Malnutrition’s multiple pathways, including malaria

The Sahel of West and Central Africa with its successive droughts is an area of nearly constant food insecurity and malnutrition.  Development partners, in trying to find more accurate ways to predict malnutrition and food insecurity have come to realize that the relationship between crop production on one hand and malnutrition on the other is complicated.

IRIN quotes USAID as saying “… the links between cereal production and malnutrition have been exaggerated, the complexities of regional market conditions inadequately conveyed, and the need for long-term structural solutions under-emphasized.” Furthermore, “While harvest outputs and malnutrition rates are linked, they are not inextricable.”  Ironically, food aid may not solve food problems.

dscn9123sm.jpgIRIN commented on the structural factors of the chronic malnutrition problem by saying that, “This is because much of the malnutrition in the region is caused by other factors: poor water quality, low-quality health care, poor sanitation and poor feeding practices.”

According to IRIN the magnitude of the problem is huge. “A third of the population of Chad is chronically undernourished, regardless of the rains or size of the harvest. More than 50 percent of the population in Niger suffers from food insecurity, with 22 percent extremely food insecure, according to the World Bank in 2009.”

IRIN suggests that the solution to the problem requires addressing “the multi-dimensional aspects of malnutrition, including livelihoods, food production, social protection, health, water and disaster risk reduction; and on responses that focus on strengthening the incomes of poor households.”

Although malaria prevalence is low and seasonal in the Sahel, it is one of the health risks that contribute to chronic malnutrition in the Sahel. Bechir and colleagues researching the problem in Chad found …

“Thirty-four percent (CI 27-40) of nonpregnant women, 53% (CI 34-72) of pregnant women, and 27% (CI 23-32) of children were anemic. In subjects infected with Plasmodium, all women and 54% (CI 22-85) of children were anemic. Malnutrition was significantly associated with anemia in mothers and with selected intestinal parasites, anemia and age in their children.”

As an intervention, Tine et al. found in Senegal that “Combining IPTc and HMM can provide significant additional benefit in preventing clinical episodes of malaria as well as anaemia among children in Senegal.”

We must not forget the interrelatedness of health and development issues and their interventions. More inter-sectoral thinking and planning is needed.

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