Africa's Nutrition Environment
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| Balanced diet Photo courtesy |
More than 300 million people in Africa live on per capita intake of 2100 kcal or less, which is well below than the accepted standard of over 2300 kcal per day. Major nutrition problems include: stunting (a measure of chronic under-nutrition), wasting (acute under-nutrition), and underweight (a combination of both stunting and wasting), as well as micronutrient malnutrition or ‘hidden-hunger,’ such as Iron Deficiency Anemia (IDA), Iodine Deficiency Disorders (IDD), and Vitamin A Deficiency (VAD). These forms of malnutrition can affect anyone but those at high risk include urban and rural poor, smallholders who are net food purchasers, the landless and female-headed households, in particular, the most vulnerable are women and children under five years of age living in such households.
The consequences are far reaching: increased morbidity and mortality, reduction in the physical ability to do work, increased absenteeism from school and work, reduced employment and earnings, reduced ability to resist infection, impaired physical and intellectual development in young children all of which are passed on through the generations. Malnutrition acts as a brake on the social and economic development of the individual, of the local community, of the nation and of the global economy as a whole.
The root cause of malnutrition in Africa is underdevelopment linked to political, economic, ecological and socio-cultural constraints and demographic dynamics. The root causes involve both man-made and natural disasters. Man-made factors include war and civil conflicts, population growth and pressure on natural resources.
Without the ability to further intensify production, agriculture has had to expand onto lands characterized by fragile ecological conditions, hence accelerated soil erosion, which minimizes future increase in food production. Investments in agriculture have declined over the long term, and what investments have been made, have largely been targeted to the production of cash crops for export rather than for food production. This has been accompanied by a serious deterioration of the publicly funded agricultural extension systems and the increased involvement of the private sector with focus on cash crop production rather than food crops. Natural disasters including drought, flood, land-slides, earthquakes, locusts and bush fires compound these problems.
The global soaring food prices between 2007 and 2008 and the ongoing financial crisis, resulting in global recession has exposed existing and potential vulnerabilities of households, governments and international systems to food and nutrition insecurity and these have reversed the gains made in reducing poverty over the last few decades. The first Millennium Development Goal (MDG) target of halving the proportion who suffer from hunger between 1990 and 2015 remained on track up to 2005. However estimates for 2007 put the number of hungry people at 923 million, an increase of more than 80 million since the 1990–92 base period.
Between 2003–05 and 2007, 75 million more people were added to the total number of undernourished, the most rapid increase on record. Preliminary estimates suggest that an additional 40 million people were pushed into hunger in 2008, bringing the total to 963 million. While several factors are responsible, high food prices and greater price instability and volatility are driving millions of people into food insecurity, worsening conditions for many who were already food-insecure, and threatening long-term global food security.
Prior to the sharp rise in food prices and the economic crisis, around 41 million children under five-years of age were underweight and 58 million were stunted in Africa, and the crisis is expected to have driven more people into poverty and hunger. The increase in food prices poses a serious problem for the poor who are net buyers of food, including urban poor, rural landless laborers and many small-holder farmers. Already, poor households spend a relatively high proportion of their income on food; with rising prices, this often translates into the consumption of diets of lower quality and reduced diversity and for the ultra poor to a reduction in overall energy intakes.
This situation poses a threat to food and nutrition security, particularly for children, pregnant and lactating women, with far-reaching consequences on theirs’ as well as their children’s survival and development. Women whose quality of diet is poor and energy consumption is low tend to have babies with lower birth-weights, increasing the babies’ risk of death or stunting in infancy and early childhood. On the other hand, improving maternal nutrition before and during pregnancy on a sustainable manner leads to improved pregnancy outcome. Children who become stunted during the first two years of life due to poor nutrition are at increased risk of morbidity and mortality, are less able to perform well in school later in life, and are more likely to be economically less productive as adults, and when they put on weight rapidly later in childhood are at high risk of chronic nutrition related diseases later in life.
The consequences of the food price crisis on households’ food consumption are most acutely felt in Low Income Food Deficit Countries (LIFDCs) where a 50% rise in staple food prices causes a 21% increase in total food expenditure, from 50 to 60% of income. Experience from previous financial crisis in Asia and Africa shows that in poor households, the first response is to save on food costs and cut down on non-staple food consumption. These coping strategies affect first the diversity and quality, and then the quantity and safety of diets, with mothers usually the first to make such sacrifices. This leads to reduced micronutrient intakes among poor people and to decreased calorie consumption among the very poor who are forced to cut back expenditures on other essential items that may jeopardize their longer term food security. Rural smallholders may reduce plantings, and may engage in distress sales of assets and cutbacks in basic needs such as clean water and healthcare.
All of these activities will increase vulnerability to food insecurity, micronutrient deficiencies, and the infectious diseases that so often accompany under-nutrition, and will further exacerbate and deepen the existing vulnerabilities particularly in countries already affected by climatic change and increasing natural disasters, endemic HIV and AIDS and protracted conflict and political crises. Food insecurity, for instance, may drive vulnerable women and girls to engage in behavior which increases their risk of contracting HIV. As well, lack of adequate food may decrease ART treatment up-take and adherence. To this end, all these activities can have permanent, negative effects on social welfare, especially among the most vulnerable population groups, women and children. .
In response to the crisis, urgent calls have been made to step up efforts towards addressing food security and nutrition in Africa during a number of high-level policy meetings. The AU-NEPAD food security workshop in Pretoria 20-23 May 2008 involving FAO, IFAD, WFP, UNICEF and key multi-lateral and bi-lateral donors, adopted a two-pronged approach, in line with the high-level task force on global food crisis recommendations.
The first, focused on the immediate needs of the vulnerable populations (increasing access to emergency food assistance, nutrition interventions and safety nets among the most vulnerable, boosting small-holder food production, and policy measures). The second aimed to strengthen in the medium to longer term food and nutrition security by addressing the underlying factors driving the food crisis (expanding social protection systems, boosting and sustaining small-holder food production growth, improved food markets, thus boosting food security of small-holder and other net food purchasers).
This was followed by formulation of food crisis task force, led by the AU/NEPAD and involving key UN agencies – FAO, WFP, UNICEF and multi-lateral and bi-lateral agencies, to provide coordinated support to countries to formulate national response strategies, and plans of action in the immediate-term to meet food security and nutrition needs among the most vulnerable, and in the long-term to enhance resilience to external shocks (e.g. climatic and market related shocks). More recently, the AU has called for the revitalization of the African Task Force on Food and Nutrition Development (ATFFND), which held its first meeting in Addis Ababa 26-27 February 2009, involving UNICEF, WHO, FAO, WFP and GAIN among others. The meeting agreed to undertake priority focused actions to provide coordinated support to Member States of Africa to accelerate progress towards MDG 1.
The first meeting of the ATFFND agreed that existing African regional food security and nutrition strategies, frameworks and initiatives should be harmonized and implemented to meet immediate needs by delivering high-impact interventions for the prevention and management of food security and under-nutrition among the most vulnerable population groups, and at the same time to meet the longer-term needs by strengthening food security and nutrition for enhanced resilience to climatic and economic shocks in the longer-term.
The main policy instruments include: the AU Regional Nutrition Strategy (2005-2015); NEPAD Comprehensive Africa Agriculture Development Programme (CAADP) Pillar III’s Framework for Africa Food Security (FAFS); Pan-African Nutrition Initiative (PANI); and Ten Year Strategy for the Reduction of Vitamin and Mineral Deficiencies (VMD). The meeting also agreed on the need to establish a mechanism to facilitate and coordinate country-led development of evidence-based food security and nutrition policies, plans and budgets that will guide the selection of priority actions that can address food security and nutrition both in the immediate- and the long-term taking into account the ongoing CAADP process with focus on Pillar III, ARNS eight-point priority action plans, and the AU Youth agenda.
Strengthening Nutrition Security
While household food security is an essential key requirement to achieve nutrition security it is not sufficient. Nutrition security is especially important for the most vulnerable groups in society: infants and young children under the age of two years, pregnant and lactating women, children under the age of five who suffer from severe-acute malnutrition and/or suffer from infectious diseases (including HIV, TB, malaria and child diarrhea). Under-nutrition in these vulnerable groups has life long irreversible consequences, and/or can lead to markedly increased morbidity and mortality.
Nutrition security implies more than just access to adequate quantities of a variety of safe, good quality food (including micronutrients). It requires access to safe water, hygiene and sanitation, access to quality health-care services, and improved household and community practices in child care, food hygiene and preparation and environmental health. Food and nutrition security is achieved when adequate food (quantity, quality, safety, socio-cultural acceptability) is available and accessible for and satisfactorily used and utilized by all individuals at all times to live a healthy and active life, and when good quality care exists and health care is available.
A variety of inter-related factors influence nutrition security and thus nutritional status of individuals, communities and populations (see UNICEF conceptual framework analyzing causes of malnutrition and FAO/FIVIMS framework on the linkages between the overall development context, food economy, households and individual measures of wellbeing in annex). It is imperative that all nutrition assessments include an appraisal of the underlying causes. Particular attention should be given to gender disaggregated data with a focus on the situation of women and girls. This will facilitate the choice of strategies to apply in particular contexts.
Courtesy: African Union.