To ensure better nutrition for children and their mothers, we need the right data

by Dr. Adelheid Onyango | The World Health Organization
Monday, 27 November 2017 11:39 GMT

A muac tape used to screen malnutrition in children at the stabilisation ward in Molai General Hospital Maiduguri, Nigeria November 30, 2016. Picture taken November 30, 2016. REUTERS/Afolabi Sotunde

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Africa is facing a classic problem in global health - when your resources are limited, what do you address first, the crisis or the incomplete data that tells you about the crisis?

If our children are our future, then our future is getting short shrift. A new report shows that almost one out of every three children under the age of 5 in Africa is not getting the right kinds of food and care to help them grow to their full potential.

Africa is the only region in the world where the numbers of stunted children are rising, from 50 million in 2000 to 59 million in 2016. And an additional 5 percent are overweight. African kids should have better odds of being healthy.

Another worrisome part of this picture is that it’s largely being painted with old data. The ‘current’ nutrition data set for 19 African countries dates from 2012 or earlier. For two of these countries, the most recent national surveys were carried out before 2000. Most countries also don’t actively track the nutrition of infants, young children, and their mothers.

This brings us with to a classic problem in global health—when your resources are limited, what do you address first, the crisis or the incomplete data that tells you about the crisis?

Burkina Faso, one of the poorest countries in West Africa, worked with donor partners to survey its population on child nutrition nine times between 2000 and 2015. The initial results were unsettling, but the investment in detailing the problems led to additional collaborations and direct interventions, including working with pregnant women and new mothers on improving the quality of their families’ diet. As a result, the progress could be measured: the prevalence of children under the age of 5 whose growth was stunted due to malnutrition dropped from 42 percent in 2006 to 27 percent in 2016.

Burkina Faso’s data gathering is an exception in Africa though, joined only by Kenya and Malawi. Everywhere else on the continent, given the infrequency of national surveys, there is a clear need to locate and tap alternative sources of data. And here’s the catch: data is already being collected routinely at the local level, in health facilities. All too often though, it doesn’t leave the premises. Data is recorded and then sits in a handwritten notebook stuck in a back-office bookshelf, or in mother-child health cards whose use is poorly understood.

Every measurement that’s taken—from body temperature to height and weight—should be done with an eye on whether the child being examined is eating, growing and developing properly.

And there are platforms and systems that can capture these recordings and pass them along for epidemiological surveys. For example, WHO and UNICEF have a joint reporting process to capture data on child immunization. And routine immunizations now include height and weight measurements. If the vaccines are noted, the growth data should also be added.

If this data can be captured, it can be harnessed to serve a wide range of needs—starting with the crisis at hand. Better and more current localized data would lead to better decisions on how to address malnutrition. Context can help drive better policies, allocate limited resources, even generate new investments.

Capturing this data does not involve complex computer networks anymore. Today, data can be captured on tablets, smart phones, or even through text messages on flip phones. Health ministries have a variety of systems they can tap to collect and process the raw data. These systems have been used in a wide variety of settings within and beyond public health.

Rwanda provides another example of effective surveys. While the government does not carry these out surveys as frequently as Burkina Faso, it does so with regularity and then uses the data to adjust policy. Its most recent study found an urban-rural divide on child malnutrition, and the government has adjusted programming appropriately. The data collected over the past ten years shows another important drop in stunting—from 52 percent in 2005 to 38 percent in 2015.

WHO member states in 2012 agreed to six global nutrition targets to achieve by 2025. In agreeing to these targets, governments also agreed to report to the World Health Assembly and be held accountable—to their constituents, to their peers, and to the international community. Now is the time to fortify this political will and invest in the required data systems.

If nearly one out of every three children is malnourished to the point where they are not growing properly, it really shouldn’t take complex technologies to locate them. But the right data can help ensure we implement policies that will to stop this tragedy in its tracks.

Dr. Adelheid Onyango is WHO Africa’s Adviser for Nutrition