Malnutrition and Early Childhood Development in Sub-Saharan Africa
Growing up in the 1980’s, I vividly remember being inundated with television images of starving African children surrounded by celebrity musicians chiming to the now classic tune “We are the World”. Back then, their aim was to galvanize global support towards ending child malnutrition in Africa. Sadly, more than thirty years after, our current reality is not very different.
Sub-Saharan Africa accounts for one third of all malnourished children globally. 49% of the 10 million deaths among children less than 5 years old each year in the developing world are associated with malnutrition. In children under five years of age, severe malnutrition manifests itself in two ways. Wasting– characterized by rapid deterioration in nutritional status over a short period of time and Stunting– a form of growth failure which develops over a long period of time. While the former is more common during conflicts and emergency situations, the latter manifests itself in regular everyday life of millions of children growing with limited access to food, health and care and is often called “a silent killer”. While stunting in children under five years of age is declining at a global level, numbers in Africa are increasing, and approximately 60 million African children under five are not growing properly.
When we say “not growing” we actually mean that their brains are not growing. This is because the period from birth – five years of age is the peak period for brain development and malnutrition in early childhood causes developmental delays that are difficult to compensate for later in life. Stunting is associated with suboptimal brain development, which negatively affects cognitive development, educational performance and economic productivity in adulthood. In this regard, African nations are not only losing out on human well-being but also economic progress and infrastructure development. There is sufficient proof that Africa’s malnutrition problem has stunted its economic growth significantly – with countries losing between 1.9% and 16% of the gross domestic product annually to under-nutrition due to increased mortality, absenteeism, chronic illnesses, and lost productivity. As at today, no African country is expected to reach the UN target of ending childhood malnutrition by 2030.
The causes of childhood malnutrition in Africa are multifaceted and largely dependent upon the context but can be broadly summarized thus (i) Household Food Insecurity due to extensive land and crop degradation, periodic droughts, widespread poverty and exponential population growth (ii) Inadequate care and feeding practices due to harmful socio-cultural practices and ignorance (iii) Limited access to the health and sanitation services, thereby perpetuating the role of infection and disease in promoting undernutrition. The prevalence of childhood malnutrition is highest within countries in East Africa (Burundi, Malawi) and West Africa (Niger, Mali, Sierra Leone, Nigeria).
To turn the tide of childhood malnutrition in Africa, a strong multi-sectoral response spear-headed by national governments is required. One of the main reasons, childhood malnutrition persists in Africa is lack of national commitment at the highest level resulting in the inability to sustain highly effective programs funded mainly through foreign aid. Senegal, is an example of a country where making malnutrition a political priority has reaped dividends. Stunting rates dropped by one-third between 2011 and 2015 after the prime minister’s office set up a coordinating body tasked with reducing malnutrition.
However, all hope is not lost. One major difference between the 80’s and present day, is that Africa is now opportune to have individuals with the resources to change this woeful narrative. That being said, it is imperative that African philanthropists only get involved with initiatives that will be effective and impactful in the long term. In this regard, here are five key points philanthropists should take note of before committing resources to initiatives poised to end malnutrition:
The government is your friend: there has to be evidence of government buy-in and commitment to the initiative
The initiative has to be technically sound: This means that it contributes to the country’s national nutrition plan, proposed interventions are driven by evidence, it is sustainable beyond the life of the project and easily scalable
Always target the most vulnerable: It needs to focus on the population most adversely affected by malnutrition– Children Under 5 and Pregnant Women
Money is not the only way to give back: Sometimes, communities are better served by other resources e.g. technology, food commodities, technical manpower, advocacy
It’s easier to reach the ground than touch the sky: Before you commit resources, always seek for information from those on the ground who are directly impacted by the situation.
*Views expressed in this article are those of the author and not the African Philanthropy Forum.
Dr Amaka Momah-Haruna is a Public Health Specialist with expertise in Early Childhood and Adolescent Health & Development. She is a graduate of the Harvard School of Public Health and pioneer fellow of the World Bank Africa “Early Years” Fellowship Program designed to groom future African leaders in Early Childhood Development. Currently, she is a Program Specialist with the United Nations.