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

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• Accept that agricultural development is the leading sector for the industrial development strategy; • Accept the importance of export-led industrialization as the primary direction of growth; • Joint ventures based on the integration of local and external investors is essential for the realization of the industrial development strategy; • Accept the promotion of labor intensive industries as the primary direction for industrialization; • Accept the leadership role of government in guiding the industrialization process; and • Mobilize society for its collective participation in the industrial development strategy. Due to the special consideration paid to the private sector as the driving force in the industrial development strategy, the following elements are envisaged as creating a hospitable environment for the private entrepreneur. Thus, in order successfully to promote industry in Ethiopia, these public goods must be put in place to create a conducive environment for industry. • Macro-economic stabilization that will include monetary and fiscal, balance of payment, and inflation policies; • Promoting modern financial services, balancing public and private borrowing, improving access to foreign currency transactions, etc.; • Providing reliable infrastructure; • Development of educated and skilled manpower; • Creating an efficient and supportive administration; and • Creating an efficient judicial system. In addition, major industrial projects and sectors identified by government to receive direct government support and assistance include the following: the textile and garment industry; the meat, hides, skins, and animal products industries; agro-processing industries; the construction industry; the strengthening of micro and small-scale industries, the promotion of technological capacity building in Information and Communication Technology (ICT) and biotechnology. These industrial sectors have strong backward and forward linkages with the agricultural, trade, and export sectors and a high employment multiplier effect. Ultimately, each has important links to mechanisms for reducing poverty and malnutrition in the country. These areas, in addition to contributing to overall economic growth, will also provide employment opportunities, thus improving the nutrition condition of children and women. The private sector will also have space to grow and expand in agro-based processing and manufacturing enterprise development, further improving incomes of many malnourished households. 2.3.1.3. Sub-national level - household, community, and woreda The third major set of macro and cross-cutting issues or basic determinants presented below are clustered at the household, community, and woreda levels. These determinants are basic causes of malnutrition, which are presumed to interact substantially with the underlying causes of malnutrition – the Food-Health-Care trio. a) Household characteristics The household and its members are the most extensively used units of analysis concerning the various dimensions of well-being, particularly in areas of nutritional status. 28
For both rural and urban areas, the main household characteristics associated with malnutrition include gender of the head of the household, literacy, schooling, family size, occupation, and regional distribution, among others. Access to health services and information are also important household and community characteristics in accounting for the prevalence of malnutrition. The chief health provider for most Ethiopians is the traditional healer. The 2000 Ethiopia DHS found that only about 44 percent of households used some form of modern health service in the previous year. Utilization was found to be much higher for urban dwellers, as they have more access to information on disease prevention and treatment. Rural Ethiopia is extremely isolated, limiting the flow of information. Less than 15 percent of the population in rural areas owned a radio and even fewer owned a television or a bicycle. It is estimated that the telephone distribution in Ethiopia at present is around 0.5 per 100 persons. In general, asset holdings at the household level are so low that the poor are extremely vulnerable even to minor physical or economic shocks during the year. They are unable to acquire much information on health and nutrition and frequently are unable to make use of the information that they do receive. b) Livelihood systems At the household and community level, the nature of the dominant livelihood system – comprised of an integrated system of production, marketing and consumption of goods and services, the provision of integrated health and nutrition services, education, and infrastructure of a physical and economic nature to varying degrees, and the level of participation of the households in the affairs of their community – will have impact on whether or not malnutrition is sustainably reduced. This is due to the impact of the livelihood system on the underlying causes of malnutrition – food, care, and health. Since the vast majority of the population earns their living from agriculture and livestock rearing, what happens in the agricultural sector determines the level of food security – through increased food availability and access brought about by sustained increased production, specialization and marketing – and whether sustained economic growth is achieved. Creating favorable conditions for raising productivity within the dominant livelihoods in a community or woreda would increase the resiliency against shocks that tend to push communities to destitution and, of interest here, to a malnourished state. Family labor and land resources are critical inputs to most rural livelihood systems in Ethiopia. Unfortunately, in the absence of productivity and supporting facilities, the demands on family labor often prevent children from attending school. Moreover, the carrying capacity of the land becomes a serious issue for the sustainability of agricultural livelihoods as land fragmentation is increased. As more children come to age and want to own a farm through inheritance, the land is increasingly subject to exploitation, overgrazing, and, ultimately, degradation. c) Local institutions and traditions Besides the woreda and kebele administrations, in which officials are elected by the community and which have a mandate to provide administrative and socio-economic services, communities in nearly all areas have parallel traditional institutions that cater to their social, economic and legal needs at the grassroots level. Certain traditional social practices are found to be harmful nutritionally to either women or children. These traditional institutions can be important vehicles for changing these practices and encouraging proper nutritional care and actions. By educating the traditional community leaders and other key persons, significant improvements in nutrition in the community can be achieved. Among some ethnic groups, soon after a new baby born he or she is forced to swallow raw butter with the belief that the butter will clean up the infant internal digestive system. The child then is kept unfed with breast milk for some time. Similarly, unhygienic practices of cutting tonsils, circumcisions, and skin burning with pointed metals are some of 29
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 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
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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
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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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