Malnutrition according to UNICEF is a broad term commonly used as an alternative to malnutrition but technically it also refers to overnutrition. People are malnourished if their diet does not provide adequate calories and protein for growth and maintenance or they are unable to fully utilize the food they eat due to illness (undernutrition). They are also malnourished if they consume too much calories (overnutrition). Of course in poor countries like Ethiopia, malnutrition refers most of the time to under-nutrition as over-nutrition can not be a threat in countries that are still working to ensure food security.

As is the case in other poor countries Ethiopia is highly affected by malnutrition and its consequences. Indeed, it is one of the sub Saharan countries with high prevalence of malnutrition. The aggregate costs of malnutrition at the national level constitute a key barrier to efforts to foster sustained economic growth and improved general welfare.

Taking this into consideration, the Federal Ministry of Health (FMoH) in cooperation with partners has taken several measures such as putting in place enabling policies and effective programmes, and implementing a range of nutrition programmes that aim at preventing and mitigating the consequence of malnutrition. This is in addition to the huge national food security programme and safe water and sanitation programme in place. One of the major steps taken among others is, the formulation of the National Nutrition Plan (NNP) in order to reduce the burden of malnutrition and its consequences in a harmonized and comprehensive approach through large scale national efforts.

Launched in 2008 with the objective to ensuring all Ethiopians adequate nutrition status in a sustainable manner, which is an essential means for a healthy and productive life, the NNP gave priority to young children, lactating women and adolescents as they are the most vulnerable segments of the society.

The formulation of the NNP has enabled the country take appropriate and coordinated nutrition actions aimed at creating healthy and productive labor force, which is vital to ensuring rapid social and economic development.

Following the concerted efforts undertaken by the government and stakeholders since the formulation of the NNP, the country has achieved a remarkable outcomes in the reduction of malnutrition and child mortality rates, according to the preliminary findings of the 2011 Ethiopian Demographic Health Survey (EDHS).
Last week, there was an event organized by UNICF to celebrate the achievements of the national nutrition programme of Ethiopia. At the event, which was also aimed at launching the Canadian funded food security for mothers and children through improving community based nutrition in Ethiopia project, officials from UNICF, the Government of Ethiopia and Canada delivered their respective speeches.

UNICEF Representative to Ethiopia Ted Chaiban, in his statement at the event, said “We are here today to congratulate the government of Ethiopia for ensuring that in a period of four years after the endorsement of the National Nutrition Strategy and Programme, we as development partners can convincingly state that Ethiopia is on track to achieving the non-income indicator for MDG 1,halving the proportion of underweight children under-five by 2015.”

How has this been achieved? One has to reflect on the broader societal and economic revolution that Ethiopia is currently undergoing in order to fully appreciate the scale and dimension on the declining malnutrition rates in Ethiopia. It is a known fact, Ethiopia is one of the three most rapidly growing economies on the continent with a growth rate averaging at 11.5% and per capita GDP growing from US$160 to US$250 over the past ten years. The country’s commitment to fighting poverty is well articulated in the Growth and Transformation Plan (GTP) and this is a key element to address the basic and underlying causes of malnutrition.

Without a sound food security intervention, the nutrition strategy alone would have been insufficient to protect the population from periodic vulnerability. To this end, the focus on agricultural productivity has been critical. The Productive Safety Net Programme has also been successful in mitigating the food insecurity in vulnerable districts in the country and building the asset base of vulnerable households.

According to Ted Chaiban, the integration of the management of nu-complicated cases of Severe Acute Malnutrition (SAM) into Integrated Community Case Management through the Health Extension Programme has been a key factor among the successes of the National Nutrition programme. A robust effort has been made to train health extension workers in the treatment of acute malnutrition throughout the country to treat severely malnourished children, which stood at almost nil in 2003. Today the programme reached over 9,200 sites throughout the country. Priority has been given to drought-prone and food insecure districts where the majority of malnutrition cases occur. Now, more than 96 per cent of health posts in food insecure woredas are providing life-saving services at a village level, providing the treatment of children without in their home places.

These systems were put into test this year as Ethiopia and the rest of the Horn of Africa faced one of the worst droughts in decades. “I am very pleased to report that the health extension workers have performed impressively, saving thousands of children’s lives. Particularly impressive is that in Ethiopia the mortality rate from SAM is less than 1per cent in comparison to the SPHERE standards which are at 10 per cent. It is clear that the health system in Ethiopia has established a robust and resilient system that can withstand periodic and cyclical shocks and emergencies without resulting in escalated mortality rates and increased levels of malnutrition, which is a remarkable achievement for the country” UNICEF Representative to Ethiopia Ted Chaiban appreciated.

According to, Dr. Keseteberhan, State Minister of Health, in 1990, an estimated 20 per cent of children under the age of five would not survive to celebrate their fifth birthday. Today, according to the 2011 EDHS, that figure has been slashed by more than half to 8.8 per cent, which is an impressive achievement.

The extent of malnutrition in a country is determined by examining the level of chronic malnutrition(prevalence of stunting, height-for-age). The level of stunting is determined by comparing the height of a child with average height of children of the same age. Based on this measurement of malnutrition, the country has witnessed a significant reduction in malnutrition. According to the data from 2011 EDHS, underweight prevalence dropped to 28.7 per cent in 2010 from 42.1 per cent in 2000. Stunting rates are also down to 44 per cent from 57.8 per cent in 2000. Furthermore, reducing malnutrition, an underlying factor in more than half of under-five deaths, has contributed to the child survival achievements. The national nutrition strategy and programme gives special emphasis to nutritionally vulnerable groups of the society, particularly children under-five, pregnant and lactating women and is aligned with the development strategies of the country as reflected in the Growth and Transformation Plan (GTP). “The National Nutrition Strategy and Programme implemented particularly through the federal ministry of health's flagship health extension programme has contributed a lot to the achievements that we are celebrating today” Dr. Keseteberhan underlined.

Four years after the endorsement of the national nutrition strategy and programme, Ethiopia is not only on track to achieving the non-income indicator for MDG1, halving the proportion of under-weight children under-five by 2015 but is also on track to achieve MDG4 which calls for reducing child mortality by two thirds from 1999 levels, it was learnt from the State Minister of Health.

As mentioned above, the Canadian funded project to boost the Ethiopian national nutrition programme was launched at the same event. Canadian Ambassador to Ethiopia, Ms. Michele Levesque, said, then, improving the health of mothers, newborns and children are top priorities for Canada. Each year hundreds of thousands of women die during pregnancy or child birth.

As the magnitude of the problem in Ethiopia is sever Canada is keen to work with partners to reduce the unacceptably high levels of malnutrition and maternal and child mortality.

An equally important reason for choosing Ethiopia according to the Ambassador is that there is clear government commitment and progress to build on with a well defined national nutrition strategy and programme in place. There has been impressing scaling up of basic health services across the country which has already been resulting in improved nutritional status and health for women and children. The Canada funded USD 50 million project is expected to reach 3 million pregnant and lactating women, and their children to improve their nutritional health in the coming five years. It will work in 100 food insecure Woredas to ensure access to community-based nutrition, and water and sanitation services.
“We acknowledge the generous support from the Canadian government as it comes at a time when we are focusing on the next generation of achievements for the nutrition programme and when we are making a concerted effort as government to reach ( and even surpass) the MDG targets” said Dr. Keseteberhan.

Indeed, it is a great contribution for the implementation of the national nutrition strategy and programme, initially meant to run for five years (2008-2013), and is currently being revised to continue until 2015 and incorporate the strategy for accelerated stunted reduction.

Having celebrated these achievements, the government hand in hand with development partners needs to remain devoted in the implementation of the national nutrition strategy and programme for further success to create well-nourished generation.[EPA]