Malnutrition is one of the world’s most serious but least-addressed development challenges. Its human and economic costs are enormous, falling hardest on the very poor, women and children. Malnutrition undermines progress towards achieving the World Bank Group twin goals of reducing poverty and promoting shared prosperity.
The prevalence of stunting (an indicator of chronic undernutrition) has declined globally. However, 159 million children are stunted in their growth (low height for age), and have limited potential to contribute to their country’s growth. In sub-Saharan Africa, stunting reduction has flat lined, and there are now 12.5 million more stunted children in the region than there were in 1990. Undernutrition increases the risk of children dying in the first few years of life and contributes to nearly one-half of all child deaths. Undernutrition causes increased frequency, severity, and duration of infectious disease, such as diarrhea, respiratory infections and malaria.
For children who survive, childhood stunting impairs long-term human capital formation. Stunting early in a child’s life has educational, income, and productivity consequences that reach far into adulthood. For example, children who are deficient in iodine and essential micronutrients have on average 13 fewer IQ points than those who are iodine-sufficient. Similarly, stunted children are more likely start school later, perform more poorly on cognitive functioning tests, and are more likely to drop out of school. Studies show that adults who are stunted as children earn 20% less than comparable adults who were not stunted and are 33% more likely to live in poverty and less likely to work in skilled labor.
The economic costs of undernutrition, in terms of lost national productivity and economic growth, are significant—ranging from 2 to 3% of GDP in some countries and up to 11% of GDP in Africa and Asia each year.
Globally, undernutrition is more common in poor households, but is also prevalent among the better-off households. For example in Bangladesh, Indonesia, and Ethiopia, more than 40% of children in the poorest households are stunted, yet one-fifth to one-quarter of children living in the wealthiest 20% of households are also stunted. Income is one—but not the only—determinant of stunting: food insecurity, diets lacking in diversity, high rates of infectious diseases and inappropriate infant feeding and care practices also contribute to persistent stunting. Food and financial crises, as well as conflict and natural disasters, have worsened undernutrition in many regions.
At the same time, a global nutrition transition is underway, leading to rapid changes in food systems, environments, and living conditions in many low- and middle-income countries (LMICs). These changes have stimulated a rapid increase in their burden of overweight/obesity, previously considered an ailment of wealthy countries. In fact, over the past 30 years rates of overweight have risen faster in LMICs than in high income countries. Overweight is now pervasive even in countries where children experience undernutrition.
Across all World Bank regions, countries are now starting to experience the double burden of overweight among women and stunting among children. Today, more of the world’s overweight individuals reside in low- and middle-income countries than in high income countries, and there is no evidence that the rise in obesity in LMICs will soon attenuate. As countries experience economic growth and achieve middle and upper-middle income status, their poor will experience a greater share of the burden of overweight and obesity, increasing their vulnerability to health and economic shocks. There is an urgent need to ensure that the world’s poor have access to the knowledge, resources, and services needed to achieve optimum nutrition.
Last Updated: Mar 31, 2016