80 percent of world's undernourished children live in just 20 countries

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Public release date: 16-Jan-2008

http://www.eurekalert.org/pub_releases/2008-01/l-8ow011108.php

Contact: Dr. C. Coitinho

denise.costacoitinho@...

39-

Lancet

80 percent of world's undernourished children live in just 20 countries

80% of the world’s undernourished children live in just 20 countries*,

and intensified nutrition action in these countries can lead to

achievement of the first Millennium Development Goal (MDG1)** and

greatly increase the chances of achieving goals for child and maternal

mortality (MDGs 4 and 5)**. These are the conclusions of Dr C.

Coitinho, World Health Organization, on temporary secondment to World

Food Programme (WFP) to coordinate the inter-agency team on child hunger

and undernutrition; and Dr Bryce, s Hopkins Bloomberg

School of Public Health, Baltimore, MD, USA, and colleagues, authors of

the fourth paper in The Lancet's Series on Maternal and Child

Undernutrition.

The authors say: “Despite isolated successes in specific countries or

for interventions – eg, iodised salt and vitamin A supplementation –

most countries with high rates of undernutrition are failing to reach

undernourished mothers and children with effective interventions

supported by appropriate policies.”

They address seven key challenges for addressing undernutrition at

national level: getting nutrition on the list of priorities; keeping it

there; doing the right things; not doing the wrong things; acting at

scale; reaching those in need; data-based decisionmaking and building

strategic and operational capacity. The authors say: “Interventions with

proven effectiveness that are selected by countries should be rapidly

implemented at scale. The period from pregnancy to 24 months of age is a

crucial window of opportunity for reducing undernutrition and its

adverse effects. Programme efforts, as well as monitoring and

assessment, should focus on this segment of the continuum of care.”

The paper looks at the varied situation within and across Latin American

countries, which as a whole have experienced a large drop in stunting,

being underweight, and wasting; and China, where a multisectoral

approach has seen rapid nutritional improvement.

The authors caution that nutrition resources should not be used to

support actions unlikely to be effective in the real life setting of a

particular country, nor to support actions that have not been proven to

have a direct effect on undernutrition. The authors say: “In addition to

health and nutrition interventions, economic and social policies

addressing poverty, trade, and agriculture that have been associated

with rapid improvements in nutritional status should be implemented.

There is a reservoir of important experience and expertise in individual

countries about how to build commitment, develop and monitor nutrition

programmes, move toward acting at scale, reform or phase-out ineffective

programmes, and other challenges. This resource needs to be formalised,

shared, and used as the basis for setting priorities in problem-solving

research for nutrition.”

They conclude by asking: “What can be done " ....there are no simple

prescriptions to reduce undernutrition, although high coverage with four

or five of the proven interventions would certainly have a sizeable

effect….the charge to nutrition leaders at country level is to review

their existing strategies and programmes to ensure that priority is

given to interventions with a proven effect on undernutrition in

pregnant women and children younger than two years of age, and then to

develop feasible strategies for increasing public demand for these

interventions and delivering them at scale.”

###

Notes to editors: *The 20 countries with a stunting prevalence equal to

or higher than 20% in children under the age of five years, that

together account for over 80% of the world’s undernourished children,

are: Democratic Republic of Congo, Ethiopia, Kenya, Madagascar, Nigeria,

South Africa, Sudan, Uganda, Tanzania, Egypt, Yemen, Afghanistan,

Bangladesh, India, Burma, Nepal, Pakistan, Indonesia, Philippines, and

Vietnam.

**MDG1: Reduce by half the proportion of people living on less than a

dollar a day, and reduce by half the proportion of people who suffer

from hunger.

MDG4: Reduce by two thirds the mortality rate among children under five

MDG5: Reduce by three quarters the maternal mortality ratio (source:

United Nations website)

Dr C. Coitinho, World Health Organization, on temporary

secondment to WFP to coordinate the inter-agency team on child hunger

and undernutrition T) +39 06 65132245 / +39 340 4732195 E)

denise.costacoitinho@...

Dr Bryce, s Hopkins Bloomberg School of Public Health,

Baltimore, MD, USA T) +1 E) jbryce@...

The paper associated with this release can be viewed at

http://www.eurekalert.org/jrnls/lance/Undernutrition4.pdf.

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