HelpAge International is proposing that distributed food is suitable for older people with revised national guidelines that include this demographic in all aspects, from assessment to service delivery.
“Older people can have specific nutritional needs, for example they may require specific nutrients or require that food be easier to chew and break down,” explained Kidist Negash Weldeyohannis, regional health and nutrition programme manager at HelpAge International.
“If emergency food distributions, and agencies coordinating these, do not take account of specific requirements, they risk excluding older people from being able to access the humanitarian assistance they are entitled to. This can lead to older people going hungry or becoming malnourished.”
Weldeyohannis is the author of a report, which details the lessons learned from droughts in Ethiopia and other Horn of Africa states.
Here, the publication describes two rapid health and nutrition assessments carried out in 2016 and 2017 by HelpAge International.
These assessments used the rapid assessment method for older people (RAM-OP) developed in 2013 by HelpAge in collaboration with Brixton Health and Valid International.
Both assessments demonstrated high levels of acute malnutrition among older people. This included a “serious” global acute malnutrition (GAM) rate in of 10.5% in the East Shewa zone (2016) and a “critical” GAM rate in the Borena zone (2017) of 15%.
Elderly rarely included
“Older people are often invisible. They are rarely included in national-level needs assessments in emergencies," said Weldeyohannis.
"This [the integration of the elderly into all health planning and response actions] begins with redesigning the Health Management Information System in a way that captures specific data and key indicators for older people disaggregated by age and sex,” she said.
Older people have specific needs in relation to their general food intake, micronutrient requirements and palatability of food.
In addition to the worst impact of food insecurity, various (physical, sensory and cognitive) negatively affect older people’s food intake and increase their vulnerability to malnutrition.
Common forms of impairments reported were visual, physical weakness, mobility and hearing, which are highly related to poor production capacity, less income, poor food intake and malnutrition.
Despite the growing body of evidence related to older people’s challenges in meeting their nutritional needs in emergencies, there are very few nutrition-specific interventions targeting older people in humanitarian situations.
In contrast, pregnant and lactating women (PLW) and children under five years old receive intensive and targeted nutrition assistance.
Malnutrition not budgeted for
“Engagement of and creating awareness among decision-makers on the magnitude and seriousness of malnutrition among older people has been crucial to the success of the programme,” the report said.
“In Adami Tulu Jido Kombolcha woreda (East Shewa zone) a decision was taken by the woreda administration and health office to use the available resources and admit severe acute malnutrition (SAM) cases for medical treatment, even though this was not specifically budgeted for.”
The 2007 Central Statistics Agency (CSA) census report indicated that 3,565,161 of Ethiopia’s population are over 60 years. This represents about 5% of the country's general population.