Nutrition

Good nutrition is the bedrock of child survival and development. Well-nourished children are better able to grow, learn, earn, and participate in their communities. They are also more resilient in the face of crisis. Investments in nutrition can unlock major economic benefits. For example, every US$1 invested to prevent stunting in early childhood can generate up to US$48 in returns because children who are well nourished lead healthier lives, complete more years of education, and contribute more to the economy.

Despite much progress, the triple burden of childhood malnutrition – undernutrition, micronutrient deficiencies and overweight and obesity – remains unresolved in the Eastern and Southern Africa region (ESAR). Stunting, a form of chronic malnutrition, affects over 30 per cent of children under 5 (26 million) in the region, jeopardizing cognitive development, learning potential and posing long-term health and economic risks into adulthood. The number of children with stunting is the same now as in the year 2000, and very few countries are on track to achieve the targets of the SDGs. Close to 4 million children suffered from severe wasting in ESAR in 2023. Severe wasting requires urgent, lifesaving treatment to save lives. In 2023, just over 2.3 million were reported to have been admitted for treatment (58 per cent). Over half of all children in Eastern and Southern Africa are deficient in essential vitamins and minerals. Micronutrient deficiencies compromise children’s immune systems and impact growth and development. Girls with micronutrient deficiencies are more likely to have poor pregnancy outcomes in future and give birth to malnourished children. Close to half of all deaths in children under 5 are attributable to child undernutrition. Over a third of adult women are anemic, and no country is on track for the global anemia target. At the same time, close to 4 million children under 5 in ESAR are affected by overweight and obesity (over 4 per cent) and this rises to 11 per cent of children aged 5 to 19 years. This trend is set to rise unless urgent, preventive action is taken. Overweight and obesity increases children’s risk of developing type 2 diabetes and cardiovascular diseases during their lifetime and costs health systems and economies huge amounts.

Poor diets drive all of these forms of malnutrition. Two in three children under 5 in Eastern and Southern Africa do not receive the minimum diverse diets they need for healthy growth and development. An estimated 67 million children under 5 in ESAR (around 80 per cent) experience child food poverty. Even more worryingly, 29 per cent or 25 million children – are living in severe food poverty and are fed extremely poor diets that include at most two food groups. Children experiencing severe food poverty are 50 per cent more likely to be wasted and 34 per cent more likely to be stunted. Overweight is also driven by poor quality diets, consisting of nutrient-poor, ultra-processed foods and beverages. In Kenya and Tanzania for example, around 30 per cent of children affected by severe food poverty consumed a sugary beverage during the previous 24 hours.

Poor quality child diets result from food systems that do not prioritize the unique dietary needs of children. On the one hand, food insecurity and lack of access to nutritious foods affects many families across ESAR, especially the poorest. Food security initiatives have tended to focus primarily on household access to staple foods and incomes from agriculture, while the specific needs of young children for nutrient-dense foods remained largely unaddressed. On the other hand, more and more children are experiencing increased availability and aggressive marketing of cheap, unhealthy ultra-processed foods and sugary beverages.

Malnutrition also has other underlying causes, including poverty, poor access to health and social services, poor food environments, poor child care practices, and gender inequalities. Meanwhile, new forces – globalization, urbanization, climate change and increasing humanitarian crises – are posing critical challenges to feeding children sustainably today and will do so for generations to come.