In rural Ethiopia, UNICEF and ECHO support community-based nutrition services for children
By Indrias Getachew
HARAMAYA, Ethiopia, 9 May 2012 – At one month old, Hannan Mohammed Ibrahim lost her twin sister. Soon after, their mother, Sephora Adem, fell seriously ill.
“The twins used to breastfeed together,” said Ms. Adem. “When the other one died, my breasts dried up as well. I took to bed sick. [Hannan] suffered as a result.”
Ms. Adem and Hannan were taken to a hospital in the town of Harar, a two-hour drive from their home in Negia Village, Haramaya District. There, Hannan was diagnosed with malnutrition and placed on a regimen of therapeutic milk.
Several months later, Hannan once again began to lose weight. Her mother brought her back to the hospital. This time, seeing that she was over six months old, the doctors advised Ms. Adem to bring her to the local health post in their village. There, health extension workers trained in outpatient therapeutic feeding would be able to treat her with ready-to-use therapeutic foods (RUTF) supplied by UNICEF with support from the European Commission Humanitarian Aid Department (ECHO).
Treatment close to home
Sima Abdurahman, a health extension worker at the Negia Health Post, conduct the post’s weekly outpatient therapeutic feeding programme. She has received UNICEF-supported training, part of the Government’s flagship Health Extension Programme to provide basic integrated health, nutrition, hygiene and sanitation services in rural areas.
Ms. Abdurahman weighed Hannan, and checked her for fever and symptoms of pneumonia, complications of malnutrition. When Hannan showed no signs of complications, Ms. Abdurahman administered an appetite test, giving Hannan a sachet of RUTF. Hannan had no trouble eating.
“Hannan came here last week,” Ms. Abdurahman said. “She was an extremely thin and weak child. Last week, her weight was 3.5 kg and her MUAC [mid-upper arm circumference] was 9.7 cm.” Measurements of less than 11.5 cm indicate severe acute malnutrition, a condition that can be deadly.
“This week she has improved a great deal. She weighs 3.9 kg, and her MUAC is 10 cm,” Ms. Abdurahman continued. “When I did the appetite test, last week and this week, she ate well. She is doing well.”
Community-based therapeutic feeding
Over 14,000 health extension workers like Ms. Abdurahman are operating in the country.
Since 2008, the Government of Ethiopia has been implementing the National Nutrition Programme and Strategy, which seeks to bring malnutrition rates down to zero.
“This therapeutic feeding programme that is being implemented at the community level has brought about many positive results,” said Angatu Mohammed, deputy head of the East Harerghe Zone health office. “From the start, when it was decided to do the work at the community level, it was to provide community-based health services, and this has brought about major change in maternal and child deaths.”
Ms. Adem is seeing these changes first-hand.
“The first week she couldn’t even open her eyes. She was not healthy,” she said. “Last week, [Ms. Abdurahman] gave me a syrup [amoxicillin antibiotics], and I gave her the syrup to drink. I fed her the things [RUTF] that she gave me … When I saw such a big difference after one week, I became very happy that my child could get better with treatment near my home.”
ECHO is contributing US$2.4 million to support the management of malnutrition in Ethiopia, benefiting over 52,000 malnourished children.
Complementing these treatment services is the UNICEF-supported Community Based-Nutrition programme, which seeks to prevent malnutrition from occurring in the first place. Haremaya is among the districts where the Community-Based Nutrition programme is being implemented, and it is seeing positive results.
“We are going house-to-house and giving advice to mothers to breastfeed their children from the time they are born until they reach six months, and then to complement their breastfeeding from six months until two years of age,” Ms. Abdurahman said. “The number of malnourished children has gone down.”
These community-based programmes are not only improving nutrition; they are empowering communities to provide the best possible care to their children.
“We have to empower communities, we have to advocate for equity, we have to work on promotive and preventive activities, and we have to really work on social protection,” said Samson Desie, a UNICEF nutrition officer working in Oromia Region, “so that the community, by themselves, will assess their problems, will analyze their problems, and will act upon their problems using their own resources.”