Simple changes can reduce malnutrition Staple food prices Sensible interventions
Sheryl L Hendriks, professor in food security and director of the Institute for Food, Nutrition and Wellbeing at the University of Pretoria, considers the missing piece in fighting Africa’s malnutrition problems.
AFRICA has made great progress in the fight against malnutrition. Between 2000 and 2016 Senegal, Ghana, Rwanda, Ethiopia, Togo, Cameroon and Angola reduced undernourishment, child wasting, child stunting and child mortality by up to 56%.
As a result of these countries’ efforts, the proportion of hungry people on the continent dropped from 27% to 20% between 1990 and 2015.
The benefits of improved nutrition are widely known. Improved nutrition increases the incomes of households. This in turn raises the demand for food, enriches livelihoods and leads to more employment opportunities.
Many past initiatives to produce more food in Africa and combat malnutrition have focused on increasing the availability of staple foods such as maize, rice, wheat or cassava.
But too little attention has been paid to diversifying diets and on how policymakers can ensure that lowincome households can access the variety of foods they need to be healthy.
It is clear from food policy research that the continent needs to learn from past mistakes across the world. There have been a variety of approaches to tackle malnutrition.
In the 1960s and 1970s, it was widely claimed that lowering the price of food staples, the most inexpensive source of energy in the diet, would alleviate malnutrition. Globally, the price of food reduced significantly after the ’70s. But it turned out this was not a silver bullet.
In the 1980s vitamin A, iron and iodine deficiencies were added to the list of scourges frequently associated with lowprotein diets. A lack of nutrients was behind the severe impact on child development and pushed up stunting and wasting levels. But it was clear simply producing more lowcost, energydense foods that were widely consumed could not solve the malnutrition problem. Greater emphasis needed to be placed on foods with highperunit protein and micronutrient content such as animalsourced foods, fish, fruit and vegetables.
In the last decade, more attention has been paid to how to promote nutritionsensitive agriculture. This puts nutritionally rich foods and dietary diversity at the heart of fighting malnutrition. But there is a lack of agreement about the best way to do this at scale and in ways that drive widespread economic development.
Governments and policymakers face two problems. Firstly, they are trapped in a shortterm mode of planning. This neglects longterm development objectives that ensure sustainable growth in household incomes and a steady improvement in the overall availability of food.
Getting out of this will require a food security policy with a clear vision and defined timelines to achieve longterm development targets. In addition, governments also need to forge alliances with private sector actors to lead to changes in food systems. This will generate livelihood opportunities and a yearround supply of affordable and diverse food for all people.
Secondly, most policy actions for nutrition happen at the national level. They have significant potential for widespread behavioural change that can benefit nutrition. Restricting the advertising of unhealthy foods or incentives for healthy foods is a good example.
Yet, national policies have the potential to bring about largescale positive change needed for nutrition sensitivedevelopment programmes. National policies can also undermine such change by influencing what is grown, processed and marketed. But national development policies often prioritise other things, such as agriculture, poverty alleviation and economic growth, at the expense of nutrition.
The challenge is that nutrition programmes are hard to design.
Some nutritionspecific interventions have worked in reducing malnutrition. Examples are supplementation, complementary feeding for children and food parcels. Complimentary baby foods have provided essential nourishment for children between the ages of 6 months and 2 years old and have been shown to save lives and reduce stunting.
But to make even more progress in fighting malnutrition, policymakers need to be smarter and sharper with nutritionsensitive planning. For example, anticipating the demand for nutritious foods will increase if incomes increase should help with plans to meet this demand through programme development and intelligent investment.
Asia in the 1970s and 1980s is an example of how things can go badly wrong if not planned well. During the Green Revolution the price of staple foods reduced more quickly than prices of vegetables and pulses. This meant vegetables and pulses became less affordable for lowincome households. In some cases, these foods became entirely unaffordable.
If African food policy only focuses on supplying cheap starches, then the demand for nutritious foods will exceed the supply. The prices of these nutritious foods could be pushed beyond the reach of those the policy was designed to help.
One solution is to invest in value chains that meet multiple development objectives: ones that increase employment, improve incomes and make more nutritious food available. The aquaculture industry is a good example, as are dairy, fruit and vegetables. — the conversation.com