Giving children the best start in life begins with breastfeeding. Breastmilk is the natural first food for newborns. It provides children with necessary nutrients for their growth and development and protects them from deadly diseases such as pneumonia and diarrhoea.
There is no better substitute food for a breastmilk. A breastfed child is 14 times less likely to die in the first six months than a non-breastfed child, and breastfeeding drastically reduces deaths from acute respiratory infection and diarrhoea, two major child killers.The longer breastfeeding is delayed, the higher the risk of death for children in their first month of life.
This year when the world celebrates breastfeeding week (1-7 August) emphasis has been made on breastfeeding and its importance to achieve Sustainable Development Goals (SGDs).
Here in Ethiopia, when the event was celebrated at the Ministry of Health the State Minister of Health, Dr Kebede Worku, said that breastfeeding has an ‘all rounded’ benefit that keeps children healthy, happy and more productive at later age. He also stressed that mothers need to be supported to breastfeed their children both at home and in the workplace.
UNICEF Deputy Country Representative to Ethiopia, Shalini Bahuguna, on her part said “optimum breastfeeding to children under six months is an effective resilience measure.” She also underscored UNICEF’s commitment to promote early and exclusive breastfeeding by engaging fathers, religious leaders as well as members of the community.
According to UNICEF, early breastfeeding rates in sub-Saharan Africa have increased by 19 per cent from 1995 to 2011. This is the highest rate when compared to other regions. It is estimated that 41 per cent of children in sub-Sharan Africa are exclusively breastfed. When it comes to Ethiopia, the numbers are encouraging. Ethiopia is one of the leading countries with 52 per cent of children exclusively breastfed within the first six month.But still there is a long way to go as the country has high stunting rate.
Breastfeeding and sustainable development
Early and exclusive breastfeeding helps children to survive. That is a fact. Yet, breastfeeding is also linked with national development. Evidence shows that the benefits of breastfeeding extend into adulthood. A well breastfed child has good sensory and cognitive development which is associated with better educational achievement. Healthy and better educated children will be more productive and positively impact socio-economic development.
Breastfeeding also contributes to poverty reduction. It is a natural and cost effective way of feeding which do not burden household budget as compared with formula feeding. Thus, supporting breastfeeding is the smartest investment nations can make to ensure the wellbeing of their citizens.
It is, therefore, critical to promote optimal breastfeeding and provide support to mothers who have social and commercial pressures that compromises their decision to breastfeed.
“The findings of the comprehensive belg assessment show changes in the humanitarian context that require immediate action. While the overall response strategy remains the same, we need to respond to address increased needs in some areas,” noted Commissioner Ato Mitiku Kassa, Head of the National Disaster Risk Management Commission (NDRMC). “Thanks to the collaboration between the Government and humanitarian partners, we have done a lot this year. We need to sustain the generous support from the international community in the second half of 2016.”
Ethiopia continues to be affected by drought, exacerbated by the strongest El-Niño on record, which significantly eroded coping capacities. Some regions experienced flooding with unusually heavy belg spring rains in April and May 2016, causing temporary displacement and a surge in disease outbreaks. At the same time, some areas did not receive sufficient rainfall and people still do not have adequate access to water, resulting in continued food and nutrition needs that requires additional health and water response. The Government-led inter-agency belg seasonal assessment, undertaken at the end of June, allowed for a timely revision of the 2016 HRD to ensure well-prioritized response until the end of the year.
“The Government of Ethiopia maintains its very strong and decisive leadership in responding to this crisis and has helped avoid what could have been a humanitarian catastrophe’’ stated Ms. Gillian Mellsop, the acting Humanitarian Coordinator. “As was highlighted at the side-event at the World Humanitarian Summit in May, Ethiopia’s response model is an excellent example of how preparation, disaster risk management and response prioritization can mitigate the impact of natural disasters,” added Ms. Mellsop.
“Nevertheless, despite marked achievements earlier this year, the humanitarian situation in Ethiopia remains critical. With a combination of drought, which significantly weakened coping capacities, and extensive flooding that has caused displacement, disease outbreaks and the disruption of basic public services, we must maintain our scaled-up response,” Ms. Mellsop stressed.
“We should not underestimate our achievements this year, especially considering that we have received more than $1 billion in funding so far” Mr. Paul Handley, Head of Office for OCHA Ethiopia, emphasized. “However, we need to scale up and prioritize our response for the rest of the year to provide assistance to the most vulnerable. It is vital that the international community continues to support the Government to ensure that we do not lose the positive momentum we have gained towards ending the humanitarian crisis.”
UNICEF’s response in pictures (Click on the picture for more)
ADIGUDOM, Ethiopia, 27 April 2016 – For Kibrom Mekonnen, the itching was the worst at night, all over his hands and chest and keeping him awake.
“When I slept it just kept itching,” said the 14-year-old, sitting in the examination room at the Adigudom Primary Hospital in Hintalo Wejarat Woreda (district) in the Tigray Region. “But I was afraid if I started scratching, it would get worse.”
Kibrom’s instincts were right because he has scabies, a contagious skin infection caused by mites that burrow along the top layer of the skin, lay eggs, hatch and spread throughout causing terrible itching.
The real danger, however, can be in the scratching which opens up sores in the skin.
“By itself, it is irritating and itchy but it also exposes you to other infections,” explained UNICEF Heath Specialist Yayneshet Gebreyohannes. “It can result in systemic infections if left untreated.”
Drought brings scabies revival
Scabies has actually been fairly rare in Ethiopia for the past several years, but with the sharp drop in the availability of water due to the worst drought the country has faced in decades, it reappeared.
Casual contact, a handshake or even a hug, is not enough to transmit the mites. There has to be prolonged skin contact or sharing of clothes, which means that outbreaks often happen within the tight confines of homes and schools.
With less water available to wash and maintain personal hygiene, there have been outbreaks in the country.
In the Tigray Region for instance, there were 27,000 new cases reported between October last year to March this year, and nearly 10,000 of those were in Kibrom’s woreda.
Since then however, there has been a significant drop in the number of cases due to the Government leadership and solid response and also UNICEF support to prevent and treat the disease.
In addition to providing medicated soap and permethrin lotion to treat the disease, UNICEF has distributed brochures and teaching guides to educate people about how to combat it and most importantly, not to stigmatize the victims.
Stopping the itch
Kibrom thinks he was infected by a visiting relative, about his age, when the latter visited from a rural village and shared Kibrom’s bed about a week earlier.
The nurse examines his hands where telltale rashes have appeared in the folds of the skin at the joints.
She walks him through the three-day treatment of soap and medication and promises to visit his family home to advise them on precautions to be taken and provide medication for the rest of the family.
For instance his clothes will have to be treated with boiling water, as will his bed linens and many of the fabrics in the house.
Kibrom is lucky in that his home has piped water, but when water is unavailable, health workers advise people to tie clothes into plastic bags for three days – the lifespan of the mite.
Kibrom is also lucky because his area was targeted by the information campaign so that someone at school identified his condition and explained to him what the horrific itching was all about. Otherwise, he might have just tried to endure – and possibly infected others.
“I kept thinking it was going to go away on its own,” he recalled.
The scabies response is part of UNICEF’s health, communication, and water, hygiene and sanitation response for drought and flood-affected populations. UNICEF also provides financial support, supplies including medicines and vaccines, and technical assistance to the Government for the prevention and treatment of major causes of childhood illnesses and deaths such as acute watery diarrhoea and other diarrhoeal diseases, vaccine preventable diseases, as well as other diseases such as meningitis.
Two months ago, I asked five friends of mine two critical questions; one where does the water that flows out of your tap come from and second where does the waste that is flushed down your toilet go to? Answers like, from a river or “my toilet waste is flushed down a sewer pipe…where it goes, I don’t know?” These answers are symptomatic of many educated peoples understanding. Last month, I asked five inhabitants of the northern Ethiopian town of Wukro the same question. All five respondents gave me an articulate description of borehole water as well as the exact location of all the septic tanks.
Water and Sanitation are a daily priority for most of the world and the Sustainable Development Goal (SDG) number 6 has been designed to ensure that everyone, everywhere has access to water and sanitation by 2030.
In Ethiopia, UNICEF was ahead of the SDG curve and in 2013 developed a programme called the ONEWASH which was designed to pull all financial resources from the government, aid agencies, development banks and the UN around ONEPLAN.
To develop the ONEWASH programme, UNICEF Ethiopia was delegated by the Government of Ethiopia to design the strategy for a 10 year plan to ensure that the 50 million people gain access to water and 70 million people gain access to sanitation in every house in every town, city and village across Ethiopia. The ONEWASH is the biggest water and sanitation initiative in Africa and requires an estimated investment of US$2.4 billion. See http://www.unicef.org/ethiopia/OWNP_LEAFLET.pdf.
The ONEWASH programme has: ONE plan, ONE Budget, ONE Procurement system, ONE monitoring system and ONE report. Led by the ONEWASH Coordination office in the Government of Ethiopia Ministry of Water, Irrigation and Electricity and with financial and technical collaboration with the Ministry of Finance, Education and Health, the ONEWASH was a “showcase” at the 2016 Sanitation and Water for All High Level Meeting.
UNICEF Ethiopia also teamed up with the key financiers in the WASH sector in Ethiopia such as the World Bank, African Development Bank, DFID, Government of Finland and others to set up a Sector Wide Approach (SWAp) pool fund called the Consolidated WASH Account where funds are blended together. To ensure all UNICEFs financial rule and regulations were respected, UNICEF Ethiopia developed a Fiduciary Risk Assessment tool. This is now been worked into a Programme Operational Manual and is used to guide the sector investments.
The SDGs present an opportunity and challenge for UNICEF Ethiopia. If ONEWASH is successful it will improve sanitation and hygiene facilities in hospitals, schools and health centres and will provide essential water supply for areas affected by climate change and drought. It will ultimately result in reducing undernutrition in children and improving the cognitive performance of school goers.
We are working in the WASH sector to complement and partner with other sector financiers to ensure that all children and all women, everywhere: rural and urban – development and emergency -have the right to water, sanitation and hygiene in communities, health centres and schools…..ONEWASH for all…
Dr Samuel Godfrey is Water Supply, Sanitation and Hygiene (WASH) Section Chief at UNICEF Ethiopia
Addis Ababa, 2 August 2016 – Ethiopia’s Leaders of major religious institutions signed Memorandum of Understanding (MoU) with UNICEF marking their joint commitment for sustained promotion of the rights and wellbeing of children, adolescents and women through strategic behaviour and social change interventions. Fourteen signatories signed the MoU, including five major religious denominations along with their respective development offices and four umbrella institutions.
Religion is at the heart of people’s value and identity and religious leaders enormously influence moral values and socialization of children in all aspects of life. Religious institutions reach out to vulnerable and disadvantaged children and families, through their inherent values of humanity and extensive structure reaching up to the family and individual levels.
Evidence shows that if investments are made to build capacity and engage religious institutions, they can create major impact for behaviour and social norm change. For example, in the Somali region, religious leaders massively contributed to stop the 2013 polio outbreak, by informing and encouraging their communities to regularly immunize their children. Religious institutions declaring against harmful traditional practices and their active engagement has a huge impact in accelerating Ethiopia’s commitment towards eliminating the female genital mutilation/cutting and child marriage by 2025. In Amhara region, for example when priests teach against child marriage, when they refuse to bless such unions, communities are receptive and young girls are given the opportunity to pursue their education and their dreams.
Although religious institutions have been working with UNICEF in the past, their unique opportunity for influencing positive behaviour and social norms was not fully maximized. The core purpose of the MoU, as stated by Gillian Mellsop, UNICEF Representative to Ethiopia, during the signing ceremony is “to build on existing commitments for the wellbeing of children and women in Ethiopia through sustained and long-term behaviour and social change actions with full engagement of the development and spiritual wings and umbrella institutions.” Gillian stressed, “This partnership will accelerate our efforts to alleviate chronic challenges in communities by addressing them at the core – in people’s minds and attitudes”
In their statements, all the signatory religious leaders avowed their commitment to what they called ‘Historic Consensus’ and outlined their respective faith values that create favourable grounds to promote the rights and wellbeing of children and women.
Dr. Abba Hailemariam Melese, the Deputy General Manager of the Ethiopian Orthodox Tewahdo Church Patriarchate remarked “…towards this cause the Ethiopian Orthodox Tewahdo Church is ready to engage over half a million clergies and religious fathers with the joint leadership of our spiritual and development wings.” Similarly, Haji Al – Fadil Ali Mustafa, General Secretary of the Ethiopian Islamic Affairs Supreme Council remarked that developmental partners have become wiser by involving and engaging religious organizations and leaders to work for a common goal.
Reverend Dr. Wakseyoum, Idosa, President of Ethiopian Evangelical Mekane Yesus Church tells the story of a girl he met a week ago who had dropped her studies from eighth grade and came to Addis Ababa fleeing forced marriage, when her relatives insisted that she returns to her village, she refused and opted to go and work in one of the Middle East countries as a house maid. “This story is one of many stories in our communities, and this is why a united effort is needed to reach to the grass roots in order to alleviate the pain that is still fresh and deserve our urgent response.”
In addition to the five major religious denominations of Ethiopian Orthodox Tewahedo Church (EOTC), Ethiopian Islamic Affairs Supreme Council (EIASC) Ethiopian Catholic Church (ECC), Ethiopian Evangelical Church Mekane Yesus (EECMY) and Ethiopian Kale Hiwot Church (EKHC) and their respective development wings, four umbrella institutions including; Inter-Religious Council of Ethiopia (IRCE),Ethiopian Interfaith Forum for Development Dialogue and Action (EIFDDA),Evangelical Churches Fellowship of Ethiopia (ECFE), and Consortium of Evangelical Churches of Ethiopia Development Association (CECEDA) forwarded a statement affirming their commitment.
Birth, death, marriage and divorce registration and certification will cover all regional states and city administrations through interventions that conform to international standards and national legislations
ADDIS ABABA, 04 August 2016 – Today, the Government of Ethiopia announces a permanent, compulsory and universal registration and certification of vital events such as birth, death, marriage and divorce throughout the country.
H.E Dr Mulatu Teshome, President of the Federal Democratic Republic of Ethiopia (FDRE), launched the inauguration of the event with other senior government officials and development partners including H.E Ms Elsa Tesfaye, Director General of Vital Events Registration Agency (VERA), H.E Mr Getachew Ambaye, Attorney General, Ms Gillian Mellsop, UNICEF Representative to Ethiopia, regional vital registration agencies, vital events registration national council members, development partners, the media and other invited guests.
At the inaugural ceremony, President of the FDRE, Dr Mulatu Teshome said, “The Government of Ethiopia has given great emphasis to vital events registration across the country by putting the appropriate policies in place, establishing a system up to the lowest administrative level and deploying massive resources in this endeavour. I am confident that, with the collaboration and commitment of all stakeholders, we will succeed in the operationalization of the system, just like we have succeeded in other development sectors in the country.”
In the past, the absence of a legal framework for a national vital events registration and vital statistics system has resulted in uncoordinated practices of producing civil status evidence. For instance, birth, death and marriage certificates were issued by hospitals, churches and municipalities in an un-systematic and fragmented manner. In response to the situation, the Government of Ethiopia in 2012 adopted a comprehensive law governing the institutional and operational framework of vital events registration. This includes the registration of birth, death, marriage, divorce and complimentary notations of birth such as adoption, acknowledgment and judicial declaration of paternity.
Since the enactment of the federal law on vital events registration, the Government of Ethiopia has made great progress by establishing the Federal Vital Events Registration Agency, including a board of management and a national council. Government’s regional and city administrations also enacted regional vital events registration laws; established regional agencies and a board of management; adopted a costed national strategy; achieved national consensus to integrate vital events registration services into the health system and established administrative structures for managing and delivering registration services.
Ms Elsa Tesfaye, Director General of Vital Events Registration Agency (VERA), said “To realize the multiple benefits of vital registration, all actors involved in the registration process, including the federal, regional, city administrators, key government stakeholders and development partners, should ensure the continuity of the system.”
Mr Getachew Ambaye, Attorney General stated that, “The conception of modernizing the registration of vital events in Ethiopia has become a reality. From federal up to city level administration, we have finalized the preparation to start registration and certification nationwide. Now, we need to focus on the coordination and the implementation of the service through a systematic coordination to ensure the sustainability of the system.”
Vital events registration is an important pre-requisite for measuring equity, monitoring trends and, evaluating impact and outcomes of broader development programmes, such as the Sustainable Development Goals (SDGs).
“UNICEF is very pleased to be supporting the establishment of a fully functional civil and birth registration system in Ethiopia- to count every child, and in the process, to make every child count. We look forward to the impact of the registration and certification of vital events, such as birth and marriage on the protection and wellbeing of Ethiopian children and the general population,” said Ms Gillian Mellsop, UNICEF Representative to Ethiopia.
In addition, vital events registration is essential for compiling statistics that are required to develop policies and implement services. The demographic data generated from such a system is critical for government planning and decision making. This is particularly important in areas such as child mortality, maternal health and gender equality.
Currently, all regional states and city administrations have finalized the preparations and established offices down to the lowest administrative level.‘Kebele’ general managers are acting as civil status registrars and over 94 per cent of ‘kebele’ general managers have received training regarding the fundamentals, rules, and regulations of vital events registration. In addition, the required registry and certificates are printed and distributed.
In order to undertake the registration process smoothly, various actors from government, UN and other stakeholders are playing key roles, but the community has the primary role to play by registering vital events within the prescribed time (birth within 90 days; marriage, divorce and death within 30 days).
Vital events registration will start on Saturday, 06 August 2016, across the country.