Emerging early actions to bend the curve in Sub-Saharan Africa's nutrition transition

摘要

BACKGROUND : Sub-Saharan Africa is the last region to undergo nutrition transition and can still avoid its adverse health outcomes.OBJECTIVE : The paper explores emerging responses to ―bend the curve‖ in sub-Saharan Africa‘s nutrition transition to steer public health outcomes onto a healthier trajectory.METHODS : Early responses in three countries at different stages in food system transformation are examined: South Africa -advanced, Ghana –intermediate, and Uganda -early. By comparing these with international experience, actions are proposed to influence nutrition and public health trajectories as Africa‘s food systems undergo rapid structural change.RESULTS : Arising from rapid urbanization and diet change, major public health problems associated with overweight are taking place, particularly in South Africa and among adult women. However, public health responses are generally tepid in sub-Saharan Africa. Only in South Africa have policy makers instituted extensive actions to combat overweight and associated non-communicable diseases through regulation, education and public health programmes. Elsewhere, in countries in the early and middle stages of transition, public health systems continue to focus their limited resources primarily on under-nutrition. Related pressures on the supply side of Africa‘s food systems are emerging that also need to be addressed.CONCLUSIONS :Three types of intervention appear most feasible: Maternal and child health programmes to simultaneously address short-term undernutrition problems while at the same time helping to reduce future tendencies towards overweigh; Regulatory and fiscal actions to limit access to unhealthy foods; Modernization of Africa‘s agrifood food system, through job skills training, marketing reforms and food industry entrepreneurship.