1. Hunger, Malnutrition and Nutrition by Margaret Kaggwa Uganda

2. Definitions Nutrition science is study about foods/nutrients Malnutrition is inadequate quality and quantity of nutrients in a body Hunger is absence of foods to eat Stunting is being short for age Wasting is being too thin compared to age Underweight is being below weight for age

3. Policy The importance of nutrition in health and socio economic development was fully recognized at the Alma-Ata conference in primary health care (PHC) in 1978, which was listed as one of the major components of PHC

4. Magnitude in Uganda 1995 UDHS showed that the proportion of children under four years of age who had chronic under nutrition or stunting, decreased from 43% in the 1988/1989 survey, to 38%. Acute under nutrition or wasting rose from 25 to 25% during the same period. And the percentage of children who are underweight increased slightly from 23% to 25%. The national of stunting children 2009/2010 33% (UDHS)

5. Cont: According to The State of the World's Children, UNICEF, 2007 0.9 Million Children less than five die in developing countries each year. Malnutrition and hunger-related diseases cause 60 percent of the deaths;The State of the World's Children

6. Top causes of morbidity/mortality In children under five years malnutrition is one of the top ten causes of morbidity and mortality. Other three leading causes include malaria, respiratory tract infections and diarrheas diseases. poor environmental sanitation, poor accessibility to physical health care facilities, and the adverse health and social consequences of HIV/AIDS.

7. Associated factors Poverty (population living in poverty 2009/2010 31% (UDHS) poverty is a cause of hunger, Un adequate food and poor nutrition, lack of awareness of proper nutrition requirements unbalanced types of food to give to the children Health education gap on nutrition

8. Fears It is estimated that 1.9 million people in Uganda are food insecure while about 6.0 million are moderately food secure but are at the risk of becoming insecure. Malnutrition in children comes about as a social economic issue among households that result in complications. Diseases like malaria, respiratory infections and HIV/AIDS contributes to the cause due to dehydration. 2008 UNAIDS Global Report on the AIDS Epidemic that in the countries most heavily affected, HIV has reduced life expectancy by more than 20 years, slowed economic growth, and deepened household poverty.2008 UNAIDS Global Report on the AIDS Epidemic

9. Dangers Malnutrition deficiencies of all forms significantly contribute to higher morbidity and mortality especially the under five and women of child bearing age. They delay the psychomotor mental and physical development. In uterus, under nutrition of mother’s results in abortions, intra uterine deaths, low birth weight babies and reduced chances of survival before this age and deformations at birth. Under nutrition in childhood also reduces the capacity to take advantage of health, education and employment opportunities (Jolly et al 1985) In adulthood under nutrition interferes with resource fullness and productivity. Thus nutritional status of a community is one of the major indicators of general socio-economic development

10. Source of the problem Most malnourished children come from large families implying competition for resources within the households to meet the needs of the family. Knowledge on the factors which contribute to malnutrition is poor. Most families have easy access to carbohydrates mainly banana (matooke), which is the staple food especially in central and southern districts of Uganda sweet, potatoes and cassava on which they mainly feed their children. The people plant their own foods which are eaten in their house holds. Purchase of expensive foods like proteins is impossible especially to most households. Seasonal conditions like dry, heavy, floods and rain affect the harvests leading to hunger that results in malnutrition due to displacements like as it was in the northern region during the 20 years of war. Lack of comprehensive quality information contributes too to the problem.

11. Indicators and solutions Nutrition indicators only in Kampala: stunted constitute 22%, wasted - 7%, underweight - 10% and women who are too thin - 5%, children with anemia 52%, women with anemia - 33% (The state of Uganda Population Report 2010). Networks like media, seminars; extension visits etc play a major role to promote nutrition but are limited to a few. Promote nutritional education at all school levels in the curriculum to provide basic information on nutrition.

12. Question: Imported policies Could globalization be the answer to hunger, malnutrition and nutrition when some other countries are far behind?

13. Thank you