Though
considerable progress has been made in recent years in Nigeria and other
African nations, in the fight to combat malnutrition or under-nutrition, a lot
more still remains to be done; this is because the percentage of health
problems related to under-, or malnutrition, is still at an unacceptable level
in most African countries.
In this
paper, we will discuss the causes of malnutrition, especially in the most
vulnerable groups of people – children 5 years and under, women of reproductive
age, pregnant women, and the elderly; we will also discuss the impact of food security
on the following childhood health problems like stunting, severe wasting, wasting,
underweight, and Obesity among children.
We will also
discuss and appreciate the importance of the following in the maintenance of
good nutrition: Micro-nutrients (iron, zinc, vitamins, iodine, etc.), macro-nutrients
(protein, fats, calories, etc.) Also, we will discuss the four dimensions of
food security which includes Availability, Accessibility, Utilization, and Stability.
We will also look at the significance of nutrition and food security on health.
Finally, we
will examine the impediments to food security in African, and offer possible
solutions toward overcoming them.
In 2003, 2011,
and 2015, according to available World Health Organization, and World Bank
Group data, the percentage of children under the age of 5 years, and who suffer
from the five classes of malnutrition in Nigeria, and some other African
nations were as follows:
Africa: 2011
6-Country Malnutrition Data (WHO, WB)
|
Severe Wasting
|
Wasting
|
Underweight
|
Overweight
|
Stunting
|
Burkina Faso
|
2.40%
|
10.20%
|
24.40%
|
0.00%
|
34.10%
|
Ghana
|
1.40%
|
6.20%
|
13.40%
|
2.60%
|
22.70%
|
Mauritania
|
4.00%
|
13.90%
|
24.40%
|
3.20%
|
29.70%
|
Mozambique
|
2.30%
|
6.10%
|
15.60%
|
7.90%
|
43.10%
|
Nigeria
|
3.10%
|
10.20%
|
24.40%
|
3.00%
|
36.00%
|
Uganda
|
1.50%
|
4.80%
|
14.10%
|
3.80%
|
33.70%
|
Nigeria – multi-year malnutrition
data (WB, WHO)
2003
|
2011
|
2015
|
|||
Severe Wasting
|
4.80%
|
3.10%
|
1.80%
|
||
Wasting
|
11.20%
|
10.20%
|
7.20%
|
||
Overweight
|
6.20%
|
3.00%
|
1.60%
|
||
Underweight
|
27.20%
|
24.40%
|
19.40%
|
||
Stunting
|
43.00%
|
36.00%
|
32.90%
|
Ethiopia: multi-year malnutrition
data (FAO, WHO)
2011
|
2014
|
2016
|
||||
Severe Wasting
|
2.90%
|
2.50%
|
2.90%
|
|||
Wasting
|
10.10%
|
8.70%
|
9.90%
|
|||
Overweight
|
1.80%
|
2.60%
|
2.80%
|
|||
Underweight
|
29.20%
|
25.20%
|
23.60%
|
|||
Stunting
|
44.20%
|
40.40%
|
38.40%
|
Ghana – 2011 & 2014 malnutrition
data (FAO, WHO)
2011
|
2014
|
|||||||
Severe Wasting
|
1.40%
|
0.70%
|
||||||
Wasting
|
6.20%
|
4.70%
|
||||||
Overweight
|
2.60%
|
2.60%
|
||||||
Underweight
|
13.40%
|
11.00%
|
||||||
Stunting
|
22.70%
|
18.80%
|
||||||
While a
progressive trend is noticeable over the years in some areas in the three individual
countries since 2011, especially in areas of severe wasting, wasting, and
overweight, much effort is still required by government and healthcare agencies
in the areas of underweight and stunting in Nigeria, and severe wasting,
wasting, stunting, and overweight in Ethiopia. The overweight trend in Ghana
appears to hold steady for the periods under review, while only a little over 2
percentage points each have been shed between 2011 and 2014 – a period of 3
years – in wasting, underweight, and stunting categories. Overall, a lot remains
to be done.
Causes of Malnutrition/ Under-nutrition
Severe
micro - and macro-nutrient deficiencies
is the major cause of, at least, three – underweight, stunting, and wasting -
of the five malnutrition problems suffered by children 5 years and under in
Nigeria, and Africa in general. Deficiencies in micro-nutrients like iron, zinc,
vitamin A, and iodine (among many others), which are chemical elements found in
the body in small quantities for normal growth and development of humans and
other living organisms; and in macro-nutrients which are required in large
amounts by humans to develop and grow, like carbohydrates (55-75%), protein
(10-15%), and fats (15-35%), contribute to, if not the main cause of all the
listed malnutrition problems that continue to plague mostly the 5 and under
population, pregnant women, those of childbearing age, and the poor and illiterate
population in African countries. These nutrients come from food and/or various
multivitamin supplements. Now, how does one ensure adequate supply and intake
of these nutrients to produce the desired health results? This is where food
security is important.
Food security
Food
security, according to the 2009 World Summit On Food Security, “exists when all people, at all times, have
physical, social and economic access to sufficient, safe and nutritious food,
which meets their dietary needs and food preferences for an active and healthy
life”. Quite a mouthful, but it encompasses so many things that will be
discussed in details when we look at the four dimensions of food security:
availability, access, utilization, and stability.
1. Food Availability:
“Water, water everywhere but nary enough to drink”. This is the same
situation with food availability. For food to be considered available, a family
has to have adequate, sufficient, and diversified supply of food to meet their
daily nutritional needs. In other words, a family has to have available to its
disposal enough combination of nutrition-rich foods to continuously satisfy its
needs. Unfortunately, this goal is never
achieved, even in industrialized nations with perennial records of excess food
production, for reasons that will be explained later
2. Food Access:
This is broken down into three types; economic, physical access, and
social support;
a. Economic access - disposable income,
food prices, and access to social support systems all determines the level of
economic access a family has to food. Where disposable income is low,
especially in large families with multiple responsibilities, though food may be
accessible, budgetary allocations for food may not be adequate to access the
needed quantity, quality, and diversity to meet nutritional requirements. Also,
food prices do play a major role in accessibility; again, in a low income or
large family environment, high food prices will force difficult choices that
may result in choosing quantity over quality. This is the situation in many
Third world countries, and even some poor sections of industrialized nations. A
family in rural Africa may choose to eat cassava or corn meal two to three
times a day, because it is heavy enough to satisfy the hunger pangs, and very
much affordable. Same thing in a low-income family in the US which might elect
to feed on Jumbo Jacks and fried chicken because of the filling effect in the
stomach.
b. Physical access - in this case,
though the food may be available, along with the disposable income to buy,
physically accessing the food is either difficult or impossible. This happens
mostly due to lack of availability of infrastructure – roads, rail, ports,
communication, and storage facilities - to transport the food from the farms
and processing plants to the market or consumers. This results in wastage of
most of the harvest, and the few that make it to market are priced so high that
they become less affordable by the average consumer, because of the high cost of
transportation/conveyance that has been passed on in the retail prices
c. Social support - social support
augments shortfalls in economic and physical access. In developed nations of
the US and Europe, governments have established social support programs,
through their agriculture and commerce ministries, and in alliance with states,
local governments, non-governmental agencies – including churches -, and
agricultural firms to provide foods and other nutritional products for those
who may need such services to augment their incomes.
Churches and many NGOs
have set up food pantries and soup kitchens for families, homeless people, and
even individuals who are temporarily between jobs, to cater for their
nutritional needs. State governments, also, have programs to provide pre- and
post-natal nutritional needs for pregnant women and their babies, either in the
form of redeemable coupons at grocery stores or debit cards with which to buy only
food and non-taxable items, at grocery stores. Only a handful – or even less –
of African countries provide this support to the disadvantaged of its
population. Even in the few countries where such services exist, corrupt
practices by those in charge ensure that the needy are denied access to this
support service.
3. Food Utilization:
A family could have food access and availability without proper
utilization, and this can result in mal- or under-nutrition. Lack of proper food
utilization can be determined through the measurement of the size and
proportion of the human body, to ascertain whether that person suffers from
stunting (caused by prolonged inadequacy of food intake), wasting (short-term
inadequacy of food intake), overweight/underweight, or severe wasting. With
food under-utilization, families simply eat to fill their stomachs without
consideration for nutritional balance; the day’s meal could be an
all-carbohydrate/starch, or all-vegetable meal, but never a combination of both
and plus fruits to have a balanced meal. In many African countries, including
the ones with yearly abundant harvests like Nigeria, Zimbabwe, Ethiopia, and Uganda,
consumption of unbalanced meal combinations still persist, due largely to
minimal nutritional/dietary education.
Other factors include the quality of food, methods of preparation, and
health/hygiene conditions. Most times, due to low income or limited access,
most of the food products are already in advanced stages of rot and decay
before reaching the consumer. At this stage, it has already lost most of its
nutritional value and is of no benefit to the consumer. Also, in some cases
where the food is still fresh from the farm, or markets, the proper cooking
method is never applied. Either the vegetables are under-cooked, resulting in
not accessing the full nutritional content, or overcooked, thus resulting in
the killing of most if not all of the nutrients. Again, this could be
attributed to lack of proper dietary/nutritional education. Finally, unsanitary
food storage facilities at the markets, warehouses, and private homes could
lead to early decomposition or spoilage, which results in severe loss of
nutritional content and value to the consumer.
4. Food Stability:
The last step in food security is stability, and this happens
in two forms; stable food supply and stable food prices.
a. Stable food Supply – uneven weather patterns
can affect food supplies. Some African nations like Southern Sudan, Somalia,
and countries near the Sahara desert suffer occasional droughts which affect
production. Typhoons and tsunami in some Asian countries, El Nino and hurricane
effects in central and North America also affect harvest outputs in these
countries. Even the warmer ozone effects on the arctic regions of, Russia,
Alaska, and the Scandinavian countries affect the supply of some food products
from that region. When weather patterns are even and favorable, food supplies
tend to be high due to increase in harvest; this will increase global and,
eventually, local food supply. The reverse is the case when weather patterns
are unfavorable; output drops, creating widespread food scarcity.
b. Food Price – The effects of uneven
weather patterns on food production and supply result in changes in global food
prices. These changes can be indirect at international supply levels, or direct
at local end-user levels. When global or regional supply is low, food prices go
up and families have to choose between nutritionally balanced meal and one that
just satisfies the hunger pangs. This is the choice that faces most consumers
in African countries. On the other hand, when food supplies are high and steady
and stable, families can make healthier purchase combination choices.
So, the
battle against malnutrition/under-nutrition in Africa starts with food security;
physical and economic access to a stable available supply line of food that is
properly utilized. Any interruption along these chain of food security, either
due to low income, inadequate infrastructure, and uneven weather patterns
affecting growth and harvest and price fluctuations, will impact nutritional
intake level of the most vulnerable of the African population which are
children 5 and under, pregnant women, and women of childbearing age, and result
in problems of wasting, severe wasting, under and overweight, and stunting
problems.
What African Nations Can Do
African
governments do know that the problem of malnutrition/under-nutrition is a
serious one in the continent, and some have declared some sort of state of
emergency on agriculture; however, their best efforts are still hampered by inadequate
budgeting, planning, and implementation. Also, poor preservation/storage and
processing facilities are still lacking in most of these countries; so, even
where you have a bumper harvest of all the necessary food products, most of the
harvest is either rotting away or never make it to the consuming public due to
poor infrastructure and distribution network.
Public
enlightenment programs on nutrition and dietary requirements (including
televised public service programs on proper meal combination and preparation)
for the 5-under population, expectant mothers, and women of childbearing age
should be a constant of every country’s health and agriculture ministries and
agencies. For the rural poor, social support services should be provided to
assist them in meeting their daily nutritional needs, either by instituting at
least one free balanced lunch programs in every kindergarten elementary school,
or issuing coupons to families making below a certain income level to augment
their food budget.
Finally, African
countries and regional bodies should pursue inter-regional economic
relationships that will ensure steady supply of nutritionally essential
commodities even in the times of drought and other severe weather patterns
which negatively affect the continent’s or global food production and supply.
Conclusion
When African
countries and governments put in place the right programs to ensure complete
and unabridged food security in the continent in which every family have
uninterrupted access to adequate, balanced and affordable food supply, the
nutritional problems of the continent, which include over/underweight,
stunting, wasting, and severe wasting will be one less problems the continent
will have to worry about. To achieve any major success in this battle, the
political will and determination to act has to be recognizable among the
leadership.
Felix Oti
Arlington,
Texas
felix.oti@outlook.com