Analytical summary - Food safety and nutrition
In Ethiopia, the Food, Medicine and Health Care Administration and Control Authority of Ethiopia (FMHACA) is responsible for undertaking inspection and quality control of health and health-related products, premises, professionals and health delivery processes in an integrated manner. The FMHACA has regional branch offices to expand its function throughout the country. It also works collaboratively with the Ethiopian Revenues and Customs Authority and other Government institutions to prevent export, import and marketing of unsafe food items and to prevent and control the use of narcotic drugs, including tobacco.
Ethiopia has a National Drug Policy and a proclamation on food, medicine, health care administration and control. The new proclamation No. 661/2009 outlined requirements for registration and licensing food producers, imports and exports, food safety and quality, packaging and labelling, nutrition and food irradiation.
The FMHACA is engaged in developing specific guidelines on food and nutrition. As part of its role in inspection and quality control of food products, 39 food supplements and 489 tonnes of food and foodstuffs destined for export in 2010–2011 were assessed, registered and given registration certificates. However, despite the many efforts made by the FMHACA and its collaborative governmental organizations, there were several incidents where unsafe food items were sold in supermarkets and retail stores, with risks to the health of society.
Food contamination due to environmental pollution, such as soil contamination with pesticides, is also commonly observed in both rural and urban settings in Ethiopia. The severity of food contamination is demonstrated by outpatient visits from 1989 to 1990, which indicated that 9.4% of total outpatient visits were due to foodborne disease. The current capacity of the FMHACA needs to be strengthened to ensure the quality and safety of locally produced, imported and exported food and nutritional items and to minimize food contamination due to environmental degradation. Community involvement in product regulation also plays a critical role in minimizing the risk that comes with product import and export.
Ethiopia remains in a precarious situation with regard to nutritional status, with malnutrition being the underlying cause of over half of child deaths. There is poor infant and young child feeding practice with regard to early initiation of breastfeeding, exclusive breastfeeding up to 6 months, and appropriate timing and practice of complementary feeding, and this contributes heavily to malnutrition. Vitamin A deficiency affects over 5 million children aged under 5 years of age, significantly contributing to impairment of vision and increased susceptibility, delayed recovery and increased mortality from infections.
In addition, iodine deficiency disorders are causing physical and mental growth retardation. Only 4% of households used iodized salt in 2010–2011. In cognizance of the existing problems, the Federal Ministry of Health launched the National Nutrition Programme during the Health Sector Development Programme III. This introduced several innovative approaches, including screening children aged 6–59 months and pregnant and lactating women for malnutrition. Vitamin A supplementation and deworming campaigns were also integrated into regular routine services. These strategies included:
- enhanced outreach strategies
- community health days using health extension workers
- strategies for community-based nutrition, iodization of salt and distribution of iron folates
- increased number of outpatient therapeutic programmes provided by health posts
- increased number of hospitals and health centres managing severely malnourished cases as inpatients.
These strategies helped to improve the nutritional status of mothers and children and increased deworming coverage. In 2010–2011, live births weighing <2500 g, moderate malnutrition in children aged under 3 years and severe malnutrition in children aged under 3 years were 11 086, 350 017 and 52 970, respectively..
There is an increasing trend in vitamin A supplementation coverage, with first-dose coverage reaching 98% and second-dose coverage reaching 83% in 2009–2010.
The percentage of underweight children aged under 2 years in 238 community-based nutrition woredas has showed an overall downward trend over the past 3 years, reaching 16.5% in 2010–2011.
Deworming coverage reached 98% in 2008–2009.
With regard to addressing iodine deficiency disorders, a regulation was recently ratified prohibiting the import, storage, transport, distribution or sale of non-iodized salt for human consumption. Preparation is now underway for the full enforcement of this regulation by the FMHACA. Other efforts to address iodine-deficiency disorders include installation of salt iodization machines with a capacity of 30 tonnes per day, along with 10 smaller mobile iodization machines, in 2011. In addition, in 2010–2011, 750 000 boxes of 1000 iron folate tablets were distributed to pregnant and lactating women in all regions along with information, education and communication, and behavioural change materials.
The way forward
- Address knowledge gap in malnutrition through advocacy activities.
- Enhance motivation and a sense of programme ownership in salt producers and their associates.