An assessment of the causes of malnutrition in Ethiopia: A ...
An assessment of the causes of malnutrition in Ethiopia: A ... An assessment of the causes of malnutrition in Ethiopia: A ...
The agriculture and food sector itself must make a radical and aggressive change in the way it does business. This should start with an improved process in the formulation, management, and administration of agricultural development plans, which should be based on long-term vision. It should prioritize, plan and deploy its resources in a manner that can be sustained over a longer-term horizon. The Government’s SDPRP is a starting point for this type of approach. Quite a large number of challenges and possible approaches to resolve them have been indicated in this document. Implementing these will go a long way to meeting the main part of the nutrition security challenge; although one should accept the fact there is a lot of room for improvement. In Ethiopia, the policy focus is on production with an objective to eliminate import dependence, particularly dependence on food aid (RDPS 2003). The three pillars that the FDRE government food security strategy rests on are: (1) increase supply or availability of food (2) improve access/entitlement to food; and (3) strengthen emergency response capabilities (FSS 2002). Based on these pillars the objectives and interventions are also explicitly obtained. It is important to make clear the implications of Ethiopia’s food security strategy for attaining nutritionally secure households and communities in different regions of the country. Policymakers have to be aware that policies that affect the social conditions of production also affect nutrition (Jonsson 1993). Jonsson argued that patterns of ownership and control of the means of production vary considerably among societies. The different modes of production – peasant, private farm, state, commercial, or cooperative – not only influence what is being produced but also, to some extent, for whom. Jonsson argued that the formulation of nutrition-oriented policy should avoid equating malnutrition with inadequate aggregate production which, according to him, is the assumption that many national food strategies are based on (Jonsson 1993). He also argued that, except for drought stricken crisis areas, the correlation between malnutrition and food production or even food availability is very low or non-existent. This implies that policymakers should be careful that national food and agriculture strategies are nutritionoriented and avoid an exclusive food-bias. National food and nutrition policies and strategies need also to be cognizant of spatial variations of nutrition and food problems within a country, both among regions and among woredas within a region. Since the causes, intensity, and spatial mal-distribution of food varies, policies targeted towards ecological and technological change may affect nutrition in different ways across different contexts. At the national level, ecological causes may dominate while at the village level; socioeconomic causes may be the most important (Jonsson 1993). Deforestation and land erosion, imbalances between people, cattle, land, and water resources affect nutrition. Too often, as Jonsson said, governments have not been aware of this delicate balance and have adopted policies that have resulted in the gradual break down of existing food and nutrition security systems. 3.7.2. Technical issues 3.7.2.1. Targeting children and adults At community level, as Kaluski et al. reported, both children and adults are at risk of malnutrition, and are in need of nutrition programs. Furthermore, enquiries into the poor nutrition of Ethiopian children, and into the remarkable inter-regional and intra-household differences found in nutrition outcomes, suggest that more work needs to be done in investigating positive and negative feeding practices and their relationship to region and culture (Robinson 2003). Intra-household targeting is a very important concept of a nutrition-focused food security approach at the household level. Targeting could benefit the most vulnerable members of a family such as infants, children, and women. Women with the lowest weight at 66
conception through early pregnancy should be treated separately in any food security intervention. The intervention should incorporate the provision of supplementary dietary food to this member of a household. Micronutrient intake can also be improved by targeting animal products to young children. 3.7.2.2. Targeting pastoral areas In pastoral areas, well studied nutrition strategies and interventions that incorporate important cultural practices have to be put in place. In the mixed farming context, the improvement of feed and water availability, establishment of water points, promoting forage and fodder crops, and enhanced management of community grazing land are essential. Availability and affordability of improved breeds, provision of livestock through savings and credit schemes and promoting livestock diversification are also key interventions. Nutrition interventions in pastoral areas should be integrated with interventions that ensure that pastoral communities have access to markets in order to sell their produce and purchase nutritionally rich food and non-food commodities and services. Trade is necessary to sustain pastoral livelihoods. Access to markets and market information needs to be improved in all pastoral areas to enable pastoralists to sell their livestock and livestock products. Improvement in terms of trade of livestock and livestock products would contribute directly to increases in livestock production and productivity and augment pastoralist’s income. 3.7.2.3. Changing production and feeding practices The NNS should integrate food and nutrition issues so that various programs and projects designed and funded for implementation lead to a nutrition secure society. On the food side, the strategy should assist in alleviating the nutrition problems in several ways. As Pinstrup-Andersen put it, first, Peasant Associations (PAs) and their members should be made more aware of the opportunities that exist for solving these problems through changes in production and feeding practices (1987). Information should be made available about which crops to add to existing cropping systems to make available the necessary nutrient to all members of the PA and, in particular the diets for young children (6 months to three years). Technical assistance on how to grow such crops and distribution of seed should be extended, together with information on feeding practices and other nutrition related issues. The information on production, consumption, and nutrition issues should be made available to men and as well as women. Small plots of nutrient dense crops might be recommended for each peasant as needed to supplement the main staples or alternatively, common plots might be grown within each PA. Providing mothers and girls with time, money, and education to improve their nutrition and hygiene practices has a central role to play. Women from the PA could take the responsibility for the production of supplementary crops after being organized. This activity could be based on an income-generating concept, which could also help to reduce the risk of sale of the crop if individual households are embarking on the production of similar supplementary vegetable or fruit crops. Similarly, preparation of the food for the infants may be done by individual mothers or it may be done collectively within the PA. Information about which commonly available foods could be combined to form a complete diet for infants, women, and other members of the household should be made available to all mothers via the extension agents-cum facilitators. The same information should be available at all health centers and health stations and should be linked with other nutrition education. Thirdly, locally produced weaning food should be distributed free to mothers of infants (6 months to 3 years of age) who show symptoms of severe malnutrition based on weight/length or weight/age. Fourth, simple labor-saving technologies based on local production should be made available at lower cost. Programs should be promoted to lower the demand for women’s time for fetching fuel wood, carrying water, cooking, 67
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conception through early pregnancy should be treated separately <strong>in</strong> any food security<br />
<strong>in</strong>tervention. The <strong>in</strong>tervention should <strong>in</strong>corporate <strong>the</strong> provision <strong>of</strong> supplementary dietary food<br />
to this member <strong>of</strong> a household. Micronutrient <strong>in</strong>take can also be improved by target<strong>in</strong>g animal<br />
products to young children.<br />
3.7.2.2. Target<strong>in</strong>g pastoral areas<br />
In pastoral areas, well studied nutrition strategies and <strong>in</strong>terventions that <strong>in</strong>corporate<br />
important cultural practices have to be put <strong>in</strong> place. In <strong>the</strong> mixed farm<strong>in</strong>g context, <strong>the</strong><br />
improvement <strong>of</strong> feed and water availability, establishment <strong>of</strong> water po<strong>in</strong>ts, promot<strong>in</strong>g forage<br />
and fodder crops, and enhanced management <strong>of</strong> community graz<strong>in</strong>g land are essential.<br />
Availability and affordability <strong>of</strong> improved breeds, provision <strong>of</strong> livestock through sav<strong>in</strong>gs and<br />
credit schemes and promot<strong>in</strong>g livestock diversification are also key <strong>in</strong>terventions.<br />
Nutrition <strong>in</strong>terventions <strong>in</strong> pastoral areas should be <strong>in</strong>tegrated with <strong>in</strong>terventions that<br />
ensure that pastoral communities have access to markets <strong>in</strong> order to sell <strong>the</strong>ir produce and<br />
purchase nutritionally rich food and non-food commodities and services. Trade is necessary to<br />
susta<strong>in</strong> pastoral livelihoods. Access to markets and market <strong>in</strong>formation needs to be improved<br />
<strong>in</strong> all pastoral areas to enable pastoralists to sell <strong>the</strong>ir livestock and livestock products.<br />
Improvement <strong>in</strong> terms <strong>of</strong> trade <strong>of</strong> livestock and livestock products would contribute directly<br />
to <strong>in</strong>creases <strong>in</strong> livestock production and productivity and augment pastoralist’s <strong>in</strong>come.<br />
3.7.2.3. Chang<strong>in</strong>g production and feed<strong>in</strong>g practices<br />
The NNS should <strong>in</strong>tegrate food and nutrition issues so that various programs and<br />
projects designed and funded for implementation lead to a nutrition secure society. On <strong>the</strong><br />
food side, <strong>the</strong> strategy should assist <strong>in</strong> alleviat<strong>in</strong>g <strong>the</strong> nutrition problems <strong>in</strong> several ways. As<br />
P<strong>in</strong>strup-<strong>An</strong>dersen put it, first, Peasant Associations (PAs) and <strong>the</strong>ir members should be made<br />
more aware <strong>of</strong> <strong>the</strong> opportunities that exist for solv<strong>in</strong>g <strong>the</strong>se problems through changes <strong>in</strong><br />
production and feed<strong>in</strong>g practices (1987). Information should be made available about which<br />
crops to add to exist<strong>in</strong>g cropp<strong>in</strong>g systems to make available <strong>the</strong> necessary nutrient to all<br />
members <strong>of</strong> <strong>the</strong> PA and, <strong>in</strong> particular <strong>the</strong> diets for young children (6 months to three years).<br />
Technical assistance on how to grow such crops and distribution <strong>of</strong> seed should be extended,<br />
toge<strong>the</strong>r with <strong>in</strong>formation on feed<strong>in</strong>g practices and o<strong>the</strong>r nutrition related issues. The<br />
<strong>in</strong>formation on production, consumption, and nutrition issues should be made available to<br />
men and as well as women. Small plots <strong>of</strong> nutrient dense crops might be recommended for<br />
each peasant as needed to supplement <strong>the</strong> ma<strong>in</strong> staples or alternatively, common plots might<br />
be grown with<strong>in</strong> each PA.<br />
Provid<strong>in</strong>g mo<strong>the</strong>rs and girls with time, money, and education to improve <strong>the</strong>ir<br />
nutrition and hygiene practices has a central role to play. Women from <strong>the</strong> PA could take <strong>the</strong><br />
responsibility for <strong>the</strong> production <strong>of</strong> supplementary crops after be<strong>in</strong>g organized. This activity<br />
could be based on an <strong>in</strong>come-generat<strong>in</strong>g concept, which could also help to reduce <strong>the</strong> risk <strong>of</strong><br />
sale <strong>of</strong> <strong>the</strong> crop if <strong>in</strong>dividual households are embark<strong>in</strong>g on <strong>the</strong> production <strong>of</strong> similar<br />
supplementary vegetable or fruit crops. Similarly, preparation <strong>of</strong> <strong>the</strong> food for <strong>the</strong> <strong>in</strong>fants may<br />
be done by <strong>in</strong>dividual mo<strong>the</strong>rs or it may be done collectively with<strong>in</strong> <strong>the</strong> PA.<br />
Information about which commonly available foods could be comb<strong>in</strong>ed to form a<br />
complete diet for <strong>in</strong>fants, women, and o<strong>the</strong>r members <strong>of</strong> <strong>the</strong> household should be made<br />
available to all mo<strong>the</strong>rs via <strong>the</strong> extension agents-cum facilitators. The same <strong>in</strong>formation<br />
should be available at all health centers and health stations and should be l<strong>in</strong>ked with o<strong>the</strong>r<br />
nutrition education. Thirdly, locally produced wean<strong>in</strong>g food should be distributed free to<br />
mo<strong>the</strong>rs <strong>of</strong> <strong>in</strong>fants (6 months to 3 years <strong>of</strong> age) who show symptoms <strong>of</strong> severe <strong>malnutrition</strong><br />
based on weight/length or weight/age. Fourth, simple labor-sav<strong>in</strong>g technologies based on<br />
local production should be made available at lower cost. Programs should be promoted to<br />
lower <strong>the</strong> demand for women’s time for fetch<strong>in</strong>g fuel wood, carry<strong>in</strong>g water, cook<strong>in</strong>g,<br />
67
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