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Analytical summary - Child and adolescent health

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Improving child health is one of the priorities of the Health Sector Development Programme IV[1] covering the period 2010–2015. The infant mortality rate is 59 deaths per 1000 live births. The estimate of child mortality is 31 deaths per 1000 children surviving to 12 months of age, while the overall under-five mortality rate is 88 deaths per 1000 live births. In addition, 67% of all deaths in children aged under 5 years in Ethiopia take place before the child’s first birthday.[2] Malaria, pneumonia, diarrhoea and nutrition deficiencies are among the major causes of child mortality. A high mortality and disease burden from nutrition-related factors is also prominent among children aged under 5 years.[3]

Malnutrition is widespread across the country. Overall, 29% of all children are underweight and 9% of children are severely underweight. Also, 31% of male children are underweight compared with 27% of female children. The percentage of children who are underweight is eight times higher in children with mothers with no education compared with children whose mothers have more than secondary education.[2]

Nutrition is a major risk factor contributing to the mortality and disease burden among children aged under 5 years. A total of 30% of rural children are underweight compared with 16% of urban children.[2] Overall, 34.6% of children are born underweight while 50.7% are stunted. Stunting (low height-for-age) reflects the cumulative effects of undernutrition and infections since birth and prior to birth.[3]

Infant and young child feeding practices in terms of early initiation of breastfeeding, exclusive breastfeeding up to 6 months and appropriate time and practice of complementary feeding are poor, contributing significantly to malnutrition. Vitamin A deficiency also affects over 5 million children aged under 5 years, considerably contributing to visual impairment and increased susceptibility, delayed recovery and increased mortality from infection.

A National Nutrition Strategy was implemented within the Health Sector Development Program III and a new National Nutrition Programme was launched. The focus of the National Nutrition Programme is on reducing malnutrition and improving child feeding as well as implementing vitamin A supplementation and deworming.[4]

Child health inequality is significant between urban and rural areas. For all areas, the national average probability of dying by the age of 5 years is 106 per 1000 live births but this figure reaches 138 per 1000 live births in rural areas. Measles immunization coverage in 1-year-old children is 32% in rural area compared with 65% in urban areas.[3] In addition, 30% of rural children are underweight, compared with 16% of urban children.[2]

To improve the quality of management of childhood illnesses, an Integrated Management of Neonatal and Childhood Illnesses Strategy has been adopted. The Strategy consists of three components:

  • improving the health system
  • health workers’ skill
  • family and community practices.

The main activities under the Strategy are prevention and control of acute respiratory infection, diarrhoea, malaria, malnutrition, measles and HIV/AIDS.[4] The Strategy aims to improve the quality of management of childhood illness, linking preventive and curative services so that programmes such as immunization, nutrition and control of malaria and other diseases are implemented in an integrated approach, focusing on the well-being of children and neonates. The Strategy aims to reduce mortality, illness and disability and promote improved growth and development.

To strengthen service implementation, in 2010 Training of Trainers was given to health professionals and a total of 605 health professionals had been trained by the end of 2010[5]


  1. Health Sector Development Program IV, 2010/11–2014/15. Final draft (pdf 780.81kb). Addis Ababa, Government of Ethiopia, Ministry of Health, 2010
  2. 2.0 2.1 2.2 2.3 Ethiopian demographic and health survey 2011 (pdf 683.08kb). Addis Ababa, Central Statistics Agency; Calverton Maryland, ICF Macro, 2011
  3. 3.0 3.1 3.2 World health statistics. Geneva, World Health Organization, 2010
  4. 4.0 4.1 Addis Ababa, Government of Ethiopia, Ministry of Health
  5. Health Sector Development Program IV. Annual performance report. Addis Ababa, Government of Ethiopia, Ministry of Health, 2010