Health ministers meeting - Milan EXPO2015

NUTRITION THROUGH DIFFERENT LIFE STAGES AND CONDITIONS: WHICH INDICATIONS FOR POLICY MAKERS. 27TH -28TH OCTOBER 2015: ITALY, MILAN.

Dr. Mumtaz Kassam

Honorable Ministers of Health  Development partners and UN Agencies
Civil society organizations,
The Private Sector,
Distinguished guests

Although Uganda has made a lot of progress in reducing poverty over the years, malnutrition sadly, affects many Ugandans in various ways, especially women, babies and children.

Optimal feeding of infants and young children is a crucial factor in determining their health, nutrition, survival, growth and development. We all know that for young children, the period from conception to their second birthday, is characterised as the 1000 days of opportunity to effectively address malnutrition.

There is evidence, throughout the world of poor Infant Young Child Feeding practices in regard to breastfeeding and complementary feeding resulting into high prevalence of under nutrition and micro nutrient deficiencies among children under-five.

Uganda with its favourable climate has at least 2 least two harvest seasons with potential of feeding the entire population and neighbouring countries is also faced with similar issues.

For every 100 children, 33 are stunted, 63 are exclusively breastfed for the first 6 months, complementary foods are not introduced timely with only fewer than seven in ten children (68%) receiving complementary foods at six months of age and anemia among children 5 years of age was at 49%. 

The dietary diversity and frequency of feeding are also low. Only 13% and 45% received food from at least four food groups and were fed the minimum number of times or more.
we all know that when malnutrition strikes children in the first years of their lives, it permanently stunts their bodies, their minds, and their potential to fully contribute to their country’s economy.

This great loss holds back our countries potential for a vibrant, productive labour force and their ability to realize the promise of the demographic dividend.

Uganda loses USD310 Million worth of productivity per year due to high levels of stunting, iodine deficiency ,disorders,iron deficiency and low birth weight. Malnutrition is expensive to treat. For example, treating severe malnutrition costs more than 120USD per child., and it contributes a loss of 4.1 per cent of GDP per year. It also affects education and intellectual potential of schoolchildren.

For our countries to grow, our children must grow while their mothers also remain healthy. We all must understand that we cannot make real gains in tackling poverty, hunger, or reduce inequality if we do not urgently address the nutrition of infant, child, adolescent, maternal, and other vulnerable groups. These under-nourished and stunted segments of children have little hope of ever achieving their full potential or contributing to economic growth. In a study on the socioeconomic cost of hunger in Uganda (2013) estimated that up to 5.6% GDP is lost each year because under-nourished children grow up to be less productive youths and adults.

The Government of Uganda has put in place statutes, Laws and Regulations to support breastfeeding. Among many are; Child’s statutes of 1996, the Convention on the Rights of a Child, Regulations of Breast milk Substitutes of 1997, and Legislation for Food Fortification. These instruments aim to provide the framework for ensuring the survival of, and enhancing the nutrition, health, growth and development of infants and young children, as well as strengthening the care and support services to their parents and caretakers to help them achieve optimal Infant Young Child Feeding.

Uganda is among the 5 early “SUN” raiser countries .Nutrition issues therefore are high on the agenda of the government and the National Development Plan as well as a component within the Health Sector Investment Plans to be implemented for the good health of the people.

In addition we have adopted the Uganda Nutrition Action Plan (2011-2016) , with the assistance of several local stakeholders and international donor community such as UNICEF ,WHO and CIDA.It was launched in October 2011, and gives a clear outline of how government and partners including the Private Sector should respond. In 2012, Uganda through WHO received funds from the Canadian International Development Agency (CIDA) entitled Accelerating Nutrition Improvements (ANI). The project aimed at improving infant and young child feeding practices through increasing consumption of nutritious foods and adequate complementary feeding, improving nutrition knowledge and practices, especially in the “critical window” of conception through 23 months.

One of the interventions undertaken was the scaling-up of evidence-informed nutrition action focusing on improvement of complementary feeding of Children 6-23months by use of Food Based Approach.  Hence recipe from the local foods is now available to improve complementary feeding of children 6-23months for the regions of Eastern and Western Uganda. Some of the interventions being implemented with potential to reduce stunting include; Growth Monitoring and Promotion, giving health and nutrition education, and supporting mothers’ to exclusively breastfeed their children for the first six months of life.

In addition other health interventions sensitive to nutrition such as immunization, malaria prevention and treatment, Antenatal care attendance, Family Planning and others are also encouraged. 

Working in collaboration with Agriculture sector we can improve nutrition of children using local crops and scaling up bio-fortified foods such as orange fleshed potatoes, iron rich beans and others.

Improving young child and maternal nutrition in Uganda over the next five years will have the following benefits

1. Reduce the number of maternal deaths by over deaths by over 6,000 and child deaths by over 16,000 every year. One in 3 of the deaths of women could be prevented if we doubled our coverage of iron supplementation among pregnant women.
2. Increase national economic productivity, both physical and intellectual, by an estimated Uganda shillings 130billion per year.
3. Provide a strong return on public investment,for every Ugs1,000 invested,about Ugs 6,000 worth of increased productivity will result from reduced child stunting,improved maternal health,enhanced micronutrient intake,and improved nutrition care. Investing in nutrition makes economic sense, with the economic benefits far outweighing the investments required for scaling up nutrition programmes.

I commend the initiatives and spirit of partnership illustrated by the Government of Italy to the Government of Uganda that has made it possible to share our experience and also learn from others eminent representatives from around the world, in regard to nutrition through different life stages. 

The Government of Uganda welcomes the initiative taken by the Government of Italy with key line sectors of Health and Agriculture, academia, local governments and various NGOs to address food security and nutrition issues with aims to improve the livelihoods of the people and increase productivity of our country.

Finally Uganda-s Ministry of Health pledges to continue working with Italian Government in order to eliminate hunger, ensure availability, accessibility and affordability of food in the quantities and qualities sufficient to satisfy dietary needs of individuals sustainably and good nutrition for all stages of life..

Amb Dr. Mumtaz Kassam.

Representing Minister of Health at the Health Minister-s Meeting in Milan.

27^th& 28^th Oct 2015.