scholarly journals Regional Overview on the Double Burden of Malnutrition and Examples of Program and Policy Responses: African Region

2019 ◽  
Vol 75 (2) ◽  
pp. 127-130 ◽  
Author(s):  
Adelheid W. Onyango ◽  
Juddy Jean-Baptiste ◽  
Betty Samburu ◽  
Tshimi Lynn Moeng Mahlangu
Keyword(s):  
Age Groups ◽  
Health Sector ◽  
Lifestyle Changes ◽  
Sub Saharan Africa ◽  
World Health ◽  
Noncommunicable Diseases ◽  
African Region ◽  
Double Burden ◽  
Double Burden Of Malnutrition ◽  
Sub Saharan

Sub-Saharan Africa is experiencing the double burden of malnutrition (DBM) with high levels of undernutrition and a growing burden of overweight/obesity and diet-related noncommunicable diseases (NCDs). Undernourishment in sub-Saharan Africa increased between 2010 and 2016. Although the prevalence of chronic undernutrition is decreasing, the number of stunted children under 5 years of age is increasing due to population growth. Meanwhile, overweight/obesity is increasing in all age groups, with girls and women being more affected than boys and men. It is increasingly recognized that the drivers of the DBM originate outside the health sector and operate across national and regional boundaries. Largely unregulated marketing of cheap processed foods and nonalcoholic beverages as well as lifestyle changes are driving consumption of unhealthy diets in the African region. Progress toward the goal of ending hunger and malnutrition by 2030 requires intensified efforts to reduce undernutrition and focused action on the reduction of obesity and diet-related NCDs. The World Health Organization is developing a strategic plan to guide governments and development partners in tackling all forms of malnutrition through strengthened policies, improved service delivery, and better use of data. It is only through coordinated and complementary efforts that strides can be made to reduce the DBM.

scholarly journals Nutrition Transition & Double Burden of Malnutrition in Africa: A Case Study of Four Selected Countries with Different Income Levels (P10-074-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Kilee Kimmel ◽  
Teresia Mbogori ◽  
Mengxi Zhang ◽  
Jayanthi Kandiah ◽  
Youfa Wang
Keyword(s):  
South Africa ◽  
Economic Status ◽  
Nutrition Transition ◽  
Overweight And Obesity ◽  
Sub Saharan Africa ◽  
World Health ◽  
Nutrition Status ◽  
Older Children ◽  
Double Burden ◽  
Double Burden Of Malnutrition

Abstract Objectives Disease and lifestyle patterns have been changing rapidly worldwide including Africa due to recent changes in economic growth and urbanization. However, research related to the effects of these changes on nutrition status in Africa is limited. This study investigated the shifts in nutritional status (undernutrition, overweight, obesity) in children and adults in 4 carefully selected low-, middle- and high income countries in Africa, identified factors associated with the shifts, and provided recommendations for future work. Methods Malawi, Kenya, Ghana, and South Africa were selected based on their economic status, population size, urbanization, etc. Nationally representative data was obtained from sources such as 2017 Global Nutrition Report, Demographic Health Surveys (DHSs), Food and Agriculture Organization Corporate Statistical Database (FAOSTAT), and World Health Organization (WHO). The prevalence of underweight, overweight and obesity (ov/ob), and some ratios were assessed and compared across the countries between 1998 and 2016. Results Varied nutrition status and shifts were observed among the countries during 1998–2016. Countries with the higher economic status also had higher prevalence and faster increasing trends of ov/ob. South Africa had the highest GDP and highest ov/ob rates in children <5, children 5-18, and adults >18 (13.3%, 24.7%, and 51.9% respectively). Malawi, with the lowest GDP, had the highest stunting rate (37%). In each country, but most notably in South Africa, trends indicated the increasing ov/ob rate (11.8%) was much greater than the declining underweight rate (2.4%). Slight declines in overweight in children under 5 years were observed in Malawi, Kenya, and Ghana, which might be due to reduced stunting rates. Sex differences existed in older children and adults, with higher rates of ov/ob in females and undernutrition among males. Conclusions Nutrition shifts, heavily influenced by economic development, are rapidly occurring in sub-Saharan Africa. The double-burden of malnutrition posts prioritization challenges for policymakers. Because undernutrition is now a declining issue, the focus should be shifted towards prevention of obesity, at least in higher income countries in Africa. Funding Sources The study is funded in part by a center grant from the US National Institutes of Health (NIH, U54HD070725).

scholarly journals Correlates of the double burden of malnutrition among women: an analysis of cross sectional survey data from sub-Saharan Africa

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029545 ◽  
Author(s):  
Dickson Abanimi Amugsi ◽  
Zacharie Tsala Dimbuene ◽  
Catherine Kyobutungi
Keyword(s):  
Household Wealth ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Sub Saharan Africa ◽  
Outcome Variable ◽  
Demographic And Health Surveys ◽  
African Countries ◽  
Double Burden ◽  
Double Burden Of Malnutrition ◽  
Sub Saharan

ObjectiveTo investigate the correlates of the double burden of malnutrition (DBM) among women in five sub-Saharan African countries.DesignSecondary analysis of Demographic and Health Surveys (DHS). The outcome variable was body mass index (BMI), a measure of DBM. The BMI was classified into underweight (BMI <18.50 kg/m2), normal weight (18.50–24.99 kg/m2), overweight (25.0–29.9 kg/m2) and obesity (≥30.0 kg/m2).SettingsGhana, Nigeria, Kenya, Mozambique and Democratic Republic of Congo (DRC).SubjectsWomen aged 15–49 years (n=64698).ResultsCompared with normal weight women, number of years of formal education was associated with the likelihood of being overweight and obese in Ghana, Mozambique and Nigeria, while associated with the likelihood of being underweight in Kenya and Nigeria. Older age was associated with the likelihood of being underweight, overweight and obese in all countries. Positive associations were also observed between living in better-off households and overweight and obesity, while a negative association was observed for underweight. Breastfeeding was associated with less likelihood of underweight in DRC and Nigeria, obesity in DRC and Ghana, overweight in Kenya and overweight and obesity in Mozambique and Nigeria relative to normal weight.ConclusionsOur analysis reveals that in all the countries, women who are breastfeeding are less likely to be underweight, overweight and obese. Education, age and household wealth index tend to associate with a higher likelihood of DBM among women. Interventions to address DBM should take into account the variations in the effects of these correlates.

scholarly journals Actions Targeting the Double Burden of Malnutrition: A Scoping Review

Nutrients ◽  
2019 ◽  
Vol 12 (1) ◽  
pp. 81 ◽  
Author(s):  
Sonia Menon ◽  
José L. Peñalvo
Keyword(s):  
Nutrition Education ◽  
Scoping Review ◽  
Low Income ◽  
Sub Saharan Africa ◽  
World Health ◽  
Low Income Countries ◽  
Nutrient Deficiencies ◽  
Global Public Health ◽  
Double Burden ◽  
Double Burden Of Malnutrition

Background: In many developing countries, nutritional and epidemiological transitions are contributing to continuous undernutrition and escalating overnutrition, resulting in coexisting forms of malnutrition often referred as the “double burden of malnutrition” (DBM). This complex phenomenon constitutes an unprecedented challenge to global public health and has been prioritized by international health organizations, prompting governments to swift action. Specifically, five years ago the World Health Organization (WHO) proposed a roadmap to tackle the DBM though so-called “double-duty actions”. The objective of this review was to synthesize the literature on interventions which address the DBM. Methods: We developed a scoping review to identify interventions addressing the DBM. We searched PUBMED for papers reporting interventions until December 2019. Articles examining interventions, government policies, or tools at the individual, household, or community level to address the DBM were included. Results: Seven articles met the inclusion criteria. Three were from sub-Saharan Africa, one was from Southeast Asia, and one was from Central America. Two were modelling studies, with one covering 24 low-income countries and the other focusing on Ghana. Conclusion: Notwithstanding the pressing issue of the DBM, there is a paucity of studies examining double-duty actions despite the attention that it has garnered within the global nutrition community. Whilst nutrient deficiencies may be curbed by poverty reduction measures, for obesity prevention nutrition, education and promotion of physical activity, along with the encouragement of local food production, may be instrumental.

scholarly journals Landscape analysis – assessing countries' readiness to scale up nutrition actions in the WHO African region

2012 ◽  
Vol 12 (52) ◽  
pp. 6260-6273
Author(s):  
U Trübswasser ◽  
◽  
C Nishida ◽  
K Engesveen ◽  
F Coulibaly-Zerbo ◽  
...  
Keyword(s):  
Child Nutrition ◽  
Scale Up ◽  
Landscape Analysis ◽  
Sub Saharan Africa ◽  
World Health ◽  
Surveillance Systems ◽  
African Region ◽  
Human Resource Capacity ◽  
World Health Assembly Resolution ◽  
Sub Saharan

The purpose of this paper is to describe the use of the Landscape Analysis to assess strengths and weaknesses in combating malnutrition in Sub-Saharan Africa. The Landscape Analysis is an inter-agency initiative to assess gaps and constraints and to identify opportunities for effective nutrition actions in order to accelerate intersectoral action for improving nutrition. In-depth Country Assessments to evaluate countries' "readiness" to scale up nutrition action have been conducted since 2008 in Sub-Saharan Africa. "Readiness" was assessed in terms of the commitment and capacity of each country and the focus was high stunting burden countries. The main focus was countries with heavy burden of undernutrition. From 2008 to September 2011, a total of 14 countries had undertaken the Landscape Analysis Country Assessment. Nine of them were in Africa: Burkina Faso, Comoros, Cote d’Ivoire, Ethiopia, Ghana, Madagascar, Mali, Mozambique, and South Africa. Three additional countries (Guinea, Namibia and Tanzania) were also planning to complete the Landscape Analysis Country Assessment in early 2012. From the findings in the nine countries, the following recommendations have been made: • Existing nutrition architectures and coordination mechanisms should be strengthened and better utilized; • Nutrition needs to be mainstreamed and integrated in relevant sector policies; • Advocacy at high levels is needed to highlight the importance of the lifecourse perspective, focusing particularly on nutrition interventions from preconception until the first two years of life; • National nutrition policies need to be translated into programmatic actions; • Human resource capacity for public health nutrition needs to be built with high quality in-service trainings in the short-term and long-term strategies to provide pre-service trainings; • Community-based outreach should be strengthened by using existing channels; • National nutrition surveillance systems need to be strengthened to ensure adequate use of data for monitoring, evaluation, and planning purposes. As part of the implementation of the 2010 World Health Assembly resolution on Infant and Young Child Nutrition (WHA 63.23) WHO has proposed a process to help countries in developing scale-up plans, which incorporates the Landscape Analysis Country Assessment as a tool to help countries in undertaking the initial context mapping. The countries that have already undertaken an in-depth Country Assessment, such as the Landscape Analysis Country Assessment, are ready to move forward in implementing the next steps in developing scaling-up plans to accelerate action in nutrition. At the same time, WHO will support additional countries that have expressed interest in conducting the Country Assessment.

scholarly journals What sub-Saharan African countries can learn from malaria elimination in China

2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Abubakar Olaitan Badmos ◽  
Aishat Jumoke Alaran ◽  
Yusuff Adebayo Adebisi ◽  
Oumnia Bouaddi ◽  
Zainab Onibon ◽  
...  
Keyword(s):  
Significant Proportion ◽  
Sub Saharan Africa ◽  
World Health ◽  
Western Pacific Region ◽  
African Region ◽  
African Countries ◽  
African Context ◽  
Sub Saharan ◽  
Health Organization ◽  
Global Reduction

AbstractMalaria is one of the most devastating diseases plaguing the sub-Saharan African region since time immemorial. In spite of a global reduction in mortality rates, a significant proportion of deaths due to malaria is still accounted for in the region. China recently joined the 40 countries declared malaria free by the World Health Organization and became the first country in the WHO Western Pacific Region to be awarded the certification. We commented on the strategies employed by China to eliminate malaria, address challenges facing malaria control in sub-Saharan Africa, and derive lessons that could be learned in the sub-Saharan African context.

Using Trials of Improved Practices to identify practices to address the double burden of malnutrition among Rwandan children

2019 ◽  
Vol 22 (17) ◽  
pp. 3175-3186
Author(s):  
Pamela A Williams ◽  
Courtney H Schnefke ◽  
Valerie L Flax ◽  
Solange Nyirampeta ◽  
Heather Stobaugh ◽  
...  
Keyword(s):  
Dietary Diversity ◽  
Sub Saharan Africa ◽  
Overweight Child ◽  
Overweight Children ◽  
Structured Interviews ◽  
Urban District ◽  
Double Burden ◽  
Double Burden Of Malnutrition ◽  
Recommended Practices ◽  
Sub Saharan

AbstractObjective:Low- and middle-income countries (LMIC) are increasingly experiencing the double burden of malnutrition. Studies to identify ‘double-duty’ actions that address both undernutrition and overweight in sub-Saharan Africa are needed. We aimed to identify acceptable behaviours to achieve more optimal feeding and physical activity practices among both under- and overweight children in Rwanda, a sub-Saharan LMIC with one of the largest recent increases in child overweight.Design:We used the Trials of Improved Practices (TIPs) method. During three household visits over 1·5 weeks, we used structured interviews and unstructured observations to collect data on infant and young child feeding practices and caregivers’ experiences with testing recommended practices.Setting:An urban district and a rural district in Rwanda.Participants:Caregivers with an under- or overweight child from 6 to 59 months of age (n 136).Results:We identified twenty-five specific recommended practices that caregivers of both under- and overweight children agreed to try. The most frequently recommended practices were related to dietary diversity, food quantity, and hygiene and food handling. The most commonly cited reason for trying a new practice was its benefits to the child’s health and growth. Financial constraints and limited food availability were common barriers. Nearly all caregivers said they were willing to continue the practices and recommend them to others.Conclusions:These practices show potential for addressing the double burden as part of a broader intervention. Still, further research is needed to determine whether caregivers can maintain the behaviours and their direct impact on both under- and overweight.

scholarly journals A prospective observational study of community acquired pneumonia in Kenya: the role of viral pathogens

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jamila Nambafu ◽  
Mary Achakolong ◽  
Fridah Mwendwa ◽  
Jumaa Bwika ◽  
Felix Riunga ◽  
...  
Keyword(s):  
Influenza A ◽  
Community Acquired Pneumonia ◽  
Etiologic Agent ◽  
Sub Saharan Africa ◽  
Respiratory Pathogen ◽  
Noncommunicable Diseases ◽  
Double Burden ◽  
High Resource ◽  
Sub Saharan ◽  
Tract Infections

Abstract Background Lower respiratory tract infections continue to contribute significantly to morbidity and mortality across all age groups globally. In sub-Saharan Africa, many studies of community acquired pneumonia in adults have focused on HIV-infected patients and little attention has been given to risk factors and etiologic agents in an urban area with a more moderate HIV prevalence. Methods We prospectively enrolled 77 patients admitted to a 280 bed teaching hospital in Kenya with radiographically confirmed community acquired pneumonia from May 2019 to March 2020. The patients were followed for etiology and clinical outcomes. Viral PCR testing was performed using the FTD respiratory pathogen-21 multiplex kit on nasopharyngeal or lower respiratory samples. Additional microbiologic workup was performed as determined by the treating physicians. Results A potential etiologic agent(s) was identified in 57% including 43% viral, 5% combined viral and bacterial, 5% bacterial and 4% Pneumocystis. The most common etiologic agent was Influenza A which was associated with severe clinical disease. The most common underlying conditions were cardiovascular disease, diabetes and lung disease, while HIV infection was identified in only 13% of patients. Critical care admission was required for 24, and 31% had acute kidney injury, sometimes in combination with acute respiratory distress or sepsis. Conclusion Viruses, especially influenza, were commonly found in patients with CAP. In contrast to other studies from sub-Saharan Africa, the underlying conditions were similar to those reported in high resource areas and point to the growing concern of the double burden of infectious and noncommunicable diseases.

scholarly journals Socio-cultural aspects of diabetes mellitus in Nigeria

2013 ◽  
Vol 01 (01) ◽  
pp. 015-021
Author(s):  
S. Chinenye ◽  
A. Ogbera
Keyword(s):  
Diabetes Mellitus ◽  
Activity Patterns ◽  
Cultural Factors ◽  
Sub Saharan Africa ◽  
World Health ◽  
Foot Care ◽  
Double Burden ◽  
Cultural Aspects ◽  
Rising Incidence ◽  
Sub Saharan

AbstractUndoubtedly, Nigeria is the most populous country in Africa with about 400 ethnic groups and languages. There is a double burden of disease with rising incidence and prevalence of diabetes mellitus. World Health statistics indicate that Nigeria has the highest number of diabetics in sub-Saharan Africa. In spite of advances in diabetes care and facilities, desired outcomes are not good and linked to this, patient satisfaction is not optimal. Reasons include inadequate attention to biological aspects of diabetes, inadequate or inappropriate pharmacology and psycho-socio-cultural factors. In this review, crucial socio-cultural factors in Nigeria include traditional medicine, religion, diet, physical activity patterns, foot care, awareness, and stress management. Diabetes programs in Nigeria should adopt the principles of education and psycho-social support highlighted by the DAWN study, integrating our socio-cultural heritage, empowering individuals to take charge of their diabetes and achieve desired health outcomes. Religion should be explored as a potential tool to reach out on facts whilst doing away with erroneous beliefs about diabetes mellitus.

scholarly journals COVID-19 mortality in women and men in sub-Saharan Africa: a cross-sectional study

2021 ◽  
Vol 6 (11) ◽  
pp. e007225
Author(s):  
Jyoti Dalal ◽  
Isotta Triulzi ◽  
Ananthu James ◽  
Benedict Nguimbis ◽  
Gabriela Guizzo Dri ◽  
...  
Keyword(s):  
Public Health ◽  
Age Groups ◽  
Case Fatality ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Age Group ◽  
African Region ◽  
Public Health Response ◽  
Cross Sectional ◽  
Sub Saharan

IntroductionSince sex-based biological and gender factors influence COVID-19 mortality, we wanted to investigate the difference in mortality rates between women and men in sub-Saharan Africa (SSA).MethodWe included 69 580 cases of COVID-19, stratified by sex (men: n=43 071; women: n=26 509) and age (0–39 years: n=41 682; 40–59 years: n=20 757; 60+ years: n=7141), from 20 member nations of the WHO African region until 1 September 2020. We computed the SSA-specific and country-specific case fatality rates (CFRs) and sex-specific CFR differences across various age groups, using a Bayesian approach.ResultsA total of 1656 deaths (2.4% of total cases reported) were reported, with men accounting for 70.5% of total deaths. In SSA, women had a lower CFR than men (mean CFRdiff = −0.9%; 95% credible intervals (CIs) −1.1% to −0.6%). The mean CFR estimates increased with age, with the sex-specific CFR differences being significant among those aged 40 years or more (40–59 age group: mean CFRdiff = −0.7%; 95% CI −1.1% to −0.2%; 60+ years age group: mean CFRdiff = −3.9%; 95% CI −5.3% to −2.4%). At the country level, 7 of the 20 SSA countries reported significantly lower CFRs among women than men overall. Moreover, corresponding to the age-specific datasets, significantly lower CFRs in women than men were observed in the 60+ years age group in seven countries and 40–59 years age group in one country.ConclusionsSex and age are important predictors of COVID-19 mortality globally. Countries should prioritise the collection and use of sex-disaggregated data so as to design public health interventions and ensure that policies promote a gender-sensitive public health response.

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