Infant mortality 76 per 10,000 live births 51% is first month
Note mention low rate of vaccination and other resions are higher far more children in Oromiya are more likely to die from preventable diseases.
Govt of ethiopiacurrentl;y pursuing policyy of decentralization towards more local level planning
Community involvementFemale orientedChildren’s nutritionFamily malnutrition awareness including parasitic risk, hygiene, nutritional mealsMicrofinancing (Sorghum)PyramidHealth work training (rapid malnutrition assessment)local leaders involvement (improving hygiene, sanitary environment, and access to clean water) Radio Show as incentive (community leader interview Iman, Church leader, Medical Professional) Sustainability/self sufficientMulti dimensional approachShort term and long term intervention
Cost - $ 300 per metric ton. CHEAP!!!
Expert to teach – leaf concentrate process, storage and advantages to community Highly Nutritious Leaf Protein Concentrate – (rich in beta carotene, iron, & high quality protein) – Effective in combating malnutrition, esp anemia & vit A deficiency prevalent in children & pregnant women in developing countries. It is easily combined with variety of local available foods to make culturally acceptable dishes.
2ND BULLET: Partnership with Coffee Grower Association to purchase – small baskets woven by local women to package retail coffee to market for export & tourists - Income generating opportunity. Women of Ethiopia traditionally weave beautiful baskets for daily use, Coffee – cash crop
Involving Principal stakeholders from the very start is a Priority-Inviting them to educational sessions and involving them in key decisions r/t intervention dev. ( based on previous pilinot studies done in the region). Avoiding exagerated expectations ( be clear that they are the ones that will make marked changes their participation is keye we will explain opbjectives very clearly from startObtain villagers consent ->
Global Health Competition Team 3Planting the Seeds of the Future Project PSF-Ethiopia Vanessa Gaioso Hunter Howell Loraine Kanyare Tsuguhiko Kato Irene Tami 1
Assessment – Oramiya Region• Population: 27,158,471 • Child mortality 178 death (2007 Census) per 1,000 live birth• 48% Muslim 31% Orthodox, • 6.4 births per a woman and local religions • 4.8 per household• 85% Oromo • Life expectancy 42 years• 89% Rural • 31 hospitals• Chronic drought • 242 health centers• 51% total coffee production • 3,758 health posts in the country• 24% engage in non-farm related jobs 2
Assessment (cont’d)• Children under 5: • Education • 41% stunted • Literacy Rates-62% Men, 30% Women • 9.6% malnourished. • 62.5% enrolled in primary school • 34.4% underweight • 10% enrolled in secondary• 32% Access safe drinking school water • High dropout rate especially among girls• Infectious Diseases: • Malaria • 44% affected Poverty • Food or water borne diseases • Governance and institutions (Bacterial, Protozoal diarrhea, hepatitis A&E, and typhoid • Public Policy and Budget fever Allocation • Respiratory infections • 50% of Budge on Military • 6% on Health Care. 3
Potential Barriers• Geographic area (Rural)• High illiteracy rate esp. among women• Drought• Access to clean water & associated hygiene practices• High mortality rate• Centralized government• Military conflicts & displaced population 4
Objectives1) Improve Nutritional Status of Children Under Five Years2) To develop Self Sustaining and Gender Sensitive Interventions that Integrate Agriculture, Education, and Income Generation3) Utilize Alternative Technology for Water Purification, Hygiene, & Extremely Nutritious Leaf Protein Concentrate 5
Malnutrition Status 41 % are stunted (children < 5 y-o) Manifestation 9.4% children malnourished 34.4%children underweight 50% women underweight Infections/Diseases Nutrition Intake Malaria Food Shortage, -Parasitic Diseases/ Diarrhea Direct 5 person per household - HIV/AIDS Causes Food delivery-no gas, truck -Hepatitis -Typhoid feverHousehold Food Behavior & Health Services Security Caring Practices ↓ sanitationRural women spend ↓ Hygiene ↓ safe water Indirect time caring wood, ↓ Education ↓ immunization Causes child, water ↓ Latrines coverage Military Conflicts Education (Literacy rate 62% men – 30% women) Fundamental Causes Unequal Distribution of Resources Centralized Government, Gender Inequality, Poverty, Agricultural resources (timing/quantity of rain season, erosion of land) Based in UNICEF Model
Pilot Study• Duration – 1 year (pilot), 2 years (replication)• Location – Borana zone in Oromiya 11%Urban, 2 million, about 4,000 households,• Sample size – 400 households 7
Intervention Health Professional, CommunityDescription: Worker Training• Tri-location Educational Sessions - • Rapid Malnutrition Assessment and triage schools, market places, local health • Health education centers etc • De-worming/partnership with other NGOs• 2 training levels -> community and • Solar Water Purification local trainers • Leaf concentrate process, storage and advantages to community 8
InterventionCommunity Education • Expert to teach – leaf concentrate process, storage and advantages to• Microfinance opportunity – High grain community Highly Nutritious Leaf Protein prices sometimes not affordable for Concentrate – (rich in beta farmers –Bioengineered drought resistant carotene, iron, & high quality protein) – sorghum seeds loaned out for subsistence Effective in combating malnutrition, esp farming anemia & vit A deficiency prevalent in – First harvest after 3 months children & pregnant women in developing countries• Women of Ethiopia traditionally weave - Easily combined with variety of local beautiful baskets for daily use, Coffee – available foods to make culturally acceptable dishes. cash crop Partnership with Coffee Grower Association to purchase – small baskets • Water purification – teach low tech water purification techniques - combine of the woven by local women to package retail suns ultra violet rays and heat to kill coffee to market for export & tourists - pathogenic germs - that spread much Income generating opportunity diarrheal in Africa • Reinforce hygiene (hand washing, vegetables, construction of latrines/ partnership) 10
Pilot Study Time Frame Activity Feb Mar Apr May Jun July Aug Sep Oct Nov Dec Jan- e MarcEstablish logistics (office sites and transportation)Identify key personnelGoverntment contacts for buy-inCommunity Based Participation (informed consent)- ProblemIdentification•Hire local experts•Trainer training – medical professionals- triage malnutritioncases, women – handicraft (illustrated training material orpamphlet), men – sorghum cultivation & storage(6 weeks)•Meet community leaders•Identify intervention sites•Purchase the intervention supplies•Partner with coffee farmer association-purchase wovenbasket local women•Community Assessment (local hospital chart-weight forheight, observation of visible severe wasting & nutritionaledema)•Community malnutrition awareness education (9 months)•Microfinance-first seeds delivery•Weaving – income generation women•Solar water purification training•Combat children malnutrition with leave extract.• Continuous evaluation•Continue interventionMicrofinance-crop returnQuarterly assessment and spontaneous director site visitCommunity leader involvement in microfinance projectQuarterly assessment and spontaneous director site visitTest effectiveness of the intervention 12
Illustrative BudgetTraining = XXXOffice overhead = $200 * 12=Experts for training = XXX*10Incentive= Goats and chickensSorghum= $300 per metric tonsDirector Salary = XXXAdministrative personnel =XXXExpert Salary (local experts, = 10 * XXXleader women experts)Transportation (vehicles, = XXXtrucks, and repair)Refreshments = XXX