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

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Sector/ Office Strength Weakness Opportunities Threats/Constraints Ministry of Agriculture • Agricultural extension Package. • Presence of food security strategy and program. • Initiation of crop diversification. • Presence of development agents and agricultural home economist agents in the community. • Presence of strategy for increasing food availability (safety net). • Care is not addressed as a cause. • Food biased approach - food security focus rather than nutrition security. • Does not have care as one of its performance indicators. • Agricultural home economist agents do not exist in most regions (except Tigray). Their training has ceased. • The possibility of intersectoral collaboration and integration with health. • MDG focusing on nutrition. • Using nutrition security as both an input and outcome of food security. • Decentralization and rural based development strategy. • Lack of understanding. • Fragmented approach. • Lack of ownership. • No regular forum for discussing with the other sectors. • Lack of nutrition strategy to guide roles, responsibilities, and necessary actions. • Diffusion of responsibility regarding malnutrition. • Lack of awareness of the cross cutting nature of the problem. • Lack of ownership- caring is not the responsibility of any one sector, it is crosscutting issue. Food Security Strategy • Efforts for community & household asset building and protection of livelihood system. • Presence of the safety net program. • Building infrastructure (water, grain mills, clinics , etc.) in the resettlement programs. • Targeted cash transfer to males. • BCC is not part of the activity or is not strong. • Caring practices like BF, CF, health seeking behavior, and hygiene are not well addressed. • Presence of the global conceptual framework of the causes of malnutrition exists. • Government committed to ensure food security. • Health policy focuses on promotive and preventive care. • MDGs target malnutrition, for which care is important intervention. • Frequent drought and food insecurity. • Rapid population growth. • High burden of HIV/AIDS. • Inadequate capacity for promotive behaviors (growth monitoring and counseling) using “triple-A cycle”. • No National Nutrition Strategy. • Lack of nutrition strategy to guide roles, responsibilities, and necessary actions. 120
Sector/ Office Strength Weakness Opportunities Threats/Constraints HIV/AIDS prevention & control office (HAPCO) • There is a strategy on psychosocial (counseling) and health care. • Voluntary confidential counseling and testing services. • Emphasis on home-based care. • Have orphan support. • No guidelines for nutritional care of PLWHA. • No institutional arrangements for nutritional care (unclear mechanisms for integration). • No link between VCT centers and caregiving centers and organizations. • There is a possibility of external assistance. • Strong governmental commitment for control and prevention of HIV/AIDS. • Presence of local NGOs working on HIV/AIDS care. • HIV/AIDS is one of the priority areas of the MDGs. • High prevalence of HIV/AIDS. • Poor access to anti-retroviral drugs. • Chronic and asymptomatic nature of the dis ease making it difficult to recognize and address. • Social stigma and discrimination. • No national nutrition policy or strategy (NNS). • Program on prevention of mother to child transmission of HIV. • Sustainable development & poverty reduction strategy (SDPRP) gives emphasis to HIV/AIDS. • Association of PLWHA. NGOs/UN agencies • Food security activities. • Some targeting of women, children, and the disabled. • Public works programs (food or cash for work) addressing some parts of care. • Development assistance. • Child growth promotion (CGP) • More a food-first approach. • Nutrition security not is well addressed. • Care is not given due attention. • Emergency nutrition and health interventions not prioritized. • Poor referral link and coordination between CGP activities and routine health care activities • HSDP supportive of promotive and preventive care. • Presence of the global conceptual framework for malnutrition. • One of the priority areas of the MDGs is improved nutrition, which can only be achieved through proper carrying practices. • There is a possibility of integrating CGP with routine household level development activities • No national nutrition strategy. • Low local capacity for promotion of caring behaviors. • Lack of integration. • Lack an institutional framework for regular dialogue with different sectors. 121
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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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works are key instruments to lay do
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due to inappropriate land mismanage
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3.6.3.5. HIV/AIDS This disease is w
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coordinates the different implement
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conception through early pregnancy
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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
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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
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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 and 128: In an emergency, therefore, care an
Page 129 and 130: • Enhance women’s capacity for
Page 131: Table 4.4: Analysis of care conside
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
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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
Page 179 and 180: 6.2. Challenges and Lessons Learnt
Page 181 and 182: 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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