MIND THE GAP – BABYWASH Launched on World Toilet Day to Improve Integrated Early Childhood Development in Ethiopia

By Samuel Godfrey

When you travel in a car through Addis Ababa, you will note that adult women and men vary greatly in height. There are tall people and short people. So which ones of these are actually stunted? And why? Scientifically stunting is defined as a reduced growth rate in human development and is a primary manifestation of malnutrition or more accurately under nutrition. The definition of stunting according to the World Health Organisation (WHO) is for the “height for age” value to be less than two standard deviations of the WHO Child Growth Standards median.

So how does under nutrition occur? Recent scientific evidence suggests that under nutrition is a result of recurrent infections such as diarrhoea or helminthiasis in early childhood and even before birth. In 2016, UNICEF Ethiopia, published a blog entitled BABY WASH – the missing piece of the puzzle[1]?, in which evidence from a paper published by UNICEF and John Hopkins University in the Journal of Tropical Medicine and International Health[2] highlighted the need to target interventions to reduce unsafe practices of disposal of baby and child faeces. To convert this evidence into action, the Government of Ethiopia, UNICEF and partners have developed a BABYWASH implementation guideline. The guideline aims at contributing to improving Integrated Early Childhood Development (IECD) through improving the baby and child environment.

World Toilet Day 2017: safe disposal of child faeces
Lack of knowledge on the health risk related to child faeces is a key factor behind poor hygiene practices in faeces disposal. ©UNICEF Ethiopia/2017/Mulugeta Ayene

The 2017 World Toilet Day was a perfect opportunity to launch the BABYWASH guideline. The document includes guidance on how to implement programmes with safe disposal of child faeces, providing protective environments through play mats and similar measures as well as prevention of soil transmitted helminths. The strategy was endorsed for implementation alongside regular safe sanitation and hygiene practices which are already being promoted by health extension workers. In his statement, H.E Dr Kebede Worku, State Minister of Health of Ethiopia said, “In Ethiopia, there is a common misconception that children’s faeces are not harmful while evidence shows otherwise. The current sanitation and hygiene promotion efforts, at times, overlook safe disposal of children’s faeces. In addition, most toilets are not designed keeping children’s special needs in mind. Hence, I am proud to endorse the Baby WASH manual today which was developed by the Federal Ministry of Health with the support of UNICEF and other partners in order to ensure a healthy environment for children’s growth and development especially those under three years of age.”

Ms Gillian Mellsop, UNICEF Representative to Ethiopia on her part said, “UNICEF is pleased to support the Ministry of Health in preparing these excellent guidelines on Baby WASH. We know that a contaminated environment harms infants and young children and puts them at risk of increased child mortality and stunting. Together, we have to ensure that parents and guardians, teachers and community leaders are aware of the importance of Baby WASH.”

According to the Knowledge, Attitude and Practice (KAP) baseline survey on Water, Sanitation, and Hygiene carried out in eight regions of Ethiopia, there is a general misconception about child faeces disposal. The survey showed that a lack of knowledge on the health risk related to child faeces is a key factor behind poor hygiene practices in faeces disposal. According to the survey, only half (49 per cent) of women knew that child faeces are dangerous to health. Misconception is higher among rural pastoralist women where only 39 per cent said child faeces are dangerous as compared with 50 per cent among rural non-pastoralist women and 54 per cent of women in urban areas. Although it may not be clear who is stunted and who is not just by looking at a child, it’s clear that safe disposal of child faeces helps improve a child’s health. Therefore, UNICEF will continue to support the Government with the implementation of the guideline throughout the country.

[1] https://unicefethiopia.org/2016/05/24/baby-wash-the-missing-piece-of-the-puzzle

[2] https://www.ncbi.nlm.nih.gov/pubmed/27546207

Children Takeover Minister Roles as Ethiopia celebrates World Children’s Day and UNICEF Ethiopia’s 65th Anniversary

20 November 2017, United Nations Conference Centre, Addis Ababa: Today, Ethiopia joined the global World Children’s Day celebrations by giving children high profile roles to become champions of their rights. In line with the event’s theme ‘For children, By children’ child parliamentarians took over the roles of the Ministers of: Women and Children’s Affairs; Health; Education; Water, Irrigation and Electricity; Labour and Social Affairs; and Urban Works and Construction. In addition, children took over the roles of the Attorney General and UNICEF Representative. In their new roles as ‘shadow Ministers’, children shared their ideas on issues that affect their lives.

World Children's Day and UNICEF Ethiopia 65th anniversary
Sara Beshir shadow Minister of Women and Children Affairs. Her message on World Children’s Day: attitudes towards violence angst children and women need to be changed. ©UNICEF Ethiopia/2017/Nahom Tesfaye

At the event, which was truly owned by children, some of the key recommendations proposed by children include:

  • Accelerate efforts to end harmful traditional practices, including child marriage and Female Genital Mutilation/Cutting
  • Provide clean water and sanitation services for all children across the country, no matter where they live
  • Build more hospitals that are focused on child health and ensure health professionals treat children with care and love
  • Involve children in child justice
  • Ensure quality education for all children through skilled teachers, including pre-primary education
  • Ensure that girls stay in school and finish their education
  • Provide more playgrounds and safe spaces, especially in urban and peri-urban settings
  • Include children’s voices when adults and local authorities discuss issues that affect children’s lives.

Child parliamentarians from different regions also had an opportunity to discuss issues relevant to children in Ethiopia with shadow Ministers and dignitaries through a Q&A session.

In her opening remarks, H.E Ms Demitu Hambisa, Minister of Women and Children’s Affairs, stated that this year’s World Children’s Day is a day of action for children by children. She highlighted that decision makers need to ensure that children’s voices are heard and reflected in decisions that affect their lives.

World Children's Day and UNICEF Ethiopia 65th anniversary
Minister of Women and Children Affairs , Ms Demitu Hambisa speaking during World Children’s Day. She says; listening to children’s voices and involving them in decision making is key. ©UNICEF Ethiopia/2017/Nahom Tesfaye

Ms Gillian Mellsop, UNICEF Representative to Ethiopia, emphasising the need for the participation of children said, “Meaningful participation of children is not only a fundamental right – and enshrined as such in the Convention on the Rights of the Child – but is also key to ensuring that decisions made by adults are relevant to the actual needs of children.”

World Children's Day and UNICEF Ethiopia 65th anniversary
Ms Gillian Mellsop, UNICEF Representative to Ethiopia speaking on World Children’s Day. ©UNICEF Ethiopia/2017/Nahom Tesfaye

In addition, UNICEF Ethiopia launched its publication ‘Hulem Lehisanat- Always for children’ depicting its 65 years history serving children and women in Ethiopia.

The event highlighted the importance of including children’s voices by providing children with an opportunity to share their own solutions on how to keep every child in Ethiopia healthy, well-nourished, in school and protected.

‘BABY WASH’ boosted at this year’s World Toilet Day in Ethiopia

Addis Ababa, 15 November 2017 – Today, Ethiopia celebrated World Toilet Day by holding a half-day workshop with the theme “Safe Disposal of Child Faeces.

At the workshop, the national ‘Baby WASH’ strategy, which focuses on hygiene of children under three years, was endorsed by the Federal Ministry of Health. The strategy includes safe disposal of child faeces, providing protective environments through play mats and similar measures as well as prevention of soil transmitted helminths. The strategy will be implemented alongside regular safe sanitation and hygiene practices which are already being promoted by health extension workers.

World Toilet Day 2017: safe disposal of child faeces
At the workshop, the national ‘Baby WASH’ strategy, which focuses on hygiene of children under three years, was endorsed by the Federal Ministry of Health. ©UNICEF Ethiopia/2017/Mulugeta Ayene

In his statement, H.E Dr Kebede Worku, State Minister of Health said, “In Ethiopia, there is a common misconception that children’s faeces are not harmful while evidence shows otherwise. The current sanitation and hygiene promotion efforts, at times, overlook safe disposal of children’s faeces. In addition, most toilets are not designed keeping children’s special needs in mind. Hence, I am proud to endorse the Baby WASH manual today which was developed by the Federal Ministry of Health with the support of UNICEF and other partners in order to ensure a healthy environment for children’s growth and development especially those under three years of age.”

Ms Gillian Mellsop, UNICEF Representative to Ethiopia on her part said, “UNICEF is pleased to support the Ministry of Health in preparing these excellent guidelines on Baby WASH. We know that a contaminated environment harms infants and young children and puts them at risk of increased child mortality and stunting. Together, we have to ensure that parents and guardians, teachers and community leaders are aware of the importance of Baby WASH.”

According to the Knowledge, Attitude and Practice (KAP) baseline survey on Water, Sanitation, and Hygiene carried out in eight regions of Ethiopia, there is a general misconception about child faeces disposal. The survey showed that a lack of knowledge on the health risk related to child faeces is a key factor behind poor hygiene practices in faeces disposal. According to the survey, only half (49 per cent) of women knew that child faeces are dangerous to health. Misconception is higher among rural pastoralist women where only 39 per cent said child faeces are dangerous as compared with 50 per cent among rural non-pastoralist women and 54 per cent of women in urban areas.

World Toilet Day 2017: safe disposal of child faeces
Lack of knowledge on the health risk related to child faeces is a key factor behind poor hygiene practices in faeces disposal. ©UNICEF Ethiopia/2017/Mulugeta Ayene

A strong early childhood foundation, which includes a safe and hygienic environment coupled with adequate nutrition as well as nurturing parenting and stimulation for optimal brain development, is critical to ensure toddlers can develop to their full potential. This will facilitate a smooth transition to primary school and a better chance of successfully completing basic education. Therefore, investing in early childhood development through improved hygiene practices and environments is one of the most critical and cost‑effective ways to improve a child’s future health, education and productivity.

The Ministry of Health and UNICEF urge citizens, parents, teachers, health workers, policy makers and government officials to play their role in making sure that every child receives the benefits of Water, Sanitation and Hygiene (WASH) in their homes, communities, schools and health facilities.

The Government of Sweden grants US$ 2.5 million to UNICEF for emergency response

The Government of Sweden provides another US$2.5 million to UNICEF Ethiopia to support Water Sanitation and Hygiene (WASH), health and nutrition programmes in the drought affected regions of Afar, Oromia Somali and Southern Nations Nationalities and People’s regions.

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In Ethiopia, where 8.5 million people are currently in need of relief food assistance due to the recurrent drought emergency, 376,000 children are estimated to require treatment for severe acute malnutrition, 10.5 million people require access to safe drinking water and sanitation services and 1.9 million school-aged children need emergency school feeding and learning material assistance.

The contribution provided by the Government of Sweden will be used to construct and rehabilitate water supply schemes, procure Emergency Drug and Case Treatment Centre kits as well as obtain Community Management of Acute Malnutrition (CMAM) supplies including ready to use therapeutic food (RUTF), tents and Stabilization Centre materials in the four regions highly affected by the drought emergency.

UNICEF is grateful to the Government of Sweden for its continued support for providing life-saving interventions during the current humanitarian situation which continues to affect mostly women and children.

In 2017, the Government of Sweden has contributed more than US$5 million to UNICEF-assisted humanitarian programmes in Ethiopia.

Researchers in Action for African children

Researchers from around the continent are gathered this week in Addis Ababa to Put Children First!

In Africa, two billion babies will be born between today and 2050, translating into more than 60 million new lives every year. By 2055, the continent of Africa will be home to 1 billion children, nearly 40 per cent of the number of children worldwide.  Therefore, as noted in the conference by UNICEF Regional Director for Eastern and Southern Africa, Ms Leila Pakkala, nowhere in the world are children more central to a continent’s future than in Africa and “children must be put first”.

Putting Children First: Identifying Solutions and Taking Action to Tackle Child Poverty and  Inequality in Africa
Policy makers, practitioners and researchers discussing better ways in identifying solutions for fighting child poverty and inequality in Africa. ©UNICEF Ethiopia/2017/Meklit Mersha

The international conference with the theme: Putting Children First-Identifying Solutions and Taking Action to Tackle Child Poverty and Inequality in Africa has been promoted by the End Child Poverty Global Coalition and organized at national level by the Ethiopian Centre for Child Research (ECCR) with UNICEF Ethiopia’s support. The Centre is currently establishing partnerships and research collaborations with potential researchers and research institutes nationally and globally.

At the conference, the Ethiopian Minister of Women and Children’s affairs stated, “Because of the Government and its development partners’ efforts, national poverty rates have seen a significant reduction over the past decade in Ethiopia, decreasing from 39 per cent in 2003 to 29 per cent in 2011. However, the decrease in poverty over the past few years has not matched the rate of economic growth, suggesting that economic growth has partly failed to benefit the most vulnerable sectors of society. Women and children are one of the least benefited and vulnerable sections in the society”.

ECCR will share an analysis on the dynamics of multi-dimensional poverty among children in Ethiopia which was also jointly presented with UNICEF Ethiopia at the Child Poverty Conference for MENA in Rabat and at the 6th International Society for Child Indicators in Canada.

Using an adaptation of the Multiple Overlapping Deprivations Approach, it has been showed that share of children who are deprived in two or more poverty dimensions, such as lack of appropriate or access to health and education services or poor quality of housing declined from 82 per cent to 35 per cent between 2002 and 2013. In the meantime, the percentage of children non-deprived increased from 18 per cent in 2002 to 65 per cent in 2013.

For researchers and other professionals in various fields, children should be the top-most priority as we all look for pathways to unlock poverty and inequality in the continent. The ongoing conference would be a great opportunity for practitioners and policy makers from Africa to contribute to the overall debate on child poverty-towards contributing to address child poverty in all its dimensions while promoting evidence generation.

Promotion of Dietary Diversity for the Healthy Growth and Development of Children

By Esete Yeshitla

Sekota, AMHARA, 21 June 2017- Meet Netsanet, a strong and independent 25-year-old mother who is very self-assured; reminiscent of her name, which means ‘freedom’.

When we visit Netsanet in her house, it is a typical morning for her. First, she waters her home garden: cabbage, carrots, tomatoes and other vegetables. The seeds were provided by FAO with funding from the European Union through the woreda (district) agriculture office as a support for her family to have balanced meals. Her next task is feeding her chickens, from which she uses eggs for cooking and as a source of income. She sells eggs on Thursdays at the nearby Hamusit market. She then starts preparing breakfast. She takes fresh vegetables from her garden; a couple of eggs, milk, mixed grains and starts to cook the meal for her daughter.

Netsanet, preparing food as per lessons learned from health extension workers
Netsanet, preparing food as per lessons learned from health extension workers, at the woreda health post. Sekota woreda , Hamusit kebele ©UNICEF Ethiopia/2017/Nahom Tesfaye

Netsanet has two daughters, Mekdes age 5 and in kindergarten; and Tsige age 2. Netsanet explains the difference between her two pregnancies, birth and the girls’ first two years of life. “I had my first child at home, as we did not have awareness. I was lucky that I did not face any complications when I had her. If something bad had happened, I would have regretted it,” says Netsanet.

Back then, even when health extension workers insisted that women give birth at the health centre, it was embarrassing for most women. Netsanet explains, “Nowadays, even the wife of a priest gives birth at the health centre. We lost many of our sisters due to high blood loss during birth. I am grateful for the awareness we are getting now.”

Twice a month, they participate in awareness training at the health post, as part of a UNICEF-supported, European Union-funded programme called EU-SHARE. They also receive education on how to prepare balanced meals for young children under two years old, something Netsanet did not know how with her first child. She says, “I was younger, I only breastfed Mekdes when I had spare time as I was busy with house chores.” For her second daughter, she breastfeeds her 8-10 times per day. Netsanet says, “It makes my child strong and at the same time, it serves as protection against unwanted pregnancy.”

Netsanet has witnessed the results. “My first child was fragile and got sick regularly. I used to spend most of my time at the hospital or pharmacy. She was malnourished and at one point, I thought I would lose her. Thank God she was better after she started taking the [ready-to-use therapeutic foods] that was provided by the health post.”

Netsanet put into practice the education given to her about healthy nutrition with Tsige. She started to feed her food when she was six months old. She says, “We did not know that we can feed different vegetables to our babies.”

Netsanet and her husband have three plots of land allotted by the Government, which they use for harvesting crops. Netsanet says, “We do not sell what we produce. We use it for our consumption.”  In addition to selling eggs, Netsanet buys lambs, raises them and sells the sheep. She also buys grains from retailers and sells it for extra money. Netsanet adds, “So the money I get, I use it to buy other stuff.”

This is not the only work Netsanet has. She is also a member of the health development army (HDA), a strategic network the Government has galvanised to reach rural communities. As part of the Government’s intervention, health extension workers train women from the community to become HDA members and drive health-related behaviour change, including breastfeeding and child feeding practices, within their communities. Netsanet is a leader of five teams that each consist of five women- a ‘network’. Netsanet and five additional network leaders are supervised by a health extension worker.

Netsanet, feeding her tow year daughter porridge made of balance nutritional ingredients based on lessons from the wereda health post.
Netsanet, feeding her two-year-old daughter porridge made of balance nutritional ingredients based on lessons from the woreda health post; Sekota woreda, Hamusit kebele ©UNICEF Ethiopia/2017/Nahom Tesfaye

Mothers meet to discuss twice a month. They meet at the health post to demonstrate how to make food for children. They bring whatever food stuff they can find at home such as eggs, flour and milk, then they cook and feed their children.

The Government of Ethiopia has placed malnutrition high on both the political and the development agenda over the past decade. As a result, bold actions have been taken in health and other nutrition-related sectors, putting in place policies, programmes and large-scale interventions to significantly reduce malnutrition among the most vulnerable groups: young children and pregnant and lactating women.

The EU- SHARE project addresses gaps in implementation of the National Nutrition Programme while strengthening nutrition outcomes of major health, food security and livelihoods Government programmes. The primary focus is on the first 1, 000 days of a child’s life, in order to accelerate the decline in stunting.

Sekota is the woredas targeted by the project and has received support with an aim to enhance quality and uptake of nutrition services being delivered to the community. This is done through building the technical capacity of health workers, improving availability of nutrition supplies and sensitizing community members towards proper infant and young child feeding practices.

These interventions have a significant impact in the overall reduction of child malnutrition, especially through contributing to the improvement of nutrition and dietary diversification practices for adolescent girls, pregnant and lactating women, and children younger than five, just like Netsanet and her girls.

UNICEF Signs Ethiopian Fiscal Year 2010 Work Plans with Government

By Metasebia Solomon

ADDIS ABABA, 30 June 2017- UNICEF Ethiopia signed the Ethiopian Fiscal Year 2010 annual work plans with the Federal and Regional Government under the umbrella of the United Nations Development Assistance Framework (UNDAF 2016-2020).  The signing ceremony, held at the Ethiopian Ministry of Finance and Economic Commission’s office, was attended by Heads of United Nations agencies including UNDP, UNFPA and UNICEF and the implementing Federal and Regional Government offices as signatories of the annual work plans.

Mr Admasu Nebebe, State Minister for Ministry of Finance and Economic Cooperation, speaking after signing the work plans, said “Implementation of the signed work plans will contribute to the achievement of Ethiopia’s current Growth and Transformation Plan [GTP II]. The results and activities are linked to the Government’s priorities at all levels.” UNICEF Representative to Ethiopia, Officer-in-Charge, Ms. Shalini Bahuguna, applauded the Government of Ethiopia’s leadership in implementing the annual work plans, saying “A recent review conducted by UNICEF’s global team has identified the annual work planning process of Ethiopia as a model for other country offices, demonstrating principle of alignment with government policy and ownership by stakeholders.”

 

UNICEF signs Ethiopian Fiscal Year 2010 Work Plans with government
Ato Admasu Nebebe, State Minister for Ministry of Finance and Economic Cooperation shakes hands with Ms Shalini Bahuguna, UNICEF representative to Ethiopia, O.i.C after signing the Ethiopian Fiscal Year 2010 Annual Work Plan. ©UNICEF Ethiopia/2017/Zerihun Sewunet

The work plans were prepared under the logic that the accomplishment of activities will contribute to the achievement of UNICEF’s and UNDAF’s intermediate and higher level results, which are in support of GTP II.  A consultative process was followed during the preparation of the work plans at the Regional and Federal level.  This year, UNICEF Ethiopia signed 143 work plans with more than 140 Regional and Federal Government implementing partners. The work plans cover fifteen programme areas including:

  • Health
  • Nutrition
  • Education
  • Early Warning and Disaster Preparedness
  • Water Supply
  • Sanitation and Hygiene
  • Child Friendly Social Welfare
  • Social Protection
  • Adolescents and HIV/AIDS
  • Violence against Children
  • Ending Child Marriage and FGM
  • Birth Registration
  • Justice for Children
  • Child Rights
  • Public Finance for Children
  • Evidence and Coordination

The total budget equals US$ 74,867,075.  Implementation of the work plans will start on the 1st of July 2017 and will close on the 30th of June 2018, following the Ethiopian Fiscal Year.