Action - Nutrition International - Ethiopia - Maternal Newborn Health and Nutrition (MNHN) Program - Iron and folic acid supplementation - Pregnant women (PW)

Programme: Nutrition International - Ethiopia - Maternal Newborn Health and Nutrition (MNHN) Program

Programme description

Pregnancy and the postnatal period are critical times for ensuring the health and wellbeing of women and their children. Anaemia during pregnancy is common and can have serious consequences for both mother and child, including increased risk of low birthweight and preterm birth, as well as maternal and perinatal mortality.[1&2] Iron deficiency is a major cause of anaemia among pregnant women.[3] Iron requirements increase substantially during pregnancy and it is difficult to meet these needs with food alone. Based on evidence of reduced risk of anaemia, iron deficiency and other adverse outcomes including having a low birthweight baby, WHO recommends daily iron and folic acid (IFA) supplementation throughout pregnancy.[4] This is in addition to a series of other recommendations for nutrition interventions as part of antenatal care for a positive pregnancy experience and other important maternal and child outcomes.[4]

Optimal care and feeding of newborns helps ensure babies survive and sets the stage for healthy growth and development. For example, initiating breastfeeding within the first hour of life, as recommended by WHO[5&6], increases the likelihood of exclusive breastfeeding and reduces the chance of newborn illness or death [7]. The newborn period, which is the first 28 days of life, is the most vulnerable time in a child’s life, and accounts for almost half (46%) of the total deaths in children under five years of age [8]. Fortunately, many of these deaths are preventable through evidence-informed, low-cost care, such as supporting mothers to start breastfeeding soon after birth, which can be delivered even in resource-limited settings.

Nutrition International works in collaboration with government and other partners to improve maternal and newborn health and nutrition (MNHN) through enhancing the provision, quality and integration of health and nutrition services and empowering women and their families to seek care and adopt healthy behaviours.     

Nutrition International contributes to improving MNHN in Ethiopia by:

  • Collaborating with the Ministry of Health and other partners to support a MNHN care package that aims to increase antenatal care (ANC) quality and attendance, provision and consumption of IFA supplements in pregnancy, and newborn and postnatal care.
  • Promoting an enabling environment through advocacy among key decision-makers for commitment to MNHN.
  • Providing technical and financial support to the Regional Health Bureaus (RHBs) for implementation in the four agrarian regions where the primary health structure is used to promote and provide MNHN care, and to Emory University’s MaNHEP project to support the RHBs of Afar and Benishangul Gumuz regions where the MNHN care package is promoted through a community-based approach. 
  • Contributing to improving the coverage and quality of MNHN care services provided by Primary Health Care Units through a collaborative Quality Improvement Approach.
  • Building the capacity of front line health workers through training, supportive supervision and provision of job aids.
  • Developing and implementing an evidence-informed MNHN behavior change intervention strategy, which focuses on strengthening community-based platforms for engaging and communicating with pregnant women and their influencers about MNHN.
  • Supporting program monitoring and assessment, and use of this information to inform decision-making.  

This work is in partnership with the Ethiopian Ministry of Health at federal and regional levels, the Pharmaceutical Fund Supply Agency, UNICEF and Emory University. This project includes national level technical assistance and supports implementation sub-nationally, in 200 woredas in 6 regions (in the two pastoralist regions of Afar (11 woredas) and Benishangul Gumuz (4 woredas) and the following four agrarian regions: Tigray region (16 woredas), Amahra region (45 woredas), Oromia region (64 woredas) and South Nation Nationality People (SNNP) region (60 woredas)). NI has supported MNHN programming in Ethiopia since 2011 and continues to do so.

Although this section describes MNHN, wherever possible, Nutrition International’s work in Ethiopia follows a comprehensive and integrated approach, with a strong focus on the first 1000 days, from pregnancy through 2 years of age.

Programme type

Community/sub-national

References

  1. Allen, L. H. (2000). Anemia and iron deficiency: Effects on pregnancy outcome. The American Journal of Clinical Nutrition,71(5). doi:10.1093/ajcn/71.5.1280s
  2. Black, R. E., Victora, C. G., Walker, S. P., Bhutta, Z. A., Christian, P., Onis, M. D., . . . Uauy, R. (2013). Maternal and child undernutrition and overweight in low-income and middle-income countries. The Lancet,382(9890), 427-451. doi:10.1016/s0140-6736(13)60937-x
  3. WHO. The global prevalence of anaemia in 2011. Geneva: World Health Organization; 2015.
  4. WHO. (2016). WHO recommendations on antenatal care for a positive pregnancy experience. (Rep.). doi:http://apps.who.int/iris/bitstream/handle/10665/250796/9789241549912-eng...
  5. WHO. (2017). Protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services: Guideline(Rep.). doi:http://apps.who.int/iris/bitstream/handle/10665/259386/9789241550086-eng...
  6. WHO. (2018). WHO recommendations: Intrapartum care for a positive childbirth experience(Rep.). doi:http://apps.who.int/iris/bitstream/handle/10665/260178/9789241550215-eng...
  7. NEOVITA Study Group. (2016). Timing of initiation, patterns of breastfeeding, and infant survival: Prospective analysis of pooled data from three randomised trials. The Lancet Global Health,4(4). doi:10.1016/s2214-109x(16)00040-1
  8. United Nations Inter-agency Group for Child Mortality Estimation (UN IGME), ‘Levels & Trends in Child Mortality: Report 2017, Estimates Developed by the UN Inter-agency Group for Child Mortality Estimation’, United Nations Children’s Fund, New York, 2017.

For more information:

Target group: 
Pregnant women (PW)

Revision log

DateUserLogState
Mon, 10/22/2018 - 19:09zillmerkpublishedpublished
Mon, 10/22/2018 - 15:14GINAadminNIAction edited by GINAadminNI.needs_review
Mon, 10/22/2018 - 15:13GINAadminNIAction edited by GINAadminNI.draft
Tue, 10/02/2018 - 16:18engesveenkEdited by GINAadminNI.published
Tue, 10/02/2018 - 13:23engesveenkEdited by engesveenk.delegated
Thu, 09/27/2018 - 21:42vhollaEdited by vholla.needs_review
Thu, 09/27/2018 - 19:33vhollaEdited by vholla.draft
Thu, 09/27/2018 - 18:30vhollaEdited by vholla.draft
Thu, 09/27/2018 - 18:30vhollaAction created by vholla.draft