Why government should invest more in nutrition

Uganda has a malnutrition problem not just in children but adults as well. Malnutrition is the imbalance between the nutrients a body needs to function well and the nutrients it actually gets. Good nutrition provides the body with the immunity to fend off diseases.

The Uganda Nutrition Situation Report for 2019/2020 shows that 25 percent of the children are stunted (under 5 years), 3.2 percent wasted meaning they have insufficient food intake or a high incidence of infectious diseases, 7.8 percent underweight while 44 percent are anemic. These current levels of malnutrition are high even although there are signs of decline.
Malnutrition has various forms which impose excessively high costs which are both direct and indirect yet incurred not only by individuals and families but as well as the government. This is therefore a major impediment in achieving the 2030 Sustainable Development Goal and the country’s goal to improve the nutritional status of all Ugandans.

The estimated impact of malnutrition on the global economy could be as high as  $3.5 trillion per year, or S$500 per individual and as for Uganda the cost to the government is estimated at $899 million per year (3.5 trillion), 5.6 percent of the national income as of 2018.
The economic cost of malnutrition in the country is high – accounting for slow development, poor concentration and fatigue. The children who aren’t getting the right nutrients often have more trouble reading or studying and are more likely to develop long-term health problems and complications like obesity, heart disease and diabetes.

There have been some very cost-effective nutrition investments put by the government through the Ministry of Health like the micronutrient interventions; breastfeeding promotions for basic child survival initiatives, and education/ supplementation programmes for antenatal care. These are however lacking and need to be intensified.
There is a strong case for the government to heavily invest in nutrition other than leaving it solely to individual households and parents. First, nutrition is not a short term but rather a long-term investment that needs more money than what a sole individual may manage given that many households are poor and female headed which leaves a gap as many women are unemployed which further bridges more malnutrition.

Second, financial institutions do not finance such investments, particularly given that there is usually no collateral. This leaves nutrition lacking in terms of investment even if the households know of the high returns associated with good nutrition.
Third, there is a gender inequality in the investment in nutrition yet women play a major role in agricultural production and should be empowered to participate as equal partners in development. This lack of investment transmits intergenerational poverty as women play a huge role in reducing malnutrition.

Fourth, nutrition is a multi-sectoral approach with many aspects coming into play. The growth in income alone is not sufficient to reduce malnutrition. Nutrition is manifested in many forms like food security, environment, education, water, roads, climate change, poverty, and more.
Finally, there are gaps in information speaking to the nutrition issue. Many individuals and communities are not fully aware of the importance of the several micronutrients and parents do not have this information. These present market failures require government intervention.

The government should invest more in a coordinated effort to ensure priority interventions in the country that includes; strengthening monitoring of the extension of the nutrition programs in Uganda; extension of coverage of nutrition information among the population not only for the poor but also corporates; enforcing existing legislation for example the food and nutrition policy aims at ensuring food security and adequate nutrition for all the people in Uganda through ensuring availability, accessibility and affordability of food in the quantities and qualities sufficient to satisfy the dietary needs of individuals sustainably. 

We also need increased promotion of best practices in breastfeeding; water and sanitation investments in all regions; and building more successful community-based nutrition programs that reach all regions, parishes and sub parishes.
The author, Ms Pauline Nakitend is a research associate at EPRC, Makerere University.