The Fight Against Stunting Should Be Top Priority [opinion]

Eric Turyasingura chases after a ball made from plastic bags outside his mud-brick home in the mountains of southern Uganda.

Yelling in his mother tongue, Runyankore, “Arsenal with the ball! Arsenal with the ball,” he jostles with his younger brothers for possession. The fame of the English football club has reached even his little ears. Pretending to be a sports star offers a moment of escape from Eric’s daily struggles. At five years old, Eric’s tiny body already tells a story of poverty and lost opportunity. He is six inches shorter than he should be for his age.

His arms and legs are pencil-thin, and his head is out of proportion to his body. Because he is stunted, experts say his chances of growing up healthy, learning at full potential, and getting a job, let alone play professional football, have been greatly diminished. In 2013, a UN report said one in four children below five years across the world – a total of 165 million – was stunted.

The Lancet also estimated that under-nutrition contributed 45 per cent of all under-five deaths. Often beginning in the womb, as poverty-stricken mothers live hand-to-mouth, stunting can be a lifelong affliction. Studies show it is linked to poor cognition and educational performance, low adult wages and lost productivity. A stunted child is nearly five times more likely to die from diarrhoea than a non-stunted one.

Development agencies say significant progress has been made in ensuring children are properly nourished, and as a result, the incidence of stunting is declining. However, huge challenges remain especially in sub-Saharan Africa, where the proportion of stunted under-fives is two in five. With crises in South Sudan, the Central African Republic, Syria and now Iraq displacing millions of people, combating hunger and ensuring stunting rates don’t creep back up has become a top priority.

As UN Secretary General Ban Ki Moon said recently, we cannot eliminate extreme poverty, or achieve sustainable development or peace if one in eight people are chronically hungry. As such, the first pillar of the secretary general’s “Zero Hunger Challenge” aims to eliminate stunting in children under two years old.

Unicef is also a partner in the Scaling Up Nutrition (SUN) movement, another major global push bringing together dozens of countries in an effort to put national policies in place and implement programmes with shared nutritional goals.

One innovative programme – the Africa Nutrition Security Partnership – being implemented by Unicef and funded by the European Union since 2011, is combating stunting at the community and institutional levels.

Acutely malnourished children at risk of death are directed to clinics, and at the same time health institutions and partners are given the tools they need to improve infant and young child feeding practices and hygiene. The four-year programme focuses on Ethiopia (with a stunting rate of 44 per cent), Uganda (33 per cent), Mali (38 per cent) and Burkina Faso (35 per cent).

The aim is to change behaviour among households, set up systems for effective multi-sectoral approaches and increase government capacity. In Uganda, for example, community workers have been provided with smart phones, programmed with information about hygiene, postnatal care and proper infant and maternal diet.

The workers share the information with household members and then log their location on the phone’s GPS to prove they were there. In Mali’s capital, Bamako, funding has been provided to broaden a master’s degree to provide aanced training to healthcare professionals about how to best design and implement nutrition programmes.

In Ethiopia, schoolgirls are being encouraged to delay marriage and pregnancy until they are at least 18, as a way of preventing intergenerational under-nutrition. The increased focus on stunting by the humanitarian community is telling: its prevalence has become a kind of litmus test for the well-being of children in general.

A child who has grown to a normal height is more likely to live in a household where they wash their hands and have a toilet is more likely to eat fruit and vegetables, is more likely to be going to school is more likely to get a good job and is less likely to die from disease. Moreover, tipping the balance in favour of a child’s future is not as hard as some might think.

The simple act of reinforcing the importance of exclusively breastfeeding a baby for the first six months of hisher life, for example, increases an infant’s chances of survival by six times. Most of the regions where the partnership is being run have ample food to go around.

It is other factors, such as failing to properly wash and dry utensils after meals, selling nutritious homegrown foods at market rather than eating them, and cultural sensitivities to things like vegetables and eggs that are causing problems. As such, education programmes can make a real difference and save countless lives.

The other challenge is ensuring there is enough political will to keep those programmes running. It could only be a few short years before children from modest African communities like the mountains of southern Uganda get to really play for teams like Arsenal.

Dr Zagre is Unicef’s regional nutrition aiser for Eastern and Southern Africa and Ambassador Quince is head of the European Union delegation to the African Union.

Source : The Observer

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