ODO SHAKISO WOREDA (BORENA ZONE) - PFEDA / Page d ...

ODO SHAKISO WOREDA (BORENA ZONE) BASELINE NUTRITION
STUDY
TABLE CONTENTS
INTRODUCTION 1
1. Background to the Study 1
2. The Survey 2
2.1 The Purpose of the Survey 2
2.2 METHODOLOGY 2
• Survey Methodology and Sampling Frame 2
• Variables Measured and Recording Information 3
2.3 Organisation and Management of the Survey 3
• Organisation 3
• Training of the Data Collectors 3
• Management of the Survey 4
2.4 Organisation and Management of the Data 4
• Data Editing and Input 4
• Data Analysis 4
2.5 Other Sources of Information 4
• Focus Group Discussion 4
• Market Survey 4
• Discussions with the Woreda Sector Offices 5
3. Results of the Study and Discussions 5
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3.1 Nutritional status 5
3.2 Vaccination and Health Status in the Studied Children 6
3.3 Socio-economics and Food Situation of the Interviewed
Households 6
• Head of Household and Household Size 6
• Staple Foods of the Family 7
• Pattern in Acquisition of Staple Foods 7
3.4 Family Health Aspects of the Interviewed Households 7
3.5 Sanitation and Water Aspects of the Interviewed
Households 8
• Water Requirement and Source 8
• Changes in Water Supplies and Quantity 8
• Inadequacy of Water Year Round and the Reason
for Shortfall 8
• Intervention Requirements in Water & Sanitation 8
3.6 Focus Group Discussions 9
3.7 Results of Market Surveys 9
4. Discussion on Context 10
4.1 Food Security Situation 10
4.2 Malnutrition Level and Related Stresses 10
4.3 Response to the Crisis 12
5. Recommendations Future Actions 12

EXECUTIVE SUMMARY
This report offers major findings of a baseline nutrition survey that
was commissioned by the Ethiopian Red Cross Society and
undertaken by the consultant in Odo Shakiso Woreda of the Borena
Zone.
Odo Shakiso Woreda is situated in the northern part of the Borena
Zone. The Woreda has a total population of about 100,000 and
organised into 20 Kebele out of which a total of 34,125 people are
affected by the current drought-induced food shortages.
The ERCS and DPPC are distributing regular monthly rations to the
selected 34,125 beneficiaries. Only 4 members in a selected
household are eligible to receive the dry ration of 12.5 kg/head.
ERCS has distributed ration to 7 Kebeles and the rest are covered
by the Federal DPPC.
The Woreda is well known for its rich alluvial gold deposits and
mining that attracts a number of fortune seekers from neighbouring
districts and regions.
Mining itself requires a lot of soil moisture and a great volume of
water for washing the clay off the gold powder.
The attractive forestry and the wildlife are also in great threats in
these non-restricted movements and clearing of trees.
i

NUTRITIONAL STATUS AT THE WOREDA LEVEL
LEVEL
Weight-for-
length(WL), n=695

unprotected sources. More than 46.6% of respondent household
have to walk (both ways) for more than 1 hour to fetch water.
Numerous respondents, (58.5%, N=318) reported that they do not
get water year round. The reason for the shortfall is drying of the
sources part of the year.
Water is a scarce commodity in many villages and house. Supply of
clean water is non-existent even in Shakiso town. Private
commercial tankers and donkeys transport water from rivers to
some populated villages for sale.
Recommendations
Strengthening of the ERCS Sub-Branch Offices in Kibre Mengist
and Shakiso and the establishment of warehouses should be an
immediate priority.
The ERCS should strongly advocate for adequate food aid and
inputs in health and water sectors development.
Launch training programs to the Youth Club members about the
activities of the ERCS including food, nutrition, health and the
benefits of wildlife for the community.
Closely monitor the nutritional and health situations in the Woreda
and follow-up nutritional surveys should be conducted every six
months.
Maize grain should constitute a priority grain for general dry ration
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distribution and the volume of shipment should be increased for
involvement of the population in food-for-work development
activities.
The possibility of extensive utilisation of able water should be
explored.
The use of baseline information for future project appraisals,
implementation, monitoring and impact evaluation is highly
recommended.
iv

ODO SHAKISO WOREDA (BORENA ZONE) BASELINE NUTRITION
INTRODUCTION
1. Background to the Study
STUDY
This report offers major findings of a baseline nutrition survey that was commissioned
by the Ethiopian Red Cross Society and undertaken by the consultant in Odo
Shakiso Woreda of Borena Zone (TOR and map of the area are attached in Annexes
Section). A separate brief report about the situation, observed in adjacent Adola-
Wadera Woreda, is also annexed (Annex 4).
Odo Shakiso Woreda is situated in the northern part of the Borena Zone. Borena
Zone is one of the areas that have been affected by drought-induced crop failures
and the precipitating food shortages and ill health.
The Woreda has a total population of about 100,000 and organised into 20 (2 urban,
and 18 rural) Kebele/Peasant Associations (K/PAs) out of which, according to the
authorities of the Woreda, a total of 34,125 people are affected by the current
drought-induced food shortages.
Currently, the Ethiopian Red Cross Society (ERCS) has been involved in the Woreda
in terms of distributing relief food and is making utmost effort in mobilising resources
to contribute towards containing the current food shortages.
Therefore, a need was felt to undertake a baseline nutrition survey of the Woreda to
understand the extent of the need and regulate the ERCS’s assistance as well as for
further advocacy for resources and planning of health, water and nutrition-related
interventions.
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The report is presented in four parts. The first part deals with the background and
description of the study site while the second part highlights the objectives and the
methodology. The third part presents the major findings of the study. The fourth part
of the report discusses the findings of the study in the context of the current situation
in the in study area and the fifth and final part gives recommendations for further
actions. Detailed accounts of the study results are presented in the appendices and
annexes sections.
2. The Survey
2.1 The Purpose of the Survey
The first and the most immediate purpose of the study were to assess the malnutrition level, to
determine the extent of the need and generate a baseline information on food, health and water needs
of the general population. The survey findings are also thought to support the suggestions to be
forwarded for the immediate and future nutritional and health inputs for action and advocacy.
2.2 METHODOLOGY
• Survey Methodology and Sampling Frame
The consultant, maintaining WHO’s/FAO’s standards and using DPPC guidelines set for such
assessment (as fit for such population dynamics), has designed the study.
A final sample size of 672 children (70-110 cm length) was determined using sample size calculation
method for a 2-stage cluster sample survey (with 30%-estimated prevalence, 5% precision and 5%
error risk). A total of 26 clusters were studied from 6 rural FA/PAs and all eligible children in a
household were included for anthropometric measurement.
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• Variables Measured and Recording Information
Recumbent length was recorded to the nearest 0.5 cm using standard length board. Each child was
weighed, using hanging spring scale graduated by 0.1 kg, with minimum clothing (estimated
deductions for the minimum clothing were made) and the weight of each child was recorded to the
nearest 100 gram. Wherever available, age and vaccination status have been recorded from their EPI
card whilst the mothers’ responses were recorded in the absence of such a card. Mothers were
interviewed about family food, health and water using structured questionnaires (Annex 2).
2.3 Organisation and Management of the Survey
• Organisation
The survey work was organised into 4 teams consisting of a team leader (a Nutrition
Field Worker) two/three trained assistants (ERCS Youth Volunteers) and a
guide/interpreter. The assistants help the team leader in measuring the children,
recording and filling-in the questionnaires. The guide/interpreter would help each
team in locating the selected Kebele/PA introducing the team. The consultant
supervised the data collection at random to ensure consistency and that the qualities
were maintained.
• Training of the Data Collectors
The survey team leaders and assistants were assigned by the consultant. Although
the team leaders were experienced Nutrition Field Workers (NFWs) who have been
conducting such surveys, a refresher orientation, in the context of the current study,
was given for 2 days in Addis. A further one-day orientation on the survey and
practical training was given to ten assistants selected and provided from the ERCS
Youth Volunteers in Shakiso town (ERCS Sub-Branch Office).
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• Management of the Survey
Assignment of teams/supervisors and selection of Kebele/Peasant Associations
(K/PA) for each team plus setting of survey dates and times for each cluster were
carried out by the consultant.
2.4 Organisation and Management of the Data
• Data Editing and Input
The data collected were coded, edited and cleaned thoroughly before they are keyed into computer
using EPI-INFO Version 6. Further cleaning of the data was made before computing and tabulations.
• Data Analysis
The standard deviation scores/indexes (Z-Scores) for anthropometric data were calculated with the
help of EPINUT software. Further analysis for associations were performed using and SPSS-PC+
statistical methods.
2.5 Other Sources of Information
• Focus Group Discussion
Focus group discussions were held with key informants and elders in K/PAs to substantiate the
information collected through formal means. The extracts of the findings are summarised and
presented in Appendix A.
• Market Survey
Market surveys were conducted by the teams and the consultant in markets of the
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Woreda during the study. In most of the cases, the teams/consultant were able to
purchase the items in the smallest unit available. However, for those commodities
difficult to buy such as livestock, the team/consultant presented itself as a buyer and
collected an average price for each item. Results from Woreda Agriculture Office
market surveys are also observed and compared. The findings of these market surveys
are presented in Appendix G.
• Discussions with the Woreda Sector Offices
The Woreda Council, Health and Agriculture offices were visited starting from the initial
stages and during the actual survey. Secondary data and other information pertinent for
the study have been collected during these visits.
3. Results of the Study and Discussions
3.1 Nutritional status
NUTRITIONAL STATUS AT THE WOREDA LEVEL
LEVEL
Weight-for-length(WL),
n=695

3.2 Vaccination and Health Status in the Studied Children
The EPI coverage is grouped into two categories; those households that have reported
to have kept the EPI card (11.7%, N=81) and who had no card and responded verbally
(88.3%, N=613). The results indicate that the combined universal coverage of
completion of vaccination totals to 33.1% (N=230 out of 694 total children) (Table C1).
As regards the health status of the studied children in the last 15 days prior to the
survey, the caretakers have reported that 318 (45.8%) out of 694 children were ill. This
is a high level of ill health. Detailed results (Table C2.) show that 45.6% (N=145), 21.4%
(N=68) and 32.7% (N=104) were suffering from fever, diarrhoea, and malaria,
respectively. Prevalence of repeated measles and malarial attacks have been reported
by a number of households and these reports are in agreement with the statements of
officials of local health institutions.
Diarrhoea alone accounted for more than 45% in children indicating a high pattern of
malnutrition. The predisposition of malnutrition to mass diarrhoea in children is common
observation during such food shortages. Attacks of malaria are equally alarming. The
area is an epidemic proportion, currently.
3.3 Socio-economics and Food Situation of the Interviewed
Households
• Head of Household and Household Size
Among the interviewed and responded households (n=545), 91.0% (N=496) are
headed by men while female-headed households are 9.0% (N=49). The reasons for
being female head of a household varied from being widowed 67.9% (N=36), divorced
15.1% (N=8), migrant husband 5.7% (N=3), to shared husband 9.4% (N=5) (Table D2).
The mean household size in the Woreda is 6.8 and the ranges are given in Table D1 in Appendix D. More
than 58% of the respondents constitute 6-13 people living under the same roof. No significant association
was observed between household size and malnutrition level in correlation computations.
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• Staple Foods of the Family
More than 88% (N=484) of the households have reported maize as their main staple
diet. Few respondents have reported sorghum (9.5%, N=52) and Tef and sorghum
(Table D3).
As regards the source of food, the majority (78.5%, N=428 out of 545) have reported
they purchase from the market. Consumption from their own produce in normal
circumstances accounted only to 11.0 (N=60). The rest, 7.9% (N=43) and 2.6% (N=14)
of the respondents have reported they get the food from wage and aid, respectively.
The survey area has been dependent for years on cash earnings from mining and
related activities.
• Pattern in Acquisition of Staple Foods
Regarding the current position of stock of the reported staple foods in the house, the
majority (96.1%, N=526) of them have reported that they have insufficient food items
under their possession at present (Table D6).
Those who currently buy food (93.4%, N=509) get the money from daily labour
(including mining, 83.6%, N=437), sale of cattle (9.4%, N=49) and sale of firewood
(2.3%, N=12). Income from petty trades accounted to 4.8% (N=25).
3.4 Family Health Aspects of the Interviewed Households
The Woreda has 6 clinics and a Health Post. Most health institutions are said to
conduct MCH programs with EPI and GM/P. Apparent malnutrition (PEM) among
clinics-visiting children are said to be on the rise. Outbreaks of measles, diarrhoea
and malarial epidemics are reported from 6 Kola (lowlands). Drugs, especially
paediatric syrups are not available or are in a short supply.
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In normal times, when a family member fails sick, 92.3% (N=503) of the interviewed
households go to a government clinic, 3.3% (N=18) of them go to a drug vendor and
2.4% (N=13) go to no where (Table E1). The majority of the reporting communities
have to walk from 2:00 to 5:00 hours to reach the nearest health institution.
3.5 Sanitation and Water Aspects of the Interviewed Households
• Water Requirement and Source
The majority of the survey population (73.9%) interviewed reported daily water
requirements of more than 20 litres. More than 96.8% of the water is from
unprotected sources (Tables F1 and F2). More than 46.6% of respondent household
have to walk (both ways) for more than 1 hour to their water sources (Table F3).
• Changes in Water Supplies and Quantity
Only 13.8% (N=72, n=536) of the respondents have changed their normal water
sources due to the drying up of the source part of the year in their usual source.
• Inadequacy of Water Year Round and the Reason for Shortfall
Numerous respondents, (58.5%, N=318) reported that they do not get water year
round. Reasons for the shortfalls are drying of the sources part of the year (94.9%,
N=299) and high competition (4.4%, N=15).
• Intervention Requirements in Water and Sanitation
In general terms, on one hand, water is a scarce commodity in many villages and
house. On the other hand, it is a common observation to big rivers flowing through
the dense forests of the Woreda.
Supply of clean water is non-existent even in Shakiso town. Private commercial
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tankers transport water from rivers to some populated villages. Donkeys also play
important roles carrying water from river sources to households or gold mining sites.
Intervention in clean water supply and possible utilisation of rivers for irrigation
(including pump irrigation) should extensively be explored.
3.6 Focus Group Discussions
Focus Group Discussions have been held with key informants and elders. The
participants of all discussions and all key informants unequivocally expressed that the
area has been experiencing a repeated drought (about 6-8 years of gradual crop
failures) and 4 years of total Belg crop failures.
The informants have pointed out that drying rivers, water wells and springs, and
about their children loosing weights, epidemics like scabies and other various health
problems. They reasoned that they are exposed to this type of famine due to
shortages of rain and lack of water. The situations have affected human, animal and
wildlife (forestry) in the Woreda.
The trend in coping strategy was sales of cattle, mining for gold and migration to
neighbouring Enset-growing Woredas like Uraga.
Deaths of considerable number of livestock have been stressed. One member of the
discussion group himself has lost 30 cattle last year.
3.7 Results of Market Surveys
The market study and other survey results obtained from secondary sources are
similar in trends (Appendix G). The market price trend for food grains show an
average 20% to 30% increase from past years during this period. The month to
month pattern was similar. The same level of decline in prices of livestock was being
observed for the same periods. These types of market price patterns are symptoms
of exiting food shortages and nutritional stresses.
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4. Discussion on Context
4.1 Food Security Situation
The Woreda is well known for its rich alluvial gold deposits and mining (traditional as
well as commercial) attracts a number of fortune seekers (including other service
providers) from neighbouring districts and regions. Therefore, the majority of the
population appear to be unstable and ever moving looking for new and promising
sites for mining and those who do not mine move with the miners to provide the
necessary services like catering, provision of gold-washing water (that is very
scarce), equipment, etc.
Mining itself requires a lot of soil moisture and a great volume of water for washing
the clay off the gold powder. The current drought, therefore, affects not only
agriculture and livestock but mining and the forestry too.
The attractive forestry and the wildlife are also in great threats in these non-restricted
movements and clearing of forests.
The local subsistence farmers also spend a great deal of their time in this very
tedious endeavour. In this context, the lucky ones who get some grams of gold would
flourish whilst those who do not get turn to their homestead. The worst happens
when the backyard crop fails and the cattle starve to death due to drought like that is
in-place now.
4.2 Malnutrition Level and Related Stresses
Odo Shakiso Woreda has recorded one of the highest levels of PEM when compared
with some national and such pocket surveys. The comparative results of some of
these nutritional surveys are summarised in Appendix I.
The 1983 and 1992 national surveys found 8.1% and 8.0% of wasting, respectively.
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The more recent 1995/96 and 1999 Welfare Monitoring Surveys have recorded
10.8% and 7.6% of wasting, respectively. Although it might not be possible to
compare national figures with this type of specialised study result, 31% of wasted
children in a population of less than quarter of a million could mean the community is
on the threshold of total starvation. The past surveys of the present type have
recorded comparatively lower figures. These include 22.7 in urban setting (Bahir Dar,
MEDAC, 1994), more than 19% in Simada Woreda of South Gonder (Tekabe, 1995),
20.2% in Konso Special Woreda (Tekabe, 1999).
Summary Of Results of Some of the Nutritional Surveys in Ethiopia
Region/ Area Wasting (%) Reference
National (EWS) 7.6 ENI, 1980
National Core Module 8.0 CSA, 1993
Four Towns (FSS)
(Bahir Dar)
South Gonder (BLS)
(Simada)
11
12.3
(22.7)
13.0
(19.6)
MEDAC, 1994
Frew Tekabe, 1995
Selected Woredas (FSS) 8.0 CRS, 1997
National (WMS) 10.8 CSA, 1996
Agro-ecological 10-14 AAU, 1994 (PC)
National (WMS) 7.6 CSA, 1999
Konso Special Woreda (BLS) 20.2 Frew Tekabe, 1999
The acute malnutrition proportion observed in Odo Shakiso Woreda, therefore, is
indicative of a prevailing household food insecurity and deteriorating nutritional and
health situation.

4.3 Response to the Crisis
In recognition of the relief needs of the population of the area, the ERCS and DPPC
are distributing regular monthly rations to the selected 34,125 beneficiaries. The
selected beneficiaries are reported to have been receiving 12.5 kg per head. Only 4
members in a selected household are eligible to receive the dry free ration. ERCS
distributes general dry ration to 7 (2 urban and 5 rural) Kebeles and the rest are
covered by the Federal DPPC.
5. Recommendations Future Actions
5.1 Strengthening of the ERCS Sub-Branch Offices in Kibre Mengist and
Shakiso should be an immediate priority. Establishment of related
logistics like warehouses (central and satellite), transport means, etc., is
essential.
5.2 Sensitisation of policy makers at the Woreda, Zone and Regional levels
and with all those concerned with the welfare of the affected population
should be the priority task of the ERCS. The ERCS should strongly
advocate for adequate food aid and inputs in health (including essential
drugs) and water sectors development.
5.3 Increase the number of members and Youth Club members. Launch
training programs to the Youth Club members about the activities of the
ERCS including food, nutrition, health and the benefits of wildlife for the
community (humanity) and the nation as a whole.
5.4 The Kibre Mengist Sub-Branch Office in collaboration with the local
health institutions, the Woreda Council, and the Woreda Agricultural
Offices should closely monitor the nutritional and health situations.
Follow-up nutritional surveys (at least with smaller samples) should be
conducted every six months.
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5.5 Maize grain should constitute a priority grain for general dry ration
distribution and the volume of shipment should be increased for
involvement of the population in food-for-work development activities.
Sorghum should be additional alternative grain for general distribution
(free and development).
5.6 The agriculture based development strategy of the country emphasises
on the development of the agricultural sector through the increased
utilisation of improved seeds, fertilisers, improved agricultural
technologies, farmers access to credit, training, information and
extension services. Free or subsidised (plus credit) distribution of early-
maturing crop seeds and introduction of root crops be encouraged. The
ERCS, in collaboration with the Woreda Council and Woreda Agriculture
Office, should look for the sources of these inputs.
5.7 The available water should be developed for sanitation and micro-
irrigation schemes. Some of the free-flowing rivers appear to be feasible
for use in backyard gardening and the like with the help of pumps. The
possibility of their extensive utilisation should be explored.
5.8 Development and/or rehabilitation activities for roads, forestry, soil,
water and wildlife conservation are essential. The ERCS should, in
collaboration with the line ministry offices in the Zone and the Woreda,
lobby for these inputs and advocate for other agencies to contribute
towards establishment or strengthening of these development schemes.
5.9 The uses of baseline information, generated from the present survey in
the area, for future projects (including development programs)
appraisals, implementation, monitoring and impact evaluation is highly
recommended.
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