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 ...
Table 6.6: (continued) Agency Intervention Disaster Prevention and Preparedness Commission Emergency nutrition coordination unit (ENCU) & Early warning department Timeframe Since 1975 Main areas Objectives Activities Target Sites Emergency surveillance Strengthen the early warning system. The ENCU is expanding, and its mandate has been changed. DPPC activities are to include more nutrition analysis and links to health. Coordination of key emergency nutrition actors through bi-weekly meetings. No service delivery, but coordination and initiative taking – calling to action. Data collection and management. Nutrition information is to be used to identify hot spots to guide decision-making on emergency nutrition. Strengthening information collection, quality assurance, analysis, and decision-making. Uses information from EOS, NGOs, and admission rates of therapeutic feeding centers, among other sources. Food insecure woredas Several hundred distribution sites Roles definition No implementation program. Rather ENCU relies on partners: EOS (data & supplemental feeding) and NGOs (data). DPPC acts more to build a network and for coordination. The regions are autonomous to conduct their DPPC activities. Federal level acts as advisory and technical support upon request (e.g. emergency assessments). Partners Training Tools developed Challenges Sustainability NGOs, WFP, UNICEF. Good coordination established through bi-weekly meeting and regular consultation and communication. Provided regular training on national disaster policy, disaster area assessment, nutrition survey methods, data management, and computer skills. • Nutritional assessment guidelines for all partners (standard methodology). • Data collection format (reporting format). • Emergency nutrition intervention manual. • Working with Tulane University, a nutritional database for the country is now under development. • Quality, timeliness, and coverage of data and information. • Division of labor, defining mandates and accountabilities with ministries, especially MOH, MOARD, and the Food Security Bureau. • In the past, limited resources, but now UNICEF paying for staff and operational costs. • Duplication of or uncoordinated data collection. NGOs take initiative but without communicating with others. Considerable room for improvement in data quality. • Price monitoring: by the Market Monitoring Unit faces financial constraints and lack of electricity in many areas. • Political: some areas reluctant to show good/bad data. • Action is taken where actors are present. • EOS workers have received little training and supervision is limited. Need better supervision and quality control. • Targeting often problematic with emergency needs estimated based on macro figures then broken down by woredas in a participatory manner, but because community quota is based on aggregate figures there is either dilution or surplus of resources. • Lack of capacity to run programs. Often long delays between detection of food insecurity and action. Lessons learnt Few lessons learnt, as too busy with actions. Some workshops conducted to evaluate regions ’ data collection on annual or bi-annual basis. 178
Table 6.6: (continued) Agency Intervention Status Timeframe Main areas Objectives CARE Micronutrient and Health (MICAH) Project active Micronutrients since 1997, but full package of Essential Nutrition Actions (ENA) since 2003. prevention Reduce malnutrition (micronutrient and protein-energy) in mothers and children through most cost-effective means, and build capacity of local institutions to sustain programs. Activities • Vitamin A distribution every 6 months to children ages between 6 months and 14 years and pregnant and lactating women • Deworming • Iron/folic acid supplementation to pregnant women during the second and third trimesters. • Diet diversification – Behavioral change communication and distribution of fruits and vegetable seeds and dairy goats on nominal fee basis. Target Sites Children under 15 and pregnant and lactating women. Oromiya: Eastern and Western Haraghe Roles definition Close collaboration with government (federal, region, woreda). Woreda-level: extension agents (diploma level employed by CARE), health workers (nurses, sanitarians employed by CARE), and development workers. Partners Training Tools developed Achievements Challenges Sustainability NGO network (CARE, World Vision (coordinator), Family Health International, KHC, FTC, and CPAR) plus Ministries of Health, Agriculture, and Education, and regional and woreda bureaus. Training for high-level managers and community members. 5 or 6-day training sessions. Participants include health workers (all categories including MDs, nurses, health officers, and the first batch of HEAs) and key community leaders, including administrators at the woreda level. Information, education, and communication: Radio spots, audio cassette for communities and extension agents, posters, flip charts, t-shirts Vitamin A supplemented twice a year for 7 years, deficiency eliminated in participating pre-schools. Iron/folic acid supplements distributed to mothers for last 7 years twice a year. Water points developed, over 39 percent of population in participating areas has access to water supply. N/A N/A Lessons learnt N/A 179
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Table 6.6: (cont<strong>in</strong>ued)<br />
Agency<br />
Intervention<br />
Status<br />
Timeframe<br />
Ma<strong>in</strong> areas<br />
Objectives<br />
CARE<br />
Micronutrient and Health (MICAH) Project<br />
active<br />
Micronutrients s<strong>in</strong>ce 1997, but full package <strong>of</strong> Essential Nutrition Actions (ENA) s<strong>in</strong>ce<br />
2003.<br />
prevention<br />
Reduce <strong>malnutrition</strong> (micronutrient and prote<strong>in</strong>-energy) <strong>in</strong> mo<strong>the</strong>rs and children through<br />
most cost-effective means, and build capacity <strong>of</strong> local <strong>in</strong>stitutions to susta<strong>in</strong> programs.<br />
Activities • Vitam<strong>in</strong> A distribution every 6 months to children ages between 6 months and 14<br />
years and pregnant and lactat<strong>in</strong>g women<br />
• Deworm<strong>in</strong>g<br />
• Iron/folic acid supplementation to pregnant women dur<strong>in</strong>g <strong>the</strong> second and third<br />
trimesters.<br />
• Diet diversification – Behavioral change communication and distribution <strong>of</strong> fruits and<br />
vegetable seeds and dairy goats on nom<strong>in</strong>al fee basis.<br />
Target<br />
Sites<br />
Children under 15 and pregnant and lactat<strong>in</strong>g women.<br />
Oromiya: Eastern and Western Haraghe<br />
Roles def<strong>in</strong>ition Close collaboration with government (federal, region, woreda). Woreda-level: extension<br />
agents (diploma level employed by CARE), health workers (nurses, sanitarians employed<br />
by CARE), and development workers.<br />
Partners<br />
Tra<strong>in</strong><strong>in</strong>g<br />
Tools<br />
developed<br />
Achievements<br />
Challenges<br />
Susta<strong>in</strong>ability<br />
NGO network (CARE, World Vision (coord<strong>in</strong>ator), Family Health International, KHC, FTC,<br />
and CPAR) plus M<strong>in</strong>istries <strong>of</strong> Health, Agriculture, and Education, and regional and<br />
woreda bureaus.<br />
Tra<strong>in</strong><strong>in</strong>g for high-level managers and community members. 5 or 6-day tra<strong>in</strong><strong>in</strong>g sessions.<br />
Participants <strong>in</strong>clude health workers (all categories <strong>in</strong>clud<strong>in</strong>g MDs, nurses, health <strong>of</strong>ficers,<br />
and <strong>the</strong> first batch <strong>of</strong> HEAs) and key community leaders, <strong>in</strong>clud<strong>in</strong>g adm<strong>in</strong>istrators at <strong>the</strong><br />
woreda level.<br />
Information, education, and communication: Radio spots, audio cassette for communities<br />
and extension agents, posters, flip charts, t-shirts<br />
Vitam<strong>in</strong> A supplemented twice a year for 7 years, deficiency elim<strong>in</strong>ated <strong>in</strong> participat<strong>in</strong>g<br />
pre-schools. Iron/folic acid supplements distributed to mo<strong>the</strong>rs for last 7 years twice a<br />
year. Water po<strong>in</strong>ts developed, over 39 percent <strong>of</strong> population <strong>in</strong> participat<strong>in</strong>g areas has<br />
access to water supply.<br />
N/A<br />
N/A<br />
Lessons learnt N/A<br />
179
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