Common Country Assessment (CCA) - ECSS | Eritrean Center for ...

Health and Nutrition (con’t)
Causality analysis
• The major root cause includes poverty,
malnutrition, traditional practice that requires
girls to marry early coupled with inadequate law
enforcement of age of marriage, and female
genital mutilation (FGM) .
• The underlying causes of health problems
include unbalanced diet, poor sanitation, and
lack of child spacing, low contraceptive
prevalence rate, and inadequate condom use
for protection from HIV infection.
• Poor maternal and reproductive health
services, communicable diseases, unsafe
abortion, resulting in obstetric deaths,
malnutrition resulting in high rates of anaemia,
home delivery and inadequate antenatal care,
lack of emergency obstetric care, lack of
postnatal care, lack of adolescent friendly and
accessible services, and lack of information and
education are among the main immediate
causes of morbidity and mortality.
Capacity gaps and key challenges
Primary health care
• This is critical at the community level. There are some important capacity gaps in terms
of skills and personnel of health officers at this level.
• Therefore, training of middle cadre personnel at community level for areas where there
are no doctors need to be stepped up to ensure that they have such skills as
recognition and treatment of communicable diseases, skills to provide basic emergency
obstetric care and to refer promptly and to provide counseling and services in child
spacing, HIV/AIDS as well as on gender related issues.
Maternal and gender-based care
• Firstly, maternal health remains the key challenge.
• Secondly, FGM, which is a harmful traditional practice, is still widely practiced. It
constitutes one of the main factors contributing to maternal morbidity and mortality, and
according to the MOH, it is a priority area for intervention. Increasing access to
emergency obstetric care and child spacing as well as changing community health
seeking behaviors will be key requirements in reducing maternal morbidity, fistula
conditions and maternal mortality.
Communicable diseases
• Tuberculosis in combination with HIV/AIDS, could become a major health problem.
Public health
• The role of public health in the overall health strategy entails broad public health
measures needed to prevent the spread of disease through poor hygiene,
indiscriminate spitting, defecating and urinating in public places, etc.
• A proper balance needs to be struck between investments in infrastructure on the one
hand and investments in education and training of health personnel and spending on
operations and maintenance on the other hand. Given the huge increase in the
number of health facilities in recent years, the more pressing need is to be able to put
the existing facilities to maximum use.
Reproductive and sexual health
• Issues of adolescent sexual and reproductive health such as early marriage of girls and
teenage pregnancy and abortion need to be addressed. This also includes ensuring
Reproductive Health Commodity Security to meet the needs of women in reproductive
age such as child spacing, emergency obstetric care and HIV/AIDS prevention.
Priority areas for UN system
support
Communicable diseases control and
prevention
• This should include malaria and
tuberculosis; reduction of maternal and
neonatal morbidity and mortality;
reduction of infant and under five
morbidity and mortality; reduction in
child and adult malnutrition; reduction
of non-communicable diseases
including disability; and improvement of
adolescent sexual and reproductive
health.