Undernutrition is one of the world’s most serious but least addressed public health challenges. Its human and economic costs are enormous, falling hardest on the very poor and on women and children.

More than 160 million children worldwide are stunted in their growth (low height for age) and in their potential to contribute to their country’s growth. Undernutrition contributes to nearly one-half of all child deaths and increased frequency, severity, and duration of infectious disease, such as diarrhea, respiratory infections and malaria.

Undernourished children are more likely to die in the first few years of life. And if they survive, they have lower educational and income attainment. 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 30% more likely to live in poverty and less likely to work in skilled labor. Thus, 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 when household income is low, but is also associated with food shortages, diets lacking in diversity, high rates of infectious diseases and inappropriate infant feeding and care practices. Food and financial crises, as well as natural disasters, have worsened undernutrition in many regions.

Last Updated: Sep 08, 2015

The World Bank has joined with more than 100 partner agencies and organizations to endorse Scaling Up Nutrition: A Framework for Action, which sets forth principles and priorities for action to address undernutrition, in line with the Sustainable Development Goals. .

The main elements of the framework for action are:

  1. Start from the principle that what ultimately matters is what happens at the country level. Individual country nutrition strategies and programs, while drawing on international evidence of good practice, must be country-“owned” and built on the country’s specific needs and capacities.

  2. Sharply scale up evidence-based cost-effective interventions to prevent and treat undernutrition, with highest priority to the minus 9 to 24-month “window of opportunity” where we get the highest returns from investments.

  3. Take a multisectoral approach that includes integrating nutrition in related sectors and using indicators of impact on undernutrition as one of the key measures of overall progress in these sectors. The closest actionable links are to food security (including agriculture), social protection (including emergency relief) and health (including maternal and child health care, immunization and family planning). There are also important links to education, water supply and sanitation as well as to cross-cutting issues like gender equality, governance (including accountability and corruption), and state fragility.

  4. Provide substantially scaled up domestic and external assistance for country-owned nutrition programs and capacity. Ensure that nutrition is explicitly supported in global as well as national initiatives for food security, social protection and health, and that external assistance follows the agreed principles of aid effectiveness of the Paris Declaration and the Accra Agenda for Action. Support major efforts at the national and global levels for strengthening the evidence base—through better data, monitoring and evaluation, and research—and, importantly, for advocacy.


In April 2015, the World Bank Group joined the Power of Nutrition, an independent charity to help millions of children reach their full potential. Backed by leading organizations from private philanthropy and international development, the partnership aims to unlock US $1 billion dollars to tackle child undernutrition in some of the world’s poorest countries.

The Power of Nutrition’s $20 million investment in Tanzania, made through its partnership with the Bank, will multiply investment in nutrition, enabling up to $44 million to be released for new nutrition-specific activities in Tanzania within a larger $306 million health and nutrition initiative in the country. This initiative will also finance additional nutrition-sensitive activities that will further improve the nutritional status of children, including the presumptive treatment for malaria among pregnant mothers and zinc treatment with oral rehydration salts for children with diarrhea.

Last Updated: Sep 08, 2015

The World Bank has led the effort to estimate the cost and cost-effectiveness of nutrition interventions to support advocacy and increase investment in nutrition at the global and country levels. At the global level, the Bank, in partnership with 1000 Days, R4D, the Bill and Melina Gates Foundation, and the Children’s Investment Fund Foundation, is estimating the cost and financing available and needed to reach the World Health Assembly/WHO nutrition targets. Final estimates will be available before the Nutrition for Growth Summit, to take place during the 2016 Summer Olympic Games in Rio de Janeiro.

At the country level, the Bank has conducted a number of studies to support governments in Africa in planning and expanding investments in nutrition. The studies provide estimates of the costs and benefits of scaling up a package of evidence-based nutrition interventions proven to improve nutrition outcomes during the first 1,000 days of a child’s life. The studies consider the current coverage of interventions, available delivery platforms, and local costs for commodities, monitoring and evaluation, and capacity building. They provide policymakers with several context-specific scale-up scenarios, designed to maximize allocative efficiency in situations where available resources for investments in nutrition are limited. As of September 2015, five scale-up studies have been completed, for Nigeria, Togo, Mali, DRC and Zambia.  Three studies are near completion --in Cote d’Ivoire, Kenya and Uganda. Analytic work is scheduled to expand to South Asia in FY 2016.


Last Updated: Sep 08, 2015

International Development Association (IDA) commitments from 2003 to 2013 provided more than 117 million people with a basic package of health, nutrition, or reproductive health services.

Country-level results include the following:

  • In Senegal, the Bank supports an innovative nutrition health program that operates at the community level in collaboration with local governments, district health authorities, and civil society organizations. National underweight malnutrition rates dropped from 22% in 2005 to 17% in 2012, bringing Senegal--among very few countries globally--within reach of achieving the MDG to halve the rate of malnutrition.

  • In Ethiopia, funding from the Bank’s Rapid Social Response Program has helped the country expand nutrition data collection and analysis and build capacity to respond quickly to worsening nutrition situations and economic shocks. In addition, the Bank supports the July 2015 Seqota Declaration, which reaffirms Ethiopia’s commitment to invest further to improve nutrition for health and sustainable development.

  • In Peru, strong government commitment, in addition to Bank and partner efforts in advocacy, operations and non-lending technical assistance, led to a reduction in stunting of 8.3%, from 27.8% in 2007/8 to 19.5% in 2011 (using WHO 2006 growth reference standards). This is among the fastest rates of reduction seen for stunting globally.

The Bank has been instrumental in advocating for food fortification as a cost-effective approach to improve nutrition. In Tanzania, for example, Bank research showed that food fortification would have a benefit-cost ratio of 8.22:1, leading to a government decision to make Tanzania the first country in East Africa to institute mandatory fortification of wheat flour, maize flour and edible oil.







Last Updated: Sep 08, 2015

The World Bank Group was a founding member of the Scaling Up Nutrition movement, and currently serves on the Executive Committee for Governance  and in the SUN Lead Group.

The World Bank Group is a partner in the Power of Nutrition, a partnership of investors and implementers committed to helping children grow to their full potential, ending the cycle of undernutrition, and enabling countries to build strong and prosperous communities.  

Last Updated: Sep 08, 2015

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