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26% of children under 5 stunted
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6% wasted
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13% underweight
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48% anaemic
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Many not exclusively breastfed
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Link between nutrition and intelligence
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USD50 million needed over 3 years
By Moses Magadza
WINDHOEK (September1, 2014): The Ministry
of Health and Social Services in collaboration with UNICEF, WHO and USAID will
today (Monday, Sept 1) launch the Child Survival Strategy: “A Promise Renewed
for Child Survival in Namibia” as the country moves to improve the nutritional
status of children under the age of five years.
South African music sensation Yvonne
Chaka Chaka who is also the UNICEF Goodwill Ambassador will join Prime Minister
Dr Hage Geingob, former Prime Minister Nahas Angula, Health and Social Services
Minister Dr Richard Kamwi and other high prolife officials at the launch.
Great
expectations
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| OPTIMISTIC:Defense Minister Nahas Angula |
The child survival strategy is part of
the outcomes of the broader Namibian Alliance for Improved Nutrition (NAFIN)
which Angula convenes. NAFIN will also today launch the Scaling Up Nutrition
(SUN) Country Implementation Plan to reduce stunting in the country.
Angula expressed optimism that investing
in the nutrition of children would benefit the country in the immediate and
long term.
“Good nutrition enhances child
survival,” he said in an interview.
Kamwi, who was one of the ministers that
met in the United States of America in 2012 to renew the promise on child
survival, said he was also excited about the launch.
“There are things that are dear to my
heart. This is one of them. There is no reason why we should let our under five
children die. We need to do something. We have been working hard and our
Demographic Health Survey which will be launched soon shows that there has been
a decline in child and maternal mortality. We are also seeing malnutrition
decreasing in our country,” Kamwi said.
He said although Namibia, like other
developing countries, would most likely not meet Millennium Development Goals 4
and 5 on child and maternal mortality, it was encouraging that the country had
made remarkable progress in that regard.
 |
| HAPPY: Health Minister Dr Richard Kamwi |
“Namibia is one of the countries that
are leading in addressing child and maternal mortality. We have a very high
ante natal care of about 97 percent while 87 percent of all deliveries take
place in facilities attended to by a skilled birth attendant. As a developing
country we should pat ourselves,” he said, adding that immunization rates
against measles were high.
“One of the killer diseases for children
under five years is malaria. Since 2010 Namibia has exceeded both the Abuja
Declaration and roll back malaria targets. We are eliminating malaria and this
has enabled us to significantly reduce HIV/AIDS mortality. Mother to Child
transmission rates of HIV/AIDS have gone down to about four percent.”
The SUN plan proposes the scaling up of
selected high impact interventions to contribute to the accelerated reduction
of under-5 morbidity and mortality in order to achieve national and
international targets by 2018.
Ms
Michaela de Soussa, the UNICEF Representative in Namibia said various studies
to determine the nutritional status on Namibian children show that although
much had been done, the country still faces major challenges.
She
cited the 2013 Namibian Demographic and Health Survey, whose preliminary survey
report indicates that 26% of children under five are stunted or short for their
age, 6% are wasted or too thin for their height, while 13% are
underweight. While this is a slight
improvement since the previous DHS which was conducted in 2006, de Soussa said
the results point to the need to do more in the area of child nutrition.
The
2013 DHS also reported that children 48 % of children under the age of five
years were suffering from anaemia. The
2006 DHS did not investigate anaemia amongst children. The MoHSS, with support
from UNICEF and WHO is now conducting a study on infant and young child feeding
practices, including breastfeeding and complementary feeding practices. De
Soussa said this study, which is expected to be finalized before the end of
this year, will provide information about what infants and young children are
being fed and whether this is nutritionally adequate to meet their growth and
development needs.
“The
findings will be used to improve the MoHSS’ programmes and services for women
and children with regard to nutrition.”
Most common nutritional problem
There
are different types of malnutrition and in Namibia, with the most significant
problem being a form of chronic malnutrition called stunting.
 |
| UNICEF Rep Michaela de Soussa |
“A
child who is stunted is too short for their age. However, there are other
developmental implications of stunting that affect a child’s potential as an
adult. Stunting results not only in
restricted growth in height but it also in cognitive development deficits that
are irreversible once the child reaches the age of two years,” de Soussa
explained.
She
said stunting was due to many different factors including poor infant feeding
practices such as inadequate duration of exclusive breastfeeding between when
the infant is born and reaches the age of six months. Poor complementary
feeding practices, whereby children are not fed the right amount of food, inadequate
variety or fed food of nutritional value can also cause stunting.
Other
causes of stunting include repeated illness and infection, poor maternal health
and poor nutritional status of young girls.
“One
of the most significant contributors to stunting in Namibia is likely the link
with poor sanitation and hygiene. The
practice of open defecation has been shown by research as a major contributor
to stunting.”
The
2013 DHS shows the region with the highest prevalence of stunting is Ohangwena (36.5%)
followed by Hardap (29.1%) and Karas (27%).
Kunene region has a stunting prevalence of 19.3%, which is below the
national average of 26%.
UNICEF
has been working with the MoHSS to develop and implement a programme whereby
Health Extension Workers (HEWs) are trained to operate in the most difficult to
reach areas of the country. The HEWs are
trained to detect acute malnutrition among other health and social issues and
to refer children and women to health facilities when necessary.
UNICEF
is also working in partnership with the Namibian Red Cross Society. Volunteers
have been trained to screen children for malnutrition and refer them to health
facilities.
Breast is best
De
Soussa said to improve the nutritional status of infants and young children,
Namibia should - apart from eliminating open defecation - increase the number
of infants who are exclusively breastfed from birth to six months of age.
“This
is not happening in Namibia. The DHS
shows that only 27% of infants aged six months are being fed only
breastmilk. When such infants are fed
other foods and liquids other than breastmilk, they become at much greater risk
of infections, illness and death.”
Elsewhere
children's food is fortified with key nutrients. De Soussa explained that Namibia has a
voluntary food fortification programme that has been running for at least the
past 10 years.
“Namib
Mills produces flour that is fortified with nutrients, which can be bought from
stores throughout the country. The
Namibian Alliance for Improved Nutrition (NAFIN), has commissioned a study to
investigate the feasibility of small millers fortifying flour. In addition to population based fortification
programmes, the MoHSS is investigating the potential for home fortification
using a micronutrient powder, which can be added to the food fed to young
children.”
Multi-sectoral approach
De
Soussa explained that to reduce stunting in the country, a multi-sectoral
approach is needed.
“This
means that sectors such as water and sanitation, agriculture, education and
social welfare need to take responsibility for investing in interventions that
have the potential to support improvements in the nutritional status of
children.”
Such interventions include support for home
gardens and improving household access to nutritious foods, elimination of open
defecation and increasing the number of people who wash their hands with soap
at critical times. Increasing social safety nets for families, improving school
meal programmes and improving national and regional preparedness and response
to emergencies and disease outbreaks are other options.
It
has been estimated that UDS50million is required to fully implement the SUN
country implementation plan over three years.
“If
fully implemented it is expected that stunting can be reduced to below 20% by
2016. If the goal to reduce stunting to
less than 20% by 2016 is achieved, not only will more Namibian children
survive, they will also have the potential to thrive.”
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| HOMEWORK: Poor nutrition is linked to poor learning outcomes |
Many
studies have shown that there is a positive correlation between stunting or
chronic malnutrition poor and cognitive development that affects a child’s
potential to learn. De Soussa said that
investing in nutrition has been proven to be one of the most cost effective
ways of achieving national development goals. –moses.magadza@gmail.com
Ends/.
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