Manicaland has thinnest women in Zimbabwe

A recent report by the Zimbabwe Demographic and Health Survey (ZDHS) has revealed that Manicaland Province is among the regions with the highest prevalence of thinness among women aged between 20 and 49. The findings have raised serious public health concerns as the country grapples with both undernutrition and rising obesity among women.

The 2023/24 ZDHS was carried out by the Zimbabwe National Statistics Agency (ZIMSTAT) with funding support from the Government of Zimbabwe, the United States Agency for International Development (USAID), the United Nations Population Fund (UNFPA), and the Global Fund to Fight AIDS, Tuberculosis and Malaria. The survey received technical assistance from ICF through the USAID-funded DHS Programme, which supports population and health surveys worldwide.

According to the report, thinness among adult women was assessed using the weight-for-height index, a measure used to identify acute undernutrition. Women with a weight-for-height score significantly below the reference population median were classified as thin, often as a result of chronic energy deficiency. This condition typically stems from insufficient or imbalanced diets and has long-term implications on health, including diminished productivity, higher risks of disease, and increased maternal and child mortality.

In the case of Manicaland, the data showed a thinness prevalence rate of six percent, tying it with Matabeleland North, Matabeleland South, and Mashonaland West as the highest in the country. The survey highlighted that chronic undernutrition continues to affect women disproportionately, particularly those of reproductive age, due to a complex web of factors including poor dietary intake, food insecurity, cultural practices, and limited access to healthcare.

Local dietician Mr Ephert Bhobho confirmed the findings, saying several underlying issues explain the high rates of thinness in Manicaland. He noted that food insecurity remains a significant challenge in rural areas, which make up 58.3 percent of the sample population in the province. Bhobho also highlighted the social dynamics unique to Manicaland, where 28 percent of women reportedly belong to the Johane Marange Apostolic sect, a religious group that permits polygamy and places strain on household food resources.

The ZDHS report also drew attention to disparities in nutrition across provinces and age groups. While Manicaland recorded high rates of thinness, Masvingo had the lowest prevalence at three percent. On the opposite end of the nutritional spectrum, Harare reported the highest prevalence of overweight and obesity at 60 percent among women aged 20 to 49.

Nationally, overweight and obesity are increasingly prevalent among older women and urban residents, with the highest rates observed in the 40 to 49 age group. In contrast, younger women aged 20 to 29 had the highest levels of thinness. Urban areas showed higher rates of overweight and obesity compared to rural ones, where thinness was more common.

The report further examined the influence of education and income on nutritional status. Women with tertiary education were more likely to be overweight or obese, while those with only primary or secondary education had higher rates of thinness. A similar trend was noted across income levels, with women in the lowest wealth bracket more prone to thinness and those in the highest bracket more likely to be overweight or obese.

National trends over the past two decades reveal a sharp increase in overweight and obesity among young women. Among those aged 20 to 29, the prevalence has doubled from 25 percent in 2005–06 to 51 percent in the 2023–24 survey. At the same time, thinness declined from nine percent to five percent in that age group. Among adolescent girls aged 15 to 19, the rate of overweight and obesity rose to 16 percent, while thinness slightly declined to 12 percent.

The findings from the ZDHS indicate a growing nutritional divide within Zimbabwe, with undernutrition persisting in rural and poorer communities, and obesity emerging as a major health concern in urban and wealthier populations. Health experts have called for a balanced national response that addresses both forms of malnutrition through tailored interventions, improved food access, and public health education.

Mr Bhobho said the government and development partners must prioritise locally informed solutions to address nutritional inequalities, particularly among women. He stressed the importance of integrating cultural, religious, and socioeconomic factors into national health and nutrition strategies to reverse current trends and improve outcomes for future generations.