Profile of Malnutrition in EAC Cyprian OUMA
of all child 45% deaths associat ed with poor nutrition
Framework of Inequalities and Causes of Undernutrition and Mortality Insufficient access to Lack of good Inadequate access to affordable, nutritious CARE HEALTH FOOD sanitation & clean for mothers & children throughout the year & support for mothers on water services appropriate child feeding practices ROOTED IN IN Disempowerment Political & Cultural Poverty and Social of women Environment Inequalities
Where do the Malnourished Children live in EAC Data shows varying sub National levels Stunting Underweight Wasting
Where do the Malnourished Adults live in EAC Data Shows High Prevalence of Obesity and Overweight in Urban Areas. Women Obesity Men Women with Obesity any anaemia
Disaggregation shows varying Prevalence of Malnutrition
Current Trends and Progress Global Ranking Of EAC Countries By Various Types Of Malnutrition Shows More Needs to be Done Adult obesity 3 37 12 38 18 Anaemia 50 91 16 153 106 Wasting 78 53 26 50 60 Stunting 131 77 110 105 104 0 100 200 300 400 500 600 Burundi kenya Rwanda Tanzania Uganda • Highest national levels of stunting in Burundi and lowest in Kenya. • Highest wasting levels in Burundi and Lowest in Rwanda. • Highest levels of adult obesity in kenya and Tanzania. • Highest levels of anaemia in Tanzania. • Highest levels of overweight in Kenya and Tanzania and lowest in Burundi. • Lowest levels of anaemia in Rwanda.
EAC has more undernutrition but overweight and obesity are on the rise in urban areas Women who are obese according to BMI (>=30.0) 14.7 16 13.4 14 12.3 12.2 12.1 10.9 12 10.4 10.1 9.5 9 10 7.2 7.2 7 8 6.3 6.2 6.1 6.1 6 5.8 5.6 6 4.4 4.4 4.5 4.2 4 4.1 3.7 3.8 3.2 2.8 2.7 2.7 2.7 4 2.6 2.6 2.4 2.2 2.1 2.1 2 1.9 1.8 1.6 1.7 1.7 1.5 1.3 1.3 1.2 0.9 0.7 0.7 0.7 2 0.6 0 2010 2014 2008-09 2003 1998 1993 2014-15 2010 2005 2000 2010 2004-05 1996 1991-92 2011 2006 2000-01 1995 DHS DHS DHS DHS DHS DHS DHS DHS DHS DHS DHS DHS DHS DHS DHS DHS DHS DHS Bur Ken Ken Ken Ken Ken Rwa Rwa Rwa Rwa Tz Tz Tz TZ Ug Ug Ug Ug Total Urban Rural Overweight trend of numbers over last 5 years in EAC 463 447 500 393 393 400 326 290 300 200 131 119 50 50 100 0 Burundi Kenya Rwanda Uganda United Republic of Tanzania Number (000) Number (000)
Kenya
Rwanda 56.8 60 51.1 48.3 50 44.2 37.9 40 30 23.7 19.5 17.5 20 11.4 9.3 8.3 10 4.8 4.7 2.8 2.2 0 2014-15 DHS 2010 DHS 2005 DHS 2000 DHS 1992 DHS Children stunted Children wasted Children underweight
Tanzania
Burundi
Uganda
Drivers of Malnutrition are Multifaceted with Strong Roots in Income Poverty • In EAC, dietary patterns are variably affected by a whole range of factors including food availability, accessibility and choice, which in turn may be influenced by geography, demography, disposable income, SES, urbanization, globalization, marketing, religion, culture and consumer attitudes. Common drivers of diet in the region include • (a) Income and food prices • (b) Urbanization EAC.Retail market prices for selected food crops\Retail market prices, Beef, USD per • (c) Trade liberalization kilogram (2001 - 2013) • (d) Transnational food corporations ( franchises 3.50 and manufacturers ) 3.00 • (e) Retailing 2.50 2.00 • (f) Food industry marketing 1.50 • (g) Consumer attitudes and behaviour Source: East African Community
EAC.Retail market prices for selected food crops\Retail market prices, Maize flour, USD per kilogram (2005 - 2013) 0.80 0.75 0.70 0.65 0.60 0.55 0.50 0.45 2005 2006 2007 2008 2009 2010 2011 2012 2013 Source: East African Community EAC.Retail market prices for selected food crops\Retail market prices, Beans, USD per kilogram (2005 - 2013) 1 1 1 1 1 1 0 2005 2006 2007 2008 2009 2010 2011 2012 2013 Source: East African Community
Food ,Nutrition and Related Policies are Developed but not well funded for at scale implementation
Right To food EAC in 2009 published the draft bill of rights in which Article 23 – is Right to Food 1. Everyone has the right to adequate food and nutrition, which guarantees an adequate standard of living. Partner States undertake to improve methods of production, supply and distribution of food, and to this end, agree to promote greater regional cooperation in support of the relevant national policies Uganda The Constitution of the Republic of Uganda has directive principles that contribute to the realization of the right to adequate food. Uganda has become a State party to the International Covenant on Economic, Social and Cultural Rights in 1987 by way of accession. Burundi The Constitution of the Republic of Burundi has directive principles that contribute to the realization of the right to adequate food. The Republic of Burundi has become a State party to the International Covenant on Economic, Social and Cultural Rights in 1990 by way of accession. Tanzania The Constitution of the United Republic of Tanzania implicitly guarantees the right to adequate food through broader human rights. The country has become a State party to the International Covenant on Economic, Social and Cultural Rights in 1976 by way of accession. Rwanda Kenya The Constitution of the Republic of Rwanda does not explicitly The Constitution of the Republic of Kenya explicitly guarantees the guarantee the right to adequate food. The Republic of Rwanda has right to adequate food. The Republic of Kenya has become a State become a State party to the International Covenant on Economic, Social party to the International Covenant on Economic, Social and Cultural and Cultural Rights in 1975 by way of accession. Rights in 1972 by way of accession.
New Impetus Bridging Inequalities by Scaling up Nutrition in EAC The multi-stakeholder platform Works to align and coordinate action across sectors. Social Health Protection Burundi February Kenya 2013 August Agriculture Rwanda 2012 Women’s December 2011 Tanzania Empowerment June 2011 Development Uganda march Education 2011 & Poverty Reduction
Positive progress in EAC and Alignment to SUN Frameworks Incorporating Best Practices Creating Political and into National Policies Operational Platforms Increasing Resources and Monitoring Implementation Aligning Actions Across Sectors UGANDA A Nutrition Action Plan is scaling up multi-sector efforts for a strong nutrition foundation for Uganda’s RWANDA development. KENYA On 22 December 2011, the Republic of Minister for Public Health and Rwanda joined the SUN Movement with a Sanitation, Hon. Beth Mugo officially letter of commitment from the Minister of launched Kenya’s Nutrition Action Health. Plan (2012-2017) at the National SUN TANZANIA Symposium. BURUNDI On 26 February 2013, the Republic of Burundi The Ministry of Finance now joined the SUN Movement with a letter from HE, includes planning and budgeting Pierre Mupira, Second Vice President. At the for nutrition at level of national time, Burundi had finalized its multi-sectoral and local authorities. roadmap for scaling up nutrition.
Funding to Link Nutrition policy to action All EAC countries need to increase expenditure on nutrition policies & programs Domes
Tanzania Uganda
Rwanda
Messages and Calls to Action
Messages and Calls to Action • Multiple forms of malnutrition coexist in EAC and vary across countries ,regions, groups: • Underweight, wasting, stunting • Micronutrient deficiencies • Overweight/obesity and diet related NCDs • Malnutrition is not decreasing at the required rate and is affecting the majority of the EAC population. • The changing burden of disease should be tracked and included in development plans. • Strengthen national accountability/governance on nutrition • Implement multi sectoral actions to address malnutrition • Find more funding for implementation of nutrition action plans • Build alliances between nutrition & other communities • Identify the data gaps that hinder action — and fill them • Targeting expansions in services specifically towards the most disadvantaged may be more successful and cost effective than using limited resources to create across-the-board increases in services where they are not required by all
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