This blog is based on a presentation by Zione Kalumikiza made to kick off the Civil Society Organisation Nutrition Alliance (CSONA) Debate on Nutrition. This event was organized in conjunction with Save the Children International for the four main political parties contesting in the forthcoming tripartite election. The event was supported by the Graça Machel Trust and the EU Afikepo Nutrition Advocacy Program and was held on April 30, 2019 in Lilongwe.
The FAO reports that in 2017 the number of undernourished people is estimated to have increased to 821 million – around one out of every nine people in the world. Adult obesity is also worsening and more than one in eight adults in the world – or more than 672 million – is obese.
While malnutrition was in the past understood primarily as a problem of deficiency, the world is now facing a double burden of malnutrition over the life course, characterized by the coexistence of undernutrition along with overnutrition (overweight/obesity, and diet-related noncommunicable diseases), within individuals, households and populations. Inconsistent with past thinking, research published reveals that overweight/obesity is no longer a problem of the affluent.
Nutrition is at the heart of the 17 sustainable development goals (SGDs) of the 2030 agenda. Achieving Malawi's development will therefore require addressing malnutrition in all its forms. Recognising that nutrition is a precondition for human and capital development, the Malawi Growth and Development Strategy (MGDS) III identifies nutrition as one of the national priorities. Malawi has made progress in its efforts to reduce undernutrition. Based on data from the Malawi Demographic Health Survey (DHS), under 5 stunting rates decreased from 47% in 2010 to 37% in 2015/2016. Micro-nutrient deficiencies have also reduced, especially for the case of Vitamin A. Based on the 2001 and 2015/16 National Micronutrient Survey findings, levels of Vitamin A deficiency reduced among pre-schoolers (6–59 months) from 59.2% in 2003 to 3.6% in 2017, from 38.3% to 0.9% among school-aged children(5–15 years), from 57.4% to 0.3% among women of reproductive age (15–49 years), and from 36.9% to 0.1% among men (20–55 years).
Still, much remains to be done: Rates of exclusive breastfeeding are declining, while infant and young child feeding practices remain poor. Based on the latest DHS, only 61% (71% in 2010) of infants under the age of 6 months are exclusively breastfed and only 8% (19% in 2010) of children age 6–23 months meet the minimum acceptable dietary standards. Zinc deficiency affects at least 6 in every 10 Malawians. Furthermore, overnutrition is on the rise also in Malawi, both among rural and urban residents, increasing the risk of non-communicable diseases. Overweight prevalence among women ages 15–49 years increased from 9.8% in 2000 to 15.1% in 2015–2016. The prevalence of obesity more than doubled during that time from 2% to 5.6%. This has led to an increase in hypertension and diabetes.
The cumulative effect of climate change is undermining all dimensions of food security – food availability, access, utilization and stability. The FAO reports that nutrition is highly susceptible to changes in climate and bears a heavy burden as a result. This can be seen in the impaired nutrient quality and dietary diversity of foods produced and consumed, the impacts on water and sanitation, and the effects on patterns of health risks and disease, as well as changes in maternal care, child care and breastfeeding. Exposure to more complex, frequent and intense climate extremes is threatening to erode and reverse gains made in ending hunger and malnutrition.
Action is needed as the cost of not acting is huge. The “Cost of Hunger” for Malawi highlighted that child undernutrition caused an overwhelming US$597 million in social and economic cost in 2012, which equaled 10.3% of the country’s GDP.
Opportunities exist as current policies and development strategies have prioritized nutrition. Some of the best practices over the years include better coordination and stakeholder collaboration, good programmes that focus on interventions shown to have high impact, and improved investments in nutrition. However, financing nutrition is also key beyond making budget allocations. “As far as addressing malnutrition is concerned,” stated Zione, “we will need to think in unusual ways and “beyond the box” of food to issues of rights, food systems, and resilience approaches. Addressing nutrition requires using a lifecycle approach, utilising all existing avenues and, opportunities, as well as working with what communities already have (indigenous knowledge). We all have a role to play to keep nutrition up the agenda.”
Following the presentation, the participants, including representatives from the political parties, debated what the nutrition priorities should be for the incoming government.
Zione Kalumikiza is a lecturer in public health and nutrition at Lilongwe University of Agriculture and Natural Resources (LUANAR). She also serves as coordinator of the Donor Group on Nutrition Security (DoNUTS).
The presentation can be found below.
Click here to download the presentation. (PDF 1.3 MB)
