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

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Table 6.6: (continued) Agency Intervention Timeframe Main areas Objectives Activities Target Sites Ethiopian Health and Nutrition Research Institute (EHNRI), Ministry of Health Various studies Merger of 3 institutions since 1995 – former Ethiopian Nutrition Institute existed from 1952 – 1995. Basic research as opposed to previous basic & applied research To conduct research on diseases of public health importance To undertake nutrition research with the view to assess nutritional impact in Ethiopia To carry out research on traditionally used drugs & medical practices alongside modern drug research thereby supporting activities for health improvement in the country Studies: • Micronutrient study on deficiency prevalence (especially vitamin A, iodine, iron). Undertaken in all regions except Somali region. Results should be ready by end-2005. • Completed mother-child health study on breast-feeding and complementary feeding. • Maternal malnutrition study now being conducted. • Food stud yon technology introduction and diet-related diseases (cardiovascular diseases) and food analysis. This is being done in cooperation with food industries. • Training: used to conduct training for government officials but then decision taken to teach communities, a manual was developed. However, a big gap in training for government officials was left. Communities at various levels Federal level only Roles definition A branch of the Ministry of Health Partners Training Tools developed Challenges Sustainability MOH, MOARD, DPPC, ESTC, ERO, Universities, UN, NGO, Training based on request Previous ENI training tools Mandate was reduced to research only, due to lack of resources. Work force shortages and consequent limited capacity. Government institution Lessons learnt Current EHNRI is the merger of three institutions but the epidemiology of nutrition in Ethiopia would require a larger mandate, similar to that of the old ENI. The NNS could open a dialogue on re-launching its mandate. 174
Table 6.6: (continued) Agency Intervention Food Security Bureau, Ministry of Agriculture and Rural Development Productive Safety Nets Program (PSNP) Timeframe since 2005 Main areas Objectives Activities Target Sites Poverty reduction Enhance productivity while delivering cash transfers or food aid. Nutrition is not an explicit component of PSNP • Safety Net Activities: i) Labor-intensive public work to provide grants to households whose adults participate in public works. ii) Direct support through grants to households who are labor-poor and cannot undertake public works. • Institutional Support: i) capacity building at community level to strengthen beneficiary identification; ii) strengthening of local level planning; financial management, procurement, and technical training at woreda and regional level to ensure adequate sub-projects design and rapid response mechanisms; and iii) support to the development of an M&E framework and program Management Information System Chronically food insecure households within food insecure woredas. Beneficiaries include: orphans, pregnant and lactating mothers, elderly households, other labor-poor, high risk households with sick individuals (such as people living with HIVIAIDS), femaleheaded households with young children Tigray, Amhara, Oromiya, SNNP, rural Harari and Dire Dawa Roles definition Food Security Bureau at regional and woreda levels Partners Training Tools developed Challenges Sustainability World Bank, USAID, DfID, WFP, DCA, CID A, EU Training of Trainers system with cascade of training from regional to kebele levels. Program Implementation Manual • There may be fragmentation and limited communication across groups, especially since safety nets were introduced (a new structure in addition to DPPC). • Hierarchical process (region, zone, woreda) implies that there is considerable information available, but in a fragmented form because of lack of integration in the information system. Government does not intend for this to be a permanent program. Lessons learnt N/A 175
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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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4.3.6. Time and energy expenditure
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Table 4.3: Care focused initiatives
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together. This demands an integrate
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In an emergency, therefore, care an
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• Enhance women’s capacity for
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Table 4.4: Analysis of care conside
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Sector/ Office Strength Weakness Op
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Page 144 and 145: supplies. The available facilities
Page 146 and 147: 5.1. Introduction 5.1.1. Conceptual
Page 148 and 149: access to a basic package of qualit
Page 150 and 151: Integrating nutrition interventions
Page 152 and 153: Although the coverage of ENA traini
Page 154 and 155: Box 5.1: Household and Community In
Page 156 and 157: The interventions that make up this
Page 158 and 159: conferences. To this effect, a nati
Page 160 and 161: with the engineering aspect of wate
Page 162 and 163: Table 5.1: Prevalence of diarrhea a
Page 164 and 165: Figure 5.3: Trends in latrine cover
Page 166 and 167: Institutional arrangements are also
Page 168 and 169: ehavior are integrated and supplied
Page 170 and 171: 5.4.2. Programs and projects 5.4.2.
Page 172 and 173: made by NGOs for the affected child
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 185: 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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