by Dilmini Abeyrathne
Published on Ceylon Today on 01st November 2022
The term malnutrition covers the two aspects of deficiencies or excesses in nutrient intake, impaired nutrient utilization and imbalances of essential nutrients. Therefore, malnutrition comprises undernutrition, inadequate vitamins or minerals, overweight, and obesity, as well as diet-related non-communicable diseases. Furthermore, undernutrition manifests in four forms including wasting, stunting, micronutrient deficiencies and underweight.
Wasting often indicates recent and severe weight loss or low weight-for-height, although it can also persist for a long time. This condition usually occurs when a person has not had food of adequate quality and quantity and/or they have had frequent or prolonged illnesses. Wasting in children is a severe condition associated with a higher risk of death in the absence of proper treatment.
Stunting refers to the impaired growth and development that children experience from inadequate psycho-social stimulation, poor nutrition, and repeated infection. In other words, stunting is a result of chronic or recurrent under-nutrition, usually associated with poor maternal health and nutrition, frequent illness and/or inappropriate feeding and care in early life. Hence it prevents children from acquiring their physical and cognitive potential. Furthermore, an underweight child may be both stunted and wasted.
Micro-nutrient deficiencies represent another aspect of malnutrition, which occurs due to lack of access to a variety of foods, lack of knowledge of optimal dietary practices, poverty, and high incidence of infectious diseases.
Sustainable Development Goal 2: Zero Hunger
According to subsection 2.2 under SDG 2, by 2030, it is expected to end all forms of malnutrition, including achieving, by 2025, the internationally-agreed targets on stunting and wasting in children under five years of age, and addressing the nutritional needs of adolescent girls, pregnant and lactating women and older persons.
The United Nations has recorded that 768 million people were estimated to be undernourished, 2.3 billion people were in some level of food insecurity, 3.1 billion people are unable to afford a healthy diet and 676 million adults were obese globally. Furthermore, it is anticipated that healthy diets can lead to a reduction of up to 97% in health costs in 2030.
Impending Malnutrition Challenges in Sri Lanka
The global nutrition report reveals that Sri Lanka is on course to meet two targets for maternal, infant, and young child nutrition. However, the target of reducing anemia among women of reproductive age has failed as 34.6% of women aged 15 to 49 years are now affected by anemia. Meanwhile, Sri Lanka has shown some progress towards achieving the target for stunting and overweight as only 17.3% and 2% prevalence are recorded in stunting and overweight among children under five years. Unfortunately, no progress has been made towards achieving the target for wasting, with 15.1% of children under 5 years of age affected.
In 2019, the Medical Research Institute figured out the prevalence of micro-nutrient deficiencies among school-going adolescents; anemia at 8.8%, iron deficiency at 22.1%, and iron deficiency anemia at 3.8%. With reference to a recent survey, the Health Promotion Bureau warned of an emerging Vitamin D deficiency among the urban population. The underlying reason for Vitamin D deficiency, irrespective of the equatorial climate in Sri Lanka, has been identified as a lack of exposure to sufficient sunlight.
Impact of current economic crisis on nutrition
The Sri Lankan economy, though going bankrupt recently, has developed the reasons for it over the past few decades. A series of recent policy decisions have also exacerbated the long-term consequences including foreign reserve shortages, increasing foreign debts, and continued budget deficits. Late unprecedented repercussions of Covid-19 on tourism and related industries, excessive money printing, significant tax cuts draining government revenue, and the negative impact on agriculture due to the overnight chemical fertiliser ban together contributed to unprecedented price hikes in basic foods and supply shortages. Several food items such as a loaf of bread which previously remained the relatively cheapest food available have increased their price by more than 200% during the past few months.
Conclusions and solutions
The Central Bank of Sri Lanka points out 93.7% of food inflation in August 2022 from 90.9% in July 2022. Within the food category, price increases were observed in fresh fish, fruit, bread, biscuits, eggs, and chicken especially, curbing the protein intake. Therefore, the country operates among several financial constraints having direct and indirect impacts on food security and health security.
In a Situation Report for August, the World Food Programme revealed that 6.3 million people are food insecure and 6.7 million people are not consuming adequate diets. The sharp depreciation in the Sri Lankan rupee and the resulting food inflation has exacerbated the pathetic plight of Sri Lankans in affording basic food.
Measures taken by the Government
With the objective of maintaining the optimal nutrition status at low cost by shifting into the consumption of locally available, less expensive foods, including not frequently utilised nutritious food items, engaging in home gardening and sharing food items with others including the vulnerable population, the Ministry of Health had declared October 2022 as the National Nutrition Month under the theme of’ ‘Nutrition at Low-Cost: Know, Find Alternatives, Grow and Share’ with an emphasis on maintaining individual and community nutrition during the prevailing economic crisis. This initiative mainly comprises two programmes; National Short-Term Programme (NSTP) on food security and nutrition and Emergency Nutrition Plan (ENP) 2022-2024 prepared by the Ministry of Health. Furthermore, the Government has focused on providing assistance to families with disabled and people with chronic illnesses, and families with more than five members who receive the current poverty alleviation programme Samurdhi under the World Food Program (WFP).
Way forward
The proposed-awareness programmes focus on four-key actions including disseminating knowledge, finding alternatives, improving home gardening and sharing with others. In making these areas a success, it is essential to conduct a national assessment on nutrition status as the previous survey by the Demographic and Health Survey (DHS) has been conducted in 2016 which lacks statistical changes of the significant figures related to malnutrition in making timely decisions in Sri Lanka.
* Ms.Dilmini Hasintha Abeyrathne is a Research Assistant at the Institute of National Security Studies. She has completed her Masters Degree in Economics from the University of Peradeniya and her Bachelor’s Degree in Economics in Second Class Upper division from the University of Kelaniya. She has held the position of the Secretary of Economics Students’ Association of her Department and she has represented Sri Lanka in the South Asian Economics Students’ Meet (SAESM) in 2019. She has served as a Research Assistant at the Department of Economics, University of Kelaniya in 2021. Currently she is in the intermediate year of her Attorney's-at-Law at Sri Lanka Law College.