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Cameroon |
CHILDREN
Malnutrition affects more than one in five children in Cameroon.
The consequences are significant, both as regards survival and for development
of the child’s mental and physical capabilitiesThe results of three surveys carried out in Cameroon in 1991, 1998 and March 2002, show that the nutritional state of children under three years has deteriorated, whatever anthropometric index is used (height/weight ratio, height and age, weight and age).
The specific situation of Cameroon arises from a worsening trend in the nutritional situation in Africa in general, towards the end of the 1990s. It runs counter to the hopes arising from the commitment made at the World Summit on Children, held in New York on 30 September 1990, to reduce malnutrition in children under 5 by a half.
Using the rate of low birth weight as a basis for the calculation, that is the percentage of newborn babies whose weight is less than 2,500gr, in Cameroon in 1991 -– our country’s aim was to cut this from 16% to 8% by 2000. Instead of this, however, the gap widened, with an estimated rate in March 2002, of 22% of children under 3 with moderately or seriously low weight.
There are regional disparities with regard to malnutrition. It is more marked in the northern province, no matter what index is used to measure it. It may also be seen that malnutrition occurs most frequently in rural areas rather than urban areas. The percentage of children suffering from delayed growth in urban areas is 22.4%, while in rural areas it is 31.7%. Large cities, such as Yaoundé and Douala, have the lowest level: 14.8%.
Emaciation and delayed growth
The increase in the percentage of under-nourished children as a function of age, confirms a common phenomenon in developing countries.
The rate of children with moderate or severe delays in growth increases steadily from birth, to a plateau (of between 30% and 35%, for Cameroon) from 24 months.
The percentage of children with moderate and severe emaciation increases rapidly from 6 months on, reaching its maximum between 12 and 23 months.
The relationship between growth and emaciation discloses several aspects of malnutrition. In general, the proportion of children experiencing delayed growth increases during the first two years of life, as does the percentage of children suffering emaciation.
The prevalence of delayed growth then levels off, while that of emaciation drops. In Cameroon’s children, emaciation is a reflection of the short-term changes in the food supply and weight loss linked to infectious diseases. The fact that it increases around about the age when weaning takes place, is not accidental. What is more, the cumulative effect of periods of emaciation results in delayed growth.
These aspects are sufficient to illustrate the expansion of malnutrition among the poor, and its increase in the last ten years. Cameroon’s household survey (ECAM) of 2002 detected higher rates of malnutrition in the «poor» and «intermediate» categories than in the «not poor» category. Poor families are not so able to guarantee a good diet for their children. They have neither the resources nor the knowledge to provide this.
ECAM 2002 also highlights a number of factors affecting the nutritional conditions of children under 5:
- Maternal malnutrition: 8% of mothers of children under 3 are themselves underweight;
- Mothers’ level of education: In 2001, 22% of children under 3 whose mothers had completed secondary education or higher had delayed growth, while for mothers with no education, this level stood at 38%;
- Inadequate level of breastfeeding: Only 4.8% of children are breastfed between the ages of 4 to 6 months;
- A lack of hygiene, causing illnesses that threaten the child’s health and growth.
«Unhygienic conditions, states the Secretary of State for Public Health, Alim Hayatou, affects growth even before any acute crisis is detected, since children living in such conditions suffer small but almost constant attacks on their immune systems».
The implications of malnutrition
The general observations made by the secretary of state, when introducing the CD-Rom produced by his department on Malnutrition in Cameroon, at a presentation on 20 August 2002, were bitter. «Setting a cat among the pigeons in a country where self-sufficiency in food is usually taken for granted», commented one observer.
According to experts from the Ministry of Health, many of Cameroon’s children are at a higher risk of mortality because they are underweight, a risk which «doubles for slight malnutrition and increases five-fold for moderate malnutrition».
A link has also been observed between delayed growth and intellectual developmental problems in the child, which persist despite efforts at school and reduce learning capacity.
According to Alim Hayatou, «the small size of children leads to fears of poor physical and mental development which could prevent them from benefiting fully from the possibilities offered by education. This could have effects on their later success in life».
It is acknowledged more and more that factors affecting the child’s intellectual development are delayed growth, lack of breast-feeding, insufficient food given after weaning or to replace mother’s milk, and the frequency of attacks of diarrhoea and respiratory infections.
Malnutrition takes the edge off motivation and curiosity and restricts play and exploration. This has implications for mental and cognitive development, reducing the child’s interaction with its environment and with the people who care for them.
Finally, delayed growth is associated with a reduction in the capacity for work of adults and an increase in the risk of contracting degenerative diseases in adult life. The economic and budgetary effects are costly. Not only is the adult’s economic capacity reduced, but the greater recourse to public health service is a burden that could have been avoided.
«Popularising micro-nutrients»
Current scientific advances have highlighted the role of micro-nutrients, such as minerals and vitamins, in providing protection from infections. «We have to popularise micro-nutrients that provide children with a vitamin supplement and reduce infant mortality, giving a comparable or even greater advantage over any vaccination against childhood illnesses», stressed the Secretary of State.
Hence the recommendation, during national vaccination days in the Provinces of the far North, North and Adamaoua, to give regular doses of vitamin A supplements to children aged between 1 and 5 years.
Since 1992, Cameroon has been promoting a campaign to adapt its legislation to require all salt imports to be iodized. «We are satisfied», stated Alim Hayatou, «that we have achieved the target set at the World Summit on childhood, of removing problems relating to iodine deficiency.
While children’s nutrition is now brought up to date, we are monitoring ways and means to allow Cameroon society to deal more effectively with this problem». These «ways and means» include:
- The right of every child to a good level of nutrition;
- The need to balance and adjust approaches, as the causes of malnutrition are evaluated;
- Promotion of breast-feeding exclusively for the first 6 months of life;
- Encouragement of the application of the international Code on the marketing and promotion of breast-milk substitutes;
- Promotion of education for girls and the reduction in the disparities between boys and girls.
«Society has a moral obligation to improve children’s nutrition, according to the Convention on the Rights of the Child», recognises the Secretary of State. This is a clear option for Cameroon’s new policy.
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