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Ali D 1 , Amare Y 2 , Menon P 3 1 International Food Policy Research Institute (IFPRI), Addis Ababa, Ethiopia ; 2 The Consultancy for Social Development, Addis Ababa, Ethiopia; 3 IFPRI, New Delhi, India. Background and Objectives. Methods.
Ali D1, Amare Y2, Menon P31International Food Policy Research Institute (IFPRI), Addis Ababa, Ethiopia; 2The Consultancy for Social Development, Addis Ababa, Ethiopia; 3IFPRI, New Delhi, India
Background and Objectives
Ethiopia has among of the highest rates of child malnutrition in the world with 44 percent stunted (chronic malnutrition) and 10 percent wasted (acute malnutrition). Historically, nutrition programs in Ethiopia have focused on the management of wasting as a response to recurring emergency conditions in the country.
Alive & Thrive focuses on infant and young child feeding (IYCF) to prevent stunting and along with other interventions, has also engaged in advocacy around a stronger focus with various stakeholders.
This study aims to understand whether the advocacy activities had led to any shifts in perceptions of stakeholders about wasting and stunting and the actions that were being taken to address these problems.
Current Focus of Nutrition Policy and Programs
“People understand malnutrition mainly in terms of wasting, not stunting. It is understood that way by development partners as well as by the government and donors. More attention and money is given to acute in the form of emergency intervention.”
“Currently, I think the focus is coming to chronic malnutrition than the acute malnutrition which used to be the focus before 2008 especially. More partners are coming to address chronic under nutrition. Funding for chronic under nutrition is increasing.”
“One of the challenges we have is stunting is very high. By the WHO cut off point, if it is more than 40%, it is very high even if the stunting rate has gone down from 61 or 62% in 1992 to 44%. There is a marked decrement but we still have the highest prevalence of stunting. So chronic under nutrition is still a major public health problem” [implementing partner]
“We should take it as a serious problem because of its implication for development in terms of having an appropriate work force for our development activities. The other thing is, once stunting has occurred, you cannot reverse it. You should act before 2 years of age, as much as possible.” [development partner]
“We are addressing the symptoms of the problem but we really are questioning, are we really addressing the underlying causes because why are we getting all these readmissions; why are we going back after a few months?” [Implementing partner]
Shift in the Discourse
“When I came in early 2010, a lot of people were talking about treatment, treatment, treatment. But what I have seen is a change, not only from the donor point of view but from the NGOs and the government point of view. They are talking about prevention. I think they know that if they want to achieve their growth and transformation plan, prevention is one of the key things.”
Perspectives on the Effectiveness of Current Nutrition Programs
“The coverage for managing acute malnutrition is very high because every health worker has been oriented on it. But coming to the proper management of chronic malnutrition there are lots of challenges starting from the level of awareness of health workers.”
“We wanted to do much better particularly at health center level with the intention that it could support the HEWs. That link is very important even for sustainability. It just started but it requires a lot of input. We hope it will improve through time but the progress is not encouraging.”[Government official]
There is indeed a perceived a shift in the policy discourse in Ethiopia to now include both stunting and wasting. The relative operational simplicity of addressing wasting, however, tilts program activities towards wasting. Continued advocacy, resources and technical inputs are likely needed to ensure that prevention of stunting is kept high on the agenda in a food insecure context like Ethiopia.
Stakeholders, Policy, Nutrition, Ethiopia
Poster Reference Number:PO1426