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

5.4.2. Programs and projects
5.4.2.1. The Health Extension Program (HEP)
The FHD at the MOH is involved in facilitating the mobilization of resources for the
implementation of the HEP. So far, about 2,500 HEP agents have been trained and deployed.
Another 6000 to 7000 candidates are already enrolled in HEP training institutions. It is too
early to say anything about implementation of the HEP. However, some gaps have already
been identified in the training of the HEP agents, especially concerning the nutrition training.
To this effect, additional reference materials have been developed to supplement the nutrition
training modules used in the HEP training. The trainers are also targeted with specific training
to improve their performance. The training modules used in the HEP are considered live
documents that can be improved progressively.
5.4.2.2. Enhanced Outreach Strategy (EOS) for child survival interventions.
The Enhanced Outreach Strategy, which is believed to be an essential bridge for the
HSDP has been recently launched in 325 drought-affected districts. This strategy incorporates
Vitamin A supplementation and nutritional screening for therapeutic feeding of the severely
malnourished children among its key components.
5.4.2.3. Nutrition programs and guidelines
Even though there are occasional food demonstration sessions, nutrition education,
and feeding centre activities carried out in some regions, coordination in the field of nutrition
seems not yet well organized.
The Family Health Department of the Ministry of Health has developed a National
Strategy for Infant and Young Child Feeding (IYCF), as well as a treatment guideline for
micronutrient deficiencies (MOH 2004d). It has also developed a guideline for what Essential
Nutrition Actions (ENA) should be undertaken for impacting nutrition. The ENA targets
infant and young children under the age of two years, as well as women of reproductive age
as main beneficiaries. The ENA, which can use the health services as their entry points,
include promotion of optimal breastfeeding as well as complementary feeding at six months,
nutritional care of sick children during and after illness; improving women’s nutrition,
controlling anemia, Vitamin-A and iodine deficiencies. The National Strategy on
Micronutrient Deficiency Control, and Management of Severe Malnutrition guidelines have
been prepared and distributed for utilization.
5.4.2.4. NGO and private sector health activities.
UNICEF has been the most active on nutrition issues among the multi-lateral NGOs
operating in the country. Recently, it has donated salt iodizing machines that have been
distributed to Ethiopian Salt Producer’s Association for universal salt iodization.
NGOs like Goal, Save the Children Fund (USA), and the World Food Programme are
engaged in the provision of food aid during emergencies and the rehabilitation phase after
emergencies. They are also involved in human resource capacity building and developmental
activities related to food production and utilization.
5.4.3. Broad evaluation of the nutrition oriented strategies and programs.
As nutrition policy and program options should be based on a generally accepted,
research-proven, conceptual framework thathas been tested in an appropriate environment,
strategies to improve nutritional needs should go beyond the conventional approach of
providing services through traditional maternal and child health care programs. Instead, a
more comprehensive life cycle approach is neededthat addresses all the factors within the
conceptual framework. Currently, there is an emerging consensus that health and nutritional
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