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A global height study released recently, names Uganda among the countries whose population have registered a decline in average height (call it stunting). The report notes that the average height of young Ugandan men and women has decreased by as much as 5 centimeters over the same period.

The 2016 WaterAid report entitled Caught short: how a lack of toilets and Clean Water contributes to Malnutrition also ranks Uganda among the top 30 countries globally with the highest percentage of population with stunted growth.

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‘‘How tall we grow is strongly influenced by nutrition and environmental factors, although an individual’s genetic factors may also play a role.’’ The Global height report notes

Local comedian Kapere
Local comedian Kapere

As such children and adolescents who are better nourished and live in better environments tend to be taller. Height may also be influenced by a mother’s health and nutrition during pregnancy.

The WaterAid report adds; lack of toilets and the water we drink too affects children growth and development leading to stunting. According to the report, 34.2 percent of Ugandan population is stunted, 21 percent of the population lack access to clean water while 80.9 percent of the population lacks access to toilet. This partly contributes to stunting.

Most rural ugandans lack do not have toilets
Most rural ugandans lack toilets facilities, they do open defecation

The report reveals a quarter of all cases of stunting are estimated to be directly caused by chronic diarrhea in the first two years of life. And 88% of cases of diarrhea are caused by inadequate WASH.

The 2014 Uganda Population Census reveals a large proportion (33 percent) of households in the rural areas use water from unimproved water sources. Uganda population is estimated at 36m and largest percentage of this population stays in the countryside.

The same report reveals a sizeable number of Ugandans lack toilet facility especially those up-country.

Stunting is defined as children having low height for age or they have not developed as they should, physically or cognitively. It is a consequence of malnutrition in the first 1,000 days from conception until age two. It is largely irreversible after the age of two.

Nutritious food not an end itself

Even if children have plenty of food they can still suffer from malnutrition

For example drinking dirty water, polluted by people going to the toilet in the open and the inability to wash hands before eating can lead to diarrhea, intestinal worms and other infections. Evidence suggests five or more cases of diarrhea before two years of age can lead to stunting.

Getting ill with diarrhea, intestinal worms and other infections stops children from being able to absorb the nutrients they need to grow physically and mentally.

The impacts beyond health

The time wasted from being sick with waterborne diseases or collecting water has a huge impact on education. Children who regularly have diarrhea or other infections caused by poor WASH are more likely to fall behind in school or even drop out altogether

Regular bouts of diarrhea not only mean children struggle to keep up at school because they are often absent, it can also cause stunting which affects the makeup of the brain and prevents children from reaching their potential.

Malnutrition also inflicts a big economic burden. The 2016 Global Nutrition Report found that the impact of malnutrition costs 11% of GDP annually across Africa and Asia.

What should be done?

The Lancet estimates that direct interventions to address malnutrition, such as nutrient supplements and exclusive breast-feeding, can only reduce stunting by 20% in the worst affected countries, even if they’re reaching 90% of the population in need. That means improving access to clean water, sanitation and hygiene, along with measures in other sectors, plays a crucial part in reducing the remaining 80% of stunting

Improving access to clean water, adequate sanitation and good hygiene must be central to nutrition action plans. Good food will only get us part of the way to the finishing line. We need clean water, clean toilets and clean hands to finish this race, end under nutrition and stunting all together.

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