Economic performance has a direct bearing on the food and nutrition situation of any people. Food and nutrition insecurity is closely related to poverty. More than half of Africa’s population are poor. Despite the existence of food and nutrition policies in a country such as Kenya, the situation has not improved. It worsens during periods of drought, heavy rains and floods, when the number of people requiring food aid rises from 2 million to 4 million.
Several factors, including inadequate budgetary allocations, unstable macro-economic conditions, limited involvement of the private sector, inadequate sectoral coordination, lack of monitoring and evaluation systems, and limited stakeholder participation, have contributed to the limited success of past food and nutrition policies. New policies that provide an overarching framework covering all the four dimensions of food security—availability, accessibility, stability and meeting nutritional requirements—and addresses the synergy linking food and nutrition security with poverty reduction are required in the continent.
These policies should adopt the lifecycle approach that emphasizes the biological needs of different specific amounts, types and varieties of food for population groups who are at specific stages of life. There is need to expand and strengthen actions to ensure pregnant and lactating women have access to and have knowledge about the need for an adequate and nutritious diet; develop systems to implement the right to proper nutrition and healthcare for all children, establish institution feeding standards and regulations for schools; and develop nutrition care strategies and support community-based feeding and health services for the elderly. African countries also need to develop nutrition and related training strategies focused on HIV/AIDS patients, orphans, children infected and affected by HIV/AIDS and on preventing malaria and tuberculosis.
For purposes of enhancing the quantity, quality and timeliness of food and nutrition information, African governments need to promote and strengthen information networking among institutions involved in food and nutrition. They should establish and strengthen the coordination of food, health and nutrition databases; enhance capacity in terms of human, equipment and finances; strengthen and expand a feed back system.
Macronutrient deficiencies are highly prevalent in Africa, particularly among groups at specific stages of their life cycles when needs for specific minerals and vitamins are high. Vitamin and mineral deficiencies exist even among groups with sufficient food in terms of meeting energy requirements. Micro-nutrients are vitamins and minerals which, though required in very small quantities, are essential for normal functioning of body systems. Diets in Africa are grossly deficient in one or more micro-nutrients particularly vitamin A, iron and zinc. Among the main causes of the widespread micro-nutrient deficiencies are low bio-availability of micro-nutrients from local foods (diets based on maize) and inappropriate food preparation and handling practices. However, some vitamins and minerals are not found in sufficient quantities in the general diet of the general population (iodine), and some population groups such as young children and pregnant and lactating women need higher levels of some minerals and vitamins because of this special period of life.
Recent studies in Kenya show that children under five years have a huge burden of micro-nutrient deficiency: 84% of children in this age group have varying levels of vitamin A deficiency, 73.4% are iron deficiency, and 51% have zinc deficiency. Women, especially pregnant women, are among the most vulnerable with a high risk of iron deficiency (60% among pregnant woman) and vitamin A deficiency (39% among women). An estimated 16% of adult males suffer from iron deficiency (anaemia). Kenya is also increasingly facing the emergence of diet-related non-communicable diseases, especially in urban areas. These are mainly caused by excessive intake of calories associated with purchased meals and processed foods, and decreasing levels of physical exercise in urban settings. It should also be noted that millions of children and adults suffer from the ill-health effects of food-borne diseases.
The main nutrition challenge facing Africa is having adequate food of sufficient diversity to meet nutritional needs. Even where households have adequate access to food they make inappropriate choices leading to nutrition related disorders. Other challenges include inadequate access to basic healthcare and sanitation, diseases (malaria, HIV/AIDS, TB).
Nutrition and health interventions in the form of increasing knowledge, changing attitudes, and improving practices related to basic primary healthcare and dietary intake are necessary to address hunger, under-nutrition, micro-nutrient deficiencies and avoid nutritional practices that result in overweight and obesity and diet related chronic diseases. Nutritional interventions will not be successful without adequate production, accessibility and dietary practices that stress a variety of foods and do not place an emphasis on cereals alone.
Four main strategies are needed to successfully address all forms of vitamin and mineral deficiencies for people in various life stages. These are dietary diversification, food fortification with vitamins and minerals, bio-fortification and vitamin and mineral supplementation. Each of these has its place in an overall strategy to assure adequate vitamin and mineral nutrition. Each has different costs, different stakeholders in terms of responsibility, and each is more appropriate alone or in combination in different circumstances.
Nutrition education, promotion of a more varied diet and shifting food subsidies to a package of food products with various macro- and micro-nutrients, as well as promotion of backyard gardens and small-scale animal husbandry all relate to diversifying diets. Iodine deficiency has largely been controlled through universal salt iodization (industrial food fortification). Some margarine in Kenya is fortified with vitamin A and there have been commercially sponsored efforts to fortify un-sifted maize flour with iron. The Kenya National Food Fortification Alliance has also been formed.
There is need for expanding the public health sector’s role in larger vitamin supplementation programmes for specific groups. There is also a need for quality control as a growing demand and influx of vitamin and mineral supplements increases the potential for poor quality supplements to reach the market or for persons to obtain supplements through channels and persons unqualified to guide the consumer in their appropriate and safe use.
By Dr Eusebius J. Mukhwana
Director, Sustainable Agriculture Centre for Research and Development in Africa (SACRED Africa)
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