Zambia

Zambia is a large, landlocked country covering an area of 752,614 square kilometers with no navigable rivers. Its population is estimated to be 8.89 million in 1993, growing at an annual average growth rate of 3.4 percent per year. About 50% of the population is urban, high in comparison with most African countries. A new government headed by President Chiluba was elected in October 1991, and initiated extensive economic reforms, including a three year structural adjustment programme begun in March 1992.

Recent Trends in Nutrition

Economic recession intensifying in the early '90s, and drought in 1991/92, had major effects on nutrition. Trends in underweight can be approximated, although there are some gaps, using two sources: the national nutritional surveillance programme, which uses clinic data; and three national surveys, one of which covered rural areas only. Combining the available results, nationally and in selected provinces for the recent years, gives the following estimates, which are also the values plotted on the graphics page for Zambia.

Map of Zambia

Note: The dashed lines indicate province boundaries.

The 1991/92 drought hit hardest just after the 1992 survey, so average prevalences would have worsened beyond the 29% estimated in early 1992 (rural areas) - although more severe deterioration was almost certainly contained by extensive relief efforts, with major inputs from NGOs. The harvest in April-June 1993 was good, and the provincial data available (examples shown in section C of the table) indicates improvement by 1994. Regional comparisons can be made from the national demographic and health survey of January to May 1992. Overall, this shows significant urban/rural differences - underweight prevalences estimated as 21% in urban areas, 29% in rural. Between the 9 provinces, the range is from a low of 22-23% in Central, Copperbelt, Lusaka and Southern; to the highest values of 30% in Luapula and 38% in Northern. These provincial rankings are similar when stunting is used - e.g. 34% in Central to 57% in Northern, with a national average of 40% (33% in urban areas, 46% in rural); these values of stunting are high (and were so in earlier years), and indicate a continuing long-term problem of malnutrition, over and above those caused by drought.

Factors Affecting Trends in Nutrition

Economic Growth. In 1993 per capita GNP was estimated at U.S.$370. Per capita GDP declined by -2.0% per year between 1986 and 1993. Major characteristics of the economy are heavy reliance on a single export product (copper), a very high debt service burden, and excessive public sector involvement in the goods and services sectors.

An important part of the explanation for the nutrition situation in Zambia is the deterioration in the economy of the country over the last decade. The country's wealth is founded mainly on copper, its largest export. Development of its infrastructure and public services is tied to earnings from this commodity.

The economic and social effects of the devastating slump in world price of copper since 1975 persist to this day. Zambia's mineral production accounts for around 20% of GDP, and 80% of all export earnings. Since the early 1980s the world copper prices and demand have remained weak mainly because of depressed economic conditions in the industrialized countries. This factor, plus drought, led to increasing debt.

Official figures put average inflation at 175% in 1992, a sharp increase from 55 percent in 1988. This increase was mainly due to aggressive action on the exchange rate, a subsidy reduction for maize, and price liberalization.

Total debt at end-1991 estimated to be U.S.$7.3 billion. Zambia's external debt per head excluding short term debt is one of the highest in the world at nearly U.S.$800 per head.

The year 1992 was a particularly bad year for Zambia, with the worst drought of the century in southern Africa. Agricultural production slumped to a six-year low, with maize production only a third of the previous year's level. That same year, the government devalued the Zambian currency against the dollar by 30% and inflation rose to an all time high, helped by the removal of 90% of the maize subsidy.

Food Security. The long-term food security problem in Zambia is not so much related to inadequate food supplies or food production at the national level as it is to general decline in per capita real income under rapid inflation Per capita food production index with base year 1979-81=100 decreased to 78 in 1992 due to drought as compared to 91 in the previous year and it is estimated to be 99 in 1993. Yields are expected to be average in 1994.

In 1992, the ratio of the food price index to the consumer price index rose to nearly 110, due to higher inflation rate for food commodities. This ratio dropped again in 1993, which may have contributed to nutritional improvement.

Agriculture sector share in GDP has decreased from 16% in 1991 to 8% in 1992 mainly due to drought. Zambia has considerable agricultural potential, with about nine million hectares of reasonable to good arable land. Despite its potential only about 20% of arable land is currently utilized, most of it for rainfed maize production. Other significant crops are sorghum, cassava, millet, sunflower, groundnut, cotton, tobacco, sugarcane, paddy rice and variety of vegetables.

A number of measures have been taken in recent years to alleviate food insecurity. In 1989, when the urban poor were increasingly unable to purchase adequate food, the government initiated an urban food subsidy scheme, through food coupons, for the poorest households. During the drought, support programmes included distribution of maize at half price to the most seriously affected households, additional income support for the poorest, labour intensive public works programmes, larger budget allocations for the social sector, and other measures. By many accounts these measures were widely successful in mitigating the worst effects of the drought on nutrition.

Health, Education. The government is taking major steps to control deterioration in social development. The government is giving more focus on women's education and primary health care. The government is also trying to increase women's participation in the labor force, and their access to credit. Health and education expenditures have increased since 1984 but still the overall conditions are not satisfactory.

ZAMBIA

(Estimates in 1993)

Population	: 9 million
Population Density	: 11 per sq. km.
Population Growth Rate	: 3% per annum
Urban Population	: 43%
IMR	:114
GNP US$ (Per Capita) (WB Atlas Methodology)	: 370
PPP estimates of GDP ($ Per Capita, in 1991)	: 1010

CHILD GROWTH AND SURVIVAL

Underweight preschool children (Percent below -2 s.d. weight for age)

Infant mortality rate (Per 1,000 live births)

ECONOMICS

GDP per capita (1987 Mkt. prices, Kwacha / capita)

Debt service ratio (Debt service/exports)

FOOD

Food production index (Per caput, 1979-81=100)

Dietary energy supply (Kcals/caput/day)

Consumer price index (1980=100)

FPI/CPI ratio (1980=100)

HEALTH

Immunization coverage (Percent)

Access to local health care (Percent)

PUBLIC EXPENDITURES

Education and health expenditures (US $ per capita)

Education and health expenditures (Percent of government expenditures)

The infant mortality rate has increased from 100 in early 1980s to 114 in 1993. Major outbreaks of cholera every year from 1991 to 1993 were directly linked to the decline of sanitation and water supply facilities in urban areas. One positive development was that about four in five children were immunized against preventable diseases. Vaccinations against DPT and measles has increased and stood at 79% and 76% respectively in 1992.

Some 95% of primary school age children were enrolled in school in 1991, with 20% continuing into secondary education; 2% of the 20-24 age group are in further education. The figures disguise high drop-outs throughout the school system. The illiteracy rate was 27% in 1991.

A potentially important source of nutritional problems especially among newborns is the AIDS epidemic. Zambia is the fourth worst affected country in the world, after Uganda, Zaire and Tanzania. In Lusaka's largest hospital, the University Teaching Hospital, a recent survey indicated that 36% of the expectant mothers attending antenatal clinics tested HIV positive. Thus, pediatric AIDS would likely affect a good portion of the infant population.

Notes

1. Chongo, D. & Kaite, C. (1991). Report on the Nutrition Module of the HBS Conducted by the Prices & Incomes Commission (PIC) in the Central Statistical Office in 1995. National Food & Nutrition Commission, 1991.

2. Hunt, S., Kaite, C., Kasonde, T. & Campbell, E. (1994). Nutrition and Food Security. Analysis of the Zambia Priority Survey I. Food Studies Group, Oxford University.

3. Cogill, B. & Zaza, M. (1990). Report of the Pilot Nutrition Module. Report of a Survey of Rural Zambia Undertaken as Part of the Crop Forecasting Survey 1990. Central Statistical Office, National Food and Nutrition Commission and UNICEF/Zambia. Lusaka, November 1990.

4. DHS/University of Zambia and Central Statistical Office (1993). Demographic and Health Survey of 1992. Macro International, Columbia, MD.

5. Food Security, Nutrition & Health Monitoring System. Central Statistical Office, various reports.