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

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,
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