Introduction

Guyana is a small country (population: 750,204) in Northern South America, which shares cultural and historical bonds with the Anglophone Caribbean. About one-third of the Guyanese population lives below the poverty line. According to the Global Nutrition Report, the country is on track for maternal, infant and young child nutrition targets in stunting prevalence in children under five (11.3 percent) and overweight in children under five (5.3 percent), although wasting prevalence is 6.4 percent.[1] However, national statistics mask much higher sub-national prevalence, with stunting as high as 28 percent in hinterland regions, among indigenous populations. Moreover, at just over 21 percent, the country’s levels of exclusive breastfeeding are well below the South American average of 57.3 percent.[1] There are also challenges with adult malnutrition. More than a third of women of reproductive age have anaemia, and 27.1 percent of women and 12.7 percent of men are obese.[1]

Country at a crossroads

The Guyanese economy has shown moderate economic growth in recent years, which has been based largely on agriculture and mining. But in 2015, an estimated 8 billion barrels of oil were found offshore and the country has become an oil producer in 2020.

“Guyana is at a crossroads – it has a new government and an optimistic economic outlook, despite COVID-19,” says Mikiko Tanaka, United Nations Resident Coordinator (UNRC) since 2016.

“There is potential for the new oil revenue to transform the country, which is in need of investment in nutrition and human development. Like many countries, Guyana is facing a double (if not triple) burden of malnutrition [undernutrition, overweight/obesity and micronutrient deficiencies] – we really want to position nutrition as a key part of the development agenda.”

The country is already experiencing changes in its food consumption patterns, driven by the move away from an agrarian economy and locally grown fruit and vegetables to the increased consumption of cheap, imported processed foods. Guyana is not a member of the Scaling Up Nutrition (SUN) Movement; however, SUN’s principles are applicable to the country’s current and emerging situation. Guyana’s Food and Nutrition Security Strategy recognizes that nutrition will increasingly play a fundamental role in the country’s development agenda.

Galvanizing the UN community on nutrition

A number of UN agencies, including the Food and Agricultural Organization of the United nations (FAO), the United Nations Children Fund (UNICEF) and the Pan American Health Organization/World Health (PAHO/WHO), are currently working together to support the national nutrition agenda and Sustainable Development Goal (SDG) framework in the country. “There is definitely a feeling of optimism for where nutrition is going in Guyana,” says Gillian Smith, FAO representative in Guyana. “But there are also deep cultural roots and geographic disparities in the country to be addressed, although the system could be set to evolve.”

As in many countries, the COVID-19 response has led to unforeseen opportunities. One of these is a call for the revitalization of a United Nations inter-agency taskforce to foster greater collaboration for nutrition. PAHO/WHO colleagues spoke of joint proposals as an effective way to work more collaboratively, and the effective functioning of the taskforce as a mechanism to catalyze this. According to PAHO/WHO, this could also be an opportunity to work with the government to restart promotion of breastfeeding – and for more inter-agency collaboration on this issue.

A multi-sectoral approach has yet to really find traction in Guyana. “There is a National Nutrition Committee but it hasn’t taken off seriously as a coordination mechanism,” says Irfan Akhtar, deputy representative of UNICEF Guyana and Suriname. “There’s much we could be doing, for example, to bring together nutrition with WASH and social protection interventions.” 

UNICEF is one of the UN agencies supporting the establishment of the National Nutrition Coordinating Mechanism, a multi-stakeholder platform that is expected to promote common standards, strategies and approaches and address critical nutrition gaps. Multi-sectoral initiatives are already underway, such as the drafting of an Integrated Early Childhood Development Policy. This policy has highlighted the importance of reaching children in a holistic manner, incorporating health, nutrition, water and sanitation, education and social protection interventions that support their development.

United Nations agencies have rallied around nutrition and food security through a number of programming initiatives, some of which are jointly implemented. These include both nutrition-specific interventions, such as the first 1000 days programme, the Baby-friendly Hospitals Initiative and the national Early Childhood Development (ECD) programme; and nutrition-sensitive programming, such as school feeding and agriculture. 

Opportunities to leverage nutrition in Guyana

“We really need to adopt a holistic approach to nutrition in the country, one that looks at a lifecycle approach and preventative programmes,” asserts Gillian from FAO. “How can we set people on a path for good nutrition?”

Through technical and financial support, UN agencies such as FAO and UNICEF are promoting systems strengthening, capacity building and integrated approaches and partnerships for nutrition. UNICEF’s focus ranges from age-appropriate nutrition in Infant and Young Child Feeding (IYCF) to developing policy and guidelines for behaviour change especially among adolescent mothers.

School feeding has also been identified in Guyana as an SDG accelerator that addresses local economic development, education and even social cohesion (e.g. between Venezuelan migrants and host communities). FAO is currently piloting a multifaceted approach to foster healthy eating habits among school-age children. Working with schools to institute healthy lunches, snacks and breakfast meals, the programme matches small-scale farmers with local community schools. Parental participation and nutrition learning through school garden activities also helps to provide a comprehensive and mutually reinforcing environment that encourages healthy eating. 

However, more could be done in an integrated manner. Policy and regulations around food standards could be better linked to broader agricultural development along the food value chain. Likewise, additional measures could be taken to connect food and social protection systems as part greater efforts to safeguard nutrition. FAO is working with the Ministries of Education and Human Resources and Social Services to identify other entry points in social protection systems that would benefit from nutrition-sensitive interventions. 

Tackling the double burden

With the country’s rapid increase in overweight and obesity, the new government is interested in tackling nutrition issues. It also understands the additional burden this places on the health system and the need to create prevention mechanisms to tackle obesity and diet-related noncommunicable diseases (NCDs). “We are looking down a double-barreled gun when it comes to malnutrition,” confirms Dr. William Adu-Krow, until recently PAHO/WHO Guyana Representative.

A number of UN agencies are members of the country’s NCDs Task Force, including FAO, PAHO/WHO and the United Nations Development Programme (UNDP). “The Caribbean was the first region to put the double burden on the map as an issue [with its regional strategy] – since then, we have stalled but as UN partners we need to energize people to do right thing,” says William.

A recent initiative to tackle the double burden is the development of the country’s first Food-based Dietary Guidelines (FBDGs), a fruitful collaboration between PAHO/WHO, FAO and UNICEF. 

Through the active leadership of the Ministry of Health, the updated Guyanese guidelines were launched in 2017 and are tailored to the country, promoting locally available and affordable diets from six food groups (staples, vegetables, fruits, legumes, animal foods and fats). The use of the traditional ‘stew pot’ as the visual for displaying portion sizes and food groups has been popular in healthy food messaging. The FBDGs are combined with messages about food storage and safety as well as the importance of an active lifestyle.

Challenges

Data was identified by UN colleagues as a real challenge in the country. “We need it to guide us so that we know exactly what to do,” confirms William at PAHO/WHO. “As UN bodies, what are the basic core data that we need to collect? FAO have tons of variable[s] to collect, PAHO have others – we need to come up with 10 core variables so as not to overwhelm the country.”

At the end of the day, though, the success of a United Nations Country Team (UNCT) depends on personalities, according to William from PAHO/WHO. “We have been really lucky in Guyana that these have not got in the way – we have really supported each other in different joint activities, such as the food safety legislation initiative, without the ‘push and pull’ that you sometimes find in other countries.”

The issue of joint planning between UN agencies can still be a challenge and has not always worked well in the past, admits William. “We have various areas that we champion but there is a lot of common ground,” he adds. “Nutrition doesn’t have to belong to any single agency, it belongs to all of us. That’s where the 17 SDGs come in – they are all a challenge for everyone in the UN family.”

Looking ahead

The UN Country Team plans to address nutrition and its multidimensional effects in the Common Country Analysis and United Nations Sustainable Development Cooperation Framework that are currently underway. Engaging and supporting the new Government in pursuing policies and programmes to scale up nutrition in Guyana is key. However, there is a concern that resources are being diverted away from food security and nutrition during the COVID-19 pandemic. “We have to ensure that nutrition remains at the centre during an emergency, such as the COVID-19 response,” says Mikiko, Guyana’s UNRC. 

The aim is to capitalize on positive developments in the country and channel them to support nutrition gains.  “This is the first year of oil – we want to help the country invest the oil revenues into health, education and agricultural modernization that bring tangible benefits to people. Nutrition is a key connector in all of this and should remain a development imperative.”

[1] https://globalnutritionreport.org/resources/nutrition-profiles/latin-america-and-caribbean/south-america/guyana/#profile

PHOTO CREDITS:

Photo 1: @ FAO/ Shara Seelall

Photo 2: @ MOH Guyana/ Abigale Caleb

Photo 3: @ FAO/ Shara Seelall

Photo 4: @ MOH