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An Urgent Call for Action: Undernourished Children of South Asia

  • High economic growth experienced by South Asian countries has not made an impact on the nutritional status.
  • South Asian children also have high levels of micronutrient deficiencies (Iron, Vitamin A, and Iodine)
  • Over a third of adult women in Bangladesh, India, and Pakistan are underweight

Dhaka, August 5, 2009 (Update) - Twenty-one civil society organizations from across South Asia won grants today from an $840,000 award pool funded by the South Asia Region Development Marketplace (DM). The winners received up to $40,000 each to implement innovative ideas on how to improve nutrition in their respective countries. List of Winners (pdf)

August 3, 2009 —Civil society organizations from across South Asia will gather in Dhaka this week to take part in a grant competition – the Development Marketplace (DM) – where they will display some of the best and most innovative ideas on how to improve nutrition in the region. The competition is hosted by the World Bank and is designed to showcase and fund such innovative approaches, focusing especially on children under two years of age and pregnant women.

Titled “Family and Community Approaches to Improve Infant and Young Child Nutrition,” the DM event will bring together 60 civil society organizations from Afghanistan, Bangladesh, India, Nepal, Pakistan, and Sri Lanka who will compete for 20 grants of up to $40,000 each to implement their ideas.

Undernutrition in South Asia

South Asia has experienced high economic growth during the last decade. South Asia, however, still has both the highest rates and the largest numbers of undernourished children in the world. While poverty is often the underlying cause of child undernutrition, the high economic growth experienced by South Asian countries has not made an impact on the nutritional status of South Asian children.

Addressing the causes of undernutrition is particularly important as it impedes productivity, economic growth, and poverty reduction. A child undernourished during its first two years of life is less likely to complete school and will earn, on average, a 10-17% lower income than well nourished children. There is an urgent need to build a strong, healthy and well-nourished population that can make the most of education and employment opportunities available in today’s rapidly globalizing world. (Read More

Micronutrient Malnutrition

South Asian children also have high levels of micronutrient deficiencies (Iron, Vitamin A, and Iodine). Proportion of children under five years with iron deficiency ranged between 55% and 81% in Bhutan, India, Nepal, and Bangladesh and the prevalence of Vitamin A deficiency among children under six years has been estimated to range between 28% and 57%.

Maternal Malnutrition

The undernutrition crisis is also a significant problem among women of reproductive age. Over a third of adult women in Bangladesh, India, and Pakistan are underweight and the prevalence of iron deficiency anemia is very high. Besides threatening their own health, undernourished women have an increased likelihood of adverse pregnancy and birth outcomes.

Why South Asia has the largest numbers of undernourished and micronourished children in the world?

South Asia’s undernourishment problem has many numbers of factors, including the following: Low birth weight, infant and young child feeding practices, poor household hygiene, and status of women in society.

Low birth weight

Approximately a third of all children born in South Asia are of low birth weight. This indicates that a child was undernourished in the womb, and/or that the mother was undernourished during her childhood and pregnancy.

Infant and young child feeding practices

Difficulties in establishing lactation due to delayed breast feeding and low rates of exclusive breastfeeding are prevalent in the region. The introduction of complementary food is also vital in preventing growth retardation of young children. Less than half of the children 6-9 months receive complementary foods in addition to breast milk.

Poor household hygiene

The overall poor hygiene increases the burden of childhood illnesses; depresses children’s appetite, inhibits nutrient absorption and increases calorie consumption during fever. These factors contribute to child malnutrition.

Status of women

Low literacy rates, age at first marriage, limited mobility, and lack of decision-making are all impediments for women in making decisions relating to their own and their child’s health.

Undernourished Children of South Asia


Afghanistan has made considerable improvements in some health indicators over the past 5 years. The indicators for child and maternal undernutrition remain low and are among the highest in the world. National Nutrition Survey in 2004-05 found over half (54%) of children below five years are chronically undernourished and 39% low weight for their age. The cause of undernutrition in Afghanistan is complex due to civil war. The immediate causes include chronic food insecurity, inadequate access to health services, and improper feeding practices. (English | Dari)


The level of child undernutrition in Bangladesh is among the highest in the world. The country made significant progress reducing undernutrition in the 1990s. However, progress in minimizing stunting and underweight has slowed since 2000. While stunting rate has continued to fall, the child underweight rates have not changed. Bangladesh may not achieve the Millennium Development Goal on child underweight rate of 33% by 2015. (Read More)


Over the last 10 years, India witnessed a rapid and robust growth, which enabled millions of people to escape poverty. India, however, still remains one of the most undernourished countries in the world. India’s 2005 National Family Health Survey -3 (NFHS) found 46% of children below the age of 3 years were underweight and 38% were stunted. The survey findings highlight that neither economic growth nor food security is likely to be sufficient to lower the prevalence of malnutrition. Factors such as appropriate infant and young child feeding, hygiene and sanitation, prevention and treatment of illnesses and status of women are critical. (Read More)


Nepal has made promising health gains despite unstable political environment. The 2006 Nepal Demographic and Health Survey (NDHS) survey found 45% and 43% of children below the age of 5 years to be underweight and stunted respectively. These represent a modest decline in the level of stunting and children underweight. With such minimal improvements, achieving the Millennium Development Goal of a 50% reduction in underweight children under 5 years by the year 2015 will continue to be a challenge for Nepal. (Read More)


Pakistan suffers from high rates of child malnutrition and has made little progress in the past 20 years. While the problem has been recognized in Pakistan for several decades, infant and children under 5 mortality remains high. Pakistan fares well in comparison to some of South Asian countries, such as India, Bangladesh, and Nepal. However, it is still much higher than most Sub-Sahara African countries. Malnutrition is not confined to infants and young children, but it is also prevalent among women of reproductive age. (Read More)

Sri Lanka

Sri-Lanka has experienced noticeable improvements in nutritional aspects of young children over the past 20 years. Underweight rates declined by almost 25%. Stunting rates, a measure of long term undernutrition, declined by about 75%. As a result, Sri Lanka has the lowest prevalence of underweight in South Asia. The recent trends in underweight rates suggest that Sri Lanka is likely to achieve the Millennium Development Goal target of 19% prevalence of underweight in 2015. However, there has been a slowdown in the rate of reduction of malnutrition in the past 7 years. Sri Lanka may not achieve the Millennium Development Goal for nutrition. (Read More)

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