The Double Burden of Malnutrition in East Africa and its connection to Poverty
Definitions and causes
Malnutrition is a major health challenge the world is currently facing. There are three forms of malnutrition; undernutrition, micronutrient deficiency and non-communicable diseases that are diet related such as obesity and overweight. Stunting, wasting and underweight are different forms of undernutrition. Stunting is the development of a low height for someone’s age, wasting is the development of a low weight for a someone’s height and underweight is the development of a low weight for someone’s age.
The double burden of malnutrition is referred to as the joint occurrence of undernourishment and overweight and obesity. This phenomenon can occur due to a shift in food systems, mainly in low- and middle-income countries. It is caused by an increase in the availability and affordability of fast-food and drinks that are nutrient-poor. In some cases, new emerging technologies are causing a reduce in performing physical activities such as transport, which can also contribute to the malnutrition burden. Low- and middle-income countries who were already struggling with the burdens of undernutrition and micronutrient deficiency, now have to deal with the burdens of overweight and obesity as well.
Double Burden of Malnutrition in East Africa
As mentioned before, the double burden of malnutrition is mainly severe in low- and middle- income countries. East Africa is a good example of a low-income region that is struggling with the double burden of malnutrition. The East African region contains a couple of the poorest countries in the world and is struggling with low agricultural productivity, bad infrastructure, a lack of market competitiveness and unreliable governance. These factors all impact the distribution, accessibility, affordability, availability and security of food. Due to these factors, the shift in food systems and poverty, East Africa is dealing with different forms of malnutrition. Not even a single country in East Africa is able to achieve the goals for tackling malnutrition on different levels such as male and female diabetes, low birth weight, male and female obesity and anaemia.
Especially stunting is a major burden in East Africa; 35,2% of children under the age of 5 is experiencing it, which is a significantly higher percentage than the average global prevalence of 21,6%. The wasting prevalence of children under 5 is 6% and 4,3% of them is overweight. The prevalence of male and female overweight is 16,3% compared to 32,6%. For obesity this is 2,8% compared to 10,1%. The male and female prevalence of diabetes is 5,9% compared to 5,6%. The prevalence of stunting under the age of 5 and the differences in overweight and obesity rates of women compared to men are striking. The last remarkable prevalence is the occurrence of anaemia in women of reproductive age; 31,3%. These East African numbers are consistent with evidence stating that infants, children, adolescents and women in particular are at risk for malnutrition.
The poverty cycle of malnutrition
Poverty has a double effect in terms of malnutrition; it increases the risk of malnutrition and also the severity of its consequences. People living under poorer circumstances are dealing with a lack of availability, accessibility and affordability of an adequate amount of nutritious foods. Therefore, they are more likely to be affected by malnutrition and have to struggle with decreased productivity, slowed economic growth and higher healthcare costs. The higher risk of malnutrition and the increased severity of consequences due to malnutrition can cause a cycle of poverty and illness. The cycle of poverty has a worsening impact on the double burden of malnutrition.
Consequences
Malnutrition can affect organ functions and the recovery of the human body in a detrimental way. Especially organ systems such as the cardio-respiratory system, the immunity system and the gastro-intestinal system are affected by malnutrition. Impaired muscle functions, poor wound healing but also psychosocial effects are possible due to malnutrition. Furthermore, malnutrition can have major long term social, medical, economic and developmental effects on an individual, family, community and country level. The healthcare systems of East African countries have to deal with the new disease burdens. Interventions to reduce malnutrition are necessary to overcome the difficulties of the joint occurrence of undernutrition, micronutrient deficiency and the increase of overweight and obesity in East Africa.
