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Community-based nutrition programme targets children at risk in Ethiopia

By Indrias Getachew

Bedria Yuya has just learned that one of her eight-month-old twins, Hehumati Shemsedin, is severely underweight. The news comes during a monthly growth-monitoring session in her village in drought-affected eastern Ethiopia.

VIDEO: UNICEF correspondent Priyanka Pruthi reports on community health workers' efforts to identify and treat children with severe acute malnutrition amidst the drought crisis in Ethiopia. Watch in RealPlayer

Conducted by volunteer community health worker Kasim Jibral in Chancho village, Kebso Tekoma sub-district, the session is part of the UNICEF-supported Community Based Nutrition (CBN) programme. The Government of Ethiopia introduced this initiative in 2008 in drought-prone and food-insecure districts such as Deder, where Kebso Tekoma is located.

Monthly community sessions to monitor and promote the growth of children two years of age and younger represent one of the pillars of CBN. The programme empowers communities to assess the nutritional status of their children and take action, using their own resources, to prevent malnutrition.

Tracking the growth of all children in the community enables the timely identification of severely underweight young children like Hehumati and their referral for further examination and treatment.

Outpatient therapeutic feeding

Ms. Yuya heeds the advice of the volunteer community health workers and takes Hehumati to the Kebso Tekoma health post for further screening. Tigist Imibir, one of two health extension workers assigned to the post, has received UNICEF-supported training on outpatient therapeutic feeding.

Ms. Imibir measures Hehumati’s mid-upper-arm circumference – an indicator of nutritional status – and finds that it is 9 cm, well below the 11.5 cm mark that indicates severe acute malnutrition in children under five. The condition can be deadly if untreated.

The health worker then weighs Hehumati and registers his weight, 4 kg, on his outpatient therapeutic feeding programme admission card. She will monitor his weight every week until he reaches the point where he is out of danger and no longer severely malnourished, and can be discharged.

Ms. Imibir also takes the baby’s temperature to ensure that he does not have fever and checks his breathing pattern for signs of pneumonia – both complications that would require clinical care.Criteria for the programme

Finally, she helps Ms. Yuya wash her hands and leads mother and child to a quiet corner with a sachet of ready-to-use therapeutic food (RUTF) for the appetite test. This is Hehumati’s first time tasting RUTF, but he needs no coaxing to eat the sweet, peanut butter-like paste.

At this point, Hehumati has passed all criteria for entering the outpatient programme. Ms. Imibir ends his first session by giving Ms. Yuya a week’s supply of RUTF and a bottle of antibiotics to treat any infections, along with instructions on how to administer the medication.

A combination of drought, poor harvests from last year and rising food prices has resulted in the current situation in Ethiopia, where more than 4.5 million people will require emergency food assistance through the end of 2011. The delayed rainy season in Deder and other areas is compounding the impact of the ‘lean season’ between harvests, when malnutrition rates generally rise.UNICEF-supported interventions

For Ms. Yuya, the impact has been doubled as she struggles to manage with her twins.

“For the first six months, I was only breastfeeding,” she says. “Then I fell ill and stopped, so that didn’t help the children. For the past two months, I have been selling things from home to buy food. I have been trying to feed them to the best of my ability.”

The Government of Ethiopia estimates that over 300,000 children under five are at risk of becoming severely malnourished this year. The CBN and outpatient therapeutic feeding programmes are ensuring that severely malnourished children are identified early and treated near their homes. These UNICEF-supported interventions aim to give children a stronger chance of recovering and surviving the worst impact of the drought.

UNICEF is urgently seeking additional funds to ensure that sufficient RUTF and other supplies remain available to respond to the on-going humanitarian emergency.

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