The East Asia and the Pacific region has seen great economic progress in recent decades but, despite this progress, nearly half of all deaths in children under 5 can still be attributed to undernutrition and progress has been uneven.
The region has experienced a 74 per cent reduction in stunting prevalence (low height for age) over a 24 year period, the largest reduction for any region. That is a reduction from 81 million stunted children in 1990 to only 16 million in 2014.
However, this regional average is largely due to the weight of the reduced number of stunted children in China, and the progress has in fact been much slower in most other countries. Six countries (Cambodia, China, DPRK, Mongolia, the Philippines and Vietnam) were rated as “on track” to achieving the global target for stunting in the 2015 Global Nutrition Report, while all the others were “off-track”.
Several countries, including Lao PDR, Papua New Guinea and Timor-Leste, still have stunting rates above 40 per cent.
The region is also confronted with other forms of malnutrition such as wasting (acute malnutrition). It is estimated that around 6 million cases of severe wasting are found each year in the region.
Micronutrient deficiencies and anaemia also continue to be a significant public health problem in about a third of all countries in the region. Some micronutrient deficiencies have declined, such as Vitamin A deficiency, due to the high coverage with Vitamin A supplementation supported by UNICEF, while in many countries the population is also no longer iodine deficient thanks to UNICEF-supported efforts on universal salt iodization.
In the region, only 30 per cent of infants are exclusively breastfed for the first six months of life. In about a third of the countries in the region, fewer than half of newborn babies are breastfed within the first hour of birth. Complementary feeding practices are also poor in many areas, particularly with regards to frequency of feedings, food quality and diversity. Lack of awareness, cultural beliefs and poverty are partly responsible for inadequate practices.
Changing face of malnutrition
While stunting and wasting persist across the region, the face of malnutrition is rapidly changing.
Overnutrition – including overweight and obesity – is now on the rise in many countries in the region, particularly China, Indonesia, Malaysia, Mongolia and Thailand, as well as all of the Pacific Island Countries. Over eight million children under five are estimated to be overweight, the single largest burden of any region.
Many countries are now facing a ‘double burden’ of malnutrition. In the same country, child can face undernutrition and micronutrient deficiencies on the one hand, and overweight and obesity on the other.
Stunted children face a greater risk of becoming overweight as adults. Poverty, lack of access to adequate diets, poor infant and young child feeding practices, and the marketing and sales of unhealthy foods and drinks can lead to undernutrition and micronutrient deficiency as well as to overweight and obesity. The costs of the resulting chronic non-communicable diseases represents a huge drain on countries’ resources. In Indonesia, for example, it is estimated that the cost will be $248 billion per year.
UNICEF in action
The first 1,000 days offer an extraordinary window of opportunity for preventing undernutrition and its consequences. UNICEF targets its actions to this critical period, using widely accepted and evidence-based interventions, including support for maternal nutrition before and during pregnancy and lactation, optimal breastfeeding, appropriate complementary feeding for infants over 6 months, management of severe acute malnutrition and micronutrient fortification and supplementation for women and children to address deficiencies.
Emerging areas of work include the prevention of childhood overweight and obesity, and adolescent nutrition.
We also work with governments and development partners to build nutrition capacity, strengthen planning, budgeting and management of nutrition programs at national, district and community levels, and to deliver communication messages on nutrition through a variety of channels.
Improving data collection and monitoring is another key area for support. Because other sectors beyond health also play a significant role in reducing under-nutrition, UNICEF works with sectors such as water and sanitation, early childhood development, education and social policy to support integrated service delivery.
UNICEF’s work on nutrition in the region is guided by a Regional Strategic Approach to Nutrition Programming.
UNICEF works with a wide range of partners, including governments, the Association of Southeast Asian Nations (ASEAN), other UN agencies, and non-governmental and academic institutions, to improve women’s and children’s nutrition in the region.
UNICEF worked with ASEAN and other UN agencies to create the 2016 Regional Report on Nutrition Security in ASEAN (Vol 1 and Vol 2). Over the past five years (2011-2015) UNICEF has partnered with the European Union to improve nutrition security in five Asian countries.