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

differently, it is important to accept that a food secure household can be malnourished. A
recent descriptive study by Kaluski et al. (2002), revealed the relevance of this conceptual
underpinning to Ethiopia’s situation. The authors assessed food security in Ethiopia along its
three dimensions: availability of safe and nutritious food, accessibility to sufficient resources
(including physical access, economic, social, and demographic factors affecting the ability to
acquire food) and adequacy of diet, hygiene practices, water, and sanitation. Kaluski et al
point out that undernutrition can exist due to lack of food, due to micronutrient deficiency, or
due to non-food reasons, e.g., illness. Moreover, food insecure and hungry people can be
present in society due to temporary household shocks or vulnerability to loss of access to
food.
Like other developing countries, in Ethiopia people suffer from one or more forms of
malnutrition. These include low birth weight, early childhood growth failure (stunting),
anemia, vitamin A deficiency, iodine deficiency disorders, and overweight/obesity. Growth
stunting in childhood is a risk factor for increased mortality, poor cognitive and motor
development, and other impairments in function (Gillespie and Haddad 2003, p.9). Stunting,
along with low birth weight is also a risk factor for adult chronic disease. Low intake of
dietary iron, supplied primarily by meat, fish, and poultry, leads to iron deficiency anemia.
Intakes of these foods are low when people have inadequate resources to buy food or when
these foods are avoided for religious or cultural reasons. In the case of the majority of smallscale
peasant farm households, because of monocropping due to fragmentation and small
farm plots, they are unable to produce a diverse food basket from home production and so do
not eat micronutrient rich foods. Both stunting and anemia are known to lower the
productivity of physical labor, which in turn constrains agricultural production and food
security.
The above conceptual models explicitly show the link between food insecurity and
malnutrition through the immediate dietary effect. There is also a reverse link between
malnutrition and food insecurity, which is a productivity effect (Figure 3.1). The FSS does not
recognize that food issues are also nutrition issues at the production level through the effect of
malnutrition on labor productivity. This missing link has contributed to an underestimation of
this major constraint on national agricultural and broad economic development. The
productivity effect should be recognized by food security strategy designers. As a result, the
strategy, now focused on agricultural production issues, including interventions to improve
agriculture through research and extension programs to augment land productivity, will not
ignore the need for farmers to have nutritionally adequate diets. The inputs to improve
agriculture often are identified as improved seeds, fertilizer, and chemicals. Labor
productivity augmenting interventions are totally neglected. Though the immediate nutrition
intervention focus of the NNS should be on infants, children, and women, there also is a need
to augment the adult labor force productivity in both agriculture and industry via nutrition
interventions.
It is important to state that Figure 3.1should be contextualized in terms of a
developing country situation. It may not necessarily reflect the malnutrition linkage to labor
productivity in developed economies. In these countries, the major malnutrition problem
could be overnutrition (obesity) which may have little to do with the productivity effect.
As shown in Figure 3.1, though food insecurity is a determinant of malnutrition,
malnutrition is also a determinant of food insecurity. Food insecurity leads to malnutrition
through the effects of dietary intake that is inadequate for a healthy life at any age.
Malnutrition leads to food insecurity through productivity containment. Since agricultural
labor productivity depends on the physical and mental well-being of labor, and since a
malnourished person is weak both physically and mentally, then a nutritionally insecure farm
household, even with sufficient physical resources (land, seed, fertilizer), will face difficulty
in producing adequate and desirable amounts of food. In other words, malnutrition leads to
food insecurity via labor productivity curtailment in a farm household.
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