By Staff Writers

Malnutrition is widespread across Lesotho. There has been little progress in addressing undernutrition, and over nutrition has emerged as a serious concern.

This growing double burden hinders the country’s potential for social and economic development and is estimated to cost the country $200 million (over M3 billion) annually in Gross Domestic Product (GDP).

This is according to the Fill the Nutrient Gap Lesotho Summary Report launched on Wednesday by Minister in the Prime Minister’s Office Temeki Tsolo.

Fill the Nutrient GAP Analysis (FNG) was conducted from March to August by the Food and Nutrition Coordinating Office (FNCO) and the World Food Programme, with the International Fund for Agricultural Development (IFAD), the United Nations Children’s Fund (UNICEF) and the United Nation’s Food and Agriculture Organisation (FAO).

The FNG process brought together stakeholders from a variety of sectors including health, agriculture, social development, education and the private sector.

According to the World Health Organisation (WHO), malnutrition refers to deficiencies, excesses, or imbalances in a person’s intake of energy and nutrients. The term malnutrition addresses 3 broad groups of conditions:

  • Undernutrition, which includes wasting (low weight-for-height), stunting (low height-for-age) and underweight (low weight-for-age);
  • Micronutrient-related malnutrition, which includes micronutrient deficiencies (a lack of important vitamins and minerals) or micronutrient excess; and
  • Overweight, obesity and diet-related noncommunicable diseases (such as heart disease, stroke, diabetes and some cancers).

According to the summary report, thirty-three percent of children under the age of five years are stunted and unlikely to reach their full mental and physical potential.

It states that although economic growth and overall improvements in the health sector resulted in a reduction of stunting by 10 percentage points (to 33 percent) from 2000 to 2014, the overall prevalence is still classified as very high according to World Health Organization (WHO) standards.

“In addition, overweight and obesity rates of adults have increased sharply over the last two decades, from 39 percent in 1999 to 54 percent in 2016, among women aged 18 or older, contributing significantly to public health problems,” reads the report.

The analysis found that factors that stand in the way of ending malnutrition include poverty, natural and man-made disasters, low consumer demand for nutritious food, low agricultural productivity, low prioritization of nutrition issues by government agencies, and limited commitment and capacity of local government units to deliver nutrition interventions.

In July, The Night’s Watch reported that Lesotho, a country which its head of state His Majesty King Letsie III is an African Union (AU) Champion for Nutrition, is experiencing a triple burden of malnutrition – under-nutrition, over-nutrition, and micronutrient deficiency across all age groups.

The Night’s Watch also reported that the nutrition sit­uation in Lesotho is characterised by wasting, high stunting rates in children under the age of five years, wide-spread micro-nutrient deficiencies in children, adolescents and adults and the growing incidence of diet related non-communicable diseases (NCDs) which are costing lives and imposing a burden on the health system.

Now the FNG Analysis has found that despite vast improvements made in health, nutrition remains a concern and the double burden of malnutrition is an issue for all most all wealth quintiles and geographic districts.

The district of Mokhotlong has the highest prevalence nationwide at 48 percent, and Mafeteng has the lowest at 26 percent, according to the report.

It reads: “Stunting prevalence also varies depending on wealth: in the lowest wealth quintile malnutrition is three times higher than the highest wealth quintile (46 percent and 13 percent respectively).”

The analysis also found that breastfeeding and complementary feeding practices are sub-optimal and recommended that “dietary diversity needs to be improved”.

Other findings:

  • Meeting the nutrient needs of adolescent girls and breastfeeding women costs more than meeting the needs of other targets. They are at higher risk for micronutrient deficiencies but little data exists to understand their vulnerabilities.
  • Household dietary diversity is low due to limited availability of fresh fruit and vegetables and low consumption of animal source foods. Livestock is an asset used for income generation but rarely for consumption.
  • Food insecurity and cost of a nutritious diet are higher in rural and remote areas. Vulnerabilities are increased by lack of access to markets. Seasonality has the highest effect on cost in rural areas.
  • Economic access is low: 56 percent of households are unable to afford a nutritious diet. One in ten households does not have enough money to cover their dietary energy needs, which exacerbates the impact of HIV.
  • Limited economic opportunities translate into a heavy reliance on social safety nets. Even though there are multiple existing programmes, they have not been able to ensure food security.
  • The primary school feeding programme has universal coverage and represents a strategic entry point to improve children’s diets.
  • Agricultural productivity is low and is expected to decrease as climate conditions worsen. Productivity is limited by sub-optimal agricultural practices but could increase through improving them and investing in infrastructure.
  • Micro, small and medium agricultural enterprises are too constrained to expand. Their participation along the agricultural value chain is limited.
  • Introducing interventions from all sectors can drastically reduce the cost and non-affordability of nutritious diets.

Every country in the world is affected by one or more forms of malnutrition according to WHO and combating malnutrition in all its forms is one of the greatest global health challenges.

Women, infants, children and adolescents are at particular risk of malnutrition.

WHO says in 2014, approximately 462 million adults worldwide were underweight, while 1.9 billion were either overweight or obese.

In 2016, an estimated 155 million children under the age of 5 years were suffering from stunting, while 41 million were overweight or obese.

Optimizing nutrition early in life – including the 1000 days from conception to a child’s second birthday – ensures the best possible start in life, with long-term benefits. NW

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