Shared responsibility and convergence of interests to end micronutrient malnutrition

Micronutrient Forum Global Conference, Addis Ababa, Ethiopia  2-6 June 2014  Bridging Discovery and Delivery
Micronutrient Forum Global Conference, Addis Ababa, Ethiopia 2-6 June 2014 Bridging Discovery and Delivery ©UNICEF Ethiopia/2014/Sewunet

ADDIS ABABA, ETHIOPIA, 02 June, 2014 – The third Micronutrient Global Conference (June 2-6, 2014) has been discussing ways of overcoming micronutrient malnutrition. The forum, which brings together researchers, policy-makers, program implementers, and the private sector has been held under the theme of “Building Bridges”, thus emphasising scientific advances and multi-sectoral programming on adequate micronutrient intake.

Honorable Madam Roman Tesfaye,  First Lady of the  Federal Democratic  Republic of Ethiopia, welcomes participants of the Micronutrient Forum
Honorable Madam Roman Tesfaye, First Lady of the Federal Democratic Republic of Ethiopia, welcomes participants of the Micronutrient Forum ©UNICEF Ethiopia/2014/Sewunet

Officially opening the conference, first lady of Ethiopia H.E. Roman Tesfaye announced: “Ethiopia is committed to sustainably addressing the challenges of malnutrition and micronutrient deficiency.” During a successive speech delivered by the Ethiopia Minister of Health, Dr Kesetebirhan Admassu, it was highlighted how for a developing country like Ethiopia, investment in nutrition at an early stage of life brings a better return both in terms of human capital and economic development. That is why, according to Dr Kesete, Ethiopia has integrated a core nutrition intervention into its Health Extension Programme. The Minister also emphasised three key issues when addressing malnutrition and other health challenges: “integration, implementation at scale and community ownership.”

On behalf of the Health, Population and Nutrition donor group and the four UN agencies involved in Renewed Effort Against Child Hunger and Under nutrition (REACH) and Scaling Up Nutrition (SUN) in Ethiopia, Dr Peter Salama, UNICEF Representative in Ethiopia outlines four lessons that the global nutrition community can take from Ethiopia:

  • Integration of services for treatment of Severe Acute Malnutrition (SAM) into the national health system.
  • Multi-sectoral approach: linking key line ministries, the private sector, civil society and development partners.
  • Making sure that all decision makers understand that spending money on nutrition is one of the best investments in terms of human capital and economic growth.
  • Political will on implementation of nutrition programmes.

As the development community turns its attention to a post-2015 agenda, Dr Salama stressed that improving nutrition should become the quintessential Sustainable Development Goal (SDG).

40 UNICEF colleagues from many countries around the world, regional offices and headquarters participated in the Micronutrient Forum, presented poster and gave oral presentations on program implementation, best practices, operations research and partnerships. UNCIEF also is member of the organising committee and funder.

UNICEF Ethiopia provided funding and had various abstracts presented at the forum in poster form or oral presentation. Several staff moderated sessions on food fortification, salt iodisation and the translation of global guidelines into policy and programmers. At a get together of all UNICEF staff, the colleagues shared observations about the forum’s contributions to their work and inter-country exchanges were set up. The Ethiopia sat down with the India country team and identified areas for exchange and support. This will continue after the forum ends.

A child getting a Vitamin A supplementation in Tergol town.
A child getting a Vitamin A supplementation in Tergol town. © UNICEF Ethiopia/2014/Bizuwerk

Micronutrient malnutrition, also referred to as “the hidden hunger” is a widespread problem in the world mainly affecting developing nations. According to WHO, micronutrient deficiency results in a poor pregnancy outcome, impaired physical and cognitive development, increased risk of morbidity in children and reduced work productivity in adults. Globally, one third of children under-5 are vitamin A deficient. It is also estimated that more than 40 per cent of pregnant women and children under-5 are anemic, while one in four children under-5 years old (more than 160 million children worldwide) are also stunted.

The third Micronutrient Global Conference looks into the challenges and opportunities for scaling up evidence-based policies and programmes from diverse sectors while discussing the effectiveness of nutrition-specific and nutrition-sensitive interventions to improve micronutrient intake and status. The conference also debates on evidence and methods for measuring micronutrient deficiencies, excesses and coverage, with implications for policies and programmes.

More on a successful nutrition-specific programme from Ethiopia

A Day in the Life of a Well-fed Child: Ethiopia

 

A Day in the Life of a Well-fed Child: Ethiopia

By Frehiwot Yilma

AMHARA REGION, 05 June 2014 – Kossoye Ambaras is a small lush green village within Wogrea woreda in northern Gondar where it is relatively cold. Amarech Ashager, a 28 years old mother of two, is used to the weather as she lived her whole life here. At the top of her daily agenda is making sure that her family, especially her youngest son, Metages Birhanu of 9 months, is well fed.

Like many of the residents, Amerech does not rise out of bed before 7 a.m., as it is too cold to leave the house. She begins her day by breastfeeding Metages and cooking breakfast for the rest of the household. Her husband, Birhanu Tagel, is a businessman and her eldest son, Muluken, 10, is a third grader. After saying ‘good day’ to Birihanu and Muluken, Amarech will cook breakfast for Metages. Since he was introduced to solid food only three months ago, Metages eats exclusively porridge. Preparing highly nutritious porridge for a child is a technique that Amarech has recently learnt. The base of the porridge, the flour, contains various grains and legumes. For breakfast the added ingredient besides the flour is an egg and minced cabbage. As well as cooking the food, feeding the child to achieve best results is also a discipline. Amarech has learnt to feed her child while also playing and talking to him to keep him engaged.

It takes a village to raise a child

Health Extension workers in Amhara region provide preventive and curative health service to the community
Health Extension workers in Amhara region provide preventive and curative health service to the community ©UNICEF Ethiopia/2014

Amarech and other mothers in the village get support from Health Extension Workers (HEWs) on how to properly raise their children. Today, HEWs Habtam Dese and Yeshiwork Tesfahun are weighing the children in the village to monitor their health and development. They too receive assistance from Gebeyaw Alamerew, the woreda Nutrition and Child Health Officer. In a typical session with a HEW, a six-month-old child will receive a vitamin A supplement, while those aged above one year will additionally receive deworming tablets. With the support of UNICEF, this has become a routine service in the woreda.

Out of 18 children weighed by the HEWs , 16 are in the average weight range. Amarech is one of the happy mothers to learn that her son, Metages, weighs 8.6 kilograms, well in the range of a healthy baby’s weight. “I am so happy that he has gained a few more grams since last time,” she says, smiling. After weighing babies in the community, Habtam and Yeshiwork demonstrate how to make a child’s diet balanced and about the importance of using iodised salt. As the child-friendly food preparation simmers over a fire, the two mothers, whose children’s weight was under the average limit, get counselling on how to improve their baby’s weight. Gebeyaw believes the woreda has come a long way. “In previous years, there were up to eight children per month in Kossoye suffering from Severe Acute Malnutrition (SAM), but this year there have been no cases,” he says. “This is because we monitor the children’s growth and give counselling and other packages of support to the mothers at the earliest stage possible, as we did with the two mothers today.” When the food has finished cooking, Habtam and Yeshiwork let the mothers feed the warm nutritious preparation to their children.

Bridging the nutrition gap before sunset

Amarech Ashager breast feeds Metages Birhanu, 9 months old
Amarech Ashager breast feeds Metages Birhanu, 9 months old © UNICEF Ethiopia/2014

The afternoons in Kossye Ambaras are usually foggy this time of the season. Amarech has subsequently decided to do her laundry the following day and so turns to preparing dinner as well as other domestic chores. For Metages, she has a new menu in mind: adding mashed potatoes and carrots to the porridge. She says she will also never forget adding iodised salt to the food. “Habtam has told us that iodised salt is key to a child’s mental growth. She also told us that we have to put in the salt after the food is cooked and out of the oven so that the iodine does not evaporate with the heat,” she says.

Habtam is one of 38,000 government salaried HEWs currently providing nutritional and other support to mothers and children across all regions of Ethiopia. Development partners such as UNICEF are committed to support this initiative. “Nations will face critical bottlenecks to economic growth if a large proportion of their working-age people’s IQ and productivity are limited by under-nutrition,” says Dr Peter Salama, UNICEF representative in Ethiopia.

As the day draws to an end, Amarech’s house becomes lively as the family come together and discuss their experiences. While breastfeeding Metages, Amarech tells her husband about the importance of investing in their children’s diet to ensure their healthy future. “I will feed my children a variety of foods so that they will have a bright mind,” she says with confidence. “And I will be happy if Metages becomes a doctor.”

On the recent Micronutrient Global Conference (June 2-6, 2014), researchers, policy-makers, program implementers, and the private sector has been discussing ways of overcoming micronutrient malnutrition. The forum has been held under the theme of “Building Bridges”, thus emphasising scientific advances and multi-sectoral programming on adequate micronutrient intake. Read more