crisis. • Maintain access to water and continued use of hygienic practices. • Protect the vulnerable from accidents, abuses, and dangers. • Support operations research on better caring practices. • Monitor and evaluate at all levels and disseminate findings. For preplanning and for evaluation, use the “triple-A cycle approach”. 4.5.2. What are the advantages of having a NNS in place? The national nutrition strategy is necessary to focus on strategic issues to address chronic nutritional problems in Ethiopia. Without a well-designed strategy all efforts will be poorly coordinated and will compete with one another rather than resulting in sustainable solutions. The national nutrition strategy will: • Facilitate the necessary institutional arrangements for effective care. • Mainstream care to the various sectors as a cross-cutting issue. • Establish an institutional framework for advocacy for and the monitoring and evaluation of better caring practices. 117
- Page 77 and 78: coordinates the different implement
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- Page 81 and 82: households who depend on purchased
- Page 83 and 84: • Improve rural radio infrastruct
- Page 85 and 86: 3.7.3.6. Improve rural market infra
- Page 87 and 88: CHAPTER 4: CARE AND MALNUTRITION IN
- Page 89 and 90: household allocation; 5) workload a
- Page 91 and 92: lack of national nutrition strategy
- Page 93 and 94: children between 6 and 24 months. T
- Page 95 and 96: Care was recognized as one of the u
- Page 97 and 98: Figure 4.1: Risk of death in infant
- Page 99 and 100: Table 4.2: Present discount values
- Page 101 and 102: Figure 4.3: Factors that affect the
- Page 103 and 104: Box 4.2: Reasons why PLWHA are vuln
- Page 105 and 106: Figure 4.7: Risk of mother to child
- Page 107 and 108: arely provide this kind of benefit.
- Page 109 and 110: Figure 4.8: The extended model of c
- Page 111 and 112: 4.3.1.2. Recognizing symptoms of il
- Page 113 and 114: the direction of the growth curve i
- Page 115 and 116: Figure 4.13: Prevalence of stunting
- Page 117 and 118: from poor exposure of children to l
- Page 119 and 120: 4.3.3.4. Response to food security
- Page 121 and 122: 4.3.6. Time and energy expenditure
- Page 123 and 124: Table 4.3: Care focused initiatives
- Page 125 and 126: together. This demands an integrate
- Page 127: In an emergency, therefore, care an
- Page 131 and 132: Table 4.4: Analysis of care conside
- Page 133 and 134: Sector/ Office Strength Weakness Op
- Page 135 and 136: International initiative Strengths
- Page 137 and 138: • Rate of continued breastfeeding
- Page 139 and 140: Figure 4.17: Community based nutrit
- Page 141: There is a strong need for enhancin
- Page 144 and 145: supplies. The available facilities
- Page 146 and 147: 5.1. Introduction 5.1.1. Conceptual
- Page 148 and 149: access to a basic package of qualit
- Page 150 and 151: Integrating nutrition interventions
- Page 152 and 153: Although the coverage of ENA traini
- Page 154 and 155: Box 5.1: Household and Community In
- Page 156 and 157: The interventions that make up this
- Page 158 and 159: conferences. To this effect, a nati
- Page 160 and 161: with the engineering aspect of wate
- Page 162 and 163: Table 5.1: Prevalence of diarrhea a
- Page 164 and 165: Figure 5.3: Trends in latrine cover
- Page 166 and 167: Institutional arrangements are also
- Page 168 and 169: ehavior are integrated and supplied
- Page 170 and 171: 5.4.2. Programs and projects 5.4.2.
- Page 172 and 173: made by NGOs for the affected child
- Page 175 and 176: CHAPTER 6: INSTITUTIONAL FRAMEWORK
- Page 177 and 178: interventions in Ethiopia, includin
• Enhance <strong>the</strong> role <strong>of</strong> husbands and non-parental family caregivers <strong>in</strong> <strong>the</strong> provision<br />
<strong>of</strong> care for <strong>the</strong> vulnerable <strong>in</strong> <strong>the</strong> household.<br />
• Establish and streng<strong>the</strong>n partnerships between frontl<strong>in</strong>e health workers<br />
(facilitators) and community mobilizers (animators) for <strong>the</strong> promotion <strong>of</strong> better<br />
car<strong>in</strong>g practices at <strong>the</strong> household level.<br />
• Conduct behavior change communication activities on better car<strong>in</strong>g practices at<br />
household level through <strong>in</strong>tegration <strong>of</strong> community level development workers <strong>of</strong> <strong>the</strong><br />
different sectors and <strong>the</strong> active <strong>in</strong>volvement <strong>of</strong> <strong>the</strong> community.<br />
• Establish effective social security and <strong>in</strong>stitutional safety nets for <strong>the</strong> vulnerable<br />
segments <strong>of</strong> <strong>the</strong> population, with clear target<strong>in</strong>g <strong>in</strong>dicators.<br />
• Streng<strong>the</strong>n car<strong>in</strong>g practices & programs directed at vulnerable groups.<br />
• Nutrition care as part <strong>of</strong> a holistic program for PLWHA.<br />
• Develop national guidel<strong>in</strong>e for nutrition and HIV/AIDS and <strong>in</strong>corporate <strong>the</strong>se<br />
guidel<strong>in</strong>es <strong>in</strong>to <strong>the</strong> Essential Nutrition Actions (ENA).<br />
• Update national HIV/AIDS home-based care handbook based on current<br />
knowledge.<br />
• Develop or adapt practical tools for local use <strong>in</strong> order to enhance nutrition support<br />
<strong>in</strong>terventions.<br />
• Tra<strong>in</strong> health workers and community based care providers and counselors on<br />
nutrition and HIV/AIDS.<br />
• Advocate for <strong>the</strong> importance <strong>of</strong> good nutrition support & care for HIV <strong>in</strong>fected<br />
<strong>in</strong>dividuals.<br />
• Expand tra<strong>in</strong><strong>in</strong>g on <strong>in</strong>fant feed<strong>in</strong>g counsel<strong>in</strong>g for PMTCT and ENA. Integrate<br />
<strong>in</strong>fant feed<strong>in</strong>g messages <strong>in</strong>to PMTCT behavior change communication strategies.<br />
• Support gender and orphan-focused credit and micro-enterprise development and<br />
agricultural extension tra<strong>in</strong><strong>in</strong>g programs <strong>in</strong> rural areas.<br />
• Establish <strong>in</strong>stitutional mechanisms to protect, promote, and support optimal <strong>in</strong>fant<br />
and young feed<strong>in</strong>g practices <strong>in</strong> <strong>the</strong> general population.<br />
• Implement and enforce <strong>the</strong> International Code <strong>of</strong> Market<strong>in</strong>g <strong>of</strong> BMS.<br />
• Make hospitals and health centers baby friendly.<br />
• Improve duration <strong>of</strong> maternity leaves to enable exclusive breastfeed<strong>in</strong>g for six<br />
months.<br />
• Arrange work schedules so that <strong>the</strong>y do not counter <strong>the</strong> breastfeed<strong>in</strong>g practice <strong>of</strong><br />
a work<strong>in</strong>g mo<strong>the</strong>r, e.g., avoid assign<strong>in</strong>g nurs<strong>in</strong>g mo<strong>the</strong>rs for night duties.<br />
• Make workplaces breastfeed<strong>in</strong>g friendly for nurs<strong>in</strong>g mo<strong>the</strong>rs, e.g., breastfeed<strong>in</strong>g<br />
corner.<br />
• Establish community support groups for car<strong>in</strong>g practices such as breastfeed<strong>in</strong>g<br />
and complementary feed<strong>in</strong>g.<br />
• Ma<strong>in</strong>stream better car<strong>in</strong>g practices <strong>in</strong> each organization.<br />
• Conduct <strong>in</strong>-service tra<strong>in</strong><strong>in</strong>gs on essential nutrition actions for health pr<strong>of</strong>essional<br />
and dissem<strong>in</strong>ate <strong>the</strong> National Strategy for Infant and Young Child Feed<strong>in</strong>g.<br />
• Implement <strong>the</strong> <strong>in</strong>corporation <strong>of</strong> ENA <strong>in</strong> to <strong>the</strong> pre-service curriculum.<br />
116
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