More than 70,000 children in Narok County at risk of permanent damage due to chronic malnutrition

Silas Tumpeine, Narok County Nutrition Officer giving his presentation during the County Steering Group Meeting held on 3rd October 2017

More than 70,000 children in Narok County are at risk of lifelong damage due to chronic malnutrition according to a recent assessment by Narok County Nutrition Department.

According to the Silas Tumpeine, Narok County Nutrition Officer, this situation is mainly caused by lack of knowledge among the residents on the value of balanced health and nutrition  in their households.  It has also been precipitated by drought, poverty, lack of water, illiteracy and non-performance of  agriculture sector in pastoral and agro-pastoral regions of the county.

Indeed, the rise in drought-related malnutrition may also be attributed to  lack of household food supplies, including milk, low food stocks, and a rise in food prices.

"We are starring at  a very sad situation. In the near future if these children are not taken care of, they will have stunted growth, perform poorly and drop out of school and lead to vicious cycle of poverty in the county," said Silas during a County Steering Group Meeting held on 3rd  September 2017 at Narok County offices. 

Mr Tumpein added that chronic malnutrition is often hidden among children. If it is not corrected at the age of 2 years, affected children experience stunted growth, poor mental development and often drop out of school. Efforts to intervene during this period to counter the effects of malnutrition can reverse the harm it causes, but if the opportunity is missed, the child will never make up the difference in growth and development, and will be adversely affected for the rest of his/her life.

The worst areas hit by malnutrition include:  Mosiro ward, Ikerin ward, Enaramarashioriki, Elalangareta Eterit, Olooltoto, Sonkoroi, Nairenke, Rokonka, Olopito and Olenkuluo, among others. 

While commenting on the assessment, Narok County Commissioner  reiterated that both national and county governments should work together to address this life threatening challenge. He added that unless something is urgently done, Narok County is likely to lose an entire future generation of 70,000 people.  

"Relief work particularly sporadic distribution of supplements cannot fully solve the problem. We need to have home grown solution through reviving agriculture, increasing water access and carrying out community education to save lives," said, Deputy County Commissioner, Narok. 

According to Kenya Nutrition Situation Overview Arid and Semi Arid areas, July 217 report,  compared to February 2017, the overall nutrition situation continues to remain of great concern, including deterioration recorded in some counties. Furthermore, the situation is at risk of further deterioration in most counties in the coming months due to the anticipated worsening of the food security situation. Currently, 420,674 children 6 to 59 months and 39,068 pregnant and lactating women require treatment for acute malnutrition across the ASAL and Urban counties. 

Chronic Severe Malnutrition

According to the Ministry of Health's Malezi Bora Strategy, malnutrition is the direct result of insufficient food intake or repeated infectious diseases or a combination of both. It can result in increased risk to illness and death and can result in a lower level of cognitive development. 

"Children who suffer from chronic malnutrition fail to grow to their full genetic potential, both mentally and physically. The main symptom of this measured is stunting - shortness in height compared to others of the same age group - and takes a relatively long time to develop," adds Save the Children. 

According to the 2014 KDHS, 4% of children in Kenya are  stunted,  wasted and experience chronic malnutrition. Among the leading counties with chronic malnutrition include: West Pokot 45.9%, Kitui (45.8%), Kilifi (39.1%), Mandera (36.1%), Bomet (35.5%) and Narok (32.9%).

Acute Severe Malnutrition 

According to WHO,  severe acute malnutrition is defined by a very low weight for height (below -3z scores of the median WHO growth standards), by visible severe wasting, or by the presence of nutritional oedema. Decreasing child mortality and improving maternal health depend heavily on reducing malnutrition, which is responsible, directly or indirectly, for 35% of deaths among children under five.

According to the 2014 KDHS, 11% of children in Kenya are underweight and are too thin for their age.

Recently, Save the Children report warned that nearly 73,000 children in Kenya are severely malnourished and at risk of dying from drought-related hunger unless urgent aid is made immediately available.

Besides Narok, other counties with alarmingly high severe acute malnutrition rates include:  Turkan (2.3%),  East Pokot (5.8%), Mandera (5.2%), Samburu (3.8%), and West Pokot (3.2%). These counties have also seen an extreme deterioration in nutrition and food security.

Call to action 

County  and nation  governments in collaboration with development partners should prioritize and implement food security programmes targeted at most vulnerable and prevent damage to young and vulnerable populations. 

In Narok, as a short-term measure,  partners should support mass screening of children in the identified hotspots. They should also support in procurement and distribution of vitamin A supplements, minerals and basic nutrition packages to affected residents.  

Further, community education and outreaches should be supported to empower affected households to appreciate the value of proper nutrition in their diets. 

For long term interventions, partners should design food security programs aimed at revitalising agriculture particularly promoting drought resistant crops such as sorghum and beans. These programs should be integrated with community health and nutrition education.

Agri-education activities such as establishment of kitchen gardens near water sources, poultry production, bee keeping , goats and sheep production targeting women groups should be supported. Nguzo Africa in Collaboration is providing some these interventions through Enhancing Opportunities for Women's Enterprises (EOWE) programme in Narok County.

Now that agriculture and health functions are devolved, counties should design sustainable food security interventions to cushion vulnerable households from food stresses.

National Drought Management Authority (NDMA) Support 

On regular basis NDMA facilitates holding of the County Steering Group meetings to review the drought and food security situation in Narok County. 

Anne Oloolumbwa , County Drought Coordinator, NDMA Narok County  noted that through the CSG platform, NDMA sharies period Narok County drought status reports. These reports are critical in providing mitigation interventions for various sectors particularly in agriculture, water, health and educations. The platform also helps partners to share what they are undertaking to address drought and food security challenges affecting the county. 

Previously through similar assessments and recommendations, NDMA in collaboration with other partners constructed water pans in hard hit areas, supplied and installed water tanks to needy schools, and distributed food supplements to malnourished children. In livestock, NDMA vaccinated animals, and dissemination of livestock feeds in hardhit pastoral areas. 

County CSG meetings bring together  technical  teams from Narok County government, National government, civil society and likeminded community stakeholders.  Nguzo Africa is one of the active members in the CSG. The platform's recommendations informs the county executive and legislative arms on key priority development areas. 

Next steps

  1. Agriculture: Revitalize agriculture in Narok county to ensure that the residents are assured of food security. This will include provision of subsidized fertilizers, drought resistant seeds, and offer farmer field education services. 
  2. Livestock: Ensure that there is enough stock of drugs and vaccines for mass treatment and rapid responses. Provide  mobile livestock clinics in livestock transit routes. Provide subsidized livestock feeds and encourage local farmers to embrace pasture production and conservation. 
  3. Health:  Carry out mass outreaches and mass screening to reach to children hit by malnutrition. Educate households to start village gardens near water sources. Advocate for resolution of nurses and clinical officers strike to ensure lives are not lost due to impaired service delivery at facility level. Support in the implementation of Ministry of Health's Malezi Bora Strategy 2017-2020. 
  4. Water:  Desilting of water pans during dry spells.  Training of water user/management committees.  Installing existing water pans with solar panels to minimise running costs. Establish more strategic water dams in the following areas:  Shankoe to supply water to Kilgoris town, Ilkerin Loita, Naroosura,  Nairegia Enkare dam to supply water to Suswa and other lower areas, and construct a dam to distribute water to  Sogoo township and sorrounding areas.  Idendified water sources must also be well secured to minimise privatisation.  Scale up WASH services in the affected areas. 
  5. Conservation: Intensify tree planting campaigns to ensure that Narok county achieves the required target of 10% forest cover.  Promotion of tree planting in schools, markets and household levels. 
  6. County Policies and planning: Ensure that identified challenges and mitigation solutions are included in the upcoming Narok County Integrated Development Plan (CIDP) (2018-2022). 

This article was compilled by Elizaphan Ogechi

For more information contact Nguzo Africa