38
Figure 19 - Weekly admissions of children to nutritional centres
for severe acute malnutrition
(2006-10)
Source: UNICEF Niamey 2011
Indeed, their number was about three times higher than in 2009 (a year which recorded a
good harvest) and five times than 2008. In particular, admissions of malnourished children to
feeding centres were already 60 percent greater in January 2010 (four months after the
harvest) than a year earlier, with significant increases in Maradi and Zinder. The peak of child
admissions was reached in August 2010, when on average 10,900 children were treated
against severe acute malnutrition every day.
Clearly, factors other than the prices of millet, fodder and exchange entitlement or the
epidemiological problems typical of the lean seasons explain such a sharp increase in child
admissions to feeding centres. The main one was the decision of the Government of Niger
and donors led by UNICEF to upscale the response to the acute and chronic problems of child
malnutrition which had beset the countries for ever and which had increased in intensity in
2010. Clearly, the country learned from the mistakes of 2005. The greater political attention
to the issue of child malnutrition materialized in: (i) a sharp increase in the number of feeding
centres, which tripled in relation to 2009, with the largest rise recorded for the CRENAS (Table
11) and in their better integration within the national health system. Moreover, while during
the 2005 food crisis the only NGO active in child feeding was MSF-France, by 2010 the
number of such NGOs rose to twenty and the number of nutritional centres they run in the
country under the coordination of UNICEF rose to 812; (ii) a shift in ‘growth standards’ used to
identify malnourished children from the NCHS to the 2006 WHO standard. With this change,
approximately eight times more children were classified as severely malnourished, compared
with the previous scale (Minetti et al. 2009). OCHA (2010) argues that such shift is the major
explanation of the sharp increase of both moderate and severe malnutrition figure between
2009 and 2010; (iii) an increased capacity of the existing CRENI and CRENAS in terms of
number of children they were able to treat thanks also to the supply of essential drugs and
ready-to-use therapeutic food (RUTF) (Deconick et al. 2010). The latter permits even severely
malnourished to be treated at their home, thanks to a new ambulatory service which
overcomes most of the difficulties due to the poor coverage of health services in Niger, and
the launch of a WFP-UNICEF sponsored Blanket Feeding Operation (OCHA 2010).
39
Table 11 - Niger: number of nutritional
centres in operation (2005-2010)
MAS
MAM
Total
CRENI
CRENAS
CRENAM
2005
24
263
574
861
2006
34
296
619
949
2007
33
303
477
813
2008
39
258
495
792
2009
39
209
322
570
2010
45
775
657
1,477
Source: UNICEF-Niamey
The regression results (Table 12) confirm (as observed in 2005) the strong correlation
between millet prices and child admission to feeding centres (elasticity 1.8-2.1). The millet
parameter is only slightly less than that computed for 2005 (Table 9). This is true also for the
prices of the exchange entitlements (cows) while that of goats has the wrong sign. The
parameter of the number of feeding centres in operation on a monthly basis
18
is high and is
strongly significant, confirming that a large part of the increase in admissions was explained
by the greater ‘political will’ shown by government and donors. Finally, the hunger season
dummy in turn is highly significant and absorbs in part the effect of cow prices whose
parameter in model 2 loses significance. The results do not change significantly if the number
of child admissions is lagged by one month (Model 3). Thus, the rapid expansion in the
number of feeding centres in 2010 appears to have played a greater role in explaining the
rise in child admissions to feeding centres than in 2005, though the gradual rise of millet
prices observed over 2006-10 explains a still significant proportion of the surge in child
admissions. Finally, the modest loss of entitlements of the agro-pastoralists who sells goats
did not affect child malnutrition (cfr. Table 8 and 10), while the substantial fall in the price of
cows and the subsequent deterioration in the millet/cow exchange rate turns out have been
significant for child malnutrition.
Meanwhile, survey data compiled by WFP suggest that the acute-severe and chronic
malnutrition remains above the emergency threshold of 15 percent in all regions, with peaks
in the two traditional granaries of the country (acute malnutrition of 17.8 percent in Zinder
and chronic malnutrition of 58.5 percent in Maradi). Figure 20 also shows that the incidence
of acute-severe malnutrition was higher in 2010 (16.7 percent) than in 2005 (15.3 percent).
However, these results are not comparable, as the 2005 survey refers to the post harvest
month when malnutrition tends to decline, while that of 2010 refers to June, i.e. beginning of
the hunger season. Be as it may, it is clear that the adoption of good short-term policy
interventions is not enough to reduce the food insecurity of the country.
Malawi’s 2002 and 2008 food crises
As noticed by Chirwa (2009) price swings are not new in Malawi, however their frequency
seems to have increased.
18
Such time series was estimated by the authors on the basis of past trends and of official annual data.