Malnutrition costs Uganda sh2 trillion

By Joseph Ssemutooke

As part of its annual series, Ugandan Making a Difference, New Vision will, until October 3, publish articles on individuals and organisations that have dedicated their efforts to fighting malnutrition in the country. The articles will highlight the causes, discuss solutions and recognise the efforts of those working to avert the problem that is affecting a big part of our population.

About sh1.8 trillion ($899), which represents 5% the Gross DomesticProduct (GDP), is the total economic loss Uganda incurs for every childthat is malnourished.One of every three children underfive years is stunted as a result of under-nourishment. Also, 54%of adults get stunted during their infancy. This is according to the Cost of Hunger in Uganda study, a first-of a- kind study carried out to establish the costs of child under-nourishment to the country’s development and prosperity agenda.

The findings from this study were released two months ago. The Ugandan study was part of a larger continent-wide study dubbed Cost of Hunger in Africa (COHA). It was a joint effort of the African Union, the World Food Programme (WFP)and local governments of the 12 participating African countries. These include Kenya, Tanzania, Rwanda, Ethiopia, among others. It was aimed at establishing the national socio-economic costs of child under-nourishment.Uganda was only the first of the 12 participating countries to complete its arm of the study and publish findings.

Importance
According to Prime Minister Amama Mbabazi, the study was crucial because it painted a definite picture of a ‘worrying’ situation. It also highlighted the fact that economic growth was not sufficient to transform the community if no special attention was devoted to correcting the nutrition situation.

Explaining how the study came to its conclusions, Lydia Wamala from WFP, says a team of researchers and analysts considered the entire life story of a child who is a victim of poor nutrition. This was done by looking at the  effects of under-nutrition suffered through the child’s life-time and attaching financial value to them/ relating them to the economy as a whole.

The economic costs of poor child nutrition were found to generally come in three major guises. These include increased medical costs to treat diseases caused by poor nutrition, impact on education and training as well as productivity at the workplace

Medical costs
The report came up with medical costs as the most direct economic cost of poor child nutrition to the country. It pointed out stunting and wasting (the first low height for age and the later low weight for age) as almost inevitable burdens among undernourished children.

It also pointed out a higher risk of experiencing health problems. These include anaemia, diarrhoea, malaria, intrauterine growth restriction and respiratory infections, as the biggest burden because stunting and wasting may not themselves cause direct health expenses.

According to the report, susceptibility to disease among underfed children causes direct economic costs to the country, as for every sick child, both the family and health system face additional treatment costs. The report also endeavoured to establish whom of families and the government carries the bigger burden of health costs when children suffer under-nutrition.

It was found that families suffer most, meeting up to 87% of the direct medical costs of children who fall sick due to under-nutrition, while the country’s health system meets 13% of the costs. The amount of money annually lost to medical costs relating to undernutrition was projected to stand at sh525m, representing 29% of the total economic cost of child under-nutrition to the economy (using 2009 figures).
Education costs
From medical costs, the report found education to bear the next significant socio-economic cost of under-fed children, costing the country about sh19b ($9.5m) per year. “When a child is under-nourished, that child’s brain is less likely to develop at healthy rates and that child is more likely to have cognitive delays,” the report states. Under-nourished children are more likely to either suffer poor grades and repeat classes, or drop out of school, costing the country and families money.

Also, in the long-run, a child who repeats becomes a burden to the country as it means spending more resources on a child to cater for theirextra year. As the cost of additional instances of grade repetitions is met by both the education system and families, the study was also tasked to find out who shared what percentage of the costs. It established that the families/ caretakers of repeating children meet 54% of the repetition costs.

This includes buying uniforms, exercise and text books and paying school fees where children attend private schools. The education system/Government meets 46% of the costs, which include
hiring more teachers and building more classrooms.
Labour force
Of the three major forms in which child under-nutrition costs Uganda’s socio-economic terrain, this was found
to bear the biggest part of the burden, representing 1.2 trillion (66%) of the total sh1.8 trillion lost to child undernutrition in 2009.

The report considers the effect of child under-nutrition on productivity under the divisions of those engaged in manual labour and those engaged in non-manual labour. On the side of manual labour, where 88% of Uganda’s working adults fall, workers who suffered stunting as children tend to have lean body mass. Therefore , they are more likely to be less productive in manually-intensive activities than those who were not
affected by retardation.

The report also indicates that child under-nutrition further affects the economy’s productivity by robbing the country of would-be members of the labour force through child mortality.With 15% of Uganda’s annual child mortality projected to be as a result of under-nourishment, the report projected that 567,000 people who would have been of working age and part of the labour force in 2009 had been lost to nutrition-related child mortality over the preceding years.
Solution
Speaking at the study report’s launch two months ago, Amama Mbabazi promised to ensure that the Government intensified efforts towards addressing child undernutrition in the country. He said Uganda had already embarked on high-intensity efforts to address the situation, through measures such as increasing financing to nutrition, establishing the Uganda Nutrition Action Plan (UNAP) and becoming a signatory to the Scaling Up Nutrition (SUN).

The UNAP is a five-year (2011-2016) action plan, which was designed by the National Planning Authority in conjunction with ministries such as that of the Prime Minister, education and health.

It is meant to spell out a multi-sectoral roadmap towards barnishing child under-nutrition in the country within a short time. The SUN campaign is a global cone that was launched in 2010 to work towards the realisation of proper child nutrition in countries like Uganda that suffer a high incidence of the problem.

The battle has not been left to the Government alone. According to Wamala, several international organisations are also putting in their own shifts to help out. These include WFP, Unicef and Oxfam, among others. According to the UNAP, the country’s target is to have reduced the burden of the problem by more than 70% by 2016.

Do you know any individual or organisation focusing efforts on improving nutrition in communities? Write to the Features Editor, P.O. Box 9815 Kampala or e-mail features@newvision.co.ug giving name, telephone contact of nominee and reasons for nomination. Type food, the nominee’s name and SMS to 8338