By Awa Sowe
Despite recent improvement in socio-economic development, The Gambia still faces many nutritional problems, including undernutrition in children less than 5 years of age, micronutrient deficiencies among women and children, sub-optimal infant and young child feeding (IYCF), and increasing rates of obesity and nutrition-related non-communicable diseases (NCDs).
According to SMART Survey (2015), The Gambia has a high stunting prevalence among children under-five years, estimated at 22.9% and underweight of 21.6%. The prevalence of acute malnutrition, with Global Acute Malnutrition (GAM) level estimated at 10.3%, is above the acceptable threshold of 10%. A pooled analysis of 10 prospective studies from Africa, Asia and Latin America found that children under 5 years that are malnourished are at a greater risk of dying. Infants and young children have high nutritional requirements because of their rapid growth and development.
Adequate nutrition is essential for the infant and young child to reach their full growth potential. Optimal feeding practices of children 0 to 24 months are critical in breaking the cycle of malnutrition. Breastmilk is the ideal food for optimal infant growth and development. Breastfeeding is beneficial to both maternal and infant health. However, the full benefits of breastfeeding can only be realized if optimal infant and young child feeding is practiced. Exclusive breastfeeding for the first six months of life followed by appropriate complementary feeding and continued breastfeeding up to 2 years.
The malnutrition situation in Gambia is further compounded by problems of food security, food safety, poor hygiene, sanitation, and health care. The deleterious effects of malnutrition include increased risk of illness and death especially in children reduction in cognitive capacity, lowered economic productivity potential, and increased risk of diet-related non-communicable diseases in adulthood.
A wide range of nutrition-specific interventions are currently being implemented by the Ministry of health, National Nutrition Agency and partners such as focusing on promotion of women’s nutrition before, during and after pregnancy, optimal breast-feeding including the context of HIV and AIDS, optimal complementary feeding, control of Vitamin A , anemia and iodine deficiency disorders; public health interventions such as deworming, promoting hygiene and sanitation, school health and nutrition; malaria control; and growth monitoring and counselling.
In addition, nutrition-sensitive interventions related to food security, poverty reduction, hygiene and sanitation, social protection, and health and nutrition education are also being implemented by various line ministries. Many of these interventions have nationwide coverage, but their impacts have been largely minimal. A major reason is that the policies were often developed and/or implemented on the basis of single sector mandates, priorities, and key functions, without clear co-ordination and national policy guidance.
The National Assembly, recently, completed the consideration stage of the Bill titled Nutrition Bill, 2023.The Bill, tabled before the plenary by the Vice President, was referred to the committee for further scrutiny and to report its findings to the plenary.
Through the National Social Protection Policy (NSPP 2015-2025), the Government of The Gambia commits itself to the realisation of a well-structured social protection mechanism.
During the debate on the Bill, Lawmakers advanced that among other things, the Bill will strengthen nutrition security in The Gambia if enacted. The Bill was then referred to the National Assembly Select Committee, for further scrutiny and to report its findings to the plenary.
The committee in its report, inter alia, recommended that the Bill is to further strengthen nutrition security in The Gambia; that it’s imperative to swiftly enact the proposed Bill, aligning with constitutional rights and international agreements.
The report of the committee was then adopted and was set for consideration which continued and was completed on Monday, 23rd September, 2024.The purpose of the Bill is to give effect to the Government’s commitment to protect the rights of Gambians as outlined in the 1997 Constitution and the United Nations Conventions and Declarations related to food and nutrition security which The Gambia is a signatory to.
As part of the process of defining the practical application of the Constitution and the UN Conventions, this Bill has made provisions to ensure adequate nutritional services that protect the rights of its people.
The Bill further seeks to give effect to the government’s commitment to strengthening the coordination of all nutrition related interventions in the country by mandating the Agency to legally carry out this function.
The Bill also provides for the establishment of a Board of Directors to manage the affairs of the Agency and equally gives it the powers to inspect hospitals, healthcare institutions, schools, care homes, prisons, and other relevant institutional establishments to ensure that the nutritional needs of persons in these institutions are met.
This will help the government ensure that the nutritional requirements of some of the most vulnerable groups are provided for. In the same vein, it will help in strengthening the governance structures such as the National Nutrition Council, and the Nutrition Technical Advisory Committee (NTAC).
To further achieve these commitments, the Government has necessitated a holistic approach to reviewing the Food Act, which gives the Agency the role of acting as the lead Agency in handling nutritional issues coupled with the wording in the National Nutrition Policy and coming up with a comprehensive legislation to address the issues of nutrition as envisaged by the government pronouncement to make available the resources as well as empower institutions to better handle nutrition issues, for a better livelihood of its people.
Furthermore, the Government ensures not only that the policy goals regarding nutrition are achieved, but that the policy goals are achieved without further delay. As the legislative body completed the consideration of the Bill, the Assembly Business Committee scheduled for the third reading.
Deputy Speaker, Hon. Seedy SK Njie. Mentioned that before that, the Vice President and the Office of the Clerk, will in accordance with Standing Order 72 (sub 20), print the amended version for circulation to members before the third reading.
Mr Abdul Aziz Ceesay, the Director of the National Nutrition Agency’s Social and Behavioral Change Communication (NaNA SBCC), explained that the Bill takes into consideration the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) and the Convention on the Rights of the Child (CRC).
He went on to explain that women bear the responsibility for food and nutrition, even at the household level.
“By providing women with adequate nutrition, they will be better equipped to fulfil their reproductive, productivity, and other duties,” he asserted.
It is very important to note that, the absence of a coherent national nutrition bill that outlines a framework for developing and implementing nutrition interventions at all operational levels, defines institutional roles and responsibilities, and articulates linkages and co-ordination arrangements has contributed to limiting the scope and scale of nutrition and other preventive health interventions.
Non availability of a national legislation/policy also limits the extent to which pressure can be brought to bear on government to provide resources for implementation in a sustained manner. The dominance of extra-governmental donors in initiating, funding, and implementing nutrition policies and interventions has created some degree of dependence by government and other policy actors on donors, leading to inadequate commitment in terms of funding.
Today although available evidence points to the proven efficacy and cost-effectiveness of nutrition solutions and the critical impact that nutrition improvements would have on the achievement of the Millennium Development Goals (MDGs), investment in the country’s nutrition remains low.
Therefore, this Bill will address maternal malnutrition in The Gambia include training of health workers on basic nutrition using the life cycle approach, promotion of dietary diversification, with the support to establishing communal or backyard gardens, iron/folate supplementation of pregnant women and the promotion of optimal infant and young child feeding practices
