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Outpatient therapeutic feeding improves child nutrition in Ethiopia

UNICEF Image: Ethiopia: Therapeutic Feeding
© UNICEF Ethiopia/2006/Getachew
Messelech Meteka has brought her 15-month-old daughter Shurube to the Manche Health Centre in Ethiopia’s Sidama Zone for a weekly nutritional screening and medical check-up.

By Indrias Getachew

SIDAMA ZONE, Ethiopia, 25 October 2006 – Fifteen-month-old Shurube Hatiso  plays on her mother’s lap as they await the child’s weekly nutritional and medical check-up. It is provided by the non-governmental organization Action Contre la Faim (ACF) with the support of UNICEF and the European Commission’s Humanitarian Aid Department.

“When we first came here four weeks ago, I thought Shurube would die,” says Messelech Meteka of her daughter’s first visit to the Manche Health Centre. “Her body was limp and she was too weak to move.”

The centre is located in the Sidama Zone of Ethiopia’s Southern Nations, Nationalities and Peoples Region (SNNPR). Nutritional screenings, conducted in July as part of the Enhanced Outreach Strategy for Child Survival – the largest-ever partnership between UNICEF, the World Food Programme and the Ethiopian Government – indicated rising levels of malnutrition in the SNNPR’s Dale District.

Complex causes

A follow-up survey conducted by ACF confirmed that malnutrition rates (3.2 per cent severe acute malnutrition and 16.7 per cent global acute malnutrition) warranted the establishment of the therapeutic feeding programme, which began providing services at Manche in September.

“It is difficult to imagine that there can be these levels of malnutrition in a place that looks like this,” says ACF nutrition programme manager Rachel Onyire. “The lush green landscape is very deceptive.”

But here, the causes of malnutrition are complex – including population pressure, families living on very small plots of land and farmers receiving poor prices for their coffee crops.

UNICEF Image: Ethiopia: Therapeutic Feeding
© UNICEF Ethiopia/2006/Getachew
UNICEF Nutrition Officer Rebecca Demelash weighs Shurube. The girl’s weight has increased since beginning treatment through the food programme at the centre.

Screening and treatment

Every week, Ms. Meteka walks two hours to the health centre to receive life-saving care for Shurube. “I have already lost two children,” she laments. “Shurube is my last surviving child.”

When it is Shurube’s turn to be seen, her mother pulls out her medical card and presents it to the community health worker, who makes note of the child’s progress. When she first arrived, Shurube was less than 75 per cent of the average weight for a 15-month-old with oedema (water retention and swelling). She now weighs between 75 and 80 per cent of the average, and her oedema is under control.

Following the nutritional screening, Shurube receives an appetite test. After passing the assessment, she is given 18 sachets of Plumpy’nut, a micronutrient-rich, highly fortified therapeutic food used to treat undernourished children. She is also checked for other medical conditions associated with malnutrition like pneumonia and diarrhoea.

Community health workers supply all the children who come to the centre with vitamin A supplements and de-worming pills to boost their immune systems and resistance to disease. Infections are treated on the spot. Children with serious conditions are sent to the nearest referral hospital.

Child survival rate improves

Since the so-called ‘green famine’ of 2004-04, malnutrition management has evolved in the SNNPR, and Ethiopia has adopted a protocol for treating severe acute malnutrition that includes the use of therapeutic foods. The child survival rate has risen under the new feeding regimens.

With the support of UNICEF and the European Commission, ACF trained 48 community health workers for the programme at Manche. The workers identify malnourished children and ensure that parents follow up with screening and treatment for them.

Although it appears that Shurube is on her way to recovery, Ms. Meteka remains uncertain about whether she will be able to provide for her daughter in the future.

“I am not sure how I am going to feed Shurube after we are finished with this programme,” she says. “For now, I am happy that she is alive and getting better.”



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