The Proportion of Households with Adequately Iodized Salt in Ethiopia.

Objectives: According to the Ethiopia Demographic and Health Survey 2011, the proportion of households using iodized salt (>15 parts per million [PPM]) was 15.4%. The 2014 Ethiopia National Micronutrient Survey (ENMS) will estimate the national and regional proportions of households using adequately iodized (>15 ppm) salt in Ethiopia. Methods: The ENMS is a cross-sectional household survey designed to produce national and regionally representative estimates. Samples of salt (20 gram) usually consumed will be collected from approximately 4,000households for qualitative testing using the rapid test kit. Salt samples will be sent to the Ethiopian Health and Nutrition Institute Laboratory where iodometric titration will be conducted. Results: The national and regional proportions of households with adequately iodized (>15 ppm) salt will be presented. Conclusions: This survey will provide national and regional data for monitoring and evaluating the progress of the Universal Salt Iodization (USI) program in Ethiopia.

Implementation of Micronutrient Supplementations in Community-Based Nutrition Program in Ethiopia after Integrated Refresher Training (IRT).

Objectives: Community-Based Nutrition (CBN) is important component of National Nutrition Program, designed to build upon the Health Extension Program packages to improve nutritional status of under-five children, pregnant and lactating women. Therefore, this study was conducted to assess CBN program implementation after IRT. Methods: The study was conducted from October to November, 2012 in four agrarian regions. Institutional based cross-sectional study with both qualitative and quantitative data collection approach at 56 kebeles were used. Results: Some of the Health Extension Workers (HEWs) were not delivering GMP in a quality way as they were trained on IRT. For HEWs it was difficult to follow the procedure of GMP service properly. The gap in skill was higher in the new CBN woredas. Task shifting from VCHWs to HDAs didn't occur in most kebeles of Amhara region. In most regions it was observed that supportive supervision and review meetings are offered but it is not regular and consistent. It was observed that some new programs contradict with CBN service like new community health management information system. Based on the information gathered, all health post of study areas were conducting Community Health Day services for micronutrient supplementations in every three months regularly except very few. Conclusions: Factors which affect the implementation of CBN are: lack of training for both HEWs and HDAs, work load for HEWs. Training should be given as it helps to improve competencies/refresh the already trained and trainees those who didn't get it. Strengthening the CBN service can be achieved by increasing the manpower.

Effects of Governance Structures in Ethiopia on Implementation of Nutrition Interventions.

Objectives: 1. Assess factors that enhance or constrain implementation of nutrition interventions at national and sub national levels. 2. Analyze how direct nutrition interventions and multi sector approaches are implemented at national, regional, zonal and woreda levels. 3. Identify models of effective governance for nutrition interventions. Methods: Key informants were interviewed using a structured questionnaire. National level interviews from the agricultural, health, education, finance, economic development, social protection sectors and UN agencies, civil society and donors were included. Parallel interviews were conducted in four regions - Amhara, Oromia, SNNPR and Tigray - and 16 woredas for a total of 312 interviews at the subnational level. Results: While there was general awareness of the Government's activities as part of the SUN movement, key individuals at the national level were, in general, not able to identify specific actions that had been launched as a result of the 2013 National Nutrition Programme. Linkages between policy and program initiatives between national and sub national levels varied. The vertical and horizontal collaborations were most active where a specific, coordinating body or mechanism had been established. Several models of effective implementation are identified and most often originate outside the health sector. Conclusions: Two dominant models of implementing a multi pronged strategy to alleviate malnutrition exist in Ethiopia. The appropriateness of these models and factors associated with each are discussed.

Factors Associated with Dietary Practices and Nutritional Status of Pregnant Women in Wondo Genet District, Sidama Zone, Southern Ethiopia.

Objectives: To assess dietary practices, nutritional status and associated factors among pregnant women in study area. Methods: A cross-sectional survey was employed for the study. Two-stage cluster sampling was used. 153 pregnant women aged 19-49 years were the subjects. Energy and nutrient intakes were calculated from one day weighed food records on a sub-sample (n = 77). Structured questionnaire was used to collect data. Results: Energy intake of study participants in 2nd and 3rd trimesters pregnancy were 2308 kcal for 2340 kcal and 1420.5 kcal for 2452 kcal. Vitamin A intake was 3 micro grams for 800 micro grams. Protein intake of the study respondents in 2nd and 3rd trimester pregnancy was 45.9 g and 31.5 g for 71 g. Majority (75.2%) of study participants did not take additional meal during pregnancy. 69.3% skipped one of their regular meals. As indicated by mid upper arm circumference a total of 9.2% of the study subjects were undernourished. Factors associated with nutritional status and dietary practices were number of pregnancy, consumption of cereal foods, household size, growing khat and vegetables. Conclusions: Energy and the nutrient intake of study participants were lower than recommended intakes. Dietary practices and nutritional status of study participants were not adequate to support their increased energy and nutrient requirement.