Ethiopia Combating Stunting in Children in Aleta-Wondo Woreda town of the Southern Regional State of Ethiopia



BY Mekonnen Teshome
Adugna Mitiku had never realized the advantage of giving colostrum to her children within an hour of their birth and also did not exclusively feed her breast in the six months after their birth, contrary to doctors’ advice to help them physically and mentally develope.
Adugna (Right) and her daughter Meron embracing her ten-month old son

Rather Adugna, a resident in 04 Dela Kebele of the Aleta-Wondo Woreda town of the Southern Regional State of Ethiopia, spilled out the colostrum before feeding breast her daughters as she thought it was something unclean and unpleasant for them to take against the teaching of health professionals.
She also gave her babies Hamessa, juice of a “medicinal” plant that usually affects newborn babies’ kidney, with in few hours of their birth thinking that it would make the newly born babies strong and healthy according to the tradition of her society. She also didn’t start complementary food when they get six months old for she was not aware about what it means and its benefits.
However, this time around, Adugna is the one who encourages and supports her daughter, Meron Ali, to properly feed her grandson and apply all the “excellent actions” of infant and young children feeding (giving colostrum, exclusive breastfeeding, variety, feeding animal food, thick food and feeding while sick, frequency & monitoring) since his birth to avoid same mistake she made after she was sensitized by health professionals and non-government partners working on child nutrition.
“Though I regret that I could not fulfill the excellent actions while upbringing my daughters, I am happy now that I could assist and encouraging Meron to follow all the nutritional instructions,” Adugna said.
“As my mother gave me ‘Hamessa’, I also gave this poisonous traditional drink to my children. This is a harmful practice that people should stop exercising it,” she added.
“Because of the poor feeding practice I pursued while raising my children, Meron and my other daughters remained poor performers in school. However, this time around I am very happy and I hope my grandchildren would be great in all their educational and social lives.”
Now it seems that Adugna and many of her fellow citizens have been aware of the problem of seriousness of stunting due to the public education carried out by the government and its partners.
Stunting is said to be the outcome of chronic deficiency in nutrition during the first 1000 days of a child’s life – from conception, through pregnancy, to the age of two. The damage it causes to a child’s development is irreversible.
Ethiopian Health Ministry Communication Directorate Director Ahmed Emano also indicated that the government is striving to curb the all the health problems related with children and mothers by expanding basic health services across the country.
He said that the Federal Ministry of Health in Ethiopia (FMOH) has made significant progress in the support of Infant and Young Children Feeding (IYCF) in the last decade. A National Nutrition Strategy was developed in 2005–06, and a National Nutrition Program for implementing this strategy on a national scale was introduced in July 2008, he added.
He has also expressed his conviction that together with local and international partners and with the active involvement of Health Extension Workers deployed by the government the nation will in the near future put an end to the problem of stunting.
UNICEF – Ethiopia Nutrition and Food Security Head Dr. Joan Matji says that UNICEF defines STUNTING (Moderate and severe) as below minus two standard deviations from median height for age of reference population (too short for age). It is a reflection of chronic or long term malnutrition.
According to Dr. Joan a stunted five-year old is inches shorter than estimated for a child of a similar age. “But this is not simply an issue of height. Chronic malnutrition makes that child more vulnerable to disease. A stunted child is as much as five times more likely to die from diarrhoea than a non-stunted child,” the head said.
“And, most important: a stunted child will never reach his or her full capacity in terms of  mental, and intellectual development and never be able to learn as much nor earn as much throughout life.”
Dr. Joan also pointed out that UNICEF has supported the Federal Ministry of Health in funding the Ethiopian Demographic Heath Survey (EDHS) since 2000 along with various international donor organizations and governments.
“The key findings of the 2011 EDHS results show that 44 percent of children under five are stunted, or too short for their age. Stunting is most common among children age 24-35 months (57 percent) and is least common among children of more educated mothers and those from wealthier families.”
The head also indicated that stunting also varies by region from 22 percent in Addis Ababa to 52 percent in Amhara region. Wasting (too thin for height), which is a sign of acute malnutrition, is far less common, only 10 percent. Twenty-nine percent of Ethiopian children are underweight, or too thin for their age, she added. According to the survey, stunting has reduced from 51 percent in 2005 to 44 percent in 2011.
Alive and Thrive - Ethiopia (A&T) project is also an initiative funded by the Bill & Melinda Gates Foundation to reduce under nutrition and death caused by suboptimal IYCF practices in three countries (Viet Nam, Bangladesh, and Ethiopia) over a period of six years (2009–2014). The initiative operates in four regional states in Ethiopia as well as in the capital Addis Ababa and said to be effective especially in creating awareness among the public utilizing the media.
Alive and Thrive-Ethiopia Senior Country Director Dr. Tewoldebrhan Hailu said that the recent Ethiopian Demographic and Health Survey shows that 44 per cent of the under-five children is stunted.
“The reduction in stunting from 47 to 44 per cent is not significant and that shows Ethiopia is suffering from the high prevalence. This means the same number of children will register low performers in their education while they go to school. These children are also expected to join universities after fifteen years of schooling. We can imagine what will happen to them at that time,” he said.
The Senior Country Director, concerning the nutrition situation in Ethiopia indicates that there are various studies and international comparison. “When we look at Ethiopia as compared to countries in the sub-Sahara, it ranks fourth next to Madagascar, Malawi and Zambia with the highest prevalence of stunting or chronic malnutrition. This is just when we see it in terms population proportion, but if you see it in absolute number Ethiopia is number one.
To this end, partners working in the area of nutrition trained over 3,000 Health Extension Workers on preventive nutritional intervention across the country and deployed to educate the society.
Alive and Thrive Nutrition Expert Dr. Yewelsew Abebe  also said that stunting is a problem demanding prime attention because-child’s height for age is best predictor of human capital, diminished immune response, reduced adult size, reduced intellectual ability ( iron, iodine, zinc deficiency are known to reduce IQ), lower economic productivity, poorer reproductive outcomes etc.
She said primary attention should be attached to the problem especially in the 1st 1000 days (pregnancy to 2 years of life), using the windows of opportunity. Mothers need healthy diet, Micro Nutrients (MI) supplementation and societal/family care during pregnancy.
“We should also maximize and promote the practices of early initiation of breastfeeding within 1hr of birth, exclusive breastfeeding during the first six month, and timely initiation of appropriate complementary feeding, while continuing breast feeding till two years of age and beyond, appropriate feeding practice of the sick child during and after illness along with proper medical care to address the problem,” she added.
http://www.newbusinessethiopia.com/index.php?option=com_content&view=article&id=807:ethiopia-combating-stunting-in-children&catid=27:health&Itemid=52

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