Integrated Nutrition Services for Better Nutrition Outcomes 

By Nardos Birru

BOLOSO SORE, SOUTHERN NATIONS, NATIONALITIES AND PEOPLE’S REGION, 26 January 2017 – It was a sunny afternoon at the Chamahinbecho health post and the trees planted by health extension workers 10 years ago provided much needed shade in the compound. A group of mothers were sitting under the trees discussing how to best feed their toddlers and among them was Beyenech.

UNICEF Ethiopia 2017 03-1610
Beyenech (middle), waiting for the porridge to feed her baby at a cooking demonstration session at Chamahinbecho health post, Boloso Sore woreda, SNNPR ©UNICEF/2017/Pudlowski

The cheery Beyenech, a mother of three, came to the health post to get her 1-year-old son weighed as part of the growth monitoring and promotion session that they attend on a monthly basis.

“I bring my son here every month and the health extension worker measures his weight and gives me advice,” says Beyenech. “She teaches us how to prepare meals for our children using different foods. I can see that my child is growing healthy and am glad to hear that [confirmed by] the health extension worker.”

Beyenech is among the many mothers in Chamahinbecho kebele (sub-district) who are benefiting from a project supported by the European Union called EU-SHARE. The project aims to contribute to improved nutritional status of children under five, adolescent girls and pregnant and lactating women through strengthening nutrition outcomes of Government health, food security and livelihood programmes. The strategy involves integration of the multi-sector interventions at the household level to create synergetic effects that will maximize programme results.

Nutrition services for adolescents

UNICEF Ethiopia 2017 04-1056
Adolescent deworming service. Chamahinbecho health post, Boloso Sore woreda, SNNPR ©UNICEF/2017/Pudlowski

It is not only Beyenech’s son who is benefiting from the nutrition services at the health post; her 15-year-old daughter has participated in the deworming campaign organized for adolescent students in the kebele. Beyenech speaks of her daughter, “Wubalem received a deworming tablet from the adolescent deworming campaign at her school last year. She also told me about the nutrition and hygiene practices that she heard from group discussion sessions during the campaign.”

Deworming of intestinal worms and schistosomiasis is an important service for young students, as both ailments affect the health and education of children and adolescents. A student with worms will be too sick or tired to attend school or will have difficulty concentrating in school. If left untreated over time, they may face stunting or malnutrition due to anaemia, as well as impaired cognitive development.

The Government-led programme, which is supported by EU-SHARE, contributes to the health and nutrition status of adolescents while improving school attendance rates. EU-SHARE project supports the programme through procurement of deworming tablets, provision of information, education and communication as well as behavioural change communication materials that are helpful to create awareness and initiate discussion on nutritional requirements during adolescence. The programme also includes technical support to health workers who carry out the deworming campaigns. Students like Wubalem have a better chance to succeed with their education due to initiatives like these.

Improving dietary diversity through backyard gardening

EU-SHARE also includes nutrition-sensitive agriculture interventions which is implemented by FAO as part of the Government’s commitment to integrate nutrition into the agriculture sector. Promotion of backyard gardening is among the initiatives being implemented in the kebele.

After meeting the eligibility criteria targeting vulnerable families, Beyenech has been selected among the 1,960 beneficiaries targeted for seed supplementation led by the woreda agriculture office. She received vegetable seeds and began growing carrots, cabbage and tomato in her backyard garden. Beyenech explained, “I started preparing a porridge mixed with vegetables from my garden, using what I learned from the cooking demonstrations at the health post. I also prepare roasted vegetables along with shiro wot [chickpea stew] for the rest of my children.”

UNICEF Ethiopia 2017 03-1876 (2)
Beyenech, a mother of three, showing her backyard garden. Chamahinbecho kebele, Boloso Sore woreda, SNNPR. ©UNICEF/2017/Pudlowski

Beyenech aspires for her children to have a better future. She wants them to be top students and become teachers or doctors so they have the knowledge and skills to impact the next generation in the community.

“Such type of nutrition interventions that consider integration as a cornerstone by addressing the different aspects of nutrition are a key weapon to combat the problem of malnutrition in a sustainable manner,” said Israel Mulualem, the nutrition focal person in Boloso Sore woreda health office.

The four-year EU-Share programme has been operational since 2015 and continues to support children, mothers and their families in seventeen woredas located in SNNP, Oromia and Amhara regions. Together with the Government of Ethiopia and donors such as the European Union, UNICEF is able to support existing initiatives of Government programmes so that children such as Wubalem, Setot and Teketel may have a bright future.

Ethiopia: Government and Humanitarian partners scale up to meet additional immediate relief needs of El Niño-driven crisis

An additional US$164million urgently needed to address increased food
and non-food needs for the remainder of the year

Temporary emergency rub hall tent built by UNICEF for drought affected people in Afar National Regional State, Adaytu woreda (district), Ethiopia.
Temporary emergency rub hall tent set up by UNICEF for drought affected people in Afar National Regional State, Adaytu woreda (district), Ethiopia. ©UNICEF Ethiopia/2015/Tesfaye

Addis Ababa, 13 October 2015: The Government of Ethiopia announced yesterday, during a meeting with UN agencies, NGOs, and Donor representatives, that the number of people in need of relief assistance in Ethiopia due to El Niño phenomenon had increased to 8.2 million. An inter-agency assessment conducted last month and led by the government identified an additional 3.6 million people in need of food assistance (from 4.55 million in August) as well as 300,000 children in need of specialized nutritious food and a projected 48,000 more children under five suffering from severe malnutrition.

An addendum to the joint-Government and humanitarian partners- Humanitarian Requirements Document (HRD) mid-year review was signed to officialise the increase in humanitarian needs. The National Disaster Prevention and Preparedness Committee (NDPPC), the high level national advisory body overseeing the Government response, further requested the government lead a multi-sector, multi-agency annual meher assessment in October (rather than November). This will enable the Government and partners to expedite planning and assistance provision for 2016.

His Excellency Mr Mitiku Kassa, NDPPC Secretary, explained during the meeting yesterday that the Government committed some 4 billion Ethiopian Birr (US$192 million), to address emergency food and non-food needs as a result of failed spring belg and poor summer kiremt rains caused by the climatic phenomenon known as El Niño.

“The El Niño conditions have brought Ethiopia a great challenge, but the Government and Regional States are ready to meet the needs of the people alongside partners in the international community,” said Mr Kassa. He further stated that the Government would continue to allocate resources as necessary to meet the needs of the Ethiopian people.

“The challenge we have before us is incredibly serious, and it will take the collective effort of the entire international community to support the Government in preventing the worst effects of El Niño now and well into next year,” said Mr John Aylieff, Acting Humanitarian Coordinator and Country Director for the UN’s World Food Programme.

Abahina Humed’s arm measurement shows that the child is acutely malnourished. He is taking treatment at Gewane Health Center, Afar region, Ethiopia.
Abahina Humed’s arm measurement shows that he is acutely malnourished. He is taking treatment at Gewane Health Center, Afar region, Ethiopia. © UNICEF Ethiopia/ 2015/Tesfaye

Affected areas include southern Tigray, eastern Amhara, Afar, and Siti zone of Somali region, eastern SNNP, East and West Hararge, Arsi and West Arsi, and lower Bale zones of Oromia. Water and pasture shortages decreased livestock production and caused livestock deaths in pastoralist and agro-pastoralist communities.

The number of woredas (districts) prioritized for nutrition interventions doubled from 97 in July to 142 in September, and the number of severely malnourished children requiring therapeutic feeding in August reached 43,000 children. This is higher than any month of the 2011 Horn of Africa crisis.

“Donors have been generous,” said Mr Paul Handley, OCHA’s Head of Office, “but if we are to meet the significant needs before us today, and more in the months ahead, we need far more support. We count on that generosity to continue,” he said.

The Mid-Year Review of Ethiopia’s Humanitarian Requirements Document (HRD), issued on 18 August 2015, listed $432 million in funding requirements with contributions totalling $258 million (or, 55 per cent funding). The September rapid assessment conducted at the end of September highlighted increases in humanitarian need across several life-saving sectors, most notably food assistance, targeted supplementary food (TSF), therapeutic nutrition, emergency water interventions, and agriculture and livelihoods. Factoring in the previous shortfalls with adjusted needs, the 2015 humanitarian requirements were adjusted to $596.4 million, leaving the HRD funded at 43 per cent.

The on-going effects of the El Niño may further affect the weather patterns this autumn, with Ethiopia’s National Meteorological Agency (NMA) predicting strong rains along the Omo, Shabelle, and Awash rivers. This may impact harvests in some areas and cause flooding during the last quarter of the year.

In addition to food and nutrition needs, Ethiopia’s Humanitarian Requirements Document outlines emergency requirements in the health, WASH, agriculture and education sectors. Most sectors saw the figures of those in need increase.

The Ethiopia Humanitarian Country Team again calls on all partners to work closely together to address emergency needs whilst safeguarding development gains.

Three weeks ago the Ethiopia Humanitarian Country Team also released a forward-looking document (prepared in consultation with Government) called ‘Ethiopia Slow onset natural disaster: El Niño Driven Emergency’, available to download here.