Monday, April 3, 2017

Adressing stunted growth & poverty among Tanzania children


By Sauli Giliard @Mansauli

Mbeya. It is around five in the evening, with her four-month-old baby boy, Adeline Mwakyusa is busy at Mafiati juction, in Mbeya city centre—vending peas and bananas.

As vehicles start moving past a green traffic light, Adeline returns to her seat near the bus stop and starts breastfeeding her lovely son.

“The boy is now ‘eating’ his nutritious food, have you taken yours?” I joked.

She smiles at me and, defensively says, “At noon, I ate rice with beans to generate energy so that I can continue selling these fruits here.”

Adeline, in her early thirties, is among thousands of mothers in the country who are feeding their babies on unbalanced diet due to economic hardships and lack of knowledge on how to prepare nutritious food.

Nutrition contributes a lot in healthy child growth as well in learning, experts say.

Mbeya is among the top regions in the country with the highest level of malnutrition.

Despite being one of the top food producers in the country and home to varieties of fruits, birds and animals, 37.7 per cent of children in Mbeya have been affected by chronic malnutrition, according to Demographic and Health Survey and Malaria Indicator Survey conducted in 2015-16.

The situation has also contributed to the poor education performance.

Analysis carried out by Your Health from the National Examination Council of Tanzania (Necta) data shows that all districts in the region didn’t surpass 60 per cent of the pass rate, below the national target of 80 per cent in Primary School Leaving Examination (PSLE).

Reproductive Health Services and Child Care Coordinator for Mbeya Region, Ms Prisca Butuyuyu, Mbeya region says that women such as Adeline are very busy working in farms and vending food and other products until late hours.

With such busy schedule, she says, they forget to feed their babies properly at an early age since they were born. The consequence of that is seen in the rising cases of malnutrition and stunting of children.

“Despite the availability of enough food amid this era of climate change, most families in Mbeya have no habit of mixing various food nutrients in their meals.

“Because of this, when majority of mothers deliver, they fail to breastfeed their babies properly for six months without mixing with another food,” she says.

Pregnant women are supposed to start attending clinic within three months period after they conceive accompanied by their partners, something that is not happening in Rungwe District, according to Halima Kameta, the District Nutrition Officer.

“Most of them start to attend clinic in their last three months of their pregnancies, and if there is something wrong with their unborn babies, it becomes difficult to correct it,’’ she says. “This is the reason why malnutrition and stunting of children are here to stay,” the nutritionist says.

Roles of fathers

Husbands who fail to help their wives to attain their nutritional goals have contributed to the challenge.

Ms Kameta says despite males lagging behind in supporting their partners lift the burden of caring for unborn babies, their tendency to quit the responsibilities of taking care of a mother and the new born is what makes the children grow without having proper meals.

Selina Mwakyambiki, who vends milk and chapati at Tukuyu bus stop in Rungwe District, says when she arrived home with newly born baby girl 11 years ago from Tukuyu Hospital, her husband whom she declined to name, disappeared leaving her with the burden of caring for the child.

According to her, she used the money she had saved while operating her small business at Tukuyu bus stand. After three months, she returned to her business.

Kameta explains that Ms Mwakyambiki’s burden of raising her baby alone is a burden that women carry due to their irresponsible partners leading to stunting of children.

“When an expectant mother is not eating balanced diet, not attending clinic when she gets out of labour room, she can fail to breastfeed her baby and this can retard the growth of body and brain,” she said calling men to be fully involved in raising children.

Julius Lwinga, a Tukuyu resident says couples in the area have failed to draw a line between social and economic affairs and the victims are children.

Despite having little children who need special attention, Lwinga says, a father and mother can leave home early in the morning rushing to the income generating activities with less consideration of meal for their children.

Malnutrition and HIV/Aids

Apart from the lifestyle and lack of nutrition awareness, there is a link between malnutrition and places that have recorded high prevalence of HIV/Aids.

The 2011-12 Tanzania HIV/Aids and Malaria Indicator Survey (THMIS) shows that Njombe is most affected region as 14.8 per cent of its population living with HIV/Aids while stunting rate stands at 41.4 per cent according to 2015-16 study.

Iringa, where 9.1 per cent of population lives with HIV/Aids virus, the chronic malnutrition has hit 41.6 of its children followed by Mbeya which the survey indicated that 9 per cent of its population have been affected by HIV/Aids with its 37.7 per cent of its under five-years-old children being affected by chronic malnutrition.

Ruvuma is another Southern Highland region where the pandemic disease has affected 7 per cent of its population while the stunting is at critical condition where 44.4 per cent of children have been affected by chronic malnutrition.

Neema Lazaro, a social worker with an international health NGO focusing on eliminating chronic malnutrition Iringa and Njombe says there is a link between family members living or died of HIV/Aids in the two regions with stunting.

“In Makete district for instance, some of children that have lost their parents due to HIV/Aids, they have no option other than live with their grandparents who are poor. So, it is difficult to get balanced diet. Food cooked at night can be eaten three times,” she said.

The social worker goes on explaining that sometimes these children are living with HIV/Aids and they need balanced diet to grow adding, “If they miss this kind of care, of which grandparents can’t afford, they are at risk of being affected by chronic malnutrition.”

Linking the two, Mbeya region nutrition officer Lewis Mahembe says children who acquired the HIV are always sick and this affects their growth because their low immunity.

The nutritionist also says if a mother is the only family’s bread winner, following the demise of the husband, time to take care of her children is minimal because she spends most of her time on business or any income generating activities.

“You can see the link in the southern highland regions. The zone is highly affected by both HIV/Aids and malnutrition,” says Mahembe who was also the one of coordinators of 2014 nutrition status survey in the southern highland regions.

Creating awareness

Mbeya region in collaboration with non-governmental organisations are fighting to eliminate malnutrition. With the Sh60 million from UNICEF, the local government is insisting on attendance of clinic for expectant mothers and after they deliver to monitor the development of their babies.

Region’s Chief Medical Officer, Dr Seif Mhina says there are other stakeholders in the campaign to eliminate chronic malnutrition such as Africare, Catholic Relief Services (CRS) and Mwanzo Bora. The efforts to eliminate the problem begun in 2012 after it was learnt that many children in the country have been affected by chronic malnutrition where in Mbeya, the problem was above 50 per cent.

Nationawide, the government has embarked on the campaign that educate people how to prepare a nutritious food according to their income level.

Tanzania Food and Nutrition Centre (TFNC) acting director, Dr Joyceline Kaganda says the institution is creating the awareness to the community to move from thinking, “nutrition is all about ugali and wali” to embark on balanced diet that involves eating varieties of food that carries different nutrition including protein.

Ms Kaganda says the government’s five year plan is to reduce stunting from current 34.4 per cent to 28 per cent. “If we reach a time when the society can demand nutrition as their basic right is when we can achieve in reducing chronic malnutrition in the country,” she says.