The state of food and nutrition in Africa,

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The state of food and nutrition in Africa, 1970s-1980s-1990s

The problem of food and nutrition in Africa

The report summarized here describes the situation as a deteriorating human tragedy with protein-energy malnutrition (PEM), that is, children weighing less than 80% of standard weight for age, affecting about 30% of children under five years of age. Fifteen countries show areas with PEM prevalence over 50%. PEM is also manifested in starvation caused by drought, social conflict, and other factors. Apart from reducing work output, PEM in pregnant and lactating women leads to low birth weight infants and poor growth in children. PEM of the deficiency type was reported in all the African countries, but obesity is now attaining a significant level in a number of countries. Next to PEM, and of equal magnitude, is anaemia, with a prevalence rate of 30% to 50% in pregnant women and lactating mothers, and 20% to 30% in children under five years. Iodine deficiency disorders (IDD) and vitamin A deficiency, apart from retarding growth and causing blindness, respectively, also worsen the effect of PEM and anaemia, and increase mortality and morbidity. Only eight African countries, mainly islands, are unaffected by IDD, while vitamin A deficiency was reported in 22 countries.

Other relevant areas highlighted in the report include: high infant mortality rates, high maternal death rates, poor environment and water supply, fast-growing urban and general populations, deteriorating agriculture, increasing food imports, poor food quality, inequitable land policies, and lack of agricultural inputs (seed, fertilizer, insecticide, and other chemicals).

Energy availability compared to requirements has always been on the low side, but between 1978 and 1979 energy production declined by 4% and remained about the same until 1985, when it began to rise. Several factors such as land tenure and land care, seasonal variation, human labour and skills for agriculture, low farm inputs, lack of farm security, and communication underlying the poor food production are discussed. A 3% annual increase in population as compared to a mean annual food production increase of 2% increases the food deficit much more. Although there have been successful community projects, none are large enough to counter the present trend of low food availability among most African communities.

The concept of the causes of hunger and malnutrition

Although there are several ways of looking at the problem, the report uses the concept of three levels of causes immediate, intermediate, and basic with an added dimension of actors as the individual, the household, and the community as a whole (table 1). These causes can also be seen as the remedies to the problem.

Recommendations

The report discusses many factors regarding hunger and malnutrition. Each of these needs attention if the problems are to be solved, but since resources are so limited it is necessary to focus on recommendations that are likely to have a high multiplier effect.

The problem of food and nutrition in Africa has not been critically analysed. Throughout the papers reviewed there was only a moderate contribution by African scientists. Therefore, the report recommends the introduction of new methods that will allow food and nutrition workers and other persons to have greater participation in assessing, analysing, and reporting the situation, and in planning and implementing action programmes.
Education and advocacy should receive top priority all over the continent. It is not enough for one country to do it because competitive intercountry food and nutrition activities like advertising, smuggling, and the black market are enough to frustrate the efforts of any one country attempting it alone. Education should involve the whole community, starting at the primary schools through to the university level. However, since it is the responsibility of senior country officials and leaders, a special campaign needs to be mounted for the leaders. Education should touch all aspects of hunger and malnutrition.
Research and training requires immediate attention. Africa needs a few centres that can conduct standard food and nutrition research using up-to-date methods and equipment. Community and household level research should be encouraged to answer the day-to-day questions of problem-solving, however. According to the report five to ten new training units should set up in the five AFRONUS subregions. Two have been started in Subregion 1 (in Nairobi, with support from the German Gesellschaft fur Zusammenarbeit, and in Harari, with Netherlands government support), but more support is needed for both. In Benin another school is in the formative state, with support from the Netherlands government. Possibilities of opening new schools in, for example, Zaire, Gambia, Nigeria, Mali, Algeria, Sudan, and Angola should be considered. National training centres that could be upgraded to subregional centres already exist in all the subregions. It is recommended that research be combined with training in one institute.
Utilization of locally produced goods, particularly foods, farm inputs, and implements is recommended strongly to encourage local workers. By limiting food imports farmers in the productive areas (mainly rural) could be assured of a market for their produce.
Methods of extending community services to the whole population in Africa should be developed through community research. Health services in 18 countries cover less than 50% of the population and 11 countries cannot provide water to 25% of their population. The problems are similar for education and agricultural extension services. In several communities old, neglected traditional practices, such as irrigation and food-storage methods, are being revived and improved upon.
As a basic change of direction, the creation of a system of cooperation and support among food and nutrition workers is recommended to allow collaboration of thoughts and actions that will benefit the entire continent. Through this and other means, intercountry food systems, policies, communication, etc., can be developed so that those less capable of producing food can rely on the more productive ones while developing nonfood materials.
It is strongly recommended that Africa learn to look to its own resources to solve the basic problems of food and nutrition on the continent.

Action plan

Historical note

The report emphasizes the importance of united action as the most effective way of solving the food and nutrition problems in Africa, but also notes that some workers believe that concentration on individual country action would be more effective. The desire to unite food and nutrition workers into one organization began during the early 1970s in west Africa, culminating in the 1st African Nutrition Congress in 1975. Intercountry communication and cooperation increased in 1979 when representatives from five countries of eastern, central and southern Africa (ECSA) met in Gaborone, Botswana. The meeting became the start of an ECSA cooperation in food and nutrition activities. Today ECSA covers 16 countries and has a full time coordinator at the Commonwealth Regional Health Secretariat.

A second congress was held in Ibadan, Nigeria, in 1983. This congress also ended without a formal agreement as to how the African scientists could cooperate, but since ECSA was fairly well organized by the mid-1980s, an African group attending the 1985 IUNS congress in Brighton, UK, met and requested ECSA to host the 3rd Africa Food and Nutrition Congress in Zimbabwe in 1988. This congress stressed that special priority be given to training and manpower development, food and nutrition policy for Africa, organization and cooperation of food and nutrition workers and the formation of the Africa Council for Food and Nutrition Sciences (AFRONUS).

The formation of AFRONUS may have marked the beginning of a continent-wide cooperation and action on food and nutrition. At present, Africa, as individual countries or as a continent, is completely unable to meet the demands of the food and nutrition problem. External assistance is required each time the problem worsens. At the "normal level," a token government service by a few people is provided by national nutrition units or institutes. Some of Africa's nutrition units were started as early as the 1940s, and to date they have not come near solving the food and nutrition problems, mainly because of their limited mandate and lack of resources. However, many units have pointed out the defects in the African food system. The report also highlights the vital role played by external agencies in the control of food and nutrition situations. Were it not for UN agencies and some NGOs, many more Africans would have died.

Africa must have its own way of dealing with the problem, and it is this aspect AFRONUS wants to explore most. The plan emphasizes organization and management of food and nutrition activities by local people. To start with there may be many failures, but eventually they will learn from their own mistakes.

Another weak aspect of food and nutrition programmes is the dependence on external planners and financiers. It is true that Africa is poor, but it is difficult to understand the inability of people to feed themselves due to poverty even where there are vast areas of unused arable land. The plan aims at developing an African internal capability to feed itself.

In this new approach Africans must volunteer first and foremost and, to set an example, the food and nutrition scientists and workers in Africa are challenged to contribute to the programme fund; African contributions may be small, but they are essential.

TABLE 2. Specific strategies for achieving the general objective of the plan

To join the African food and nutrition workers into one professional body to allow combined thought and action.

To work out and initiate solutions to hunger and malnutrition in Africa on a larger scale and on a more permanent basis, with particular attention to advocacy, education, and food production.

To create cooperation and harmony between the African food and nutrition workers and external agencies.

To create policy instruments through working jointly with OAU and individual African governments.

General objective of the plan

The general objective is to significantly lower the prevalence of hunger and malnutrition in Africa. It is not possible to fix a time limit, but each country should try to state its target for the year 2000. Strategies and activities for achieving this objective are listed in tables 2 and 3.

Implementing procedure

The advocacy campaign

The campaign called "Africa without Hunger" is a series of video education materials linked to the rest of the programme for eliminating malnutrition. The intent of the campaign is to produce a series of nine educational films aimed at decision makers at all levels. Such a series will require significant financing. Therefore, the first film will be produced when finances are available from donors. The films will be made in such a way as to attract viewers (as educational entertainment) and donors who will be asked to purchase most of the copies, so as to pay for the production of the other eight films.

This campaign is essential because the success of the whole food and nutrition programme depends on the actions of political and government leaders, university and school teachers, researchers, and the senior business community. Although some very important steps in this direction have already been taken, it is not enough to convince a few top leaders. A critical mass of convinced executive leaders is essential. Efforts should therefore be made to convey similar information to as many leaders as possible. A small study conducted by AFRONUS in 1990 indicated that even in countries where there is no television service most of the leaders own television and video sets and they purchase and watch video films for pleasure and educational benefit. Where there is a television service the films can be shown to all viewers. The nine film themes suggested include:

hunger and malnutrition with abundance in Africa,
food security—the family options,
food and nutrition policy the status report and action,
forms of malnutrition and how to manage them,
community and household food and nutrition activities,
land and water management in food production,
food storage, transport, and processing,
food preparation—weaning and adult diets, 9. government and leaders' responsibility.

AFRONUS has solicited technical assistance from a number of experts, particularly the Educational Broadcasting Services Trust, UK, who have expertise in preparing such films and have free access to the BBC archives and others. Efforts have also been made to solicit African experts on film-making in French and English.

Fund-raising and country group meetings and plans

Activities have to start at the national level, but as this continues AFRONUS has to concentrate on fund-raising. Donations for the Africa Fund for the Eradication of Hunger and Malnutrition in Africa have to be raised through various professional methods applicable to Africa. Methods similar to those applied by SCF (UK) or any other suitable organizations could be used. Without some degree of success in the advocacy campaign and the fund-raising project, it is not possible to pursue the rest of the programme.

Monitoring and evaluation

Indicators for monitoring the progress of some of the projects are shown, but it is not possible to specify impact indicators before getting details of the national plans. Once every four years the AFRONUS Secretary-General, with the help of evaluation teams, will report on the state of each project.

Funding

AFRONUS has to take responsibility for raising funds from any sources, but with emphasis on contributions from Africa. The mechanism for doing this has not been developed and AFRONUS will appreciate advice from anyone.

TABLE 3. Specific activities for achieving the general objective of the plan

Form AFRONUS subregions and country committees (to date two of the five subregions have been formed). Register and establish an AFRONUS office, staff (initially voluntary), create a fund at council, subregion, and country levels, and establish relations with relevant research bodies in Africa.

Conduct meetings to review the situation, select priorities, and assign duties at all three levels.

Publish regular reports of the food and nutrition status and activities at country, subregional, and regional levels, and circulate them to other equivalent levels (e.g., country to country). Such reports should include a list of all food and nutrition institutes and experts.

Encourage food and nutrition research, and at the same time start subregional training centres—one postgraduate and one for training intermediate cadres of country trainers in each subregion.

Monitor food and nutrition status; explore the use of mass media, e.g., one or two broadcasting stations capable of reaching most of Africa.

Reorient institutes of learning, researchers, and educators on food and nutrition through educational literature. Develop food and nutrition textbooks for schools, colleges, and universities.

Work towards specific goals set for each country, particularly on food production, reduction of malnutrition, and incorporation of food and nutrition programmes into national plans.

Create a consultative body of AFRONUS consultants to work with the various agencies involved in food and nutrition and facilitate cooperation and support for national action groups. Where necessary the consultative body can work with any African government in examining the country problems and formulating solutions using AFRONUS experts.

Request and use already compiled agency data as a starting-point.

Monitor food aid, food imports, production, IMF activities, and other food and nutrition related activities.

Join the OAU food and nutrition commission and, if possible, work with OAU in establishing a technical secretariat or department of food and nutrition.

Develop African food and nutrition policy guidelines. Initial steps should aim at developing guidelines for nutrition workers, i.e., what should nutrition workers do in their countries?

With the help of the IUNS and other nutrition research organizations, collect, publish, and disseminate useful past survey and research data and results for the purpose of application. Many very useful papers are published outside Africa, but little is available to African workers even at university level.

Encourage young researchers in schools and universities to embark on food and nutrition studies.

Identify food and nutrition activities in progress and determine neglected areas in every country.

Compile food production data for each district or province and identify deficit and surplus areas. A map showing provinces or districts is essential.

At the country level compile PEM prevalence data per province or district. This may prove very difficult, but it has to be done. Small sample surveys using students or junior staff in each district may be enough to start with. Without these data the food production data are not of much use. Where maternal and child health (MCH) services are widely spread and child growth records kept, samples of the cards will provide data which, although biased, are better than nothing.

Assess food and nutrition training needs and facilities. Subregion 1 (ECSA) has conducted an initial survey and circulated its report to all subregions.

Start and strengthen the Africa Fund for the Eradication of Hunger and Malnutrition.

Convene an Africa Food and Nutrition Congress once every four years.

Comment on the effect of, e.g., food aid and or structural adjustment policies on the nutrition status of Africans. Studies and comments can be limited to, e.g., SAP policies and food price or food availability; SAP policies and food imports and exports; food aid effect on farmer prices and food imports; food aid in inducing change of palate; food aid and the saving of lives in emergencies; misuse of food aid; UN agency programmes on food and nutrition. The studies can be conducted in several ways, such as interviewing beneficiaries of a programme.

Compile and distribute an African directory of food and nutrition experts, institutions, industry, and related institutions outside Africa. All concerned (i.e., specialists in food science and technology, food scientists, nutritionists, dietitians, and other related and interested African scientists) are requested to send their details to the AFRONUS Secretary-General, P.O. Box 20265, Dar es Salaam, Tanzania. The 1992-1996 manuscript is ready for printing.

Once every four years AFRONUS is to consider and adopt a document on the regional food and nutrition status and the plan of action for the following four-year period. This means updating this IUNS report every four years.

AFRONUS will participate in determining and implementing activities of the UN Food and Nutrition Decade for Africa.

The role of the IUNS

Research, training, and formation of AFRONUS are the areas of greatest need now and IUNS can be of great assistance in any of the three areas.

The report was compiled by T. N. Maletnlema, with contributions from the following:

»IUNS Working Group II/3, on Food and Nutrition in Africa members: Marie-Therese Basse (Senegal), Leslie Burgess (UK), Frits van de Haar (Netherlands), Gladys Martin (Cameroon), Nago C. Mathurin (Benin), Richard Orraca-Tetteh (Ghana), Alex P. Vamoer (Zambia), Zwodie Worlde-Gabriel (Ethiopia), T. N. Maletnlema (Tanzania);

»IUNS Committee 1/10, on Food and Nutrition in Africa—members: 1. Semega-Janneh (Gambia), Safia Giama (Somalia), C. Nago Mathurin (Benin), R. Orraca Tetteh (Ghana), Leslie Burgess (UK), Frits van de Haar (Netherlands), Tsire Maribe (Botswana), Estefanos Tekle (Ethiopia), T. N. Maletnlema (Tanzania);

»other contributors of data: Elizabeth Morris Hughs (FAO, Rome), K. Gobotswang (Nutrition, Botswana), Osman M. Galal (USA), Beverley Carlson (USA), Kenneth Vernon Bailey (WHO, Brazzaville), R. Andrianasolo (Madagascar), Godwin P. Kaaya (ICIPE, Kenya), Katagile (ILCA, Zimbabwe).

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