Summary
Children that live in pastoralist areas of Africa are increasingly referred to as some of the most nutritionally vulnerable in the world. In Somali Region Ethiopia, levels of global acute malnutrition among young children are regularly reported to rise above 15%; the level defined as a nutritional emergency by the World Health Organization. Yet, from work going back many decades in the Region, we know that animal milk; one of the most nutritionally complete foods in the world, plays an extremely important role in the diets of these children. Whilst there is considerable research and early warning literature that highlights the importance of livestock and livestock products for the income and the dietary intake of pastoralists in Somali Region, there is little work that describes the distribution of livestock–derived products such as milk within households or the use of such products by vulnerable groups. Particularly, the approach used by this study explores the link between animal products and nutrition of infants and young children by seeking out local views and perspectives.
Conducted in Shinile and Liben Zones of Somali Region, this study aimed to ask pastoralist women and men what they think about the important causes of child malnutrition, links between child nutritional status and milk supply, and 'best bet' interventions for addressing malnutrition in their communities. It used recognized participatory methods such as matrix scoring, seasonal calendars and ranking to produce detailed information on how young children were fed, the reasons behind the choice of foods used, and on seasonal trends and relationships.
The main study findings include the following:
- Somali pastoralists, and especially women, are a valuable source of knowledge on child nutrition. Despite a context of a harsh environment and limited formal education, they are well aware of the nutritional value of foods such as livestock milk and try to prioritize the consumption of these foods by young children.
- The demand and perceived benefit of animal milk for young children is high and generally much higher than that for cereals. In Liben and Shinile, the milk of camels and goats is held in particularly high regard. This is linked to these animals' ability to produce milk through the dry season, for the perceived health benefits of the milk and for the taste.
- The large contribution that animal milk makes to the dietary intake of young children in the study communities is startling. When milk is available it is added to most complementary foods in both Liben and Shinile, and during a normal wet season the average milk intake of a one year old provides about two–thirds of the mean energy required and 100% of the protein required by a child of this age.
- Season plays a crucial role in milk supply and by the end of a 'normal' year milk intake of young children has reduced by more than 70%.
- In a drought year this reduction in intake was far more pronounced. By the end of a drought year milk intake in young children had fallen to negligible amounts in both areas.
- When milk is in short supply it is replaced, in the most part, by an increase in grain consumption, and by the end of a long dry season or drought year the grain is cooked and consumed with little else but water. Such a severe reduction in milk intake has a serious impact on dietary quality by reducing the amount of high quality protein, fatty acids and micronutrients that young children consume.
- Study participants perceived a direct and important association between reduced milk intake and weight loss among their young children. They use the phrase Cano la'an to describe 'the suffering due to lack of milk' which is known by local people as the pre–cursor to malnutrition as they define it. In future it will be important to examine the implications of this seasonal availability of milk for patterns of nutritional status as defined by international indicators and how this overlaps with pastoralists own definitions of malnutrition in this context.
- In the opinion of the pastoralists that participated in this study, the most effective way to improve availability and access to milk for young children is clear; that is through the maintenance of the health and nutritional status of their livestock. They identified broad areas for possible intervention, including animal health, fodder production and water supply that could help to maintain the supply of milk to children during the dry season and drought. The separation of larger stock from young children during seasonal migrations was also highlighted as an important factor that disrupted children's access to animal milk. It is these areas therefore that have potential to form the basis of any intervention that aims to improve children's resilience to drought and malnutrition.
- Many of the programs that might fall into the broad categories discussed are not new, and there is already some evidence that they can lead to real improvement in livestock health and milk production. There is far less evidence however of any impact of such interventions on the nutritional status of children, and it is here that more work is needed.
- Given the issue of milk access for young children during late dry season and drought, especially access to camel milk, it is possible that the benefits of interventions that aim to improve child nutrition such as veterinary care for camels or camel restocking would not be fully captured in terms of milk consumption by children at critical times. This points to a need to review these projects and look more carefully at ways to ensure that milk reaches young children when they need it most.
