Tackling child malnutrition in Ethiopia : do the sustainable development poverty reduction programme's underlying policy assumptions reflect local realities?

Abstract

This paper emphasises that malnutrition cannot be tackled without understanding its causes. Child malnutrition remains a major public health problem in Ethiopia, yet the government has no specific nutrition policy. Levels of wasting (acute malnutrition) and stunting (chronic malnutrition) in children aged six to fifty-nine months are among the world’s highest. As long as so many children remain malnourished, Ethiopia will not achieve the first Millennium Development Goal – eradication of extreme poverty and hunger. Drawing on a sample of 1,999 one-year-olds from twenty sentinel sites, the Young Lives Project has sought to better understand the child, household, community and policy level determinants of malnutrition and the ways in which they differ across different regions of Ethiopia. The paper quantifies the impact of poverty, healthcare and caring practices and challenges the World Bank belief that investment in growth monitoring to promote change in caregivers’ behaviour will, by itself, significantly improve nutritional status. Coverage of health services may have expanded, but limited and costly services discourage users. Healthcare choices primarily depend not on proximity to health facilities but lack of quality services. Respondents complained about inadequate equipment, poorly trained and/or insensitive medical staff and expensive medication...