Malnutrition remains a major health problem faced by Ugandans, especially women and children aged below five years despite the country being dubbed ’an agricultural economy’. The Uganda Demographic and Health Survey (UDHS) report of 2016 reports that 29 percent of Ugandan Children age 6-59 months are stunted (short for their age), 4 percent are wasted (thin for their height) and 11 percent are under weight (thin for their age). The report further indicates that 32 percent and 16 percent of women and men respectively in the age bracket of 15 to 49 are anemic, a condition which is as a result of vitamin and iron deficiency. Trends in the prevalence of anemia indicate that in 2006, 73 percent of children in the 6-59 months age bracket were anemic, but the percentage dropped to 49 percent in 2011 before increasing to 53 percent in 2016. 42 percent of women aged 15-49 were found to be anemic in 2006, and a decline in the trend was realized in 2011 by 19 percent (to 23%) before it also increased to 32 percent in 2016 (UDHS, 2016 and 2011).
According to the 2018 nutrition profile by USAID, malnutrition has far-reaching consequences for human capital, economic productivity and national development as a whole. The three forms of undernutrition (underweight, stunting and wasting) are costly to the country, given how much it spends on treating the victims. Moreover, school performance and overall human productivity are undermined since malnutrition affects the child’s brain development in their first years of life, not forgetting the human capital loss as people die due to malnutrition. According to World Food Programme (WFP), Uganda loses US $899 million annually due to the effects of malnutrition (an equivalent of a loss of 5 percent of Gross Domestic Product) and therefore necessitating a call for alarm.
Important to note is the fact that, in Uganda, the situation has been found to be worse in rural areas (30 percent) compared to the urban areas (24 percent). For instance stunting ranges from a high of 41 percent in Tooro sub-region to a low of 14 percent in Teso sub-region as reported by UNHS of 2016, which further confirmed that the challenge is enormous in Tooro where stunting affects one in four children, raising a question of why malnutrition is high in Uganda, especially the rural areas where the main activity is agriculture, moreover subsistence agriculture where the crops grown and the animals reared are basically for home consumption.
The government has shown commitment to improve the nutrition status of the country through different strategies, including the Uganda Nutrition Action Plan (UNAP), National Development Plan II (NDP 2015/16-2019/20), Health Sector Development Plan (2015/16-2019/20), Food and Nutrition Policy (2003), National Nutrition Planning Guidelines (2015), Multi-Sectoral Nutrition Coordination Committee Orientation Package (2017), and many others as aligned in the government’s vision 2040. Notwithstanding the government’s effort to curb the problem, some parts of the country are still way below nutrition related performance targets.
To reverse this trend, there is need to strengthen/support the existing community-based healthcare structures such as the Village Health Teams (VHTs) and health centers. Additionally, nutritional issues should be included in the scope of work of the community health workers which the government recently proposed to recruit. Creation of awareness is needed; so as part of their work, these teams should be responsible for teaching households how to manage food, and ensuring that smart, nutritious but affordable diet choices are made and teaching mothers the different food nutrients that a child needs especially for their first two years and the family at large.
Rehema Kahunde is a Research Analysis – Macroeconomics Department, Economic Policy Research Centre (EPRC)