Reaching the marginalized: EFA global monitoring report, 2010; 2010

010CHAPTER 22Education for All Global Monitoring Reportevery three deaths of children under age 5. Whilethere have been some advances towards improvedchild nutrition, and expanded access to Vitamin Asupplements and iodized salt, achievements fallfar short of the goals that have been set:Figure 2.1: High levels of child stunting are holding back progress in educationSevere and moderate stunting among children under 5, selected countries, 2000–2007 1CameroonKenyaUgandaCôte d’IvoireMaliBurkina FasoGuineaBeninC. A. R.D. R. CongoEritreaLesothoNigeriaSomaliaU. R. TanzaniaEquat. GuineaLiberiaZambiaSierra LeoneChadGuinea-BissauMozambiqueComorosAngolaRwandaMalawiEthiopiaMadagascarNigerBurundiDjiboutiMauritaniaSudanYemenPhilippinesMyanmarViet NamCambodiaDPR KoreaLao PDRTimor-LesteBangladeshPakistanIndiaBhutanNepalAfghanistanPeruGuatemalaSub-Saharan AfricaArab StatesEast Asia and the PacificSouth and West AsiaLatin America and the Caribbean0 10 20 30 40 50 60Severe and moderate stunting (%)Note: Countries included are those in which the proportion of stunted children is 30% or more.1. Data are for the most recent year available during the period specified.Source: Annex, Statistical Table 3A.Childhood stunting. 1 Around one in threechildren under age 5 – 178 million in total –suffers severe or moderate stunting. By the timethese children enter school, malnutrition willhave diminished their potential for learning– a disadvantage they will carry into adulthood.Apart from its damaging consequences forindividuals, malnutrition in early childhoodinevitably erodes the benefits of investment ineducation. The highest regional rates of stuntingare found in central and eastern Africa andSouth Asia. Of the forty-nine countries wherestunting prevalence rates are in excess of 30%,thirty are in sub-Saharan Africa (Figure 2.1).Low birth weight. Recent international estimatessuggest that about 19 million infants – 14% of allnewborns – are delivered with low birth weight(UNICEF, 2008b). More than half of these birthstake place in South Asia: over one in four of theregion’s children are delivered with low birthweight (Figure 2.2). These children face aheightened risk of early mortality: low birthweight is an underlying factor in 60% to 80%of deaths in the first month. They also facelonger-term risks of disadvantage in healthand education. Low birth weight is stronglyassociated with loss of years in school andpoorer cognitive skills (Victoria et al., 2008),which undermine the potential benefits ofimproved access to secondary education. Manyof the 8.3 million Indian children born with lowbirth weight will carry a burden of disadvantagewith them into primary school. Moreover,almost half of all children under age 3 in Indiaare underweight for their age, pointing to fardeeper nutritional deficits.Micronutrient deficiency. Early cognitivedevelopment can be severely impaired bymicronutrient deficiencies. It is estimated thatone-third of all pre-school children is affectedby iodine deficiency, a condition associated witha loss of ten to fifteen points on IQ tests evenin moderate forms. A similar proportion ofchildren is affected by Vitamin A deficiency,a major cause of blindness, ill health and poorconcentration (Victoria et al., 2008).The factors behind malnutrition vary acrosscountries. Poverty, social inequalities and livelihoodinsecurity all play a role. National wealth is often a1. Stunting, or low height for age, is caused by long-term insufficiency ofnutrient intake and frequent infections. It generally occurs before the ageof 2 and the effects are largely irreversible.44