Kenya, like other African countries, grapples with undernutrition and overnutrition.
At the national level, 26 per cent of children under five are stunted and will never attain their full physical and mental potential. Some 11 per cent are underweight while four per cent are too thin for their height.
While the levels of wasting and stunting have remained almost constant in the past 20 years, there has been a slight decline in underweight from 22 per cent in 1993 to 16 per cent in 2008.
The prevalence of undernutrition is particularly high in urban slums, where stunting among children under five is more than 40 per cent. This is occasioned by food insecurity (especially due to frequent droughts), poor access to clean water, infections (especially from diarrhoea, HIV and malaria), poor maternal nutrition, and poor child feeding practices.
The persistence of high levels of malnutrition, particularly stunting, may also reflect poor prioritisation and commitment to nutrition by the government and development partners, hence low budgetary allocation in the past. For instance, the government allocated only 0.5 per cent of its limited health budget to nutrition in the 2010-11 financial year.
Substantial levels of overweight and obesity have also been documented. At the national level, 25 per cent of women of reproductive age (15-49) are either overweight or obese. This is higher in urban areas at 40 per cent. Surprisingly, more than a third of women aged 18 and above in urban slums are also either overweight or obese.
Social and environmental factors at play include dietary and lifestyle changes, catalysed by rapid urbanisation and negligence.
Addressing malnutrition, therefore, calls for innovative strategies as well as political commitment if we are to achieve the Millennium Development Goals for 2015 or the World Health Assembly goals for 2025. There is need for a multisectoral approach.
Nutrition is no longer just a health problem, but a social and development one that needs to be addressed collaboratively by various actors, including government ministries (health, agriculture, gender, sports, culture and social services, finance, education, and water, etc), the private sector, civil society, researchers, and development partners.
There should be an effective coordination mechanism, only possible in the presence of strong political commitment. Countries such as Senegal and Rwanda that have implemented multisectoral action in nutrition programming are closer to meeting the MDG nutrition target than Kenya.
Kenya, like many other African countries, signed up (in 2012) to the Scaling Up Nutrition Movement, which brings together governments,civil society, the private sector, researchers, the United Nations and donors.
Sun implements both nutrition-specific and nutrition-sensitive interventions or strategies to address malnutrition.
In line with Sun’s objectives, Kenya has drawn up a national nutrition action plan for 2012 to 2017 that outlines 11 strategic objectives for tackling undernutrition and overnutrition.
They include improving the nutritional status of women of reproductive age. This entails nutrition education on eating healthy foods during pregnancy and strengthening iron and folate supplementation during pregnancy.
Second, improving nutritional status of children under five, which entails enhancing exclusive breastfeeding, timely introduction of complementary feeding and micronutrient supplementation.
Third, reducing the prevalence of micronutrient deficiencies in the general population through food fortification and supplementation.
Fourth, improving knowledge, attitude and practices on optimal nutrition.
Fifth, improving prevention, management and control of diet-related non-communicable diseases.
Sixth, enhancing evidence-based decision-making through operations research and strengthening coordination and partnerships in water, sanitation and hygiene, education, health, and livelihoods.
To achieve these objectives, a budget of approximately Sh70 billion was drawn up. Kenya has committed to spending Sh6 billion over five years to scale up nutrition interventions. The money will be shared across the ministries of health, agriculture, water and irrigation, fisheries development, andnational planning and development.
The rest of the money is being sourced from development partners. Kenya has to put in more effort to curtail the heavy double burden of malnutrition before it gets out of hand. With Vision 2030, Kenya may be on track to curtailing this burden. However, continued government commitment as well as that of other actors is critical.
Under devolution, 96 per cent of nutrition activities are now handled by the county governments. There is a greater need for advocacy at each of the 47 counties to ensure that nutrition is prioritised.
For civil society to effectively function there is need for strong monitoring and evaluation and engagement of users. Governments have a choice – to lose valuable revenue to fighting the diseases caused by under-nutrition, or to benefit from the increased revenue that comes from a healthy and productive workforce.
A new series of studies in The Lancet has revealed that 10 simple interventions could save close to one million lives every year. The Global Nutrition Report highlights the simple steps required to improve nutrition. They include greater spending, greater accountability in implementation of nutrition programmes, and more and better data about nutrition.
MPs can advocate and communicate the urgency to reduce malnutrition and stunting in households, communities, and the nation at large. Government should demonstrate more commitment by increasing investments in nutrition and ensure they trickle down to the counties. Civil Society should continue with its advocacy role and holding governments and other stakeholders to account for the resources.
Investment in proper nutrition is investment in a healthy and productive future generation.
Stephen Mule is MP for Matungulu and sits on the Parliamentary Health Committee and the Human Rights Caucus.