Food for thought: Invest in nutrition for a healthy, productive future generation

Kenya, like other African countries, grapples with two burdens of malnutrition: traditional under-nutrition and over-nutrition, often seen in instances of being overweight and obese.

At the national level, 26 per cent of children under five years are stunted and are too short for their height, meaning they will never attain their full physical and mental potential; 11 per cent are underweight; and 4 per cent are too thin for their height.

While the levels of wasting and stunting has remained almost constant in the past 20 years, there has been a decline in the underweight bracket from 22 per cent in 1993 to 16 per cent in 2008.

The prevalence of under-nutrition is particularly high in urban slums where, for example, stunting among the under-fives is more than 40 per cent. This high level is occasioned by food insecurity (especially due to frequent droughts), poor access to safe water, infections (especially from diarrhoea, HIV, and malaria), poor maternal nutrition, and poor child feeding practices.

High levels of malnutrition, particularly stunting, may also reflect poor prioritisation and commitment to nutrition by the government and development partners, hence low budgetary allocation. For example, the government allocated only 0.5 per cent of its limited health budget to nutrition in the 2010/2011 year.

Substantial levels of overweight and obesity cases have also been documented. At the national level, 25 per cent of women of reproductive age (15-49 years) are either overweight or obese. The prevalence is even higher in urban areas, where 40 per cent of women are either overweight or obese.

Many social and environmental factors are at play, including lifestyle and dietary changes.
Malnutrition has multiple causes. Addressing it calls for innovative strategies, as well as political commitment if we are to achieve global targets such as the Millennium Development Goals for 2015 or the World Health Assembly goals for 2025.

A multisectoral approach will be needed by different actors, including government ministries (health, agriculture, gender, sports, culture and social services, finance, education and water).

PRIVATE SECTOR PARTICIPATION

Participation by the private sector, civil society, researchers, and development partners is also required, as is an effective coordination mechanism, only possible in the presence of strong political commitment. Countries such as Senegal and Rwanda that have implemented multisectoral action are closer to meeting the MDG target than Kenya.

To address the double burden of malnutrition, Kenya, like many other African countries, signed up in 2012 to the Scaling up Nutrition (SUN) Movement which brings together governments, civil society, private sector, researchers, United Nations and donors. SUN implements both nutrition-specific and nutrition-sensitive interventions.

In line with SUN’s objectives, Kenya has drawn up a national action plan for 2012 to 2017 that outlines 11 strategic objectives to tackle both under and over-nutrition.

These include improving the nutritional status of women and of children under five years.
Others are: improving prevention, management and control of diet-related non-communicable diseases; enhancing evidence-based decision-making through operations research; and strengthening coordination and partnerships among key nutrition actors, including partners in water, sanitation and hygiene, education, health, and livelihood sectors.

To potentially achieve these objectives in the national nutrition action plan 2012-2017, a budget of approximately Sh70 billion was drawn. Kenya has committed to spending Sh6 billion over five years to scale up nutrition interventions outlined in the action plan, shared across various ministries.

The rest of the money is being sourced from development partners. This is a drop in ocean compared with what is required.
Within the Vision 2030 policy framework, Kenya may be on track to curtailing this double burden of malnutrition. But continued government commitment, as well as that of other actors, is critical.

With the devolution of government since 2013, whereby 96 per cent of nutrition activities are handled by county governments, there is even greater need for advocacy at each of the 47 counties.

Ultimately, the government has a choice—to lose revenue to fighting the disease burden caused by nutrition issues, or to benefit from increased revenue from a healthy, productive workforce. Proper nutrition is an investment in future generations.

Mr Mule is Matungulu MP. He is a member of Parliament’s health committee and human rights caucus