Recently the Ministry of Health held a forum to discuss The Formative Research to Inform Adolescent Programming in Kenya report compiled by The World Food Program (WFP). The report focuses on issues surrounding adolescent nutrition in Kenya. It is in line with the Sustainable Development Goal 2 which advocates for Zero Hunger.
Addressing teen nutrition will go a long way in combating global malnutrition. Stakeholders involved with adolescents attended the forum to analyze how best the challenges and barriers can be tackled to ensure that teenagers from across the country are getting the required nutrition.
Adolescents are children between the ages of 10-19, and this makes up 22% which is almost quarter the size of the population in the country. However, it was clear from the beginning of the forum that the greatest challenge in tackling issues to do with adolescents is the lack of current data. Other issues that stood out during the discussion include;
Anaemia among children between 5-14 years old stood at 16.5% and 13.8% in children between the ages of 15-19.
Additionally, zinc deficiency among adolescents is at 80%. That is a clear indication of the health nutrition situation among the countries teens.
The interventions focusing on nutrition should focus more on girls. 18% of girls are pregnant and malnourished adolescents are under risks such as preconception anaemia, gestational hypertension, and pre-eclampsia.
Additionally, 31.5% of non-pregnant women have folate deficiency and 47.7% of them lack vitamin B12.
The major challenges facing adolescent nutrition in Kenya stated are;
Early marriages especially with communities that practice Female Genital Mutilation FGM). All these put adolescent girl’s health at risk. There is need for specialized nutrition and a balanced diet.
Peer influence and social media. Adolescents are consumed by the hype of eating junk food all the time. Most of these meals consumed do not constitute of a balanced diet thus many lack nutrients such as iron.
Mindset. Teenagers believe that eating healthy right is boring. They think foods that constitute of a balanced diet are meant for the sick and the old. These include vegetables and fruits. Additionally, the ‘hustler’ mentality forces many to consume one meal a day.
Poverty in many households. Many parents and caregivers lack the funds to continually buy food that constitutes a balanced diet. Living within their meals mean they have to compromise on some food groups such as fruits. This leaves most adolescents in those households malnourished.
Little or no physical activity. Since adolescents are still children, physical activity does not entail much. Simple things such as walking often are enough to keep one fit. However, most teenagers associate walking with poverty especially for those in urban areas.
Social norms and restrictive food practices– In nomadic areas, most communities avoid certain food groups either due to tradition or preference. They focus more on one food group which may cause the adolescents to suffer malnutrition.
Lack of nutrition knowledge. Some of these teenagers lack the information on what constitutes a balanced diet.
Various projects carried out to combat the issues among adolescents were presented during the forum. One such project is one which was one undertaken by Nutrition International. The project was aimed at addressing anaemia amongst adolescents in Kitui, Nakuru, and Busia through nutrition education and provision of Weekly Ionic Folic Acid Supplements (WIFS).
It is clear that managing anaemia especially in girls is of great importance. The project involved dispatching of iron supplements every week to all menstruating adolescent girls and women in the areas selected. The project also focused on giving these supplements to areas where 20% of non-pregnant women had anaemia. The idea behind the project was also to come up with the best possible approaches to delivering WIFS and more so nutrition education to these areas. Some of these approaches include;
Using teachers, healthcare workers and local radio stations to spread the word on WIFS.
Distributing the WIFS in school rather than health centres. Children visit school more regularly than they do health centres.
For those girls who could not make it to school, they preferred using channels such as church groups and youth clubs.
Training existing health workers to administer the WIFS since they understand and know their community better.
During the distribution of these WIFS, it was noted that most people in these areas had little or no knowledge of preventing anaemia.
Another project presented during the forum was A Program for Promoting Healthy Living among Adolescents in Kenya. It was organized by Diabetes Management Institute. The program aimed at identifying the cause of Non-communicable Diseases (NCD’s) in adolescents and how best to manage them. Some of the risk factors for NCD’s reported included; abuse of drugs such as alcohol, tobacco, indulging in unhealthy diets, and lack of physical activity. The main problem with these habits is that when started during the adolescent age and finally adulthood.
Most of the adolescents reported that even though they knew that those habits were not good of them, very few understood the health risks involved. The major avenue for help is continuously empowering these communities on healthy living and how best to manage these risk factors.
The last project presented was a program ran by Global Alliance for Improved Nutrition (GAIN) which used football to push the nutrition agenda. The visited various communities and initiated football sessions for adolescent girls. The choice to use football as a tool was because football itself is connected to nutrition due to physical activity. It was also very easy to organize, many girls were actually interested to join and have fun. Every football session included an interactive talk about nutrition. The project also involved engaging the teachers and community members in nutrition conversations so they could share it in their households.
One important aspect of the discussion was that even with the formulation of interventions, all efforts would go to waste if we do not figure out how to reach these adolescents wherever they may be.
Some of the challenges discussed on reaching adolescents include;
Engaging students in schools
Most teachers always think other things such as academics and providing any kind of food as opposed to a balanced diet are more important than nutrition. Thus engaging the teachers and members of the community about health care becomes an issue. Moving forward, it is of utmost importance to approach the school and community leaders to show that good nutrition and quality education are connected.
Most nomadic communities have cultural barriers that may hinder nutritional education such as early marriages and FGM. These practices often put adolescent girl’s health at risk and most communities are not willing to allow alterations to their traditions. The solution here is to work with these communities as opposed to working against them.
Excluding adolescents from the conversations at hand
While mapping out interventions dealing with how best to manage nutrition for adolescents, we may tend to push out the adolescents themselves. This is based on the premise that we are older and may know better. However, we cannot presume to know the issues these adolescents face when it comes to health and how best to solve these issues other than including them in these conversations as well.
Legal restrictions and policies
When it comes to issues such as HIV/AIDS, measures such as self-testing have been implemented for adults. This has increased the number of people who know their status. This is because they do not have to fear stigmatization of visiting clinics. However, when it comes to adolescents, their lack of legal age prohibits administration of self-testing kits. This makes it hard for many of them to know their status. Many do not take the initiative to get tested in healthcare centres.
Approaching adolescents the wrong way
Adolescence is a very fragile stage in one’s life. Teenagers are very rebellious and often think that adults have no idea what is good for them. If we are going to ensure that they are actively involved in these nutritional conversations, we need to target people who they look up to and would listen to. A group of mentors their age to help push the agenda of nutrition. Adolescents react better when confronted by someone they relate to.
Using the right means of communication is also of great importance. Where are the adolescents you are trying to reach? You will find some on social media. Engage their minds using video content, storytelling and using influencers to drive conversations about nutrition in social media.
There was a panel discussion which involved Willie Ngumi of GSMA, Dr Myriam Sidibe of Unilever, Immaculate Nyaugo from the Ministry of Health, Anastasia Mirzoyants of Well Told Story and Dr Christine Wambugu of Adolescent Health Program at the Ministry of Health. The issues discussed here involved how best businesses and the government can help push the agenda of gender nutrition.
Some points put forth were;
Leveraging technology to reach teenagers. 90% of households have access to mobile phones and this can be of great help to reach them.
Businesses should promote positive nutrition habits with their products. This is because these businesses have indirect contact with these teens. Thus they need to be careful about the products they put on the market.
The government needs to work with schools to prepare menus that are within the schools budget but still cater to all nutritional needs of the students.
The forum came to a close with a skit promoting engaging adolescents when it comes to making policies and interventions concerning their nutrition. The skit was performed by Safisha Mtaa, an initiative run by the youth of Mathare to promote good nutritional habits in their area.