Nutrition in the First 1,000 Days - Save the Children

16 the gloBal MalNUtritioN criSiS
Four types of malnutrition
Stunting – A child is too short for their age.
This is caused by poor diet and frequent
infections. Stunting generally occurs before
age 2, and the effects are largely irreversible.
These include delayed motor development,
impaired cognitive function and poor
school performance. In total, 171 million
children – 27 percent of all children globally
– are stunted.15 stunted. 15
Wasting – A child’s weight is too low
for their height. This is caused by acute
malnutrition. Wasting is a strong predic-
tor of mortality among children under 5.
It is usually caused by severe food short-
age or disease. In total, over 60 million
children – 10 percent of all children globally
– are wasted.16 wasted. 16
Underweight – A child’s weight is too low
for their age. A child can be underweight
because she is stunted, wasted or both.
Weight is a sensitive indicator of short-term
(i.e., acute) undernutrition. Whereas a
deficit in height (stunting) is difficult to
correct, a deficit in weight (underweight)
can be recouped if nutrition and health
improve later in childhood. Worldwide,
more than 100 million children are underweight.
weight.17 17 Being underweight is associated
with 19 percent of child deaths. deaths.18 18
Micronutrient deficiency – A child
lacks essential vitamins or minerals.
These include vitamin A, iron and zinc.
Micronutrient deficiencies are caused by
a long-term lack of nutritious food or by
infections such as worms. Micronutrient
deficiencies are associated with 10 percent
of all children’s deaths, or about one-third
of all child deaths due to malnutrition.
malnutrition.19 19
maLnUtRition and ChiLd moRtaLity
Every year, 7.6 million children die before they reach the age of 5, most
from preventable or treatable illnesses and almost all in developing countries.20
Malnutrition is an underlying cause of more than a third (35 percent) of these
deaths.21
A malnourished child is up to 10 times as likely to die from an easily preventable
or treatable disease as a well-nourished child.22 And a chronically
malnourished child is more vulnerable to acute malnutrition during food shortages,
economic crises and other emergencies.23
Unfortunately, many countries have not made addressing malnutrition and
child survival a high-level priority. For instance, a recent analysis by the World
Health Organization found that only 67 percent of 121 mostly low- and middle-income
countries had policies to promote breastfeeding. Complementary
feeding and iron and folic acid supplements were included in little over half of
all national policy documents (55 and 51 percent, respectively). And vitamin A
and zinc supplementation for children (for the treatment of diarrhea) were part
of national policies in only 37 percent and 22 percent of countries respectively.24
While nutrition is getting more high-level commitment than ever before, there
is still a lot of progress to be made.
Persistent and worsening malnutrition in developing countries is perhaps
the single biggest obstacle to achieving many of the Millennium Development
Goals (MDGs). These goals – agreed to by all United Nations member states in
2000 – set specific targets for ending poverty and improving human rights and
security. MDG 1 includes halving the proportion of people living in hunger.
MDG 2 is to ensure all children complete primary school. MDG 4 aims to
reduce the world’s 1990 under-5 mortality rate by two thirds. MDG 5 aims to
reduce the 1990 maternal mortality ratio by three quarters. And MDG 6 is to
halt and begin to reverse the spread of HIV/AIDS and the incidence of malaria
and other major diseases. Improving nutrition helps fuel progress toward all
of these MDGs.
With just a few years left until the 2015 deadline, less than a third (22)
of 75 priority countries are on track to achieve the poverty and hunger goal
(MDG 1).25 Only half of developing countries are on target to achieve universal
primary education (MDG 2).26 Just 23 of the 75 countries are on track to
achieve the child survival goal (MDG 4).27 And just 13 of the 75 countries are
on target to achieve the maternal mortality goal (MDG 5).28 While new HIV
infections are declining in some regions, trends are worrisome in others.29 Also,
treatment for HIV and AIDS has expanded quickly, but not fast enough to
meet the 2010 target for universal access (MDG 6).30
mateRnaL maLnUtRition
Many children are born undernourished because their mothers are undernourished.
As much as half of all child stunting occurs in utero,31 underscoring
the critical importance of better nutrition for women and girls.
In most developing countries, the nutritional status of women and girls is
compromised by the cumulative and synergistic effects of many risk factors.
These include: limited access to food, lack of power at the household level, traditions
and customs that limit women’s consumption of certain nutrient-rich
foods, the energy demands of heavy physical labor, the nutritional demands
of frequent pregnancies and breastfeeding, and the toll of frequent infections
with limited access to health care.
Anemia is the most widespread nutritional problem affecting girls and women
in developing countries. It is a significant cause of maternal mortality and
can cause premature birth and low birthweight. In the developing world, 40