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

More documents

Recommendations

Info

Table 6.6: (continued) Agency Intervention Status Timeframe Main areas Objectives Activities Target Sites Concern Ethiopia Community-based therapeutic care (CTC) active March 2003 - present Therapeutic programmes Treat severe acute malnutrition; build capacity of the Ministry of Health to run programme with minimal external support. Provide supplementary feeding. • Vaccination • Sick child consultation: treat severe malnutrition and any medical complications. • Nutritional surveillance – monthly nutrition surveys, depending on the situation. • Food distribution – distribute ready-to-use-therapeutic food (RUTF) & supplementary food rations Severely malnourished under-fives. South Wollo - Offa woreda; Wolayita - Damot Weyde woreda; Bale Zone. Roles definition Ministry of Health does most of the work for the outpatient therapeutic program, with Concern Ethiopia staff supporting. Volunteers identified to screen and refer children to the programme & support children registered in the program. Partners Training Tools developed Achievements Key partner is Ministry of Health. Also work with DPPC, WFP, and UNICEF. For Ministry of Health and Concern staff in management of malnutrition. Training for volunteers in identification of malnutrition and appropriate health seeking behavior. Normal anthropometric measuring tools - particularly MUAC at village level. Most of the activities of the outpatient therapeutic program are now being carried out by the lower level Ministry of Health workers in all Concern CTC programs. Challenges • Ensuring a sustainable referral system . • High government staff turnover. • Ensuring a sustainable logistic and supply of RUTF. • Meager budget of the Ministry of Health. Sustainability Requires adequate training of staff according to national guidelines . Need to ensure continuous availability of affordable and accessible RUTF Build capacity of Ministry of Health to sustain the service in non-emergency times. Lessons learnt • Need for advocacy work to incorporate CTC in the IMCI protocol and in national guidelines, and to involve national health institutions. • Critical need to ensure sustainable and affordable supplies. • Commitment of UNICEF to the program has been central. • Initial s teps in starting up the program will affect its sustainability. For example, if start paying per diems to the Ministry of Health staff then will have to continue payment. If can convince Ministry of Health that treatment of malnourished children is part of their regular workload then more likely to ensure some sustainability. • Time load of volunteers. People are very busy. Unrealistic to expect someone to be able to give you more than half a day a week of their time for free. • The many programmes relating to nutrition and primary health care in Ethiopia should co-ordinate better about who is doing what to avoid duplication or undermining each other’s programs. 180
Table 6.6: (continued) Agency Intervention Status Essential Services for Health in Ethiopia (ESHE) Child survival and health system strengthening active Timeframe 2003 to 2008 Main areas Objectives Activities Target Sites Expanded Programme on Immunization (EPI), nutrition, integrated management of childhood illness (IMCI) and health care financing To build capacity of the basic health system to promote key child survival interventions. ESHE is not providing direct service on its own, but supports the government system and health facilities . Vaccination. Healthy child consultation. Under-five children and their mothers In 64 Selected Woredas in SNNP, Oromiya, and Amhara. Roles definition At community level Community Health Promoter (volunteers ) are selected by the community and trained to be role models and to pass messages to their neighbors. Partners Training Tools developed Achievements Challenges Sustainability Federal MOH, Regional Health Bureaus , Zonal, and Woreda Health offices. EPI, nutrition and IMCI Training manuals developed in EPI, nutrition and IMCI. Frontline health workers and community volunteers are given training, with intensive follow up. Over 9,000 community health promoters have been trained. In nutrition and EPI, over 300 and over 1,600 health workers trained, respectively. High turn over of health staff and shortage of health work force. If the capacity of the regional, zonal and woreda health management staff is put in place adequately. Lessons learnt • Good collaboration • Any training undertaken needs to be followed up by on-job training or mentoring. Supportive supervision by the health system is important to ensure the implementation of skills and knowledge gained through training. 181
Page 1:
An assessment of the causes of maln
Page 4 and 5:
• Bantirgu Hailemariam coordinate
Page 6 and 7:
3.4. National and Regional Trends:
Page 8 and 9:
LIST OF TABLES Table 2.1: Child stu
Page 10:
LIST OF ACRONYMS ADLI AGOA AIDS BCC
Page 14 and 15:
Figure 1.1: Stunting among children
Page 16 and 17:
these underlying determinants of th
Page 18 and 19:
experimental body of evidence that
Page 20 and 21:
water can have significant impact o
Page 22 and 23:
2.1. Introduction In the early 1960
Page 24 and 25:
violating the basic tenets presente
Page 26 and 27:
Table 2.3: Regional profile of stun
Page 28 and 29:
A rich food through popularization
Page 30 and 31:
key tenet in the process of identif
Page 32 and 33:
Basic Causes Major Features High im
Page 34 and 35:
commodity trading is the most signi
Page 36 and 37:
Table 2.9: Gross primary enrollment
Page 38 and 39:
following and in alliance with the
Page 40 and 41:
• Accept that agricultural develo
Page 42 and 43:
the other practices that need to be
Page 45 and 46:
CHAPTER 3: FOOD SECURITY AND MALNUT
Page 47 and 48:
Afar in 2000 was 12.6 percent and 5
Page 49 and 50:
3.1. Introduction The economic grow
Page 51 and 52:
In a more technical way, it is diff
Page 53 and 54:
differently, it is important to acc
Page 55 and 56:
households will not be as difficult
Page 57 and 58:
the drought prone areas, the rain f
Page 59 and 60:
insecure, these activities will als
Page 61 and 62:
viewed as a proxy for household foo
Page 63 and 64:
Figure 3.3: Per capita food product
Page 65 and 66:
Intermediate means of transport suc
Page 67 and 68:
educated, environmentally conscious
Page 69 and 70:
1995-96 revealed that ‘the greate
Page 71 and 72:
works are key instruments to lay do
Page 73 and 74:
due to inappropriate land mismanage
Page 75 and 76:
3.6.3.5. HIV/AIDS This disease is w
Page 77 and 78:
coordinates the different implement
Page 79 and 80:
conception through early pregnancy
Page 81 and 82:
households who depend on purchased
Page 83 and 84:
• Improve rural radio infrastruct
Page 85 and 86:
3.7.3.6. Improve rural market infra
Page 87 and 88:
CHAPTER 4: CARE AND MALNUTRITION IN
Page 89 and 90:
household allocation; 5) workload a
Page 91 and 92:
lack of national nutrition strategy
Page 93 and 94:
children between 6 and 24 months. T
Page 95 and 96:
Care was recognized as one of the u
Page 97 and 98:
Figure 4.1: Risk of death in infant
Page 99 and 100:
Table 4.2: Present discount values
Page 101 and 102:
Figure 4.3: Factors that affect the
Page 103 and 104:
Box 4.2: Reasons why PLWHA are vuln
Page 105 and 106:
Figure 4.7: Risk of mother to child
Page 107 and 108:
arely provide this kind of benefit.
Page 109 and 110:
Figure 4.8: The extended model of c
Page 111 and 112:
4.3.1.2. Recognizing symptoms of il
Page 113 and 114:
the direction of the growth curve i
Page 115 and 116:
Figure 4.13: Prevalence of stunting
Page 117 and 118:
from poor exposure of children to l
Page 119 and 120:
4.3.3.4. Response to food security
Page 121 and 122:
4.3.6. Time and energy expenditure
Page 123 and 124:
Table 4.3: Care focused initiatives
Page 125 and 126:
together. This demands an integrate
Page 127 and 128:
In an emergency, therefore, care an
Page 129 and 130:
• Enhance women’s capacity for
Page 131 and 132:
Table 4.4: Analysis of care conside
Page 133 and 134:
Sector/ Office Strength Weakness Op
Page 135 and 136:
International initiative Strengths
Page 137 and 138:
• Rate of continued breastfeeding
Page 139 and 140:
Figure 4.17: Community based nutrit
Page 141: There is a strong need for enhancin
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 191: 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
show all

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

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?