2010 team 2
- 1. Biyyoolessaii IjaBiyyoolessaii Ija MukaaMukaa “Fruit of the Land”“Fruit of the Land” Team 2Team 2 Devin Broadwater, Karen Hamby, Naomi Chen,Devin Broadwater, Karen Hamby, Naomi Chen, Amanda Hasseltine, Bernice BoursiquotAmanda Hasseltine, Bernice BoursiquotOnline Image. 07 November 2009. EthioGardian.com
- 2. Presentation OutlinePresentation Outline Demographics on OromiyaDemographics on Oromiya Meet the Adabbos, an Average Oromo familyMeet the Adabbos, an Average Oromo family Child Malnutrition and Its FactorsChild Malnutrition and Its Factors Strategy to Combat Child MalnutritionStrategy to Combat Child Malnutrition Emergency Food AidEmergency Food Aid Comprehensive ApproachComprehensive Approach Allocation of FundsAllocation of Funds SummarySummary
- 3. Oromiya Region BackgroundOromiya Region Background DemographicsDemographics 27 Million People27 Million People 4.8 People Per Household4.8 People Per Household Ethnic GroupsEthnic Groups 87.8% Oromo87.8% Oromo 7.22% Amhara7.22% Amhara ReligionReligion 48.2% Christian48.2% Christian Orthodox and ProtestantOrthodox and Protestant 47.5% Muslim47.5% Muslim 88.7% Rural Inhabitants88.7% Rural Inhabitants Current Health CrisisCurrent Health Crisis 34.4% of Children under the34.4% of Children under the age of five are underweightage of five are underweight Estimated 126,000 children areEstimated 126,000 children are in need of urgent therapeuticin need of urgent therapeutic care for severe malnutrition incare for severe malnutrition in EthiopiaEthiopia This number is expected toThis number is expected to climbclimb Ethiopia is rated the sixthEthiopia is rated the sixth worst country in terms ofworst country in terms of nutritional outcomesnutritional outcomes worldwide.worldwide. Central Statistical Agency (CSA) of Ethiopia, 2007
- 4. Meet the AdabbosMeet the Adabbos The World Factbook 2009. Washington, DC: Central Intelligence Agency, 2009. https://www.cia.gov/library/publications/the-world-factbook/index.html Online image. PBS.org
- 5. Online image. Current food shortages in Ethiopia. (2009) http://news.bbc.co.uk/2/hi/8319741.stm
- 6. Identifying Cases of Severe AcuteIdentifying Cases of Severe Acute MalnutritionMalnutrition Children with mid-upper arm circumference (MUAC) <11cm or bilateral legChildren with mid-upper arm circumference (MUAC) <11cm or bilateral leg pitting edema referred to regional health centers weight for height. Childrenpitting edema referred to regional health centers weight for height. Children with weight for height less than 85% of median national center for healthwith weight for height less than 85% of median national center for health statistics (NCHS) classified as having Severe Acute Malnutritionstatistics (NCHS) classified as having Severe Acute Malnutrition Advantages:Advantages: Practice currently in usePractice currently in use Independent of ageIndependent of age Simple, low cost technologySimple, low cost technology Low stress on children and caregiversLow stress on children and caregivers AccurateAccurate Highly sensitive and specificHighly sensitive and specific Recommendation: increase usage of MUAC measurementsRecommendation: increase usage of MUAC measurements Belachew, T, & Nekatibeb, H. (2007). Assessment of outpatient therapeutic programme for severe acute malnutrition in three regions of Ethiopia. East African Medical Journal. Amsalu, S & Tigabu, Z. (2008). Risk factors for severe acute malnutrition in children under the age of five: A case-control study. Ethiop.J.Health Dev.
- 7. Black. “Framework of the relations of poverty, food insecurities, and other underlying and immediate causes to maternal and child malnutrition and its short-term and long-term consequences” Maternal and Child Undernutrition.
- 8. CholeraCholera OutbreakOutbreak August 8August 8thth 20092009 The shaded region indicates theThe shaded region indicates the area of outbreak.area of outbreak. Online image. Zones affected with the cholera are highlighted in red (the current map of Oromia). Ethiopia: Cholera and Severe Acute Malnutrition Ravage Oromia
- 9. TheThree SectionsTheThree Sections WestWest •Generally Food StableGenerally Food Stable •Without CholeraWithout Cholera SouthSouth •Highly Food InsecureHighly Food Insecure •Without CholeraWithout Cholera NorthNorth •Highly Food InsecureHighly Food Insecure •With CholeraWith Cholera
- 11. The 1 million dollar question (USD)?The 1 million dollar question (USD)? How can severe acute malnutrition be sustainably reduced inHow can severe acute malnutrition be sustainably reduced in the Oromiya region of Ethiopia with 1 USD million?the Oromiya region of Ethiopia with 1 USD million?
- 12. TheTwo-Pronged StrategyTheTwo-Pronged Strategy Emergency Food AidEmergency Food Aid Comprehensive ApproachComprehensive Approach
- 13. Emergency Food AidEmergency Food Aid Ready to use therapeutic foods (RUTFs) are currently distributed in Ethiopia •High rate of acceptance •Distributed by government, Doctors Without Borders, and other non- governmental organizations (NGOs) Immediate response to current Ethiopia conditions •Results: •Point of entry •Local acceptance •Requirement: •Using available infrastructure to deliver RUTFs •Coordinate with work of NGO’s within the region Belachew, T, & Nekatibeb, H. (2007). Assessment of outpatient therapeutic programme for severe acute malnutrition in three regions of Ethiopia. East African Medical Journal.
- 14. ComprehensiveTargeted ApproachComprehensiveTargeted Approach Develop local RUTF’s—”Fruit of the land”Develop local RUTF’s—”Fruit of the land” Local farmersLocal farmers Training of CHA’sTraining of CHA’s Community membersCommunity members Radio Soap OperaRadio Soap Opera Mass communication, disseminationMass communication, dissemination
- 15. Time Emergency / Imported RUTFs Local RUTFs Community Health Advisors Soap Opera Accountability and Evaluation 1-3 months Evaluate current partner NGO efforts Focus groups Identify farmers, formulas Stockpile food- secure area crops Recruit CHA’s -- Ethics clearance Assess distrib. Adapt local RUTF “chain” 3-6 months Start efficacy trial Start efficacy trial with several formulas Create curriculum -- Baseline statistics Local distribution feasibility 6-9 months Analyze results Discontinue Analyze results Plant for next season Training -- Intervention impact AssessmentAssessment
- 16. Time Emergency / Imported RUTFs Local RUTFs Community Health Advisors Soap Opera Accountability and Evaluation 9-12 months -- Local crop farming, production Educating community Local economic initiatives Identify radio stations, recruit talent Harvest trends Economic stability indicators 12-18 months -- Same as above Same as above Quality assurance Training new CHA’s Preliminary scripts Same as above Fidelity of CHA training Concept testing 18-24 months -- Same as above Same as above Recording Same as above ImplementationImplementation
- 17. ReplicationReplication Time Emergency / Imported RUTFs Local RUTFs Community Health Advisors Soap Opera Accountability and Evaluation 3 years -- Local crop farming, production Educating community Local economic initiatives Training new CHA’s Broadcast Evaluate media reach, impact Crop sustainability Child nutrition indicators 5 years -- Same as above Same as above Fundraising to record new episodes Same as above 10 years -- Same as above Same as above Syndication Same as above
- 19. Allocation Of FundsAllocation Of Funds ShortTerm – 15%ShortTerm – 15% Import Tax 20-50% of cost Short Term $150,000 RUFTs $77,700 Cost of RUTFs $77,700 Internal Shipment $22,300 Internal travel & distribution $20,000 Efficacy evaluation/ research $30,000
- 20. Allocation Of FundsAllocation Of Funds LongTerm – 85%LongTerm – 85% Long Term $850,000 Education/ CHAs $340,000 Acceptance of paying for supplements Sanitation Breastfeeding/ Child feeding practices Family Planning Female Empowerment Malnutrition screening (bangle) Soap Opera $85,000 Accountability & Evaluation $85,000 Local RUTFs $340,000
- 21. SummarySummary Child malnutrition is a multi-faceted issueChild malnutrition is a multi-faceted issue Requires:Requires: Comprehensive, long-term approachComprehensive, long-term approach Community involvementCommunity involvement Four components :Four components : Initial importation of RUTF’sInitial importation of RUTF’s Training Oromiyan farmers to produce local RUTFsTraining Oromiyan farmers to produce local RUTFs Training CHA’s to educate mothers on proper feeding practicesTraining CHA’s to educate mothers on proper feeding practices Health soap opera broadcastingHealth soap opera broadcasting
Editor's Notes
- #16: Harvest in May, October 4 months between each (May-June, Oct-Dec)