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

CHAPTER 5: HEALTH SERVICES, A HEALTHY ENVIRONMENT, AND
MALNUTRITION IN ETHIOPIA
AN ASSESSMENT AND ANALYSIS OF UNDERLYING DETERMINANTS OF
MALNUTRITION
Ayele Gebremariam, MD
Department of Pediatrics & Child Health, Faculty of Medicine
Abera Kumie, PhD
Department of Community Health, Faculty of Medicine
Damene Hailemariam, PhD, MD
Department of Community Health, Faculty of Medicine
and
Fikru Tesfaye, MD, MPH
Department of Community Health, Faculty of Medicine
Addis Ababa University
Executive Summary
This is a review and analysis of the role of health services and a healthy environment
on the situation of child malnutrition in Ethiopia. The report was produced as an input to the
process of developing a national nutrition strategy. The methodology used in the preparation
of this report includes desk reviews of the relevant literature and a process of consultation
with the sectors and stakeholders relevant to the issue. The consultation process involved
officials and other actors within the sectors at federal, regional and community levels.
The global conceptual framework of the causes of child malnutrition that considers
nutritional status a result of a combination of the activities of economic and developmental
sectors as well as the socio-cultural traditions within a given country has been adopted in the
analysis of the determinants of malnutrition. According to this framework, health services and
a healthy environment are among the factors that operate at the immediate and underlying
levels in determining malnutrition and child mortality. Socio-economic and political factors
are among the major determinants at the basic level.
Ethiopia, being one of the least developed countries in the world, is known for
suffering from recurrent drought and food shortages. Consequently, malnutrition is a major
food security issue, and, as such, the food security strategy is among the major strategies
contributing to the Ethiopia Sustainable Development Poverty Reduction Program (SDPRP).
In addition, however, the importance of adequate nutritio n for good health, and conversely,
the implication of poor nutritional status for susceptibility to other common diseases suggest
that nutrition is an important component within the child and family health sub-components
of health service delivery. The latter would be particularly true in the Ethiopian setting where
nutritional disorders and deficiencies rank among the top problems affecting the population in
general and children and mothers in particular.
Access to adequate preventative and curative health care, safe water supplies, and
sanitation facilities are critical for a healthy living environment. The water supply and
sanitation coverage of the Ethiopian population is still very low. Even though coverage with
basic health services has shown significant change within the recent past as a result of the two
phases of the Health Sector Development Program (HSDP), the available facilities are still
plagued with a lack of trained human resources and a shortage of necessary equipment and
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