I don’t want a world where all children are healthy, happy and safe to be just a dream. I want it to be reality: Hannah Godefa

Canada mobilizes support for innovation, integrated action for youngest children

#EveryNewborn

Mother and child at Wukro Clinic
Improving newborn and child health also depends on better accountability — and more thorough accounting. Wukro Clinic, Ethiopia ©UNICEF Ethiopia/2009/Tuschman

Toronto/Addis Ababa, 29 May 2014 – Every minute, 10 babies die or are stillborn across the world, a staggering 5.5 million lives ended every year just as they start.  The majority of those deaths are from preventable causes, including prematurity, childbirth complications and newborn infections.

While child death rates have been reduced by almost half since 1990, newborn mortality has increased as a proportion of overall of child mortality, as highlighted by papers published in The Lancet earlier this month.

“We are succeeding in rapidly reducing child mortality because we have made it a global priority, with a commitment to innovation, partnership, and equity,” said UNICEF Executive Director Anthony Lake.   “We need the same global commitment, and the same political will, to reduce newborn mortality — working together to find new ways of reaching every family.”

Poorer families bear the greatest burden of newborn deaths.  If current trends continue, it will take over a century before a baby in the Central African Republic has the same chances of survival as a baby born in Canada.

Lake hailed Canada’s leadership in galvanizing global support to reduce maternal, newborn and child mortality.  The Toronto Summit will explore the most effective ways to speed up progress on newborn, child and health.

“The fact that not all children and young people around the world have access to critical health care is unacceptable. It must change,” said UNICEF Ethiopia National Ambassador, Hannah Godefa, who was the only young person to speak at the Summit. “I hope we can redouble our efforts and be catalysts for change. I urge all of you today to renew your promise to the women and children of the world and commit to taking concrete action to ending the preventable deaths of women and children. Because I don’t want a world where all children are healthy, happy and safe to be just a dream. I want it to be reality.” she added.

Improving newborn and child health also depends on better accountability — and more thorough accounting.

In 2012 alone, around two out of five births worldwide were not registered. Around the world, nearly 230 million children under age five have never been recorded – meaning they do not have the legal identity they need to access health, education and other services. And the numbers will rise unless action is taken.

But increasing the number of children registered at birth enables governments to improve the planning and budgeting of life-saving interventions, and to summon the political will and civil society support that is needed to meet targets.

“This year we will celebrate the 25th anniversary of the Convention on the Rights of the Child.  Millions of children are still being deprived of the most precious right — the right to survive,” said UNICEF Executive Director Anthony Lake.  “We must reach every family, every woman, every child, and every newborn.”

 

Health Extension Workers: Key to Reducing Malnutrition in Ethiopia

Eneayehu Beyene and Tena Esubalew, helth extention workers Amhara rigion of Ethiopia.
Eneayehu Beyene and Tena Esubalew, Health Extension Workers in Delma kebele of Machakel woreda Amhara region of Ethiopia. Preparing their monthly report on community based nutrition activities to submit to the health. ©UNICEF Ethiopia/2014/Tsegaye

AMHARA REGION, 3 April 2014- Tena (meaning health in Amharic) Esubalew, 25, and Eneayehu Beyene, 27, are the heroines of Delma kebele as they have become the health confidants of the community. Delma Kebele (sub district), which is located in Machakel woreda (district) in the Amhara Region in northwest Ethiopia. Delma is a community 10 kilo meter from an asphalt road with a population of 4,733. As part of the EU funded Africa Nutrition Security Project (ANSP), UNICEF launched a community health programme (2012-2015) in 20 districts across three regions of Ethiopia to help the Government boost the nutritional status of children under two in communities like Delma where child malnutrition has been alarmingly high.

Key to the programme’s success has been the role of community Health Extension Workers (HEWs). From Delma, Tena  and Eneayehu have received intensive training with the support from UNICEF on nutrition so they can effectively carry out health extension duties.

“It is clear to us that three years ago no-one in this community could identify if a child was malnourished or not, this problem has been recently solved through the programme’s awareness strengthening on nutrition,” says Eneayehu

Breast Feeding-Tena Esubalew Health Extension Worker coaches Etenesh Belay positioning of the child for effective breast feeding
Tena Esubalew Health Extension Worker coaches Etenesh Belay positioning of the child for effective breast feeding Amhara rigion of Ethiopia. ©UNICEF Ethiopia/2014/Tsegaye

Eneayehu and Tena spend most of their days walking between households in Delma, visiting young mothers in the community and engaging them about the importance of child nutrition. They are trained to identify mild and moderate malnutrition and also growth faltering – based on which they provide age-tailored counselling. Additionally, they can diagnose if a child has Severe Acute Malnutrition (SAM) with or without complications. If a child is suffering from SAM with complications then the health extension workers will quickly have them referred to a health centre in the nearest town.

The health post where Tena and Eneayehu  work is  situated on top of a hill surrounded by open fields and grazing livestock. It is a busy hub frequented by the community’s young mothers, who are eager to learn about their children’s health status. The walls are plastered with graphs charting the health and development of the community’s under-five children. It is here that growth monitoring of all the community’s children under-two-years is conducted on a monthly basis and compared with World Health Organisation growth standards.

Breast Feeding-Yedeneku Aynalem 38 with her son Barkelegn 10 month
Yedeneku Aynalem 38 with her son Barkelegn 10 month, who is benefiting from community based nutrition Machakel woreda Amhara region. ©UNICEF Ethiopia/2014/Tsegaye

Yideneku Aynalem, 38, reaches up to a mud shelf in her hut and retrieves an illustrated booklet. “This is a very important document”, she says carefully opening the page to reveal a colourful chart. The HEWs have distributed  the materials printed with the support of UNICEF throughout the community to enable lactating mothers to track their child’s weight. Yideneku points to a graph and traces with her finger a green upward curve signifying the trajectory of a healthy child’s development based on optimum height and weight measurements. She explains with a smile how her 10 month old child Barkelegn Walelign’s growth has started to correlate with the green line on the chart. “I have been given the knowledge and it is now my responsibility to keep putting this learning into action so that my child can remain strong and healthy”, she says. Yidenku’s child is one of 270 children under-two years of age that have benefited from the EU-UNICEF supported package of high impact interventions in Delma.

The community results are encouraging: the rate of underweight young children has reduced from six per cent to one per cent in two years. “At the start of the programme, six children in the village were diagnosed with Severe Acute Malnutrition (SAM) – this year only two children suffered this extreme health condition”, says, Tena.

Sudan and its partners learn how Ethiopia brings nutrition and health to doorstep of its people

By Sylvie Chamois

Team of visitors from Sudan getting a briefing on the Health & Nutrition programme
Salwa Abdelrahim Surkati Hassan, FMOH nutrition director, Nada Yahya Omer Hamza, WHO IMCI coordinator and Naglaa Osman Khidir Babikir, UNICEF nutrition officer visiting Tula health post in Babile woreda, East Hararghe zone of Oromia region ©UNICEF Ethiopia/2014/Gemeda

From the 24th to the 28th of March 2014, the Ethiopian Federal Ministry of Health (FMOH) and UNICEF Country Office had the pleasure to host a team from Khartoum composed of the Sudanese FMOH (planning, nutrition and IMCI[1] departments), WHO, WFP and UNICEF.

The objective of the visit was to learn how Nutrition has been integrated in the Health system and how the Government of Ethiopia managed to bring Health & Nutrition services to the doorstep of its people.

Following an opening meeting with the State Minister of Health, H. E. Dr Kedede Worku, the team proceeded directly to the domestic airport heading to East Hararghe zone of Oromia region. They were introduced to the programme by the Zonal Health Department’s head, Ato Ali Abdulai, before visiting Babile and Gursum woredas.

In the two districts, they were able to visit and discuss with the one-to-five network, a team of Health Development Women; female Health Extension Workers working in health posts; Health Workers in health centres and finally, nurses and doctors in Bessidimo hospital.

Team of visitors from Sudan getting a briefing on the Health & Nutrition programme
Team of visitors from Sudan getting a briefing on the Health & Nutrition programme in Babile health centre, Babile woreda, East Hararghe zone of Oromia region on March 25, 2014
©UNICEF Ethiopia/2014/Gemeda

In Harare, Frehiwot Mesfin presented a project managed by Haromaya University, with the support of UNICEF and FAO, to produce complementary food for children under two years of age using exclusively locally available ingredients.

Back in Addis Ababa, the team had the opportunity to visit the local producing factory for Ready-to-Use Therapeutic Food[2], Hilina PLC.

On the last day, during the debriefing meeting at the FMOH with Ato Birara Melese, head of the Nutrition unit, the visitors appreciated having been able to see all levels of the Health system, from the Federal Ministry down to the households with the one-to-five network. They said that they were impressed by the very well organised and functional system and confident that they can adapt the Ethiopian experience to integrate child and maternal Health & Nutrition to the lowest level. Sudan is working hard to accelerate the achievement of the Millennium Development Goal 4 – to halve child mortality by 2015.

UNICEF calls for US$2.2 billion to help 59 million children in emergencies, including Ethiopia

Largest emergency appeal on record, almost 40 per cent for Syria and region

Somali children concentrate on their learning at a school supported by UNICEF and operated by Save the Children in Kobe refugee camp in Ethiopia. © UNICEF Ethiopia/2013/Ose

GENEVA/ADDIS ABABA, 21 February 2014 – UNICEF appealed today for almost US$2.2 billion to provide life-saving humanitarian assistance in 2014 to 85 million people, including 59 million children, who face conflict, natural disasters and other complex emergencies in 50 countries.

“I have just returned from South Sudan, the latest large-scale conflict to disrupt the lives of millions of innocent children. Over 400,000 children and their families have been displaced by the conflict, and over 3.2 million people are in need of humanitarian assistance. The rainy season is coming and we need to preposition supplies and reinforce essential services, for which we need urgent funding to prevent a catastrophe,” said Ted Chaiban, UNICEF’s Director of Emergency Programmes.

“The children of South Sudan join millions of others affected by conflict in the Central African Republic and Syria. But while today’s headlines focus on these complex, under-funded crises, many other desperate situations also require immediate funding and urgent humanitarian assistance. These include Afghanistan, Colombia, the Democratic Republic of the Congo, Myanmar, Somalia and Yemen, and other countries reflected in UNICEF’s appeal,” Chaiban said.

UNICEF’s Humanitarian Action for Children 2014 appeal highlights the daily challenges faced by children in humanitarian crises, the support required to help them survive and thrive, and the results that are possible even in the most difficult circumstances.

For Syria and the sub-region, UNICEF is appealing for US$835 million to deliver life-saving assistance including immunization, water and sanitation, education, and protection; and to support the social cohesion and peace-building skills needed to build a more sustainable future.

“Children are always the most vulnerable group in emergencies, facing a high risk of violence, exploitation, disease and neglect,” Chaiban said. “But when support is made available, we can change the lives of children for the better. With its partners, UNICEF is working to address a diverse range of humanitarian situations including malnutrition in the Sahel; lack of safe drinking water and adequate sanitation in Yemen; cholera in Haiti; increased attacks on children in Afghanistan; and drought in Angola.”

In Ethiopia, to support children affected by humanitarian crisis and accelerate efforts to break the vicious cycle of drought, hunger and poverty, UNICEF is appealing for US$31,126,000 million by working closely with Government and partners. The fund is allotted to treat 238,700 children aged 6 to 59 months affected by severe acute malnutrition, provide water for drinking, cooking and personal hygiene for 1,200,000 people and offer formal and informal education to 90,000 children. This year’s appeal will build on the past gains made towards strengthening the resilience of communities in Ethiopia and save the lives of children. The 40 per cent decrease in requirements from 2013 reflects a projected improvement in the food security and nutritional situation in 2014.

See the press release here. 

Simple, Cheap Health Remedies Cut Child Mortality In Ethiopia

Health extension worker Bruktawit Mulu
Health extension worker Bruktawit Mulu ©UNICEF Ethiopia/2013/Ose

By NPR

Poor countries are starting to realize something that richer ones sometimes forget: Basic, inexpensive measures can have dramatic impacts on the health of a country. And they can save thousands of lives.

Take, for instance, the situation in Ethiopia.

The country used to have one of the highest rates of child mortality in the world.

“If you were a kid born in 1990 [in Ethiopia], you had a 1 in 5 chance of not surviving to your fifth birthday,” says Peter Salama, who directs UNICEF’s efforts in Ethiopia.

Since then, the country has improved that survival rate by about 60 percent. “So [Ethiopia has made] a tremendous achievement in the space of two decades,” Salama says.

This progress isn’t a result of expensive international aid or the recruitment of foreign doctors into Ethiopia. Instead, the country has invested in simple, bare-bone clinics scattered around the country, which are run by minimally-educated community health workers.

Foos Muhumed Gudaal is one of 35,000 rural health extension workers in Ethiopia. She practices at a post in the village of Walgo Yar in the eastern part of the country. The clinic is a simple, cement building with only two rooms: one for Gudaal to live in and one that serves as a consultation room. There is no electricity. There are no lights.

Gudaal’s role at the post is a bit like the old image of a small-town pediatrician. But she isn’t even a nurse. Instead, Gudaal, along with all the other health extension workers, has gone through a special, one-year training program.

Her salary also isn’t anywhere near that of a pediatrician. She earns roughly $35 each month.

But Gudaal can still treat the diseases that often cut a child’s life short in Ethiopia. And she can make sure kids in the village are up to date on their vaccines.

One of the main conditions Gudaal deals with is malaria. The parasite kills about 600 million people worldwide each year, and the vast majority of those deaths occur in children under age 5. Gudaal can diagnose and treat most malaria cases at her health post.

She can also easily treat diarrhea and respiratory infections, two other major killers of children in the developing world.

Because there is no electricity at the clinic, Gudaal has to rely on a kerosene-fired refrigerator to keep her vaccines cold. The aging fridge sits in a small shed next to the consultation room.

Gudaal lifts several vaccine vials out of the fridge. She not only administers immunizations, but she also keeps records for who in the village needs shots and boosters.

Since being launched a decade ago, this health extension program in Ethiopia has had a huge effect in the country, Salama says.

Quite simply, it has saved lives. “Children are now treated right across the country on a scale that was previously unheard of around the world,” he says.

“Take acute severe malnutrition, for which Ethiopia was famous in the ’70s and ’80s,” Salama says. “Today, successfully, these same lady health workers treat 300,000 children [each year] for severe malnutrition.” Previously, these children would have most invariably died, he says.

Despite these improvements, Ethiopia still has a long way to go when it comes to children’s health. Malnutrition is still the leading cause of death for children under age 5 in the country. Nearly 20 percent of Ethiopian babies are born underweight, weighing less than 5 1/2 pounds. And about 40 percent of kids don’t reach a normal height because of malnutrition.

But, Salama says, the beauty of Ethiopia’s health extension program is that it’s sustainable. It’s run by the government, not a foreign foundation or agency. So as long as there’s the political will, it’s able to reach kids across the country.

Original Story http://www.wbur.org/npr/255448192/simple-cheap-health-remedies-cut-child-mortality-in-ethiopia 

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Ethiopia meets MDG 4 by cutting Under 5 mortality By Two-Thirds Since 1990

In Ethiopia, DFATD support improves community based child and maternal care

By Frehiwot Yilma

Paul Rochon thanks Misa Wondimagen, 25, Health Extension WorkerDERA DISTRICT: AMHARA REGION, 30 October, 2013 – It is early Thursday morning and Gibtsawit Health Post, found in a rural village of Gibtsawit Mariam located 42 kilometres from Bahirdar, is busy with patients. The small room is crowded with mothers who are there to check their babies’ growth; pregnant women having their antenatal care and men and women of the community who are receiving malaria treatment.  Today is a special day, because the health extension workers of the health post are welcoming Mr Paul Rochon, Deputy Minister of International Development, Foreign Affairs, Trade and Development Canada (DFATD) and Dr Peter Salama, UNICEF Representative to Ethiopia.

Misa Wondimagegn, a 25 year old health extension worker, supports the community in Gibtsawit village of Dera district with curative and preventative health and nutrition services.  Misa and her colleagues Meseret and Hagere are supported by the health development army (a network of one volunteer to five Households) attend the 13,366 population of the kebele.

Misa has been working at Gibtsawit Health Post for seven years. “It was just when I finished tenth grade that I had the opportunity to join the training for health extension workers. It was hard convincing people to allow me to monitor the growth of their baby and take my advice about what to feed their children,” she says.  “We travelled long distances to reach as many households in the village as possible.  In each of our visit we tried to improve the health seeking behaviour of the community and eventually encouraged them to go to the health post.”

Growth Monitoring and Promotion is the cornerstone in the Community Based Nutrition Programme.  It creates a platform for the health extension workers to contact the caregivers and check the nutritional status of children, detect growth faltering at early stage and provide counselling on Infant and Young Child Feeding practices (IYCF).

“Now, the situation has changed a lot: we have mothers who bring their children for check-up and pregnant women who come for antenatal care. The support we get from UNICEF and the Canadian Government has increased the variety of treatments we provide for the community. We have outpatient treatment for children diagnosed with severe acute malnutrition and for pregnant women we give antenatal care and supply iron –folate. We promote good Hygiene and sanitation and we also give treatment for common childhood illnesses like pneumonia malaria and diarrhoea for the community,” Misa explains with smile on her face.

Support in Action

Haimanot Andarge, 20, and her daughter Azeb Abraru, 23 month, relax at home in Dera Woreda in Amhara region of Ethiopia

Since 2007, the Canadian Government has been supporting UNICEF Ethiopia’s interventions in Child Survival with Vitamin A and Zinc Supplementation and Integrated Health System Strengthening as well as routine immunization. Dera is one of the 100 UNICEF supported districts implementing the preventive and curative nutrition interventions. It is implementing Community Based Nutrition (CBN), integrated with other Community Maternal New-born and Child Health Interventions (CMNCH) to prevent child malnutrition, focusing on the first 1000 days: the time between conception and when a child turns two years of age.

In August 2013, 1,247 children attended the monthly Growth Monitoring and Promotion session in Dera enabling Misa and the other 78 health extension workers in the district to identify nutritional status of the children, detect early growth faltering, help the caregivers visualize the status and counsel them on appropriate age specific feeding messages using the Family Health Card as a counselling aid and refer children for further care in a timely manner whenever needed.

Haimanot Andarge, a 20 year old mother of baby girl Azeb, is one of the many mothers in the district who got follow ups from Misa and her colleagues during their pregnancy. “Misa used to come to my house regularly ever since she knew I was pregnant. She gave me vaccines and other supplements which was important for my baby. And when my labour began my husband took me to the health post. Misa encouraged me to deliver at Hamusit Health Centre which referred me to Bahirdar Hospital in time as my delivery was complicated. My baby was delivered safely because the health post was in our village to identify my condition,” Haimanot remembered. Her eyes reflect her fear of what might have happened. “ Azeb, is going to be two this year and  Misa still follows up on her  regularly and gives me advice on what to feed her,” adds Haimanot.

Integrating approaches to combat malnutrition

Holding Plumpy'Nut produced in Ethiopia, Misa Wondimagen, 25, Health Extension WorkerOne of the challenges to the health extension workers was what kind of advice to give to families with low income, regarding additional food for their children. “Health Extension Workers usually explain to families to use variety of cereals, animal protein and vegetables. Those who have money would buy and others barter with what they have produced,” explains Ato Worku Endale, Head of the Dera District Health Office. “Recently we have been integrating the health extension programme with the agriculture extension programme to support farmers on what to produce and how they can support their children and family with variety of food items. In addition, the safety net programme that has been implemented in this particular community allows families with low income to be involved in the income generating activities.”

With the integrated multisectoral approach of the government of Ethiopia and the support of UNICEF and partners such as DFATD, the hard work of health extension workers like Misa and colleagues is paying off.

Revolutionizing treatment of Severe Acute Malnutrition (SAM)

The support from UNICEF and the Canada Government that started the preventive nutrition programme of Community Based Nutrition linked with provision of WASH facilities has helped reduce the number of children who are malnourished.  According to Dr. Peter Salama, the collaborative work of all stake holders, the availability of treating health posts within the community have made saving a child easier than ever before.

At the end of the visit the team eagerly waits to hear from Misa and her colleagues on their response to the fundamental question of how many children were lost to malnutrition recently.  “There were 27 children diagnosed with Severe Acute malnutrition in July 2012- August 2013. They were treated with the Out-patient Therapeutic Programme (OTP) and 20 have been cured and seven are still on follow up with good prognosis but we have not lost a single child,” Misa explained boastfully.
Group Photo: Joint visit of UNICEF and DFTAD

“It was not easy to change the attitude of the community. When we started, there was no one before us working with the community reaching every  household door to door. We started from nothing. But with the support of donors like  UNICEF and the Canadian Government, I cannot even remember the last time a child died in the community for the last four years,” Misa reminisces.

“It makes me realise that it was not for nothing that I worked so hard at the beginning. I have brought change in my community.” Misa concludes.

Commiting to Children is Commiting to The Future – Angélique Kidjo

While visiting UNICEF Ethiopia in November, Angélique Kidjo UNICEF Goodwill Ambassador,  asked the public to join her and UNICEF and commit to ensure that children have adequate food, shelter and clean water; every boy and girl has access to education and primary health care and  protect children from all forms of abuse, neglect and exploitation.

She said: Committing to children, is committing to the Future!