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Situational Analysis: Improving Economic Outcomes by Expanding Nutrition Programming in the Kyrgyz Republic

Summary

Undernutrition is a major public health problem in the Kyrgyz Republic, causing preventable deaths of mothers and children and delaying the physical and cognitive development of girls and boys, sometimes beyond repair. Despite improvements since the 1990s, 22 per cent of all deaths of under-fives in the country are still caused by undernutrition. In 2006, some 14 percent of children in the age group were stunted, with stunting rates in three provinces of over 20 per cent.

The burden of undernutrition on the Kyrgyz Republic is also substantial in economic terms: estimated to be US$32 million annually. Deaths in the labor force from undernutrition cost the country nearly US$5 million a year; while productivity lost to stunting and iodine deficiency loses nearly six times more to the economy. Iodine deficiency is a key concern, accounting for almost half of the workforce’s lost productivity.

However, this report shows that at least US$6.25 million of the country’s economic losses from undernutrition can be prevented by improving nutrition through a combination of behavioral changes and strengthening and scaling up of existing programs. The effects of stunting can be treated and even reversed in children under five.

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Multimedia

Building Tomorrow Through Better Nutrition in the Kyrgyz Republic
Slideshow: Situational Analysis:Improving Economic Outcomes by Expanding Nutrition Programming in the Kyrgyz Republic.

Chapter 1: Overview
The World Bank and The United Nations Children’s Fund (UNICEF) jointly developed this report to calculate the potential human and economic benefits to be gained from increasing nutrition investments in the Kyrgyz Republic. This report provides compelling evidence of the potential to improve health and economic outcomes through scaling up effective nutrition interventions and introducing new proven interventions to reduce the direct causes of undernutrition in order to support the Kyrgyz government’s commitment to the well-being and prosperous future of the Kyrgyz people.

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Chapter 2: Putting Nutrition in Perspective
Undernutrition is one of the world’s most serious health problems, yet, it remains among the least addressed. Undernutrition encompasses low birth weight, low weight-for-age (underweight), low height-for-age (stunting), low weight-for-height (wasting), and inadequate intakes of key vitamins and minerals (micronutrient deficiencies). In developing countries, nearly one-third of children are underweight or stunted (Black and others 2008). Globally, undernutrition interacts with repeated bouts of infectious disease to cause an estimated 3.5 million preventable maternal and child deaths annually. An estimated 35 percent of child deaths are attributable to undernutrition (Black and others 2008). The economic costs of undernutrition, in terms of lost national productivity and economic growth, are huge, and these costs fall hardest on the very poor. .

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Chapter 3: Methods
The structure we use to describe the nutrition situation and context in the Kyrgyz Republic follows the structure proposed by Menon and others (2011). Our structure builds on the UNICEF conceptual framework explaining the three levels of causes of undernutrition, and includes the influence of factors in the policy context, as well as factors at the community, household, and child levels. Menon’s structure was developed based on the experiences of scaling up nutrition interventions in several countries, which participated in the World Bank-funded Mainstreaming Nutrition Initiative from 2006 to 2009.

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Chapter 4: Addressing Challenges and Seizing Opportunities
This chapter describes the Kyrgyz Republic’s nutrition context, including the biological, epidemiological, and operational aspects of sectors, through which interventions could be delivered. It also discusses the economic burden of undernutrition and the possible estimated health and economic gains achievable by scaling up priority interventions to address the immediate causes of undernutrition. Finally, it makes initial suggestions for recommended actions as a basis for discussions to determine the country’s next steps.

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Chapter 5: Nutrition Intervention Priorities for the Kyrgyz Republic

Undernutrition costs the Kyrgyz Republic more than US$ 32 million annually due to workforce losses caused by mortality (US$ 4.45 million), and lost productivity (US$ 27.94 million). Future productivity losses from childhood anemia alone are estimated at between US$ 1.2 and US$ 6.1 million per year. Improving the population’s nutrition through evidence-based, preventive, and therapeutic nutrition interventions at scale could save approximately US$ 6.25 million annually.

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Chapter 6: Putting it All Together
The evidence from this report offers national policy makers tools to identify the most appropriate and
effective interventions to combat undernutrition in a cost-effective manner. In some cases, the evidence
supports existing programs, and in others, it lends support to advocate for and attract additional funding
for expanding effective programs.

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Chapter 7: Annexes
Indicators were grouped into two categories: (1) nutrition indicators in children under five and (2) risk factors associated with women of reproductive age—factors that may increase the risk of childhood malnutrition. The categories were then stratified by region, locality, maternal education, and wealth quintile.

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Multimedia
Video: Interview with Tamer Rabie
Report
Improving economic outcomes by expanding nutrition programming in the Kyrgyz Republic.
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