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

households will not be as difficult as the efforts needed to transfer and make a household
nutrition secure. Nutrition security requires priority target groups. Nutrition security is more
focused at the individual, household and community levels. The individual and the household
are ultimately responsible for assuring their own or their members’ nutritional status (Benson
2005).
Most nutrition programs target women and children, while food security programs
target households and communities. In the case of Ethiopia, the same should apply. Adequate
care, access to sufficient health and sanitation services, as well as adequate household food
security of women and children should be central activities in ensuring a well-nourished
population capable of being highly productive, both mentally and physically. In a more
focused way, children of age two and below should be prime targets. Additionally, the
nutritional improvement of adolescent girls and women of reproductive age should get high
priority.
The impact of malnutrition can be moderate or severe depending on the food status of
the target group in view of time, climatic conditions, and seasonal variation. In drought years
or famine periods, the impact of malnutrition will be heightened. Emergency response is
focused on basic nutritional interventions, providing quality food in the quantity needed to
feed disaster-stricken populations. In an emergency, malnutrition from too little food and too
much disease affects all age groups, particularly those at high risk such as infants, young
children, pregnant and lactating women, and those affected by HIV/AIDS.
3.3.3. Food fortification, standards, and quality
As stated earlier, nutrition is not solely ‘a food issue’, as malnourishment can exist
even when food is available in the market place or in the household, due to non-food
determinants such as health and environmental factors and the paucity of caring. However,
malnutrition is commonly an outcome of specific development problems related directly to
the level of dietary intake. The link between agriculture and nutrition occurs via food, either
processed from homegrown sources or procured from elsewhere. The determinants of
nutrition that are related to food security are made up of a wide variety of factors: the quantity
of food produced, procured, or received through transfers from other households or the
government; the quality of the food; and the diversity of the diet. In addition, the availability
and use of micronutrient-fortified food is also important.
Dietary inadequacies might be caused by a low supply of food or by inadequate time
to prepare food or feed children (Jonsson 1993). In most poor rural and urban families, the
food items encompass a very limited set of dietary elements. In Ethiopia, often what people
eat is Enjera-be-wot. Enjera is an Ethiopian thinly baked bread type food item prepared from
dough of teff (Eragrostis teff) or cereals such as wheat, barely or sorghum. Wot is prepared
from a mix of pulses, vegetables, animal products. Poor households usually eat the Enjera
with wot prepared from pulse crops. Usually diets are very limited in many Ethiopian
households, with a preponderance of protein and basic starches and a lack of vitamins (lack of
vegetables, fruits) and other higher value nutrients, resulting in micronutrient deficiencies. At
farm household level, in terms of production, dietary diversification can be achieved through
promotion of horticulture or backyard gardening, and dairy production. However,
community-based fortification programs should be encouraged in order to tackle the problem
of common micronutrient deficiencies.
The three common micronutrient deficiencies in Ethiopia, as elsewhere, are vitamin
A, iodine, and iron. These deficiencies should be addressed via improving the variety of foods
rich in these micronutrients available at household level. This requires diversification of
production and value-addition through processing and preservation practices, as well as the
promotion and adaptation of fortified foods. Specifically, fortified food is important in areas
where agricultural production lacks diversification and monocropping is common. In areas
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