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Stunted Children, Stunted Economies: African Leaders Pledge Action on Nutrition

Meera Shekar's picture



Action on reducing child stunting across Africa is imperative for driving economic growth and reducing poverty. That was the message emanating from a  roundtable of African heads of state, ministers, CEOs and civil society leaders this morning, on the eve of President Obama’s U.S.-Africa Leaders Summit in Washington, D.C.

The high-level group -- including World Bank Group President Jim Yong Kim; Jamie Cooper-Hohn, Chair of the Children’s Investment Fund Foundation (CIFF); Rhoda Peace Tumusiime, Commissioner for the Department of Rural Economy and Agriculture, African Union Commission; and Amama Mbabazi, Prime Minister of Uganda* -- met to discuss child under-nutrition and its links to economic growth, an issue that has far-reaching implications for African nations, many of which are growing rapidly and want to ensure their children grow to be healthy, productive members of society.

“When malnutrition strikes children in the first years of their lives, it permanently stunts their bodies, their minds, and their potential to fully contribute to their country’s economy,” said Dr. Kim “This great loss holds back a country’s potential for a vibrant, productive labor force and its ability to realize the promise of the demographic dividend.” He went to quote and African leader who said, “When children grow, the nation grows.”

Those attending today’s roundtable agreed: We cannot make real gains in tackling poverty or reducing inequality if we do not urgently address child stunting. Of the 162 million stunted children in the world, nearly 60 million live in Africa. Of the 44 countries in Africa where we have data, only two (Gabon and Senegal) have child stunting rates below 20%; and in 33 of these 44 countries more than 30% children are stunted.

These malnourished children have little hope of ever achieving their full potential or contributing to economic growth. In fact, up to 16% of GNP in Africa is lost each year because malnourished children grow up to be less productive youths and adults.

Good nutrition is also crucial for development goals such as MDGs 4 and 5, which address maternal health and child survival. Under-nutrition causes 45% of all child deaths in sub-Saharan Africa – 3.1 million deaths annually –making it a moral as well as economic issue.

How can African governments tackle the challenge? Interventions carried out during the 1,000 day “window of opportunity”  --  starting with improving the nutrition of an expecting mother and continuing until a child is two years old -- show great potential to strengthen human capital. These include giving Vitamin A supplements to children, which has the potential to reduce child mortality by an average of 23%, and educating and supporting mothers to exclusively breast-feed their children for the first six months of their lives.

Such investments in human capital – or “grey matter infrastructure,” as one roundtable participant put it – will drive economic growth in Africa. If we do not make these investments at this time, it will take generations to correct it.

Many African nations are leading on  investing in nutrition through a multisectoral approach (across health, social protection, agriculture, water and sanitation sectors); setting bold targets and measuring against them; fostering public-private partnerships with companies who are committed to improving nutrition using local crops; scaling up biofortification of foods; and empowering local governments to develop their own nutrition plans.

As one roundtable participant pointed out, nutrition experts can learn a lot from what was achieved in the fight against HIV/AIDS, using the “Three Ones Principle” – one agreed framework/plan, one national coordinating authority across sectors, and one monitoring and evaluation approach.



Ending child stunting is certainly a priority for the World Bank Group, both through our health sector investments, as well as our agriculture and social protection investments, among others. In Ethiopia, for example, Bank-supported safety net programs have become an important channel to educate poor mothers about the importance of good nutrition and the availability of nutrition services when they collect their cash transfers. In Mali as well, we have a pilot project embedded within a social safety nets project to test how we can deliver preventive nutrition services linked to cash transfers.

In other countries like Nigeria, we are working with Ministries of Agriculture to scale up biofortified crops, and we’re introducing agricultural technologies that reduce women’s workloads, especially during pregnancy, which evidence shows will improve children’s birth weights.

We know that economic growth in itself will not improve nutrition outcomes. Concerted action is needed to improve nutrition, which in itself will drive future economic growth –thus moving from a vicious cycle of poverty and malnutrition to a virtuous cycle of better nutrition and higher economic growth.

In Africa in particular, there’s a sense of urgency to make sure child stunting doesn’t dim the promise of the demographic dividend and economic growth. As Jamie Cooper-Hohn, Chair of the Children’s Investment Fund Foundation, noted today, “Africa is booming, but estimated to be foregoing over 10 percent in annual GNP due to the permanent damage of stunting resulting from poor child nutrition. With the continent’s population anticipated to quadruple this century, leadership on nutrition is needed now to ensure countries and people can thrive.”

The good news is: Malnutrition is a problem with available solutions. By investing smartly and mobilizing political will, governments can pave the way for Africa’s children to lead the continent forward. We know what to do, we are learning how to do it, and we now need to do it, at scale! We cannot afford to leave behind 30-40% of Africa’s children.
 
*Today’s roundtable was organized by the Children’s Investment Fund Foundation, World Bank Group, and the African Union. Participants also included senior ministers from Cote d’Ivoire, Guinea, Kenya, Mali, Nigeria, Rwanda, and Tanzania.

Follow the World Bank health team on Twitter: @worldbankhealth.

Related
World Bank and Africa
World Bank and Nutrition
Children’s Investment Fund Foundation
African Union

Comments

Submitted by Patricio V Marquez on

Thaks Meera for sharing this blog on a critical challenge that requires priority attention to support human capital accumulation in countries. We need to realize that stunted children are not only physically impaired but more importantly they suffer cognitive impairments the rest of their lives. And that while nutrition-related interventions do help, we need to keep in mind that we should tackle undernutrition via different entry points to generate a combined impact: from facilitating access to safe water to prevent gastrointestinal infections that impair the absorption of nutrients, breastfeeding promotion to strengthen the immune systems of the baby, vaccines and deworming measures, hygienic practices, to basic sanitation practices, including latrine construction and promotion about their use to prevent open defecation in a community. The latter is indeed a critical investment to secure good nutrition for two reasons as shown by recent research. The first and most commonly recognized mechanism is diarrhea from digesting feces. The second, which is only recently becoming understood, is a disorder of the intestine caused by continued fecal exposure. This condition called chronic environmental enteropathy prevents absorption of nutrients, even without the child getting diarrhea and appearing ill. (Checkley et al. 2008 and Humphrey 2009).

Submitted by Enabu Joseph Maurice on

Thanks for the commitment of Political leaders towards the fight against malnutrition. It is now the tasks of technical officers to be fully involved in the implementation at all levels in the community. In Uganda, the Uganda Nutrition Action Plan is being implemented at Local Governments by the District and Subcounty Nutrition Coordination Committes.

Thanks Enabu. It is wonderful to see the high level commitment in Uganda and several other Countries. The world bank team stands is working closely with the country teams to help translate this political commitment in to action at scale so we can achieve the dream of a world free of poverty and malnutrition. We depend on the technical expertise in the countries and work hard to build this capacity so the programs can be designed in-country by local experts, owned by them and implemented by them. The Uganda Nutrition Action Plan is an excellent example of this collaboration. We look forward to the partnership in implementing it and monitoring and documenting results on the ground. 

Submitted by Dr. Sridevi on

thanks meera for the excellent information on the world bank. the initiativies taken by the world bank as well as the African Nations is laudable. It is time for the indian Government as well to tackle this problem in India. Nearly half of the child population in India are malnourished and the steps taken are not sufficient and more steps need to be taken by the Indian government also to tackle this problem and act early to prevent the devastating affects of malnutrition on the future generations.

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