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

agents in the community. The issue of sustainability has to be considered and each sector
needs to design an inbuilt mechanism of sustaining such an approach. The following key
questions need to be answered:
How could such networks be established effectively and supported in a sustainable
way? Is there sufficient human capacity in communities? If not, how might it be built?
• These mobilizers are to be supported by facilitators, with each supporting the efforts
of 10 to 20 mobilizers. Could such a system work? Each kebele has approximately
1,000 households, who will require 50 to 100 mobilizers. These mobilizers will need
to be supported by 3 to 10 facilitators. Current draft proposals are for two health
extension workers, three agricultural extension workers (production, livestock,
natural resources), one food security monitor (in selected woredas), and one home
economist in each kebele. This totals between 5 to 7 development agents who might
serve as facilitators.
• How feasible is this? Is there sufficient human capacity? Are there sufficient
government resources to manage all of these workers? Will the other obligations of
these kebele-level workers permit them also to take on nutrition-oriented activities?
• For how long should the volunteers be trained? How will their performance be
monitored and mentored? How will they be motivated to sustain their efforts?
To address these questions and enable the system to work, in a sustainable way, an
integrated approach and careful planning by all sectors using “Triple-A cycle approach” is
required. This calls for an institutional framework and mandate to coordinate and organize
these efforts.
4.8. Conclusion
Regardless of all of the efforts to address malnutrition in Ethiopia, the problems are
increasing with time. The victims are the vulnerable groups including children, women,
disabled people, people infected with and affected by HIV/AIDS, orphans, street children,
Internally Displaced Persons (IDPs) and refugees. Past approaches to addressing nutritional
problems in Ethiopia have focused on the food aspect of malnutrition. Poor nutritional status
starts during the intra-uterine life due to the poor transfer of nutrients from the mother to the
fetus, perpetuating malnutrition across inter-generational cycles. This can only be addressed
through interventions focusing on food security, better caring practices for the vulnerable, and
adequate healthcare together with a healthy environment. For this reason, the global
conceptual framework is based on these three underlying causes of malnutrition. Availability
of food alone is not sufficient to address the nutritional security of the most vulnerable
segments of the population, as they need someone to feed them, counsel and guide them, and
take them to receive healthcare. Additionally, these segments of the population are at great
physical and social disadvantage because of poor access to resources.
There is a big gap in addressing care for the vulnerable groups by all sectors in
Ethiopia. Proper care enables the full utilization of existing food and healthcare services.
However, without proper caring practices food and healthcare services will not better the
nutrition situation in the country.
The reason for the low level of proper caring practices in Ethiopia is that most of the
actions that government can take to improve caring practices have to take place at the
household and community levels through interactions with caregivers. Moreover, these
activities are not as sector specific as those linked to the food security and health
determinants. Therefore, efforts to improve care are difficult to assign to a specific sector of
government. That is a principal reason nutrition security is not given effective government
support in many countries around the world – no single sector is responsible for ensuring the
nutritional well-being of a country’s citizens.
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