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

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commodity trading is the most significant for nutrition. The focus on international trade is primarily because the export sector in Ethiopia has been dominated over the past decades by primary commodities of agricultural origin. Agricultural exports accounted for about 90 percent of all exports of Ethiopia of which a single commodity, coffee, provides 40 to 60 percent of the export earnings. However, the persistent decline in prices of coffee on the world market over the past years has depressed the prospects of growth in this sector. Over the past two years, cut flower exports have increased, and the government has initiated various incentive schemes for promoting the export of goods and services. As a result, total export earnings during fiscal year 2003/04 reached US$ 601 million, which was an increase of 24.4 percent over the preceding fiscal year. The share of coffee in total export earnings increased to 37.2 percent in 2003/04 from 34.2 percent in 2002/03 (MOFED 2004, 13). The total import bill in 2003/04 reached US$ 2,587 million showing a growth rate of 39.4 percent over the previous fiscal year. The major import items include consumer goods, capital good and semi-finished goods, which constituted 34.6, 33.9, and 16.8 percent of total imports, respectively (ibid, 15). The current deficit level of external trade is considered high and the component of consumer goods, partly food items, in the import bill is disturbingly large. In the newly emerging international assistance packages, major donors encourage the export of commodities from Africa. Two significant examples of this are the Everything But Arms (EBA) program initiated by the EU and the AGOA program initiated by the USA. These initiatives are commendable, despite the fact that significant gains from European markets could not be realized due to quality standards and other restrictions. Such efforts to improve export-market linkages offer important possibilities for increased household incomes and, thus, better nutrition. The link between international factors and the nutritional status of Ethiopian households is most clearly seen in the sharp decline in the world price of coffee over a threeyear period prior to 2003/04, resulting in what is known as “green hunger” in some parts of the SNNP region. During this period, the area looked green and productive. However, due to sharp falls in the global price for coffee, farmers’ returns declined dramatically and many lost most of their purchasing power. Due to a lack of savings or reserves from past earnings, the communities faced food shortages and hunger. As a result, acute malnutrition was experienced in the coffee growing areas, which was later averted in 2003/04 when the world price of coffee recovered and revenue from coffee showed an increase of about 28 percent as compared with the previous year. The importance of the positive relationship between a favorable balance of payments and nutritional status cannot be overlooked. Thus, diversification of export of goods and services that are targeted for the international market should be pursued. Condit ions should be created to attract foreign direct investment in the production of goods and services that meet international standards. 2.3.1.2. National level The macro and cross-cutting issues, which are likely to create the largest impact on nutritional status, are concentrated at the national level of analysis. These factors or issues include a) natural resource endowment, b) human resource development, c) institutions, and d) development commitment and priorities. nutrition in Ethiopia. However only four of the factors with international dimensions have been selected here. 22
a) Natural resource endowment It is true that the country is endowed with varied and plentiful natural resources – land, water, forest, wildlife, and climatic resources. However, the potential contributions of these natural resources towards the well-being of the population have not been fully realized. Moreover, these resources are being seriously degraded. The traditional agro-climatic zones based on climate and topography of the country includes Kola (hot to warm arid and semiarid), Woina Dega (Warm to cool moist midlands), and Dega (cold to very cold highlands) 7 . The arid and semi-arid zones (below 1600 masl) account for nearly 40 percent of total area of the country and are found in the northern, northeastern and eastern lowland regions. The humid and semi-humid zones, covering about 7 percent of the total area are located in the southern and western mid to high altitude parts of the country, where most of the remaining forests, trees and forest coffee and wildlife are concentrated. The sub-moist, moist and sub-humid zones, covering about 54 percent of the country, consist of the northern, central, western and eastern mid to high altitude regions. With a growing period of 61 to 240 days, these zones are the most important rain-fed agriculture and livestock production areas and accommodate over 80 percent of the rural population. These zones also cover the highland areas, which are exposed to serious natural resource degradation (Solomon 1993). Because of the cultivation methods used for cereal production and the erratic nature of the rainfall, erosion of the topsoil is massive, estimated at up to 1,900 million tons per year. The water resources of the country are considered abundant with major transboundary rivers and numerous steams. About 2.5 million ha are identified as suitable for irrigation in the lowland areas of the arid and semi arid zone. However, only 5 to 10 percent is used at present mainly due to high infestation of malaria and other diseases and underdeveloped infrastructure. There is a huge potential for hydropower generation, but less than one percent is used at present. The forest resources are fast dwindling because of clearing for cultivation expansion and use of wood for construction and fuel. The wildlife in the forest sanctuary is also disappearing along with the forest. Due to the great disturbance of the agroecology, particularly in the highlands, climatic variability is increasingly felt. With the degradation process unabated, coupled with the high level of population growth and use of traditional technology, unsustainable use of natural resources ultimately will result in increased exposure to food insecurity and illness and finally to malnutrition 8 . b) Human resources development Ethiopia has the second largest population in sub-Saharan Africa, presently about 70 million. About 84 percent reside in rural areas, earning their livelihood from the agricultural and livestock sector. Over the past several decades, the structure of the economy has changed little. In nearly all indicators of the Human Development Index (UNDP), the country is reported as close to the bottom of the Least Developed Countries of the world. Ethiopia’s literacy rate has remained low, reaching 29 percent in 1999/00, and the country is still faced with problems in producing the required manpower at all levels. Significant achievements, however, have been registered in recent years in primary education in Ethiopia. Table 2.9 shows recent trends in the gross net enrollment ratios for primary levels. ‘Primary education for all’ is the goal set by the government under its New Education Policy. Major constraints revolve around the quality of primary education, use of language at 7 A more systematic and detailed classifications of the agro-ecological zonations have been carried out in the past by various institutions. The FAO executed Ethiopian Highland Reclamation Study in 1984 to 1986 proposed 3 main zones and 11 sub- zones. In 1988, a National Technical Committee under the auspices of Institute of Agricultural Research (IAR) came up with agro-ecological zonations for the country that consisted of 18 major zones and 62 minor zones. See IAR 1988. 8 The 'environmental trap' the country faces is described in detail in World Bank 2005b, 18-19. 23
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 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
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Page 53 and 54: differently, it is important to acc
Page 55 and 56: households will not be as difficult
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Page 63 and 64: Figure 3.3: Per capita food product
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Page 77 and 78: coordinates the different implement
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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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access to a basic package of qualit
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Integrating nutrition interventions
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Although the coverage of ENA traini
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Box 5.1: Household and Community In
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The interventions that make up this
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conferences. To this effect, a nati
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with the engineering aspect of wate
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Table 5.1: Prevalence of diarrhea a
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Figure 5.3: Trends in latrine cover
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Institutional arrangements are also
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ehavior are integrated and supplied
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5.4.2. Programs and projects 5.4.2.
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made by NGOs for the affected child
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CHAPTER 6: INSTITUTIONAL FRAMEWORK
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interventions in Ethiopia, includin
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6.2. Challenges and Lessons Learnt
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Training Post-secondary training is
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Table 6.6: (continued) Agency Inter
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Achievements Challenges Sustainabil
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Berhane G. 1995. Nutrition surveill
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Ethiopian PROFILES Team & AED/Linka
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Middlebrook, P. 2002. Social protec
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Raisin, J. 2001b. Improving food se
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Yamano, T., H. Alderman, & L. Chris
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