Harvest in May, October 4 months between each (May-June, Oct-Dec)
Team 2 case study
Biyyoolessaii Ija Mukaa “Fruit of the Land” Team 2 Devin Broadwater, Karen Hamby, Naomi Chen,Online Image. 07 November 2009. EthioGardian.com Amanda Hasseltine, Bernice Boursiquot
Presentation Outline Demographics on Oromiya Meet the Adabbos, an Average Oromo family Child Malnutrition and Its Factors Strategy to Combat Child Malnutrition Emergency Food Aid Comprehensive Approach Allocation of Funds Summary
Oromiya Region Background Demographics Current Health Crisis 27 Million People 34.4% of Children under the 4.8 People Per Household age of five are underweight Estimated 126,000 children are Ethnic Groups in need of urgent therapeutic 87.8% Oromo care for severe malnutrition in 7.22% Amhara Ethiopia Religion This number is expected to climb 48.2% Christian Ethiopia is rated the sixth Orthodox and Protestant worst country in terms of 47.5% Muslim nutritional outcomes 88.7% Rural Inhabitants worldwide. Central Statistical Agency (CSA) of Ethiopia, 2007
Meet 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
Online image. Current food shortages in Ethiopia. (2009) http://news.bbc.co.uk/2/hi/8319741.stm
Identifying Cases of Severe Acute Malnutrition Children with mid-upper arm circumference (MUAC) <11cm or bilateral leg pitting edema referred to regional health centers weight for height. Children with weight for height less than 85% of median national center for health statistics (NCHS) classified as having Severe Acute Malnutrition Advantages: Practice currently in use Independent of age Simple, low cost technology Low stress on children and caregivers Accurate Highly sensitive and specific Recommendation: increase usage of MUAC measurementsBelachew, 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.
Black. “Framework of the relations of poverty, food insecurities, andother underlying and immediate causes to maternal and childmalnutrition and its short-term and long-term consequences” Maternaland Child Undernutrition.
CholeraOutbreakAugust 8th 2009The shaded region indicates thearea 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
The Three SectionsWest •Generally Food Stable •Without CholeraSouth •Highly Food Insecure •Without CholeraNorth •Highly Food Insecure •With Cholera
The 1 million dollar question (USD)?How can severe acute malnutrition be sustainably reduced in the Oromiya region of Ethiopia with 1 USD million?
The Two-Pronged StrategyEmergency Food Aid Comprehensive Approach
Emergency Food AidReady 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.
Comprehensive Targeted Approach Develop local RUTF’s—”Fruit of the land” Local farmers Training of CHA’s Community members Radio Soap Opera Mass communication, dissemination
Assessment Time Emergency / Local RUTFs Community Soap Opera Accountability Imported Health and Evaluation RUTFs Advisors1-3 months Evaluate Focus groups Recruit -- Ethics current CHA’s clearance partner NGO Identify farmers, efforts formulas Assess distrib. Stockpile food- Adapt local secure area crops RUTF “chain”3-6 months Start efficacy Start efficacy trial Create -- Baseline trial with several curriculum statistics formulas Local distribution feasibility6-9 months Analyze Analyze results Training -- Intervention results impact Plant for next Discontinue season
Implementation Time Emergency / Local RUTFs Community Soap Opera Accountability Imported Health Advisors and Evaluation RUTFs9-12 months -- Local crop Educating Identify Harvest trends farming, community radio production stations, Economic Local economic recruit stability initiatives talent indicators12-18 months -- Same as Same as above Preliminary Same as above above scripts Quality Fidelity of CHA assurance training Training new Concept CHA’s testing18-24 months -- Same as Same as Recording Same as above above above
Replication Time Emergency / Local RUTFs Community Soap Opera Accountability Imported Health Advisors and Evaluation RUTFs3 years -- Local crop Educating Broadcast Evaluate farming, community media reach, production impact Local economic initiatives Crop sustainability Training new CHA’s Child nutrition indicators5 years -- Same as Same as above Fundraising Same as above above to record new episodes10 years -- Same as Same as above Syndication Same as above above
Allocation Of Funds Short Term – 15% Import Tax 20-50% of cost RUFTs $77,700 Cost of RUTFs $77,700Short Term Internal travel & $150,000 distribution $20,000 Internal Shipment $22,300 Efficacy evaluation/ research $30,000
Allocation Of Funds Long Term – 85% Malnutrition screening (bangle) Local RUTFs $340,000 Acceptance of paying for supplements Education/ CHAsLong Term $340,000 Sanitation$850,000 Soap Opera Breastfeeding/ Child feeding $85,000 practices Accountability & Family Planning Evaluation $85,000 Female Empowerment
Summary Child malnutrition is a multi-faceted issue Requires: Comprehensive, long-term approach Community involvement Four components : Initial importation of RUTF’s Training Oromiyan farmers to produce local RUTFs Training CHA’s to educate mothers on proper feeding practices Health soap opera broadcasting