Malnutrition, obesity persist among African children

Some local farmers carry part of their sorghum produce at Naoros farm in Turkana Central during harvesting exercise earlier January 2025. [Lucas Ngasike, Standard] In a world armed with unprecedented scientific knowledge, lifesaving medicines, and sophisticated health technologies, millions of African children continue to suffer the twin scourges of malnutrition and obesity. In countries like Kenya and South Africa, this contradiction is especially stark. We can develop mRNA vaccines in record time, but we can't guarantee a child a balanced meal. Speaking during the Africa Health Communications Fellowship in Johannesburg, health activist, journalist, and social justice advocate Mark Heywood explains this contradiction: "Twenty-nine per cent of South African children under five are stunted. That is politics impacting health. We have the means, but not the outcomes." Heywood argues that health in the 21st century is no longer just a medical or social issue - it is deeply political. Governments today have access to epidemiological data, health technologies, and scientific breakthroughs like never before. Yet, public health is worsening, particularly among the most vulnerable. In Kenya, the 2022 Kenya Demographic and Health Survey (KDHS) paints a worrying picture. Eighteen per cent of children under five are stunted, ten per cent are underweight, five per cent are wasted, and three per cent are overweight. While some progress has been made compared to previous years, deep disparities remain. Children from poorer households continue to bear the brunt of malnutrition. Emily Njunguna, a pediatrician at PATH Kenya, stresses that malnutrition is more than just low body weight. "We're also dealing with 'hidden hunger' -micronutrient deficiencies in iron, zinc, and essential vitamins that quietly erode a child's ability to grow, learn, and fight infections," she explains. In Kenya, about five per cent of children under five years old suffer from wasting -being dangerously thin for their height, often due to food shortages or illness. Around 18 per cent are stunted, a form of chronic undernutrition that permanently impairs both physical and cognitive development. Dr Luchuo Engelbert Bain, a global health expert and Head of International Programs at the African Population and Health Research Center. [Maryann Muganda, Standard] At the same time, childhood obesity is rising, particularly in urban areas, where about three per cent of children are now overweight. "This paradox is largely driven by the widespread availability of cheap, ultra-processed foods," Dr Njunguna says. "In many Kenyan households, vegetables are a luxury, while sugary snacks and refined carbs are abundant and affordable." Yet most families aren't making poor food choices out of ignorance-they simply can't afford better. Climate shocks like droughts and floods are decimating crops, while rising food prices make nutritious diets out of reach for many. Meanwhile, supermarkets and street vendors are flooded with junk food aggressively marketed to both parents and children. "Treating malnourished children without fixing the broken systems around them is like mopping the floor while the tap is still running," Dr Njunguna warns. "The real issue here isn't just hunger-it's inequality." She calls for a comprehensive response: climate-resilient agriculture, stronger regulation of junk food marketing, and bold, pro-nutrition policies that make diverse, healthy diets affordable and accessible to all. "This isn't a task for the health sector alone," she adds. "It will take political leadership, community action, and cross-sector collaboration." Data from the Kenya National Bureau of Statistics' 2021 (KNBS) report shows that while stunting among children aged 0 to 5 years dropped from 40 per cent in the early 1990s to 26.3 per cent by 2014, disparities remain. In rural areas, stunting remains alarmingly high at 42.9 per cent, compared to 29.3 per cent in urban centres. Additionally, severe wasting alone contributed to 4,367 deaths among children under five, while 2,304 deaths were attributed to stunting, and 4,755 to underweight. This means thousands of children continue to die every year due to preventable forms of malnutrition. Mark Heywood Health activist, journalist, and social justice advocate during the Africa Health Communications Fellowship in Johannesburg South Africa. [Maryann Muganda, Standard] South Africa faces a similar paradox. Despite being the continent's most industrialised nation, it grapples with a dual epidemic of stunting and obesity. The government introduced the Health Promotion Levy (sugar tax) in 2018 to curb obesity, but its impact has been weakened by intense lobbying from the sugar industry. "We know sugar is a major factor in obesity and diabetes," Heywood explains. "Yet the levy hasn't been adjusted in years, and inflation has eroded its value." The result? Childhood obesity rates have doubled. Many South African children are filled with sugary drinks and snacks but are starved of nutrients. Meanwhile, the poorest still suffer from chronic malnutrition. "In Kenya, malnutrition goes far beyond being just a health concern, it is a profoundly political and economic issue," says Luchuo Engelbert Bain, Head of International Programmes at the African Population and Health Research Centre. "Inequitable resource distribution, regional disparities, and weak policies leave certain communities more vulnerable than others. Meanwhile, soaring food prices and aggressive marketing of cheap, ultra-processed foods make it nearly impossible for low-income families to afford nutritious diets." APHRC is leading efforts to reframe how nutrition is discussed and addressed in Kenya. "Our goal is to ensure that strong research translates into real action so that every Kenyan child, no matter their background, has a fair chance at a healthy life," Dr Bain says. Data from the Ministry of Health and Unicef reveals that an estimated 760,488 children under the age of five are acutely malnourished, with 180,400 classified as severely malnourished. These children are at immediate risk of death or long-term health complications if left untreated. The crisis is most severe in the arid and semi-arid counties of northern Kenya, where access to food, clean water, and healthcare remains limited. Wajir, Turkana, Marsabit, Mandera, and Samburu record the highest rates of acute malnutrition, with wasting prevalence ranging between 15 and 23 per cent-well above the emergency threshold set by the World Health Organisation. Stunting, a sign of chronic undernutrition that affects physical and cognitive development, is also deeply entrenched in several counties. Kilifi (37 per cent), West Pokot (34 per cent), Samburu (31 per cent), and Turkana (23 per cent) rank among the worst affected. Alarmingly, even agriculturally productive regions like Nairobi, Nakuru, Nyandarua, and Kakamega are reporting elevated cases of child stunting, suggesting that malnutrition in Kenya is not only a rural or drought-related problem but also one linked to poverty, inequality, and poor infant feeding practices. This intersection of poverty, politics, and health makes malnutrition a human rights issue. Article 25 of the Universal Declaration of Human Rights recognises health as a basic right. South Africa's Constitution, under Section 27, guarantees access to healthcare. Kenya's Constitution also recognises the right to health. But legal protections mean little without implementation. Health justice requires more than hospitals. It means ensuring food security, clean water, climate resilience, equitable health education, and policies that put people before profit. In South Africa, Heywood warns, public health suffers under "austerity politics," where budgets are slashed even as disease burdens rise. Recent data from the National Information Platform for Food Security and Nutrition indicates stunting among children aged six to 59 months in Kenya remains high at over 28 per cent-higher than among younger children. Wasting has slightly improved, but inequalities between rural and urban communities persist. This double burden of malnutrition and undernutrition alongside overnutrition is a growing crisis. It lays the groundwork for an unhealthy adulthood and strains already fragile health systems. Nutrition experts emphasise the critical importance of the first 1,000 days-from conception to a child's second birthday. Proper nutrition during this period can prevent stunting, enhance brain development, and build lifelong resilience. Yet in many African countries, maternal and infant nutrition remains neglected. Heywood argues that scientific breakthroughs alone cannot solve the crisis. What's missing is political will. He stresses that journalism has a critical role to play: "Without accessible, high-quality journalism on health, we will continue to see health injustice." He cites South Africa's Treatment Action Campaign (TAC) as proof that civic mobilisation can drive policy change. A similar grassroots movement is needed today to combat malnutrition, obesity, and food insecurity. "Journalists need to understand the entire health ecosystem-not just the surface symptoms. Reporting on malnutrition must connect the dots: climate change, trade policy, junk food advertising, and gender inequality." According to a 2025 BMC Public Health study, socioeconomic status remains the strongest predictor of malnutrition in Kenya. Children from the poorest quintile are nearly three times more likely to be stunted than those from wealthier households. Kenya has implemented initiatives such as the Baby-Friendly Community Initiative and school feeding programs. But chronic underfunding and uneven implementation often limit their reach. In South Africa, nutrition interventions are similarly fragmented and susceptible to political changes. As part of efforts to strengthen health journalism and bridge the gap between the media and health experts, the Africa Health Communications Fellowship, hosted by Fray College of Communications in Johannesburg, South Africa, brought together a diverse cohort of health journalists and public health professionals from across the continent. Participants included representatives from the Ministries of Health in Nigeria and Zambia, as well as health experts and communicators from Ethiopia, South Africa, Malawi and Kenya. This collaborative platform fostered cross-border learning on pressing health issues like Covid-19, HIV, and malnutrition, with a shared vision to improve how Africa tells its health stories-accurately, urgently, and with impact.

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