Tracking Progress on Child and Maternal Nutrition - Unicef

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CONTENTS Foreword ...................................................................................................................................................................................................................3 Glossary of terms used in this report ..........................................................................................................................................................4 Introduction .............................................................................................................................................................................................................5 Key messages .........................................................................................................................................................................................................7 Overview ...................................................................................................................................................................................................................9 1. The challenge of undernutrition ...........................................................................................................................................................10 2. The importance of nutrition ...................................................................................................................................................................12 3. Current status of nutrition ......................................................................................................................................................................15 4. Coverage of interventions to improve nutrition ..............................................................................................................................23 5. Effective interventions to improve nutrition .....................................................................................................................................31 6. Underlying causes of undernutrition: Poverty, disparities and other social factors ..............................................................35 7. Factors for good nutrition programming ..........................................................................................................................................37 8. The way forward .......................................................................................................................................................................................40 References .......................................................................................................................................................................................................41 Notes on the maps ........................................................................................................................................................................................42 Nutrition profi les: 24 countries with the largest burden of stunting ........................................................................................ 43 Acronyms used in the country profi les ....................................................................................................................................................92 Interpreting infant and young child feeding area graphs ...................................................................................................................92 Data sources ....................................................................................................................................................................................................94 Defi nitions of key indicators .......................................................................................................................................................................97 Defi nitions of policy indicators ................................................................................................................................................................100 Statistical tables ............................................................................................................................................................................................... 101 Table 1: Country ranking, based on numbers of moderately and severely stunted children under 5 years old..........................................................................................................................................102 Table 2: Demographic and nutritional status indicators ...................................................................................................................104 Table 3: Infant feeding practices and micronutrient indicators ......................................................................................................108 Annexes ................................................................................................................................................................................................................ 113 Summary indicators .................................................................................................................................................................................... 114 General notes on the data ......................................................................................................................................................................... 116 Acknowledgements ........................................................................................................................................................................................ 119 2 <strong>Tracking</strong> <strong>Progress</strong> on Child and Maternal Nutrition
FOREWORD Undernutrition contributes to more than one third of all deaths in children under the age of fi ve. It does this by stealing children’s strength and making illness more dangerous. An undernourished child struggles to withstand an attack of pneumonia, diarrhoea or other illness – and illness often prevails. Undernutrition is caused by poor feeding and care, aggravated by illness. The children who survive may become locked in a cycle of recurring illness and faltering growth – diminishing their physical health, irreversibly damaging their development and their cognitive abilities, and impairing their capacities as adults. If a child suffers from diarrhoea – due to a lack of clean water or adequate sanitation, or because of poor hygiene practices – it will drain nutrients from his or her body. And so it goes, from bad to worse: Children who are weakened by nutritional defi ciencies cannot stave off illness for long, and the frequent and more severe bouts of illness they experience make them even weaker. More than a third of the children who died from pneumonia, diarrhoea and other illnesses could have survived if they had not been undernourished. This report shows that an estimated 195 million children under age 5 in developing countries suffer from stunting, a consequence of chronic nutritional deprivation that begins in the period before birth if the mother is undernourished. Of these, more than 90 per cent are in Asia and Africa. Maternal undernutrition affects a woman’s chances of surviving pregnancy as well as her child’s health. Women who were stunted as girls, whose nutritional status was poor when they conceived or who didn’t gain enough weight during pregnancy may deliver babies with low birthweight. These infants in turn may never recoup from their early disadvantage. Like other undernourished children, they may be susceptible to infectious disease and death, and as adults they may face a higher risk of chronic illness such as heart disease and diabetes. Thus the health of the child is inextricably linked to the health of the mother. In turn, the health of the mother is linked to the status a woman has in the society in which she lives. In many developing countries, the low status of women is considered to be one of the primary reasons for undernutrition across the life cycle. Undernutrition in children under age 2 diminishes the ability of children to learn and earn throughout their lives. Nutritional deprivation leaves children tired and weak, and lowers their IQs, so they perform poorly in school. As adults they are less productive and earn less than their healthy peers. The cycle of undernutrition and poverty thereby repeats itself, generation after generation. Exclusive breastfeeding for the fi rst six months and continued breastfeeding together with appropriate foods can have a major impact on children’s survival, growth and development. Adding vitamin A to the diet, to boost resistance to disease, and zinc, to treat diarrhoea, can further reduce child mortality. Fortifi cation of staple foods, condiments and complementary foods for young children can make life-saving vitamins and minerals available to large segments of the population. Ensuring against iodine and iron defi ciencies improves lives and cognitive development. Studies show iodine defi ciency lowers IQ 13.5 points on average. For children who suffer from severe acute malnutrition, often in the context of emergencies, ready-to-use foods can effectively reduce the malnutrition and replenish many of the nutrients and energy lost. Lack of attention to child and maternal nutrition today will result in considerably higher costs tomorrow. With more than 1 billion people suffering from malnutrition and hunger, international leadership and urgent action are needed. Global commitments on food security, nutrition and sustainable agriculture are part of a wider international agenda that will help address the critical issues raised in this report. Ann M. Veneman Executive Director, UNICEF Foreword 3
Page 1 and 2: TRACKING PROGRESS ON CHILD AND MATE
Page 3: TRACKING PROGRESS ON CHILD AND MATE
Page 7 and 8: INTRODUCTION The fi rst Millennium
Page 9 and 10: KEY MESSAGES Overview Undernutritio
Page 11 and 12: OVERVIEW
Page 13 and 14: About this report This report offer
Page 15 and 16: Every level of undernutrition incre
Page 17 and 18: 3. CURRENT STATUS OF NUTRITION Stun
Page 19 and 20: Decline in stunting prevalence in A
Page 21 and 22: Decline in underweight prevalence i
Page 23 and 24: Wasting prevalence Percentage of ch
Page 25 and 26: Micronutrient defi ciencies Vitamin
Page 27 and 28: Exclusive breastfeeding rates in Af
Page 29 and 30: Recently adopted new indicators for
Page 31 and 32: Increases in excess of 30 percentag
Page 33 and 34: 5. EFFECTIVE INTERVENTIONS TO IMPRO
Page 35 and 36: Priority interventions for the prev
Page 37 and 38: 6. UNDERLYING CAUSES OF UNDERNUTRIT
Page 39 and 40: 7. FACTORS FOR GOOD NUTRITION PROGR
Page 41 and 42: PROGRAMME SUCCESS FACTORS 1. Situat
Page 43 and 44: REFERENCES 1 Pelletier, David L., e
Page 45 and 46: NUTRITION PROFILES: 24 countries wi
Page 47 and 48: 100% 80 60 40 20 0 MICRONUTRIENTS V
Page 51 and 52: MICRONUTRIENTS Vitamin A supplement
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100% 80 60 40 20 0 MICRONUTRIENTS V
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MICRONUTRIENTS Vitamin A supplement
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MICRONUTRIENTS Vitamin A supplement
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Figure 1. Breastfeeding practices b
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(continued) Indicator Data source G
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DEFINITIONS OF KEY INDICATORS Indic
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(continued) Indicator name Defi nit
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STATISTICAL TABLES
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(continued) Ranking Country Stuntin
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(continued) Countries and territori
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DEFINITIONS OF THE INDICATORS Under
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(continued) % of children (2003-200
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DEFINITIONS OF THE INDICATORS Early
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ANNEXES
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Latin America and the Caribbean Ant
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elevant population for the same are
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ACKNOWLEDGEMENTS Editorial and rese
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