Malnutrition affects about 30 percent of children in Africa, caused by low birth weight and post-natal growth faltering. Child malnutrition is a persistent problem. The long term trend shows only slow improvement, and malnutrition rates worsen during droughts, economic crises, conflicts and displacement, and HIV.
Resilience to these crises is better than anticipated. Slow progress towards reducing malnutrition is re-established when they recede. The provision of food or income support (through cash transfers) can help this resilience. Documented examples include:
- the Enhanced Outreach Strategy following drought in Ethiopia in the early 2000s
- supplementary feeding programmes in Zimbabwe in the early 2000s, following drought and economic stresses
- drought mitigation programmes in Botswana.
Sustained improvement in the nutrition status of children requires fair social and economic development. Education is particularly important, notably for women. Community-based programmes and health services can reduce malnutrition, usually without food distribution. This has been seen in Tanzania through the Iringa and Child Health and Development programmes during the 1980-90's, and the Community Nutrition Project in Senegal in 1996. Experiences from effective community-based programmes in Asia and Latin America also need to be applied in Africa.
The accelerating globalisation of food production, trade and marketing threatens the food security of poor communities in Africa, however. Removing barriers to trade (such as tariffs) and reductions in income support to farmers in richer countries would help to create greater export opportunities for African farmers. These actions would also reduce the price of food and other commodities imported into Africa. Both of these changes would improve the nutrition status of poor communities.
Without greater attention to nutrition, increased child mortality, morbidity and impaired intellectual development are inevitable.
- Policies must tackle intermittent crises through emergency programmes and support sustained community-based programmes.
- Nutrition should be reinstated as a priority programme area alongside HIV, tuberculosis and malaria.
Department of International Health & Development, Tulane School of Public Health and Tropical Medicine, New Orleans, USA
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The Public Health Programme, University of the Western Cape, Modderdam Road, Bellville, Cape Town 7535, South Africa
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