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

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Table 6.6: (continued) Agency Intervention Status Médecins Sans Frontières - Greece Reduction of mortality from malaria and malnutrition Active, but approaching closing Timeframe 2005 Main areas Objectives Activities Target Sites Therapeutic and supplementary feeding • Provide nutritional support for malnourished patients. • Provide nutritional support for kala-azar (leishmaniasis) malnourished patients. • Nutritional support for severely and moderate malnourished patients (all ages), affected or not by kala-azar. • Material provided: blanket, mosquito net, soap, mattress chlorinated water and food (3 times per day); • Medical management for kala-azar and malnutrition – nursing care and therapeutic nutritional support. • Diagnosis for kala-azar and related diseases, screening of patients and training of health personnel. Severe and moderate patients (all ages) affected or not by kala-azar Libo Kemkem Woreda, Amhara region Roles definition Patient screening, sample collection (serology). If positive for kala-azar or clinically malnourished, referred for admission to IPD. Partners Training Tools developed Achievements Challenges Sustainability UNICEF, District Health Office, Regional Health Bureau, and Regional DPPC Training on kala-azar, malnutrition, nursing techniques to health personnel in health posts, health centers, and mobile teams, as well as to kebele representatives. Educational material on kala-azar and malnutrition (posters, flip charts, presentation materials). Overall, 300 patients treated. • Sustainable handover of the activities to Ministry of Health. • In the rainy season, difficult access to specific points of some kebeles . Handover of all the activities to Ministry of Health will be followed-up in the first months by MSF. Lessons learnt • Need to define kala-azar endemic area. • In non-migrant workers areas, kala-azar can be treated by an outreach team . • Additional benefit of outreach team is that it enables close follow-up to look for treatment defaulters and borderline results. 186
Table 6.6: (continued) Agency Intervention Status Médecins Sans Frontières - Switzerland Pilot therapeutic feeding project Handed over to MOH. Timeframe 2005 Main areas Objectives Activities Target Sites Therapeutic feeding for severe acute malnutrition, malaria treatment, reduction of mortality from malaria and malnutrition N/A Nutritional surveillance N/A Damot Gale Woreda, Wolayita zone, SNNP Roles definition MOH staff implemented with no salary incentive from the program. Coordination by MSF staff. Partners Training Tools developed Achievements Challenges Sustainability MOH Training in community therapeutic feeding for MOH health workers. Key protocols for use in community therapeutic clinic (CTC) program 600 malnourished children were treated in an in-patient therapeutic feeding center (TFC). 100 of these children transferred to the community therapeutic program. Their nutritional indicators have improved significantly. • Chronic nature of nutrition problem due to overpopulation, high fertility rates, and insufficient land. • MOH unwilling or unable to take on responsibility of treatment of severe malnutrition. • HIV/ AIDS and TB – many children are recurrently or chronically malnourished from these diseases. • Financial barriers - after NGO withdrawal, patients must pay for basic medications and hospitalization costs, which are usually unaffordable. Training of the health workers, in addition to implementing the program within the health structures , has a potential for sustainability. However, health workers are over-worked with small salaries. Consequently, they are reluctant to take on extra responsibilities of those tasks that were previously done by the NGO. Lessons learnt • Positive experience in training of government health workers, but serious concerns about sustainability. Need to look at structural reform of the health system to make a real difference. • Food targeting has been done quite poorly in the past. 187
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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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International initiative Strengths
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• Rate of continued breastfeeding
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Figure 4.17: Community based nutrit
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There is a strong need for enhancin
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supplies. The available facilities
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5.1. Introduction 5.1.1. Conceptual
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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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