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Global Health Competition
                                        Team 3



Planting the Seeds of the Future
      Project PSF-Ethiopia




             Vanessa Gaioso
              Hunter Howell
             Loraine Kanyare
             Tsuguhiko Kato
                Irene Tami                             1
Assessment – Oramiya Region
• Population: 27,158,471        • Child mortality 178 death
  (2007 Census)                   per 1,000 live birth
• 48% Muslim 31% Orthodox,      • 6.4 births per a woman
  and local religions           • 4.8 per household
• 85% Oromo                     • Life expectancy 42 years
• 89% Rural                     • 31 hospitals
• Chronic drought               • 242 health centers
• 51% total coffee production   • 3,758 health posts
  in the country
• 24% engage in non-farm
  related jobs

                                                              2
Assessment (cont’d)
• Children under 5:                    •   Education
   • 41% stunted                           • Literacy Rates-62% Men, 30%
                                             Women
   • 9.6% malnourished.
                                           • 62.5% enrolled in primary school
   • 34.4% underweight
                                           • 10% enrolled in secondary
• 32% Access safe drinking                   school
  water                                    • High dropout rate especially
                                             among girls
• Infectious Diseases:
   • Malaria                           • 44% affected Poverty
   • Food or water borne diseases      • Governance and institutions
     (Bacterial, Protozoal diarrhea,
     hepatitis A&E, and typhoid        • Public Policy and Budget
     fever                               Allocation
   • Respiratory infections            • 50% of Budge on Military
                                       • 6% on Health Care.

                                                                           3
Potential Barriers
• Geographic area (Rural)
• High illiteracy rate esp. among women
• Drought
• Access to clean water & associated hygiene
  practices
• High mortality rate
• Centralized government
• Military conflicts & displaced population


                                               4
Objectives
1) Improve Nutritional Status of Children Under Five Years

2) To develop Self Sustaining and Gender Sensitive
   Interventions that Integrate Agriculture, Education, and
   Income Generation

3) Utilize Alternative Technology for Water
   Purification, Hygiene, & Extremely Nutritious Leaf Protein
   Concentrate



                                                                5
Malnutrition Status
                          41 % are stunted (children < 5 y-o)                         Manifestation
                             9.4% children malnourished
                             34.4%children underweight
                              50% women underweight


                                                       Infections/Diseases
      Nutrition Intake                                             Malaria
        Food Shortage,                                 -Parasitic Diseases/ Diarrhea       Direct
    5 person per household                                       - HIV/AIDS                Causes
   Food delivery-no gas, truck                                    -Hepatitis
                                                               -Typhoid fever



Household Food                 Behavior &                        Health Services
   Security                  Caring Practices                     ↓ sanitation
Rural women spend                ↓ Hygiene                        ↓ safe water
                                                                                          Indirect
 time caring wood,               ↓ Education                     ↓ immunization            Causes
    child, water
                                 ↓ Latrines                         coverage
  Military Conflicts

                                    Education
                       (Literacy rate 62% men – 30% women)
                                                                                       Fundamental
                                                                                          Causes
                  Unequal Distribution of Resources
            Centralized Government, Gender Inequality, Poverty,
   Agricultural resources (timing/quantity of rain season, erosion of land)
                                                                                             Based in UNICEF Model
Pilot Study
• Duration – 1 year (pilot), 2 years (replication)

• Location – Borana zone in Oromiya
  11%Urban, 2 million, about 4,000 households,

• Sample size – 400 households



                                                     7
Intervention
                                           Health Professional, Community
Description:                               Worker Training
•   Tri-location Educational Sessions -    •   Rapid Malnutrition Assessment and triage
    schools, market places, local health   •   Health education
    centers etc                            •   De-worming/partnership with other NGOs
•   2 training levels -> community and     •   Solar Water Purification
    local trainers                         •   Leaf concentrate process, storage and
                                               advantages to community




                                                                                      8
Intervention
Community Education
                                                •   Expert to teach – leaf concentrate
                                                    process, storage and advantages to
•   Microfinance opportunity – High grain           community Highly Nutritious Leaf Protein
    prices sometimes not affordable for             Concentrate – (rich in beta
    farmers –Bioengineered drought resistant        carotene, iron, & high quality protein) –
    sorghum seeds loaned out for subsistence        Effective in combating malnutrition, esp
    farming                                         anemia & vit A deficiency prevalent in
     –   First harvest after 3 months               children & pregnant women in developing
                                                    countries
•   Women of Ethiopia traditionally weave           - Easily combined with variety of local
    beautiful baskets for daily use, Coffee –       available foods to make culturally
                                                    acceptable dishes.
    cash crop Partnership with Coffee Grower
    Association to purchase – small baskets     •   Water purification – teach low tech water
                                                    purification techniques - combine of the
    woven by local women to package retail
                                                    sun's ultra violet rays and heat to kill
    coffee to market for export & tourists -        pathogenic germs - that spread much
    Income generating opportunity                   diarrheal in Africa
                                                •   Reinforce hygiene (hand
                                                    washing, vegetables, construction of
                                                    latrines/ partnership)
                                                                                           10
1/2
Pilot Study Time Frame
                            Activity                             Feb   Mar   Apr   May   Jun   July   Aug   Sep   Oct   Nov   Dec   Jan-
                                                                                         e                                          Marc
Establish logistics (office sites and transportation)
Identify key personnel
Governtment contacts for buy-in
Community Based Participation (informed consent)- Problem
Identification
•Hire local experts
•Trainer training – medical professionals- triage malnutrition
cases, women – handicraft (illustrated training material or
pamphlet), men – sorghum cultivation & storage(6 weeks)
•Meet community leaders
•Identify intervention sites
•Purchase the intervention supplies
•Partner with coffee farmer association-purchase woven
basket local women
•Community Assessment (local hospital chart-weight for
height, observation of visible severe wasting & nutritional
edema)
•Community malnutrition awareness education (9 months)
•Microfinance-first seeds delivery
•Weaving – income generation women
•Solar water purification training
•Combat children malnutrition with leave extract.
• Continuous evaluation
•Continue intervention
Microfinance-crop return
Quarterly assessment and spontaneous director site visit
Community leader involvement in microfinance project
Quarterly assessment and spontaneous director site visit

Test effectiveness of the intervention



                                                                                                                               12
Illustrative Budget

Training                        = XXX
Office overhead                 = $200 * 12=
Experts for training            = XXX*10
Incentive=                      Goats and chickens
Sorghum=                        $300 per metric tons
Director Salary                 = XXX
Administrative personnel        =XXX
Expert Salary (local experts,   = 10 * XXX
leader women experts)
Transportation (vehicles,       = XXX
trucks, and repair)
Refreshments                    = XXX
Dissemination and Replication




                                14
Thank you




            15

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Team 3

  • 1. Global Health Competition Team 3 Planting the Seeds of the Future Project PSF-Ethiopia Vanessa Gaioso Hunter Howell Loraine Kanyare Tsuguhiko Kato Irene Tami 1
  • 2. Assessment – Oramiya Region • Population: 27,158,471 • Child mortality 178 death (2007 Census) per 1,000 live birth • 48% Muslim 31% Orthodox, • 6.4 births per a woman and local religions • 4.8 per household • 85% Oromo • Life expectancy 42 years • 89% Rural • 31 hospitals • Chronic drought • 242 health centers • 51% total coffee production • 3,758 health posts in the country • 24% engage in non-farm related jobs 2
  • 3. Assessment (cont’d) • Children under 5: • Education • 41% stunted • Literacy Rates-62% Men, 30% Women • 9.6% malnourished. • 62.5% enrolled in primary school • 34.4% underweight • 10% enrolled in secondary • 32% Access safe drinking school water • High dropout rate especially among girls • Infectious Diseases: • Malaria • 44% affected Poverty • Food or water borne diseases • Governance and institutions (Bacterial, Protozoal diarrhea, hepatitis A&E, and typhoid • Public Policy and Budget fever Allocation • Respiratory infections • 50% of Budge on Military • 6% on Health Care. 3
  • 4. Potential Barriers • Geographic area (Rural) • High illiteracy rate esp. among women • Drought • Access to clean water & associated hygiene practices • High mortality rate • Centralized government • Military conflicts & displaced population 4
  • 5. Objectives 1) Improve Nutritional Status of Children Under Five Years 2) To develop Self Sustaining and Gender Sensitive Interventions that Integrate Agriculture, Education, and Income Generation 3) Utilize Alternative Technology for Water Purification, Hygiene, & Extremely Nutritious Leaf Protein Concentrate 5
  • 6. Malnutrition Status 41 % are stunted (children < 5 y-o) Manifestation 9.4% children malnourished 34.4%children underweight 50% women underweight Infections/Diseases Nutrition Intake Malaria Food Shortage, -Parasitic Diseases/ Diarrhea Direct 5 person per household - HIV/AIDS Causes Food delivery-no gas, truck -Hepatitis -Typhoid fever Household Food Behavior & Health Services Security Caring Practices ↓ sanitation Rural women spend ↓ Hygiene ↓ safe water Indirect time caring wood, ↓ Education ↓ immunization Causes child, water ↓ Latrines coverage Military Conflicts Education (Literacy rate 62% men – 30% women) Fundamental Causes Unequal Distribution of Resources Centralized Government, Gender Inequality, Poverty, Agricultural resources (timing/quantity of rain season, erosion of land) Based in UNICEF Model
  • 7. Pilot Study • Duration – 1 year (pilot), 2 years (replication) • Location – Borana zone in Oromiya 11%Urban, 2 million, about 4,000 households, • Sample size – 400 households 7
  • 8. Intervention Health Professional, Community Description: Worker Training • Tri-location Educational Sessions - • Rapid Malnutrition Assessment and triage schools, market places, local health • Health education centers etc • De-worming/partnership with other NGOs • 2 training levels -> community and • Solar Water Purification local trainers • Leaf concentrate process, storage and advantages to community 8
  • 9.
  • 10. Intervention Community Education • Expert to teach – leaf concentrate process, storage and advantages to • Microfinance opportunity – High grain community Highly Nutritious Leaf Protein prices sometimes not affordable for Concentrate – (rich in beta farmers –Bioengineered drought resistant carotene, iron, & high quality protein) – sorghum seeds loaned out for subsistence Effective in combating malnutrition, esp farming anemia & vit A deficiency prevalent in – First harvest after 3 months children & pregnant women in developing countries • Women of Ethiopia traditionally weave - Easily combined with variety of local beautiful baskets for daily use, Coffee – available foods to make culturally acceptable dishes. cash crop Partnership with Coffee Grower Association to purchase – small baskets • Water purification – teach low tech water purification techniques - combine of the woven by local women to package retail sun's ultra violet rays and heat to kill coffee to market for export & tourists - pathogenic germs - that spread much Income generating opportunity diarrheal in Africa • Reinforce hygiene (hand washing, vegetables, construction of latrines/ partnership) 10
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  • 12. Pilot Study Time Frame Activity Feb Mar Apr May Jun July Aug Sep Oct Nov Dec Jan- e Marc Establish logistics (office sites and transportation) Identify key personnel Governtment contacts for buy-in Community Based Participation (informed consent)- Problem Identification •Hire local experts •Trainer training – medical professionals- triage malnutrition cases, women – handicraft (illustrated training material or pamphlet), men – sorghum cultivation & storage(6 weeks) •Meet community leaders •Identify intervention sites •Purchase the intervention supplies •Partner with coffee farmer association-purchase woven basket local women •Community Assessment (local hospital chart-weight for height, observation of visible severe wasting & nutritional edema) •Community malnutrition awareness education (9 months) •Microfinance-first seeds delivery •Weaving – income generation women •Solar water purification training •Combat children malnutrition with leave extract. • Continuous evaluation •Continue intervention Microfinance-crop return Quarterly assessment and spontaneous director site visit Community leader involvement in microfinance project Quarterly assessment and spontaneous director site visit Test effectiveness of the intervention 12
  • 13. Illustrative Budget Training = XXX Office overhead = $200 * 12= Experts for training = XXX*10 Incentive= Goats and chickens Sorghum= $300 per metric tons Director Salary = XXX Administrative personnel =XXX Expert Salary (local experts, = 10 * XXX leader women experts) Transportation (vehicles, = XXX trucks, and repair) Refreshments = XXX
  • 15. Thank you 15

Editor's Notes

  1. Infant mortality 76 per 10,000 live births 51% is first month
  2. Note mention low rate of vaccination and other resions are higher far more children in Oromiya are more likely to die from preventable diseases.
  3. Govt of ethiopiacurrentl;y pursuing policyy of decentralization towards more local level planning
  4. Community involvementFemale orientedChildren’s nutritionFamily malnutrition awareness including parasitic risk, hygiene, nutritional mealsMicrofinancing (Sorghum)PyramidHealth work training (rapid malnutrition assessment)local leaders involvement (improving hygiene, sanitary environment, and access to clean water) Radio Show as incentive (community leader interview Iman, Church leader, Medical Professional) Sustainability/self sufficientMulti dimensional approachShort term and long term intervention
  5. Cost - $ 300 per metric ton. CHEAP!!!
  6. Expert to teach – leaf concentrate process, storage and advantages to community Highly Nutritious Leaf Protein Concentrate – (rich in beta carotene, iron, &amp; high quality protein) – Effective in combating malnutrition, esp anemia &amp; vit A deficiency prevalent in children &amp; pregnant women in developing countries. It is easily combined with variety of local available foods to make culturally acceptable dishes.
  7. 25kg
  8. 2ND BULLET: Partnership with Coffee Grower Association to purchase – small baskets woven by local women to package retail coffee to market for export &amp; tourists - Income generating opportunity. Women of Ethiopia traditionally weave beautiful baskets for daily use, Coffee – cash crop
  9. Involving Principal stakeholders from the very start is a Priority-Inviting them to educational sessions and involving them in key decisions r/t intervention dev. ( based on previous pilinot studies done in the region). Avoiding exagerated expectations ( be clear that they are the ones that will make marked changes their participation is keye we will explain opbjectives very clearly from startObtain villagers consent -&gt;