Tanzania: Why Efforts Against Malnutrition Should Be Strengthened

By Meddy Mulisa in Bukoba

MALNUTRITION is a major public health problem in developing countries including Tanzania, contributing up to 50 per cent of

under-five mortality.

Good health lays the foundation for vibrant and productive communities, stronger economies, safer nations and a better world. Concerted efforts were needed to ensure that unnecessary deaths resulting from undernutrition are stopped.

Every year, that is around 3.1 million deaths of children under the age of five are due to under nutrition while globally, 161 million chronically undernourished children are not getting the right nutrients and care at the right time.

Kagera Regional Nutrition Officer, Mr Paul Makari revealed that prevalence of stunting in Kagera Region was 39 per cent above the national average which stood at 34 per cent.

Other regions with high rate of stunting include Iringa (41.6 per cent), Geita (40.5 per cent), Rukwa (56.3 per cent ) while Njombe had 49.4 per cent. Causes of malnutrition include inadequate or excess dietary intake, infectious diseases, inadequate maternal and child care and poor access to health services, unhealthy environment and poverty.

Individuals who are vulnerable to malnutrition are children under five years of age, women of reproductive age especially pregnant and lactating women and adolescent girls due to their physiological needs for growth and reproduction.

Malnutrition can manifest itself in the forms of overweight and obesity which is an indication of excessive intake of nutrients or under nutrition which denotes inadequate intake of such ingredients. Investing in children's nutrition has the power to trigger big social and economic changes Children with well-developed brains and bodies have better life chances.

They live longer and healthier lives, they do better in school and they grow into healthy and productive adults. Improving children's well-being at the earliest age must be an integral and systematic component of education and poverty reduction.

East Africa region was among the three United Nations sub regions with the highest prevalence of stunting in 2011. During the period 1992- 2015, there was a tangible reduction in the number of underweight children and those suffering from chronic malnourishment.

However, despite these gains, concerns persist regarding the high rates of stunting among children and the stark disparities in nutritional status. The number of undernourished people in sub-Saharan Africa rose from 181 million in 2010 to almost 222 million in 2016.

Although the prevalence of stunting decreased from 38.3 per cent in 2000 to 30.2 per cent in 2017 while the number affected increased from 50.6 million to 58.7 million due to population growth. The rate of wasting in 2017 was 7.1 per cent or 13.8 million children, of whom 4 million were severely wasted.

Overweight rates are also increasing. The number of children younger than 5 years who are overweight increased from 6.6 million in 2000 to 9.7 million in 2017. For children aged 5-19 years, obesity rates doubled between 2006 and 2016, while for adults, overweight and obesity increased from 28.4 in 2000 to 41.7 in 2016.

Progress on various indicators has been either stagnant or has slipped. In 2015, more than 2.7 million children under 5 years of age were estimated to be stunted and more than 600,000 were suffering from acute malnutrition, of which 100,000 were severe cases.

There are huge variations in the nutritional status of children under 5 years of age. Ten regions account for 58 per cent of all stunted children and five regions account for half of the children suffering from severe acute malnutrition in Tanzania.

All three forms of undernutrition are higher among children from the poorest quintile than the richest quintile and higher among boys than girls. Given the importance of nutrition in the overall physical and cognitive development of children, there is a need to focus on the first 1,000 days of a child's life to prevent the negative effects of malnutrition from becoming irreversible.

This requires a multipronged approach to address risk factors ranging from inadequate food and illness to poor access to safe drinking water, sanitation and hygiene. High rates of anaemia and low body mass index among adolescent girls and pregnant women are also causes of concern.

Investing in nutrition is essential for Tanzania to progress. It is estimated that the country will lose US$20 billion by 2025 if the nutrition situation does not improve. In contrast, by investing in nutrition and improving the population's nutritional status, the country could gain up to US$4.7 billion by 2025.

A strategic plan to reduce the double burden of malnutrition in the African Region was adopted at the 69th Regional Committee meeting of the World Health Organisation (WHO) for the African Region in Brazzaville on 21 August, 2019.

The plan outlines the urgent and accelerated action that we must take if we are to meet our goal of ending hunger and all forms of malnutrition by 2030, said WHO Regional Director for Africa, Dr Matshidiso Moeti.

The WHO Secretariat will be developing and implementing a resource mobilization plan, supporting research collaborations and mounting high-level advocacy for increased investment to reach 90 per cent coverage of the 10 highest-impact nutrition interventions that must be taken to meet the malnutrition challenges in our region.

The double burden of malnutrition is particularly prevalent in countries undergoing nutrition transformation in which undernutrition and overweight or obesity coexist, often because of the increasing consumption of cheap, processed foods that are high in energy, fat and salt content but low in nutrient quality.

This diet, which is common in Africa, fails to address chronic undernutrition and micronutrient deficiencies and contributes to increased obesity and diet-related noncommunicable diseases. The strategic plan aims to strengthen evidence-based policies and national capacity and contains clear targets to be achieved by 2025.

Priority interventions include reinforcing legislation and food safety standards, using fiscal measures to incentivize healthy food choices and integrating essential nutrition actions in health service delivery platforms.