4.1 Article

Policies and program implementation experience to improve maternal nutrition in Ethiopia

Journal

FOOD AND NUTRITION BULLETIN
Volume 33, Issue 2, Pages S27-S50

Publisher

INT NUTRITION FOUNDATION
DOI: 10.1177/15648265120332S103

Keywords

Ethiopia; nutrition programs; maternal nutrition; anemia; intrauterine growth retardation; birthweight

Funding

  1. Bill & Melinda Gates Foundation

Ask authors/readers for more resources

Background: Maternal undernutrition persists as a serious problem in Ethiopia. Although there are maternal nutrition interventions that are efficacious and effective in improving maternal, neonatal, and child health (MNCH) outcomes, implementation has been limited. Objective: This study explored needs, perceptions, priorities, facilitating factors and barriers to implementation of relevant policies and programs to find opportunities to improve maternal nutrition in Ethiopia Methods: Background information was compiled and synthesized for a situation analysis. This informed focus group discussions and in-depth interviews with mothers, community leaders, health workers, and district health officials in four woredas (districts) in Tigray and Southern Nations, Nationalities and Peoples Region. Results: Findings focused on three priority issues: maternal anemia, intrauterine growth retardation (IUGR), and maternal thinness and stunting. Community-level investigations found that women's low status, food insecurity and poverty, and workload were key factors perceived to contribute to women's undernutrition. Awareness of and demand for services to improve women's nutrition were low, except for high demand for supplementary food. On the supply side, barriers included low prioritization of maternal nutrition in health and nutrition service delivery and weak technical capacity to deliver context-sensitive maternal nutrition interventions at all levels. Conclusions: Community-based health and nutrition services were promising platforms for expanding access to interventions such as micronutrient supplements and social and behavior change communication. Investments are needed to support these community-based programs, including training, supplies, supervision and monitoring. To address IUGR at scale, increased access to cash or food transfers could be explored.

Authors

I am an author on this paper
Click your name to claim this paper and add it to your profile.

Reviews

Primary Rating

4.1
Not enough ratings

Secondary Ratings

Novelty
-
Significance
-
Scientific rigor
-
Rate this paper

Recommended

Article Nutrition & Dietetics

Postpartum Weight Change in Relation to Pre-Pregnancy Weight and Gestational Weight Gain in Women in Low-Income Setting: Data from the KITE Cohort in the Northern Part of Ethiopia

Kebede Haile Misgina, Henk Groen, Afework Mulugeta Bezabih, Hendrika Marike Boezen, Eline M. van der Beek

Summary: This study assessed postpartum weight change and its associated factors. The findings suggest that in low-income settings, higher weight gain during pregnancy and better mental health may help women achieve better nutritional status in the postpartum period.

NUTRIENTS (2022)

Article Public, Environmental & Occupational Health

Magnitude and determinants of animal source food consumption among children aged 6-23 months in Ethiopia: secondary analysis of the 2016 Ethiopian demographic and health survey

Gebretsadkan Gebremedhin Gebretsadik, Amaha Kahsay Adhanu, Afework Mulugeta

Summary: Undernutrition has negative effects on the physical and cognitive development of children. A study in Ethiopia found that only nearly half of children aged 6-23 months consume any type of animal source foods (ASFs). Factors such as religion, child age, household assets, livestock ownership, and ownership of land usable for agriculture were found to be significant determinants of ASF consumption.

BMC PUBLIC HEALTH (2022)

Article Obstetrics & Gynecology

Community food beliefs during pregnancy in rural kebeles of Ofla Woreda, Northern Ethiopia: an explorative qualitative study

Kebede Eyasu, Lemlem Weledegerima Gebremariam, Freweini Gebrearegay, Zinabu Hadush, Afework Mulugeta

Summary: This study qualitatively assessed community food beliefs during pregnancy in rural kebeles of Ofla Woreda, Northern Ethiopia. It found that consumption of animal source foods such as eggs was discouraged, but locally produced alcoholic drinks were encouraged. Avoidance of animal source foods and meal skipping during religious fasting were common practices among pregnant mothers in the area.

BMC PREGNANCY AND CHILDBIRTH (2022)

Article Environmental Sciences

Wealth and Education Inequities in Maternal and Child Health Services Utilization in Rural Ethiopia

Alem Desta Wuneh, Afework Mulugeta Bezabih, Yemisrach Behailu Okwaraji, Lars Ake Persson, Araya Abrha Medhanyie

Summary: This study aimed to examine the association between household wealth, maternal education, and the interplay between these in utilization of maternal and child health services. The results showed the importance of poverty alleviation and girls' education for universal health coverage.

INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH (2022)

Article Environmental Sciences

Is Women's Engagement in Women's Development Groups Associated with Enhanced Utilization of Maternal and Neonatal Health Services? A Cross-Sectional Study in Ethiopia

Fisseha Ashebir Gebregizabher, Araya Abrha Medhanyie, Afework Mulugeta Bezabih, Lars Ake Persson, Della Berhanu Abegaz

Summary: This study aims to assess the association between engagement in women's groups and the utilization of maternal and neonatal health services. The results indicate that pregnant women who had contact with women's groups were more likely to utilize maternal and neonatal health services, but there was no significant impact on facility delivery and postnatal care utilization. Therefore, there is a need to improve the organization and management of the women's development group program and strengthen the engagement of group leaders to promote the utilization of maternal and neonatal health services.

INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH (2023)

Article Obstetrics & Gynecology

Theory-based mHealth targeting fathers and mothers to improve exclusive breastfeeding: a quasi-experimental study

Kidane Tadesse Gebremariam, Afework Mulugeta, Danielle Gallegos

Summary: This study assessed the effectiveness of an SMS-based mHealth intervention targeting fathers and mothers in improving exclusive breastfeeding at three months in a low-income country. The results showed that both the mothers-and-fathers intervention group and the mothers-only intervention group had significantly higher rates of exclusive breastfeeding at three months compared to the control group. This study highlights the potential of SMS-based interventions in improving exclusive breastfeeding in low-income countries.

INTERNATIONAL BREASTFEEDING JOURNAL (2023)

Letter Obstetrics & Gynecology

Armed conflict drives most births to occur out of health facilities: evidence from Tigray, Ethiopia

H. E. Abraha, M. M. Ebrahim, H. Teka, A. Yemane, A. Mulugeta

BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY (2023)

Article Medical Informatics

Co-design and implementation of a mHealth intervention targeting fathers and mothers to improve breastfeeding

Kidane Tadesse Gebremariam, Afework Mulugeta, Danielle Gallegos

Summary: This study designed an SMS intervention targeting parents in Tigray, Ethiopia, and found that sending SMS messages related to infant feeding can effectively improve exclusive breastfeeding rates.

BMC MEDICAL INFORMATICS AND DECISION MAKING (2023)

Article Multidisciplinary Sciences

Clinical presentation, maternal-fetal, and neonatal outcomes of early-onset versus late onset preeclampsia-eclampsia syndrome in a teaching hospital in a low-resource setting: A retrospective cohort study

Hale Teka, Awol Yemane, Hiluf Ebuy Abraha, Ephrem Berhe, Habtom Tadesse, Fanos Gebru, Mohammedtahir Yahya, Ytbarek Tadesse, Daniel Gebre, Marta Abrha, Bisrat Tesfay, Ashenafi Tekle, Tsega Gebremariam, Birhane Amare, Mohamedawel Mohamedniguss Ebrahim, Yibrah Berhe Zelelow, Afework Mulugeta

Summary: This study aimed to investigate the clinical presentation and maternal-fetal and neonatal outcomes of early and late onset preeclampsia. The results showed that women with early onset disease had unfavorable maternal outcomes, such as severe preeclampsia with severity features, liver dysfunction, uncontrolled diastolic blood pressure, and prolonged hospitalization. They also had increased unfavorable perinatal outcomes, including low APGAR score at the 5th minute, low birth weight, and neonatal death.

PLOS ONE (2023)

Article Multidisciplinary Sciences

Unimproved water and sanitation contributes to childhood diarrhoea during the war in Tigray, Ethiopia: a community based assessment

Akeza Awealom Asgedom, Birhanu Tewoldemedhin Abirha, Askual Girmay Tesfay, Kelali Kaleaye Gebreyowhannes, Hayelom Birhanu Abraha, Gessessew Bugssa Hailu, Mesele Bahre Abrha, Mache Tsadik, Tesfay Gebregziabher Gebrehiwet, Aregawi Gebreyesus, Tilahun Desalew, Yibrah Alemayehu, Afework Mulugeta

Summary: Access to water, sanitation, and hygiene (WASH) is a global public health problem that is particularly severe in conflict-affected areas. This study aimed to investigate the sources of WASH during the war in Tigray and the incidence of diarrhoeal diseases among children.

SCIENTIFIC REPORTS (2023)

Article Public, Environmental & Occupational Health

Armed conflict and household food insecurity: evidence from war-torn Tigray, Ethiopia

Aregawi Weldegebreal Weldegiargis, Haftom Temesgen Abebe, Hiluf Ebuy Abraha, Meron Micheale Abrha, Tsegay Berihu Tesfay, Rieye Esayas Belay, Alemnesh Abraha Araya, Mengish Bahresilassie Gebregziabher, Hagos Godefay, Afework Mulugeta

Summary: The objective of this study was to determine the status of household food insecurity in the armed conflict affected communities of Tigray. The results showed that the levels of household food insecurity and hunger were unacceptably high, indicating a significant negative effect of the armed conflict on food security in Tigray. It is recommended to take measures to protect these communities from the immediate and long-term consequences of conflict-induced household food insecurity.

CONFLICT AND HEALTH (2023)

Article Public, Environmental & Occupational Health

Prevalence and multi-level factors associated with acute malnutrition among children aged 6-59 months from war affected communities of Tigray, Northern Ethiopia, 2021: a cross-sectional study

Gebretsadkan Gebremedhin Gebretsadik, Mahlet Abraha, Tedros Bereket, Ferehiwot Hailemariam, Freweini Gebrearegay, Tigist Hagos, Mizan Assefa, Kidanemaryam Berhe, Hadush Gebregziabher, Amaha Kahsay Adhanu, Mekonnen Haileselassie, Mulugeta Gebregziabher, Afework Mulugeta

Summary: Armed conflict in Tigray, Ethiopia has led to acute malnutrition among children, with factors such as age, gender, vitamin A supplementation, diarrhea history, and poor water, toilet, and food security conditions significantly associated with the condition. Immediate international intervention is required to alleviate the problem.

CONFLICT AND HEALTH (2023)

Article Nutrition & Dietetics

Trends in and predictors of animal source food consumption among 6-23 months age children in Tigrai, Northern Ethiopia: evidence from three consecutive ethiopian demographic and health surveys, EDHS 2005-2016

Gebretsadkan Gebremedhin Gebretsadik, Zuriyash Tadesse, Tesfay Yohannes Ambese, Afework Mulugeta

Summary: Despite an increasing trend, the consumption of animal source foods among children in Tigrai is not statistically significant. The study found that the age of the child, religion, maternal education, household assets, and livestock count were predictors of animal source foods consumption.

BMC NUTRITION (2023)

Article Medicine, General & Internal

Effects of continuum of care for maternal health service utilisation on intention to use family planning among pastoralist women of Ethiopia: a robust regression analysis and propensity score matching modelling

Mussie Alemayehu, Araya Abrha Medhanyie, Elizabeth Reed, Znabu Hadush Kahsay, Mebrhatu Kalayu, Afework Mulugeta

Summary: This study examines the effect of continuum care for maternal health service utilisation on intention to use family planning among the pastoralist community in Ethiopia. The results indicate that intention to use family planning would increase by 12.2% if all married pastoralist women received continuum of care for maternal health service utilisation. Factors such as discussion about family planning with their husband, possession of electronic devices, and unmet need for family planning were associated with higher intention to use family planning, while being in a polygamous marriage was associated with lower intention. Attitude towards family planning, subjective norm, and perceived control over family planning were positively associated with intention to use family planning.

BMJ OPEN (2023)

Article Multidisciplinary Sciences

Influence of perinatal distress on adverse birth outcomes: A prospective study in the Tigray region, northern Ethiopia

Kebede Haile Misgina, Lindsay Levine, H. Marike Boezen, Afework Mulugeta Bezabih, Eline M. van der Beek, Henk Groen

Summary: In low-income countries, perinatal distress, including anxiety, depression, and stress during pregnancy, is associated with adverse birth outcomes such as low birth weight and small for gestational age birth. This study found that perinatal distress acts as a mediator between socioeconomic adversity and adverse birth outcomes.

PLOS ONE (2023)

No Data Available