Globally,
we have made significant progress in reducing child mortality and increasing
school enrollment. The deaths of children under age five declined from circa 12
million to less than 7 million between 1990 and 2011. Similarly, the number of
children enrolled in primary school is up by 40 million worldwide.
However,
if unchecked a lack of investment in early childhood development could erode these
gains. And President Yoweri Museveni gets it! In the foreword to Uganda’s Nutrition
Action Plan, Museveni writes, “Malnutrition affects millions of Ugandans in
various ways, but it is particularly devastating to women, babies, and
children. Malnutrition also impairs educational achievements and economic
productivity, costing the government and families enormous amounts of money to
treat related illnesses”.
About 40 percent of children in sub-Saharan
Africa are stunted. Stunted children often endure painful and debilitating
cycles of illness, depressed appetite, insufficient food and inadequate care. Children
who survive carry long-term deficits in cognitive capacity. Stunting is a
devastating early-life growth failure.
A recent study reported
by Save the Children shows that compared with normal children, stunted
children: score 7 percent lower on math tests; are 19 percent less likely to be
able to read a simple sentence at age 8, and 12 percent less likely able to
write a simple sentence; and, are 13 percent less likely to be able to be in
the appropriate grade for their age at school.
In a survey of 350,000
children in Kenya Uganda and Tanzania, Uwezo, an education advocacy organization
found that 2 out of every 3 children in grade 3 failed to pass basic tests in
English, Kiswahili or numeracy set at the level of grade 2. The study also
revealed that children from poor households perform worse on all tests at all
ages.
Invariably, children are
the most visible victims of undernutrition. Undernutrition magnifies the effect
of every disease, including measles and malaria. The estimated proportions of
deaths in which malnutrition is an underlying cause are roughly similar to
diarrhea (61 percent), malaria (52 percent), pneumonia (52 percent) and measles
(45 percent). Malnutrition can also be caused by diarrhea, which reduces the
body’s ability to convert food into useable nutrients.
Malnutrition, as measured
by stunting affects nearly 40 percent of children in Africa. In many cases
their plight began even before birth, with a malnourished mother. Under
nutrition among pregnant women in developing countries leads to 1 out of 6
infants born with low birth weight. This is not only a risk factor for neonatal
deaths but also causes learning disabilities, mental retardation, poor health,
blindness and premature deaths.
Extensive epidemiologic
studies have suggested that adult disease risk is associated with adverse
environmental conditions early in development. The molecular basis for these
apparently non-genetic trans-generation effects is not known. One hypothesis is
that it involves epigenetics. Epigenetics is the process by which patterns of
gene expression are modified in a heritable manner by mechanisms that do not
involve alterations in gene sequence.
The
Dutch Hunger Winter provides developmental biologists a rare opportunity for
understanding differences associated with prenatal exposure to adverse
environmental conditions. The Dutch Hunger Winter was occasioned by the German
imposed food embargo in the western part of The Netherlands close to the end of
the World War II in the winter of 1944-45. Studies have shown that Dutch babies
whose mothers were exposed to famine during early gestation grew up to have
higher rates of obesity than those born before or after the famine.
Hundreds
of millions of hungry mothers in Africa live on less than 400–800 calories per
day, equivalent to the rations Germans limited the Dutch to. Recent
estimates show that the number of hungry people in Africa grew from 175 million
to 239. Nearly one in four people are hungry in Africa.
Given
the prevalence of poverty, hunger and malnutrition it is highly likely that a
majority of children entering school have critical early-life growth failure,
which constrains learning ability and hence their potential to be healthy and economically
productive citizens. Studies estimate that early-life growth failure could lead
to earning deficits of up to 66 percent in adulthood.
Programs
like free primary education must go hand in hand with robust interventions in
early childhood development to forestall early-growth failure. And there is
such a thing as quality of citizens and our country ranks very low.
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