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Tackling child malnutrition in Ethiopia: Do the sustainable development poverty reduction programme’s underlying policy assumptions reflect local realities?
2005
Alemu Mekonnen, Nicola Jones, Bekele Tefera
Young Lives
This paper emphasises that malnutrition cannot be tackled without understanding its causes. Child malnutrition remains a major public health problem in Ethiopia, yet the government has no specific nutrition policy. Levels of wasting (acute malnutrition) and stunting (chronic malnutrition) in children
aged six to fifty-nine months are among the world’s highest. As long as so many children remain malnourished, Ethiopia will not achieve the first Millennium Development Goal – eradication of extreme poverty and hunger.
Drawing on a sample of 1,999 one-year-olds from twenty sentinel sites, the Young Lives Project has sought to better understand the child, household, community and policy level determinants of malnutrition and the ways in which they differ across different regions of Ethiopia. The paper quantifies the impact of poverty, healthcare and caring practices and challenges the World Bank belief that investment in growth monitoring to promote change in caregivers’ behaviour will, by itself, significantly improve nutritional status.
Coverage of health services may have expanded, but limited and costly services discourage users. Healthcare choices primarily depend not on proximity to health facilities but lack of quality services. Respondents complained about inadequate equipment, poorly trained and/or insensitive medical staff
and expensive medication.
The following measures would contribute significantly to tackling child malnutrition:
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training more nutritionists to work alongside other health professionals
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training to make health workers more sensitive and monitoring levels of user satisfaction
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introducing therapeutic feeding in clinics
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concerted efforts to ensure that essential quality drugs are available and health personnel know how to administer them
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a streamlined system to allow certified poor households to receive free medical care
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action to eradicate harmful practices – such as removal of milk teeth and the uvula - carried out by traditional healers
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inclusion of specific nutritional indicators in Ethiopia’s new Poverty Reduction Strategy Paper so that a designated agency can be held accountable for progress to improve child nutrition.
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