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

these underlying determinants of the nutritional status of household members are present and
sufficient.
Two important points arise from the nature of the underlying determinants of
nutritional status. First, the three underlying determinants make explicit the cross-sectoral
nature of any comprehensive effort to improve the general nutritional status of the population.
We see, for example, that agriculture is important for the quantity and quality of food
available; education, so that the nutritional care provided is appropriate; health care, so people
can effectively utilize available nutrients; and so on across multiple and most sectors. Any
one sector operating in isolation likely will not succeed in significantly enhancing nutrition
security in a sustainable manner.
Secondly, the overlapping ovals of food, health, and care are meant to imply that
these three are related to each other in complex ways. These inter-relationships must be
analyzed and properly understood in a given context in order to design appropriate actions.
For instance, food secure households may still contain malnourished children because the
burden of women’s agricultural and other work or inadequate knowledge may compromise
the quality of child care. Moreover, efforts to increase household food security may either
increase or decrease child (and maternal) malnutrition, depending upon how these increases in
production are achieved. Similar contingencies exist between care and health.
The quality of the underlying determinants of nutritional status for a household is
dependent to a considerable degree on how available resources are distributed within society.
In examining these issues, here the framework moves from the realm of the individual and
household to the political. The availability of nutrition resources at the household level is
linked to a set of basic determinants, which are themselves a function of how society is
organized in terms of economic structure, political and ideological expectations, and the
institutions through which activities within society are regulated, social values are met, and
potential resources are converted into actual resources. Policy processes by which decisions
are made as to what constitutes the common good and the broad objectives of a society are a
central element of these basic determinants and at the core of where any changes in their
nature – and sustainable improvement in the aggregate nutritional status of a society – will
occur. In many ways, the formulation of the Ethiopia National Nutrition Strategy is situated
within this constellation of elements, seeking to arrange them appropriately so that all
Ethiopians enjoy improved nutritional status as a consequence.
1.2. Nutrition as an Element of Public Policy Concern
The discussion now turns to an argument for why a National Nutrition Strategy is
needed for Ethiopia. This is done by considering the magnitude of the burden malnutrition
imposes on Ethiopian society and the increased potential that would be open to a wellnourished
population. This section ends by considering the interplay between economic
growth and the prevalence of malnutrition.
1.2.1. The economic consequences of malnutrition
In addition to the consequences of malnutrition on non-economic measures of poverty
such as those reflected in the Millennium Development Goals, child malnutrition imposes
substantial economic costs on the economy.
• Malnutrition leads to higher mortality and the loss of the economic potential of the
child.
• Malnourished survivors have higher morbidity, requiring additional health care
services and divert the time of caregivers from productive activities.
• Malnutrition leads to lower cognitive development and, thus, slower learning
throughout life.
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