An assessment of the causes of malnutrition in Ethiopia: A ...
An assessment of the causes of malnutrition in Ethiopia: A ...
An assessment of the causes of malnutrition in Ethiopia: A ...
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Table 6.6: (cont<strong>in</strong>ued)<br />
Agency<br />
Intervention<br />
Nutrition Unit, Family Health Department, M<strong>in</strong>istry <strong>of</strong> Health<br />
Micronutrient deficiency control<br />
Timeframe s<strong>in</strong>ce 1995<br />
Ma<strong>in</strong> areas<br />
Objectives<br />
Activities<br />
Vitam<strong>in</strong> A, Iod<strong>in</strong>e, Iron<br />
Elim<strong>in</strong>ate micronutrient deficiencies<br />
• Currently conduct<strong>in</strong>g basel<strong>in</strong>e survey on <strong>the</strong> three micronutrient deficiencies.<br />
• Vitam<strong>in</strong> A capsule distribution as part <strong>of</strong> EPI+. Post-partum supplementation with<strong>in</strong> 45<br />
days from delivery. Child (6-59 months) supplementation campaigns twice a year<br />
(June and October). Vitam<strong>in</strong> A food fortification (<strong>in</strong> stand-by) Assessments conducted<br />
to identify most effective food vehicle. Production mach<strong>in</strong>eries and fortificants<br />
procured (UNICEF). One sugar factory selected for pilot. Diet diversification: IEC<br />
brochures and advocacy meet<strong>in</strong>gs. Information on Vitam<strong>in</strong> A <strong>in</strong>cluded <strong>in</strong> <strong>the</strong> HEP<br />
tra<strong>in</strong><strong>in</strong>g module on nutrition.<br />
• Iron: iron/folic supplementation.<br />
• Salt iodization: plans underway, 10 mach<strong>in</strong>es for fortification (mid-level capacity)<br />
distributed to factories and tra<strong>in</strong><strong>in</strong>g conducted (<strong>in</strong> Afar with <strong>in</strong>vestors association).<br />
Iodization has started. However, producers compla<strong>in</strong> about market – fear <strong>of</strong> not<br />
cover<strong>in</strong>g costs. NGOs have <strong>of</strong>fered to buy production. Big producers are ready to start<br />
fortification <strong>in</strong> September 2005.<br />
Target Children under 5<br />
Sites<br />
Vitam<strong>in</strong> A supplementation is <strong>in</strong> all <strong>of</strong> Amhara. This will be extended to Oromia <strong>in</strong><br />
September 2005.<br />
Roles def<strong>in</strong>ition Health personnel (facility-based and Health Extension Agents)<br />
Partners<br />
Tra<strong>in</strong><strong>in</strong>g<br />
Tools<br />
developed<br />
Challenges<br />
USAID, UNICEF, MOST (USAID program).<br />
National micronutrient committee <strong>in</strong>cludes membership <strong>of</strong> M<strong>in</strong>istry <strong>of</strong> Trade, M<strong>in</strong>istry <strong>of</strong><br />
M<strong>in</strong>es, universities, <strong>Ethiopia</strong>n Quality and Standards Authority, UN agencies, NGOs.<br />
EHNI (quality control) and food factories (and <strong>the</strong>ir research centers) tra<strong>in</strong>ed <strong>in</strong><br />
Guatemala.<br />
National micronutrition control guidel<strong>in</strong>es for Vitam<strong>in</strong> A, iod<strong>in</strong>e, and iron.<br />
• Vitam<strong>in</strong> A supplementation: EPI+ covers under-ones, while Vitam<strong>in</strong> A supplementation<br />
targets under-fives. More outreach strategies are needed.<br />
• High rickets prevalence, but vitam<strong>in</strong> D is not <strong>in</strong>cluded <strong>in</strong> strategy.<br />
• Salt iodization: Until 1992, iodized salt was available through Eritrea. Now us<strong>in</strong>g<br />
Djibouti salt, which is not totally iodized.<br />
Susta<strong>in</strong>ability<br />
Vitam<strong>in</strong> A fortification: There is no legislation to oblige producers to fortify <strong>the</strong> foods <strong>the</strong>y<br />
produce. More legislation and advocacy is needed.<br />
Lessons learnt • Sugar identified as most effective food vehicle for Vitam<strong>in</strong> A supplementation, due to<br />
centralized state-owned production, so it is easier to plan/coord<strong>in</strong>ate/supervise.<br />
• Poor understand<strong>in</strong>g on food fortification<br />
• Concerns were raised on costs <strong>of</strong> fortification <strong>of</strong> sugar ($0.02/kg) and on consumption<br />
(a CSA report mentioned that only 50 percent pop especially <strong>in</strong> urban areas consume<br />
sugar) so advocacy was conducted by M<strong>in</strong>istry <strong>of</strong> Health.<br />
• Health Extension Package (HEP) has been identified as most cost-effective delivery<br />
strategy for Vitam<strong>in</strong> A supplementation.<br />
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