The 2017 FAO State of Food Security and Nutrition in the World Report reveals that 815 million people go hungry and yet there is more than enough food produced in the world to feed every one. A 2018 survey by UWEZO disclosed that 70 per cent of Ugandan households are hungry without food.
In many parts of sub-Saharan Africa, including Uganda, dietary deficiency, a form of hidden hunger, remains a persistent health and development challenge for governments. Diverse factors have been attributed to exacerbate and perpetuate hunger and malnutrition, ranging from climate change effects and shocks, and conflicts, among others.
The Uganda Demographic and Health survey (UDHS, 2016) reveals that 29 per cent of children under 5 are short for their age and stunted; a reflection of cumulative effects of chronic malnutrition with a high 41 per cent in Tooro sub-region, which is renown for high food production enough to feed its own and neighbouring districts.
Similarly, 53 per cent of children from six to 59 months, suffer from some degree of anaemia and about one in three women aged between 15 and 49 (32 per cent) are anaemic. Not surprising, the same survey details that the prevalence of stunting, proportion of children who are underweight, decreased with increasing wealth.
Stunting, weight for height and anaemia, are used in the measurement of nutritional status.
A low income household lives from hand-to-mouth, cannot afford decent housing, clothing, education, healthcare and many other services and goods they desire. In Uganda, these are largely subsistence farmers in rural areas and emerging slum dwellings with nearly inhabitable housing occupied by wage earners and casual workers. Having two-three “meals” a day for a low income household is a luxury. Consequently, consuming different nutritious let alone healthy food is often inconceivable.
The order on the scale of priorities renders dietary diversity void amid competing needs such as healthcare, education, clothing, fuel, water, the list is infinite. Subsistence farming households, a majority in Uganda at more than 60 per cent, are not an exception as between 70 per cent to 80 per cent of what they grow and domestic animals and their products find their way to the market. The multiple revenue streams sought by governments to boost economies worsen the already dire situation. Inevitably, households trade every nutritious crop and animal product such as eggs, etc, to earn income.
It is apparent that with low household incomes, food dietary diversity is the opportunity cost incurred to meet a host of other competing priorities, which are equally in no way guaranteed. It is a case of trial and error.
To suppose that low income households are oblivious of the benefits of consuming diversified and nutritious foods may be invalidated. While these and other documented linkages of household incomes, food access and ultimately healthy diets exist, often times, this are downplayed.
Consequently, planning for food security and nutrition programmes falls short as resources are channelled to solving symptoms rather than causes. Just as there are diverse drivers of hunger and malnutrition, a multiplicity of solutions should be tried and tested without downplaying another. Until now the antidote continues to fall short
Current solutions to address malnutrition need to be re-thought. Nutrition awareness programmes, one of the many common strategies implemented without the means to meet dietary needs, can only achieve so much. For a low income household that lives from hand- to-mouth, with cynicism, the question would be - you have sensitised me, so what? How do I apply the knowledge with no means?
Government programmes in Uganda aimed at improving household incomes, including Operation Wealth Creation and livestock restocking, are far from improving household income. Inputs may be important, but for how long will these be provided? They are perceived to be handouts and in the long-run, dis-empowering to low income earners, who are supposedly targeted.
Earlier programmes such as the Plan for the Mordenisation of Agriculture, and Poverty Action Plan - all came and went, but the situation cannot be said to have improved that much.
The multi-stakeholder approach to nutrition planning and programming, a recent development, presents a viable prospect. However, increased budgets across all vital sectors – health, education, agriculture, gender, planning - are key for tangible changes to be realised.
Programmes envisaged to contribute to improved nutrition status and indicators in the country need to incorporate interventions that boost household income – the approach should be citizen led and ultimately for them.
Ms Daisy is the regional advocacy manager-sustainable Diets for all Hivos - The Humanist Institute for Co-operation with Developing Countries.