Care for severely wasted children

UNICEF is working to strengthen community and health systems to detect, refer and treat severely wasted children across South Asia.

A wasted child eating soup in a hospital in Afghanistan
UNICEF ROSA/2016/Lemoyne


In South Asia, 9 million children under the age of 5 are dangerously thin, a condition known as severe wasting. They represent half of the world’s severely wasted children.

Severely wasted children are more likely to die because their immunity to infections is weakened by a lack of nutrients. Those who survive may go on to suffer poor growth and development and fail to thrive. Children become severely wasted if they do not gain sufficient weight or lose weight due to inadequate dietary intake or diseases like diarrhea and respiratory infections. The high proportion and number of severely wasted children reflect the poor nutritional status of women during pregnancy, poor breastfeeding and feeding practices, lack of sanitation and hygiene, poor access to quality health services, and food insecurity.

Across South Asia, government statistics indicate that less than five percent of severely wasted children are receiving appropriate care and treatment. This unacceptable situation stems from a number of reasons. First, there is a perception that the treatment of severe wasting is only relevant in an emergency or humanitarian contexts, while prevention is only applicable in stable or development settings. This is not true – every country in South Asia needs systems in place to both prevent and treat severe wasting in both crisis and stable settings. Second, families often do not realise that their severely wasted children need urgent medical assistance, and do not seek treatment until very late when the condition is more difficult to treat – if at all. Third, there is a belief among some medical professionals that children with severe wasting need to be treated in a hospital or health facility. In the past, hospital admission was the only option available. However, we now know that children can be safely treated in their homes and communities provided they have no medical complications.


The consequences of severe wasting on children’s survival, growth and development demand greater and more efficient investments in proven actions to prevent and treat it. 

UNICEF works across all South Asian countries to ensure services are available to care for severely wasted children. 

In countries where the burden of severe wasting is high, we advocate for community-based approaches to detect, refer and care for severely wasted children. Community-based workers can use a simple colour-coded tape to measure the arm circumference of children in the community and identify those that need to be referred for treatment. This increases the identification of severely wasted children. Most children with severe wasting can be treated at home with appropriate therapeutic foods and counseling provided they do not have any medical complications. This community-based care is highly beneficial because it is less costly to families and the health system, and allows more children to be successfully treated.   

We work with the South Asian Association for Regional Corporation (SAARC), national governments and other partners to ensure that countries have evidence-based policies and guidelines on the care and treatment of severe wasting that align with the latest global guidance. We also assist in developing the capacity of the health workforce to care for severely wasted children, to ensure necessary supplies and equipment are available, and to monitor the coverage, quality, and equity of services.  


Color coded arm measurement for wasting symptoms
UNICEF ROSA/2016/Pirozzi


These resources represent just a small selection of materials produced by UNICEF and its partners in the region. The list is regularly updated to include the latest information.

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