Nutrition, diet key factors in achieving Universal Health Coverage in Africa

Colorful fruits and vegetables colorfully arranged at a local fruit and vegetable market in Nairobi, Kenya. PHOTO: COURTESY.

Nairobi, KENYA: Experts have warned that unless countries in Africa start enacting measures to tackle the double burden of nutrition affecting the continent it will be very hard to achieve Universal Health Coverage (UHC) and Sustainable Development Goals(SDGs).

Poverty, hunger and disease have been reported to be the main drivers of malnutrition in Africa and have also been linked with poor living conditions, lack of education, insecure livelihoods, and lack of access to basic services including health care and healthy, safe, nutritious foods.

Every year, World Health Organisation estimates that 11 million Africans fall into poverty due to high out-of-pocket payments for healthcare.

Undernutrition, obesity and diet-related noncommunicable diseases have been reported to be huge contributors to catastrophic costs to individuals, to communities and to national healthcare systems in Africa.

Speaking in Nairobi during a meeting attended by experts, Dr. Matshidiso Moeti, the WHO Regional Director for Africa, said nutritional status is a critical component of a person’s health and well-being.

She says this must be recognized as a necessary building block towards achieving Universal Health Coverage (UHC) and the Sustainable Development Goals (SDGs) by 2030.

“Not only do current figures mean we are unlikely to achieve the six global nutrition targets for 2025 but also the more ambitious target of ending all forms of malnutrition by 2030, which is integral to the goal of ensuring healthy lives and promoting wellbeing for all, at all ages,” said Dr. Matshidiso Moeti.

She added that an exclusive focus of energies and finances on curative services and related medical equipment, supplies and medicines to treat diseases that often are rooted in malnutrition will limit chances of achieving health and wellbeing for all.

According to WHO, In 2016 an estimated 59 million children in Africa were stunted and 14 million suffered from wasting – a strong predictor of mortality among children under five.

In the same year, 10 million were overweight; almost double the figure from 2000. According to doctors, the burden of undernutrition still persists across the African region, and today its impacts are being felt alongside overweight, obesity and diet-related noncommunicable diseases in many poor households.

In a 2014 report on Africa, it was estimated that 5 percent of males and 15 percent of females over 18 years of age were obese. The same report showed that 8 percent of adults above 25 years of age had diabetes and that is expected to double by 2035, while hypertension affected 46 percent of adults.

According to Dr.Zawaira, Director of the Family and Reproductive Health Cluster at the WHO Regional Office, there has been a strong focus on addressing hunger instead of nutrition.

“In recent years, we’ve rightly focused many of our energies on addressing hunger, but what we must recognize is that ending hunger does not guarantee improved nutrition,” Said Dr. Zawira.

Experts say that Obesity and diet-related NCDs are largely the result of lifestyles characterized by limited physical activity and the consumption of unhealthy diets consisting of highly processed foods that are rich in calories, sugars, fats, salt and additives, but low in essential nutrients.

“When micronutrient deficiencies are taken into account, Africa is, in fact, experiencing a triple burden of malnutrition,” said Abdulaziz Adish, Deputy Regional Director and Nutrition Advisor, Nutrition International.

“Micronutrient deficiencies, which often pass unnoticed, are responsible for reduced bodily resilience and resistance to infections. They compromise early child development, negatively affect reproductive health and reduce work rate capacity,” he added.

It is estimated that almost 50 percent of pregnant women in Africa suffer from anaemia, which increases death risk for themselves and their unborn babies, as well as incidences of low birth weight.

According to Dr. Zawaira, improving nutrition sustainably requires consideration of how to produce, deliver and ensure access to healthy diets and essential nutrients and not just greater quantities of food.

“Tackling all forms of malnutrition for the achievement of UHC and the health-related SDGs requires remedial actions from multiple sectors and on many fronts, these actions include policies and community action to control the marketing and consumption of unhealthy foods and beverages (including breast milk substitutes); setting nutrition standards and dietary goals; nutrition labelling of processed foods; policies to promote consumption of healthy foods through taxation and subsidies; initiatives to promote consumption of fresh fruits and vegetables and increased physical activity; social marketing campaigns and multi-component community-based interventions, among others. ” Dr. Zawaira added.

Civil society and consumer organizations have also been called upon to continue looking out for the common good and holding stakeholders accountable for safeguarding public health.

The education sector has also been called upon to support the integration of nutrition and health promotion in the curriculum by coming up with initiatives such as having school garden projects, nutrition standards for school meals and controlling the marketing of unhealthy foods and non-alcoholic beverages in schools.