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Uganda midwife Susan Ejang in a nutrition class for new moms (Photo credit: author)
Susan Ejang, a midwife in northern Uganda, stunned the dozens of new mothers who gathered for her nutrition class.
“Your child,” she boldly proclaimed, “can achieve great things.”
Greatness? A murmur of excitement rolled across the veranda of the rural health clinic. It was rare to even imagine greatness in a region plagued by years of conflict and weak health care, where mere survival through childhood was considered a blessed achievement.
Now Susan had the moms dreaming big. They imagined their children becoming successful farmers, business owners, police officers, teachers, soccer champions. One, Susan suggested, might even become President.
The women gathered at the health clinic were new moms bringing forth a new generation – and new expectations. As she dispensed advice on the best nutrition practices, Susan spoke for all those in Uganda, and all across Africa, who are counting on the next generation to lift their families, communities, and nation out of poverty.
A new report by The Chicago Council on Global Affairs on the potential of Africa’s next generation notes that over 60 percent of the population in Sub-Saharan Africa is younger than age 25, and that the continent’s youth numbers are expected to double by 2050. The report further notes that the labor force in Sub-Saharan Africa is growing about three percent per year, with an estimated 375 million young Africans reaching working age by 2035.
This rising generation is one of Africa’s richest resources. If it can be nurtured with proper education and engaged in productive employment, this growing cohort of young people represents a key asset for social and economic transformation. Yet, the Chicago Council report notes, formal sector job creation has not kept pace with the rise in the workforce; the gap between the number of labor market participants and available wage job opportunities widens by approximately 8 million annually.
But even if jobs are available, would the continent’s youth be able to adequately perform them? Eliminating malnutrition is key to unlocking their potential.
About one-third of Africa’s children under five years of age are malnourished and stunted in some manner, either physically, cognitively, or both, according to the World Health Organization. Stunted children become stunted adults. A child who is severely stunted is sentenced to a life of underachievement: diminished performance in school, lower productivity and wages in the workplace, more health problems throughout life, and a greater propensity for chronic illnesses such as diabetes and heart disease as an adult. And that life sentence is most often rendered by the time a child is two. For stunting is largely the result of a debilitating mix of poor nutrition, unclean environments, and lack of caregiver stimulation during the first 1,000 days – the time from conception to the second birthday.
Stunting impoverishes individuals, families, communities, countries, continents, and the entire world. The World Bank estimates that childhood stunting and malnutrition costs Sub-Saharan Africa the equivalent of 11 percent of its GDP each year, and costs the world economy about $3.5 trillion in lost economic activity annually.
The World Bank’s President, Jim Yong Kim, agonizes over so many children having inequality of opportunity locked into their brains before they even begin nursery school. What will become of such children in a world where labor markets are swiftly shifting from rural to urban areas, and where workplaces are becoming ever more automated and digital? What, he worries, will become of all those countries with childhood stunting rates of 20 percent or more? He, along with African Development Bank President Akin Adesina, have called for greater investments in what they call “gray matter infrastructure,” the nutritional building blocks – the crucial vitamins and minerals -- necessary for the healthy development of the brains of children.
“You cannot walk into the future with 20-30-40 percent stunting rates and expect to succeed,” Kim has told heads of state and their finance ministers. “To compete in the new economy, it’s necessary to end cognitive stunting.”
That message has landed loud and clear in Uganda. “Our children’s cognitive development represents Uganda’s greatest natural resource,” the country’s Minister of Gender, Labor, and Social Development, Wilson Muruuli Mukasa, wrote in the foreword to a report called Situation Analysis of Children in Uganda.
The report found that Vitamin A deficiency afflicted about 40 percent of all children under five, while anemia plagued about half of all children between six months and four years of age. The report estimated that Uganda lost nearly $1 billion worth of productivity every year due to high levels of stunting, iodine deficiency disorders, iron deficiency, and the lifetime impact of low birth weight – all of which compromise brain development.
The first 1,000 days became a central focus of the government’s Nutrition Action Plan, a document that conveys a palpable urgency. It reported that Uganda’s stunted children (about 30 percent of all children under 5, a total of about 2 million) had 1.2 fewer years of education than did healthy children. More than half of the country’s current adult population had suffered from stunting as children, and as a result these adults were less productive in their jobs and earned lower wages than those who had not suffered from stunting.
Minister Mukasa concluded that Uganda’s ambition to become a middle-income country by 2040 remained “highly contingent” on the country’s children having the best possible start in life.
Midwife Susan Ejang has taken up the challenge. She, too, focuses on the first 1,000 days in firing imaginations of what is possible for the nation’s children.
“This time is very important to you as mothers and to your children,” Susan told the gathering of moms at her clinic. “The time of your pregnancy and the first two years of your child’s life will determine the health of your child, the ability to learn in school, to perform at a future job. This is the time the brain grows most and good nutrition is very important.”
Susan promised, “You take good care in these days and you can have great children who won’t be malnourished. Your child can achieve great things.”
Greatness. “Yes,” she insisted, “if you take good care, the next president of the country may come from this group.”