Changes on Nutrition Action – Health Post Experience of West Gojam Zone, Ethiopia

About the authors: This article was documented and shared by Kenaw Gebreselassie and Sosina Melese- Ethiopia Civil Society Coalition for Scaling up Nutrition (ECSC-SUN)].

Yeshimbet, Health Extension Worker at Zallema Kebele © Kenaw G/ECSC-SUN

Yeshimebet Hailu is one of the roughly 30,000 health extension workers the government has trained and deployed all over the country. Based in Bure Woreda at Zallema Kebele Health Post, she welcomes those who need health and nutrition services to a small wooden and mud house with facilities of basic health care and meticulously documented health and nutrition data of the villagers posted all across the wall.

Yeshimebet outreaches for more than 2000 households with 1657 under 5 children. She rotates on daily foot patrols to educate villagers mainly on basic health and nutrition practices and services that are mainly lifesaving interventions in the mentioned kebele. Vaccinations, antenatal care, hygiene, sanitation and nutrition are among the main interventions she manages.

Nutrition Front

Box of Iodized salt hung at Zallema Health Post © Kenaw G/ECSC-SUN

As an integral part of the country’s effort to reduce malnutrition, health posts are expected to treat malnutrition, along with numerous health problems. At Zallema health post, Yeshimebet and her workmate are tasked with educating and clinically helping pregnant and lactating women. Paying particular attention to children under 2 years old, they monitor weights of all under-two children and classify them based on their nutritional status. “I commend and encourage mothers whose children gain weight  in light of their ages while I counsel and follow-up mothers whose children do not gain (the standard) weight.’’ Yeshimebet said.

The health extension workers at Zallema do also their best to ensure all under-five children get periodic deworming tablets and vitamin A supplementation. The health post treats all children who catch diarrheal disease with ORS and zinc supplementation as well. Besides, when sickly children visit the Health Post, they screen them for all diseases based on the integrated common childhood illness management program including malnutrition. That is to say, children in Zallema Kebele are checked if they are malnourished due to any illness.

On a community health day that happens every three months, they screen under-five children, pregnant and lactating women for treatment of malnutrition. Then, they treat severely malnourished children in their outpatient program and counsel mothers of moderately malnourished children about cooking, child feeding and hygiene in the course of meal preparation.

Promotion of iodized salt utilization is among the key nutrition awareness raising activities carried out by the health post. When mothers come to the Health Post for treatment of any kind, they are made aware of iodized salt utilization. The community now demands for it and consumes every day.

The Health Post organizes pregnant mothers’ conference every month. All pregnant mothers and their husbands are required to attend. The involvement of husbands in the conference is highly encouraged as there is a need to make them aware that their help will always make a difference in the nutrition of their children.

Local Nutrition data posted on the wall of Health Post © Kenaw G/ECSC-SUN

Interestingly, all the health extension workers we visited meticulously keep a record of mothers and children screened and treated for malnutrition; and directory of their kebele’s pregnant and lactating women and their check-up schedules are all posted on the walls of their offices – the health posts.

The daily record they keep helps these frontline workers closely follow up pregnant and lactating women and how well they feed their children as per their teaching. This, in turn, helps measure progress of the woreda office in terms of nutrition action.

Zallema kebele offers several good experiences of health and nutrition services, which can be exemplary for thousands of localities in other regions of the country.

The Ethiopian Civil Society Coalition (ECSC) was established in 2013 in order to galvanise efforts to alleviate the burden of malnutrition. The ECSC-SUN is chaired by Save the Children and funded by IrishAid.