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

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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; 160
7) A mechanism should be developed to define and institutionalize the integration in a sustainable manner activities related to food security with nutrition services; 8) Programs should be developed within the education sector on nutrition. This includes nutrition courses for primary and secondary schools, as well as school-lunch programs in kindergartens and day care centers; 9) The coverage of Essential Nutrition Actions Program should be extended and integrated with family planning, reproductive health, IMCI and HIV/AIDS related activities; 10) A mechanism should be established for the education of mothers and all household members for bringing about behavioral changes in understanding and managing nutritional activities; and 11) Research programs should also be developed for effective monitoring of the extent and the progress in the control of the nutrition problems with capacity building for continued in-depth and applied nutrition related studies. 161
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An assessment of the causes of maln
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• Bantirgu Hailemariam coordinate
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3.4. National and Regional Trends:
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LIST OF TABLES Table 2.1: Child stu
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LIST OF ACRONYMS ADLI AGOA AIDS BCC
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Figure 1.1: Stunting among children
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these underlying determinants of th
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experimental body of evidence that
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water can have significant impact o
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2.1. Introduction In the early 1960
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violating the basic tenets presente
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Table 2.3: Regional profile of stun
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A rich food through popularization
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key tenet in the process of identif
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Basic Causes Major Features High im
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commodity trading is the most signi
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Table 2.9: Gross primary enrollment
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following and in alliance with the
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• Accept that agricultural develo
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the other practices that need to be
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CHAPTER 3: FOOD SECURITY AND MALNUT
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Afar in 2000 was 12.6 percent and 5
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3.1. Introduction The economic grow
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In a more technical way, it is diff
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differently, it is important to acc
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households will not be as difficult
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the drought prone areas, the rain f
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insecure, these activities will als
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viewed as a proxy for household foo
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Figure 3.3: Per capita food product
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Intermediate means of transport suc
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educated, environmentally conscious
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1995-96 revealed that ‘the greate
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works are key instruments to lay do
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due to inappropriate land mismanage
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3.6.3.5. HIV/AIDS This disease is w
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coordinates the different implement
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conception through early pregnancy
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households who depend on purchased
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• Improve rural radio infrastruct
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3.7.3.6. Improve rural market infra
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CHAPTER 4: CARE AND MALNUTRITION IN
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household allocation; 5) workload a
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lack of national nutrition strategy
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children between 6 and 24 months. T
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Care was recognized as one of the u
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Figure 4.1: Risk of death in infant
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Table 4.2: Present discount values
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Figure 4.3: Factors that affect the
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Box 4.2: Reasons why PLWHA are vuln
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Figure 4.7: Risk of mother to child
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arely provide this kind of benefit.
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Figure 4.8: The extended model of c
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4.3.1.2. Recognizing symptoms of il
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the direction of the growth curve i
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Figure 4.13: Prevalence of stunting
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from poor exposure of children to l
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4.3.3.4. Response to food security
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Page 131 and 132: Table 4.4: Analysis of care conside
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Page 135 and 136: International initiative Strengths
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Page 144 and 145: supplies. The available facilities
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Page 156 and 157: The interventions that make up this
Page 158 and 159: conferences. To this effect, a nati
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Page 162 and 163: Table 5.1: Prevalence of diarrhea a
Page 164 and 165: Figure 5.3: Trends in latrine cover
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Page 170 and 171: 5.4.2. Programs and projects 5.4.2.
Page 175 and 176: CHAPTER 6: INSTITUTIONAL FRAMEWORK
Page 177 and 178: interventions in Ethiopia, includin
Page 179 and 180: 6.2. Challenges and Lessons Learnt
Page 181 and 182: Training Post-secondary training is
Page 183 and 184: Table 6.6: (continued) Agency Inter
Page 203 and 204: Achievements Challenges Sustainabil
Page 205 and 206: Berhane G. 1995. Nutrition surveill
Page 207 and 208: Ethiopian PROFILES Team & AED/Linka
Page 209 and 210: Middlebrook, P. 2002. Social protec
Page 211 and 212: Raisin, J. 2001b. Improving food se
Page 213: Yamano, T., H. Alderman, & L. Chris
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