Maputo, 19 April 2013 – The UNICEF Global Nutrition Report 2013, released on April 15, highlights the grave problem of child stunting around the world. Mozambique is featured quite prominently in the report, as one of 21 countries with very high levels of stunting. We spoke to UNICEF Mozambique’s Nutrition Specialist Maaike Arts to find out why.
Q. Maaike Arts, what does the latest UNICEF Global Nutrition Report tell us about the state of child nutrition around the world? Maaike Arts: What this report tells us first and foremost is that stunting, also known as chronic malnutrition, is a big concern, affecting 165 million children around the world, or about 26% of all children under the age of 5. Stunting means that the child is too short for its age, which is a result of less than optimal growth either in the womb or within the first two years of life, or both. A stunted child is not only shorter than it should be, but it will also most likely suffer compromised cognitive development and have difficulties learning, and ultimately this will have a negative effect on employability, which in turn affects gross national product and the development of the nation itself. Stunted children are also at an increased risk of diseases, as well as overweight in later life. So this is a serious problem with a large impact.
Stunting can be decreased surprisingly quickly with the right interventions in place.
Q: What is the situation in Mozambique? MA: The problem of stunting, or chronic malnutrition, in Mozambique is very big, indeed, with 43% of children under 5 too short for their age. This puts us among the 21 countries with the highest prevalence of stunting in the world. Acute malnutrition (thinness) and underweight (weight for age) are both within acceptable range here, relatively speaking. In fact, the country is on track to achieve its goal with regards to the problem of underweight, which is a Millennium Development Goal. But this masks the problem of stunting, which is the issue that requires our immediate attention.
Q: What can be done about stunting? MA: Stunting cannot be treated nor reversed, but it can be prevented, and the report shows concrete and compelling examples from six countries that have managed to significantly reduce stunting. A wide range of issues need to be addressed in totality to make sure that children and mothers can thrive in conditions that discourage stunting, focusing on the 1,000-day window of opportunity between conception and a child’s second birthday during which stunting develops. Though interventions will need to begin earlier, before conception, by avoiding pregnancies below the age of 19, ensuring the proper nutritional status of women before and during pregnancy, and during the first two years of a child’s life. It requires a package of interventions in all areas connected to food, health and care. It is a multi-sectorial problem that requires a multi-sectorial response, and we are working with government and partners to make sure we have everything in place for that to happen.
Q: What is Mozambique doing to reduce stunting? MA: In 2010, the Council of Ministers in Mozambique approved a multi-sectorial action plan to bring stunting down to 20% by 2020. It is certainly doable, but all efforts need to be well-coordinated across the different ministries. SETSAN, the Technical Secretariat for Food and Nutrition Security, is the main entity in charge of this coordination, and reports directly to the Council of Ministers. Right now, several provinces are in the process of formulating their own plans, and UNICEF is supporting Zambezia in this, while the ministries are working to improve the quality and coverage of all the services that can help reduce stunting, including agriculture, healthcare, water, and education.
Q: What is UNICEF’s role in this work to reduce stunting in Mozambique? MA: Many of the interventions UNICEF supports are related to improving the conditions that can directly or indirectly cause stunting. Specifically, we support the multi-sectorial coordination lead by SETSAN. We also co-chair the Nutrition Partners’ Forum consisting of donors and UN agencies to make sure we are all up-to-date about what is being done and can work together. We support the Government in interventions related to infant and young child feeding, vitamin A supplementation and deworming, the treatment of acute undernutrition and the production and use of iodized salt. We also help increase the skills and capacity of health and social action workers, who are present in communities and work directly with mothers and children. UNICEF supports interventions related to immunization, the prevention and treatment of malaria, pneumonia, diarrhea and HIV, the improvement of water and sanitation facilities and practices, education and social protection measures, which all contribute to improved nutrition.
Q: How optimistic are you about Mozambique’s prospects in terms of solving the problem of stunting? MA: I am optimistic, and I have seen the momentum around stunting increase tremendously in the past couple of years. Ministries are onboard, as is donor funding. I believe we can make big change happen. But we will need to make sure our attention is focused on the right things. We all agree that people need to eat better in Mozambique, but for stunting to decrease, we need to focus our efforts on pregnant women and children under 2, and not only look at food but also at health and care practices. Our interventions, planning, budgeting, funding, everything needs to be designed in a more focused, targeted manner with stunting reduction as the end goal. We also need to strengthen monitoring and tracking of interventions and ensure accountability. Stunting can be decreased surprisingly quickly with the right interventions in place. We have seen it happen in other countries similar to Mozambique in terms of development such as Ethiopia and Rwanda, so it is possible.