1.1.2  Childhood and maternal malnutrition in Ethiopia

Malnutrition is one of the main health problems facing many women and children in Ethiopia. Ethiopia has the second highest rate of malnutrition in Sub-Saharan Africa (SSA). Ethiopia faces the four major forms of malnutrition: acute and chronic malnutrition, iron deficiency anaemia (IDA), vitamin A deficiency (VAD), and iodine deficiency disorder (IDD). The 2005 Ethiopian Demographic and Health Survey (DHS) highlights the different levels of deficiencies in different age groups (see Table 1.1).

Vitamin A deficiency is the most common cause of preventable blindness. The 2005 national IDD survey showed a goitre (enlargement of the thyroid gland in the front of the neck) of over 35%; both of these are considered emergency proportions by WHO standards. There is a marked decrease in the number of Ethiopian households that consume iodised salt compared with a decade ago, leading to increased iodine deficiency disorder.

The prevalence of low birth weight (LBW) in Ethiopia (14%) is one of the highest in the world. One major contributing factor for LBW is the poor nutritional status of women both before and during pregnancy, made even worse by inadequate weight gain during pregnancy.

Table 1.1  Nutritional indicators for Ethiopia. Source: 2005 Ethiopian Demographic and Health Survey (DHS)

Type of nutritional problemRate
Children under-five who were:
Stunted47%
Wasted11%
Underweight38 %
Women (15-49 years) who were:
Chronically malnourished (Body Mass Index [BMI]* less than 18.5)27%
Vitamin A deficiency:
Children from 6-59 months old61%
Iodine deficiency:
Goitre (IDD)

Children with goitre

Mothers with goitre

39.9%
35.8%
Ethiopian households consuming iodised salt4.2%
Iron deficiency anaemia:
Children age 6-59 months54%
Women age 15-4927%
Low birth weight (LBW)14%
* BMI is weight in kg divided by height in cm².

The consequences of malnutrition for Ethiopia if no action is taken are enormous. The greatest functional consequences of malnutrition for children are increased risk of illness, and death; and for those who survive, mental impairment and reduced capacity to produce and contribute to the economy of the country. These consequences of malnutrition are often not fully appreciated because they are hidden. Based on a national study, malnutrition contributes to an estimated 270,000 deaths of under-five children each year; and VAD contributes to 80,000 children’s lives lost every year. As malnutrition and VAD weaken the immune system of children, they will be susceptible to common childhood infections and more liable to suffer from serious complications.

Beyond the individual human suffering, malnutrition reduces mental development and, thus, will mean slower learning throughout life. About 685,000 babies are born to mothers with IDD and are likely to suffer from some degree of reduced mental capacity. Malnutrition also reduces work productivity, as stunted, less educated and mentally impaired adults are less productive. It has been estimated that the annual value of the loss in productivity that can be attributed to child stunting is 2.92 billion ETB (Ethiopian Birr). Moreover, iodine deficiency, which results in irreversible impairment of intellectual capacities, has been estimated to cost the Ethiopian economy 1.35 billion ETB per year. The productivity losses due to malnutrition in Ethiopia over the next ten years will be 144 billion ETB.

Malnutrition impacts on health, mental development, and work productivity.

When aggregated, the effects on illness, education and productivity have an enormous impact on the economic growth and poverty reduction effort of the country. Given the benefits of reducing the burden of malnutrition in Ethiopia, the government efforts to address malnutrition in a comprehensive approach can be easily justified.

  • What are the major nutritional problems in Ethiopia?

  • Acute and chronic undernutrition, vitamin A deficiency, iodine deficiency disorders, and iron deficiency are the major problems in Ethiopia.

  • What are the consequences of different types of malnutrition?

  • The consequences of malnutrition (undernutrition) for children are illness and death. For those who survive, many have mental impairment and reduced capacity to produce and contribute to the economy. Malnutrition reduces mental development and, thus, will mean slower learning throughout life. Iodine deficiency results in irreversible impairment of intellectual capacities. Vitamin A deficiency, if untreated, can lead to blindness.

  • Why is chronic undernutrition a serious problem for developing countries?

  • Malnutrition reduces work productivity, as stunted, less educated and mentally impaired adults are less productive. For example, time is lost to economic activities in looking after sick children and days are lost from school. This will have a negative impact on economic growth and poverty reduction efforts of developing countries.

The most critical time for preventing malnutrition is during pregnancy and the first two years of a child’s life. You will look at how you can plan nutritional support for mothers and babies in your community in the next section.

1.1.1  The global burden of childhood and maternal undernutrition

1.2  Planning nutritional care and support in your community