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Malnutrition Remains a Public Health Problem

By Beaven Dhliwayo

After the Tropical Cyclone Idai, which affected Zimbabwe, Mozambique and Malawi, early this year, a 46-year-old Margaret Sithole of Chimanimani now feeds her children with plain manhuchu (samp) also known as Umngqusho.

Samp is a common dish in Zimbabwe and since it is rich in starch, many combine it with meats and vegetables, but not for poor Sithole and her family.

Cyclone Idai destroyed her crops and she was forced to sell a few chickens and goats that survived to fend for her three kids.

With her husband in neighbouring South Africa and doing nothing for the upkeep of the children and with no reserves to fall on, Sithole is running out of options.

“We got nothing from the fields for the last two years. My husband had not been sending anything to support the family and I rely on piece jobs in the community,” Ndebele said in a telephone conversation from Ndima Village in Chimanimani.

Sithole says her family is now down to one meal a day, consisting mainly of samp, and whatever vegetables they are able to get. At other times, she receives relief from Government programmes.

Like many others, the family’s water source is the nearby riverbed, where the children get water through sand-abstraction, a method in which wells are dug near or in the river bed to tap the sub-surface water flow.

The lack of adequate food and unsafe water makes children vulnerable to malnutrition. While there has been a general improvement in the lives of many Zimbabwean children in the last five years, according to Government statistics, the country still faces nutritional problems among children.

The Zimbabwe Vulnerability Assessment Committee (ZVAC), led by the Government, with support from various partners and the World Food Programme (WFP), in its 2018 rural livelihoods assessment report states that despite the decrease in the number of people needing food assistance due to an improvement in production levels, food and nutrition security remains fragile and subject to natural and economic shocks, with chronic and persistent rates of undernourishment.

According to the Organisation for Economic Co-operation and Development (OECD), Zimbabwe had a stunting rate of 32,0 percent in 2016, representing 0,84 million children under-five.

But latest Government data in 2018 shows a decline to 27,6 percent.

In 2015, the Zimbabwean economy recorded a GDP of US$17,6 billion.

In the same year, out of a national budget of US$3,5 billion, 0,47 percent was allocated to nutrition.

In its latest report of National Budget allocation to nutrition, an analysis of nine countries, East and Southern Africa Civil Society Nutrition Network (ESA), said Zimbabwe must increase the share of nutrition budget through the national budget from 0,47 percent of the total budget to three percent progressively from the 2019 National Budget.

“Overall, Government spends US$6,38 per child, while donors, through off-budget support spend US$19,40, making a total of US$25,78, still below the Nutrition for Growth (NG4) commitment of US$30 per child.

“For overall national investment in nutrition, donors again carry a majority of the burden at 75,2 percent.

“Nutrition budget in agriculture, livestock and fisheries is 6,4 percent, while national efforts on gender issues through budget, which addressed nutrition is only allocated 0,7 percent.

“Budgetary allocation to health and childcare is far less than 15 percent of the national budget as recommended by the Abuja Declaration to which Zimbabwe is a signatory. A slight increase by one percentage point from 6,9 percent in 2017 to 7,9 percent in 2018 was noted,” said the report.

The report further recommended Government to integrate nutrition in the national development plans and framework by adopting nutrition sensitive programming through sectoral mainstreaming.

ESA also recommended that Government should develop mechanisms to increase nutrition spending per child as an approach to fight malnutrition or stunting and potential strategy to address long-term challenges in nutrition.

On agriculture, livestock and fisheries, ESA said Government should mainstream and integrate nutrition in their work and increase nutrition investment in the three sectors from the current 6,4 percent since most rural households eat what they grow.

According to WFP, food production in Zimbabwe has been devastated by a number of factors, including natural disasters and economic and political instability.

Recurrent drought, a series of poor harvests, high unemployment (estimated at more than 80 percent), restructuring of the agriculture sector and a high HIV and Aids prevalence rate — at 14,7 percent, the fifth highest in the world — have all contributed to increasing levels of vulnerability and acute food insecurity since 2001.

This situation has necessitated large-scale humanitarian food relief operations in the country.

WFP says a malnourished person finds their body has difficulty doing normal things such as growing and resisting disease.

Disease and malnutrition are closely linked. Sometimes disease is the result of malnutrition, sometimes it is a contributing cause.

Even if people get enough to eat, they will become malnourished if the food they eat does not provide the proper amounts of micronutrients — vitamins and minerals — to meet daily nutritional requirements.

In fact, malnutrition is the largest single contributor to disease in the world, according to the UN’s Standing Committee on Nutrition (SCN).

In its Growth for Nutrition Statement to members of the media in the capital last Friday, Zimbabwe Civil Society Organisations Scaling Up Nutrition Alliance (ZCSOSUNA), applauded the Government of Zimbabwe for crafting the necessary policy and legal framework for addressing the food and nutrition security challenges in the country, for example the Food and Nutrition Security Policy for Zimbabwe and its implementation strategy.

National Coordinator Kudakwashe Zombe said despite progress made in reducing hunger and undernourishment in the country, nearly one in four children under the age of 5 years continue to experience long episodes of poor nutrition within their first 1 000 days that is from conception until they reach two years.

“The National Nutrition Survey of 2018 key findings revealed that 26,2 percent of children are stunted. “

“We would like to remind policymakers and key decision makers in Government that everyone in the country has the right to adequate, safe, and nutritious food as articulated in the Constitution of Zimbabwe.

“Despite this right, malnutrition in all its forms remains a public health problem in Zimbabwe and needs urgent attention if we are to eliminate it within our lifetime and we cannot afford to delay.

“It is unacceptable that one in every four children under the age of five continue to suffer from or die of preventable causes of malnutrition in all its forms.

“We cannot continue to deny children the right to realise their full potential because of preventable causes, we need to ensure children realise their human right to adequate food and nutrition. The time for action is now,” said Zombe.

The alliance called Government to take into consideration findings of the 2016 Global Nutrition Report — NG4 Tracking and take stock and report on progress made in honouring its 2013 N4G commitment in preparation of the upcoming Japan 2020 Nutrition for Growth Commitment.

According to ZSCOSUNA, the country needs to renew its commitment towards the fight against malnutrition in all its forms during the Japan 2020 N4G summit.

In that regard there is need to consider adopting recommendations from previous NG4 reports and formulate specific, measurable, achievable, realistic and time framed nutrition commitments since some of the previous reports revealed that the country’s commitments were not clear.

In addition, ZSCOSUNA said Government should ensure food and nutrition security for all people, including access to adequate, diverse and nutritious food by all times through effective implementation of current policy frameworks.

According to proponents of the fight against malnutrition, there are two sides to eliminating malnutrition: sustaining the quality and quantity of food a person eats; and ensuring adequate health care and a healthy environment.

Therefore, the Government’s role in fighting malnutrition is to give malnourished people the food and nutrients they need, but also to prevent it, by acting where there is the threat of malnutrition.

Source : The Herald

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