[Blog Series] World Health Day – Diabetes and RMNCAH in Africa: C for Child Health
The Global Strategy for Women’s, Children’s and Adolescents’ Healthprovides a roadmap for ending preventable deaths of women, children and adolescents by 2030 and achieving health and well-being in all settings. This roadmap seeks to bring about the change needed to create a more sustainable and peaceful future, where every person not only survives, but thrives and can transform the world. In support of the Global Strategy, urgent action is needed to identify and to protect vulnerable children. The debilitating effects of diabetes in Africa are not only largely undiagnosed within poor health infrastructure systems, but are compounded by other child related health epidemics such as chronic malnutrition. Without a holistic response, the global community risks sleepwalking into a diabetes epidemic in Africa and beyond.
Type 1 diabetes is one of the most common and life threatening childhood diseases across the world. However, with limited access to healthcare, information and good nutrition, children in developing economies are among the most vulnerable victims to the illness. In turn, children in low to middle income countries run a higher risk of developing diabetes, partly because women in poorer countries are more likely to develop the illness (particularly gestational diabetes), leaving their offspring with a much higher chance of developing type 2 diabetes. There are currently 46,400 children in Africa with type 1 diabetes and each year 7,600 more are diagnosed, (and this doesn’t take into account the mortality rates due to lack of insulin and trained health professionals).
Good nutrition is both crucial to reducing the likelihood of children getting diabetes, and one of the most effective ways to manage it. However, with nearly 40 percent of children in Africa suffering from chronic malnutrition (60 million), and up to 450 million children at risk from chronic malnutrition over the next 15 years, improving children’s nutritional health must itself be seen and treated as an urgent global health priority.
Yet the challenge is even more complex. Up to 50 percent of chronic malnutrition oc- curs in the womb, and many children are born under-nourished simply as a result of the fact that their mothers are also suffering from malnutrition. Further, girls not only stand a higher chance of getting diabetes because of the future pregnancy risks, but they are more likely to be under-nourished than boys. This is compounded as they get older due to factors such as heavy physical labour, their lower position of power in the home, cultural traditions which inhibit female’s access to certain nutrient rich foods, and, as a new mother, the demands of breast feeding. This creates a situation where girls run a higher risk of getting diabetes which is exacerbated throughout their life, and are consequently less likely to be sufficiently nourished to a level that will reduce the potential effects of the illness when pregnant. This double disadvantage creates a recurring cycle, continuously reinforcing and strengthening diabetes’ grip on women and their children.
Yet the situation is far from hopeless. Much can be done to combat the spread and reduce the impact of diabetes. Early child care interventions and access to healthcare professionals are critical. Through a skilled midwife, not only will the mother’s chances of delivering a healthy baby increase, but health conditions can be detected early in children, and health advice on breastfeeding and appropriate nutrition can empower a mother to look after her child well. Furthermore, women who receive education about their own and their child’s health can pass this on to other women, creating a cycle of positive health behaviour which has a cumulative effect on the wellbeing of communities.
Another way to address diabetes in children is by breastfeeding, which is a proven method for protecting newborn babies. From the first hour of a baby’s life to age two, breastfeeding offers invaluable protection from infection, malnutrition, stunting and other health ramifications; it is estimated that this can prevent the death of over 800,000 children from malnutrition each year and reduce their chances of developing non-communicable illnesses such as diabetes.
The critical role of healthcare professionals cannot be overstated. Today in Nigeria, for example, the babies most likely to breastfeed within an hour of birth are delivered by a doctor, nurse or midwife at a health facility in an urban area, while the babies least likely to start breastfeeding early are delivered without any assistance, at home in rural areas.
The Wellbeing Foundation Africa, an Every Woman Every Childpartner, supports women across the continent to improve early childcare. The Foundation works with partners to initiate breastfeeding initiatives for mothers in Nigeria, alongside sensitivity campaigns within the country to encourage more mothers to breastfeed. As strong advocates for midwives, who need access to the right education, regulation, and midwifery associa- tions within a global midwifery services framework. They are crucial to implementing the Global Strategy and achieving Sustainable Development Goal 3, which is to ensure healthy lives and promote wellbeing for all, at all ages.
Diabetes affecting children in Africa is an urgent issue that can no longer be treated as an isolated health condition. Governments must recognise that the worrying rise in instances of diabetes is directly linked to a failure to sufficiently improve children’s nutritional health.
The data on diabetes in the developing world remains limited, however the picture on malnutrition is clear, and provides a compelling case for action from Governments and civil society leaders. It is imperative that leaders and populations work together to tackle this growing threat by implementing the Global Strategy. There are upcoming opportunities to engage country and sector leaders at the Women Deliver Conference and World Health Assembly in May. By acting now we can prevent another generation of the unborn and innocent being lost to preventable diseases.
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Anita Sharma
Executive Director
United Nations Foundation