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Profile Photo: MINISTER of Health Chitalu Chilufya (right) with Vice-President Inonge Wina during the recently held Food and Nutrition Summit in Lusaka. PICTURE: CHANDA MWENYA

Fighting malnutrition in Zambia

AN INSPIRATIONAL proverb about the value of teamwork suggests that if one is to go fast, one must go alone, but if one must go far, one must go together with others. To fight a war, various weapons must be employed.
At the recently held National Food and Nutrition Summit in Lusaka, stakeholders from various sectors held solidly to the view that a multi-sectoral approach is necessary to alleviate malnutrition in Zambia and promote food sustainability for healthy generations to come.
The multi-sectoral approach calls for the interlinking of different sectors such as health, education and agriculture to combat malnutrition successfully.
One country that has applied the multi-sectoral approach in fighting malnutrition is Thailand, which was represented by a respected ambassador of food and nutrition at the summit.
Kraisid Tontisirin delivered an inspirational address, sharing lessons from Thailand that can be applied in Zambia to reduce malnutrition.
Thailand is known for a successful nationwide community-based nutrition programme implemented during the 1980s to mid-1990s.
So what did Thailand do? Among other strategies, the country worked with rural development communities and devised a poverty alleviation plan that was multi-stakeholder or multi-sectoral in its approach.
“It’s community-based. I need to stress this. Once we have a national plan we implement at district level and go down to the community. We identified the major cause as poor maternal nutrition and health leading to low birth weight of newborns so we have to promote maternal nutrition and health,” Professor Tontisirin said.
Like Prof Tontisirin, Assistant UN Secretary General and Scaling Up Nutrition (SUN) Movement coordinator, Gerda Verburg who was a special guest at the summit, stressed the need for a multi-sectoral approach in food and nutrition programming.
Zambia has been a member of the SUN movement since 2011 and has adopted a multi-sectoral approach to food and nutrition as supported and encouraged by the movement.
Yet, despite Zambia being a member of the SUN movement, the number of stunted children in the country stands at a worrying 40 percent.
“The first and foremost important thing is the political leadership. You will not solve the problems with nutrition if there is no political will. Improving nutrition is a matter of political will and in Zambia there is room for the government to step up,” Ms Verburg shared.
When Ms Verburg met with leaders in Government over the course of the summit, her encouragement to them was to take more ownership in the malnutrition fight by prioritising food and nutrition in the domestic budget.
Zambia has over the years invested little in nutrition as compared to international donors. Ms Verburg is hopeful that the pattern will change.
“It is about time for the government to step up and the best proof of ownership is more investment from the domestic budget,” Ms Verburg said. “Walking the talk and investing the money in a traceable way is accountability because to promise something is one thing but to submit and invest it in the right way is another.”
Once the Government steps up its investment and takes ownership, she is certain that it will be easier to draw investment from other stakeholders.
“You need different stakeholders so my suggestion is that the Vice- President will take a role here as well and in her office there will be a political focal point to bring the different partners together and work with them,” Ms Verburg said.
At the local level, Christopher Dube founded the first District Nutrition Coordination Committee (DNCC) in Zambia. It coordinates all nutrition-related activities led by key ministries from the bottom up.
Dr Dube shared the lessons learnt from coordinating multi-sectoral food and nutrition programming with Mumbwa district as a case study.
He said many factors tie into the state of one’s nutrition, including the level of one’s education.
“The UNICEF framework basically shows that multiple determinants of malnutrition are there and that it is a complex social challenge. To fight malnutrition we need a coordinated fashion for maximum effect,” he emphasised.
Through the DNCC, Dr Dube has been able to argue that multi-sector coordination and alignment, through health, agriculture and other key stakeholders, is a viable and effective approach to address stunting in Zambia.
The DNCC therefore has created a forum for the recognition and understanding of multiple causes of malnutrition and provided an opportunity for learning space where solutions to malnutrition are found. It has further created dialogue among stakeholders to influence interventions to address malnutrition.
“To have a fully functional DNCC or multi-sectoral committee requires commitment, sacrifice and bonding by team members to be able to think and act as one,” Dr Dube shared. The multi-sectoral approach has helped bridge the gap between stakeholders in the district and has highlighted the concept of nutrition as a cross-cutting issue. This has helped inform the citizens about the difference between having food and being healthy in terms of nutrition.”
The National Food and Nutrition Sector Strategic Plan 2018-2022, is a second multi-sector five-year plan which is a response to addressing nutrition issues in the country.
The plan is needed to effectively improve the population’s household food security and nutrition and is in line with Zambia’s Seventh National Development Plan (7NDP) and its 2030 vision as well as the country’s commitment to the global Sustainable Development Goals (SDGs).
One of the key foundational strategic areas of the plan is to have a common results framework for the country where every stakeholder is held accountable for what they are doing to improve the nutrition status of the country.
If the plan is effectively followed over the next five years, Zambia should be successful in dramatically reducing its malnutrition levels to become a food and nutrition model in the southern African region.