Challenges and opportunities in CBN adaptation to pastoral areas in Ethiopia

Challenges and opportunities in CBN adaptation to pastoral areas in Ethiopia

Ethiopian pastoralist community are more than 12 million occupying 61 per cent of the total land mass with more than 29 nationalities and ethnic groups. They inhabit land with natural resources and a wealth of cultural and traditional heritage that remains largely untapped.

The health sector development plan has increased its efforts to enhance good nutritional practices through health education, treatment of malnourished children, and provision of micronutrients to the most vulnerable group of the population in both agrarian and pastoral regions. In addition, the Health Extension Program (HEP) has included nutrition as part of the health packages. A National Nutrition Strategy (NNS) and National Nutrition Program (NNP) has also been developed and implemented. One of the components of NNP is Community Based Nutrition (CBN), which comprises list of nutrition and health care packages.

This report indicates the study that was conducted to investigate challenges and opportunities in adapting CBN into pastoralist communities of Ethiopia. In the study, four main pastoral regions namely; Afar, Somali, South Omo and Borana are included.

The study highlights the following major challenges and opportunities in the endeavour to provide adequate healthcare service to Ethiopian pastoralists:

  • food insecurity and consequently the widespread acute and chronic malnutrition is directly or indirectly associated with chronic poverty, poor infrastructure, ecological constraints, limited arable land, absence of irrigation, disease, poor water and sanitation, inadequate nutritional and health knowledge and ethnic conflicts
  • reasons behind the low performance of healthcare service are associated mainly with pastoralist lifestyles that include dispersed settlement pattern, seasonal mobility, pervasive prevalence of harmful traditional practices, which, among other things, perpetuate under utilisation of services even when and where the health services are available
  • health facilities in pastoralist communities are limited in number, are under-staffed and service delivery is poorly organised
  • recruiting, training and retaining female Health Extension Workers (HEWs) is most difficult
  • absence of commitment of frontline armies (HEWs and Woreda Health Office (WoHO)), very low salary, absence of means of transportation together with dispersed settlement of pastoral community and absence of incentives despite the livelihood hardships
  • prevalence of endemic diseases, such as malaria, trachoma, and zoonotic diseases (e.g. bovine TB) and infectious diseases associated with poverty (poor housing, poor environmental and personal hygiene, lack of potable water, etc.) are common

Some of the recommendations made by the study to address the challenges above are:

  • attaching human health care services with veterinary and involving the veterinarians in nutrition works  
  • irrigation might be an important instrument to settle people into areas where health and other important services can address the pastoralists
  • training and involvement of TBAs and traditional healers in primary healthcare program might help as those people have acceptance by the communities
  • involving pastoralists in any health planning and execution programme will also maximize the achievement