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

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
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