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

ehavior are integrated and supplied to the community and when they are sustained as a
service as far as they are important to the beneficiaries. The countrywide implementation of
HSDP and HEP hopefully will bring some changes in the development of a better, healthier
environment, particularly in terms of access to safe and clean water and sanitation services.
Despite the ongoing discussion of integrating water and sanitation at a higher level,
very little is done at the community level. In fact, most of the water projects are given the
name water and sanitation and are designed with the aim of bringing a health impact during
implementation. However, most of these projects fail to address the sanitation issue. Policies,
proclamations, and regulations are already in place, but they lack clarity on the establishment
of an institutional framework.
5.3.7. Safety issues and their link to malnutrition
Food is an element of our environment that can significantly diminish or intensify
risk of communicable diseases. Children, uneducated adults, and elders are the most
vulnerable to exposure to unhygienic food. Given the circumstances prevailing with poor
hygiene found throughout the country, the consumption of contaminated food is likely.
Gastroenteritis and other forms of diarrheal diseases are the products of exposure to infected
foodstuffs. Food safety is maintained at the levels of households, markets, food
establishments, and food production centers. Individual family member’s concern is relevant
in the consumption of hygienic food. This depends on various factors, with income and
awareness to hygiene being the major ones. The Ministry of Health, with its branches at
regional level, undertakes the responsibility of accounting for the safety of food that is for
public use. The food processing factories and public food establishments are inspected by
MOH staff trained to evaluate the hygienic conditions of food processing and production.
The promotion of hygiene education at household level is one key intervention for the
improvement of food hygiene. If mothers are well oriented in the hygienic handling of food
sources, potential disease transmission and diarrhea, in particular, can be significantly
reduced. The health extension service potentially can bring major changes in the protection of
food to safeguard vulnerable groups of family members from the transmission of food borne
diseases.
5.4.1. Policies
5.4. Strategies and Programs
The Ethiopian Health Sector Development Program (HSDP) is a 20-years effort to
achieve universal access to essential primary health care services by 2017. Based on the
concept of the Sector Wide Approach to Development (SWAP), the overall objective of the
Ethiopian HSDP is to improve the health status of the population, resulting in increasing the
productivity of the population, decrease household expenditures on health, increasing
opportunities for the productive investment of these resources, contribute to the alleviation of
poverty, and support socioeconomic development.
The formulation and implementation of a food and nutrition policy was recommended
at the evaluation of the HSDP-I that categorized nutrition as a crosscutting issue (MOH
2003a). Actually, the Family Health Department of the MOH had drafted a “National
Nutrition Policy” in 2003 for the purpose of discussion (MOH 2003b). The draft policy was
meant to be a framework for demonstrating nutrition as a crosscutting issue involving key
stakeholders working in many different sectors and development programs. As a policy
evolving within the context of the country’s Sustainable Development Poverty Reduction
Program (SDPRP), it was intended to guide the formulation of programs that effectively
address the causes of malnutrition through a harmonized and coordinated approach.
Coordination in the field of nutrition seems not yet well organized. A nutrition unit has also
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