Malnutrition: Causes
- Malnutrition is a complex condition that can involve multiple,
overlapping deficiencies of protein, energy and micronutrients —
so called because they are nutrients needed by the body in only tiny
amounts. A child becomes malnourished because of illness in
combination with inadequate food intake. Insufficient access to
food, poor health services, the lack of safe water and sanitation,
and inadequate child and maternal care are underlying causes.
- In as many as 35 of the poorest countries, 30-50 per cent of the
population may have no access to health services at all.
- More than 1.1 billion people lack access to safe drinking water
and some 2.9 billion people lack access to adequate sanitation. The
result is the spread of infectious diseases, including childhood
diarrhoea, which in turn are major causes of malnutrition. Each
year, diarrhoeal dehydration claims the lives of 2.2 million
children under five in developing countries.
- Inadequate care for children and women is an underlying cause of
malnutrition only recently recognized in all its harmful
ramifications. Good hygiene in and around the home and in handling
food reduces the risk of illness. Care also includes all interaction
between parent and child that helps children develop emotionally as
well as physically. Several studies have found that malnourished
children who were stimulated verbally and cognitively had higher
growth rates than those who were not.
- Discrimination against women and girls is an important basic
cause of malnutrition. The very high rates of child malnutrition and
low birthweight throughout much of South Asia are linked to such
factors as women's poor access to education and their low levels of
participation in paid employment, compared with other regions.
- Breastfeeding is the foundation of good nutrition for infants,
and inadequate breastfeeding can jeopardize infants' health and
nutrition, particularly in areas where sanitation and hygiene are
poor.
- In some industrialized countries, widening income disparities,
coupled with reductions in social protections, are having worrying
effects on the nutritional levels of children.
Costs
- Malnutrition contributes to over 6 million child deaths each
year, 55 per cent of the nearly 12 million deaths among children
under five in developing countries. Half of all children under five
years of age in South Asia and one third of those in sub-Saharan
Africa are malnourished.
- Malnutrition leads to reduced productivity, hampering economic
growth and the effectiveness of investments in health and education,
and deepening poverty. Vitamin and mineral deficiencies are
estimated to cost some countries the equivalent of more than 5 per
cent of their gross national product in lost lives, disability and
productivity.
- In countries where infant mortality rates are high or moderately
high, a bottle-fed baby in a poor community is 14 times more likely
to die from diarrhoeal diseases and 4 times more likely to die from
pneumonia than a baby that is exclusively breastfed.
- In the United States, researchers estimate that 13 million
children, more than one fourth of all children under the age of 12,
have a difficult time getting all the food they need. In the United
Kingdom, children and adults in poor families have been found to
face increased risks due to poor diet, including premature births,
low birthweights, anaemia, dental diseases, diabetes, obesity and
hypertension. In the Russian Federation, the prevalence of stunting
among children under two years of age increased from 9 per cent in
1992 to 15 per cent in 1994.
Progress
- Over 12,700 hospitals in 114 countries are now baby-friendly,
establishing a good start to breastfeeding for millions of babies.
- Sixty per cent of all edible salt in the world is now iodized,
helping reduce the toll of iodine deficiency disorders. Bolivia is
the first and only country to certify that iodine deficiency has
been virtually eliminated as a public health problem.
- In 1997 alone, the lives of at least 300,000 young children were
saved by vitamin A supplementation programmes in developing
countries.
- In Mbeya in Tanzania, a project improving health coverage and
access to safe water, as well as growth monitoring and promotion,
has produced a drop in moderate malnutrition of 11 percentage
points. In contrast, malnutrition among children under five in areas
not covered by the project actually increased by 7 percentage
points.
- In Brazil, the rate of malnutrition among children covered by a
community-volunteer growth monitoring and promotion programme run by
the Child Pastorate is half the national rate.
- In a village in Niger, malnutrition rates have fallen by 10
percentage points as a result of a programme that helps women
organize to reduce their workloads and enrich family diets with new
foods.
- Community volunteers in Oman's Al Dakhiliya region are helping
reduce child malnutrition through improved care and health
activities.
- Nutrition promoters in Bangladesh are working in 1,000 community
centres to help support breastfeeding and better caring practices
for women and children.
- Guatemala has brought vitamin A deficiency under control by
fortifying sugar with the vitamin. Sugar is also being fortified
with vitamin A in parts of Bolivia, Brazil, El Salvador, Honduras
and the Philippines.
- UNICEF supplied a total of 2.7 billion iron/folate tablets to 122
countries between 1993 and 1996 for distribution among pregnant
women to help reduce iron deficiency anaemia and folate deficiency.
Wheat flour is being fortified with iron in a number of countries in
Latin America and the Middle East.
- The nutrition of millions of children around the world has
benefited from improvements in health services, particularly the
achievement of immunization rates between 80 and 90 per cent in many
countries.
|
