Why child nutrition is critical in accelerating development

A country’s primary healthcare and its economy are inseparable. A robust economy is founded upon the health of the nation. Children’s health is especially critical. You know how the nation will be tomorrow by looking at its children. In this respect, the importance of properly feeding the child as a key component of primary healthcare cannot be overstated. Nutrition directly shapes the child’s health and his or her future productivity. Undernourished children are susceptible to infection and disease. Beyond this, poor nutrition also impairs the child’s mental and physical development and future abilities. Stunted children are less likely to fulfil their cognitive potential as adults.

The consequences of malnutrition for the individual child can be cumulatively devastating for the whole nation. The 2019 Cost of Hunger in Africa study by the African Union Commission shows that in 2014 alone, over Sh370 billion were lost as a result of child undernutrition. That is equivalent to seven per cent of Kenya’s GDP.

Children who enjoy a balanced and nutritious diet, and related primary healthcare and stimulation can thrive. They have increased resistance to disease. They concentrate better on their studies. They become more productive future members of society. This is one reason why nutrition is prioritised in several international agreements, including the UN Convention on the Rights of the Child and the UN Sustainable Development Goals.

Despite significant gains in improving nutrition, Kenya still has a long way to go. Twenty-six out of 100 children under five years of age are stunted. This means that they are too short for their age and are, therefore, at risk of cognitive and physical limitations. Such limitations will impair their human capital accumulation during a lifetime. Findings from the 2020 short rains assessment show that several counties including Mandera, Marsabit and Turkana have critical levels of acute malnutrition.

The advent of Covid-19 has also affected childhood nutrition. The World Bank has monitored its socio-economic impacts on firms and households, including among refugees. Curfews and restrictions on movement in the early stages of the pandemic helped to slow the spread of the virus. However, they also caused hardship, as incomes plummeted. Many families reduced the amount and variety of food they ate. School closures also removed the most vulnerable children’s access to free school meals. Meanwhile, the number of young children accessing vital health check-ups fell, as did that of pregnant and breastfeeding women enjoying the same. This was a perfect storm that hit child and maternal nutrition on multiple fronts.

Nevertheless, we know that we can turn this around. According to a UNICEF and World Bank working paper on child malnutrition in Kenya, for every 100 shillings invested in childhood nutrition, over Sh2,200 are generated for the economy.  This is a nearly unrivalled return on investment. And we know how to do it – the Kenya Nutrition Action Plan (2018-22) defines what needs to be done across sectors to support better practices, care and diet for improved maternal and child nutrition in Kenya.

As part of these efforts, UNICEF and the World Bank are working together with the national Government and Kitui, Kilifi, Marsabit, Turkana and West Pokot Counties on Nutrition Improvements through Cash and Health Education (NICHE). Based on a first impactful pilot initiative in Kitui, a larger innovative cash transfer and nutrition programme has started. The programme provides cash top-ups and nutrition support through education and counselling to vulnerable families.

These targeted families receive basic cash transfers through the National Safety Net Programme, which covers pregnant or breastfeeding women, and children under two years old. NICHE is funded by the United Kingdom’s Foreign, Commonwealth and Development Office and aims to reach 23,500 of the most vulnerable families over five years.

Cash transfers are one of the most effective proven ways to alleviate poverty. They allow parents to decide what their children need most, such as food, medicine and education. They help families get through tough times, like the current pandemic, while also increasing their resilience. Research by UNICEF and the Institute of Development Studies shows that combining transfers with other interventions – the “Cash plus approach” – has a more powerful effect than implementing either alone.

This is why NICHE includes nutritional and health counselling, via a network of community health volunteers. Families will receive information on and be supported to practice early and exclusive breastfeeding for the first six months, correct complementary feeding from 6 to 23 months, good maternal nutrition and vitamin supplementation. In Kilifi, the programme also focuses on child protection, providing parenting sessions on how to prevent violence at home.

- Zaman is the Unicef Representative to Kenya while Hansen is the World Bank Kenya Country Director.