Nutrition (UNICEF)

Proper nutrition is a powerful good: children who are well nourished are more likely to be healthy, productive and able to learn. Malnutrition is, by the same logic, devastating. It blunts intellect, saps productivity, and perpetuates poverty for any family and society it touches.      

While significant progress has been made in ensuring proper nutrition for children, challenges remain throughout the world. For Eastern and Southern Africa, stunting, also referred to as chronic malnutrition (low height for age), is of a particular concern with more than 25 million, or 40 percent of children under five years of age suffering from it.

“One of the most compelling investments is to get nutrients to the world’s undernourished. The benefit from doing so – in terms of increased health, schooling, and productivity – are tremendous.” - Vernon Smith, Nobel laureate economist

In addition, 18 per cent of under-fives are underweight (they weigh too little for their age); and 7 percent are suffering from acute malnutrition (also called wasting, a rapid loss of weight because of illness or insufficient food intake). Unlike underweight and wasting, stunting is largely irreversible, and it is affecting more children than the first two conditions combined in the region.

There are many factors contributing to malnutrition. One of the most significant is the low rate of exclusive breastfeeding from birth to six months of a child’s life. Studies have shown that exclusive breastfeeding is one of the single most effective interventions to combat child mortality. Yet, in ESA, just over half of infants are being exclusively breastfed in that crucial period.

Furthermore, inadequate complementary feeding for children older than six months, low consumption of iodized salt by households, low vitamin A coverage for children under-five, and anaemia during pregnancy, all contribute to malnutrition in children.

As data have confirmed, malnutrition starts in utero and increase markedly from three to 23 months of age. Ensuring adequate nutrition during this “1000 days window of opportunity”, therefore, is critical in preventing long-term and irreversible damage to children’s health and cognitive and physical development.

Routes to better nutrition:
- Adequate food and nutrient intakes through promoting agriculture and food security;
- improving social protection, including emergency relief;
- ensuring access to health care, including maternal and child health care, water, hygiene and sanitation, immunization, education, family planning, among others.

Together with more than 100 organizations and groups, UNICEF is a partner in the Scaling Up Nutrition (SUN) movement, a global effort to advance health and development through improved nutrition at country levels. The partnership focuses on implementing evidenced-based nutrition interventions and integrating nutrition goals into broader health, development and agricultural efforts.

To tackle the widespread and growing problem of malnutrition, UNICEF, together with the European Union launched Africa’s Nutrition Security Partnership (ANSP) to improve nutrition security among women and young children on the continent. The partnership aims to address the root causes of malnutrition, and create an environment of pro-nutrition policy and programmes.

UNICEF also works in the following areas:
Infant and young child feeding
Under the Guiding Principles for Complementary Feeding of the Breastfed Child, UNICEF advocates exclusive breastfeeding in the first six months of life and continued breastfeeding up to two years and beyond.

Micronutrient deficiencies
Many lives can be saved and improved through a range of cost-effective interventions, including micronutrient supplementation and fortification. To this end, UNICEF supports countries to deliver vitamin A supplementation to children 6-59 months through routine health programmes and also campaigns such as the Child Health Days. It also fosters partnerships to support countries on salt iodization, and leverages funding, commitment and innovations for better essential vitamin and mineral intake of children.

HIV and nutrition
HIV has a profoundly negative impact on the nutritional status of children. While the interactions between HIV and nutrition exist at many levels, nutrition programmes are often rolled-out in a more vertical fashion. In response, UNICEF, together with partners, works on integrating service delivery for prevention and treatment of HIV and under nutrition in children.

Integrated management of severe acute malnutrition
Given the lack of a systematic approach to the scale up of community-based management of acute malnutrition, a framework for integration of management of severe acute malnutrition (IMSAM) into national health systems has been developed and is being piloted in the region.

Results for Children
Over the years, awareness of nutrition issues, particularly stunting, has increased, thanks to advocacy informed by researches and partners. Sixteen out of the 21 countries in ESA now have improved nutrition plans that no longer treat nutrition as a standalone sector, but one that needs to be integrated with health, agriculture, sanitation, welfare, education and others. Most countries in the region have bi-annual mass vitamin A supplementation as part of the Child Health Days campaign, together with other high impact interventions such as de-worming, immunization and distribution of insecticide-treated mosquito nets.

Countries are increasingly recognizing Integrated Management of Acute Malnutrition (IMAM) as part of the minimum core package of nutrition interventions. Seventeen of the 21 countries in the region have begun to build national capacities to scale up this approach.