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

More documents

Recommendations

Info

Table 2.9: Gross primary enrollment and net primary enrollment ratios, percent. Year Gross Primary Enrollment Net Primary Enrollment Grade 1 - 8 Grade 1 – 8 Boys Girls Total Boys Girls Total 1994 - 95 28.9 19.0 24.1 20.7 14.7 17.8 1995 - 96 38.8 24.0 32.0 28.0 18.6 23.4 2000 - 01 67.3 47.0 57.1 55.7 41.7 48.8 Source: World Bank 2005a, 191. primary education level, and finance and administration of primary education. Solving the problems faced by primary education institutions, particularly through the promotion of community participation and private sector involvement, will remain the major challenge. The figures for both Gross and Net Primary Enrollment have substantially improved for Amhara and Tigray Regions, reaching reported levels of 83 percent for Amhara and over 90 percent for Tigray. 9 Increasing the educational levels and number of teachers will have a significant impact on the improved quality of primary education. Training of teachers is a key to capacity building within the educational system. Progress has been made over the last decade in the provision of health services in both rural and urban areas. The increased participation of the private sector in the provision of health services in urban areas allows space for the expansion of public health services in rural areas through a primary health care strategy. The disease burden in Ethiopia is heavily associated with ailments of the population that come as a result of poverty, low access to health service and low utilization. The Millennium Development Goals (MDGs) have identified four major areas that need particular attention in order to reduce mortality rates among children and adults. First, they call for halting the spread of HIV/AIDS by 2015. 10 Second, the MDGs call for halting and reversing the increased incidence of malaria. Third and fourth, they call for reducing maternal mortality by two-thirds and under-five mortality by half, all by 2015. These are daunting tasks for a country that is confronting the situation from the worst position. These and other health challenges are made worse by the burden of malnutrition and poverty. Consequently, efforts to improve health and provide sanitation and clean water supply facilities will have a high payoff in reducing the impact of malnutrition. c) Institutions Institutions refer to the set of rules, regulations, and arrangements by which society organizes itself in order to administer itself and to define its relationships in order to ensure its continued existence. Ethiopia’s history was dominated by Imperial rule for centuries until it ended in 1974 by a military coup. The military regime that took power sought to develop a semblance of a modern system of government until its downfall in 1991. Under the present regime of the 9 Gross Primary Enrollment is defined as the number of children enrolled in primary school, regardless of age, divided by the population of the age group that officially corresponds to the primary level; Net Primary Enrollment is the ratio of the number of children of official school age who are enrolled in primary school to the total population of children of official school age. 10 In Ethiopia, the disease has become a threat to the productive labor force and a growing cause of death among children. (World Bank 2005a, 177) 24
EPRDF, a federal system of government was set up in 1995. The Federal government and the nine Regional States are organized under three branches of government – the Executive, the Legislative, and the Judiciary. The Executive branch is the strongest of the three and is charged with the day-to-day administration of the country. Based on needs and requirements, various ministries, commissions, authorities and agencies have been established to function as state organs, being accountable to the constitution and to the Office of the Prime Minister. Institutional development in Ethiopia has been blurred and short lived. The reorganization of institutions has been so rapid that there seems to be no attention given to an assessment and evaluation of what works and what does not work. The formal public sector institutions related to or working on issues of food and nutrition are numerous and varied. The Ministry of Health (MOH), as a major organ of the state, was charged with the responsibility for the healthcare of the people through health maintenance, control, and prevention of communicable diseases. It also served as the home base and overseer of nutrition activities since the 1950s. However in the 1970s, within the structure of the Office of the National Committee for Central Planning (ONCCP), the task of promoting nutrition-security received prominence. Under the ONCCP’s Department of Agriculture, the country’s general directives on the improvement of nutrition was developed and later incorporated into the Ten Year Perspective Plan that covered the period from 1984 to 1993. Further development of the food and nutrition strategy continued in 1980s. The first National Food Security Strategy was prepared and presented to the government and was finally approved by the Council of Ministers in March 1996. A number of Regional States developed their own versions of the NFSS to suit their conditions and started implementing the strategy. By March 2002, the Federal Government published a revised version of the Food Security Strategy. In June 2003, the Government of Ethiopia convened a meeting of donors and relevant NGOs and governmental agencies to launch what is known as the New Coalition for Food Security in Ethiopia. In the same line, the MOH published a draft National Nutrition Policy in November 2003 to be considered as part of its Health Sector Development Program. Recently the Federal government has reached a decision that all food and nutrition related strategies and programs should be coordinated through the Food Security Bureau of the Ministry of Agriculture and Rural Development. This decision provides a home base for nutrition-related activities within government, while respecting the multidimensional and multi-sectoral characteristics of food and nutrition. d) Development commitments and priorities related to food and nutrition Soon after the take-over of government by the EPRDF in May 1991, a major shift was introduced in the economic management of the country. The new government published the “National Economic Policy” that would bring about a transition from a centrally planned to a market oriented economy, as articulated in the policy document of the Transitional Government of Ethiopia (1992). The Economic Reform and Recovery Program (1992/93) was initiated to rectify factor and product market distortions, and was supported by the World Bank and the IMF. Because of this structural adjustment program, the economy experienced an upturn (1993-96) and significant growth was registered in the agricultural and industrial sectors. The EPRDF government has formulated several broader strategies within whic h any efforts made to sustainably reduce malnutrition in the country must fit. i) Agricultural Development Led Industrialization (ADLI) strategy The strategy, which serves as an umbrella for all other sectoral policies and strategies since its announcement in 1994, focuses on agriculture, since capital is scarce in Ethiopia whereas the work force is abundant. It is expected that trade and industry will grow faster 25
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 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 185 and 186:
Page 187 and 188:
Page 189 and 190:
Page 191 and 192:
Page 193 and 194:
Page 195 and 196:
Page 197 and 198:
Page 199 and 200:
Page 201 and 202:
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?