Child malnutrition: a critical risk factor in Africa

Lazarus Sauti

Child malnutrition, according to the World Health Organisation, is a critical risk factor in Africa as it is estimated to contribute to more than one third of all child deaths, although it is rarely listed as the direct cause.

The WHO adds that lack of access to highly nutritious foods, especially in the present context of rising food prices and acute food shortages, is a common cause of malnutrition.

“Poor feeding practices, such as inadequate breastfeeding, offering the wrong foods, and not ensuring that the child gets enough nutritious food, also contribute to malnutrition,” affirmed the WHO.

The United Nations Children’s Fund (UNICEF) agrees, saying in Africa, malnutrition contributes to half of all deaths in children under five.

“Nearly half of all deaths in children under five are attributable to malnutrition; this translates into the unnecessary loss of about three million young lives a year,” explained the UNICEF.

It added: “Malnutrition also puts children at greater risk of dying from common infections as it increases the frequency as well as severity of such infections and contributes to delayed recovery.

“In addition, the interaction between malnutrition and infection can create a potentially lethal cycle of worsening illness in addition to deteriorating nutritional status.”

The WHO Africa region also said two thirds of the under-five deaths in the African region are due to preventable causes, and the chief causes of such deaths are neonatal conditions and acute respiratory infections mainly pneumonia, malaria, diarrhoeal diseases, measles and HIV/AIDS, most of which are complicated by malnutrition that accounts for one third of all deaths in children under five years.

“It has been estimated that every minute, eight under-five children die in sub-Saharan Africa.

“Of the 46 countries in the African Region, 36 have under-five mortality rates (U5MRs) of above 100 per 1000 live births; 8 have U5MRs of at least 200 per 1000 live births; 5 countries have had static U5MRs in the past fifteen years while in 9 countries the U5MRs have reversed,” noted the WHO Africa region.

Speaking during the regional training workshop on quality assurance and quality control for floor fortification in Harare recently, Zimbabwe’s Minister of Health and Child Care, Dr David Parirenyatwa, also alluded that poor nutrition in the first 1 000 days of a child’s life can lead to stunted growth, which is irreversible and associated with impaired cognitive ability and reduced school and work performance.

Sadly, there are multiple constraints in African health systems that still hamper effective scaling up of child health interventions.

“Insufficient human, financial and material resources coupled with limited managerial capability, and out-of-pocket payments are some of the factors that lead to poor service delivery and/or low coverage of interventions,” added the WHO.

This, therefore, calls for African countries to put in place mechanisms that lower child malnutrition.

Finn Kydland, a Norwegian economist, concurs.

“People of every age deserve to be well-nourished, but nutrition is especially critical for young children. A good diet allows children’s brains and muscles to develop better, producing life-long benefits.

“Further, well-nourished children stay in school longer, learn more and end up being much more productive members of the society,” he said.

Kydland also noted that the available evidence suggests that providing better nutrition for 68 million children each year would produce over US$40 in long-term social benefits for every dollar spent.

Dr David Parirenyatwa also said improving access to affordable nutritious complementary foods is an effective avenue that could help vulnerable populations overcome the nutrition-related obstacles faced on a day-to-day basis.

He, therefore, said there is a serious need to accelerate effort of food fortification – the practice of adding essential vitamins and minerals (for example, iron, vitamin A, folic acid and iodine) to staple foods to improve their nutritional content – if African countries are to protect and promote the health and wellbeing of children.

“Micronutrient malnutrition is a problem of public health in developing countries including Zimbabwe.

“Therefore, these countries need to accelerate effort of food fortification,” he said, adding that African countries need to urgently craft food fortification strategies to accelerate food fortification as a pivotal public health intervention.

The Food and Agricultural Organisation (FAO) sub-regional co-ordinator, David Phiri, said that issues of food and nutrition should be a priority of government sectors.

“Food safety, nutrition and food security issues are key to sustaining lives as well as promoting good health; therefore, it is the mandate of government sectors to ensure access to such issues.”

Phiri added: “To eliminate stunting among children under five as well as to ensure food security in Africa, a multi-sectoral commitment is necessary; hence, non government organisations must support governments in providing highly nutritious food to children suffering from malnutrition, including a ready-to-use nutrient supplements for children affected by moderately acute malnutrition.”

Bjorn Lomborg, President of the Copenhagen Consensus Centre, agrees and urges African states to fight poverty.

“Poverty is the ultimate source of many other problems. Poor families have trouble providing their children with adequate food, education and medical care.

“The immediate result is high rates of infant mortality, as well as poor cognitive skills as well as reduced productive capacity among surviving children. The ultimate result is a cycle of poverty,” he explained.

The Danish climate contrarian also assured: “Solving poverty is necessary for addressing hunger. Better nutrition and better schools will help alleviate poverty. Accordingly, African governments should view poverty relief efforts as an investment rather than as an expense.”

Without doubt, poverty hinders the continental fight against hunger because those living in poverty lack the opportunity to receive adequate education as well as the healthcare necessary to carry on productive lives and have greater access to nutritious food.

Political and business leaders, together with development partners, should, therefore, fight poverty to protect Africa’s girls and boys.

Save the Children, an international non-governmental organisation that promotes children’s rights, provides relief and helps support children in developing countries, puts it correctly: “Do not let all the potential of Africa’s girls and boys go to waste.

“Just because they were born into hunger and poverty, does not mean they cannot have a bright future.

“Together, we can empower African families to fight hunger and end poverty for this generation and beyond.”