Addressing Malnutrition in Africa: A Community Development Report

This report critically evaluates research articles on community development interventions addressing malnutrition in Africa. It highlights the double burden of malnutrition, with both under-nutrition and overweight posing significant threats. Poverty, lack of infrastructure, gender inequality, and AIDS exacerbate hunger and under-nutrition. The report discusses various strategies and frameworks, including nutritional capacity assessment, therapeutic feeding programs, and community management strategies. Key findings from reviewed articles emphasize the importance of locally available food supplementation, community-based programs, and addressing the nutritional needs of vulnerable populations. The PRISMA framework is used to evaluate the interventions and assess the quality of research. Ultimately, the report underscores the need for sustainable measures and collaborative efforts to combat malnutrition and improve the overall well-being of individuals in Africa; solved assignments are available on Desklib.

Running head- PUBLIC HEALTH MASTERS
Community development on malnutrition in Africa
Name of the Student
Name of the University
Author Note

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Executive summary
Malnutrition occurs in all forms, such as, overweight or under-nutrition. It presents significant
threats, and challenges, to the human health. At present, the world is facing a double burden of
malnutrition, which can be attributed to the high rates of overweight children in developed
countries, and under-nourished children in developing countries. Inadequate nutrition and hunger
have been found to contribute to higher rates of mortality that result in maternal and children
death. It also leads to impairment in the brain and physical development of infants. Furthermore,
this inadequate nutrient intake is correlated with several chronic illnesses and infectious diseases.
All of these conditions are life-threatening and extremely difficult to apply proper intervention,
in regions such as, Africa that has limited resources and overburdened health systems. Efforts
have been taken to reduce these rates of under-nutrition in several countries of Africa. The report
will critically evaluate research articles that elaborate on the interventions.

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Table of Contents
Introduction......................................................................................................................................3
Discussion........................................................................................................................................3
Literature review..........................................................................................................................5
Analysis of the articles.................................................................................................................6
Recommendations and Conclusion................................................................................................14
Research question..........................................................................................................................15
References......................................................................................................................................15
Appendix 1.....................................................................................................................................20
Appendix 2.....................................................................................................................................21

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Introduction
Millions of people living in Africa lack the basic human needs that can be attributed to
poverty. The nation is generally ranked low, with regards to economic growth and development.
The small task According to research studies, poverty, in addition to lack of infrastructure,
gender inequality and AIDS create significant impacts on hunger in Africa. While there is plenty
of food in some regions, lack of reliable pathways for delivering the food to the vulnerable and
disadvantaged people contribute to hunger, and subsequent under-nutrition (Gohou and Soumaré
2012). Similarly, gender inequality plays an essential role because there is a tendency to deliver
more food to women. AIDS also renders the community members of rural regions too sick to
participate in agricultural activities, thereby resulting in their failure to acquire food (Justesen
and Bjørnskov 2014). The assignment will illustrate several strategies and frameworks that have
been formulated as a part of community development to address the severe issue of malnutrition
in Africa.
Discussion
Malnutrition can be defined as the condition that arises when an individual consumes diet
that does not contain adequate proportion of the nutrients, needed by the body. Commonly
encompassing overweight and under-nutrition, malnutrition is a global issue and presents a
plethora of threats to health (Neis, Zielstra and Zipf 2013).
According to research reports, the continent is under serious nutrition related threats that
stem from deficiency in nutrients in the diet. Despite an reduction in prevalence of stunting on a

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global scale, more than 60 million African children, under the age of 5 years demonstrate poor
growth and development. Recent reports from the WHO indicate that the issue is still persistent
in the region, which thereby contributes to an increase the number of undernourished children
(Horton and Steckel 2013). The major factors that contribute to under-nutrition are population
growth, limited resources for purchasing food and mounting food wastes. This lack of nutritious
food items creates a significant impact on the infrastructure development and economic progress
of the nation, in addition to human wellbeing. African nations are found to lag behind on
attaining appropriate physical and mental capacities for the population due to under-nutrition. An
increase in mortality rates, chronic illnesses, and loss of productivity contribute to this condition
(Chan et al. 2012). Thus, it can be stated that improving the dietary intake and ending
malnutrition in the nation will greatly help in reversing the problem. The African government
and non-governmental organizations have adopted several strategies with the aim of formulating
productive and sustainable measures that will counteract the issue of malnutrition and enhance
the overall growth and wellbeing of all individuals.
According to statistical data, about 1 in 12 children living in the sub-Saharan regions of
Africa suffer from malnutrition. The World Bank reports state that approximately 17.6 million
children living in the region are affected with acute malnutrition (Bain et al. 2013). Furthermore,
there was an increase in the number of stunted children, between the years 1990-2014, by
approximately 20 million. Further reports from the WHO also suggest that Africa demonstrates
the highest risk of a child dying before the first birthday (Grace et al. 2012). Research findings
also illustrate the fact that more than 6.7 million people die each year in Africa due to hunger (de
Sherbinin 2011). Health promotion is defined as the process that enables individuals to improve
and increase their control over their health status. It focuses on a range of environmental and

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social interventions. Socio-economic differences directly influence the educational attainment,
occupational status, and income. The social determinants of health are most often amenable to a
range of political interventions and depend on political action (Ahnquist, Wamala and Lindstrom
2012). Health promotion strategies are governed by the politics of the nation because wellbeing
and good health are the basic aspects of human rights and citizenship (Savedoff et al. 2012).
Cultural aspects of a the residents also influence health promotion owing to the wide plethora of
existing experience and knowledge, regarding health promotion and disease prevention that
exists among the culturally diverse populations (Mackenbach 2012). Thus, it can be stated that
these factors play a major role in the adoption of effective health promotion strategies.
Literature review
The primary aim of PRISMA is to evaluate the interventions that have been applied in the
context of research. It acts as an essential critical appraisal tool that facilitates the quality
assessment of the selected literature, thereby assisting in gauging the reliability and effectiveness
of the research findings (Stovold et al. 2014). Thus, the PRISMA acts as a broader effort for
improving the reporting of various kinds of healthcare based research. The PRISMA flow
diagram helps in depicting the flow of relevant information through a wide variety of stages that
are imperative for a systematic review. The diagram assists in mapping out the records that have
been identified, excluded or included in the search. The diagram also explains the probable
reasons for exclusion of the articles. The major themes for the literature review include
nutritional capacity assessment, nutritional feeding or therapeutic feeding programs, integrative
protocol, and community management strategies.
Relevant research articles were extracted from PubMed databases by using specific key
words such as, “child”, “children”, “malnutrition”, “under-nutrition”, “prevention”, “reduce”,

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“strategies”, “community development”, “framework”, “Africa”. Several boolean operators such
as, AND, OR, and NOT were used to narrow down the search and exclude articles that were
irrelevant to the topic of interest. Articles that were published in English, not prior to 2011, were
selected for the analysis. Unpublished articles, abstracts and articles published before 2011 were
excluded. Fourteen articles were enlisted (refer to appendix for PRISMA flow chart).
Database PubMed
Total number of hits after search 228
Records that were identified after thorough
search
58
Number of duplicates 26
Excluded articles 12
Full text articles that were extracted 14
Table 1- Summary showing database search results
Analysis of the articles
Theme 1: Nutritional capacity assessment
A framework developed by (Shrimpton et al. 2014) was based on building the nutritional
capacity for addressing the needs of child and mother malnutrition. The methodology was
appropriate due to the fact that capacity refers to the ability to conduct the predetermined
objectives and the procedure by which groups, individuals or organisations are able to increase
their problems solving ability. The researchers demonstrated an appropriate practice in building
the concept on existing approaches. Furthermore, the research focused on the operational effects

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of system, organizational, workforce and community level on nutritional assessment of the
community. The methodology acknowledged the importance of involving beneficiaries to
improve nutrition. It also illustrated the role of population coverage, village organizational
structure, community ownership and proper training to improve the nutritional needs. Issues
were associated with superficial conceptualizations of capacity development.
Theme 2: Nutrition feeding/therapeutic feeding
Another research study (Tomedi et al. 2012) was conducted with the aim of determining
the effectiveness and feasibility of locally available food supplementation to prevent child
malnutrition in Kenya. The research study was accurate in the way that it focused on the rural
population that had higher rates of child under-nutrition. The methodology can be stated accurate
due to the fact that food supplementation has been earlier proved to increase the amount to
nutrients in the normal diet among people suffering from its deficit. Furthermore, the researchers
focused on administering essential nutrients to the undernourished children. Thus, distribution of
food ration on a monthly basis was a necessary step that facilitated consumption of essential
proteins, vitamins and minerals, required by children in their growth years. Moreover,
conducting educational sessions on appropriate food handling and hand washing techniques were
also needed for preventing any adverse health effects.
The nutrition intervention programs that focused on malnutrition were assessed by
another study (Iversen et al. 2012). This demonstrated a correct methodology due to the fact that
the primary aim of these programs was related to alleviating malnutrition among the young
population. The primary drawback of these intervention programs was the fact that they failed to
address the nutritional needs of the blacks and other disadvantaged population. The research was

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accurate in analyzing the positive impacts of the community-based programme such as, the
Integrated Nutrition Programme on the population. However, it was also successful in
establishing failure of the programmes in increasing growth rates among the under-nourished
children in Africa.
Effectiveness of a mid-upper arm circumference related therapeutic feeding program on
treating acute malnutrition in West Africa were determined by another study (Goossens et al.
2012). The research was conducted in Burkina Faso, a region in West Africa that is severely
affected by high prevalence of children under-nutrition. Therefore, the research study was
correctly able to identify the global issue related to malnutrition and focused on a community-
based management to reduce the high burden of the disease. The methodology was correct in
using a routine program for monitoring data from the nutritional program that was conducted in
collaboration with the ministry. It was also accurate in identifying nutritional indicators for the
reason that emphasized on high levels of wasting and stunting. The nutritional program was
appropriately implemented following recommendations imposed by the national guidelines. The
methodology focused on increasing accessibility of the nutrition programs to all people,
regardless of their social standards. Accuracy can be demonstrated by the fact that children, who
received their nutritional intervention recovered better, achieved the standards of weight gain,
showed absence of pathological diseases, and had minimum duration of stay.
Another research article identified the effectiveness of community management strategies
in reducing acute malnutrition in regions of the developing world, such as, Ethiopia (Park et al.
2012).The methodology was correctly able to focus on the fact that more than 52 million
children under the age of 5 years suffered from protein energy malnutrition. It also speculated
that addressing malnutrition properly would lead to reducing one third of the total rates of child

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mortality and morbidity. It illustrated the importance of the management strategies formulated by
the WHO, in addressing under-nutrition. It also focused on effectiveness of gaining knowledge
on the function of different proteins, and antioxidants that play a major role in pathogenesis of
malnutrition. Necessary administration of mixture of oil, sugar and dried skimmed milk in
diluted clean water, which is supplemented with additional magnesium and potassium, was
elaborated. The article focused on the importance of readymade recovery diet that is widely
available and easily accessible. Importance of providing adequate training to the staff, and
increasing provisions of emergency interventions were also discussed.
The long term benefits of nutritional therapy among children suffering with moderate
acute malnutrition (MAM) in rural regions of Malawi were determined by another study (Trehan
et al. 2015). The methodology was correct in recruiting children aged 6 to 59 months suffering
from MAM, due to the fact that this physiological condition creates a drastic reduction in weight
of children. It was accurate in measuring year-long benefits of supplementary feeding among
such children regardless of their anthropometry. It focused on administration of soy ready-to-use,
whey ready-to-use, and blended supplementary foods. The researcher’s demonstrated accurate
practice in providing training to the research nurses, responsible of implementing the nutritional
program upon a child. Standard methodologies were set for the anthropogenic measurements.
Effectiveness of the research lies in the fact that lower rates of malnutrition and a reduction in
death rates, on supplementary feeding were observed.
Effectiveness of outpatient therapeutic feeding programs in improving recovery rates
among children suffering from acute malnutrition in Kamba district was determined by another
study (Shanka, Lemma and Abyu 2015). This research accurately reported that severe acute
malnutrition resulted in maximum number of paediatric hospital admissions in poor countries of

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Africa. The researchers demonstrated a correct practice in recruiting children, suffering from this
physiological disorder and were treated in outpatient services, through administration of feeding
programs. The methodology was correct in focusing on semi-structured data collection procedure
for determining the socio-demographic baseline characters, outcomes status and follow-up
conditions. Effectiveness of the therapeutic program was shown by high recovery rates among
children who received the treatment (67.7%). However, upon comparison with international
standards, recovery rates were found to be lower, which indicates conduction of therapeutic
programs on a more rigorous basis.
Infants suffering from severe acute malnutrition were also treated in a study that was
conducted in the Niger (Vygen et al. 2013). The methodology accurately recruited young infants,
admitted to nutrition rehabilitation programs for curing under-nutrition. The researchers
demonstrated an accurate practice in establishing importance of intensive antibiotic therapy,
exclusive breastfeeding, and coaching mothers on infant feeding practices. These interventions
showed significant improvements in rates of recovery (85%). Furthermore, effective
implementation of the nutritional rehabilitation program reduced mortality, infection and default
rates among the recruited infants.
Major ethical issues were associated with the existing debate on artificial nutrition and
hydration techniques. Furthermore, a large proportion of the population most often refused
therapeutic and nutritional feeding programs due to stereotypes and prejudices.
Theme 3: Integrative protocol
Another research also investigated the implications of an integrated protocol in managing
severe and moderate malnutrition among people living in Sierra Leone (Maust et al. 2015). The

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research was correct in identifying global acute malnutrition as a major problem that contributes
to high rates of mortality and morbidity among children and infants. It was also able to recognise
the fact that humanitarian emergencies like war, and draught often escalate rates of malnutrition.
Following recruitment of children with mid-upper arm circumference less than 12.5 cm, and
inadequate appetite, the researchers implemented the treatment protocol, recommended by the
government. Standard management protocol included proper administration of vaccines, food
supplements, folic acids and vitamins. They also demonstrated an accurate practice in feeding
the children with fortified blended flour that contained correct proportion of all essential
nutrients. Effectiveness of this treatment protocol can be associated with greater recovery rates,
and improved weight. The program also showed significant effects on reducing the number of
clinical visits, fever, infections and diarrhoea.
Implications of sustainable nutrition research agenda in sub-Saharan African regions
were also evaluated by a study that was correct in stating the fact that considerable economic
growth in the country fails to improve under-nutrition rates, when compared to the world (Lachat
et al. 2014). It was also correct in addressing the fact that diet related non-contagious diseases are
a major public health issue in the continent. The research focused on community interventions
for improving nutritional status among the members. It also established the importance of
behavioural strategies and food security interventions for improving impression. The findings
were accurate in stating that better governance on research that addresses nutrition problems,
aligning all nutrition related funding with priorities of the population, increasing the capacity of
nutrition research competency, and enhancing the process of information sharing in nutrition
research, are some of the major approaches that were considered essential by the primary
stakeholders of the nation.