One in every three people globally suffers from malnutrition. And nearly half of all countries in the world face multiple serious burdens of malnutrition such as poor child growth, micronutrient deficiency and overweight adults, according to the 2015 Global Nutrition Report.
Three years after the World Health Assembly set the 2025 goals to improve undernutrition, countries across the globe have scaled up their programs to address malnutrition. The 2015 nutrition report reveals this is not nearly enough to meet the assembly’s targets.
The targets are to:
- reduce stunting in children under the age of five by 40%;
- reduce anaemia in women of reproductive age by 50%;
- reduce low birth weights by 30%;
- reduce and maintain childhood wasting to 5%;
- improve exclusive breastfeeding to 50%; and
- ensure there is no increase in overweight children.
Out of 74 countries that were analysed for the report, Kenya is the only country that is on track to meet all five targets by 2025. This is mainly based on its achievements in the last few years.
Kenya has reduced stunting to 26%. Its low birth weights are down to 5.6% and it has improved exclusive breastfeeding to 61.4%. Childhood wasting and obesity both sit at 4% and anaemia in women of reproductive age has been reduced to 25%.
Of the remaining 73 countries, only four others – Colombia, Ghana, Vanuatu and Vietnam – are on course for four targets.
So what is Kenya doing right, and how can it continue with its progress?
A bold plan
Kenya’s National Nutrition Action Plan 2012-2017 has been central to it combating malnutrition. There are several elements that have led to the strategy being successfully implemented.
Strong government leadership and co-ordination
A Nutrition Interagency Co-ordinating Committee, which was formed and is chaired by the government’s head of nutrition, has resulted in well-co-ordinated structures that implement actions around nutrition. Within these structures, all the stakeholders both inside and outside the government have clear roles and responsibilities.
The committee includes a network of government ministries: Health, Education, Agriculture, Planning, Labour as well as United Nations agencies, civil society, academic and research institutions, the private sector and multilateral and bilateral donors.
A budget of US$687 million (KES70 billion) was drawn, and the Kenyan government committed a total of US$58 million (KES6 billion) of public funds to the five-year plan.
Kenya has also forged international partnerships to boost the plan. Since 2012 it has been part of the global Scaling Up Nutrition movement. The movement is made up of 55 countries committed to improving their nutrition figures. This has helped to develop an approach that works across sectors to implement nutrition-specific and nutrition-sensitive interventions and strategies.
Support from donors
Kenya’s network of development partners, which include the UN system and bilateral donors such as the European Union, the US, Japanese and UK governments and the World Bank, are all making commitments to support the national nutrition initiative.
Good monitoring and research
And to measure progress around the nutrition indicators, Kenya has incorporated strong monitoring and research and information management and sharing. It has guided how the nutrition plan is implemented and overseen by a nutrition information working group in the health ministry.
Improved human resources for health
The government and its implementation partners have increasingly enhanced the capacity of the healthcare staff. They support nutrition counselling by training healthcare workers on high-impact nutrition interventions such as importance of infant and young child feeding.
The impact of policy changes
The National Nutrition Plan is part of a roadmap to success, called Kenya Vision 2030. Along with the nutrition plan, it draws on other strategies and policies:
The infant nutrition strategy makes sure high-impact, cost-effective nutrition interventions like promoting breastfeeding and other maternal, infant and young child nutrition practices are implemented at health facilities in communities.
Along with Kenya’s newly promulgated constitution, the roadmap has brought positive changes to improve the Kenyan people’s health status.
One of these changes is a free maternity policy, which encourages more deliveries at health facilities. This has increased the number of babies born with a trained attendant at a facility from 43% in 2008 to 61% in 2014, based on the recent national survey.
Birthing at a facility results in care for the mother and baby after birth before going home. Mothers are taught how to adequately breastfeed and are counselled on family planning and babies get the required vaccinations.
Another change is the recently enacted Breast Milk Substitutes (Regulation and Control) Act. The act protects, promotes and supports breastfeeding. Better breastfeeding practices leads to better child growth, development and survival.
What next?
Kenya is on track to achieve these highly ambitious but critically important global nutrition targets. But more needs to be done.
Despite the strong commitment by the Kenyan government to raise close to 10% of the budget to implement the national nutrition plan, more government resources are critical to ensure success.
Although co-ordination is strong, there are still some gaps that need to be addressed, particularly around convening powers. To address these, discussions are underway to establish a Multi-sectoral Food Security and Nutrition Secretariat and a Nutrition Technical Committee. The secretariat would fall under the office of the oresident while the technical committee under the cabinet secretary for health.
A systematic investigation of the success factors is needed to ensure the entire country is on track to achieve these targets. But the championing of optimal nutrition is universal.
With sustained investment, sustainable progress towards our goal as a nation to ensure a high quality of life for everyone – beginning with the first day of their lives can be achieved.
As Kenya marks National Nutrition Week, promoting good nutrition as a human right, the Kenyan government must increase its support to the national nutrition plan to ensure that every child born in Kenya has a healthy start.
Betty Samburu, programme manager at the maternal infant and young child nutrition programme within the Kenyan Ministry of Health; Marjorie Voleje from UNICEF and SUN Movement and nutritionist Grace Gitau also contributed to this article.