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BUILDING THE EVIDENCE BASE FOR STRENGTHENING THE AGRICULTURE/NUTRITION

NEXUS: THE CASE OF CAMEROON

BYFLORENCE FONTEH ANYANGWE

ASSOCIATE PROFESSORTHE UNIVERSITY OF DSCHANG, CAMEROON

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OUTLINE Introduction:justification, objectives,

methodology State of nutrition security in Cameroon Determinants of nutrition status in Cameroon The enabling environment Stakeholder clusters/linkages Lessons learned and gaps

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JUSTIFICATION (1/2)

FNS is of special significance for the ACP region Without adequate nutrition it will be difficult to

attain the sustainable development goals (SDGs) A mutual relationship exists between agriculture

(food supply) and nutrition and the benefits/casualties are bi-directional.

However, insufficient attention has been paid towards improving the agriculture and nutrition nexus

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JUSTIFICATION (2/2) Malnutrition does not simply arise just from poor

access to food, but also from a host of interacting processes (health care, education, sanitation and hygiene, access to resources, women’s empowerment etc) which are indispensable to the AN nexus

Furthermore, a combination of several options (enabling env, research, SH cooperation, capacity bldg, etc) contribute to strengthening the AN nexus and in achieving the desirable FNS outcomes

The effectiveness of roles played by these options vary tremendously between countries and regions

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OBJECTIVES

To build the evidence base for strengthening the agriculture/nutrition nexus in Cameroon

To share the lessons learned

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METHODOLOGY

Desk top review Interviews with key stakeholders Stakeholders’ consultation workshops

(pending)

7Figure 1: Map of Cameroon, showing administrative

Regions

Population : 22.3 million

Surface area: 475,650 km2

Pop growth rate : 2.5 %

GDP/capita : 1426 USD 

Life expectancy : 55 years

HDI : 0.505

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TABLE 1: INFANT MORTALITY RATES IN SELECTED SUB SAHARA AFRICAN COUNTRIES

Country Infant mortality (under one) per 1000 live births

Infant mortality (under five) per 1000 live births

Gabon 57 89

Ghana 64 111

Cameroon 74 144

Kenya 77 115

Uganda 88 152

Ethiopia 97 168

Nigeria 100 201

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TABLE 2: SOME INDICATORS OF NUTRITIONAL STATUS IN SELECTED SUB SAHARA AFRICAN COUNTRIES

Indicator

Prevalence

Very high (>35 %)

High (30 – 35 %)

Moderately high(15 – 29 %)

Low(less than 10 %)

Undernourishment

Sudan, Central African Republic, Democratic Republic of Congo, Somalia

Chad, Mali, Cote d’Ivoire, Ethiopia, Zambia

Cameroon, Kenya, Nigeria

Ghana

Stunting

Sudan, Central African Republic, Democratic Republic of Congo, Somalia, Congo

Cameroon, Nigeria, Chad, Mali, Cote d’Iv, Malawi, Zambia

Gabon, Tanzania, Uganda, Namibia, Ghana, Zimbabwe

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STATE OF NUTRITION SECURITY IN CAMEROON

1991 1998 2004 20110

5

10

15

20

25

30

35

13.6

22.2

18.1

14.6

24.4

29.331.7 32.5

3

6 5 5.6

% Underweight

% growth retardation

% Emaciation

Figure 2. Evolution of malnutrition in Cameroon

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STATE OF NUTRITION IN CAMEROON

Indicator % Children under five affected

Growth retardation (moderate)

31.7

Growth retardation (severe) 12.9Stunting 33Wasting 6Severe wasting 2Underweight (moderate) 14.8Underweight (severe) 4.2

Overweight 7

Low birth weight 11

Table 3. Child anthropometry

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STATE OF NUTRITION IN CAMEROON

Micronutrient % National

% South % North

Zinc 69.1 67.6 80.5

Folate 8.4 5.4 19.8

Vitamin B12 28.1 24.3 43.6

Vitamin A 35 28.6 43.0

Iron 38 16.6 49.0

Table 4. Prevalence of micronutrient deficiencies in children (1-5 yrs old)

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STATE OF NUTRITION IN CAMEROON

Indicator % National

% South % North

Severe underweight (%)

1.5 0.3 4.3

Moderate underweight (%)

0.5 0 1.3

Mild underweight (%)

5.4 2.3 12.3

Total underweight (%)

7.3 2.6 17.8

Table 5. Prevalence of malnutrition in women (15-49 yrs)

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STATE OF NUTRITION IN CAMEROON

Micronutrient % National % South % North

Zinc 76.9 72.6 86.5

Folate 16.6 10.5 17.8

Vitamin B12 28.6 28.1 41.2

Vitamin A 21.4 14.8 32.2

Iron - 7.1 20.1

Table 6. Prevalence of micronutrient deficiencies in women (15 – 49 yrs)

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MAIN DETERMINANTS OF NUTRITION STATUS

Food security Education (esp. of women) Poverty Health care Water and sanitation Gender equality/women empowerment Enabling environment

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STATE OF FOOD SECURITY IN CAMEROON Only 20% arable land is cultivated 53% of nat. pop. live in rural areas, where > 50% live

below national poverty line Low productivity, high food exportation to CEMAC, high

influx of refugees, result to high food prices Most rural people are too poor to buy food Strategies used: eat cheap (72%); eat less (45%);

reduce # meals (33%) 10% of rural households live in persistent food

insecurity Severe food insecurity: FN= 4.1%; N= 3.7%, W= 3.3% Food insecurity is recurrent in FN & N Regions

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Country GNI (2003)

Life expectancy (yrs)

Mortality rate (/1000)Adult (2011) Infant

(2012)Females Males

Madagascar 1333 64.7 167 213 41Rwanda 1403 64.1 291 344 39Ethiopia 1303 63.6 265 306 47Senegal 2169 63.5 239 293 45Kenya 2158 61.7 294 346 49

Tanzania 1702 61.5 322 363 38Liberia 752 60.6 292 331 56

Zimbabwe 1307 59.9 473 501 56Uganda 1335 59.2 363 410 45

Cameroon 2557 55.1 372 415 61

Table 7. Health status in selected African countries

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Region Year2001 2005 2010

Littoral 56.2 67.6 78.6

South West 78.2 66.3 75.4

Adamaoua 41.8 40.4 60.7

West 29.6 38.2 59.7

Centre 23.5 47.6 58.8

North West 47.9 52.0 51.5

South 33.0 39.7 44.3

Far North 40.7 32.9 37.8

North 42.8 28.0 35.4

East 12.8 26.7 25.3

National 49.7 50.5 59.8

Urban areas 84.4 84.6 88.5

Rural areas 31.2 32.8 42.0

Table 8. % CMR pop. with access to improved drinking water

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Region Year2001 2005 2010

Littoral 58.4 54.2 66.8South West 55.3 49.2 61.4Adamawa 47.2 42.7 60.6West 43.5 47.6 56.4

North West 27.1 35.8 56.2South 57.5 52.2 55.6Centre  31.4 40.4 37.9East 33.1 44.3 35.8North 27.4 12.4 32.6

Far North 27.2 15.2 16.9National 44.7 41.5 52.4

Urban Areas 77.3 75.0 81.3Rural Areas 27.4 24.2 34.3

Table 9. % CMR pop. using improved sanitation facilities

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THE ENABLING ENVIRONMENT: NATIONAL NUTRITION POLICIES

The adoption of a National Policy on Food and Nutrition in the year 2006;

The creation of an inter-ministerial commission on food security in 2010;

The admission of Cameroon into the SUN movement in 2013;

The creation of an inter-ministerial commission to combat malnutrition in the three northern regions and the East region in 2014;

The adoption in 2014 of a national policy on gender -2011-2020;

The elaboration of a national policy on food and nutrition (NPFN) – 2015-2034 in 2015.

Rich policies environment but poor implementation

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THE ENABLING ENVIRONMENT: TABLE 10. FINANCIAL AND HUMAN RESOURCES ALLOCATED TO HEALTH/EDUCATION SECTORS IN SOME AFRICAN COUNTRIES

Country # physicians/1000 (2003-2012)

Expenditures on health

Pupil-Teacher ratio (2003-2012)

Expenditure on

education, 2005-2012 (%

GDP)

% GDP % by househ

old

Cameroon 0.08 5.2 65.1 46 3.2Ethiopia 0.03 4.7 33.8 54 4.7Kenya 0.18 4.5 46.4 47 6.7Liberia 0.01 19.5 17.7 27 1.9

Madagascar 0.16 4.1 25.2 43 2.8Rwanda 0.06 10.8 21.4 59 4.8Senegal 0.06 6.0 32.7 32 5.6Tanzania 0.01 7.3 31.7 46 6.2Uganda 0.12 9.5 47.8 48 3.3Zimbabwe 0.06 nd nd 39 2.5

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STAKEHOLDER IDENTIFICATION AND CLUSTERING

Various stakeholders execute activities that impact on the factors influencing nutritional status

The different stakeholder clusters include: Policy makers (government ministries)Research and Education institutionsUN systemNGOs (national and international)Business world (Food processors)Farmer’s associations/women’s groupsConsumer syndicatesDonorsMass mediaSH collaboration is essential to achieve common

objectives

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STAKEHOLDER CLUSTERS AND LINKAGES IN THE AN NEXUS

Research/Education

Business

world

Farmer/women

groups

NGOs

Donors

Consumer syndicates

Mass medi

a

UN-system

Policy makers

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LESSONS LEARNED The inevitable relevance of data-base. This is indeed very

scarce w.r.t. nutrition sector in Cameroon Insufficient linkages/interactions btwn many SH clusters

(conflicts, overlapping of roles,etc) Inadequate nutrition education/training programs for

capacity building Low gov’t commitment to promote AN nexus: Well-written

policies but little resources allocated for implementation. Insufficient gov’t investment in promoting the supporting

sectors of the AN nexus Nutrition-sensitive intervention programs use both the

curative and preventive approaches. However, monitoring and impact evaluation is lacking

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GAPS Best practices for building multi-

stakeholder cooperation Entry points for integrating nutrition into

agric. projects Opportunities for strengthening

women’s participation in the nexus Strategies for improving gov’t

investment in the AN nexus

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THANK YOU!!

MERCI!!