The Issue Of Malnutrition In Africa
With over one-third of the global under 5 stunting cases and a quarter of both the under 5 wasting and overweight cases in 2018, Africa is disproportionately affected by all forms of malnutrition.1 Furthermore, despite a reduction of childhood stunting in other regions of the world between 2000 to 2018, Africa is the only continent where the number has increased from about 50 million in 2000 to almost 59 million under 5 stunting cases in 2018.1,2 The Global Nutrition Report in 2018 also revealed that 30 of the 41 countries worldwide with a high burden of the three types of malnutrition are from Africa.3
Malnutrition refers to deficiencies, excesses or imbalances in the intake of energy and/or nutrients and its physical manifestations range from stunting, wasting and being overweight. Malnutrition is life-threatening and the leading driver of the global burden of disease.4 About 18 million and 10 million children are wasted and overweight in Africa leading to dire consequences that affects life expectancy, economic growth, education, development and several other domains of physical, social, and mental health. Asides the significant loss in human potential, the economic consequences are dire – an estimated 11 percent of African countries GDP are lost every year due to the unacceptably high level of malnutrition in the region.4 Living without the disabling consequences of malnutrition is a fundamental human right and the persistent scourge of childhood malnutrition in Africa is immoral, unjust and unacceptable.
In 2015, the United Nations adopted the first-ever United Nations Decade of Action on Nutrition which will span from 2016 – 2025. UN Member-states also made a commitment to end all forms of malnutrition by 2030. Despite being in the midst of the UN Decade of Action its achievement in Africa has been painfully slow to deliver on results that is needed to eradicate all forms of malnutrition in 2030.1
Child malnutrition in Africa is caused by complex and multidimensional factors as a result of a constellation of political, sociocultural, economic and environmental influences – from direct causes such as inadequate quantity and quality of food intake and repeated incidences of diseases such as diarrhoea that compromise nutrient intake and absorption to indirect causes such as food insecurity which results from drought, climate change, explosive population growth, inequality, armed conflict, access to and use of health services; and a safe and hygienic environment.5
For African countries to end all form of malnutrition, there is a need for political commitment and increased financial investment in nutrition interventional programs – knowing fully well that every $1 invested on early nutrition intervention leads to an average return on investment close to $20.6 Scaling-up high-impact nutrition-specific interventions in Africa to address the global nutrition targets of stunting, breastfeeding, wasting, obesity and anaemia would require an additional $2.7 billion per year over the next 10 years.7 Hence, African governments and international donor agencies will have to triple their commitment this decade to meet these nutritional milestones.3
Strengthening the evidence-base on key nutrition indicators is crucial to winning the war on malnutrition – as data is needed to drive decisions. Countries like Ghana, Senegal, Burkina Faso that make nutrition a political priority are reaping the rewards; for instance, between 2011 and 2015, Senegal’s stunting rate reduced by almost one-third after the establishment of the Cellule de Lutte contre la Malnutrition, a coordinating body tasked with reducing malnutrition by the government.8
Bolstering the design, implementation, monitoring and evaluation of policies and programs tackling malnutrition while building the research and leadership capacity of workers in this sector is crucial to ending malnutrition in Africa. For instance, a school meal programme that tackles food insecurity can have a school nutrition education component, WASH component and ensure that sugar-sweetened beverages and snacks are kept out of schools. Also, multiple types of malnutrition co-exist (known as the “double burden”) in many African countries, but most nutrition policies and interventions target only one form. Countries and international partners must identify shared drivers of the double burden and establish comprehensive ‘double-duty’ interventions that simultaneously address the double burden of malnutrition.9
African countries must do more against this burgeoning public health crisis by boosting intersectoral actions through the strengthening of their security, agricultural, environmental and housing sectors while concurrently driving international and grassroots support for comprehensive evidence-informed nutritional interventions to put an end to all forms of malnutrition by 2030.