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

More documents

Recommendations

Info

therapeutic care, and to give them psychosocial support. Better care practices play a significant role in enabling better nutritional status, growth, development, and survival. 4.1.3. The link between underlying and basic causes of malnutrition The underlying causes of malnutrition – food, care and health – themselves are underpinned by basic causes that relate to the amount, quality, control, and use of various resources. “Care, like household food security, is the outcome of complex processes in society, but it ultimately depends on the availability, accessibility, and use of resources (Jonsson 1995).” Important causes of inadequate child care include poor health of the mother; lack of education and incorrect beliefs of caregivers; lack of self confidence of the mother; inadequate social support from community, family, and husband; excessive workload of the mother; and mother's lack of control of available resources. The availability and control of human, economic, and organizational resources at different levels of society are the results of historical processes in society. These processes can be seen as the basic causes of malnutrition and can be divided into four groups: • Ecological/technical conditions of production, including the environment (soil and climate), the population-resource ratio, the level of technology used, and the level of people’s skills; • Social conditions of production, including such aspects as the ownership of the means of production, the division of labor, and power relationships; • Political factors (including state interventions), including policies on employment, prices, incomes, subsidies, health, education, and agriculture, as well as the legal system as a whole; and • Ideological factors, including habits, beliefs, cultural preferences, and all ideas that legitimize actions in society. The development and interaction of these different factors explain the existing availability and control of resources, which in turn explain the degree of fulfillment of the three necessary conditions (food, health, and care) for good child nutrition (Jonsson 1995). 4.2. Care 4.2.1. What is meant by care? Care includes the provision of time, attention and support to meet the physical, mental and social needs of socio-economically deprived and nutritionally vulnerable groups (Jonsson 1995; Ruel & Arimond 2003; Lung’aho 1999). These groups include children, women, the elderly, urban poor, street children, people infected and affected with HIV/AIDS, the disabled, refugees and internally displaced persons. Adequate care of women and children has only recently been fully recognized as having an important bearing on the nutrition status of mothers and children. "Care" includes care-giving behavior such as breastfeeding and complementary feeding practices, food and personal hygiene, diagnosing illnesses, stimulating language and other cognitive capabilities, and providing emotional support. Care also refers to the support that the family or community provides to members of the family and to behaviors within the household that determine the allocation of the food supply to members of the household. In addition, care includes the utilization of health services and water and sanitation systems to create a healthy microenvironment for family members (Arimond & Ruel 2002). Therefore, care can be viewed as a relationship between the caregiver and care receiver. 82
Care was recognized as one of the underlying causes of malnutrition after many years of trying to understand why malnutrition was prevalent in spite of an adequate supply and delivery of food and health services. This reality led to the conceptualization of care as a process that translates both household food availability and the presence of health services into the positive growth and development of the child (Gillespie & Haddad 2003; Ruel & Arimond 2003). Giving emphasis to care practices is not to suggest that other underlying causes should be ignored. “In each program setting a thorough analysis is necessary to determine the extent to which each of the underlying causes is fulfilled or unfulfilled” (Gillespie & Haddad 2003). 4.2.2. Linkage between different types of care and malnutrition 4.2.2.1. Maternal nutritional care - a life cycle issue In developing countries malnutrit ion begins in utero, being constrained by a number of maternal factors that result in intrauterine growth retardation (IUGR). Most important are the mother’s height (reflecting her own nutritional status during childhood), her nutritional status prior to conception (as measured by her weight and micronutrient status), and her weight gain during pregnancy. Diarrheal diseases, intestinal parasites, respiratory infections, and endemic malaria are all major determinants leading to IUGR (Guyon & Quinn 2004). When we consider care for women, it is not a one time event. Rather it is a life cycle issue with different factors operating at different periods in a woman’s life, each with the potential Box 4.1: Factors affecting nutritional status at different stages of a woman’s life • Infancy and early childhood (0-24 months) • Sub-optimal breastfeeding practices • Inadequate complementary foods • Infrequent feeding • Frequent infections • Childhood (2-9 years) • Poor diets • Poor health care • Poor education • Adolescence (10-19 years) • Increased nutritional demands • Greater iron needs • Early pregnancies • Pregnancy and lactation • Throughout life: • Higher nutritional requirements • Increased micronutrient needs • Closely-spaced reproductive cycles • Food insecurity • Inadequate diets • Recurrent infections • Frequent parasites • Poor health care • Heavy workloads • Gender inequities Source: Guyon & Quinn 2004 83
Page 1:
An assessment of the causes of maln
Page 4 and 5:
• Bantirgu Hailemariam coordinate
Page 6 and 7:
3.4. National and Regional Trends:
Page 8 and 9:
LIST OF TABLES Table 2.1: Child stu
Page 10:
LIST OF ACRONYMS ADLI AGOA AIDS BCC
Page 14 and 15:
Figure 1.1: Stunting among children
Page 16 and 17:
these underlying determinants of th
Page 18 and 19:
experimental body of evidence that
Page 20 and 21:
water can have significant impact o
Page 22 and 23:
2.1. Introduction In the early 1960
Page 24 and 25:
violating the basic tenets presente
Page 26 and 27:
Table 2.3: Regional profile of stun
Page 28 and 29:
A rich food through popularization
Page 30 and 31:
key tenet in the process of identif
Page 32 and 33:
Basic Causes Major Features High im
Page 34 and 35:
commodity trading is the most signi
Page 36 and 37:
Table 2.9: Gross primary enrollment
Page 38 and 39:
following and in alliance with the
Page 40 and 41:
• Accept that agricultural develo
Page 42 and 43:
the other practices that need to be
Page 45 and 46: CHAPTER 3: FOOD SECURITY AND MALNUT
Page 47 and 48: Afar in 2000 was 12.6 percent and 5
Page 49 and 50: 3.1. Introduction The economic grow
Page 51 and 52: In a more technical way, it is diff
Page 53 and 54: differently, it is important to acc
Page 55 and 56: households will not be as difficult
Page 57 and 58: the drought prone areas, the rain f
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
Page 67 and 68: educated, environmentally conscious
Page 69 and 70: 1995-96 revealed that ‘the greate
Page 71 and 72: works are key instruments to lay do
Page 73 and 74: due to inappropriate land mismanage
Page 75 and 76: 3.6.3.5. HIV/AIDS This disease is w
Page 77 and 78: coordinates the different implement
Page 79 and 80: conception through early pregnancy
Page 81 and 82: households who depend on purchased
Page 83 and 84: • Improve rural radio infrastruct
Page 85 and 86: 3.7.3.6. Improve rural market infra
Page 87 and 88: CHAPTER 4: CARE AND MALNUTRITION IN
Page 89 and 90: household allocation; 5) workload a
Page 91 and 92: lack of national nutrition strategy
Page 93: children between 6 and 24 months. T
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
Page 107 and 108: arely provide this kind of benefit.
Page 109 and 110: Figure 4.8: The extended model of c
Page 111 and 112: 4.3.1.2. Recognizing symptoms of il
Page 113 and 114: the direction of the growth curve i
Page 115 and 116: Figure 4.13: Prevalence of stunting
Page 117 and 118: from poor exposure of children to l
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
Page 133 and 134: Sector/ Office Strength Weakness Op
Page 135 and 136: International initiative Strengths
Page 137 and 138: • Rate of continued breastfeeding
Page 139 and 140: Figure 4.17: Community based nutrit
Page 141: There is a strong need for enhancin
Page 144 and 145:
supplies. The available facilities
Page 146 and 147:
5.1. Introduction 5.1.1. Conceptual
Page 148 and 149:
access to a basic package of qualit
Page 150 and 151:
Integrating nutrition interventions
Page 152 and 153:
Although the coverage of ENA traini
Page 154 and 155:
Box 5.1: Household and Community In
Page 156 and 157:
The interventions that make up this
Page 158 and 159:
conferences. To this effect, a nati
Page 160 and 161:
with the engineering aspect of wate
Page 162 and 163:
Table 5.1: Prevalence of diarrhea a
Page 164 and 165:
Figure 5.3: Trends in latrine cover
Page 166 and 167:
Institutional arrangements are also
Page 168 and 169:
ehavior are integrated and supplied
Page 170 and 171:
5.4.2. Programs and projects 5.4.2.
Page 172 and 173:
made by NGOs for the affected child
Page 175 and 176:
CHAPTER 6: INSTITUTIONAL FRAMEWORK
Page 177 and 178:
interventions in Ethiopia, includin
Page 179 and 180:
6.2. Challenges and Lessons Learnt
Page 181 and 182:
Training Post-secondary training is
Page 183 and 184:
Table 6.6: (continued) Agency Inter
Page 185 and 186:
Page 187 and 188:
Page 189 and 190:
Page 191 and 192:
Page 193 and 194:
Page 195 and 196:
Page 197 and 198:
Page 199 and 200:
Page 201 and 202:
Page 203 and 204:
Achievements Challenges Sustainabil
Page 205 and 206:
Berhane G. 1995. Nutrition surveill
Page 207 and 208:
Ethiopian PROFILES Team & AED/Linka
Page 209 and 210:
Middlebrook, P. 2002. Social protec
Page 211 and 212:
Raisin, J. 2001b. Improving food se
Page 213:
Yamano, T., H. Alderman, & L. Chris
show all

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

Create successful ePaper yourself

Delete template?

Save as template?