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

• Establishment of comprehensive social security and institutional safety nets for the
vulnerable segments of the population, with clear targeting indicators.
• Conduct strong behavior change communication activities on better caring practices
at the household level through the integration of community level development
workers of the different sectors and the active involvement of the community.
• Strengthening of programs focusing on vulnerable groups and caring practices.
• Incorporation of nutrition care components under programs targeted at People Living
with HIV and AIDS (PLWHA).
• Establishment of institutional mechanisms to protect, promote, and support optimal
infant and young child feeding practices in the general population.
• Increased attention to the care of vulnerable populations (children, women, orphans,
and the elderly and disabled) during emergency and crisis situations.
• Support of operations research on better caring practices.
• Monitoring and evaluation at all levels and the dissemination of key findings, with
usage of the “triple A cycle approach” for preplanning.
4.1. Why Nutrition Matters in Ethiopia?
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. Malnutrition and famine
has become commonplace in Ethiopia (Crowther et al 1999). Compounding the preexisting
nutrition situation, the advent of the HIV/AIDS pandemic is another threat to nutrition
conditions in recent years. Ethiopia is one of the sub-Saharan African countries that are hit
hard by the pandemic.
Despite the destruction and loss of lives that past disasters caused, it was only in the
early 1970s, in the wake of a big famine in northern Ethiopia, that the need for an organized
state response to address the immediate needs of the victims was recognized. The government
established a Relief and Rehabilitation Commission (RRC) in 1974 to mobilize resources and
coordinate responses (Berhane 1995).
In recent decades, the response to Ethiopia’s chronic food insecurity has had a foodfirst
approach, primarily focused on food production. However, the level of malnutrition has
actually worsened in this time. It is, thus, necessary to stop and think as to what went wrong
with the endeavors so far. The cause of malnutrition is well understood to be more than just
shortage of food. The global conceptual framework focuses on three-pronged underlying
causes: “Food, Care, and Health”. So far, “Care” has been the missing piece of the
undertaking. Improving the quality of care practices as a necessary element in reducing
malnutrition in Ethiopia likely has been overlooked due to the crosscutting nature of efforts to
improve care, the lack of a designated sector, and the natural diffusion of responsibility
between different agencies.
In all situations – 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 intrauterine life and in the first two years after birth suffer from a
wide range of long-term consequences. Addressing malnutrition in these segments of the
population requires improvement in care practices like breastfeeding, complementary feeding,
and hygiene, as well as the promotion of healthy behaviors through communication and
education. Breastfeeding provides 100 percent of the nutrient requirements for children less
than 6 months of age and contributes 35 to 50 percent of energy requirements for those
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