UNIVERSITY OF HYDERABAD

MASTERS IN PUBLIC HEALTH

PUBLIC HEALTH NUTRITION ASSIGNMENT

STATUS OF SGD GOAL 2 (ZERO HUNGER) IN MALAWI

SUBMITTED TO: DR ANITHA CT

BY: JOSEPH CLEMENT CHIPETA

21MHMH43

Date: 30 OCTOBER 2022

 SUSTAINABLE DEVELOPMENT GOAL 2-ZERO
HUNGER
SECTION 1: INTRODUCTION
In a global village where happenings in one part of the world affects what happens in another
part, the need for shared goals is increasingly becoming a need. Thus it was only paramount at
the end of the Millennium development goals to come up with a different set of goals which
are responsive to the current needs of the planet. Thus the sustainable development goals
(SGDs) were rolled out from 2015 and adopted by all United Nations member states. This is to
act as a blueprint for a global partnership towards making earth a better place. SGGs are a set
of 17 goals all intertwined and tackling major issues in the world. (1) While all are relevant in
all parts of the world, a few are more of an issue in the developing countries like goal number
2. SGD2 calls for ending hunger, achieving food security and improved nutrition and promote
sustainable agriculture. Malawi is one of the countries trying to achieve SGD goal 2.
In Malawi, even though a number of strides have been made, the country still has a long way
to go to achieve zero hunger and deal with malnutrition. In the recent released global hunger
index Malawi ranks 87th in the world with the index score of 20.7 which is still considered
serious. This is however an improvement from the year 2000 when the country had an alarming
level of 43.3 as score. In this article we will explore more on the current status of hunger and
malnutrition in the country and also look more into the causes and challenges as well as try to
come up with solutions to the problem.

SECTION 2: LITERATURE REVIEW

A number of sources have been used to come up with information used in this article. The
tables below give a summary of these sources and how they were found.
Date of Resource used Years searched Search terms # of hits/results
Search

26/10/2022 PUBMED 2005-2022 Sustainable development 75

goal 2 “Malawi”
26/10/2022 PUBMED 1993-2022 (Hunger) and (Malawi) 38

27/10/2022 Google Scholar 2015-2022 "hunger" and "malawi" 19500

27/10/2022 Google Scholar 2015-2022 “food security” in “Malawi” 19300

28/10/2022 Google Global Hunger Index

29/10/2022 Google Hunger status in Malawi

30/10/2022 Google Food Security in Malawi

30/10/2022 Google Malnutrition in Malawi

30/10/2022 Google Sustainable development

goals
 LITERATURE REVIEW TABLE

AUTHOR AND TITLE FINDINGS/IDEAS

YEAR
Doctor, Nkhana- Trends and Determinants of Child
Salimu (2017) Growth Indicators in Malawi and
Implications for the Sustainable
Development Goals
Anderson et al Relating Seasonal Hunger and
(2018) Prevention and Coping Strategies:
A Panel Analysis of Malawian
Farm Households
Gladstone et al The care, stimulation and nutrition
(2018) of children from 0-2 in Malawi—
Perspectives from caregivers;
"Who’s holding the baby?"
IPC (2022) IPC Analysis Report on the
Chronic Food Insecurity Situation
Duchoslav Targeting Hunger or Votes? The
(2022) Political Economy of
Humanitarian Transfers in Malawi
Malawi The Fifth Integrated Household
Government Survey (IHS5) 2020 Report
(2020)
This study analyses the trends in undernutrition and
stunting in children from the 5 demographic health
surveys and correlates them with major factors such as
education, economic status and women empowerment
The study shows that seasonal hunger leads to early
harvesting of crops which increases the likelihood of
hunger in the next cycle.
Explores some of the issues affecting nutritional status
of children both from the facilitating factors and
limiting factors
Trends and levels of chronic food insecurity in Malawi
between 2011 and 2021 and some of the contributing
factors
Portrays some of the issues pertaining to social cash
transfers and how politicians use such for political
mileage
Figures of household food security and agriculture
involvement in Malawi

SECTION 3: STATUS OF HUNGER, MALNUTRITION AND

FOOD SECURITY IN MALAWI
As already briefly alluded, Malawi ranks 87th in global Hunger Index. The global Hunger Index
Measures Indicators such as undernourishment, child stunting, child wasting and child
mortality. The graph below portrays the trends and current status of these measures in Malawi.
(3-4)

Global Hunger Index Trend for Malawi (4)

Global Hunger Indicators trends in Malawi (4)

This graph portrays the trends in the four indicators used to assess the global hunger index.
Stunting measures long term nutritional status of a society and often reflects intergenerational
status. In the graph there shows an improvement with the percentage of child stunting dipping
from over 50% in 2007 to mid-30s in 2022. This is a reflection of nutritional efforts and
programs that may date way back 10 to 20 years ago whose results may only be reflecting now.
The trend for undernourishment which is a general population measure and often used in
estimating SGD 2 is worrying. According to Food and Agriculture organization,
undernourishment refers to a status where a person is not able to acquire enough food to meet
the daily minimum dietary energy requirements, over a period of one year. (5) It is often
referred to us as hunger. Between 2000 and 2014 the levels were going down, however from
2014 to 2022 there has been a rise in undernourishment levels. A number of factors might be
attributed to this especially between 2006 and 2014 when the country was going through a
period of economic growth and great agricultural policies that foresaw surplus agriculture
production. However, post 2014, the country was grappled with change in political and
economic ideologies, an increase in natural disasters such as floods and erratic rainfalls which
all might have had a bearing on the food accessibility of the population. child wasting which is
a measure of acute malnutrition has been generally on the low in the country. progress has also
been made in tackling under 5 mortalities with the rates dropping from around 18% to less than
5%. This might be due to a number of factors in addition to nutrition such as improvement in
child health care and primary health care and efforts to combat some of the leading causes of
mortality such as diarrhea diseases, Malaria, malnutrition and respiratory diseases.
A study by Nkhana Salimu and Doctor studying trends in under 5 nutrition focusing on stunting
and underweight trends from 5 Demographic Health Surveys (DHS) from 1992 to the last DHS
in 2016 summarizes the results as follows basing on the regions. (6)
Prevalence of underweight among children under-5 years by year of survey and region of residence, Malawi
demographic and health surveys conducted from 1990 to 2015-16. (6)

Prevalence of stunting among children under-5 years by year of survey and region of residence, Malawi
demographic and health surveys conducted from 1990 to 2015-16. (6)

These two figures show similar trends for stunting and underweight as portrayed in the Global
Hunger Index. While both have been decreasing, the figures are still large.
The Integrated Household Survey also shows the trend of food security in the country. the table
below shows the food security status between integrated household survey 3 (2011), survey 4
(2016) and survey 5 (2019)

This table shows that high food secure households fall from 58% in 2011 to 24% in 2019 and
very low food secure households rose from 33% in 2011 to 63% in 2019 which is worrying.
(7)
These findings are supported by another important measure for assessing hunger issues in the
country which is The integrated food security phase classification (IPC Scale). It was
established in 2004 by Food and Agricultural organization as a standard tool for improving
food security analysis and decision making. According to IPC Analysis Report on the Chronic
Food Insecurity Situation in Malawi which was based on data from 2011 to 2021, showed that
over 33% of population was facing moderate and severe chronic food insecurity. As shown in
the factsheet info graphic below (8)

Factsheet of IPC chronic food insecurity in Malawi (8)

This figure also shows that only 41% of the population is long term food secured in the country
which is very alarming.
The IPC acute food insecurity analysis for the period between June 2022 to March 2023, gives
the following results.
Figure of IPC Acute food insecurity in Malawi between June 2022- March 2023 (9)

From these figures it is shown that over 20% of the country is currently in need of urgent action
with only close to half of the population fully food secured for the period.
Another correlating term with the figures above is seasonal hunger. Seasonal hunger occurs
when an individual has limited access to food during the months prior to the annual harvest.
The Malawi harvest period spans from April to June hence hunger levels are lowest at this
period and they peak between December and March. Findings have shown that up to 57% of
the population in rural areas and 36% in urban areas experiences seasonal hunger. (10)
Thus as shown in this section, Malawi as a country is still a long way from achieving child
nutrition targets as well as in reaching the global target of zero hunger by 2030. If the country
continues in the current trajectory, instead of getting closer to the goal, it is only likely that the
country will move further away.

SECTION 4: CAUSES OF HUNGER AND MALNUTRITION

1. HUNGER
Hunger is a multifactorial issue. A range of issues contribute to hunger and below we explore
some of the possible causes of hunger in Malawi
a. Poverty
Poverty is a key cause of hunger and food insecurity. Due to poverty people are unable to buy
adequate food, they are unable to invest in farming and food production and cushion themselves
from life stresses such as natural disasters. As already shown over 70% of the country lives
below the poverty line. This makes it difficult for people to have adequate food throughout the
year. In a country where seasonal farming is practiced by most small holders, most households
are able to harvest adequate food to last whole year in cases where there has been no natural
disaster, however due to poverty and lack of other basic needs, families are forced to sell a
large portion of their produce to carter for their immediate other needs which eventually leads
to food insecurity and seasonal hunger.
b. Natural disasters
Malawi as a country continues to be grappled with natural disasters. In recent years there have
been increase in natural disasters. In 2016/17 there was a major drought that had a big impact
on food production, floods have also been grappling the country with the rainy season of
2021/2022 experiencing some of the worst floods in the country’s history affecting most of the
districts in the lakeshore and lower regions. These floods led to destruction of crops and
animals, they destroyed property and led to displacement of people and also led to loss of life.
The impact of these floods on food security thus was multifold with no production, the loss in
property and displacement leading to more poverty and loss of food. The country also
experienced other disasters such as hurricanes and cyclones which led to damage of properties
and produce. Thus from all these disasters the country was grappled with a food crisis. Natural
disasters also lead to more vulnerability to infectious diseases for example there has been an
increase in incidence of cholera in the country following the floods and cyclones. These
diseases add on the economic toll of the people as well as leads to the vicious circle of disease
and malnutrition. (11)
c. Poor agriculture practices
The integrated household survey (HIS) shows that about 85% of households are involved in
agriculture in the country. (7) almost all these are small holder farmers with the majority
practicing subsistence farming. As small holder farmers, manual methods of farming are used
with hoes and manual labors as the common practice. In addition, the majority of farmers grow
maize with only a few rotating with other crops. The IHS though shows increased intercropping
at 84%. These all make it difficult to mechanize and modernize farming to maximize output
and also leads to delay in finishing required husbandry practices hence poor agriculture
performance. In addition to poor output, there is poor storage of produce with most families
still using traditional storage methods such as thatched granaries. This leads to losses in food
due to wastage and damage. The seasonal production of food and lack of processing means
there is a pattern of surplus foods at end of harvest season which is usually wasted and shortage
of food before planting season leading to seasonal hunger.
The lack of irrigation farming also limits farmers to only rainy season production failing to
maximize land value as well as leaving most vulnerable to natural disasters such as droughts
and erratic rainfalls.
d. Poor Political and Economic Decisions
The country has continued to face numerous questionable political decisions. There is a lack
of continuity of projects and long term plans solely for political reasons as every leader wants
to discontinue projects started by predecessor even if proven beneficial. Some policies as well
have been short term with focus on enticing the mass to vote for leaders in the imminent
elections even if they do more harm than good to the communities. For instance, in 2007 the
then government introduced the farm input subsidy program which aimed at providing small
holder farmers with farm input to ensure food sufficiency. The aim was to empower farmers to
be independent and self-sufficient and for about 7 years, the program saw increase in the
countries production with ability to export surplus food to neighboring countries, however 15
years down the line the program is still available with no longer promoting sufficiency but just
as a form of voter enticement. While this project still continues other projects aiming at
improving large scale farming such as green belt projects have continuously faced political
resistance after change of governments. There has also been rampant corruption in major
projects such as farm input subsidy programs, mechanization drives for example where the
country purchased over a hundred tractors from government of India and all these ended up
being misused by politicians. These all have led to failure for economic growth leading to
increasing poverty levels affecting food security.
 e. Rapid Population Growth
There is rapid population growth in the country. this means households are increasing in size
and yet the resources are remaining the same. Families are having to share small land among
different household members. This is leading to families not being able to produce enough food
to meet the increasing demand.

2. UNDER 5 MALNUTRITION
While almost all the factors above lead to food insecurity which has a major impact on
nutritional status of children, other factors also specifically play a role in childhood
malnutrition.
a. Economic Status
As already portrayed above, social economic status has a huge bearing on nutritional status of
children. Studies have shown a strong correlation between poverty and undernutrition.
Unavailability, inappropriate use of food and inappropriate distribution have a strong bearing
on children leading to high levels of stunting, underweight and wasting among the poor
compared to the better to do families.
b. Education/Maternal education
Regions with intergenerational better levels of education have been shown to do better with
indicators such as stunting and underweight than those with poor educational indicators that’s
why the northern region which has had better education levels has portrayed a better
performance than the central and southern region. An analysis of all the 5 demographic health
surveys from 1992 to 2016 showed a very strong correlation between maternal education and
malnutrition. Mothers with least education had worst levels of stunting and underweight in
their children. (6)
c. Feeding practices and culture
Studies have shown that feeding practices have a strong bearing on child nutrition. Children
who are well breastfed have better performance than those who are not. In the analysis of the
Demographic Health Survey, the trends showed that the prevalence of underweight and
stunting increased significantly after 6 months which might be due to poor complementary
feeding practices. In some cultures, as well children are discouraged from eating protein foods
such as eggs. The cultural background of this is that giving children protein diets habituates
them to protein foods which leads them to have a preference for them and reject other foods.
Thus this practice of completely avoiding eggs and meat to children deprives them of proteins
which are critical at their stage for growth and development. (6)
d. Infectious Diseases
The demographic health surveys have also shown a strong correlation between diarrhea and
poor water sources and malnutrition. Malaria has also been shown to contribute towards
malnutrition. These diseases affect child feeding behavior, food utilization by the body,
hydration and others which lead to malnutrition. This malnutrition affects immunity levels
predisposing children to more diseases thus a vicious circle. (6) As shown in the figure below.
Vicious circle of undernutrition and infectious disease (12)

The united nations children’s fund (UNICEF) identifies two major causes of malnutrition and
micronutrient deficiency in the country which are poor diet (with only 8% of children aged 6
to 23 months meeting the minimum acceptable diet) and infectious diseases especially diarrhea.
(13)

SECTION 5: SOLUTIONS TO ACHIEVE SGD 2

Achieving most of these SGDs requires flipping the switch on the causes.
A multi-dimensional approach is needed to tackle both the micro and macro environment to
ensure no stone is left behind. Food security can only be achieved if all its four elements are
achieved. These are shown in the figure below

Four key elements of food security (14)

All these involve tackling individual, immediate environment, and global aspects. Below will
highlight some of the ways in which the country can achieve food security through the
elements.
 1. AVAILABILITY
To ensure food availability, as a nation there is need to flip from the casual approach taken in
food production to a serious approach. In a global village, issues like conflicts have a bearing
on food availability. Conflicts such as Russia Ukraine war has reduced production of some
foods such as wheat. Global warming and climate change as well also have an influence on
food productivity. Due to global warming, there is increased incidences of floods and droughts,
among others these leads to destruction reducing food output. Thus as a globe there is need to
tackle these major issues through policies, funding and others.
At the national level, to ensure the availability of food, there is need for policies that foster
increased food production. Mechanization is one approach through which large pieces of land
can be cultivated within little time. Mechanization can also include irrigation technology such
as green belt projects to ensure all year round farming and also as a shock against drought and
erratic rainfalls. Substituting farm input subsidy programs for agriculture cooperatives can also
ensure more production through sharing of knowledge, ensuring easy access to input as well
as agriculture loans. Investing in agriculture research will also ensure coming up with Malawi
specific crops and animals that are able to adapt and all. Apart from investing in agriculture,
there is need to invest in all other social economic areas such as health (healthy individuals will
lead to more production), economic growth (which will ensure availability of more resources
for food production), education, infrastructure and many other sectors. In case of national food
shortfalls, the government need to put in place measures to ensure food availability such as
importing food from other countries and making available in areas with shortfalls such as those
hit with famines and floods. Food availability in Malawi needs to be redefined from just
availability of grains (maize and rice) to availability of other food groups such as legumes,
vegetables, fruits and animal products. Policies to control population growth are also crucial.
the current fertility rate of over 4 per woman means that most households are large in size and
this coupled with poverty among others makes families fail to have adequate food for the whole
year. Population growth also puts pressure on the natural resource hence affecting output.
At the society level, there is need to diversify beyond the current scope. Most communities are
used to producing only one kind of crop. This leads to diseases and lack of resilience in times
of disasters. By diversifying crops, there will be a variety which will also improve nutrition.
Communities also need to learn to work together to achieve more. As a country there is too
much individualism, however through working together such as cooperatives, can lead to more
resources leading to more production.
At individual level, there is need for improving both crop and animal husbandry practices, need
for diversity, and change in approach. By changing from viewing farming as a subsistence
activity, individuals should shift towards viewing farming as commercial activity. Through that
they will be able to maximum production from their lands and also be able to sell the surplus
to feed others. Drought resilient crops such as cassava should be encouraged.
At all stages, protection of the environment is key in ensuring sustained maximum production.
Overuse of commercial fertilizer will later lead to reduced output. Wanton cutting down of
trees leads to global warming and more soil erosion. All these lead to reduced production.
Hence need for efforts to conserve the environment.
 2. STABILITY
Availability isn’t enough if there are constant disparities. Thus there is need to ensure all time
adequacy.
As similar with availability, global phenomena such as wars do affect food stability. Food
poaching by other countries also do affect availability in other areas. tackling these can help in
improving food sustainability at global level.
At the national level, Malawi as a country needs to put in place measures to ensure food
stability. For instance, during the years between 2007 and 2010 when the country was
producing surplus, the government built silos for grain storage. This was a good move for
storing food ensuring its availability in off peak periods. However, down the line, poor
practices such as poor storage practices led to more grains being damaged in the silos due to
moisture among others. Policies to ensure there is no unnecessary food export by individuals
especially in border regions need to be put in place. The ministry of Agriculture through state
owned The Agricultural Development and Marketing Corporation (ADMARC) came up with
such measures including illegalizing unauthorized selling of produce to neighboring countries
and also for ADMARC to be buying produce from farmers and resell later at a reasonable price.
However, malpractices in ADMARC led to less buying of products. Also the low buying prices
of ADMARC in comparison with other private entities meant farmers preferred selling at a
higher fetching price depriving ADMARC of a buying market. Thus by ensuring proper prices
and tightening regulations, there will be controlled food movement in the country leading to
stability. economic empowerment of individuals also ensures that families are not forced to sell
produce for immediate needs.
At the society level, there is need for educating chiefs and leaders on safeguarding community
foods. All stakeholders including the media, community leaders, religious leaders, civil
societies, non-governmental organizations need to work hand in hand to ensure communities
properly consume their food, have good storage plans including food processing for future use,
also ensuring no unnecessary selling of food. Mobilization of food cushions can also ensure
availability of food in times of crises.
At individual level, proper usage of food is important. Families over consume and waste foods
during time of excess leading to shortage in later times. There is also a trend in rural areas
where families exchange grains post-harvest with commodities such as buckets, cups and fish.
Since these families have much food during this period, they do not mind the unfairness of
such trades which in most cases is daylight robbery of farmers produce. These are the same
produce which are sold to the same farmers at 4 to 5 times the price at the later stages when the
farmers have depleted their food. Individuals also need to be empowerment through economic
measures and education to ensure proper management of farm products such as proper storage,
consumption and local means of processing.

3. ACCESS
Availability and Stability mostly focuses on the whole population and not individual. Hence
they are not enough for food security unless every person is able have access to all required
food.
At a global level, accessibility issues might be in form of over stalking by some countries at
the expense of others. Over stalking and hoarding of food means that those countries can be
able to control the ones with less through politics and others. In addition, these countries can
sell at exorbitant prices leading to accessibility challenges.
As a nation, to ensure accessibility, the primary way is to improve economic status of its
citizens. If Malawi citizens are financially able, they will be able to buy and access the required
food needs. However, in the current status most Malawians are unable to achieve this status.
Most vulnerable groups such older citizens, those in extreme poverty, those with disability need
measures such as food rations to ensure they are able to access food. Social cash transfers also
enable vulnerable individuals to have access to food. Work for pay/food projects such as
Malawi Social Action Fund are also good measures to ensure people have access to food.
Programs such as school lunch feeding also helps children have access to food. Controlling
food prices is also another way the government of Malawi should employ to ensure food
accessibility. By putting maximum selling prices, it will provide a ceiling to ensure private
dealers who are profit oriented don’t take advantage of food shortages to sell food at high
prices. Reviving and reforming ADMARC which has adequate distribution points even in rural
areas will ensure that there is accessibility of food close to individuals and across the whole
nation.
At society and individual level, the Society also needs to work hand in hand towards
empowerment of individuals, relief activities can also help in alleviating hunger issues in
societies desperately affected. individuals can also ensure they have access to food through
self-empowerment as well as following good practices which will ensure more production
hence availability and sustainability at all time.

4. UTILIZATION
While the other three aspects, mostly impact hunger, the aspect of utilization also plays a key
role in nutritional status. The availability of food is not enough if people do not use the food
properly. Poor utilization of food is one of the key reasons for child malnutrition. Key issue
with food utilization is education and empowerment.
Good education enables individuals to make proper diet choices, in addition the government
can educate the masses through different means such as media on proper diet and other
nutritional needs. At every stage from communities through use of agriculture extension
workers, religious leaders, health workers and all can play a role in ensuring dissemination of
nutritional information. Ensuring education of women is a key issue in tackling nutrition
through utilization. As has already been shown above, educated women are able to have better
child nutritional outcome than uneducated women. In addition to women education,
empowerment of women is also a key issue. Being educated propels women towards
empowerment but it is not adequate. Women should be able to make decisions on key issues
affecting their health and livelihood. This enables women to be able to access more health care,
follow proper contraceptives and family planning, ensure proper food consumption practices
among others all of which improves the nutritional status of the woman and the child.
Taking special care of pregnant women is also key. if women are supplemented with all
required nutrients and also meet the required nutrient needs, it enables intrauterine growth
which has highly been correlated with later nutritional and health status. Thus well-nourished
pregnant women mean well-nourished babies.
Good health care is also a key issue on ensuring food utilization. Immunization, food
supplementation, proper hygiene practices all ensures that children do not suffer from
infectious diseases which affects food utilization and food eating habits. Thus by improving
overall health of communities, it enables communities to have better nutritional outcomes.
Need for variety of food doesn’t require rocket science. Identifying culturally acceptable and
sensitive food and food preparation methods is key in ensuring communities and families
follow such.
All the measures above are nothing without political will. As a country, Malawi has produced
a number of great blueprints which if they were implemented would have propelled the country
forward. Currently the vision 2063 offers great potential for ensuring growth and development
and if implemented will surely see the country reach greater levels of food security.

SECTION 6: CONCLUSION
Sustainable development goal number 2 calls for zero hunger, achieving food security,
improving nutrition and sustainable agriculture. Malawi as a country has made strides in some
of the issues relating to nutrition such as reducing levels of stunting and wasting. However, the
country recently been grappled with increased food insecurity with causes ranging from natural
disasters, increased poverty levels, poor agricultural practices and increasing population
growth. Gender disparities, poor education especially among women, lack of access to health
care and poor feeding practices all have also had impact on the nutritional status of the
population especially children.
In order to tackle these problems, a multisector approach needs to be deployed to ensure long
term food availability, accessibility and utilization. Need for a conducive global environment
through peace and tackling global warming and climate change cannot be overemphasized.
The government of Malawi also needs to put in place measures to ensure food security. The
government need to put in place policies that control population growth and promote economic
growth. There is need for government enhanced shift in agriculture from small holder
subsistence farming to large scale commercial farming. The government also need to put in
place control measures to ensure there is sustainability of food such as increasing farm gate
prices for ADMARC and instituting maximum retail prices for private entities. Promoting
education, health care and other social determinants of health is also critical in ensuring
security.
Civil societies and individuals also have an important role to play. Women empowerment and
education is critical in achieving good nutritionals status for families and children. Good food
handling and consumption strategies also play a major role in ensuring food sustainability and
security. Food supplementation programs also can assist in ensuring proper nutrition.
Thus through joint efforts of all stakeholders and moving beyond petty politics, the country
can be able to tackle the current food insecurity and nutritional issues.
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