Milk consumption, nutrition and health in southern Ethiopia
Interview with Bekele Megersa, Ethiopia, IMMANA Fellowship holder under Round 1
Project title: Milk consumption, nutrition and health in southern Ethiopia
What is the nutrition and food security situation in Borana, the pastoralist part of Ethiopia where your study is taking place?
A previous study suggests that pastoralists have observed a decreasing trend in child growth in the Borana area as milk consumption declined overtime. And yet, Ethiopia’s demographic and health survey (DHS 2011) report shows a reverse scenario at national level, for example the proportion of stunting and underweight have decreased by 24% and 32% from 2000 to 2011 while the prevalence of wasting remained constant over the last one decade. The same report showed that the prevalence of stunting, underweight and wasting were 33%, 33.5% and 22.2% respectively for the Somali region which has similar conditions as Borana.
In general, various studies have shown that child nutrition is negatively affected by decreasing intakes of animal products, including milk, which is likely to be the case in the Borana area.
What is the role of milk and dairy products in child nutrition?
Dairy products are essential for meeting child nutrition and food security in pastoral areas of southern Ethiopia as households have few high-quality sources of nutrients needed for healthy growth and cognitive development of children. Since the semiarid environment is not suitable for cultivation of crops, diverse food items are unlikely.
Since nearly every household owns livestock, milk and dairy products can play an important role in addressing nutritional needs. Households are also increasingly rearing backyard chickens, mainly for egg selling. However, chicken meat and eggs have not been traditionally part of the diet and consumption of these food items is low except in the case of some young people with education and urban attachments. Animal-source foods, including dairy, are very nutrition-dense: high in protein, fat, calories and certain micronutrients.
However, in Borana, trends in milk consumption are dwindling, and cereal-based food is dominating diets. In addition to decreasing milk production, milk is increasingly sold in exchange for cereals of low nutritional quality.
What does your IMMANA-funded project intend to do?
My research project funded under IMMANA Fellowships will investigate whether households are favoured or disfavoured by selling milk (rather than consuming it).
My project will use a case study of the Borana areas of southern Ethiopia to develop improved diet diversity measures for these settings, where standard food-frequency questionnaires may miss the many ways in which animal source foods are consumed.
What are the commonly used measures of diet diversity?
Different proxy measures are used to assess food consumption as indicators of actual caloric intake and diet quality. Among these indicators is the dietary diversity score (DDS) based on a number of food groups, such as seven (for children), nine (for women) and 14 (for adult individuals). DDS has been standardized and widely applied to measure food security among specific study subjects.
Under pastoral conditions however, food varieties are too limited to fulfil the standards set for dietary diversity score measurements. Hence, there is a need to look for an alternative indicator that could measure the actual caloric intake and food quality in pastoral context.
What is the measure of diet diversity that you are planning to develop?
My study tries to explore an alternative indicator, by combining food frequency, food quantity and dietary diversity to measure dietary intake and food quality in pastoral areas. The alternative indicator will be compared with the conventional dietary diversity questionnaire and tested against other measurements such as anthropometric measurement, for its suitability. Once validated, this method can be used to measure food and nutrition security under pastoral settings.
How will you go about developing the new measure of diet diversity?
To develop this alternative dietary measurement, I will use a series of studies such as:
(1) socio-economic survey of households, (2) child dietary intake survey, (3) anthropometric measurements of children, (4) study on terms of exchange between milk and food grain, (5) laboratory analysis of food samples for selected nutrient contents, and (6) application of statistical tests to verify the new measurement.
What stage is your project at?
The first round of surveys has been conducted and the second round is to be carried out soon. Before the actual survey, the questionnaire intended for collecting socio-economic variables and household characteristics was subjected to a pre-test by interviewing five households in mid August for possible corrections. The pre-test practice was also used as training for field assistants. Subsequently, mothers from selected households were interviewed. The first round as well as subsequent surveys are primarily conducted by myself and field assistants who are clinical nurses and have experience with the Borana culture and dialect.
And what will you do next?
Once this study is completed, the results will be shared with the IMMANA community and further presented on local and international forums. There will be a possibility of continuing with other dimensions of food and nutrition security.
The photos you have shared show the village and the people you visited in Borana. What struck you most about this community while conducting your research there?
Although I have long-term experience with the Borana community, there are lots of changes overtime such as increasing settlement of households with limited herd mobility, increasing opportunistic crop farming and chicken rearing, all of which imply dietary changes.