Solving Zambia’s malnutrition conundrum
Solving Zambia’s malnutrition conundrum
By Reginald Ntomba
Reginald Ntomba is coordinator of the Nutrition Learning Hub for CARE International’s Southern Africa Impact Growth Strategy. Based in Zambia, Reginald’s hub revolves around a network of people and resources focused on food and nutrition security in six countries – Zambia, Mozambique, Tanzania, Malawi, Madagascar and Zimbabwe. Three other Learning Hubs are located in Malawi, Mozambique and Tanzania focusing on gender, climate-smart agriculture and savings-led financial inclusion, respectively.
I find myself working in a sector that is seeking to solve one of Zambia’s big conundrums. We grow plenty of food yet millions of our people face nutrition insecurity. We grow maize, rice, millet, sorghum, sweet potatoes, pumpkins, cassava, groundnuts, beans, soya beans, cowpeas, fruits and vegetables - everything you need for a healthy diet - in abundance. There is no shortage of food yet we have a huge malnutrition problem.
Forty percent of children under age five in Zambia are stunted and 52 percent of child deaths are caused by malnutrition. CARE is working to improve people’s food and nutrition security, helping them respond to the changing climate and empowering women to contribute to development solutions.
Globally, there is a network of development stakeholders known as Scaling Up Nutrition (SUN). It’s a coalition of 59 countries working alongside their governments, civil society, the United Nations, donors, the private sector and academia to take collective action to improve nutrition. CARE is part of this global movement. SUN’s goal is that ‘by 2030, we will have a world free from malnutrition in all its forms.’ It's about ensuring that every child, adolescent, mother and family can realize their right to food and nutrition, reach their full potential and shape their own sustainable and prosperous societies. Achieving that is going to require collective action and the cooperation of leaders from the global level to the community level.
In Zambia and other countries, the problem of nutrition isn’t really about lack of food but lack of access to food and important information about food. When people don’t have the right information, they’re unlikely to make informed decisions about what and how much to grow and consume and how to preserve and store their food. The information they lack might vary depending on where they live. For instance, for people in urban areas who have money, accessibility isn’t the problem. They can access and pay for different kinds of food yet they still eat a monotonous and unhealthy diet that lacks essential nutrients because they only know how to eat, cook and store a limited range of foods. Having resources, accessibility and a wider choice of food doesn’t necessarily translate into people making healthy nutritional choices.
In rural communities, on the other hand, people eat what they grow. So, if their production isn’t diversified, it means they eat the same things over and over again. Diversifying production and growing a variety of crops requires specialized information and education opportunities that teach people how to widen their range of crop production and increase the amount of food available. Ensuring dietary diversity in this case starts with convincing households to diversify production.
Even when people eat the right kinds of foods, many still face serious nutrition insecurity because you can’t detach food from other poverty and inequality-related factors. People can eat plenty, but if they drink dirty water and their sanitation and hygiene conditions are poor, their nutritional status will still be compromised. You also can’t detach nutrition from climate change, which affects food systems and undermines food production.
While many complicated factors can negatively impact nutrition statuses, poverty, inequality and climate change override them all. Poverty might mean financial lack but might also mean a lack of knowledge and access to information. Inequality among members of families and societies impacts distribution of resources and access to services and both are made worse when you add climate change. People who live in unequal conditions have very limited or no ways of dealing with the climate change issues that directly impact their agricultural production, water quality and sanitation.
These interlinked issues are why we must implement both nutrition sensitive and nutrition specific approaches to nutrition programming. Nutrition specific programming to focus on the direct causes of malnutrition, and nutrition sensitive programming to focus on the underlying causes of malnutrition like water, sanitation, hygiene, food systems, climate change and social protection.
Nutrition can’t be compartmentalized as a single-silo problem, for instance, as simply an agriculture issue or health issue. It’s a development issue and if countries are serious about their development, they can’t afford to ignore nutrition. Using Zambia as an example, having a population where 40% of children under five are stunted, seriously truncates their future capacities and undermines the country's future human capital development. More broadly, it’s estimated that the cost of malnutrition in Africa and Asia consumes about 11 percent of the GDP.
In the last few years, many governments have incorporated nutrition policies in their development plans, but it’s not enough simply to commit to improving nutrition. That commitment must translate into tangible actions that will improve a country’s nutrition status. Resources must be allocated to actualize policies and governments are recognizing that one sector alone cannot do all that, hence the multisectoral approach. It’s going to take many departments, organizations and members of civil and academic societies to come together to put these plans in motion.
We should each be asking ourselves: what am I doing to contribute to improve food and nutrition security in my country?