The 2013 edition of The State of Food and Agriculture, from the Food and Agriculture Organisation (FAO), places Botswana in a category where rates of child stunting (being too short for one’s age) and micronutrient deficiencies are moderate or severe. The report says that all countries where stunting is a public health concern also have prevalence rates for micronutrient deficiencies classified as moderate or severe.
FAO uses standards of a sister United Nations agency – the World Health Organisation (WHO).
Stunting is caused by long-term inadequate dietary intake and continuing bouts of infection and disease, often beginning with maternal malnutrition, which leads to poor foetal growth, low birth weight and poor growth. Stunting causes permanent impairment to cognitive and physical development that can lower educational attainment and reduce adult income.
Children under five years of age are considered stunted when their height-for-age is two standard deviations below WHO’s 2006 child-growth standards. By WHO standards, a country is designated as having a public health threat related to stunting if at least 20 percent of its children are stunted. The prevalence of stunting among Botswana children stands at 31.4 percent, making it the second highest after Lesotho.
“Low birth weight, childhood undernutrition, exposure to poor sanitary conditions and inadequate health care are reflected in poor physical growth and mental development, resulting in lower adult productivity. In addition, the “developmental origins of adult disease” hypothesis (also known as the Barker hypothesis) posits that low birth weight has lasting negative health effects, such as being at greater risk of overweight, diabetes and coronary heart disease in adulthood. More insidiously, stunted girls grow up to be stunted mothers, and maternal stunting is one of the strongest predictors for giving birth to a low-birth-weight infant,” the report says.
Countries face micronutrient deficiency-related public health threats if 10 percent or more of their children are deficient in vitamin A or if at least 20 percent of children suffer from anaemia. In the Botswana case, the prevalence for anaemia among children stands at 38 percent; prevalence of Vitamin A deficiency at 26.1 percent and iodine deficiency at 15.3 percent.
Botswana also has an obesity problem, its prevalence among adults recorded as 13.5 percent in 2008.
Countries where 20 percent or more of the adult population are obese (equivalent to the global median prevalence for that indicator) are considered to be facing a public health threat related to obesity. Adults over 20 years of age are considered obese when their body mass index (BMI) is greater than or equal to 30. BMI equals body weight in kilograms divided by height in metres squared. The overweight and obese impose economic costs on society directly through increased health care spending and indirectly through reduced economic productivity.
The FAO survey also considered whether advertising by food and beverage manufacturers and retailers contributes to the rise in overweight and obesity. It concluded that “commercial advertising almost certainly influences consumers’ food choices and diets ÔÇô otherwise, companies would be unlikely to spend the sums they do.”