EU Partnership Paves the Way for Better Nutrition for Children and Women in Ethiopia

By Nardos Birru

ADDIS ABABA, September 2016 – Ethiopia has experienced repeated droughts, particularly in the past few years, which have eroded rural livelihoods, causing increased food insecurity and malnutrition among vulnerable communities. The 2015/2016 El Niño-driven drought, for instance, left 9.7 million people in need of emergency food assistance.

In response to recurrent food insecurity, UNICEF has partnered with the European Union (EU) to contribute to building resilience of the most vulnerable groups, which includes children under five, as well as pregnant and lactating women. Resilience, or the ability of a community to withstand, adapt and quickly recover from shocks such as drought, is a cornerstone of the EU’s humanitarian and development assistance.

To this effect, the EU has provided €10 million to UNICEF-assisted programmes as part of its Supporting the Horn of Africa’s Resilience (SHARE) initiative through a project entitled Multi-Sectoral Interventions to Improve Nutrition Security & Resilience. The project is implemented in collaboration with the Food and Agriculture Organization of the United Nations (FAO) in the drought-affected woredas (districts) of Amhara, Oromia Southern Nations, Nationalities and People’s Region (SNNP) regions, benefiting 285,665 households.

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As part of the community-based nutrition programme, Binti, a Health Extension Worker counsels a mother on best nutrition practices. ©UNICEF/2014/Nesbitt

How does SHARE work?

The project aims for communities to have access to quality nutrition services in their vicinity and a better understanding of the importance of proper infant and young child feeding (IYCF) practices.

It covers a wide range of interventions including the promotion of exclusive breast feeding and adequate complementary feeding, vitamin A supplementation and deworming of children, as well as the promotion of hygiene and sanitation.

This is complemented by a series of nutrition-sensitive agriculture interventions led by FAO in partnership with the Ministry of Agriculture. This component helps build the capacity of women to improve the variation of their diet through livestock and poultry rearing, as well as backyard gardening. It also brings opportunities for women to collaborate as peer support groups to produce nutritionally valuable complementary foods such as cereal mixtures for sale. This stimulates the local economy by creating jobs and empowering women to ensure the healthy growth of their children.

An evidence-based approach

Launch of document entitled “Situation Analysis of the Nutrition Sector in Ethiopia” from 2000-2015
Left to right: H.E Chantal Hebberecht, Ambassador of the European Union; Birara Melese, National Nutrition Programme Team Coordinator; Gillian Mellsop, UNICEF Representative to Ethiopia; at the launch of the 2000-2015 “Situation Analysis of the Nutrition Sector in Ethiopia” in Addis Ababa, Ethiopia ©UNICEF/2016/Tesfaye

One achievement of the project was an initiative to analyze and document the nutrition situation in the country from 2000 to 2015.  The report was launched in March 2016 and highlights critical gaps in terms of existing policies and programmes which need to be addressed urgently to accelerate nutrition results for women and children. Key findings of the situation analysis report include poor water supply and sanitation as high risk factors for child stunting, educating mothers as a key factor for improving nutrition, as well as the need to improve production diversity, nutrition knowledge and women’s empowerment to ensure that diverse and nutritious foods are available and accessible at all times.

The SHARE project also serves as a platform for multiple non-governmental organizations where they can exchange expertise and best practices to improve implementation and follow a harmonized approach in their respective intervention sites. This way, efforts are combined and the impact on the nutrition status of children and women will be maximized.

UNICEF would like to express its gratitude to the EU for the generous financial contribution to UNICEF-assisted programmes and looks forward to strengthening successful collaboration for children and women in Ethiopia. Thanks to EU support, over 225,000 children under five and over 50,000 mothers will have better access to improved nutrition services. This is in line with the efforts of the Government of Ethiopia to realize the Seqota Declaration to make undernutrition, in particular child undernutrition, history in Ethiopia.

Government of Ethiopia and Humanitarian Partners Release 2017 Humanitarian Response Planning Document

ADDIS ABABA, 11 January 2016 – The Government of Ethiopia has released the Joint Government and Partners’ Humanitarian Document, an initial humanitarian response planning document for 2017 while the comprehensive Humanitarian Requirements Document (HRD) is being finalized. Based on the early warning data and modelling undertaken by partners such as UNICEF, the document reflects the joint humanitarian response planning and provides a shared understanding of the crisis, including the most pressing humanitarian needs.

While Ethiopia battles residual needs from the El Niño-induced drought, below average rains in the southern and eastern parts of the country caused by the negative Indian Ocean Dipole, another climatic phenomena, have led to new symptoms of drought. It is anticipated that 5.6 million people will need emergency food assistance in 2017, in addition to those still suffering from effects of El Niño. Ongoing assessments for the HRD will provide total figures of those in need for 2017.

In 2016, international donors contributed US$894 million toward the humanitarian response efforts and from that figure, UNICEF raised US$108.7 million to support the Government of Ethiopia and partners to reach around seven million people with access to health and nutrition care, education, safe water, sanitation and hygiene services, and protection support. At least 73 per cent of those reached were children.

The total anticipated financial requirements for the 2017 HRD is US$1.1 billion, of which, the UNICEF Humanitarian Action for Children (HAC) appeal for Ethiopia is US$110.5 million. This includes US$13.6 million to respond to the new influx of South Sudanese refugees in the Gambella region. While the funding will be critical to UNICEF’s ability to respond to immediate needs, it will also be used to take appropriate actions to strengthen preparedness, improve early warning systems and reduce vulnerability, contributing to more resilient communities.

Immediate responses have already taken shape from regional governments allocating funds to water trucking and fodder provision in the south and south eastern regions, those most affected by the below average rainfall. In 2016 and years prior, UNICEF has supported such emergency interventions, in addition to child health and nutrition, sustainable water and sanitation, quality education for boys and girls, and the protection of children from violence and exploitation. UNICEF Ethiopia looks forward to continuing this support with the Government of Ethiopia and partners in 2017, for every child and their family.

Giving a village in the Amhara region its own water supply transforms lives

By Ayuko Matsuhashi

WOIRU DIKALA, Amhara region, 7 August 2016 – The women of Woiru Dikala kebele (sub-district) used to spend much of their day searching for water, a mission that grew even more difficult as drought ravaged Ethiopia’s Amhara Region over the past year.

Women and children often walked for more than six hours to get the water their community needed, searching for scarce rivers and ponds among the dry, rugged gorges of Raya Kobo woreda (district).

Local women at Raya Kobo woreda, Woiru Dikala Kebele -Amhara National Regional State enjoys the newly inaugurated water supply.
Women in Woiru Dikala kebele spend much of their time looking for water.   Now they can easily access clean water thanks to the multi-village water supply system built with UNICEF’s support.  ©UNICEF Ethiopia/2016/Mersha

This area, near the borders of Tigray and Afar regions, is full of migrants from these parts of the country also searching for water for their family and herds and fleeing the recurrent droughts.

So it was with great rejoicing that the people of Woiru Dikala welcomed a joint UNICEF and DFID project introducing a multi-village water supply system drawn from a deep well with a total of eight water points around the village – including one for the primary school.

Comments we received from community members included “We can avoid the risks of abuse of women and children as they travel to collect water from the gorges including at night time,” and “Our children and even adults have been frequently affected by diarrheal diseases and intestinal parasites. We feel happy that our life will be changed.”

The new water system will help 5,000 people over the next 20 years, including the 2,100 living in Woiru Dikala kebele.

The El Niño-driven drought has hit much of the country over the past year, but eastern Amhara has been especially hard hit, with over 1.5 million people suffering from a critical shortage of water.

The shortage also has severe health implications. The kebele has seen an outbreak of the itching menace of scabies because the lack of water means poor sanitation and personal hygiene.

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Boys and girls in Woiru Dikala kebele can grow healthily as they have unrestrained access to clean water. They can also attend school more regularly without worrying about fetching water. ©UNICEF Ethiopia/2016/Mersha

The condition breeds in cramped, dirty conditions and can move quickly through a population causing a great deal of distress among children, who make up half the population of the kebele.

Poor water quality also led to an outbreak of Acute Watery Diarrhoea, which can be fatal for the young and infirm.

Regular access to clean water is key to combatting these diseases. There is no health facility in the kebele.

The inauguration of the new water supply for the area was attended by several regional officials as well as representatives of UNICEF.

“This water supply system provided from a deep well should support local resilience in times of climatic uncertainty,” said Jane Bevan, UNICEF’s manager for rural Water, Sanitation and Hygiene.

Ms. Gillian Mellsop, UNICEF Representative to Ethiopia visits and inaugurates the UNICEF/DIFID supported community emergency water supply scheme at Woiru Dikala Kebele, Raya Kobo woreda, Amhara region.
Attending the inauguration of the new water system were Ato Woldetnsae Mekonnen, head of the Water, Irrigation and Energy Department for North Wollo Zone, Jane Bevan, UNICEF’s Rural WASH Manager, Ato Ayenew Belay, head of Amhara’s Bureau of Finance, Ato Kedir Mustefa, administrator of Raya Kobo woreda, Gillian Mellsop, UNICEF representative to Ethiopia, Ato Yimer Habie, deputy head of Amhara’s Bureau of Water, Irrigation, and the Bureau of Energy. ©UNICEF Ethiopia/2016/Mersha

 

Ethiopia: Vital events registration launched

By Nikodimos Alemayehu and Marie Angeline Aquino

ADDIS ABABA, Ethiopia. August 2016 – Ethiopia launched throughout the country on 4 August 2016 a permanent, compulsory and universal registration and certification of vital events such as birth, death, marriage and divorce.

Vital events registration kicks off in Ethiopia
(L-R) Ms. Gillian Mellsop, UNICEF Representative to Ethiopia , H.E Ms Elsa Tesfaye, Director General of Vital Events Registration Agency (VERA), H.E Dr Mulatu Teshome, President of the Federal Democratic Republic of Ethiopia and H.E Mr Getachew Ambaye, Attorney General holds a symbolic certificate for birth registration. ©UNICEF Ethiopia/2016/Ayene

The inauguration ceremony took place in the presence of the Ethiopian President Dr Mulatu Teshome, UNICEF Representative Gillian Mellsop as well as representatives of other ministries and development partners.

“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 endeavor,” said Teshome at the ceremony. “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.”

Mellsop underscored in her address the importance of the registry in protecting children and combatting child trafficking.

‘’With no proof of age and identity, Ethiopian children become a more attractive ‘commodity’ to a child trafficker, and will not even have the minimal protection that a birth certificate provides against early marriage, child labour, or detention and prosecution of the child as an adult.”

Ethiopia ranks among the lowest in sub-Saharan countries on birth registration with less than 10 per cent of children under the age of 5 with their births registered.

The issue is especially urgent because 48 per cent of the 92 million-strong population is under the age of 18 – 90 per cent of whom are unregistered. The Government has committed itself to reaching at least 50 per cent of children with registration and certification services over the next two years.

UNICEF’s support to Ethiopia’s national civil registration is based on a recognition that birth registration is an important element of ensuring the rights and protection of children.

For children, being registered at birth is key to other rights such as access to basic social services, protection, nationality and later the full rights of citizenship, including the right to vote. Moreover, not only is vital events registration essential for compiling statistics that are required to develop policies and implement social services, it is also, as Mellsop points out, “a pre-requisite in measuring equity; for monitoring trends such as child mortality, maternal health and gender equality.”

Inaugural ceremony of National Vital Events Registration in SNNPR capital Hawassa
One-month child Samrawit at a birth registration centre in Southern Nations, Nationalities and People’s Region (SNNPR) capital Hawassa August 6, 2016. ©UNICEF Ethiopia/2016/Ayene

UNICEF has supported the Government in putting in place a decentralized registration and certification system, which is informed by a legislative framework promulgated in August 2012.

UNICEF is a catalyst in creating this new system with support that includes the reform of the legislative framework, the development of a national strategy and its implementation across the country.

An important element of the Civil Registration and Vital Statistics (CRVS) system is its interoperability with the health sector. On this aspect, UNICEF has worked in collaboration with the Ministry of Justice and Ministry of Health in its efforts to formalize the interoperability, culminating in the signing of Memorandum of Understanding (MoU) between the two ministries.

The important of involving the Health Ministry is because it already has its own well organized and decentralized network stretching across the country. This arrangement allows the health facilities found in nearly every community to manage notifications of births and deaths.

The actual registration and certification of all vital events started on 6 August 2016 at the lowest administrative level of the kebele (sub-district).

With Ethiopia’s new conventional vital events registration system in place, there are better opportunities for accelerating vital events registration in Ethiopia, and realizing one of the fundamental rights of children – the right to be registered upon birth.

Saving a child too thin to be vaccinated

By Bethlehem Kiros

Fatima Yesuf, 25, brings her 8 months old daughter to the Metiya health center for checkup and to receive the Plumpynuts food supplementsAMHARA REGION, Ethiopia, February 2016 – Moyanesh Almerew, a Health Extension Worker in Arara Kidanemeheret Kebele (sub-district) in Amhara Region can testify to how bad the current drought in Ethiopia is for children. She is one of thousands employed as part of the nationwide Health Extension Programme, a community-based programme bringing basic health services to the doorstep of Ethiopia’s large, rural population. According to Moyanesh, they have had seen many more cases of severe acute malnutrition among children this year as compared to previous years and the cases they are receiving are worse. Among them, six-month-old, Fikir, whom Moyanesh saw during a home visit, stands out.

“You would not believe how thin she was when we first found her,” recounts Moyanesh, “She had never been vaccinated so when we tried to give her the vaccines, it was not possible because she was only skin and bones,” explains Moyanesh. When she was first brought to the Arara Kidanemeheret Health Post, the child weighed just 4.5 kg and the measurement of her mid-upper arm circumference – the criteria for identifying severe malnutrition – was 10.5 cm. She was severely acutely malnourished.

Thankfully, after receiving treatment, Fikir has gained 2kg after treatment, which included medicine and therapeutic food for several weeks, and her mid-upper arm circumference grew to 11.8 cm, which puts her in the moderately acutely malnourished range. She continues to receive outpatient treatment at the health post.

Moderately acutely malnourished children are enrolled in the World Food Programme-supported Targeted Supplementary Feeding programme through which they receive fortified blended food and vegetable oil for six months to aid their nutritional recovery. Both this and the UNICEF-supported treatment for severe acute malnutrition are routine responses which are all the more critical in a crisis.

Weynitu Demissie, 34, has a 7 months old daughter who is recovering from acute malnutrition
Weynitu Demissie (far left) walks a long distance to get to Arara Kidanemeheret Health Post where she receives therapeutic food for her seven-month-old malnourished daughter, Mastewal. ©UNICEF Ethiopia/2016/Nahom Tesfaye

Seven-month-old Mastewal is another child who has been treated at the Arara Kidanemeheret Health Post. Her mother, Weynitu, says that the drought has taken quite a toll on her family, especially on Mastewal. The child was extremely emaciated before receiving treatment for severe acute malnutrition. Weynitu walks for more than two hours over steep hilly ground to get to the health post for Mastewal’s treatment but she says it is worth all the hardship since her daughter has shown a lot of progress in the last few of months.

To Moyanesh, it is a relief to see the wonders that therapeutic food treatment does for the children. “I doubt that some of these children would have survived if they didn’t receive this treatment,” she says.

Across the country, 458,000 children are expected to need treatment for severe acute malnutrition in 2016. More broadly, 10.2 million people, 6 million of them children, are in need of emergency food assistance due to the drought. UNICEF, the Nutrition sector lead agency, continues to coordinate the nutrition emergency response. With the support of donors, UNICEF provides supplies for the management of severe acute malnutrition and supports the treatment of malnourished children through the community-based management of acute malnutrition, along with training, quality assurance and monitoring of the nutrition emergency response. UNICEF is also supporting efforts to provide drought-affected communities with access to clean water and health services to address major causes of child illnesses and deaths that have been exacerbated by the drought.

To continue nutrition emergency response activities over the coming months, additional funds of US$5 million are needed, subject to needs-based revisions. A further US$ 42 million is needed over the next four years to strengthen nutrition services and build resilience to future shocks among communities that are worst-affected by the drought.

Priests in Amhara advocate to End Child Marriage

Yazew Tagela and Degu Eneyew are both Priests of the Ethiopian Orthodox Church and members of the UNICEF supported Community Conversation Group against Child Marriage in the Bandani Kebele (neighbourhood) of the Dangla Woreda (district) in Amhara, Ethiopia.

Both are vehemently against child marriage, but come from different perspectives:

Yazew Tagela, 41, has directly experienced financial loss as a result of marrying his daughters as children.

Preist Yazew Tagel, member of the conversation group, regrets marrying his two young daughters at a very early age, having learned of the negative consequences of child marriage after the community advocates group was formed. Dangla Woreda, Badani Kebel
Priest Yazew Tagela, 41, has directly experienced financial loss as a result of marrying his daughters as children. He is a member of Bandani Kebele’s Community Conversation Group against Child Marriage, Amhara, Ethiopia ©UNICEF Ethiopia/2016/Mersha

Yazew Tagela comments: “If I had known before what I know now, I could have helped save so many girls. I married both my daughters at age 12 and 16, and I really regret it. I spent 20,000 ETB (around $1,000) on the marriages of my two girls. I could have bought urban land with that, which would now be worth up to 200,000 ETB ($10,000). The girls lead a rural life like me, and do not enjoy life like their peers who were educated.

“Three years later, neither are yet pregnant, but I really worry about that. With the poor living conditions they have, if they give birth life will get more complicated. If I had not married them, they could have contributed a lot to their country through their being educated.

“My own wife was 15 when we married – I was 25. She showed such childish behaviour but I supported her and she became pregnant straight away.”

“As a priest I am responsible for these marriages as I have to marry a virgin girl, so there is so much pressure on the girls being of younger ages. But I am no longer prepared to bless a marriage if a girl is below the age of 18.

“The government has committed to stop child marriage by 2025, but I know we can stop it way before then. This Kebele is a role model for what can be achieved, a learning site. Everyone here shares ideas and supports each other against child marriage.”

Degu Eneyew, 50, has seen first-hand how girls thrive when they are educated.

Preist Degu Eniyew, 50 lives at Dangla Woreda, Badani Kebele, Awi Zone, Amhara Region. He says he values the education of girls after seeing how they can economically improve their own lifestyle as well as their family's, after finishing school.
Priest Degu Eneyew, 50, has seen first-hand how girls thrive when they are educated. He is a member of Bandani Kebele’s Community Conversation Group against Child Marriage, Amhara, Ethiopia. ©UNICEF Ethiopia/2016/Mersha

Degu Eneyew comments: “At the age of 38 in 2003 I went back to school. It was then that I saw the impact education has on the girl – how well she can do in life. But the community sees education negatively as they associate it with a girl’s exposure to risk. We are teaching the community that if a girl is educated she will support the family. Every Sunday I include in my regular preaching to say “no to child marriage” and send girls to school instead.

“Look at the difference between two families – one which is fast to marry its girls too young, one which does not. You can see life’s consequences from child marriage – giving birth early, scarce resources, limited land. You marry a girl before 18 and it is like killing the very life of the girl. Where families are strong enough to send their girls to school the girls have jobs. Her life will be completely different.

“In the past, a priest would bless the marriage of a child. But today, if the girl is under 18 the priest will not be told. The family will conduct a customary marriage instead with any elder, but witnesses to such marriages are criminally liable.

“Hereafter if a marriage involves parties who are under 18 I will denounce it and report it to the police. If the couple are 18 or above I will bless the marriage. I want everyone to condemn the practise as an evil act.”

“I could help my family be free from poverty if I was educated. Not if I am married.” Lakech, 13

By Elizabeth Willmott-Harrop

Lakech, 13 8th grade, wants to be a doctor when she grows up. Out of sheer poverty, her parents arranged her a marriage with a relatively wealthy family. Having heard of this arrangement, the community conversation groups approached her parents and
Lakech, 13, had her marriage cancelled as a result of reporting her parents to the Community Conversation Group in Bandani Kebele (neighbourhood), Amhara, Ethiopia. ©UNICEF Ethiopia/2015/Mersha

Lakech*, aged 13, is from a poor family in the Bandani Kebele (neighbourhood) of the Dangla Woreda (district) in Amhara, Ethiopia. Her father, 55, is frail from ill health and her mother, 45, supports the family on her own.

Although Lakech’s older sisters have been educated, times are now hard. Lakech’s mother had arranged for her to be married, to both benefit from a dowry and to avoid the additional costs of Lakech’s presence in the household.

“We sometimes do not have enough to eat. We do not even have clothing”, explains Lakech’s mother, “I was given this dress by Hebeste the Health Extension Worker. My girls are always asking me: Why do we not have clothing? Why do we not have soap? Life is hard.”

Lakech found out about the planned marriage from school friends. She explains the impact when she found out: “I was determined not to be married. I wanted to run away, to an urban area where I would look after myself. I planned to work as a housemaid and continue my schooling. I could help my family be free from poverty if I was educated. Not if I am married.”

Lakech reported the planned marriage to Girma Demlash, the facilitator of the Community Conversation Group which campaigns against child marriage.

“I felt distrust for my parents during that time. At first my parents were angry when I reported them, as they said they had no capacity to send me to school. But we have been offered help because I reported it. So I am no longer in fear of a planned marriage,” explains Lakech.

Shashe Gebre, 45, decided to arrange marriage to her daughter Lakech 13, 8th grade, because she couldn't afford to send her to school or provide her food in the house. But after having a conversation with the community conversation groups, she decid
The Mother of Lakech, 13, agreed to cancel her daughter’s planned marriage as a result of an intervention by the Community Conversation Group in Bandani Kebele (neighbourhood), Amhara, Ethiopia. ©UNICEF Ethiopia/2015/Mersha

Lakech’s mother was relieved when the marriage was cancelled. “The Community Conversation Group told me about the legal consequences. I have been supported by the community since. My friends are very happy that Lakech will not be married,” she says.

The family has been able to access a UNICEF supported Revolving Fund to prevent child marriage. So-called because when funding is paid back by beneficiaries it is reinvested into the next family who needs it, so it circulates within the community. Families can start a business, make money and send their girls to school. Plus the fund gives support for education materials including uniform and clothing.

Meseret Debalkie, Child Protection Officer, UNICEF Ethiopia, says of the fund: “For the wealthy family you just have to change attitudes. That is relatively easy. But for the poorer families, if you do not offer any other life options, what will they do? You have to give them alternatives.”

Atalele Abera, 35, is a member of the Women’s Development Group and of the Community Conversation Group. Atalele says of Lakech’s cancelled marriage:

“The girl’s family received 1,000 ETB ($47) as a gift from the husband’s family, but we made sure they gave it back. I am following up with Lakech. I didn’t trust the parents to stick to their decision to cancel. So I visited them four times in the aftermath and continue to collect information from the neighbourhood on whether the marriage plans have really stopped.”

Lakech, 13, and her Mother.
Lakech, 13, and her Mother. Lakech’s planned marriage was cancelled as a result of an intervention by the Community Conversation Group in Bandani Kebele (neighbourhood), Amhara, Ethiopia. © UNICEF/ESARO 2015/Elizabeth Willmott-Harrop

Lakech’s mother explains that she had ambiguous feelings over educating Lakech: “I was worried that I will lose my daughters if I educate them as there are no schools nearby. My eldest daughter went to school some miles away and we have lost contact with her. So I was worried that when we face a challenge due to poverty that my other girls will do the same thing – they will leave and find a life elsewhere.

“But now we have the fund to help us. We will get 5,300 ETB ($250), I will buy sheep. It will cost me around 900 ETB ($43) to by one sheep if she is pregnant, so then I will have two. I will prepare local whisky and the leftovers from that will feed the sheep.”

*Name changed to protect identity