1.1.1  The global burden of childhood and maternal undernutrition

Undernutrition contributes to more than 50% of all deaths in children under the age of five. It does this by impacting on children’s strength and making illness more dangerous. An undernourished child struggles to withstand an attack of pneumonia, diarrhoea or other illness — and illness often prevails. Undernutrition is caused by poor feeding and care, aggravated by illness. The children who survive may become locked in a cycle of recurring illness and slow growth, diminishing their physical health, irreversibly damaging their development and their cognitive abilities, and impairing their capacities as adults. If a child suffers from diarrhoea — due to a lack of clean water or adequate sanitation, or because of poor hygiene practices — it will drain nutrients from his or her body.

Chronic undernutrition (meaning low height for age, also known as stunting) in early childhood also results in diminished mental and physical development, which puts children at a disadvantage for the rest of their lives. They may perform poorly in school, and as adults they may be less productive, earn less and face a higher risk of disease than adults who were not undernourished as children. For girls, chronic undernutrition in early life, either before birth or during early childhood, can later lead to their babies being born with low birth weight, which can again lead to undernutrition as these babies grow older. Thus a vicious cycle of undernutrition repeats itself, generation after generation.

The global burden of stunting is far greater than the burden of underweight. Based on the latest available data, in the developing world, the number of children under five years old who are stunted is close to 200 million, while the number of children under five who are underweight is about 130 million.

Infants with low birth weight may never recover from their early disadvantage. Like other undernourished children, they may be susceptible to infectious disease and death, and as adults they may face a higher risk of chronic illness such as heart disease and diabetes. Thus the health of the child is inextricably linked to the health of the mother. In turn, the health of the mother is linked to the status a woman has in the society in which she lives. In many developing countries, the low status of women is considered to be one of the primary reasons for undernutrition across the life cycle.