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Tackling malnutrition and hunger in Nicaragua: a battle on many fronts
By Karla Jacobs, 12th September 2009

“Hunger is a consequence of poverty, caused by diverse factors that reduce or impede access to food, one of those factors being insufficient income to obtain food. Hunger is also a cause of poverty given that it affects the physical and intellectual development of children as well as limiting people’s general capabilities and their ability to produce or generate income for themselves and for their country as a whole.”
(UN document about millennium goals in Nicaragua)

This week the UN Special Rapporteur on the Right to Food, Olivier de Schutter, visited Nicaragua for the first time to evaluate the situation with regards to food security and malnutrition in the country.

As part of his week-long visit, ending on September 13th, de Schutter has met with Agriculture Minister, Ariel Bucardo, and other high level government representatives, the Human Rights Ombudsman, Omar Cabezas, Supreme Court magistrates, National Assembly deputies and representatives of civil society and other organizations whose work involves programs to do with food security and nutrition. In early 2010 de Schutter will report on his findings at the UN headquarters in New York.

During comments to the press, de Schutter acknowledged the FSLN government’s legal, institutional and programmic advances towards reducing hunger in the country emphasizing the 6% reduction in infant malnutrition.

The UN Rapporteur described the recently approved Food and Nutritional Security and Sovereignty Law as “encouraging” and a “model“ on which to base efforts to guarantee the Nicaraguan population’s right to food.

The state of food security in Nicaragua

Diverse government and other institutional studies confirm that the sectors of Nicaraguan society who are most likely to suffer hunger and malnutrition are children, women, impoverished families, people who have had little or no access to formal education, indigenous peoples and rural dwellers.

A UN Food and Agriculture Organization (FAO) report  published in 2008 about the state of food security in the world, found that more than a fifth of the overall Nicaraguan population (22%) was malnourished in 2005. While the overall percentage of under nourished citizens fell steadily from 52% in 1990 to 22% in 2005, other in-country studies demonstrate that food insecurity among certain sectors of society, specifically women in child bearing age and under-fives, did in fact increase between 2001 and 2006, as did the number of people living in extreme poverty.

The 2006-2007 National Health and Demographic Census found that the percentage of under weight newborns (an indicator of malnutrition in both infants and mothers) grew from 2.6% to 6.4% between 2001 and 2006. It also found that more under-fives were falling ill with diarrea in 2006 than in 2001.

According to a UN report about food security in Nicaragua the percentage of the population living in extreme poverty fell by just 0.1% from 15% to 14.9% between 2001 and 2005. Taking into account the year on year population growth in the country for that period, this figure actually translates into a higher number of people living in destitution in 2005 than four years earlier.

The same report demonstrates the intrinsic link between higher levels of education and food security. While 18% of under fives with mothers who were unable to study themselves are undernourished in Nicaragua, only 1% of under fives with mothers who have high school qualifications are malnourished.

As part of the public sector Food Security and Sovereignty Policy, published by the Ministry of Agriculture in May 2009, a number of cultural and other factors that contribute to a high tendency towards malnutrition among the Nicaraguan population were outlined.

The average Nicaraguan’s diet tends to be unbalanced with over 65% of calories derived from carbohydrates, something which leads to a high possibility of poor health related to insufficient protein consumption. On top of this the daily average per capita calorie intake in Nicaragua is 200 calories less than recommended daily levels. Considering the extremely unequal distribution of wealth in Nicaraguan society, we can assume that a significant percentage of the Nicaraguan population has a much greater calorie intake-deficit than the per capita average.

The tendency for ordinary Nicaraguans not to incorporate fruit and vegetables into their diet is a factor that contributes to the considerable levels of vitamin deficiency registered by the Nicaraguan health authorities.  

High levels of consumption of processed and synthetic foods (like soft drinks, and other processed sweets and snacks) in urban areas and growing levels of consumption of this sort of food in rural areas are a cause of concern for the authorities, who admit that as yet no program to tackle this specific problem has been introduced.

In terms of the extent to which the population’s organisms are able to biologically make the most of the nutrients in their diet, the persisting problems of lack of access to sanitation and safe drinking water constitute a major obstacle. It is estimated that 75.3% of water sources used by rural dwellers in Nicaragua are not safe, while over 20% of the urban population still does not have access to one of the state water company’s water systems. Meanwhile a significant proportion of the overall population does not have access to basic sanitation.

People without access to safe drinking water and basic sanitation have a high probability of suffering from chronic bacterial stomach infections that reduce the body’s ability to digest food properly provoking malnutrition.

What has the FSLN government done to increase food security?

Since coming to power in January 2007 the FSLN government has brought in a number of measures aimed at increasing food security and sovereignty for the population and the nation as a whole.

The measures implemented by the Ministry of Agriculture (MAG-FOR) and other public institutions related to agricultural production include the Zero Hunger Program which aims to ensure that 75,000 rural families previously suffering varying levels of food insecurity are able to produce enough food to meet their own needs over a period of five years.

During the first two years of the FSLN government 32,359 food production packages (consisting of a pregnant cow, a pregnant sow, ten chickens, one cockerel, seeds and other inputs) were provided to the same number of families in rural areas of Nicaragua.

The government has also successfully increased the amount of basic grains being produced by small and medium farmers and agricultural cooperatives since 2007 as a result of its certified seeds program. 140,010 small and medium farmers who previously did not have access to credit to produce food were provided with zero interest in-kind loans of certified seeds and fertilizer in 2008.

Additionally MAG-FOR has overseen the implementation of the National Seed System, an inter-institutional system involving a number of public institutions. By November 2008, the national seed system had converted Nicaragua into the biggest producer of certified seeds for national production in Central America.

Certified seeds are the product of extensive quality monitoring and guarantee higher yields for farmers, reducing the need for excessive use of pesticides and other agro-chemicals.

The State company responsible for guaranteeing basic food supply, ENABAS, which had been effectively mothballed by previous neo-liberal administrations, has been reactivated by the Sandinista government. As a result, the company, which has basic grain storage facilities across the country, is able to exercise growing influence on basic grain markets resulting in much greater stability of both the price paid to producers and the price paid by consumers.

As part of the government’s Food for the People program, 3,506 ENABAS supervised, community run shops selling basic foods at below market prices have been set up in neighbourhoods and communities across the country since 2007.

Free school meals and increased medical attention for infants and mothers

In terms of tackling the specific problem of malnutrition in Nicaragua’s child population, the FSLN government’s policy is based on two main projects.

Since 2007 the Ministry of Education (MINED) has guaranteed free school meals for all primary school children, something that was never achieved during previous administrations. The meals consist of rice, beans, corn, oil and cereal, and are prepared by pupils’ parents as part of a school supervised rota system.

The impact and reach of this program is substantially increased thanks to the record number of children and young people who are able to attend school since the public school system was de-privatized in 2007. Over one million primary school pupils (more than 15% of the entire Nicaraguan population) receive school meals as part of this program.

Additionally, a new piece of legislation obliging the State to provide resources to fund a school milk program as of next year was passed recently. This will allow for all primary school children to receive a glass of milk with their school meal.

In 2008 the Ministry of Health (MINSA) presented its plan “Towards the Eradication of Chronic Malnutrition in Infants” which aims to halve the percentage of children under three suffering from chronic malnutrition by 2015 in line with the UN Millennium Goals.

This plan, which is aimed at children under three and pregnant and breastfeeding women, involves the progressive implementation of a number of public health system supervised measures to reduce nutritional deficiencies in the most vulnerable sectors of society. 

As part of the plan MINSA has identified the regions where children are most likely to suffer from malnutrition. 88 municipalities, home to 57% of the population, were identified as areas with high, very high or extreme nutritional vulnerability. In the ten municipalities with the highest levels of malnutrition, over 50% of children were undernourished. These municipalities account for the most remote areas of the country where there is least access to healthcare and other basic services.

Among the measures to be implemented in the 88 prioritized municipalities are universal provision of iron and folic acid to women of child-bearing age, universal provision of vitamin A and iron supplements for children between 6 months and five years, treatment of diarrea with zinc and rehydration salts, universal vaccines against rotavirus, programs to promote and support the practice of exclusive breastfeeding until six months of age and the provision of family planning advice with the option of contraception methods for all women in child-bearing age.

This plan, currently in its second year, is being implemented with the supervision of MINSA’s Food and Nutritional Security Technical Commission.

Food Security and Sovereignty Law

In June the National Assembly approved the Law of Food and Nutritional Security and Sovereignty, which recognizes the right to nutritious and safe food as a fundamental human right. Surprising as it may seem, Nicaragua is among only a handful of countries in the world to actually recognize the right to food as a basic human right. 

This law sets out the institutional framework of the National System of Food and Nutritional Security and Sovereignty involving local, departmental, regional and central government, relevant public ministries and institutions, NGOs and other national and international organizations working on food security issues and other relevant institutions and organizations.

This system, presided by the President of the Republic, is responsible for designing, facilitating and implementing measures to directly increase national food security and sovereignty in the short, medium and long term. It is also responsible for articulating all the different food security initiatives carried out by different groups in the country as a way of ensuring maximum impact.

The law obliges the State to provide funding for food security and sovereignty programs and establishes the creation of a Food Security Emergency Fund to respond to situations of extreme food insecurity resulting from natural disasters and social or economic crises.

Also as a result of the law, Nicaragua will appoint a Right to Food Ombudsman to monitor and report on the evolving situation regarding the right to food in the country.

FAO representative praises government’s efforts to increase food security

Obviously the impact of the government’s multipronged approach to tackling the problems of hunger and malnutrition is not something that can be measured in the short term. FAO’s in-country representative, Gero Vaagt, is confident, however, that the government’s efforts are making a difference to those Nicaraguans who are most vulnerable to the effects of long-term economic exclusion and the ongoing global food crisis.

During the inauguration of the 2009-2010 agricultural cycle, an event that took place in the southern region of Nueva Guinea, Vaagt announced that the Nicaraguan food security program had been identified as one of the two most successful such programs monitored by the international organization:

“I want to applaud the Nicaraguan government for its efforts in the area of food security. FAO, as an international, intergovernmental organization, has classified these efforts and Nicaragua as a model country, an exemplary country in terms of confronting issues relating to food security, reducing hunger and improving the nutritional situation of the population. …

The Special Food Security Program in Nicaragua, PESA, was identified as one of the two most successful of the 62 food security programs that FAO is involved with around the world. …

The main reasons for this are the fact that the issue of food and nutritional security has been defined as a priority by the Nicaraguan government, but not just for the agricultural sector, also for the education and health systems. In Nicaragua the Ministries of Agriculture, Health and Education have been working together on food security programs. It is as a result of this approach, of the collaboration between these three sectors, that the creation of the Food and Nutritional Security and Sovereignty Law was possible."