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Health and Nutrition: Zero Tolerance Initiative

Childhood Malnutrition


Early Childhood Development


Childhood Malnutrition

© UNICEF RD/R.Piantini/2006

Malnutrition occurs as a consequence of insufficient food consumption and the repeated appearance of infectious diseases. Malnutrition may be chronic or acute, or weight-for-age malnutrition.

Malnutrition means having a body weight that is lower than normal for age, a lower height than normal for age (delayed growth), being dangerously thin or displaying vitamin and/or mineral deficiency - malnutrition as a result of a lack of micro-nutrients, better known as hidden hunger.

Factors affecting malnutrition

Although poverty is usually mentioned as the main cause of malnutrition, other factors are just as important, such as failure to breastfeed exclusively, the presence of illnesses like diarrhoea, acute respiratory infections, and others, such as lack of education and information about good or adequate nutrition, failure to consume vitamin supplements or fortified foods, and the cost of food.

Malnutrition, especially among children, is an obstacle that prevents individuals, and even societies from developing their full potential. A 2006 UNICEF report states that each year over 20 million children are born weighing less than 5.5 lbs, which is equivalent to 17% of all births in the developing world, more than double the rate in industrialised countries, where this percentage is 7%.
According to UNICEF’s “State of the World’s Children 2007 Report” one of every four boys and girls – around 146 million – representing 27% of the under-five age group, weigh less than normal. For children with nutritional deficiency, common childhood ailments like diarrhoea and respiratory infections can be fatal. Of these 146 million, 78 live in Central Asia, 22 in East Asia and the Pacific, 17 in West and Central Africa, and 4 million in Latin America and the Caribbean.

Malnutrition in the Dominican Republic

Between 1940 and 1989, malnutrition was responsible for 265,000 deaths of children under five years of age who would have been between the ages of 15 and 64 in 2004, and would have made up part of the working population.

According to the State of the World’s Children Report for 2007, between the years 1998-2005 some 11% of babies were born with a low birth rate, and between the years 1995-2005 2% suffered from moderate and serious malnutrition and 9% from chronic (age-for-weight), moderate and severe malnutrition.

According to a study by ECLAC and the WFP in 2006, the Dominican Republic formed part of a group of countries that registered a low prevalence of malnutrition in Latin America and the Caribbean, with a ponderal deficit affecting one of every 19 boys and girls under the age of five and low height in 1/11 of this age group.

However, according to ENHOGAR 2006, height for age deficiency is found in 7% of boys and girls under the age of five, and is severe in 2%. The areas with the greatest rates of chronic malnutrition were the Enriquillo Region with 10%, El Valle with 9% and  North Eastern Cibao with 9%. San Juan de la Maguana and Elías Piña are two other areas with the highest rates of malnutrition, with 6% of boys and girls displaying acute symptoms.

A recent preliminary study by ENDESA 2007 set the rate of chronic malnutrition in under-fives using the new WHO criteria, at 9.8%. It observed the way in which the mother’s educational level influenced malnutrition rates, and found that 15.4% of children of mothers with no education suffered from chronic malnutrition, while 9.4% and 4.7% in children of mothers with secondary or higher education levels respectively.

The survey also shows that the low rate of exclusive breastfeeding is a decisive factor in determining malnutrition levels in babies under the age of six months, which is just 2.1%. This situation is responsible for the high prevalence of acute malnutrition among babies under the age of six months, which is 5.6%, in contrast with the rate of malnutrition in children between the ages of 18 to 23 months, where it is 0.6%.

These results show that although the country is heading towards the achievement of the Millennium Development Goals, efforts need to continue in order to meet the commitments by 2015.

By: Loreta Acevedo
With contributions from Sara Menéndez


Progress for Children:  An Evaluation of Nutrition.  No. 4/UNICEF, 2006.

State of the World’s Children. /UNICEF, 2006

The Cost of Hunger: The Economic and Social Impact of Childhood Malnutrition: Dominican Republic/Economic

Commission for Latin America (ECLAC); World Food Programme, 2006.

Demographic and Health Survey 2007: Preliminary Report; CESDEM, 2007



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