The Cost of Hunger in Africa (COHA) is an African Union Commission (AUC)-led initiative through which countries are able to estimate the social and economic impacts of child undernutrition. Twelve countries are participating in the study. Swaziland is part of the four first-phase countries.
The COHA study illustrates that child undernutrition is not only a social but also an economic issue, as countries are losing significant sums of money as a result of current and past child undernutrition. To that end, in March 2012, the regional COHA study was presented to African Ministers of Finance, Planning and Economic Development, who met in Addis Ababa, Ethiopia. The Ministers issued a resolution confirming the importance of the study and recommending it continue beyond the initial stage.
The COHA study in Swaziland is led by the National Children's Coordination Unit in the Office of the Deputy Prime Minister (NCCU/ODPM) with support from the Ministry of Health, Ministry of Agriculture, Ministry of Education, Ministry of Finance, Swaziland National Nutrition Council (SNNC), University of Swaziland and the World Food Programme Swaziland. These departments and ministries make up the National Implementation Team (NIT).
During the process, all data for the study was collected from national data sources including the Swaziland Labour Force Survey 2007, Demographic and Health Survey 2008 and previous DHS studies, Ministry of Health, Ministry of Education, African Centre for Statistics, and primary data collection.
Methodology
The COHA model is used to estimate the additional cases of morbidity, mortality, school repetitions, school dropouts and reduced physical capacity that can be directly associated to a person’s undernutrition status before the age of five. In order to estimate these social impacts for a single year, the model focuses on the current1 population, identifies the percentage of that population who were undernourished before the age of five, and then estimates the associated negative impacts experienced by the population in the current year. Using this information and the economic data provided by the Swaziland NIT, the model then estimates the associated economic losses incurred by the economy in health, education, and in potential productivity in a single year.
Trends in child stunting
A recent nutritional survey led by the Ministry of Health showed an important increase in the prevalence of stunted children of more than 10 percentage points, from 29.5% to 40.4%, from the previous DHS survey for 2005-06. The cause for this highly unusual increase in prevalence is not clear and it might require a deeper analysis and review of the methodological process carried-out in this last survey, to ensure comparability of the results. On the other hand, the prevalence of underweight children has maintained a relatively stable trend, between 9% and 6% between the years 2000 and 2009. This would mean that 46,000 of the 156,000 children under the age of five in 2009 are affected by growth retardation. Additionally, 40% of the school age population and working age population, representing 157,000 and representing 270,000 people respectively, are also suffering from the consequences of childhood stunting.
