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

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3.7.3.9. Use of experience sharing visit programs Increased use of knowledge dissemination via grassroots sharing of experiences through, for instance, organizing farmer-to farmer visits to promote best nutritional practices should be included in the NNS interventions. The objectives of such exposure visits are to facilitate sharing of experiences, exchange of ideas, and providing opportunities to observe and learn from the best practices for producing a dietary-diversified crop and livestock mix at household level. This will give the groups the opportunity for greater interaction and openended discussions by raising relevant nutrition issues related to agricultural development. In the exposure visit programs, the proportion of women should be high since at the rural household level home gardening, petty selling of agricultural produce, the purchase of consumables, and food preparation is handled by them. 74
CHAPTER 4: CARE AND MALNUTRITION IN ETHIOPIA AN ASSESSMENT AND ANALYSIS OF AN UNDERLYING DETERMINANT OF MALNUTRITION Tefera Belachew MD, MSc Community Health Programme, Faculty of Public Health Jimma University Executive Summary Ethiopia is a country renowned for its chronic nutrition insecurity and high rate of malnutrition. The recorded history of famine and food shortages in the country dates back hundreds of years, having exacted a considerable toll on the Ethiopian people —routinely destroying their livestock and livelihoods and taking countless lives. Famine has become a descriptive tag for Ethiopia due to its frequent occurrence for many years. Malnutrition is likewise seen as a permanent condition for the country. An analysis of famine and nutrition insecurity in Ethiopia cannot be undertaken without examining the complex and destabilizing role of malnutrition. In all periods – emergency and normal – the most common victims of malnutrition are infants, children less than five years old, and pregnant and lactating women. Children who suffer from malnutrition in intra-uterine life during pregnancy and in the first two years after birth suffer from a wide range of long-term consequences. In Ethiopia, 51.5 percent of children less than five years are chronically malnourished (stunted). The implication of this in terms of economic development is that they will grow up to be small adults with decreased physical and intellectual capacity for production. It is widely recognized that just a 1 percent decrease in height will decrease physical productivity by 1.4 percent, while stunting can decrease a child’s intelligence quotient (IQ) by 5 points. This effect will most likely be perpetuated across generations, from parent to child. Malnutrition of the mother during pregnancy leads frequently to intrauterine growth retardation, resulting in low birthweight babies that are susceptible to frequent morbidity, poor physical growth, learning disabilities, and reduced chances of survival. Additionally, poor nutritional status of the mother during pregnancy compounded by repeated short birth intervals exposes the mother to maternal depletion syndrome. In Ethiopia, studies have shown that cultural factors, including lack of care for pregnant women, increased workloads, and early marriage and teenage pregnancy make the situation worse. The emergence of HIV/AIDS is another significant burden on the vulnerable segments of the population. Due to able-bodied adult mortality, children, the disabled, and the elderly are obliged to lead their lives under difficult conditions. Children are given care either by their siblings or by elderly people who frequently need care themselves, or are forced to live on the streets as orphans. Adults living with the virus need frequent health attention— psychosocial and nutritional care—further stripping the limited assets of the household. Due to the effects of the disease, people living with HIV/AIDS have dramatically higher nutritional requirements and decreased intakes of food. Without proper nutritional care, adults will be less productive, rapidly deplete household resources due to frequent illness, and die prematurely—stripping their family of invaluable caring and coping skills. In Ethiopia, 4.6 million children under 17 years of age are estimated to be orphans, of whom 537,000 were orphaned due to HIV/AIDS. These groups are both socially and biologically vulnerable to nutritional insecurity. Availability and accessibility of health care and food is not sufficient to address their needs. Their specific and vital need for nutrients, 75
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An assessment of the causes of maln
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• Bantirgu Hailemariam coordinate
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3.4. National and Regional Trends:
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LIST OF TABLES Table 2.1: Child stu
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LIST OF ACRONYMS ADLI AGOA AIDS BCC
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Figure 1.1: Stunting among children
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these underlying determinants of th
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experimental body of evidence that
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water can have significant impact o
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2.1. Introduction In the early 1960
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violating the basic tenets presente
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Table 2.3: Regional profile of stun
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A rich food through popularization
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key tenet in the process of identif
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Basic Causes Major Features High im
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commodity trading is the most signi
Page 36 and 37: Table 2.9: Gross primary enrollment
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Page 40 and 41: • Accept that agricultural develo
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Page 45 and 46: CHAPTER 3: FOOD SECURITY AND MALNUT
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Page 49 and 50: 3.1. Introduction The economic grow
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Page 55 and 56: households will not be as difficult
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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
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Page 73 and 74: due to inappropriate land mismanage
Page 75 and 76: 3.6.3.5. HIV/AIDS This disease is w
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Page 81 and 82: households who depend on purchased
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Page 93 and 94: children between 6 and 24 months. T
Page 95 and 96: Care was recognized as one of the u
Page 97 and 98: Figure 4.1: Risk of death in infant
Page 99 and 100: Table 4.2: Present discount values
Page 101 and 102: Figure 4.3: Factors that affect the
Page 103 and 104: Box 4.2: Reasons why PLWHA are vuln
Page 105 and 106: Figure 4.7: Risk of mother to child
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Page 109 and 110: Figure 4.8: The extended model of c
Page 111 and 112: 4.3.1.2. Recognizing symptoms of il
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Page 115 and 116: Figure 4.13: Prevalence of stunting
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Page 119 and 120: 4.3.3.4. Response to food security
Page 121 and 122: 4.3.6. Time and energy expenditure
Page 123 and 124: Table 4.3: Care focused initiatives
Page 125 and 126: together. This demands an integrate
Page 127 and 128: In an emergency, therefore, care an
Page 129 and 130: • Enhance women’s capacity for
Page 131 and 132: Table 4.4: Analysis of care conside
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Page 135 and 136: 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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