A Conversation with Action Against Hunger’s Nutrition and Health Expert Muluneh Girma Mekonnen

Ethiopia has faced an onslaught of humanitarian emergencies in recent years. Its population has only just begun to recover from a two-year civil war which devastated entire cities and left millions displaced. Conflict primarily centered in Tigray, where families were cut off from food, shelter, and external assistance. Many were left with little else than hope to hold onto. Today, the country faces some of the highest hunger rates in the world, with about 18% of the population—or 20.1 million people—at crisis levels of food insecurity or worse.

Children bear the brunt of hunger in Ethiopia. In fact, 5.9 million children under five, or 40%, are stunted, or chronically malnourished. Around 1.2 million suffer from acute malnutrition, the deadliest form of hunger. Our teams are on the frontlines of this hunger crisis, providing essential clean water, sanitation, and nutrition support to children and families who need it most. Nevertheless, our work is far from over. As drought, economic shocks, rising food prices, and instability still grip the country, our teams are rapidly increasing our malnutrition screenings in some of the country’s hardest-to-reach communities.

Between January and June 2023, our teams in Ethiopia screened more than 665,000 children for acute malnutrition. At this rate, we’ll reach over a million by the end of the year. Once malnutrition is detected in children, they are then treated in our programs, with around 97% of admitted cases cured.

In places like Ethiopia, where there’s limited access to frontline health workers, this community-based nutrition response is critical. We talked with Muluneh Girma Mekonnen, Action Against Hunger’s Head of the Department for Nutrition and Health in Ethiopia, about the screening process and how it’s vital to saving lives.

Why is community health screening so important?  

M: Globally, as many as two million children die from malnutrition each year. This tragedy is avoidable—we know today that hunger is preventable and treatable. Nutrition screenings in communities are the first step to detecting malnutrition before it is too late. We work directly with the community—especially mothers—to train interested participants on how to screen children for malnutrition. This close interaction creates a network of dedicated health workers. We empower, inspire, and support these workers to screen children and refer them to the appropriate health center.

What does a health screening look like? 

M: There are six different types of nutrition screenings that we have helped to implement across the country. These include mass screenings in camps for displaced people, screenings conducted during measles immunizations, and of course, the Family MUAC approach.
The latter is designed to protect children by involving their caretakers in every stage of the process. Parents and guardians are taught to use a mid-upper arm circumference (MUAC) band to measure their child’s arm, determine if they are malnourished, and keep track of the measurements themselves. It’s an innovative and useful way to incorporate community members and encourage them to play an active role in nutrition screenings.

How are we increasing our screenings? 

M: So far, we have already screened 168,000 more children than all of those screened last year. This is due to many reasons, including breakthrough screening methods, expanded operational presence, and increased ability to work safely in Tigray.

How are we responding to needs in Tigray? 

M: Our teams worked hard to address humanitarian needs during the war in Tigray, which culminated in a ceasefire last fall. Now more areas of Tigray are safe to access, we have been able to expand our services.

The conflict there resulted in death, displacement, and the loss of livelihoods for countless civilians. Now, our teams are finally able to reach and help communities that were previously inaccessible. It’s our job to revitalize health services and ensure that people have improved access to them.

Who typically comes to the screenings? 

M: Our screenings are open to anyone who needs health care. In the Somali region, our mobile teams are meeting mothers like 34-year-old Timiro Abdulahi, who brought her two-year-old daughter Nimo Abdi to the clinic. Both Timiro and her child live in a settlement for displaced people, who typically have some of the highest rates of malnutrition.

Nimo, who had grown weak and lost lots of weight, was quickly diagnosed as severely malnourished. She was immediately treated by our team, who monitored her progress while giving her calorie-dense foods, checking up on her health weekly, and monitoring her nutrition status using MUAC bands. Her mother has expressed so much gratitude that her child is healthy and safe. She’s started to encourage her family and neighbors to attend regular check-ups, too.

These nutrition screenings are saving the lives of children throughout Ethiopia, as far south as the Somali region and as far north as Tigray.

Have you seen a positive response?  

M: Yes, communities are always eager to engage with our work. Every day, we’re learning more and more how necessary it is to involve families in the screening process. When they feel included in planning, implementing, evaluating, and monitoring, then they become part of the equation and we’re all able to reach more children than ever before.

What does the future hold for your team?  

M: Make no mistake—our work is never easy. The cost of living and inflation is extremely high in Ethiopia, and many face debilitating poverty every day. Rising food, fuel, and material prices also affect our ability to obtain supplies and maintain the scale of our operations.

Make no mistake—our work is never easy.

Still, we know that community health screenings hold the key to saving lives. Our expanded presence is a victory that’s worth celebrating. Even though the future holds challenges, we’ll mobilize, screen, and treat children until everyone is free from hunger.