Transcript kenya newspaper

COHA Briefing
ADFNS ACCRA
26-28 October 2016
STUCTURE OF PRESENTATION
1. Introduction and background of
the Study
2. Findings of the study - 10 Countries
3. Conclusions/Way Forward
4. Questions?
COHA – An African Union Led Initiative in
Nutrition implemented by Member States
The Cost of Hunger in Africa is an African Project, led by the African Union
Commission (AUC), implemented by Members States to improve the lives of
Africa’s children. The AUC provides political leadership and platforms for
advocacy on elimination of child under-nutrition in Africa.
NEPAD provides technical guidance in
nutrition related issues and serves as a
convener to ensure the integration of
complementary regional action.
The technical backstopping by UNECA
and UNECA through the Social
Development Policy Division, in a SouthSouth partnership to adapt methodology
to African context.
The World Food Programme is technical
lead, and provides oversight of country
level coordination, through its expanded
presence in Africa.
Funding Partners
COHA - Introduction
 COHA was initiated to raise the profile of malnutrition in
Africa – demonstrate its far reaching consequences to
social/economic development – as multi-dimentional implications.
 COHA was adapted for African Context, from a model
developed by the Economic Commission for Latin American
Countries - ECLAC. Initiated in 2010.
 Study is implemented by National Implementation
Teams (NITs) – comprising multi-sectoral representation,
and uses National Data – DHS, Household surveys,
National Census etc.
 It estimates the social and economic impact of child undernutrition by quantifying costs to 3 sectors - Health,
Education and Labour Productivity (and opportunity
cost to labour force, derived from premature death).
COHA Countries
Completed countries
Egypt, Ethiopia, Uganda, Swaziland, Malawi,
Burkina Faso, Rwanda, Ghana, Chad, Lesotho
and Madagascar
Ongoing countries
Mauritania, Mozambique, DRC, Zimbabwe,
Zimbabwe and Mali
Under discussion
Botswana, Cameroun, Kenya, Niger, Nigeria,
Benin, Togo, Guinea Bissau, Equatorial Guinea,
South Africa
PARTICIPATING COUNTRIES
Countries Phase I
Egypt
Swaziland S
R Ethiopia S
R Ouganda S
Countries Phase II
R Burkina Faso
R Ghana S
Malawi
R Rwanda S
Countries Phase III
R Chad S
DRC S
Lesotho S
R Mali S
R Mauritania S
Madagascar S
R Mozambique S
Zimbabwe S
ALGERIA
LIBYA
WESTERN
SAHARA
EGYPT
MAURITANIA
MALI
NIGER
CHAD
SENEGAL
GAMBI
A GUINE
ABISSA
U
GUINEA
SIERRA
LEONE LIBER
BENI
N
IA
BURKIN
A
FASO
GHA
NA
NIGERIA
CAMERO
TOGO BENI
ON
N
SAO TOME &
GAB
PRINCIPE
ON
EQUATORIAL
GUINEA
ETHIOPIA
SOUTH
CENTRAL
l
SUDAN
AFRICAN
REPUBLIC
DEMOCRATIC
UGANDA
REPUBLIC OF
THE CONGO
KENYA
RWAND
A BURUND
I
TANZANIA
ANGOLA
R
SUDAN
COMOR
OS
ZAMBIA
MAURITIUS
ZIMBAB
WE
NAMIBIA
BOTSWANA
S
New requests
SWAZILAND
South Africa
LESOTHO
COHA
Methodological
Framework
Methodological Foundations
Universe of Analysis
Variables and Indicators
• Intrauterine: LBW due to
Intrauterine Growth Retardation:
• Infant Underweight – Health:
Low Weight for Age (< -2sd)
• Stunting – Educational
Performance and Productivity:
Low Height for Age (< -2sd)
• Children under 5
years of age who
suffered or are
suffering from
undernutrition
Effect
Life cycle step
Age (Years)
Health
Intrauterine and preschool
0 to 5
Education
School Performance
6 to 18
Productivity
Adult at working age
15 to 64
Results from
COHA
Effects on HEALTH
“Undernourished children have
lower resistance to infection
and are more likely to die of
common childhood illnesses
such as diarrhea and lower
respiratory-tract infections.”
For every additional case of
child illness, both the families
and health system are faced
with additional economic costs.
Increased cases related
pathologies (diarrhoea,
anaemia, acute respiratory
infection, fever etc)
A child who is undernourished is at risk of
suffering from cognitive and
physical impairment, which
have impact on quality of life
as a child and an adult within
the society.
Stunted children are more
likely to repeat grades in
school or even drop out.
Effects on EDUCATION
Economic costs of grade repetitions associated with stunting, 2012
Population 5-18 ans
suffering from stunting
Total repetitions
% of repetition associated with
undernutrition
Number of repetition
associated with stunting
% repetition in primary
school
Chad
2,5 millions
748 139
14,1 %
105 732
Burkina Faso
3,2 millions
229 002
5,8%
Ghana
2,95 millions
160 576
Malawi
3,2 millions
Rwanda
2.1 millions
Countries
Economic costs
local
USD
(en millions)
91%
CFA 9,1
milliards
18,3
13 201
74%
FCFA 853 millions
1,7
10,5%
16 875
66%
GHC 14,9 millions
8,3
818 138
18,0%
147 044
89%
MWK 3,42
Milliards (Billion )
13,9
327 500
13,5%
44 255
96%
RWF 2,4 milliards
(Billion)
3,9
14 percent of class repetitions are due to the high risk that children with stunting are confronted with
% of costs covered by the public system
% of costs covered by families
55%
Tchad
46%
25%
Burkina Faso
75%
44%
Ghana
56%
65%
Malawi
35%
33%
Rwanda
0%
10%
20%
67%
30%
40%
50%
60%
70%
80%
90%
100%
How much on Education?
Country
% Repetitions associated
with Stunting
Economic Cost
Local Currency
USD (in millions)
Egypt
Ethiopia
Swaziland
Uganda
10%
16%
12%
7%
EGP 271
ETB 93 million
SZL 6 million
UGX 16.5 billion
49
8
1
8
Burkina Faso
Ghana
Malawi
Rwanda
5,8%
10,5%
18%
13,5%
853 millions FCFA
14,9 millions GHC
3,4 billions MWK
2,4 billion RWF
1.7
8.3
13.9
3.9
Chad
Lesotho
14%
17.7%
900 million FCFA
115.2 million LSL
18.3
11.7
Various studies have shown
that when a child is stunted,
this will have an impact on
him/her when he/she enters
the labour force.
In general, stunted workers
are less productive in
manual and non-manual
labour than non-stunted
workers, and are less able to
contribute to the national
economy.
Effects on PRODUCTIVITY
Incremental mortality associated with child
undernutrition
Chad
Burkina Faso
Malawi
Ghana
42,6%
40,1%
23%
24%
Ghana
24%
Rwanda
26%
Chad – 42.6% of child mortality is associated with child undernutrition
How much on Productivity?
Economic Cost
Countries
Annual Working Hours National Currency (in
Lost (in millions)
billions of local
currency)
US$ (in Millions)
% of GDP
Egypt
Ethiopia
Swaziland
857
4,786
37
5
41
0.3
988
3,396
40
0.50%
11.90%
1.40%
Uganda
Burkina Faso
Ghana
Malawi
Rwanda
943
697
344
2.10%
2,600
2,300
1,700
319
3,3
90,8
624
1,850
368
6.00%
4.54%
6.37%
923
309
503
7.10%
1,558
334
675
5.50%
2763
1,809
184
6.56%
Chad
Lesotho
THE AGGREGATE LOSS
Economic Impact of Child Undernutrition
Country
Losses in Local Currency
Annual Losses in USD
Ethiopia
ETB 55.5 billion
$4.7 billion
Egypt
EGP 20.3 billion
$3.7 billion
Ghana
GHC 4.6 billion
$2.6 billion
Chad
FCFA 575.5 billion
$1.2 billion
Uganda
UGX 1.9 trillion
$899 million
Rwanda
RWF 503 billion
$820 million
Burkina Faso
FCFA 409 billion
$802 million
Malawi
MWK 147 billion
$597 million
Lesotho
LSL 1.96 billion
$200 million
Swaziland
SZL 783 million
$92 million
The aggregate cost estimation for Health, Education and
Productivity are equivalent to between 1.9% to 16.5% of GDP
What are the
potential
savings of a
reduction in
child
stunting
prevalence?
Progress after
COHA Results
Strategic Wins
AUC/ CONTINENTAL LEVEL

Raised profile of malnutrition at highest level – Heads of state and
Government – set nutrition goals of 10% and 5%

King of Lesotho, King Lestie III – as Africa Nutrition Champion launched
the COHA results – FFD#3, and recently in Lesotho.

Positioning Nutrition as a multi - sectoral development issue – concerted
multi-sectoral response – Ministers of Finance and Economy

ARISE – AFRICA’S RENEWED INITIATIVE FOR STUNTING ELIMINATION BY
2025 – Rally efforts, campaigns to address stunting

Global and Continental leaders are making reference to COHA results.
UNSG, AfDB president, Global Panel on F/N security
Progress After COHA Results
Ethiopia Example

Stunting prevalence is monitored with short intervals. MICS
every two years – instead of the DHS which was every 5yrs.

Widely recognized report at national and sub-regional Level.

Study was presented jointly with the National Nutrition Plan.

Strongly recognized by the Ministry of Economy.

Supported the revision of the National Nutrition Plan.
Uganda Example

Study contributed to scaling up existing interventions,
especially in fortification.

The government embarked on awareness raising campaigns
through the New Vision newspaper.

Stunting is recognized as a key development indicator and included in the
draft National Development Plan II.
Progress After COHA Results
Swaziland Example

Momentum generated by COHA to reduce under-nutrition.

Stunting reduction targets included in Swaziland Development Index
(SDI) COHA paved way for Swaziland to join SUN Movement.

Swaziland National Agriculture Investment Plan (SNAIP)
incorporated nutrition targets for the first time, including
reduction of stunting and wasting.

SDI final target for stunting reduction set at 10% by 2022.

WFP and the MoH started a gap analysis to prioritize interventions to
address causes of stunting and develop national guidelines for a
national stunting reduction programme.

Moving the first national strategy for food and nutrition (National Food
and Nutrition Policy) from draft stage closer to development.
Going Forward
1. Complete studies in about 15 more Countries (2016
-17)– including Nigeria, DRC, South Africa –
undertake regional comparisons. 26-30 Countries
2. Expand the continental analytical capacity – CoHA
and Cost of the double burden.
3. Rally efforts around AUC/ Member States - ARISE.
4. Expand partnerships – FAO, WHO, UNICEF,
REACH/SUN others…. ???
Going Forward
6. Online Data repository – with a dataset of over 26-30
Countries, data can be made available for “public
good” - additional analysis and research - inform
policy.
7. AUC/WFP/ ECLAC – adapt the methodology to
analyze “cost of closing the gap” – identify and cost
nutrition specific/nutrition- sensitive response.
8. Analyzing cost of Obesity- Double burden
9. Continue with M&E and progress reviews of the
countries to ensure COHA is creating sustained
impact on nutrition issues.
THANK YOU
The Role of Partners on COHA
Financial/ technical
Support in the
Implementation of the
COHA
Supporting
the
Implementati
on of the
Study at
National &
Regional
Levels
Supporting
the M&E
Regional, Continental
and Global advocacy
Initiatives and Efforts
to Position Nutrition
Dissemination
of the Results
at National
and
Continental
levels
Maintaining
Nutrition
Advocacy
Thank You
Merci
A Brief Recap Of The COHA Status
1st Phase
Reports
Launched
Partnership to
bring the LACCoH to COHA
2010
COHA
Presented
at AU
Summit
2012
AU/ECA
Mandate for
COHA
Declaration
898 at
5th CAMEF
Addis Ababa
2013
2014
Endorsement
of
Methodology
by 4th
Progress
Report on
initial Results
at AU/ECA
ATFFND,
Malawi
6th CAMEF,
Abidjan
Launching of
1st Regional
Report
AU/ECA
7th CAMEF,
Abuja
2nd Phase
Reports
Launched
2015
Launching of
2nd Regional
Report
3rd FfD
By King
Letsie III of
Lesotho
JUNE 2014 – MALABO DECLARATION – HIGH LEVEL ENDORSEMENT OF COHA BY
AFRICAN HEADS OF STATE AND GOVERNMENT - REQUESTING A CONTINENTAL ROLL-OUT
PROGRESS IN REDUCING STUNTING BETWEEN 2000-2010
60.00%
50.00%
Malawi
Stinting
Rwanda
Swaziland 40.00%
Tchad
Ethiopia
Uganda
Cameroon
Kenya
Burkina Faso
Botswana
Egypt Arab Rep
30.00%
Ghana
Mauritania
20.00%
10.00%
0.00%
-15.00%
-10.00%
-5.00%
0.00%
5.00%
Progress in reduction
10.00%
15.00%
20.00%
25.00%
Some Concluding Facts
 Undernutrition is responsible for 45% of all under-five deaths.
 Stunting is irreversible, but preventable.
 Prevention is cost-effective.
 A 10% increase in GDP leads to a 6% reduction in stunting.
 Malnutrition is multi-causal-> must focus on nutrition-sensitive,
as well as nutrition-specific programming.
 Governments need support to address the underlying causes.
 Partnerships are essential for a multi-sector approach.
 COHA demonstrates the heavy costs governments are paying in
terms of GDP and development, but it also has severe
consequences for the community, the family and the child.