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© UNICEF/Togo/2007/Pudlowski
Immediate and exclusive breastfeeding is the best source of nutrition for newborns.

Each year, in West and Central Africa, one million children under five die from causes related to malnutrition.

Malnutrition contributes to 35 per cent of all the child deaths in the region.

Among the 15 countries in the world with the worst under 5 mortality statistics, 10 are in West and Central Africa. Here, at any time one out of four children are underweight, giving the region the unwanted status of having the highest prevalence estimates for underweight in the world.

Malnourished children fall sick more often. When they survive, they can suffer from irreversible mental and physical impairment.

Causes of child malnutrition

Most of the reasons causing such suffering are preventable. Malnutrition is usually the result of a combination of inadequate dietary intake and infections. Malnutrition also results from a complex interplay of factors such as household access to food, child and maternal care, safe water and sanitation and access to basic health services.

In 2009, UNICEF conducted a nutritional vulnerability analysis that looked at indicators for factors such as prevalence of children undernutrition, access to vitamin A and iodized salt, level of food insecurity and governance. This analysis demonstrated that Burkina Faso, Central African Republic, Chad, Guinea Bissau, niger and Sierra Leone and have the highest degree of nutritional vulnerability in West and Central Africa.

The seasonal peaks of acute malnutrition in CAR, Niger, Chad and Burkina Faso regularly reach, or exceed, the levels defined as nutrition emergencies.

Food security is not the only solution to reverse the rising trend of malnutrition. The condition can also be combated through a number of initiatives involving action at the household and community level.

Improving breastfeeding practices (exclusive breastfeeding for the six first months and children’s adequate nutritional intakes after six months), promoting family essential practices such as hand-washing with soap, fighting against common diseases such as diarrheas or respiratory infections, while improving access to safe water and to health care, are key issues that would reduce the rates of under nutrition and make children healthier.

Forms of malnutrition

There is no one kind of malnutrition. And malnutrition is not a simple matter of whether a child can satisfy his appetite. A child who eats enough to satisfy immediate hunger can still be malnourished.

Malnutrition can take a variety of forms that often appear in combination and contribute to each other, such as protein-energy malnutrition, iodine deficiency disorders and deficiencies of iron and vitamin A.

Measuring weight and height of children and comparing to a ‘reference population’ known to have grown well is the most common way of assessing malnutrition in populations.

Acute malnutrition is the type of malnutrition which damages children’s health and is life-threatening. In 8 countries of the region, the prevalence of wasting (global acute malnutrition) is equal to, or exceeds, 10%. This is the ‘alert rate’ according to WHO standards. In real terms the rate means that about 7.8 million children suffer from wasting in West and Central Africa.

Chronic malnutrition is due to long lasting deficiencies of ‘micronutrients’ — substances like vitamin A and iodine that are needed, often in only tiny amounts, to ensure adequate bodily functions. Chronic malnutrition can turn into acute malnutrition when a child gets sick or when the dietary intakes are too poor.

High time to act

Tackling child malnutrition is essential to attaining the Millennium Development Goal to reduce child malnutrition (MDG 1) and child mortality (MDG 4) rates by two thirds by 2015.

The other health-related goals – MDG 5 on maternal health and MDG 6 on combating key diseases – are also intimately linked to nutrition, given that an undernourished body is more vulnerable.

Good nutrition is the cornerstone for survival, health and development. New evidence indicates that if high-impact health and nutrition interventions such as breastfeeding, complementary feeding and vitamin A and zinc supplementation are scaled up, they will combine to have a huge impact on child growth and development, as well as survival.

A few figures from West and Central Africa

  • An estimated 11% of children under five – or 7,8 – suffer from acute malnutrition (wasting) (1,7 million in Nigeria, 1.7 million in DRC and 1.3 million in the countries of the Sahel, based on latest data available from 2003-2008).
  • Chronic malnutrition (stunting) affects 40% of the children – or 26,5  million children in the region (10.1 million in Nigeria and 5.3 million in DRC).
  • Underweight, the indicator used for MDG 1, affects 22% of the children under five –  or 15.4 million children in the region (5.7 million in Nigeria and 2.9 million in DRC).



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