Members of the University community are hereby invited to an Inaugural Lecture to be delivered by Professor Matilda Steiner-Asiedu, Dean, School of Biological Sciences as follows:
Topic: The Nutrition Landscape in Ghana: Implications on our Human Resources and National Development
Date: Thursday, April 25, 2019
Time: 5:00 pm
Venue: Great Hall
Chairman: Professor Ebenezer Oduro Owusu, Vice – Chancellor
All are cordially invited
Abstract
Ghana’s developmental agenda depends on the health, and wellbeing of its citizenry. This can only be achieved if the highest priority is given to the nutrition of its people. Currently, Ghana faces the triple burden of malnutrition- underweight, overweight and hidden hunger (micronutrient malnutrition). Nutrition plays a key role in the development of individuals, families, communities, and hence the nation.
Ghana has been commended worldwide for reducing poverty, hunger and malnutrition. Nevertheless, hunger and malnutrition still persist in many parts of Ghana, especially the 8th Parallel which covers 45 administrative districts that lie above Latitude 8°N, and in four regions: Brong-Ahafo; Northern; Upper East; and Upper West as well as many rural and peri-urban communities across the nation. Reducing poverty is a driver for food and nutrition security, well-being and national development. It is therefore, not surprising that poverty elimination is the first Sustainable Development Goal (SDG1); thus, to achieve SDG2, calls for total elimination of hunger and all forms of malnutrition across the life stages.
Poverty as a primary cause of hunger, poverty in monetary terms as well as poverty in nutritional knowledge must be truly tackled. The recent Ghana Cost of Hunger Ghana Report puts the implications of hunger on Ghana’s human resource in perspective: 24% of all child mortality cases in Ghana are associated with undernutrition; 10.5% of all repetitions in schools are associated with stunting; undernourished children achieve an average of 0.8 years less at school than well-nourished children; Child mortality associated with undernutrition has reduced Ghana’s workforce by 7.3%; 37% of the adult population in Ghana suffered from stunting as children; The annual costs associated with child undernutrition are estimated at 4.6 billion GH¢, which is equivalent to 6.4 % of GDP. The question therefore is, why has Ghana not eliminated hunger and all forms of malnutrition? From my perspective, a holistic approach and team work across sectors are lacking, including political will but if Ghana will adhere to the recommendations given in the Ghana Strategic Review to eliminate hunger and malnutrition, then we can look forward to a nation full of healthy people who will work to move the national agenda forward. It must be noted that growth and development are synergistic.
Looking at the nutrition of the population holistically means not leaving anyone behind; men, women, children, and the elderly, which is in line with SDG2. What is the situation like now in Ghana and most developing countries? Attention is mostly focused on women of child-bearing age (15-49 years) and children under 5 years. What happens to the rest when neglected? Their nutrition security worsens and impacts the family, society and the nation, negatively.
Within the Ghanaian socio-cultural context, men are supposed to be the head of households and bread winners. The situation is changing, nevertheless, their role in propagating the nutrition agenda for Ghana and their own nutrition and health have mostly been left with very little or no consideration. Interestingly, findings from the men’s study, in a peri-urban community in Accra,
indicated that 32.2% had hypertension, 50% had high chronic stress, close to 19% were anaemic and some showed signs of vitamin A deficiency.
In order to provide sound support for the family, it is necessary to ensure that men stay healthy and are well informed on nutritional matters but most of the time they are neglected or do not take interest in nutritional issues and perceive it as a woman’s business, which is a very wrong connotation. In recent times for example, Ghana has experienced a downward trend in breastfeeding status, most importantly exclusive breastfeeding. Understanding the knowledge and perceptions of men towards breastfeeding is key to promoting and planning educational programmes that will consider both genders. In one of my studies with men, I indicated that their perception is very negative and very few see their role as supporters for successful breastfeeding. However, breastfeeding is recognised scientifically as the golden standard mode of feeding/nutrition for the first 6 months in a child’s life; this lays the right foundation for a child’s growth, development and well-being.
Another segment of the population that needs holistic nutrition intervention is the aged/elderly. With fertility and mortality steadily declining, there is a shift in the world’s age structure towards older ages, which is of great concern with respect to nutrition and care for the aged/elderly. This segment of the population continues to be marginalised and their nutritional situation continues to worsen, yet they provide significant social support to the family especially during pregnancy, lactation, and child care. All forms of malnutrition have been observed in this population both in southern and northern Ghana. Thus, their nutrition is paramount in sustaining the family structure for our existence and development. A critical look at our national policy on the nutrition and health of the elderly cannot be overemphasized if Ghana is to develop and reduces current levels of NCDs.
The latest Ghana Demographic Health Survey (GDHS) (2014), indicated that 19% of children under-five are stunted, that is, they are too short for their age. This indicates chronic under-nutrition and is more common in the Northern Region where about 33% of children are stunted, compared to the Greater Accra Region of about 10%. On the other hand, about 5% of children are wasted, that is, they are too thin for their height, and this represents acute under-nutrition. Furthermore, 11% of Ghanaian children under five years are underweight, indicating they are too thin for their age. This represents both acute and chronic under-nutrition
Even though the nutritional status of Ghanaian children has generally improved as indicated by stunting rates of the GDHS reports since 2003 (35%), 2008 (28%) and 2014 (19%); it is important to note that despite the progress at national level, there are disparities at regional levels. Stunting is significantly high in the Northern, Upper West, Central, Volta and Western Regions while wasting is most severe in the Upper East, Northern and Central Regions. This is a wakeup call for our politicians and the Regional, Districts and Sub-district heads to understand the nutritional situations in their respective jurisdictions and work towards alleviating all forms of malnutrition to enhance and ensure a strong and able working force for development. They should use nutrition research findings to leverage their development agenda towards the achievement of African Union (AU) agenda 2063 and the sustainable development goals that have replaced the MDGs.
Hidden hunger is an issue of public health concern, but it is rather unfortunate that most of the time, they are not seen or recognised by all, so it does not even ring a bell in the ears of our leaders. This is so because as the name implies it is hidden and not easily visible to the naked eye. For example, if one is suffering from iron deficiency anaemia, it cannot be recognised as compared to Kwashiorkor or Marasmus (protein-energy malnutrition disorders) which are visible hence seen as a problem. Vitamin A, Iodine and Iron deficiencies are prevalent, especially among children and women of child-bearing age and this has great impact on the high maternal mortality associated with anaemia being recorded in the country.
The impact of hidden hunger is evidenced by findings from a nationwide survey conducted in 2017, under the auspices of UNICEF for Ghana Health Services, which covered a broader scope beyond data provided by the GDHS. The data showed that 35% of children under 5years were anaemic and 1/5th were vitamin A deficient. Among women of reproductive age, 7%, more than 50% and nearly 22% were vitamin B12, folate, and iron deficient respectively. One major challenge with micronutrient malnutrition is the general reluctance of the population to consume fruits and vegetables, due to the myth that fruits are food for the sick or rich. Another dimension is the relatively high cost of fruits and vegetables compared with staple foods. A recent study that explored the consumption of fruits and vegetables among Ghanaians revealed that only 1 out of 4 Ghanaians, consumes the recommended 400grams per day.
The altering climate change we currently face, has negatively impacted our food systems as observed in a study conducted across some selected regions in Ghana. This has affected the growth and availability of micronutrient rich vegetables particularly green leafy varieties such as Kontomire, Ademe, Bokobokor, Alefu and Gboma. Hence, the continuous prevalence of hidden hunger as fruits and vegetables are the major sources of vitamins and minerals. As the old adage goes, ‘an orange a day is important to keep the doctor away’; and this is very relevant in our setting. Clearly, climate change is with us and it is contributing to the non-communicable disorders we are seeing in Ghana. Research data indicates that dams and ponds that even provide water for watering vegetables and provide some fish as protein source are drying up if not dried and this has affected families and their nutrition and livelihoods immensely.
Clearly, the food and nutrition insecurity in Ghana is seriously being impacted by climate change. It is important to note that when dams and ponds are built to help with irrigation and to provide fish, it is important that all stakeholders come together during the planning and implementation phases to ensure that the community obtains the fullest benefit of the resource. Why am I emphasizing this? A typical example is when a dam was constructed at the Sisala West District to help women get water for their vegetables and also get some fish, it came to light that the fish was never harvested. Investigations showed that the men in the community said they are not fishermen and they were never taught how to harvest the fish. Also, the people reported high incidence of malaria, which caused a rise in the prevalence of anaemia, which indirectly affected work output. If proper consultations had been done the appropriate fish would have been put into the dam that will eat the larvae of the mosquitoes. This clearly shows how working as a team is important in driving the nutritional agenda forward to impact our population positively. Yes, participatory approach in implementation of nutrition agenda is vital for national development and this creates a sense of belonging.
While Ghana is making excellent efforts in the reduction of all forms of undernutrition, overweight/ obesity is on the rise in all regions and across all segments of the population, but it is quite significant in Greater Accra, Central and Volta Regions and skewed towards females with current statistics standing at about 40%, men at about 16%. Among men it manifested itself mostly as visceral fat in the abdominal area (pot belly). It is rather unfortunate that most Ghanaians see it as a sign of good living (wealth). This challenge in most instances is due to the behaviour/culture of consuming beer (empty calorie) together with meat in excess and thereafter having late dinner and then sleep off. This behaviour, however, is seen as a sign of “good living”, a great misconception.
A recent survey of restaurant foods from Accra, Ghana and four other countries (a multicenter study), which looked at the contributions of restaurants to the obesity pandemic globally, revealed high content of saturated and trans-fats embedded in these fast foods making them energy dense but nutrient poor. It was rather unfortunate foods served at restaurants in Ghana recorded the highest caloric load (fats and oils and carbohydrates). It is therefore not surprising the current trends of overweight/obesity seen in Ghana. These fast food joints and restaurants are almost everywhere, and some are especially active all through the night resulting in increased eating out episodes. These trends have compounded the alarming rates of chronic Non-Communicable Diseases (NCDs). Obesity alone has been found to be an independent risk factor for most of these NCDs (cardiovascular disorders). Apart from low consumption of the protective fruits and vegetables, there is also a general decline in the level of physical activities because of technological advancement which have also accentuated the obesity situation.
Additionally, frequent snacking and choice of snacking foods are also implicated in the overweight/obesity rise in the country. This coupled with snacking while watching television was a common practice among children and students. Snacking on foods high in sugar and fats were strongly found to be associated with the likelihood of being overweight/obese.
On the question of physical activity, (an important way to lose body weight), Ghanaians are catching up with the concept of going for brisk walks, jogging or engaging in other bodily movement. Nevertheless, the environmental conditions, as reported by most for not engaging in any activity include lack of walk ways, street lights, unleashed dogs and theft. For Ghana to have a healthy working force, policies that will ensure conducive environment for walking, will be a move in the right direction. Employers can take the lead in creating places for staff to perform physical activities. It has been found to reduce NCDs, increase productivity and ultimately national development
With the influx of all kinds of packaged food products and fast food restaurants in the country and the transition from home prepared meals to pre-packaged foods, understanding and making a conscious effort to read food labels, watch out for expired products, as well as the nutritional profile of the food is a step in the right direction where consumers will buy food worth their money’s value and also promote own health.
These behaviors will indirectly reduce health care cost to individuals and the nation; enhance productivity and improve overall health and wellbeing. It is important that Ghanaians read food labels and policies should be put in place to make Nutrition Labelling mandatory, make
nutritional information on food labels easier to understand and enable consumers to easily compare foods by nutrient content in order to make healthy choices and also to plan a healthful diet.The link between nutritional knowledge and food label information use by consumers in making food choices should be considered in designing labels that are user friendly for all to understand.
The multiple implications of malnutrition on our human resource span across various life stages but the most dire of them all is the effect on children under 2 years and pregnant women. This period perceived as the “window of opportunity”, (first 1000 days of life) indirectly shapes the future of families, communities and prosperity of the global world. Therefore, adequate nutrition is critical in the development and growth of children especially from conception to their second birthday. Consequently, cravings during pregnancy must be carefully managed as women tend to snack on non-nutritive foods, which could predispose mother and unborn baby to poor pregnancy outcomes. Moreover, malnutrition during this crucial period could make children suffer irreversible cognitive damage, affecting their health, quality of life and economic well-being in the future. The negative effects of insufficient nourishment may carry on to adulthood resulting in a vicious cycle of growth failure that could continue for generations.
Good nutrition is fundamental in sustaining effective human capital development. Consequently, an “all hands-on deck” approach is required to help remove barriers to optimal nutrition. Some proven pillars that can be adopted to improve on nutrition in Ghana include; (i) diversification of our diet (ii) fortification of our staples among other foods- like snacks, oils, etc. (iii) bio-fortification of crops like potatoes, cassava, etc and (iv) supplementation when necessary. To enforce these, nutritional education and advocacy to the populace by trained professionals is key to help scale up nutrition.
In conclusion, attributes of a sustainable food system which include the following: availability, accessibility, affordability to all humans are just ways that are necessary to promote a healthy people and a healthy nation. In light of this, a sustainable food system should consider those that produce the food, like farmers and fishermen, those who process, package, distribute, and regulate food (farm to table) instead of being narrow minded and looking at food security. Eliminating the nutritional poverty among our people through education, better understanding of food groups, knowing what to buy, how to buy, when to buy and where to buy and preparation methods to preserve nutrients are some health promoting strategies to consider. Cost effective technologies to address micronutrient deficiencies are also needed to mitigate negative impact of climate change in Ghana as observed in some communities. Thus, placing diet quality (nutritional and safety) at the core of all the 17 SDGs is the right step for Ghana in ensuring healthy people and sustainable development. The nutrition landscape in Ghana can be changed when data informs policy. This will in turn lead to direct human resource and national development. The SDGs and AU objectives can be achieved.
Profile
PROFESSOR MATILDA STEINER-ASIEDU, appointed professor of Nutrition in 2016, is currently the Dean of the School of Biological Sciences, College of Basic and Applied Sciences, University of Ghana, Legon. She was the head of the Department of Nutrition and Food Science from 2011 to 2015. Prof. Steiner-Asiedu started her basic education at St. Banabas Anglican School, Osu and continued at St. Anthony’s Preparatory School at Latebiokoshie both in Accra. Prof. Steiner-Asiedu pursued her secondary education at St. Monica’s Secondary School, Ashanti Mampong where she successfully completed the General Certificate of Education (GCE) at the Ordinary and Advanced Levels.
In 1979, Prof. Matilda Steiner-Asiedu gained admission to the University of Ghana, Legon to pursue Bachelor of Science (B.Sc) in Home Science (Foods option) degree. Upon completion in 1983, she won an award to pursue another B.Sc. in Biology and Chemistry at the University of Bergen, Norway. She graduated in 1987, and enrolled for a graduate programme in Nutritional Biology at the same University. Through hard work, commitment and dedication to her studies, she was awarded a grant to pursue a PhD programme in Nutrition upon completion of her Master of Philosophy in 1989. Once again, Prof. Steiner-Asiedu proved herself to be among the best and successfully defended a dissertation titled “Evaluation of the Nutritive Value of Locally Processed Fish and Cereals from Africa: Special Emphasis on their Use in Weaning Food” in a record time in 1994. In 2002, she won another scholarship to Brown University (RI, USA) where she read Masters in Public Health, a necessary Course to complement the Nutrition.
Prof. Steiner-Asiedu was appointed a lecturer in Nutrition at the Department of Nutrition and Food Science, University of Ghana, Legon in 1993. Since 1993, Matilda has been teaching at both the undergraduate and graduate levels; supervising local and international students in Nutrition, Food Science, Agriculture, Medicine, Dietetics, Sports, Nursing and Public Health at both undergraduate and graduate levels; and undertaking cutting edge research work. A significant number of her students are occupying important positions across the globe and working in different organizations, including academia, business, governmental and non-governmental organisations. Prof. Steiner-Asiedu gives Public Health Nutrition talks and lectures to diverse groups at national and international levels and writes on health promotion issues as part of her extension activities.
Because of her visibility in the field of nutrition, Prof. Steiner-Asiedu collaborates with various researchers in different Universities, such as University of Georgia and Washington University (both in USA) and University of Bergen (Norway) to undertake research activities to improve nutrition and health of the most vulnerable in society. To this end she continues to supervise international students who come to Ghana for research. She is able to bridge the gap between cultural barriers to ensure successful planning, design and implementation of nutrition research activities in Ghana. She also collaborates with industries in Ghana to identify and research into nutritional problems and relevant solutions that are pertinent to national development. Attributable to these, graduate students have been sponsored on the projects.
Prof. Steiner-Asiedu’s research interests are in food and nutrition security to alleviate malnutrition and Non-Communicable Diseases (NCDs) across the life stages. Matilda has also undertaken extensive research in the following areas: nutrition education, body weight control and obesity reduction advocacy, health promotion with high/low literate populations, infant and child nutrition, dietary communication and behavior change as well as effect of processing on nutrient composition of foods. Prof. Steiner-Asiedu has written books (3), co-authored chapters (10) in books and published over 70 scientific papers in reputable peer reviewed journals. She has presented her research results at various international and national conferences as well as workshops. She has been a planning member and key note speaker at some of these events. She is a reviewer for highly rated journals across the globe
Prof. Steiner-Asiedu’s activities are not limited to the classroom; she also plays an active role in University Sports. It is not surprising that in 2009 when the University of Ghana Sports Directorate was undergoing reorganization, she was made the Deputy Director of Sports (first female to be appointed into position). She performed this task successfully and efficiently to the admiration of all till 2011. She serves on many University Committees and Boards as well as Boards outside the University. She is a member of the American Society for Nutrition, International Obesity Consortium, Global Nutrition and Non-Communicable Disease Team, African Nutrition Society, Ghana Nutrition Association, and Ghana Science Association. She is the immediate past president of the Ghana Nutrition Association.
Through innovation, perseverance and hard work, Prof. Steiner-Asiedu motivates herself and those around her to do their best under difficult conditions. Prof. Steiner-Asiedu never gives up when the going gets tough and persists till she achieves her goals. She is a creative teacher and an excellent role model to many young scientists – both males and females. Matilda maintains high standards for herself as well as those she works with, always quietly providing the necessary support to help her peers and students to succeed. She demonstrated these unique qualities when she motivated graduate students and young lecturers to come out with one of the UG Reader Series- “Perspectives in Food and Nutrition” for the Department of Nutrition and Food Science.
Matilda’s teaching, research and extension activities have proved her worth. It is therefore not surprising that she was recognized by the African Union (AU) as the Best Female Life and Earth Scientist for the 2012 edition of the AU Kwame Nkrumah Scientific Award for Life and Earth Sciences. In 2015 and 2016, Matilda was invited to speak at the Global Panel on “Agriculture and Food Systems for Nutrition” round table forum held in Accra, Ghana. In October 2017, she was one of the main speakers at the International Congress on Nutrition held at Buenos Aires, Argentina to speak on the “Role of salt in the reduction of NCDs within the West Africa Sub-Region. In November 2018, she was invited to Norway as a resource person on “The Role of Fish in Improving Food and Nutrition Security”. Again in November 2018, she was invited to Cali, Columbia by the International Institute for Tropical Agriculture (IITA) as a resource person to detail on the need for bio-fortification of crops to enrich nutrition. She is a trained Advocacy Champion of the Building Nutritious Food Basket (BNFB) Project and Biofortification in the African Subregion.
Prof Steiner-Asiedu led a team of 4 experts to draft the “Ghana’s Zero Hunger Strategic Review” (Sustainable Development Goal 2) which was launched in September 2017. She has developed handy measures for the Ghana School feeding programme to ensure quality in meal service that will improve nutrition. She continues to project the image of the University, through teaching/supervision, research and presentations/talks both local and international and offering her expertise on critical national/international issues on food and nutrition.
Prof Steiner-Asiedu is a born-again believer in Jesus Christ. She has an unwavering love for God and derives her strength from studying the word of God. Matilda worships with the Royal House Chapel International, where she is a Deacon and serves on the Advisory Board for the Christian Leadership College of the Church.She is blessed with three grown-up children – Daniel, Mercia and Emmanuel. Her hobbies include singing, dancing, window shopping and travelling.
Prof Matilda Steiner-Asiedu strongly believes The LORD has shepherded her through all these achievements and knows The LORD will continue to guide and direct her path in the years ahead. Matilda intends to continue to work to improve nutrition security in Ghana and across the globe through advocacy, cutting edge research and above all providing mentorship.
