New research published Online First in The Lancet suggests that developing countries have a less than 5% chance of meeting the UN’s Millennium Development Goal target for the reduction of child malnutrition by 2015. The Article analyses trends in the weight and height of more than 7.7 million children worldwide between 1985 and 2011, and is the first large-scale study to provide a detailed examination of trends in children’s weight and growth in all developing countries.
Professor Majid Ezzati, from the School of Public Health at Imperial College London, UK, and the Article’s senior author, said: “Our analysis shows that the developing world as a whole has made considerable progress towards reducing child malnutrition, but there are still far too many children who don’t receive sufficient nutritious foods or who lose nutrients due to repeated sickness. Severe challenges lie ahead.*”
The proportion of children who are underweight is one of the indicators for the Millennium Development Goal to end poverty and hunger by 2015. The study uses data collected to estimate past and current levels of malnutrition in 141 countries as well as how levels are likely to change if current trends continue.
The estimates suggest that over 250 million children were mildly to severely underweight in 2011, with 17 countries – mainly in sub-Saharan Africa and Oceania – seemingly undergoing no improvement in the number of children who are underweight or restricted in growth. Although the outlook appears to be poor in these regions, the authors point out that the situation is considerably better in some regions – particularly in some parts of Asia and Latin America – with 61 of the 141 countries studied estimated to have a 50-100% chance of meeting the UN goals.
China has undergone the largest improvement in children’s height over the last 25 years, with Latin America and the Caribbean region also experiencing significant improvements in this area. The authors suggest that, in many of these countries, the improvements seen are down to overall improvements in the populations’ nutrition, rather than specific interventions targeting children at high risk.
According to Professor Ezzati, “There is evidence that child nutrition is best improved through equitable economic growth, investment in policies that help smallholder farmers and increase agricultural productivity, and primary care and food programmes targeted at the poor. We mustn’t allow the global economic crisis and rising food prices to cause inequalities to increase, or cut back on investments in nutrition and healthcare.*”
In a Comment linked to the paper, Professor Penny Gordon-Larsen from the Gillings School of Global Public Health, University of North Carolina, USA, writes: “[This study] emphasises the vastly different circumstances faced by children in low-income and middle-income countries. Barring radical change, children in the lowest-income countries (especially in the sub-Saharan African and South Asian regions), will continue to bear the enormous social, economic, health, and human capital costs of maternal and childhood undernutrition into the foreseeable future.”
Professor Gordon-Larsen also points out that some regions which previously faced high levels of child undernourishment now need to tackle rising levels of obesity: “The dual burden of undernutrition and overnutrition at country level will challenge resource allocators to meet the needs of undernourished and overnourished populations simultaneously. The successful balance between reduction of hunger and curbing of rising obesity is a challenge.”
“Trends in mild, moderate, and severe stunting and underweight, and progress towards MDG 1 in 141 developing countries: a systematic analysis of population representative data” Gretchen A Stevens DSc,Mariel M Finucane PhD,Christopher J Paciorek PhD,Seth R Flaxman BA,Richard A White MA,Abigail J Donner MSc,Prof Majid Ezzati PhD,on behalf of Nutrition Impact Model Study Group (Child Growth)
The Lancet – 5 July 2012