Recently, Ghana affirmed her commitment to banishing hunger as the President of the Republic of Ghana, HE Nana Addo Dankwa Akuffo-Addo launched the national Zero Hunger Strategic Review (ZHSR).The comprehensive national report and road map which is expected to inform national efforts to achieve zero hunger by 2030 was applauded by many social commentators as a commendable feat in efforts to realizing Sustainable Development Goal 2.
Prepared under the supervision of the Ministry of Planning, the report establishes the current state of hunger in the country and offers tangible possibilities available to help reverse the situation.
In his address at the launch, which was organized by the John A. Kufuor Foundation and the World Food Programme, President Akufo-Addo submitted that Ghana had excelled in her attempts to stop hunger in its tracks.
“Indeed, we were the first country on the African continent to attain the Millennium Development Goal No. 1 of halving poverty and hunger, for which the country received an award ‘for reducing the level of its malnourished population from 7 million in the early 1990s to less than 1 million today’”, he asserted.
In this piece, I present you key excerpts from chapter 4 of the report which reflects ‘Priority Actions and Key Findings’ from the report. Read on.
Ending hunger and malnutrition cannot be achieved without critically improving on the agricultural sector in all spheres as well as harnessing the efforts of all sectors of government that directly or indirectly affect food production from farm to table in both quantity and quality. Having enough food must however be coupled with nutrition education and behaviour change communications for zero hunger and malnutrition to be achieved. People must be able to make healthy food choices and apply preparation methods that will conserve nutrients.
It is a fact that if Ghana must end hunger, food security and malnutrition in all its form by 2030 the people to target are small scale farmers, the poor in both rural and urban areas, rural woman, people living under severe environmental conditions, the disabled and the aged. However for food value chains to function so that value can be added to the pro-aggregators, food processers, marketers, financiers and others to facilitate the production, processing, marketing and consumption processes.
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SDG TARGET: END HUNGER
To end hunger by 2030 the following priority actions are recommended by the report:
1) Poverty eradication (SDG 1) is critical for ending hunger, but SDG 2 will be very important for the eradication of poverty especially in rural areas and the reduction of north-south, rural-urban and female-male inequalities national statistics indicate that there has been significant poverty reduction nation-wide yet in the rural and peri-urban communities all groups interviewed felt poverty and hunger had increased over time. That clearly indicates a widening rural-urban inequality and hunger gap. Government has to show greater commitment to SDG 2 targets in terms of provision of resources to support actions being suggested here. If government does not show commitment by action, development partners will be lukewarm in their support.
2) Small-holder farmers are largely the poor and their poverty arises mainly from lack of markets as well as the low prices. They however produce over 90 per cent of the food of Ghanaians. There is therefore need to innovatively create markets for foodstuffs being produced by them. Many suggestions were made with respect to this issue during the country-wide stakeholder consultations. They included the need of a drive to promote the consumption of locally made foodstuffs and to incentivize the private sector to purchase local foodstuffs for processing or for onward sale to areas of need. The public procurement system should also enable schools, hospitals, prisons and other organized institutions to purchase local foodstuffs. There are also suggestions to create farmer’s markets across the country where farmers can once in a week sell their produce directly to consumers. As stated earlier, effective marketing cannot take place without grading and standardizing of the produce. Methods such as those used by WFP in parts of the Brong Ahafo Region should be replicated across the country.
3) Apart from market creation within Ghana, there is a need to look beyond the country to the Sahel countries and even to countries outside West Africa. There should indeed be greater South-South cooperation in the area of agriculture trade to redress this problem of wastage in the developing countries. A priority action is for the various agricultural and trade ministries in countries interested in the idea to start discussions and drawing up plans to start the process.
4) Many stakeholders at all levels have also called for the promotion of small and medium-scale irrigated agriculture, especially in the drier parts of the country. That is certainly necessary and helpful for the eradication of hunger, especially in the rural areas. At our current level with irrigated agricultural in Ghana (less than 5 per cent of total cultivated area ) and given the level of investments required in irrigated agriculture, sustainable irrigation development can only be undertaken gradually, within a long term plan. The promotion of sustainable rain-fed agriculture should be the short, medium and long-term priority.
SDG TARGET: END MALNUTRITION
Ending malnutrition means starting from the beginning of life cycle, that is maternal nutrition should be given a lot more attention because a malnourish mother will give birth to a malnourish child, and the cycle will continue. The NHIS is available but it does not meet all the needs of the pregnant women. There are also programmes by the government and other agencies to ensure proper child care and feeding practises in Ghana. Pro-poor programmes include the LEAP, which targets poor households and pregnant and lactating women. Exclusive breast feeding and complementary feeding, school feeding programme, Infant and Young Child Feeding (IYCF), free NHIS and others are other government programmes that support child nutrition. However, due to several factors including the lack of resources, the programmes are not very effective.
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CHALLENGES OF FOOD AND NUTRITION SECURITY PROGRAMMES
The following are some of the main challenges of food and nutrition security programmes:
• Inadequate funding of food and nutrition security programmes at all levels: national, regional, district and community has been a chronic problem.
• Human resource capacity of districts for nutrition activities is woefully inadequate. Most districts have 2-3 nutrition officers in charge of all nutrition programmes so there is hardly any nutrition technical officer at the point of service delivery.
• There is weak inter-ministerial collaboration. Food and nutrition security is multi-sectorial and so without strong collaboration of the relevant ministries and agencies very little can be achieved.
• There is lack of proper documentation on what segments of the population are foods insecure and what foods are considered as food by the people.
• Disproportionate attention is paid by partners to nutrition programmes in different districts even within the same region.
• There is very inadequate supervision and monitoring of programmes.
• The process of selection of schools for school feeding is an issue in several places. In some region the right schools have not been selected and therefore the meals are not provided for those who are in need. Additionally, the amount of money spent on each child in the school feeding programme (GHS 0.80 per child per day) is grossly inadequate. This tends to influence the kind of meals given to the school children. This therefore defeats the purpose of the programme. Also meals provided by the school feeding programmes are substandard partly due to lack of nutrition personnel to help with meal planning. The school feeding caterers are also not using fortified food ingredients.
• IYCF has some major gaps:
o Exclusive breastfeeding is not done by a majority of mothers due to time constraints as well as the duration of maternity leave, which is only for 3 months.
o There is sub-optimal complementary foods and feeding practices coupled with shortfalls in minimum dietary diversity standards for IYCF.
• Women and children do not meet nutrient requirements for micronutrients of public health importance (vitamin A Folic acid, Iron, and iodine) partly due to lack of knowledge, poverty and seasonality issues.
• There is lack of dietary diversity due to limited education on the subject to farm families.
• Though males form the largest percentage of farmers, they have not been involved in many of the educational programmes of proper care and feeding practices. This limits their understanding of nutrition security and their ability to ensure that children and other vulnerable groups are well cared for and fed.
• Poverty is the backbone of hunger and malnutrition but support systems for farmers to increase production to ensure food security is not efficient partly due to inadequate agricultural and nutrition extension.
• There is very inadequate promotion of bio-fortified foods such as orange-flesh sweet potatoes and yellow-flesh cassava.
HEALTH CARE DELIVERY CHALLENGES THAT INDIRECTLY IMPACT ON NUTRITION
Other challenges related to health care delivery that indirectly impact on nutrition include the following:
• There are inadequate staffs at health facilities.
• There are also inadequate monitoring and supervision of the work being done by health workers.
• There are very poor health worker attitudes. (Health workers these days especially the nurses enter the profession because of the benefits they will get and not the passion they have for it).
• There are very inadequate rehabilitation centres to manage malnourished children.
• There is also inadequate health education. (Instead of doing house to house education in the communities especially the CHNs/CHOs, they rather do static education at one point).
• Access to water (for personal hygiene and sanitation) in most health facilities is big challenge. Most of the facilities do not have access to clean water making it difficult for staff and clients to use toilet facilities.
NUTRITION SPECIFIC AREAS THAT NEED ACTION
For the above challenges, the following actions are suggested:
• Food and nutrition security is so important that government funding of food and nutrition security programmes must be ring-fenced and provided at the times required.
• There should be nation-wide nutrition sensitization since many people at all levels lack a good understanding of nutrition. Hidden hunger (micronutrient deficiency), for example, is not well known to the generality of the population and that explains why many people do not regard fruit and vegetables as “food”. Also, foods that are fortified are not popular among the populace due to lack of information. Besides, adolescents constitute a key subgroup for special nutrition attention since early pregnancies are high and the young would-be mothers need special nutrients.
• Males should be encouraged to attend ANC/WCW with their wives.
• The amount given for the school feeding programme per child must be drastically increased.
• Government needs to partner with the private sector to strengthen the school feeding programme.
• Nutritionists at the district and community levels should be tasked to monitor schools under the school feeding programme and to advice on meal planning and preparation of quality foods.