Improvements in nutrition and stronger government policies have led to a decline in childhood stunting, according to a new report on child nutrition by the UN Children’s Fund (UNICEF). However, the condition continues to affect some 165 million children under the age of five globally.
Stunting can lead to irreversible brain and body damage in children, making them more susceptible to illness and more likely to fall behind in school. Based on UNICEF’s report, IRIN has put together a round-up of the nutrition situations in six East and Central African countries that are among 24 countries with the largest burden and highest prevalence of stunting.
Burundi: Under-five mortality in this small central African country dropped from 183 deaths per 1,000 live births in 1990 to 139 per 1,000 live births in 2012. This is far short of the 63 deaths per 1,000 live births necessary for the country to achieve UN Millennium Development Goal (MDG) 4, which aims to reduce child mortality by two-thirds by 2015. An estimated 58 percent of children under age five are stunted, compared with 56 percent in 1987, according to demographic and health surveys from those years.
According to the UNICEF report, Burundi has made “no progress” on MDG 1, which aims to eradicate extreme poverty and hunger.
Central African Republic (CAR): An estimated 28 percent of under-five deaths in CAR occur within the first month of a child’s life; the biggest killers of children under five are malaria, diarrhoea and pneumonia. The percentage of children under age five who are stunted has changed little since 1995, standing at 41 percent in 2010, as has the percentage of children who are underweight, which has remained at about 24 percent for the last 18 years.
There has, however, been significant progress in the number of mothers exclusively breastfeeding their infants. In 2010, 34 percent of infants under six months old were breastfed, compared to just 3 percent in 1995. According to UNICEF, infants who are not breastfed in the first six months of life are “more than 14 times more likely to die from all causes than an exclusively breastfed infant”.
Democratic Republic of Congo: Africa’s second-largest country bears 3 percent of the global stunting burden, with 43 percent of children under age five suffering from stunting and 24 percent being underweight. Stunting is significantly higher (47 percent) in rural areas than it is in urban areas (34 percent).
The percentage of children who are underweight dropped from 34 percent in 2001 to 24 percent in 2010. DRC’s progress towards MDG 1 is described as “insufficient”.
Ethiopia: The Horn of Africa nation, which bears 3 percent of the global stunting burden, has seen a steep drop in stunting levels, from an estimated 57 percent in 2000 to 44 percent in 2011. The percentage of underweight under-fives has also dropped significantly, from 42 percent in 2000 to 29 percent in 2011. Between 2000 and 2011, under-five mortality was cut from 139 deaths per 1,000 live births to 77 per 1,000 live births - within striking distance of its MDG 4 target of 66 per 1,000.
A national nutrition programme launched in 2008 has been key to reducing national food insecurity, a major cause of stunting. The country’s health service extension programme has also played a role in bringing nutritional interventions to villages.
Rwanda: Community interventions - such as kitchen gardens and increasing the availability of livestock, as well as measures to boost healthy infant feeding practices like exclusive breastfeeding and the provision of nutritional supplements - saw the percentage of underweight under-fives in Rwanda drop from 20 percent in 2000 to 11 percent in 2010. Enhanced data collection and analysis has also enabled the government to improve its planning and monitoring of child malnutrition.
The report describes the country as “on track” to meet MDG 1.
Tanzania: Bearing 2 percent of the world’s stunting burden, Tanzania has made significant strides in improving child nutrition. An estimated 50 percent of infants under six months old were breastfed in 2010, compared to 23 percent in 1992. The country has also brought under-five stunting levels down from 50 percent in 1992 to 42 percent in 2010, but continues to suffer significantly higher stunting in rural children (45 percent) compared to urban children (39 percent).
Tanzania’s under-five mortality rate dropped from 158 per 1,000 live births in 1990 to 68 deaths per 1,000 live births in 2010, putting it close to its MDG 4 target of 53 deaths per 1,000 live births. UNICEF’s report says the country is “on track” to meet its MDG 1 targets.