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

to render her and her child vulnerable to malnutrition (Box 4.1).
Maternal nutrition during pregnancy has a significant impact on fetal growth and
birthweight (Ethiopian PROFILES Team & AED/Linkages 2005). As described in Chapter 1,
the presence of an intergenerational link between maternal and child nutrition means a small
mother will have small babies who in turn grow to become small mothers. Studies show that a
high proportion of low-birthweight and stunted children were observed among malnourished
mothers (Johnson-Welch 2001), and the malnutrition continues across generations in a cycle
(Figure 1.3).
The nutritional deficit during the fetal period results in a decrease in the individual’s
capacity to reach their genetic potential for productivity (intellectual and physical) as well as
the perpetuation of this condition through generations. There is a growing body of evidence
that undernutrition in the intrauterine period may result in permanent changes in the body
structure and metabolism that may lead to increased susceptibility to chronic non-infectious
diseases later in life. Malnutrition may have long-term consequences due to the
intergenerational transmission of poor nutrition (Guyon & Quinn 2004).
An additional contributing factor is micronutrient deficiency, particularly deficiencie s
in iodine, iron and vitamin A. Maternal malnutrition both in the form of chronic energy and or
micronutrient deficiencies will have a number of consequences, including infections, maternal
mortality, low birth weight, neonatal and infant mortality, Vitamin A deficiency, abortion,
still birth, reduced physical activity, and poor cognitive development of the baby leading to
poor educational capability and performance.
4.2.2.2. Nutritional care of children
The second most vulnerable period of a child’s life is the first two years of life when
young children have high nutritional requirements, in part because they are growing so fast.
Young children are also susceptible to infection because their immune system fails to protect
them adequately. Foods and drinks are contaminated due to poor hygiene and infection is
common, resulting in a decrease in appetite and an increase in the metabolic demands.
Furthermore, traditional home remedies for childhood infections, including withholding of
foods and breast milk are often sub-optimal (Guyon & Quinn 2004). Malnutrition during this
period results in the reduction of both physical and mental development.
Malnourished children score poorly on tests of cognitive function and have poorer
psychomotor development and poor fine motor skills. Stunted children have, on average, an
IQ that is 5 points lower than healthy children (Ethiopian PROFILES Team & AED/Linkages
2005). For every 1 percent decrease in height there will be 1.4 percent decrease in
productivity (Haddad and Bouis, 1990). Therefore, stunting is a development issue and should
be addressed as such.
4.2.2.3. Mechanism of improving maternal and child nutrition
Adequate infant and child nutrition is the outcome of appropriate food and health
inputs mediated through positive child care practices. Both dietary quality – particularly
access to micronutrients – and quantity are important for children. These can be improved
partly through investments in agricultural research that improves the micronutrient value of
crops.
“Some of the most promising interventions related to infant and child nutrition do not
aim to increase the amount of food available or the amount consumed, but how it is provided
to the infant. Breastfeeding promotion and improved knowledge and use of complementary
foods are examples of this opportunity”. In addition to reducing mortality, these interventions,
where successfully implemented, are effective in reducing morbidity—particularly diarrheal
morbidity. Thus, they reduce stunting and consequent loss of productivity. Mechanisms for
reducing micronutrient deficiencies include idolization of salt, vitamin A supplementation and
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