The One Health Concept; Applied in nutrition sensitive interventions VÉTÉRINAIRES SANS FRONTIÈRES SUISSE

Transcription

1 The One Health Concept; Applied in nutrition sensitive interventions VÉTÉRINAIRES SANS FRONTIÈRES SUISSE

2 Nutrition-sensitive livestock-based emergency interventions in Ethiopia Lensse Gobu (BSc, MPH) Tropentag, September 19,

3 Outline of the Presentation Background- Context Nutrition sensitive interventions- experience of VSF-Suisse in Ethiopia EVSP as a showcase Lessons learnt 3

4 Background- Ethiopia (2017) Population 94.3 million (100+ according to UN) Annual growth rate of 2.3% - 12% are pastoralists Geography It is the 27 th largest country in the world 11 administrative regions Pastoralists live in parts of 4 of the regions Service 2.6 health service provider (all level) for 1000 population 4

5 The current challenge in pastoral areas of Ethiopia Inadequate access to services Inadequate institutional capacity Vulnerability due to recurrent droughts Inadequate infrastructure Increased competition for resource and associated conflicts 5

6 Somali Region of Ethiopia One of the 11 Regions of Ethiopia- 5 m population Stunting (chronic malnutrition) prevalence is 27.4% (National- 38.4%) Wasting (acute malnutrition)- 22.7% (the highest from all regions) National- 10% The highest prevalence of anaemia in children -82.6% (national prevalence- 56%). The highest prevalence of severe anaemia in children- 12.8% (national prevalence- 2.9%) The highest prevalence of anaemia in women - 59% (national prevalence- 23%) Source: EDHS

7 VSF-Suisse and Its Nutrition Sensitive interventions in Ethiopia 7

8 Trajectory of one-health implementationin VSF-CH in Ethiopia Nutritionbased livestock offtake project; 2012 EVSP- Emergency veterinary support programme; 2013 NEVSP- Nutrition based emergency Veterinary support program in Siti Zone; 2015/16 BCIN- Behavioral Change for improved Nutrition; Different one health initiatives integrated to RESET project;

9 Implemented in three projects in Somali Region 1. UN/OCHA financed project in Gode and Hargele Districts SDC financed and UN/OCHA cofinanced project in Siti Zone SDC financed project in Warder Zone- 2017/2018 Nutrition based livestock off-take 5 kgs of camel meat per household per week for 12 consecutive weeks. Households severely affected by droughtinduced emergency nutrition situationwith malnourished children < five were targeted. These interventions improved the availability of animal derived protein in the targeted households Implemented in severe drought scenario 9

10 Milking goats distribution Implemented in 2 rounds: Kebriderhar and Shilabo Districts Nogob and Jarar Zones Fresh goat milk Households with malnourished children < five Recently been discharged from therapeutic feeding centers 10

11 The intervention 9 goats/hh with a package of voucher-based veterinary services Locally available and culturally appropriate nutrient dense food. Implemented in scenarios where there is some pasture 11

12 Effects. Improvement of the family food basket Cash injection to the local economy through the sale of meat and milking goats 12

13 EVSP as a showcase 13

14 Project details of the EVSP Name of the project Duration October April 2013 Emergency Community Veterinary Support Program to Mitigate Drought in Korahe Zone Through Improved Food and Nutritional Security (EVSP) Core activities Community-based livestock service interventions, Emergency animal health treatment based on vouchers Milking goats distribution Donor UN/OCHA- HRF Targets of the project 760,000 livestock of poor households (6,000HHs) 50 households hosting children in emergency nutrition services specifically targeted for milking goats distribution. 14

15 Why milk? Animal milk -an important component of pastoralist diets across the world (Sadler, Kerven et al. 2010). A nutrient-dense food known to contribute a high proportion of the nutrients, such as high quality protein and micronutrients. A need to improve availability of milk for young children of drought affected vulnerable community members in program targeted areas. 10/15/18 15

16 Why milking goats? Contributes to asset building More sustainable source of food Safer than collecting the milk from market (avoids spoilage during handling, storage and transportation of the milk) 10/15/18 16

17 Why 9 goats per HH? 1. Milking Performance of Ethiopian Goats (in Somali) Daily milk yield: Liters/Day (assumed an average of 1.25 Lt/Day Lactation length: Days (assumed an average of 160 days in milk) 2. How much milk is needed to supplement a child? Daily milk-based diet recommended for children under 5 years of age is ml/Day (an average of 420) for healthy and nutritious life. 3. How much milk is needed for one household? Assumptions: 4 children per household 4 children X 0.42 Lt/day = 1.68 Lts; 4. How many goats can provide this volume of milk daily? A best goat can give 1.25 Lts/ day, two milking goats can give 2.5 Lts/ Day which is sufficient for about 5 children. The least producing goat yielding only 0.5 Liters of milk per day- we need 4 milking goats per household to feed 4 children. 4 milking goats with their kids- 9 m 17

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19 MUAC for age before intervention MUAC for age after the intervention Age N MUAC-for-age (%) Age N Mid-upper arm circumference-for-age groups % < -3SD % <-2SD Mean SD groups (%) % < -3SD % < -2SD Mean SD (6-11) (12-23) (24-35) (36-47) (48-60) Total: (6-11) 0 (12-23) (24-35) (36-47) (48-60) Total: MUAC for age Assessed using WHO Anthro for PC software 19

20 Number of food groups consumed in a day Household Dietary Diversity Score Percentage of Households % at Baseline % at intervention /15/18 20

21 Other outcomes of the project Feeding practices % of HHs giving pure goat milk to their children increased from 17.3% at baseline to 50% at intervention. A two-fold increase (from 20% at baseline to 41%) in the % of HHs giving milk with tea for their affected childrenas special. 10/15/18 21

22 Other outcomes,..cont d Livelihoods The mean monthly income has increased from 880 birr to 1,380 birr indicating an increasing trend in income among the beneficiaries in the intervention period. 10/15/18 22

23 Other outcomes. KII with the father of one of the beneficiaries I was Faramaal (flexing muscles) before I got the milking goat. Men from poor households like me water more than 100 camels of the better-off families from m depth wells by lifting 20 liter of water per minute for 8 consecutive hours per day in exchange of 3 liters milk for free or for lower price. We then used this milk to feed our needy children. 10/15/18 23

24 Another beneficiary mentioned the unintended effect of this intervention on thefamilies as: After you havegiven us themilking goats we got trust from others. People started giving us credit from shops, which means that we becamepart of thecommunity. 10/15/18 24

25 However, None of the mothers were breastfeeding at the end of the intervention 25

26 Nutrition sensitive interventions needed to be coupled with tailored BCC interventions to improve the nutritional status. 26

27 The BCIN study 27

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29 The learning continued 29

30 One health for integrated service delivery for pastoral areas? 30

31 The challenge-access to services Inadequate health services Only 62% of women access ANC (51 % in Somali Region) 26% of deliveries are in health institutions (18% in Somali Region) Immunization coverage for under 1 is 39% (22% in Somali Region) Inadequate vet services Less than 10% of households report access to vet services In Ethiopian Somali Regional State asof 2015: Only 1 regional lab in Jijiga 622 AH facilities (70% are functional) 5% reporting rate 23% vaccine distribution 81,660 livestock per clinic 31

32 People Livestock Their environment 10/15/18 32

33 WHAT WE DO to ensure Human Health to promote Environmental Health to support Animal Health Our goal: Ensuring healthy people derive their livelihoods from healthy livestock in a sustainably managed environment. 33

34 Thank you! Lensse Gobu: