The
impact of stunting:
· Globally,
nearly one in four children under age 5(165 million or 26 per cent in 2011) are
stunted.
· Stunting,
or low height for age, is associated with impaired brain development, which is
likely to have long-lasting negative consequences throughout a child's life.
· Recent
studies from Brazil, Guatemala, India, the Philippines and South Africa
confirmed the association between stunting and reduced school attendance and
performance. The studies also found that stunting was a predictor of grade
failure.
·
Reduced
school attendance and diminished educational outcomes mean these children will
earn less once they become adults. A 2007 study estimated an average 22 per
cent loss of yearly income in adulthood.
·
A
stunted child enters adulthood with a greater propensity for being
overweightand for developing chronic diseases.
·
Sub-Saharan
Africa and South Asiaare home to three quarters of the world's stunted
children. In sub-Saharan Africa, 40 per cent of children under 5 are stunted;
in South Asia, 39 per cent are stunted.
·
In
2011, the five countries that count the highest numbers of stunted
childrenunder 5 were: India (61.7 million), Nigeria (11 million), Pakistan (9.6
million), China (8 million) and Indonesia (7.5 million).
Stunting
affects the most marginalized children:
·
Beyond
regional and national averages, there are disparities by wealth and area of
residence.
·
Globally,
one third of rural children under 5are stunted, compared to one quarter in
urban areas.
·
Similarly,
children under 5 in the poorest communitiesare more than twice as likely to be
stunted as children under 5 in the richest communities.
Timing
is essential:
·
The
most crucial time to meet a child's nutritional requirements is during the
1,000 days beginning from pregnancy to the child's second birthday.
· Evidence
from 54 low- and middle-income countries indicates that growth deficiencies
begin during pregnancy and continue until about 24 months of age. Catch-up
growth later in childhood is minimal- the damage caused is largely
irreversible.
·
Undernourished
mothers have a greater chance of giving birth to low-birth-weight babiesthan
adequately nourished mothers.
·
An
estimated 60 to 80 per cent of neonatal deathsoccur among low-birth-weight
babies.
·
In
South Asia, more than 25 per cent of children are born with low birth weight.
More
than just food:
·
The
nutritional status of a child is influenced by three broad factors: food,
health and care.
·
This
status is optimized when children and mothers have access to: affordable,
diverse, nutrient-rich food; appropriate maternal and childcare practices;
adequate health services; and a healthy environment including safe water,
sanitation and good hygiene practices.
Approaches
that work:
·
Countries
that have demonstrated political will and commitment to tackle malnutritionhave
enjoyed great success in reducing stunting prevalence.
·
Successful
direct nutrition interventions include: improving women's nutrition, especially
before, during and after pregnancy; early and exclusive breastfeeding for first
6 months; timely, safe, appropriate good quality complementary feeding for 6-24
months; and adequate intake of micronutrients.
·
There
are many examples of countries that have witnessed great decreases in
stuntingprevalence.
§
In
Peru, stunting fell by one third in just a few years - from an estimated 30 per
cent of children under 5 in 2004-2006 to 20 per cent in 2011.
§
In
Rwanda, in just five years (from 2005 to 2010), stunting prevalence decreased
from an estimated 52 per cent of children under 5 to 44 per cent.
§
In
Ethiopia, between 2000 and 2011, rates of stunting among children under 5
decreased from an estimated 57 per cent to 44 per cent.
§
In
Haiti, preliminary survey results indicate that stunting prevalence fell from
an estimated 29 per cent of children under 5 to 22 per cent between 2006 and
2012.
§
In
Maharashtra state in India, provisional estimates suggest that the prevalence
of stunting had dropped from 39 per cent of children under 5 in 2005-2006 to 23
per cent in 2012.
§
In
Nepal, stunting prevalence among children under age 5 dropped from 57 per cent
in 2001 to 41 per cent in 2011.
Malnutrition
and child mortality:
·
One
third of deaths of children under 5are attributable to undernutrition.
·
Undernutrition
puts children at far greater risk of death and severe illness due to common
childhood infections, such as pneumonia, diarrhoea, malaria, HIV/AIDS and
measles.
·
Children
with severe acute malnutrition are nine times more likely to die than children
who are well-nourished. Seventy five per cent of children who receive treatment
can recover.
The
nutritional status of the world's children
Stunting
·
The
global prevalence of stunting has declined 36 per cent over the past 20 years,
from an estimated 40 per cent in 1990 to 26 per cent in 2011.
·
While
every region has observed reductions in stunting prevalence, the greatest
declines occurred in East Asia and the Pacific. This region experienced a 70
per cent reduction since 1990, declining from 42 per cent in 1990 to 12 per
cent in 2011.
Underweight
·
Globally,
underweight (low weight for age) prevalence has declined, from 25 per cent in
1990 to 16 per cent today - a 37 per cent reduction.
·
An
estimated 101 million children under 5 years were underweight in 2011,
representing approximately 16 per cent of the world's under-5 children.
Wasting
·
Globally,
52 million children under 5are moderately or severely wasted (low weight for
height), an 11 per cent decrease from an estimated 58 million in 1990.
·
Globally,
more than 29 million (5 per cent) children under 5 suffer from severe wasting.
·
The
highest prevalence is in South Asia, where approximately one in six children
are severely or moderately wasted. The burden is highest in India, where more
than 25 million children are wasted.
Low
birth weight
·
More
than 20 million children(an estimated 15 per cent of infants) were born with
low birth weight worldwide in 2011.
·
India
accounts for more than one third of the global burden.
Overweight
·
In
2011, more than two thirds of overweight children under 5 resided in low- and
middle-income countries.
·
Globally,
an estimated 43 million children under 5 are overweight.
Coverage
of interventions
·
81
per cent of pregnant women globally have at least one antenatal visit, but the
coverage of specific interventions and the quality of antenatal care varies.
·
Globally,39
per cent of infants less than 6 months old were exclusively breastfedin 2011.
·
Among
50 countries with available trend data, the majority (40 countries) have posted
gains in exclusive breastfeeding rates since 1995.
·
Globally,
only 60 per centof children aged 6-8 months receive solid, semi-solid or soft
foods, highlighting deficiencies in the timely introduction of complementary
foods.
·
Globally,
between 1995 and 2005, one in three preschool-age childrenand one in six
pregnant women were deficient in vitamin A due to inadequate dietary intake.
·
In
most countries profiled in the report, less than 50 per cent of womenreceived
adequate iron and folic acid supplementation during their pregnancy.
·
Globally,
75 per cent of householdshave adequately iodized salts, but coverage varies
considerably by region.
·
An
estimated 2 millionchildren under 5 were treated for severe acute malnutrition
in 2011.
What
is UNICEF doing?
Around the
world, UNICEF is working to: build political commitment among governments and
partners to reduce stunting and other forms of undernutrition; support the
design and implementation of comprehensive and effective national policy and
programmes based on sound situation analysis at country level; help strengthen
the capacity of community workers; develop effective communication and
advocacy, promote multisectoral delivery of services and supply; and provide
ready-to-use therapeutic food during emergencies (27,000 metric tonnes in 2011,
some 80 per cent of the global supply). The organization works with governments
and partners in fivemain areas:
·
Maternal
nutrition: To
provide nutrition counselling and supplements, and prevent diseases. These
services are delivered during antenatal visits.
·
Infant
and young child feeding: To
guarantee the best start in life by:
§
promotingtimely
initiation ofbreastfeeding within one hour of birth andexclusive breastfeeding
for the first six months;
§
ensuring
timely, adequate and appropriate complementary feeding along with continued
breastfeeding from six months onwards.
·
Prevention
and treatment of micronutrient deficiencies: To
provide Vitamin A, zinc, salt and other micronutrients to women, pregnant women
and children. This improves the health of expectant mothers, the growth and
development of the unborn child, and the survival and physical and mental
development of children up to age 5.
·
Prevention
and treatment of severe acute malnutrition: To
facilitate the treatment of severe acute malnutrition in the heart of
communities by qualified community health workers and to improve the delivery
of ready-to-use-therapeutic food. This avoids the risk of death and minimizes
complications.
·
Promotion
of health, hygiene, and water and sanitationpractices:To support vaccination campaigns; to promote
sanitation and hand-washing with soap; to improve access to safe drinking
water; to promote the use of oral rehydration salts and therapeutic salts to
treat diarrhoea; to distribute mosquito nets to prevent malaria and provide
treatment; to treat pneumonia with antibiotics.
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