Giving children the best start in life begins with breastfeeding. Breastmilk is the natural first food for newborns. It provides children with necessary nutrients for their growth and development and protects them from deadly diseases such as pneumonia and diarrhoea.
There is no better substitute food for a breastmilk. A breastfed child is 14 times less likely to die in the first six months than a non-breastfed child, and breastfeeding drastically reduces deaths from acute respiratory infection and diarrhoea, two major child killers.The longer breastfeeding is delayed, the higher the risk of death for children in their first month of life.
This year when the world celebrates breastfeeding week (1-7 August) emphasis has been made on breastfeeding and its importance to achieve Sustainable Development Goals (SGDs).
Here in Ethiopia, when the event was celebrated at the Ministry of Health the State Minister of Health, Dr Kebede Worku, said that breastfeeding has an ‘all rounded’ benefit that keeps children healthy, happy and more productive at later age. He also stressed that mothers need to be supported to breastfeed their children both at home and in the workplace.
UNICEF Deputy Country Representative to Ethiopia, Shalini Bahuguna, on her part said “optimum breastfeeding to children under six months is an effective resilience measure.” She also underscored UNICEF’s commitment to promote early and exclusive breastfeeding by engaging fathers, religious leaders as well as members of the community.
According to UNICEF, early breastfeeding rates in sub-Saharan Africa have increased by 19 per cent from 1995 to 2011. This is the highest rate when compared to other regions. It is estimated that 41 per cent of children in sub-Sharan Africa are exclusively breastfed. When it comes to Ethiopia, the numbers are encouraging. Ethiopia is one of the leading countries with 52 per cent of children exclusively breastfed within the first six month.But still there is a long way to go as the country has high stunting rate.
Breastfeeding and sustainable development
Early and exclusive breastfeeding helps children to survive. That is a fact. Yet, breastfeeding is also linked with national development. Evidence shows that the benefits of breastfeeding extend into adulthood. A well breastfed child has good sensory and cognitive development which is associated with better educational achievement. Healthy and better educated children will be more productive and positively impact socio-economic development.
Breastfeeding also contributes to poverty reduction. It is a natural and cost effective way of feeding which do not burden household budget as compared with formula feeding. Thus, supporting breastfeeding is the smartest investment nations can make to ensure the wellbeing of their citizens.
It is, therefore, critical to promote optimal breastfeeding and provide support to mothers who have social and commercial pressures that compromises their decision to breastfeed.
NEW YORK/Addis Ababa, 9 September 2015 – The rate of decline in mortality among the world’s youngest children has more than doubled over a generation, and an additional 38 million lives could be saved by 2030 if progress accelerates further, in line with the Sustainable Development Goals (SDGs) world leaders are set to approve later this month.
Since 2000, when governments committed to achieving the Millennium Development Goals (MDGs), the lives of 48 million children under the age of five have been saved. This remarkable progress is the result of sustained action by leaders – to make saving children’s lives a policy and a political priority, to improve and use data about child survival, and to scale up proven interventions.
The number of children who die from mostly preventable causes before they turn five now stands at 5.9 million a year – a 53 per cent drop since 1990. At 3.9 percent the global annual rate of reduction of under-five mortality between 2000 and 2015 was more than twice as high as what it was in the 1990s.
Some of the world’s poorest countries have demonstrated that substantial reductions in child mortality can be achieved despite formidable obstacles:
24 out of 81 low- and lower-middle income countries, including Cambodia, Ethiopia, Bangladesh and Uganda, achieved the MDG of reducing the under-five mortality rate by two-thirds or more.
Between 2000 and 2015, twenty-one sub-Saharan African countries reversed a rising mortality trend or at least tripled their pace of progress compared to the 1990s.
Low income countries are: Cambodia, Ethiopia, Eritrea, Liberia, Madagascar, Malawi, Mozambique, Nepal, Niger, Rwanda, Uganda, and the United Republic of Tanzania. Lower-middle income countries are: Armenia, Bangladesh, Bhutan, Bolivia (Plurinational State of), Egypt, El Salvador, Georgia, Indonesia, Kyrgyzstan; Nicaragua; Timor-Leste; Yemen.
To reiterate the agenda, A Call to Action Summit took place from 27-28 August 2015 in New Delhi, India with the aim of ending preventable deaths of children and mothers by 2035. This was a prelude to the United Nations Summit for the adoption of post-2015 development agenda that will be held as a high-level plenary meeting of the UN General Assembly in September 2015.The two-day Leadership Summit was a confluence of health ministers from over 10 priority countries that committed to the global Call to Action for Child Survival in June 2012 including Ethiopia.
At the Summit, Ethiopia was represented by His Excellency Dr. Kesetebirhan Admasu accompanied by the technical team, including representatives from CSOs. In addition, Abelone Melese, UNICEF National Ambassador to Ethiopia, deliberated a speech and recited two songs entitled, “Welaj Enat” and “Happy Birthdays” to the participants of the Summit.
Dr. Kesete presented the progress accomplished by the Government of Ethiopia during the last decade and the new priorities- Ensuring “Quality” & Equity” in health care. He said, “The Government of Ethiopia is committed to end preventable maternal and child deaths. This will be possible through unwavering political commitment, community ownership, and universal health
coverage of high impact interventions. To consolidate the gains that were made during the MDGs and accelerate the progress towards the noble cause of ending preventable maternal and child deaths, the Ministry of Health has developed a 5-year-Health Sector Transformation Plan (HSTP) 2015-2020. The plan has set out ambitious goals to be achieved in this period. I would like to state four of the transformational agendas that were set out in this plan. Ensuring “Quality” & Equity” in health care: Equity and quality are the core goals of the health sector transformation plan, which aspires to build a high performing health system”.
UNICEF will continue to support the Government of Ethiopia to sustain the gains made on Child Survival and ensure that the unfinished business of neonatal and maternal mortality are rapidly addressed.
“Saving the lives of millions of children in urban and rural settings, in wealthy and poor countries, is one of the first great achievements of the new millennium — and one of the biggest challenges of the next 15 years is to further accelerate this progress” said UNICEF Deputy Executive Director Yoka Brandt. “The data tell us that millions of children do not have to die — if we focus greater effort on reaching every child.”
Simple, high-impact, cost effective solutions that contributed to this dramatic reduction of under-five deaths include skilled antenatal, delivery and postnatal care; breastfeeding; immunization; insecticide-treated mosquito nets; improved water and sanitation; oral rehydration therapy for diarrhoea; antibiotics for pneumonia; nutritional supplements and therapeutic foods.
Despite this impressive progress, the world has not met the MDG target of reducing under-five mortality by two-thirds.
Between 1990 and the end of 2015, an estimated 236 million children will have died from mostly preventable causes before turning five. Today, leading causes of under-five deaths include prematurity; pneumonia; complications during labour and delivery; diarrhoea; and malaria. Under-nutrition contributes to nearly half of all under-five deaths.
The SDGs challenge countries to significantly increase their efforts to bring rates of under-five mortality down to 25 deaths (or fewer) per 1,000 live births by 2030. By picking up the pace, especially in countries that are lagging, the world stands to save the lives of 38 million more children under the age of five.
About A Promise Renewed
Since its initiation in 2012, A Promise Renewed has focused on promoting the Millennium Development Goal (MDG) 4 of reducing the under-five mortality rate by two-thirds between 1990 and 2015, and continuing the effort until no child or mother dies from preventable causes. Partners that support A Promise Renewed have committed to five priority actions:
Increasing efforts in the countries facing the greatest challenges on under-five mortality;
Scaling up access to underserved populations everywhere;
Addressing the causes that account for the majority of under-five deaths;
Increasing emphasis on the underlying drivers of child mortality, such as women’s education and empowerment;
Rallying around a shared goal and using common metrics to track progress.
36 Rotarians from Ethiopia, Canada and the United States visited East Shewa zone in the Oromia region of Ethiopia to deliver polio vaccinations to more than 600 children under the age of five.
The visit marked the launch of the first round of polio National Immunisation Days in the country and the group also visited the country office of UNICEF Ethiopia, which is a partner in the global polio eradication initiative.
The visit coincided with an intensified immunisation campaign in Ethiopia, in response to the polio outbreak which began in August 2013, triggered by the Horn of Africa outbreak in Somalia and Kenya.
As of November 2014, 10 cases of Wild Poliovirus Type 1 (WPV1) had been confirmed in the Somali region of Ethiopia.
At the UNICEF Ethiopia offices, members of the Rotary Polio Advocacy Group were shown a video and presentation on polio eradication efforts in the country, followed by a discussion.
Patrizia DiGiovanni, Acting Representative to UNICEF Ethiopia, welcomed the Rotarians and thanked them for their continued support in efforts to eradicate polio, which included a recent grant.
The grant is part of a larger announcement by Rotary International marking World Polio Day of a pledge of $44.7 million to fight polio in Africa, Asia and the Middle East.
To date, Rotary has donated more than $1.3 billion to global eradication efforts, allowing the mobilisation of resources at the grass-roots level through volunteer leaders.
During their visit to the Oromia region, the Rotarians attended a colourful ceremony at a primary school, alongside Dr Kebede Worku, State Minister at the Federal Ministry of Health and Dr Taye Tolera, Special Adviser to the State Minister of Health.
They were joined by the Federal Ministry of Health Expanded Programme on Immunisation (EPI) team, staff from the East Shewa Zone Health Office, UNICEF, WHO and other partners.
The group visited several kebeles within East Shewa Zone to visit people’s homes and carry out vaccinations, accompanied by kebele Health Extension Workers and Health Workers.
The Lume district health office and Shara Didandiba Health Post organised a kebele launching ceremony to mark the Rotarians’ visit. The Rotarians handed out t-shirts and caps to children and parents at the event.
The visiting Rotarians have a range of backgrounds, but share a common interest in supporting polio immunsation, child health and development programmes in Ethiopia. Some members of the group have visited Ethiopia several times.
The visit was intended to inform and promote polio advocacy work in Canada and the US through advocacy and fundraising, as well as engagement with US Congressional leaders.
Rotary International is spearheading the Global Polio Eradication Initiative, alongside the World Health Organisation, Bill & Melinda Gates Foundation, US Centers for Disease Control & Prevention and UNICEF. It has been at the forefront of the global fight against polio for the last three decades.
Jigjiga/Wardher, 9 February 2015: A pledge of commitment for a polio-free Ethiopia was made on 8 February 2015 in Jigjiga and Warher to launch the polio national immunization days (NIDs) in Somali Regional State. Ethiopia has been polio free since 5 January 2014, but the risk of polio cases in Horn of Africa prevails. The campaign running until 11 February 2015 aims to reach over one million children under the age of five in the region.
“Despite the progress, Ethiopia is in a fragile position and the risks for outbreaks remain. We invite all stakeholders to make the goal of a polio-free Africa in 2015 a reality,” said Dr Pierre M’Pele-Kilebou, WHO Representative to Ethiopia at the launch event in Jigjiga.
The pledge signatories – the State Ministers of Health, the Vice President of the Somali Regional State, the Head of the Somali Regional Health Bureau, Doollo Zonal Administration, religious and clan leaders, WHO, UNICEF, Rotary International and Ethiopian Pharmaceuticals Fund and Supply Agency among others, – pledged to do their part to ensure that all children are provided with an equal chance for health and success in life through immunization.
The State Ministers of Health are supervising the work of almost 3000 vaccination teams in Somali Region. H.E. Dr Amir Amin, State Minister of Health, said at the launch in Wardher, the epicentre of the Ethiopian polio outbreak, that the Government, partners, communities and families need to share responsibility to ensure immunization of children and “to save children from sickness, disability and death.” H.E. Dr Kebede Worku, State Minister of Health, stressed in Jigjiga that parents should get their children vaccinated even if they had been vaccinated in the previous round.
“Ethiopia is working to find hard-to-reach communities and settlements, to bring vaccination to those areas. So, when polio eradication is achieved, we will end polio everywhere for everyone and leave a legacy of healthy families and communities, rooted in equality for all,” – Ms Anupama Rao Singh, Country Representative a.i. to UNICEF Ethiopia.
The national polio campaigns conducted in all regions of Ethiopia between 6 to 9 February 2015 reached over 13 million children under 5 years of age. Since August 2013, when the outbreak began, 12 rounds of polio immunization campaigns have been conducted in addition to vaccination of children along Ethiopia’s border with Somalia. A total of 10 polio cases are recorded in Ethiopia during the outbreak. Working closely with national and regional authorities, WHO and UNICEF established an Operations base in Wardher, Doollo Zone, in August 2014 to bring together the needed expertise to support polio interventions in the zone and kick polio permanently out of Ethiopia.
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
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
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