Milk MattersImproving the Health and Nutritional Status of Children in Pastoral Communities

Children in pastoral/semi-pastoral areas in the horn of Africa are particularly vulnerable to increasingly frequent drought and to chronically high rates of acute malnutrition. The dominant response to this from the international community continues to be the delivery of large quantities of food aid each time rains fail and rates of acute malnutrition peak. Despite acceptance of the urgent need for risk reduction and drought mitigation, there is still little understanding of the causes of malnutrition, and which interventions in the medium to long term should be prioritized to improve the health and nutritional status of children in these settings.

In pastoral communities milk is well known as the staple food of children’s diets and therefore is directly linked with the nutritional status of young children. In some areas, young pastoral children obtain up to 66 percent of their daily energy intake from milk. In order to improve nutritional status in children who live in pastoral communities, this project aims to take a critical look at the factors that affect the quality, quantity, and access to human and animal milk across all seasons, particularly during drought, and among various wealth groups.

The Africa Region Pastoral Initiative was created by the Save the Children Alliance in mid-2007 to develop the evidence base for programming in pastoral settings and to use this experience to advocate for better practices, programs, and policies. One component of the Regional Initiative is the Pastoral Health and Nutrition Initiative (PHNI), created in April 2008 to help us understand and prioritize interventions that improve health and nutritional status of children in pastoral settings. Within the PHNI, Save the Children US and UK and Tufts/FIC have joined efforts to explore interventions related to the most important component of children’s diets, milk.

Closely linked to this work is our technical coordination of USAID’s Pastoral Livelihoods Initiative (PLI) in Ethiopia, on which Save the Children was collaborators and for which we have already produced best-practice guidelines (in January 2006). Continuing our work with SC to examine the nutritional impact of livelihood interventions in pastoral communities is a key step in producing evidence to inform best-practice.

The first phase of this work was a literature review which aimed to improve our understanding of those aspects of pastoral child nutrition that are well-established, and those issues that remain debated or poorly covered by the literature.

The next phase of this work included a qualitative study that aimed to “ground-truth” some of the literature review findings for the Save the Children’s program areas of Liben and Shinile zones in the Somali region of Ethiopia. The study also asked pastoralist women and men themselves 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 was during this trip that Kate Sadler traveled to the Somali Region and conducted a series of focus group discussions using standardized participatory methods to answer these questions.

Subsequently, a third phase of this work is underway and will test the hypothesis that a package of community-defined livestock interventions will improve both animal milk consumption by young pastoral children and their nutritional status during the dry season. This phase is currently in the design phase and has involved a long consultative process with Save the Children USA and UK pastoral livelihood teams and pastoralist communities in Somali region on the design, timing, and management of interventions to take place between August 2010 and June 2011. Kate Sadler has recently made several trips to Ethiopia to participate in this consultative process, to set up a nutritional surveillance system in the project area that will be one of our project impact measurement mechanisms, and to present findings of previous project phases to donors and other interested stakeholders.

This research project resulted in the 4 publications listed below in the “Publications” tab.

We seek primarily to clarify some of the underlying causes of the chronically high levels of acute malnutrition found in pastoral regions in Ethiopia and to help the Save the Children Fund Alliance and the Regional Health Bureau of Somali Region in Ethiopia to prioritize interventions that could improve the health and nutritional status of children in these settings. Through workshops, briefing notes, and discussion we hope to offer them tools to enable them to develop more appropriate responses for the future. We also envisage that this work will have wider impact on the design of interventions supported by the international community that aim to support human health, nutrition and livelihoods in these settings.

The Save the Children Alliance is the main collaborating partner for this work which links closely to ongoing collaboration under the Pastoralist Livelihoods Initiative.

Milk Matters-Phase One Report The Role and Value of Milk in the Diets of Somali Pastoralist Children in Liben and Shinile, Ethiopia
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By Kate Sadler, Andy Catley | September 2013

Milk Matters ultimately aims to improve the nutritional status of children in pastoralist/semi pastoralist areas in the horn of Africa.

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Milk Matters The Impact of Dry Season Livestock Support on Milk Supply and Child Nutrition in Somali Region, Ethiopia
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This report presents the findings of two cohort studies assessing the impact of small-scale livestock interventions, designed to sustain access to and availability of animal milk at the household level over the dry season, on the nutritional status of children under 5 years of age.

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Milk Matters in Karamoja
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By Elizabeth Stites, Emily Mitchard | September 2013

Households in the Karamoja region of northeastern Uganda have seen a precipitous drop in access to and availability of animal milk in recent years. The declining milk supply affects livelihoods,...

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Milk Matters: A Literature Review of Pastoralist Nutrition and Programming Responses
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By Kate Sadler, Andy Catley | September 2013

Children across pastoralist/semi pastoralist areas of the horn of Africa are often referred to as some of the most nutritionally vulnerable in the world. The dominant response from the international...

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