TOGO: Malnutrition unacceptably high, aid to start - UNICEF

The international community is sending therapeutic food to communities in Togo, where a UN study into children's health and welfare has shown that in some areas nearly one in three children suffers from acute malnutrition.

The study, which was completed by the UN children’s fund (UNICEF) in 2006, calls malnutrition rates in two regions in the north of the country and one in the south "unacceptably high". UNICEF is set to launch a project it says will save children's lives as well as help prevent malnutrition, which the study said causes 51 percent of child deaths in Togo.

"Acute malnutrition is an indicator of a sharp degradation of a population's general state," said Stephane Quinton, head of the West Africa office of ECHO, the humanitarian aid arm of the European Commission.

ECHO, which recently made an assessment mission to Togo, has given 500,000 euros (US$683,000) to assist children in the affected regions, where Quinton said conditions "have deteriorated significantly."

UNICEF’s study, which was endorsed by the Togolese government in May 2007, said in the northern regions of Savanes and Kara acute malnutrition stands at 32 percent and 24 percent respectively. The rate is 17 percent in the southern region of Maritime, close to the capital Lome.

The nationwide rate is 14.3 percent, double that of Togo's neighbours, Benin and Ghana, and similar to that found in parts of Sahelian countries like Niger, Burkina Faso and Mali. It is barely under the World Health Organization's emergency threshold, aid agency officials said.

Togo, with a population of about 6.1 million, is among the world's 20 poorest countries where the UN says in absolute terms children's nutritional situation has worsened in the past decade. But a history of corruption and poor governance has limited development aid and dissuaded aid agencies from intervening there.

Combination of causes

In Togo as elsewhere, malnutrition’s causes are many, say health experts. “As with other countries in the region, several factors contribute to child malnutrition in Togo, whose northern region is at the edge of the Sahel,” said Victor Aguayo, UNICEF’s senior nutrition adviser for West and Central Africa. “These include a failure to feed children appropriate foods in quantity and quality; lack of access to essential health services, water and sanitation; and increasing levels of poverty and vulnerability, particularly among women.”

Aid officials say it is difficult to know to what extent high child malnutrition and mortality rates in Togo are due to a lack of donor assistance but a link cannot be ruled out.

"It is difficult to tease out the effect lack of donor support has had on child health," Aguayo told IRIN. "But obviously the fact that Togo has received little support has not benefited children and few people would dispute that."

Turning point

UNICEF's representative in Togo said the project to begin in the coming days, with US$2.3 million from the UN's Central Emergency Response Fund (CERF), could signal a turning point. "This is the first time in a long time such sizeable amounts have been given for a humanitarian response in Togo," Una McCauley told IRIN. "We hope this marks the re-entry of Togo onto the agenda of the international community."

The CERF grant will pay for a joint UNICEF-World Food Programme (WFP) project to provide therapeutic and supplementary foods to 93,000 children under five – those children in the Kara, Savanes and Maritime regions identified as having acute or moderate acute malnutrition.

UNICEF and government officials have been visiting community health centres and training health agents in the care and prevention of malnutrition, training that will continue, aid officials say.

The project, which will coincide with a UNICEF study into the causes of malnutrition in Togo, is part of a broader effort to tackle malnutrition in the country. "The immediate objective of this response is to save lives," said Stephanie Savariaud, West and Central Africa spokesperson for WFP. "But the programme is part of a larger concerted effort to improve food security in Togo" with prevention and nutrition education as well as agricultural assistance by the Food and Agriculture Organization.

ECHO is financing therapeutic food and care, treated mosquito nets, training for health workers, and assistance to malnutrition prevention programmes, Quinton said.

Early marriage, early motherhood

Aid officials said just as important as immediate aid is an examination of the causes of such high child malnutrition and mortality rates. "We don't know exactly what the main causes are [in Togo]," ECHO's Quinton said. "We must analyse that."

In its study into causes, UNICEF will look closely at the extent to which cultural and socioeconomic factors play a role, UNICEF's McCauley said. One likely cause, particularly in the northern regions of Kara and Savanes, is early marriage, she said.

"A large component of the problem has been created by the fact that these regions have high levels of early marriage and of illiteracy among girls," she said. "A lot of the malnourished babies we see are the children of young girls - 15 to 17 years of age who do not know enough about child health care.”

According to the 2006 UNICEF report, Kara and Savanes regions have the lowest levels of primary school attendance, at 64 percent and 48 percent respectively.