Address malnutrition to reduce economic burden

Friday December 28 2018


By Tonny Odokonyero

Malnutrition is a misfortune that strikes universally - no single country boasts of being untouchable in the face of malnutrition. World over, a great deal of children under the age of five years grossly suffer as a result of malnutrition.

Despite the global and domestic commitment to fight malnutrition, progress has remained slow, both globally, and in some instances stalled. The problem is graver for Africa, and in particular, Uganda.
At the global level, for example, the Global Nutrition Report (GNR) for 2018 shows that stunting has reduced but at a slow rate, to 151 million children under five years globally (about 22 per cent) from 198 million (about 32 per cent) between 2000 and 2017, but the numbers are increasing for the case of Africa, with stunting at 30 per cent.
Most countries are not on track regarding progress on globally adopted nutritional outcome targets set to be achieved by 2025. Generally, Africa is home to most of the countries suffering from high levels of at least two types of malnutrition.

In Uganda, progress has been made in reducing some aspects of malnutrition such as wasting and stunting. However, the level of malnutrition is still unacceptably high.

Stunting among children under five years is at 31 per cent and 27 per cent for boys and girls, respectively. About 15 per cent of child deaths are associated with malnutrition.

Apart from the health hazards (stunting, wasting, obesity, under-weight, low-birth weight, etc.), malnutrition erodes the economy.

The economic burden across the globe due to malnutrition is estimated at close to $4 trillion annually, according to the latest GNR. These are costs incurred directly and indirectly by individuals, households, and nations.


The direct cost is healthcare, for example, the cost of a full course of therapy to save the life of a wasted child is between $100 (Shs365,000) and $200 (about Shs735,000).

Indirect costs include compromised labour productivity, reduced income due to illness, and poor educational performance, among others. All these contribute to economic costs or losses for the economy, arising from foregone investments and economic growth due to sufferings and preventable loss of life as a result of diet-related Non-Communicable Diseases.

To put the economic burden into perspective, Uganda’s Gross Domestic Product (GDP) is approximately $27 billion. By corollary, this implies that every year, malnutrition can potentially destroy nearly 150 economies of the size of the Ugandan economy across the globe.

Particularly for the Ugandan economy, considering wasting alone, if the current trend of malnutrition continues, the projected number of wasted children under the age of five years will be at least 250,000 and 256,000 in 2019 and 2020, respectively.

Therefore, if existing malnutrition trend holds, then Uganda will on average incur a direct economic loss worth $76 million (about Shs280b) over the next two years due to wasting in children.

This excludes indirect costs. The overall economic burden of malnutrition is therefore enormous.

Accordingly, something must be done differently to tackle malnutrition in order to abate the economic and health losses it inflicts on the economy.

The GNR points out critical areas where fundamental nutrition-related problems lie, and accordingly, countries should domesticate important recommendations such as ensuring that nutrition action plans or related policies are costed, funded and implemented.

Countries should also strive to improve nutrition-specific funding and spending. In addition, for Uganda, implementing locally devised interventions prescribed in the nutrition action plan must be fast-tracked. This involves, among others, increasing access and utilisation of nutrition services, for example through scaling up community-based nutrition initiatives.

Efforts should also enhance access and utilisation of diverse nutritious foods at household level, for example through interventions that support development of farm enterprise mix to ensure steady production and supply of diversified foods, and integrating nutrition into agricultural programmes at all levels.

Overall, malnutrition must be tackled through a multisectoral approach, given that it manifests in distinct forms.

Implement a holistic package of nutrition actions through healthy-diet policies or programmes – multisectoral efforts must stimulate actions that address malnutrition in all forms.

Different sectors, agencies, and development partners must work together to ensure all coexisting types of malnutrition are dealt with through integrated and coherent interventions.

The author is a researcher at Economic Policy Research Centre, SPEED for Universal Health Coverage.