Malnutrition

The Nutrition Barometer produced by Save the Children provides a snapshot of national governments’ commitments to addressing children’s nutrition, and the progress they have made. It looks at 36 developing countries with the highest levels of child undernutrition. The Barometer measures governments’ political and legal commitment to tackling malnutrition (eg, whether they have a national nutrition plan), as well as their financial commitment. Countries’ progress in tackling malnutrition is measured by children’s nutritional status – the proportion who are underweight, stunted or suffering from wasting – and children’s chances of survival. Countries are then ranked according to both their commitments and their nutritional and child survival outcomes.

According to the report titled The Nutrition Barometer: Gauging national responses to undernutrition (2012) by Save the Children and World Vision, please click here to access:

• The Democratic Republic of Congo (DRC), India and Yemen show the weakest performance, with frail commitments and frail outcomes. Outcomes for India are dated as they are based on the National Family and Health Survey-3 from 2005–06. However, since the country has not had a nationally representative survey since then, these figures are still generally used.

• India urgently needs a new population-based, nationally representative survey to check what has happened to nutrition since 2005–06. The fourth National Family Health Survey was about to take place in 2014.

• Spectacular economic growth has not translated into better nutrition outcomes for many of India’s children. Growth has lifted millions out of poverty but it has also been largely unequal, with the benefits accruing to a small segment of the population. Many sources of data show that almost half its children are underweight and stunted, and more than 70% of women and children have serious nutritional deficiencies such as anaemia.

• Children in the poorest households are more than twice as likely to be stunted as those in the richest households in India. However, even in the wealthiest 20% of the Indian population, one child in five is undernourished.

• India's showing on commitments was set back by the lack of nutrition-specific commitments to Every Woman Every Child and not being a member of Scaling up Nutrition movement (SUN) as yet.

• A criticism of the Integrated Child Development Services (ICDS) was its failure to target children between the ages of 0 and two years, which is the crucial growth period. One reform involves increasing the number of Anganwadi [community health] workers in the 200 districts with the highest levels of undernutrition.

• In 13 of the countries (just over a third of the sample of 36 countries) the Nutrition Barometer study looked at, commitments and outcomes point in exactly the same direction. Three countries – Guatemala, Malawi and Peru–have both sound political and financial commitments and sound outcomes relative to the other countries in the group in this study.

• The Barometer shows 12 countries where there are high political, legal and/or financial commitments to nutrition, yet outcomes are lower.

The report titled A Life Free from Hunger: Tackling child malnutrition (2012), which has been brought out by Save the Children (please click here to access) analyses the causes of malnutrition, focusing on chronic malnutrition and stunting in children. It identifies solutions that are proven to be effective in containing child malnutrition: a. direct interventions, such as exclusive breastfeeding, micronutrient supplementation and fortification; b. indirect interventions, such as introducing social protection programmes, and adapting agricultural production to meet the nutritional needs of children.

Key findings of the report are as follows: 

• 48 percent of children in India are stunted. 450 million children around the world will be affected by stunting in the next 15 years, if current trends continue.

• The economic losses due to undernutrition are pervasive–experimental evidence suggests that tackling malnutrition in early life can lead to as much as a 46% increase in earnings as an adult. Productivity loss due to foregone waged employment was estimated to be US$2.3 billion a year in India.

• A study by Ravi and Engler (2009) on the impact of the Mahatma Gandhi NREGA in India, which guarantees poor households 100 days of paid employment, found the scheme increased food spending by 40% on average, and that the effect is strongest for the poorest households who participated in the scheme the longest.

• It’s estimated that 2–3% of the national income of a country can be lost to malnutrition. Childhood malnutrition can lessen productivity – stunted children are predicted to earn an average of 20% less when they become adults

• Staple food prices hit record highs globally in February 2011 and may have put the lives of upto 400,000 more children at risk.

• One in four of the world’s children are stunted. In developing countries this figure is as high as one in three. That means their body and brain has failed to develop properly because of malnutrition.

• Every hour of every day, 300 children die because of malnutrition. Malnutrition is an underlying cause of the death of 2.6 million children each year–one-third of the global total of children’s deaths.

• Global progress on stunting has been extremely slow. The proportion of children who are stunted fell from 40 percent in 1990 to 27 percent in 2010 – an average of just 0.6 percentage points per year.

• In 2008 the Lancet medical journal identified a package of 13 direct interventions – such as vitamin A and zinc supplements, iodised salt, and the promotion of healthy behaviour, including handwashing, exclusive breastfeeding and complementary feeding practices– that were proven to have an impact on the nutrition and health of children and mothers. This cost-effective and affordable package could prevent the deaths of almost 2 million children under five and a substantial amount of illness if it was delivered to children in the 36 countries that are home to 90% of the world’s malnourished children.

• At a cost of just over US$1 per person per year, the World Bank has estimated that more than 4 billion people would be able to benefit from access to fortified wheat, iron, complementary food and micronutrient powders. Fortification, or the process of adding vitamins and minerals to food, is one of the most cost-effective direct interventions.