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Why we need data to end malnutrition in Africa

by Mercy Lung’aho | International Center for Tropical Agriculture
Wednesday, 15 August 2018 15:30 GMT

A child is checked for signs of malnutrition by a United Nations International Children's Emergency Fund (UNICEF) health worker in Thonyor, Leer county, South Sudan, February 25, 2017. REUTERS/Siegfried Modola

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The first thing we must do is realize that we can only solve a problem if it is diagnosed correctly

If my child went to the doctor with a fever, and the doctor told me to give him baobab leaves to make him better, I would want to know what caused the fever and why only baobab leaves will cure him. In contrast, much of the African population is suffering from fatigue, weakness, dizziness and drowsiness and many people prescribe food-based interventions, like baobab leaves, without asking: Why? What is the root cause of these ailments?

As a nutritionist, I know that the root cause of such ailments too often is malnutrition. Data generated by countries in the Japan International Cooperation Agency (JICA)-led initiative for Food and Nutrition Security in Africa (IFNA) indicates that in some countries, up to 80 percent of the population is anemic, which causes symptoms like fatigue and dizziness.

Recent reports tell us that no African country is expected to reach the United Nations’ target of ending childhood malnutrition by 2030. Many countries may not even end hunger or food insecurity. We have a severe public health problem on our hands. While baobab leaves are high in iron, and a good antidote to anemia, they cannot comprise our first or only response to malnutrition in general.

Indeed, when food-based interventions such as baobab leaves are the only solution offered, there is a fundamental problem within our health system. Any credible nutritionist will inform you that our dire malnutrition status requires multiple and immediate forms of action, including efforts to prevent such incidents from occurring in the first place.

Enter technology. To have any hope of putting things back on track, and meeting the 2030 development agenda, we need to fully unleash a data revolution to find data, fill gaps and equip us with full knowledge.

The first thing we must do is realize that we can only solve a problem if it is diagnosed correctly. At its core, chronic malnutrition is the consequence of a broken food system. Poor people can’t afford nutritious foods in supermarkets, and their own food supply may have been decimated by drought; floods; low fertilizer use — or one of the other myriad reasons why food harvests fail. Each country needs an accurate problem tree, incorporating rigorous responses to specific issues like anemia which will differ with context. These should follow standard planning procedures within each country and outline appropriate interventions to address core issues.

IFNA aims to leverage agriculture for nutrition and is taking bold steps to bring multiple sectors together to act. But we must be bolder. It has been said that there is little evidence linking agricultural interventions to improvements in nutrition. But we in the scientific community do have evidence clearly demonstrating that agricultural improvements – like new bean varieties biofortified with high iron for example – can have impactful health benefits. Some of our studies show such high-iron beans can reverse anemia and even improve brain function in young women in Rwanda.   

Second, we must identify clear menus of intervention with goals and benchmarks. Then we must map partners; outline a theory of change; an impact pathway; logic framework; and unite agriculture and health sectors through joint implementation plans.

Finally, these implementation plans must be couched in evidence-based, peer reviewed science.  An independent peer review process under the Africa Leaders for Nutrition platform is critical. All nutrition projects go through an independent review board to ensure proposed interventions are technically and ethically sound, often registered on the clinical trials website.

This needs to happen for all nutrition-sensitive projects in Africa. Open-access project manuals with relevant program information can improve peer review, accountability, transparency and traceability. We can leverage already-existing systems and institutions, like the Agriculture, Nutrition & Health (ANH) Academy as a peer review partner.

In this regard, there is a role for Big Data Platforms in Africa. To establish development project standards linking agriculture to nutrition everywhere in Africa, we need the high-resolution, fine data that tells us exactly how the situation is on the ground in any specific location. Better data will help us build better response plans.

When my son is ill and goes to the doctor, I expect that tests will be run, and the root cause will be identified. Then a combination of the right medicine, applied in the right doses, at the right times, together with rest and rehabilitation, will make him better. We should not think that our response to malnutrition should be any different.

Mercy Lung’aho is is a Research Scientist for the International Center for Tropical Agriculture (CIAT). She received her Ph.D. in Food Science and International Nutrition from Cornell University. She is a member of the American Society for Nutrition, the African Nutrition Society and a registered nutritionist at the Kenya Nutrition and Dietetics Institute among others.