Government spending on nutrition programs for babies and mothers has increased more than six-fold in past 5 years but thousands of babies will not survive unless more cash is allocated, says a new study.
The World Bank commissioned a study to review Rwanda’s actions meant to tackle stunting which is far more serious here than in regional neighbors. Current figures show at least 38 percent of children under 5yrs stunt due to a combination of various factors.
Concerns over Rwanda’s stunting problem has dominated government policy discussions since at least 2016. President Paul Kagame himself, repeatedly scolds local officials over “bwaki”, a Kinyarwanda reference to the openly visible malnutrition seen just by taking a walk across Rwanda’s villages.
The dire impact of malnutrition is not among kids alone. A seperate 2012 study commissioned by the African Union said 49.2 percent or 3 million of Rwanda’s working-age population between the ages of 15 and 64 had suffered from stunting as children.
The situation is so serious that government has set up a specific agency charged with malnutrition in kids and their entite surrounding. It is called the National Early Childhood Development Program, headed by Dr Anita Asimwe, a former deputy health minister. In addition, there is state minister in charge of primary healthcare.
The World Bank study just published last week, looked at whether the resources available were enough to reach the government’s own target of bringing down child stunting level to less than 19% by 2024. It is actually also the time when Kagame’s current 7year tenure ends.
The study found that in the 2018 budget, more than Rwf 67.4billion was allocated to programs meant to improving nutrition for children. The funding caters for things like free fortified blended foods, deworming, free mosquito nets, free milk and nutrition centers.
At the individual child level, the study found that Rwanda is spending $5.8 (Rwf 5,640) annually on key aspects meant to prevent a child growing poorly.
“This amount is far below the recommended US$10 per under-5 child to provide a comprehensive package of nutrition interventions,” says the World Bank assessment.
In other words, the researchers, determined that for President Kagame and his team to reach their target of reducing stunting levels (below 19%), they must increase spending by 72.4%.
Currently, 83% of all annual funding to nutrition programs is from government’s own revenue, which the researchers found to be a very positive thing as it shows political commitment. The balance is from donors.
Should the government not put more cash into reversing the stunting trend in the country, the World Bank research paints a scary picture of what will happen.
The researchers say: “…it is estimated that a cumulative 751,000 children under 5 years of age will be stunted, 152,000 children will die, 325,000 children will have anemia, 273,000 pregnant women will have anemia, and 5,000 pregnant women will die.”
But why is dealing with malnutrition, and eventually stunting so crucial? Besides, government and World Bank data shows there is plenty of food, and much of it goes to waste in various ways.
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Well, if the financing needed isn’t available, then Dr Asimwe and her colleagues will be wasting time, at least as seen by the numbers. In four years time, here is how the country’s indicators will look like.
Malnourished children are more likely to fall sick from goiters, gum and eye diseases, anemia and other nutrition-related diseases that require outpatient care or hospitalization.
Stunted children have a 12.7 percent higher rate of grade repetition than non-stunted children and are more likely to drop out of school, which will affect their participation in the labor market. Nutrition-related illnesses contribute to high rates of absenteeism from the workforce.
As a result, malnutrition and related diseases have cost implications not only for the health sector but also for the broader economy.
Malnutrition leads to grade repetition, which is associated with a Rwf 2.37 million cost to the education system, private costs of Rwf 794 million of lost productivity in the labor market due to low educational attainment, and Rwf 309 billion in over 922 million working hours lost due to nutrition-related morbidity and mortality.
The cumulative impact of malnutrition “is estimated to result in a loss of 11 percent of GDP annually,” says the World Bank researchers.
In other words, if we don’t deal with malnutrition now, more than $1billion will be shed off the country’s GDP every year.