Engaging Elected Representatives
Cameroon is targeting multiple groups including parliamentarians to raise issues around malnutrition.
Georges Okala, Deputy Director of Food and Nutrition, Ministry of Public Health and SUN Government Focal Point highlights the successes…
Cameroon’s approach to nutrition advocacy has been born out of a long-term neglect for nutrition in the country. Cameroon is among the 36 countries in the world with the largest number of children under five suffering from stunted growth. Nearly 33% of children under five suffer from stunting: equivalent to approximately one million children. Six out of ten children are anaemic (due to iron deficiency). The prevalence of acute malnutrition is 6% across the country and reaches 10% in the northern and Far North regions.
To address this situation, nutrition interventions have been supported by development partners for many years together with the health sector: the only sector formerly engaged with nutrition. PROFILES 10, an advocacy tool, had been applied to estimate the cost of malnutrition in the Cameroon but there was a mixed reception to the findings as Cameroon was considered self-sufficient in food. The lack of funding for nutrition meant that the situation was likely to worsen over the years.
The first warning came in 2006 with the arrival of refugees fleeing from the Central African Republic to the East of the Cameroon which meant that nutrition services had to be reinforced in order to cope with the refugee population. The first surveys collecting nutrition information (MultiCluster Surveys or MICS and Standardized Monitoring and Assessment of Relief and Transitions or SMART) that were carried out showed an alarming situation among children less than five years of age. This drew the attention of the government. Faced with this alarming situation and to visibly increase the level of interventions and accountability, Cameroon joined the Scaling Up Nutrition Movement in March 2013.
A new approach to nutrition advocacy
To develop a common understanding of malnutrition in Cameroon and to analyse coordination mechanisms and platforms, an inter-agency mission was jointly undertaken by United Nations (UN) agencies: Food and Agriculture Organisation (FAO), World Health Organisation (WHO), World Food Programme (WFP) and United Nations Children’s Fund (UNICEF) in April 2013 with the support of nutrition regional offices. The mission involved five key sector ministries (health, agriculture, water and sanitation, women’s empowerment and family, economic and planning), the Minister Secretary General of the Prime Minister, as well as technical and financial partners. The mission concluded that malnutrition was unrecognised in Cameroon.
An advocacy plan for nutrition was therefore initiated under the joint leadership of the Ministry of Health and UNICEF with the aim of embedding nutrition within the development agenda of Cameroon. The plan called for intensified advocacy actions to:
- Inform decision makers and stakeholders about the process
- Engage key stakeholders
- Equip key actors to be able to advocate for nutrition and put nutrition at the heart of development priorities at all levels
- Prepare for broader communication with the general public that is credible, effective and sustainable
- Seek funding and/or technical support from agencies located in Cameroon
- Explore innovative funding mechanisms for Cameroon
Mass mobilisation and sensitization
A range of actions have been undertaken to raise the profile of nutrition in the Cameroon.
A nutrition media training session with field visits in the Far North was organized in July 2013 for 40 journalists. A large number of articles, radio and television reports were aired as a result. A paper on the state of malnutrition was published by UNICEF and 7,000 copies distributed in April 2014.
In February 2014, to compensate for the lack of awareness about the existence of malnutrition in their communities, a mass mobilization and sensitization campaign was organized in four regions of the country where the rate of malnutrition is the highest in the country, among traditional and religious leaders, local elected officials, administrative authorities and through community radio. Nearly 500 people were sensitized through information exchange and visits to communities and health facilities. The mass mobilisation campaign, supported by UNICEF, was launched and closed by the Secretary of State for Health.
Affected by the extent of malnutrition in Cameroon through the advocacy campaign, the President of the Republic of Cameroon asked the Ministry of Public Health to produce a report on the situation of malnutrition, with concrete measures to remedy the problem. Following this report, the President instructed the Prime Minister to create a multi-sectoral platform for nutrition hosted in the Office of the Prime Minister and to establish a national nutrition programme within the Ministry of Public Health.
Four televised debates on different themes
(i) state of malnutrition in Cameroon
(ii) malnutrition does not mean death,
(iii) the importance of the 1000 days and
(iv) economic losses of malnutrition,
were aired in the months of April and May 2014 on the television channel Canal 2.
Those who took part included government officials, non-governmental organisations, civil society, parliamentarians and UNICEF.
In November 2013, a high level visit to Cameroon was made by Dr Philippe Douste Blazy, President of UNITAID11 and UN Assistant Secretary in charge of innovative financing. During the audience granted him, the President of the Republic His Excellency Paul Biya, Dr Blazy pleaded for greater allocation of resources and innovative funding for nutrition.
This visit prompted the creation of the first Business Forum on Nutrition which was held in May 2014 under the aegis of the Ministry of Public Health in partnership with the Ministry of Industry, Mines and Technological Development, the Ministry of Commerce, Ministry of Small and Medium Enterprises, Social Economy and Handicraft, Chamber of Commerce and Industry, the Employers Group of Cameroon and UNICEF. The idea of creating a ‘Nutrition Investment Fund’ was identified as a proposed private sector platform to support the SUN Movement in the country.
The role of elected representatives
Elected representatives have an important role to play in the fight against malnutrition especially in endorsing legislation, developing budgets, and auditing the use of budgetary allocations. Six Cameroonian parliamentarians took part in two orientation sessions on nutrition conducted in Congo Brazzaville in November 2013 and Addis Ababa, Ethiopia. The sessions brought together parliamentarians from West and Central Africa who agreed to create a network of parliamentarians on nutrition and implement national networks with the view to pooling their efforts to eradicate malnutrition in the region. The parliamentarians from Cameroon have created their own network to promote nutrition ‘Network Root of Life’ which today includes more than 40 elected representatives.
To enable parliamentarians to appreciate the reality on the ground, a mission involving 15 Members of Parliament led by the UNICEF Representative was undertaken in March 2014 in the Far North region. Raising awareness of government to ensure better allocation of financial resources was the main recommendation from the visit.
In June 214, an information session on nutrition was held in front of 50 deputies in the National Assembly followed by a visit to a nutrition centre. A letter of engagement was prepared by parliamentarians and senators which included:
(i) adoption for 2015 of legislative documents for
eradication of under nutrition in Cameroon;
(ii) integration of nutrition in sectorial strategic plans and
(iii) proposal to increase the budget allocation and
monitoring mechanisms; and
(iv) strengthened local networks for nutrition.
A number of other advocacy actions are planned for 2014. These include the organization of a fundraising event on nutrition.
- It is important to target advocacy at multiple groups (i) journalists, (ii) parliamentarians, (iii) local
authorities, (iv) private sector, (v) UN agencies, (vi) civil society
- Information needs to be provided in a simple manner and tailored to audience. Information about economic losses due to malnutrition is important for a country that is emerging economically
- There is a need to close the gap between theory and reality. Field visits are important to raise awareness of problems and to provide information about all sectors and determinants of malnutrition.
- Local and religious authorities need to be involved in advocacy efforts in the most affected areas.