•A Zambian mother with her child. Picture by Arturo Sanabria/Photoshare

By JULIUS PHIRI  –

CARE International Zambia is implementing a five-year programme on Nutrition at the Centre (NAC) in Eastern Province.
The project seeks to improve nutrition for mothers and children in resource-poor areas of Chadiza and Lundazi.
The project, which began in 2013, is expected to come to an end in 2017.
Twenty-two health centres have been identified to work with the organisations in the two districts.
Care International Zambia monitoring and evaluation coordinator Paul Chipoma told journalists during a two-day media sensitisation workshop on maternal and child nutrition in Katete that the project to reduce anaemia in Eastern Province was on the right track.
Mr Chipoma said currently anaemia in girls and women who were between 15 and 49 stands at 43.3 per cent. He said Care International was determined to reduce prevalence to 13 per cent by 2017.
He said that at national level, stunting was at 40 per cent while Eastern Province had the highest prevalence at 43.3 per cent.
Mr Chipoma said the five –year- project was targeting to reduce anaemia in children from zero to 24 months by 13 per cent and reducing stunting in children from zero to 24 months by nine per cent.
“This is a five year privately funded project designed to significantly reduce anaemia in women aged between 15 and 49 years at 13 per cent by 2015. Presently at national level stunting is at 40 per cent out of which 17.5 per cent are cases of severe stunting.
In Eastern Province, it stands at 43.3 per cent of which 15 per cent of those affected are underweight,” he said.
Most of the children who were stunted were under the ages of five years, of which six per cent had wasted low weight.
Mr Chipoma said Care International was working with the Government, particularly the line ministries, and collaborating partners in ensuring it achieved its goal of reducing stunting and anaemia.
He said the project of nutrition and food security was aimed at improving nutritional status for women between the ages of 15 and 49 years.
Micronutrient deficiencies continues to be of the public health concern.
Statistics indicate that 50 per cent of women attending antenatal clinics and 15 per cent of children under 5 years have iron deficiency.
Malnutrition has been long been recognised as a serious public health problem in Zambia and keeps on worsening.
Protein-energy deficiency results in low-quality breast milk that was not as caloric and nutritious.
Iron deficiency anaemia increases maternal and infant mortality rates, chances of stillbirth, cases of low-birth-weight babies, premature delivery and probability of fetal brain damage.
Ministry of Health Eastern Province principal nutritionist  sydney Kambowe said after six months, all babies were required to take complementary foods while breastfeeding continues for up to two years of age or beyond.
Mr Kambowe said complementary feeds should be timely, adequate, safe and proper.
He said breast milk was a natural producer of Vitamin.
The milk supplies the infant with sufficient amounts of Vitamin A while at breast feeding age.
According Lundazi Senior Agricultural Officer Fredrick Mwansa, food security was one of major elements of development and poverty alleviation in the country.
Mr Mwansa said food security was the major element of development for many international and national public organisations.
He said in Zambia, agriculture was currently playing a key role of supporting industries by the production of the required raw materials, producing exportable agricultural goods, and generating employment particularly in rural areas, as well as providing foodstuffs essential for the sustenance of acceptable nutrition standards and levels.
Mr Mwansa said although the phrase ‘food security’ was being used widely, its definition and concept was elusive and had evolved and expanded over time.
“All people at all times have both physical and economic access to enough food for an active, healthy life.
The ways in which food is produced and distributed are respectful of the natural processes of the earth and thus sustainable for both the consumption and production of food is governed by social values that are just and equitable as well as moral and ethical,” he said.
He said according to a report published by the Food Agricultural Organisation (FAO) in 2012, the state of food insecurity in the world was that around 870 million people, of which 852 million were from developing countries, were estimated to have been undernourished in period.
Mr Mwansa said the Zambian Government has continued with conventional farming and largely promoted maize mono-cropping.
He said new farming methods have emerged such as conservation agriculture which is aimed at improving productivity and environmental stewardship.
Care International-Zambia Project Management Communications and Advocacy Coordinator Joseph Mumba said the media was playing a key role in nutrition and health programmes although in the Zambian context, there was limited reportage on maternal and adolescent nutrition.
Mr Mumba said it was vital for the media to be adequately equipped to understand issues of behaviour change.
“Care International Zambia recognises the importance of the role the media plays in health promotion particularly maternal and child nutrition.
The organisation is cognisant to the fact that for the media to play their role in health promotion, they need adequate and relevant information,” he said.
The workshop attracted journalists from print and electronic media houses across Eastern Province. Globally, it is estimated that about 50 per cent of maternal mortality is directly attributed to postpartum hemorrhage, sepsis, obstructed labour, abortion and eclampsia.
Indirect causes of maternal mortality include malaria, anaemia and HIV/AIDS related conditions.
Other contributing factors include delays in accessing health care at community and health centre levels.
Although about 90 per cent of all pregnant women receive some kind of ante-natal care, only 43 per cent deliver in health facilities.
The number of supervised deliveries in the health institutions increased from 39 per cent in 2001 to 43 per cent in 2004. National antenatal coverage also rose from 86 per cent in 2001 to 95 per cent by 2003.
For the Prevention of Mother to Child Transmission (PMTCT) programme, an average of 5,000 women were counseled each month.
However, the main challenges in integrated reproductive health include shortage of appropriately trained staff, socio-cultural factors leading to delays in seeking health care, poor transport resulting in delays in reaching health facilities, poor quality of antenatal care, inadequate infrastructure, equipment, inadequacy of drugs and other essentials.
According to United Nations Fund for Population  Activities(UNFPA) report, it is estimated that , 289,000 women died of pregnancy or childbirth related causes in 2013.
It is not disputable that currently, maternal deaths and disabilities are leading contributors in women’s disease burden with an estimated 275,000 women killed each year in childbirth and pregnancy worldwide.
Women have gained access to family planning and skilled birth attendance with backup emergency obstetric care.
The global maternal mortality ratio has fallen from 380 maternal deaths per 100,000 live births in 1990 to 210 deaths per 100,000 live births in 2013.
This has resulted in many countries halving their maternal death rates.
While there has been a decline in world-wide mortality rates, much more has to be done.
High rates or mortality still exist particularly in impoverished communities, 85 per cent of which are located in Africa and Southern Asia.
The effect of a mother’s death results in vulnerable families and their infants. If the infants survive childbirth, they are more likely to die before reaching their second birthday.
While 99 per cent of such maternal deaths occur in developing countries, the United States was the only developed country in the world where maternal deaths increased between 1990 and 2013.
In 2013, about 28 women were dying for every 10,000 births compared to 12 women for every 100,000 births in 1990.
The world mortality rate has declined 45 per cent since 1990 but still 800 women die every day from pregnancy or childbirth related causes.
The child mortality rates have in the recent past shown some slightly decrease and during the period from 1992 to 2002.
Under-five mortality rate declined in Zambia by 12 per cent from 191 per 1,000 live births to 168 while infant mortality declined by 11 per cent from 107 per 1,000 live births to 95.
Despite the sharp decrease, the current child mortality rates were still unacceptably high in the country.
The major causes of child mortality are malaria, respiratory infection, diarrhoea, malnutrition and anaemia.
Whereas all these figures paint a gloomy picture, interventions by a conglomerate of Government and its stakeholders, such as care International, point to a brighter future for women and children.
Over the years, emphasis has been placed on public health interventions.
But a strategic approach of improving dietetic care in hospitals would be a major area of focus for improvement.
One critical aspect that needs to be considered is the dietetic management of in-patients and referrals for non-communicable diseases.