Ethiopia: Nutrition assessment in west Belessa woreda, north Gondar zone

Save the Children UK Funding from UNICEF
July 18 - 30, 2002
SC (UK) undertook a nutrition survey in West Belessa Woreda of North Gondar zone in July 2002 in response to a request made by the Amhara National Regional State. A summary of the findings is presented in this document.

Nutritional status

A prevalence of global acute malnutrition of 13.0% indicates a serious situation according to internationally recommended norms (WHO 2000). The overall nutritional situation related to health, food security and other aggravating factors also indicates that the current situation is serious and that there is a need for immediate intervention.

6 - 59 months=902
Prevalence of global malnutrition
(<-2z-score and/or oedema)
(118) 13.0% 95% CI (10.2-15.7%)
Prevalence of severe malnutrition
(<-3z-score and/or oedema)
(7) 0.8%

The prevalence of oedema is 0.4%

Food security

Generally, the food security situation in the Woreda is poor. The majority of the rural population in the Woreda are dependent on the meher harvest. Sorghum, teff and chickpeas are the major food crops grown and consumed in the Woreda in a normal year. However, in the month prior to the survey period, 81% of the interviewed households reported that maize and millet were their main staple foods.

At the time of the survey, 55% of households reported that their major source of food was the market and 31% said their main source was relief food. These households indicated that they will continue to depend on the market and relief food until the next meher harvest in November/December 2002.

Meher - 2001

In this assessment, 94% of the key informants and interviewed households identified excess rainfall coupled with early cession of the rains in 2001 as the major problems that resulted in poor meher production in 2001. The average yield obtained per household was only 1.9 quintals, which compares to a reported average of 4.5 quintals in a better year. This was one factor contributing to large numbers of people facing a prolonged food shortage in 2002.

Map of North Gonder

Prospects for meher - 2002

Normally farmers use the Belg rains in May for planting long-cycle crops. However, this year the rains did not appear in May, and as a result farmers were not able to plant long-maturing high-yielding varieties of crops. Instead, they were forced to shift to short maturing low-yielding crop varieties. This shift is expected to have a negative impact on the yield of the 2002 meher harvest.


The Woreda Council reported that farmers who have been targeted to receive relief food during the annual appeal are below the actual needy population in the Woreda. Due to the increased need, the leaders have been forced to reallocate the food to include non-targeted beneficiaries. Thus, beneficiaries have been receiving rations below the recommended amount of 15 kg.

Health and care

The CMR was estimated at 1.67/10,000/day and under-five mortality rate at 2.96/10,000/day. These rates are above the recommended benchmarks (WHO 2000), which indicate an emergency crisis. Malaria continues to be one of the important health problems in the Woreda, and is likely to be one of the factors contributing to increase the mortality rates.

29% of the mothers reported that their children have been ill in the last two weeks prior to the survey. This rate is excessively high. Diarrhoea and fever were reported as the most common cause of morbidity in children under five years. In addition to this, 99% of the interviewed heads of household reported that their sources of water are rivers and streams. Therefore, access to clean water is also a major problem in the community.

The BCG vaccination rate was estimated at 31.2%. Measles vaccination coverage as confirmed by card was very low at 11.2%, although this increased to 32.4% when the mothers were asked to remember whether or not their children had been vaccinated. All the indicated coverage rates are very low compared with the international standards.

Only 27% of the mothers of young children reported that they introduce weaning food to their children between 4-6 months.

55% of the mothers reported that they introduce weaning food at the age of one year. However, 40% of mothers of young children fed their children less than four times per day, largely because of a lack of food. The majority of mothers (98%) did not give their children special weaning food and only fed them the normal family diet. This could be due to a lack of education or resources. Only 1% of mothers interviewed could read.


Note that these recommendations are intended not only for ANRS DPPC, but also for other agencies working in the Amhara region. In particular, the long-term recommendations are intended to indicate future areas of research/work that could benefit the long-term nutritional situation of the people.

Short term

  • A prevalence of global acute malnutrition of 13.0% is indicative of a serious situation. Under-five and crude mortality rates are above normal benchmarks, and the food security situation is poor - farmers will not receive a harvest until November/December 2002. Therefore, increased relief assistance until the next meher harvest is required to improve the situation and protect against a further decline in nutritional status.

  • A provision of supplementary food for children under five is also essential.

  • Abnormal out-migration from the Woreda has been reported. Currently the appeal-based beneficiary numbers are lower than perceived need and so reduced rations are being distributed to more beneficiaries. Migration, mortality and morbidity rates will further increase unless more people are included in the food distribution.

  • In order to ensure proper distribution of food, the targeted beneficiary numbers suggested by the pre-meher harvest assessment team should be revised and people identified to be under close monitoring should be included for immediate assistance to avoid further deterioration of nutritional status.
  • EGS programmes should be promoted, as there are a few labour opportunities in the area to sustain the food security situation of the community.

Long term

  • In general the health services provided to the community are very poor. BCG, measles vaccination and the provision of Vitamin are also low. Therefore access to health services should be improved.

  • Advocate for measles and BCG vaccinations throughout the Woreda.

  • Advocate for the provision of Vitamin

  • As the topography of the Woreda is suitable for implementing irrigation projects these would help to decrease long-term food insecurity.

  • Improve access to drinking water throughout the Woreda by constructing water points.

Save the Children UK's Emergency Nutrition Assessments are undertaken using standard two stage 30 by 30 cluster methodology (WHO, 2000), In this survey, 902 children aged 6-59 months were measured. 900 households were interviewed about mortality and 300 households were questioned about food security.

To obtain a full copy of this report, or other Save the Children reports concerned with Nutrition and Food Security, please contact the NSP Manager, Save the Children UK P.O.Box 7165, Addis Ababa, Ethiopia. E-mail