BUILDING THE EVIDENCE BASE FOR STRENGTHENING THE AGRICULTURE/NUTRITION NEXUS: THE CASE OF CAMEROON

1. BUILDING THE EVIDENCE BASE FOR
STRENGTHENING THE
AGRICULTURE/NUTRITION NEXUS:
THE CASE OF CAMEROON
BY
FLORENCE FONTEH ANYANGWE
ASSOCIATE PROFESSOR
THE UNIVERSITY OF DSCHANG, CAMEROON
1

2.  Introduction:justification, objectives, methodology
 State of nutrition security in Cameroon
 Determinants of nutrition status in Cameroon
 The enabling environment
 Stakeholder clusters/linkages
 Lessons learned and gaps
2

3.  FNS is of special significance for the ACP region
 Without adequate nutrition it will be difficult to attain
the sustainable development goals (SDGs)
 A mutual relationship exists between agriculture (food
supply) and nutrition and the benefits/casualties are bi-
directional.
 However, insufficient attention has been paid towards
improving the agriculture and nutrition nexus
3

4.  Malnutrition does not simply arise just from
poor access to food, but also from a host of
interacting processes (health care, education,
sanitation and hygiene, access to resources,
women’s empowerment etc) which are
indispensable to the AN nexus
 Furthermore, a combination of several options
(enabling env, research, SH cooperation,
capacity bldg, etc) contribute to strengthening
the AN nexus and in achieving the desirable FNS
outcomes
 The effectiveness of roles played by these
options vary tremendously between countries
and regions
4

5.  To build the evidence base for strengthening
the agriculture/nutrition nexus in Cameroon
 To share the lessons learned
5

6.  Desk top review
 Interviews with key stakeholders
 Stakeholders’ consultation workshops
(pending)
6

7. 7Figure 1: Map of Cameroon, showing administrative Regions
Population : 22.3 million
Surface area: 475,650 km2
Pop growth rate : 2.5 %
GDP/capita : 1426 USD
Life expectancy : 55 years
HDI : 0.505

8. 8
Country Infant mortality
(under one) per 1000
live births
Infant mortality
(under five) per 1000
live births
Gabon 57 89
Ghana 64 111
Cameroon 74 144
Kenya 77 115
Uganda 88 152
Ethiopia 97 168
Nigeria 100 201

9. Indicato
r
Prevalence
Very high (>35 %) High (30 –
35 %)
Moderately
high
(15 – 29 %)
Low
(less than
10 %)
Underno
urishme
nt
Sudan, Central African
Republic, Democratic
Republic of Congo,
Somalia
Chad, Mali,
Cote
d’Ivoire,
Ethiopia,
Zambia
Cameroon,
Kenya,
Nigeria
Ghana
Stunting Sudan, Central African
Republic, Democratic
Republic of Congo,
Somalia, Congo
Cameroon,
Nigeria,
Chad, Mali,
Cote d’Iv,
Malawi,
Gabon,
Tanzania,
Uganda,
Namibia,
Ghana,9

10. 13.6
22.2
18.1
14.6
24.4
29.3
31.7 32.5
3
6
5 5.6
0
5
10
15
20
25
30
35
1991 1998 2004 2011
% Underweight
% growth retardation
% Emaciation
10
Figure 2. Evolution of malnutrition in Cameroon

11. Indicator % Children under five affected
Growth retardation (moderate) 31.7
Growth retardation (severe) 12.9
Stunting 33
Wasting 6
Severe wasting 2
Underweight (moderate) 14.8
Underweight (severe) 4.2
Overweight 7
11
Table 3. Child anthropometry

12. Micronutrient % National % South % North
Zinc 69.1 67.6 80.5
Folate 8.4 5.4 19.8
Vitamin B12 28.1 24.3 43.6
Vitamin A 35 28.6 43.0
Iron 38 16.6 49.0
12
Table 4. Prevalence of micronutrient deficiencies
in children (1-5 yrs old)

13. Indicator % National % South % North
Severe
underweight (%)
1.5 0.3 4.3
Moderate
underweight (%)
0.5 0 1.3
Mild underweight
(%)
5.4 2.3 12.3
Total underweight
(%)
7.3 2.6 17.8
13
Table 5. Prevalence of malnutrition in women
(15-49 yrs)

14. Micronutrient % National % South % North
Zinc 76.9 72.6 86.5
Folate 16.6 10.5 17.8
Vitamin B12 28.6 28.1 41.2
Vitamin A 21.4 14.8 32.2
Iron - 7.1 20.114
Table 6. Prevalence of micronutrient deficiencies
in women (15 – 49 yrs)

15.  Food security
 Education (esp. of women)
 Poverty
 Health care
 Water and sanitation
 Gender equality/women empowerment
 Enabling environment
15

16.  Only 20% arable land is cultivated
 53% of nat. pop. live in rural areas, where > 50% live below
national poverty line
 Low productivity, high food exportation to CEMAC, high influx
of refugees, result to high food prices
 Most rural people are too poor to buy food
 Strategies used: eat cheap (72%); eat less (45%); reduce #
meals (33%)
 10% of rural households live in persistent food insecurity
 Severe food insecurity: FN= 4.1%; N= 3.7%, W= 3.3%
 Food insecurity is recurrent in FN & N Regions
16

17. Country GNI
(2003)
Life
expectancy
(yrs)
Mortality rate (/1000)
Adult (2011) Infant (2012)
Females Males
Madagascar 1333 64.7 167 213 41
Rwanda 1403 64.1 291 344 39
Ethiopia 1303 63.6 265 306 47
Senegal 2169 63.5 239 293 45
Kenya 2158 61.7 294 346 49
Tanzania 1702 61.5 322 363 38
Liberia 752 60.6 292 331 56
Zimbabwe 1307 59.9 473 501 56
Uganda 1335 59.2 363 410 45
Cameroon 2557 55.1 372 415 61
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Table 7. Health status in selected African countries

18. Region Year
2001 2005 2010
Littoral 56.2 67.6 78.6
South West 78.2 66.3 75.4
Adamaoua 41.8 40.4 60.7
West 29.6 38.2 59.7
Centre 23.5 47.6 58.8
North West 47.9 52.0 51.5
South 33.0 39.7 44.3
Far North 40.7 32.9 37.8
North 42.8 28.0 35.4
East 12.8 26.7 25.3
National 49.7 50.5 59.8
Urban areas 84.4 84.6 88.5
Rural areas 31.2 32.8 42.018
Table 8. % CMR pop. with access to improved drinking
water

19. Region Year
2001 2005 2010
Littoral 58.4 54.2 66.8
South West 55.3 49.2 61.4
Adamawa 47.2 42.7 60.6
West 43.5 47.6 56.4
North West 27.1 35.8 56.2
South 57.5 52.2 55.6
Centre 31.4 40.4 37.9
East 33.1 44.3 35.8
North 27.4 12.4 32.6
Far North 27.2 15.2 16.9
National 44.7 41.5 52.4
Urban Areas 77.3 75.0 81.3
Rural Areas 27.4 24.2 34.319
Table 9. % CMR pop. using improved sanitation facilities

20.  The adoption of a National Policy on Food and Nutrition in
the year 2006;
 The creation of an inter-ministerial commission on food
security in 2010;
 The admission of Cameroon into the SUN movement in
2013;
 The creation of an inter-ministerial commission to combat
malnutrition in the three northern regions and the East
region in 2014;
 The adoption in 2014 of a national policy on gender -
2011-2020;
 The elaboration of a national policy on food and nutrition
(NPFN) – 2015-2034 in 2015.
Rich policies environment but poor implementation20

21. Country #
physician
s/1000
(2003-
2012)
Expenditures on
health
Pupil-
Teacher
ratio
(2003-
2012)
Expenditure
on
education,
2005-2012
(% GDP)
% GDP % by
househol
d
Cameroon 0.08 5.2 65.1 46 3.2
Ethiopia 0.03 4.7 33.8 54 4.7
Kenya 0.18 4.5 46.4 47 6.7
Liberia 0.01 19.5 17.7 27 1.9
Madagascar 0.16 4.1 25.2 43 2.8
Rwanda 0.06 10.8 21.4 59 4.8
Senegal 0.06 6.0 32.7 32 5.6
Tanzania 0.01 7.3 31.7 46 6.2
Uganda 0.12 9.5 47.8 48 3.3
Zimbabwe 0.06 nd nd 39 2.5
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22.  Various stakeholders execute activities that impact on the
factors influencing nutritional status
 The different stakeholder clusters include:
 Policy makers (government ministries)
 Research and Education institutions
 UN system
 NGOs (national and international)
 Business world (Food processors)
 Farmer’s associations/women’s groups
 Consumer syndicates
 Donors
 Mass media
SH collaboration is essential to achieve common objectives22

23. Research/
Education
23
Business
world
Farmer/
women
groups
NGOs
Donors
Consumer
syndicates
Mass
media
UN-
system
Policy
makers

24.  The inevitable relevance of data-base. This is indeed very
scarce w.r.t. nutrition sector in Cameroon
 Insufficient linkages/interactions btwn many SH clusters
(conflicts, overlapping of roles,etc)
 Inadequate nutrition education/training programs for
capacity building
 Low gov’t commitment to promote AN nexus: Well-written
policies but little resources allocated for implementation.
 Insufficient gov’t investment in promoting the supporting
sectors of the AN nexus
 Nutrition-sensitive intervention programs use both the
curative and preventive approaches. However, monitoring
and impact evaluation is lacking
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25.  Best practices for building multi-stakeholder
cooperation
 Entry points for integrating nutrition into
agric. projects
 Opportunities for strengthening women’s
participation in the nexus
 Strategies for improving gov’t investment in
the AN nexus
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