By DOMINIC CHANDIWILA NALI –
UNDER-NUTRITION has been recognised by many as one of the biggest problems affecting development efforts in the rural communities in Zambia today.
According to a 2012 National Food and Nutrition Commission Report, the previous stunting levels in Zambia were at 47 per cent, but with interventions put in place, the country’s stunting levels reduced and are currently standing at 40 per cent with Luapula Province alone being rated at 56 per cent.
This has highly been attributed to previous nutritional policies and traditional farming methods that had characterised the agricultural sector in rural Zambia since time immemorial.
Other problems associated with under-nutrition have included issues to do with mono cropping, higher rural poverty levels and poor access to social services, markets and infrastructure among others.
“When we compare with Africa, Zambia is within the stagnating range of 40 per cent, but according to UNICEF, about 300 million deaths of the under five children are caused by under-nutrition worldwide” said the Programme Against Malnutrition (PAM) Project Coordinator Precious James Watanuka.
Ms Watanuka said if under-nutrition and stunting were not taken care of, they would cause serious implications such as prolonged period of illnesses among the children and being susceptible to various infections on a frequent basis.
Before Zambia became a signatory to the Scaling-Up Nutrition movement five years ago, nutrition was not seen as a serious priority, simply because the majority of policies were focused more on national food security and less on diversification and nutrition security.
This was as a result of inadequate resources, lack of effective coordination, and absence of nutritional donor agencies or insufficient advocacy strategies.
In that instance, the little nutritional interventions available were not well coordinated because they completely fell mostly within the health, education and agriculture sectors.
This situation to a larger extent made it difficult for the ministries to reach out to the majority of the households in most rural part of Zambia.
According to Ms Watanuka, the ministries of Education, Health and Agriculture were the only major stake holders on issues to do with stunting and nutrition, hence the little efforts that were applied to reach out to the affected communities because of funding issues.
She further indicated that such a situation eventually created a very big gap in the implementation process of nutritional activities.
“In the Ministry of Education, yes nutritional programs were there, but issues such inadequate funding affected most of the planned activities,” said Ms Watanuka.
Under-nutrition is an important determinant of maternal and child health in particular because this is the outcome of multiple causes, such as inadequate food intake, inadequate child feeding practices, poverty, and poor access to education, health and social services.
Under-nutrition also includes being underweight for one’s age, too short for one’s age, too thin for one’s height and deficient in vitamins and minerals.
And the most susceptible in this case are rural households who heavily depend on seasonal food production and survive mostly on diets that are lack in a variety of micronutrients.
Another group of concern in the nutritional sector are pregnant women who are at a very high risk of giving birth to an underweight baby who could also become vulnerable to growth failure during infancy and early childhood.
“In women, under-nutrition is caused mostly by a number of problems such as, poor food preparations, less diverse food intake, lack of general cleanliness, poor water and sanitation and having worms that take away food nutrients from the body,” said Bridget Chileshe, a nurse in-charge at Njipi Rural Health Centre in Samfya District.
It is because of such that the Program Against Malnutrition has taken it upon itself to ensure that nutritional programs are implemented and benefit the intended targets in different communities in Luapula Province.
These nutritional activities under the umbrella of Scaling-Up Nutrition (SUN) program were currently being implemented in Samfya and Mansa districts where a number of nutritional food supplements were being given to a number of selected households.
The programme’s focus is mainly to contribute towards the reduction of under-nutrition and stunting by implementing activities meant to scaling up nutrition for a healthy community.
SUN also endeavors to raise the nutritional awareness and status among vulnerable groups hence their various food security and nutrition programmes which are being promoted among the communities in the past one year.
Samfya District acting nutritionist, Mwansa Chewe said, “Our main focus is to reduce the levels of stunting and under-nutrition among the children below the age of five, that’s why we picked about 300 children from Njipi alone and grouped them into two.”
Mr. Chewe further said that these two groups were divided into what is called treatment and control groups, implying that the treatment group consisted of very serious undernourished children compared to the control which just needed to boost up their nutrition and avoid disease infections.
“When PAM came, they brought two products such as spirulina and Heps just to promote them among the community but we had challenges in picking the beneficiaries because the programme was mostly associated with satanism by members of the community,” Mr Chewe said.
He added that “At the moment, the program is doing fine and the community has finally seen the benefits in the supplement and have since accepted them”.
These food supplements that PAM is promoting among the communities have the ability to modulate immune functions and are being used as a measure to reducing stunting among children.
“We have a new product that is being promoted for the first time in the Luapula Province and it is called spirulina a micro algae and it is very nutritious,” said Ms Watanuka.
Ms Watanuka said PAM is not only promoting spirulina, but has also trained members of Chumfwa Women Group to locally produce the product so that it can readily be available to households and individuals who might want to use it.
The safety of these food supplements have also been established through numerous researches conducted especially to evaluate their effectiveness in promoting health and controlling various human disorders.
Health promotions, targeting knowledge enhancement about the production, processing, promotion and marketing of these food supplements among the community is at the moment being used by PAM as a means for adaptation and sustainability purposes.
“Our friends in Kenya and Madagascar have even gone far beyond in terms of using spirulina and as I am speaking right now, they are using it on people living with HIV/AIDS and on those that are suffering from Tuberculosis,” said Ms Watanuka.
Obviously, rolling out such a multi-sectoral response to stunting and under-nutrition among the children demands strong and effective governance and leadership for effective planning, coordination and monitoring at all levels.
The need to focus on the crucial period from conception to a child’s second birthday had been a key issue under the scaling up nutrition project because of the need to ensure that various cost effective interventional activities were implemented.
In this case, activities such as food processing and utilization and infant feeding trainings are interventions that PAM is using as a tool to tackle common public health problems affecting the majority rural communities.
“As Ministry of Agriculture, we are promoting activities such as, food processing and utilisation, food preparation and preservation as well as cookery demonstration,” said Mansa District Nutrition officer, Joyce Kalumba.
Ms. Kalumba said that under production, her ministry is also encouraging SUN beneficiaries under PAM to produce high nutritious crops like Orange maize and Orange sweet potatoes that are fortified with vitamin A.
According to Ms Kalumba, if two farmers grew orange and white maize varieties, it would be very obvious that the one with orange maize would have benefited more than the one who grew white maize because there would be a difference in terms of nutrients.
“Besides what I have said, we are also promoting growing of Mbereshi beans among the SUN beneficiaries because these varieties are very rich in minerals such zinc and iron that are important especially for pregnant mothers,” said Ms Kalumba.
It is clear that the level of under nutrition among the children in Zambia is very high, as such commitment to changing this situation holds out the prospect of a real decline in under nutrition over the coming years.
There is need also for a multi-sectoral approach to strengthen nutrition, not only in the health sector but other sectors in conjunction with the various stakeholders.
More than ever, Zambia today needs to focus and monitor progress, in its efforts to reduce levels of under nutrition especially among women and children. – NAIS