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Nutrition Country Profiles Preface

Nutrition Profiles of the Countries with the Highest Burden of Undernutrition were created to provide summary information for country leaders, development partners, and stakeholders about the extent, costs, and causes of malnutrition, as well as potential solutions to malnutrition. The country profiles focus on three key messages:

1. Malnutrition remains the single largest cause of child mortality. Over one-third of all child deaths are due to malnutrition. Malnourished mothers often produce malnourished children who are more likely to die before five years of age; if they survive, they tend to start school late, they are more likely to drop out, and less likely to learn in school – and more likely to be malnourished adults where the vicious cycle begins again. The resulting compromised human capital means that malnutrition robs many developing countries of at least 2-3% of economic growth; and it pre-disposes them to negative impacts of shocks such as the food, fuel and finance crises. To achieve MDG 1 (end poverty and hunger) and MDGs 4 and 5 (reduce child and maternal mortality and improve maternal health), it is imperative to address malnutrition. It is particularly important to ensure adequate nutrition during the critical window of opportunity, from pregnancy through the first two years of life, when rapid development is occurring. Poor nutrition during this period can cause large and irreversible deficits in growth and brain development. Access to optimal nutrition from conception to 24 months helps to ensure that all children have the ability to reach their full potential.

2. Economic growth alone does not solve malnutrition. Poverty is an undeniably significant factor in child malnutrition, but in many high-burden countries, malnutrition rates are much higher than would be expected given national income or economic growth rates. Examples of such countries include India (which has shown sustained and robust economic growth for more than a decade now but no significant reductions in malnutrition), Guatemala, Angola, and Pakistan. On the other hand, countries which have made significant investments in nutrition, such as Thailand, Senegal, and Brazil, now show malnutrition rates much lower than would be expected based on their GDP. Furthermore, while economic growth alone fails to solve child malnutrition, it also often leads to increases in the other side of malnutrition – obesity and chronic disease – which are rapidly increasing in many low and middle-income countries. At the household level, in many countries malnutrition rates are surprisingly high even in the wealthiest quintile of households. These facts indicate that concerted efforts must be taken to reduce malnutrition; income growth does not automatically solve the problem.

3. Investing in nutrition is cost-effective, yet grossly under-funded. Of the top ten “best-buys in development,” five are nutrition interventions, according to the 2008 Copenhagen Consensus (a panel including several Nobel laureate economists). Despite the availability of relatively simple and extremely cost-effective interventions to address malnutrition, nutrition remains to-date the “forgotten MDG.” Overseas development assistance for nutrition has been abysmally low (see figure below), and national budget allocations have been equally small. The forthcoming G8 Summit and the UN Summit on the MDGs are opportunities for world leaders to fast track progress towards achievement of several MDGs, by positioning nutrition at the centre of the maternal and child health initiatives that link food security with health, social protection and human capital development.

Total Overseas Development for Health & Nutrition 1995-2008

Nutrition Country Profiles will inspire action and investment in nutrition in the high-burden countries. Two kinds of investments are needed. Nutrition-specific interventions include, for example, breastfeeding promotion, vitamin and mineral supplements, and deworming. Nutrition-sensitive development across many sectors is also necessary to ensure that development agendas fully utilize their potential to contribute to reductions in malnutrition.

Targeted nutrition interventions and increased attention to nutrition in overall development plans are called for, to reduce child and maternal mortality, and to improve the economic potential of nations. The time to act is now.

 The country nutrition profiles were developed in collaboration with regional staff and country offices. This work was made possible by the generous support of the Government of Japan through the Scaling Up Nutrition trust fund and the World Bank’s Regional Reprioritization Fund.

Last updated: 2010-04-23

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