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

made by NGOs for the affected children. Women, Water Resources, and other sectoral
Bureaus are also involved in various issues that address the health of women and children.
Health Centers are involved in the handling of severely and moderately malnourished
children by using Community Therapeutic Care (CTC) for admitted children, and Outpatient
Therapeutic Care (OTC) for those who are at a rehabilitation phase. Health extension
workers, home agents, and DAs are frontline workers at village level to make first contact
with households. These community-based workers manage nutrition education, food
handling, and food production.
Integrating efforts that target vulnerable mothers and children is one key area of
concern. While at regional level the Bureau of Agriculture and Rural Development
coordinates the efforts of food security and nutritional matters, sectoral approaches
predominates at more local levels. Making links between activities of the various sectors is an
important area needing immediate attention. Some kind of sustainable mechanism to
institutionalize nutrition activities at both regional and woreda levels is needed to bring
changes in the nutritional status of children and women.
Currently, there is no agency responsible for setting and monitoring malnutrition
related indicators in Ethiopia. The former Ethiopian Nutrition Institute is currently
restructured within the Ethiopian Health and Nutrition Research Institute. With its limited
resources, the team is mainly involved in conducting basic research with inadequate emphasis
to operational issues.
Human resource development in nutrition is weak at country level and nutrition
services are not well institutionalized and are poorly managed at both central and local levels.
The responsibilities of sectoral offices in nutritional matters are not well defined or
institutionalized.
5.5.2. Recommendations
Based on the analysis and conclusions made above, the following recommendations
are put forth:
1) As the Health Service Extension Program is the major vehicle for the implementation
of the HSDP in its third phase, it is critical to create adequate links between this
program and nutrition and food security issues in order to increase the population’s
access to preventative health services that also reduce levels of children’s
malnutrition and morbidity and mortality;
2) There should be mechanisms for instituting a strong continuing education and
retraining component within the HEP on issues including nutrition;
3) Appropriate nutrition surveillance and early warning system should be established at
regional and district levels for mounting appropriate responses as and when required;
4) Nutrition information systems need to be established both in key sectors and, more
importantly, at national level, and harmonized with the activities that monitor the
implementation of SDPRP and MDG related activities;
5) Coordination should be established between this system and the various emergency
related nutritional activities. Similarly, coordination is needed between the various
sectors in order to clearly define their responsibilities and accountabilities for
nutrition actions;
6) The development of a strong nutrition training program within the university system
should be realized for producing the needed manpower for advocating and
implementing nutrition and food security interventions;
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