Published on Africa Can End Poverty

Invest in nutrition to invest in the future?

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ImageLet's think together: Every week the World Bank team in Tanzania wants to stimulate your thinking by sharing data from recent official surveys in Tanzania and ask you a couple of questions. This post is also published in the Tanzanian Newspaper The Citizen every Sunday.

Malnutrition has detrimental effects on a child's physical growth (stunting); it can also result in irreversible damage to their brain and mental development, and it increases their risk to illness and death. The biggest impact of malnutrition is seen in the first 1,000 days of life of a child's life - from the time of conception to the time they reach their second birthday.

For women, malnutrition increases risk during pregnancy and the delivery of low birth weight babies. Malnutrition is a serious issue in Tanzania as shown by the following statistics:

  • In 2010, more than 3 million (42 per cent) of Tanzanian children under five years of age were physically stunted.
  • Between 2004/05 and 2010 stunting in children under five years of age only marginally declined only from 44.3 to 42 per cent.
  • 59 per cent of children are anaemic – a significant proportion inherited it from their mothers who suffered from iron deficiency during pregnancy.
  • 40 per cent of women of childbearing age are anaemic compared to just 17 per cent in Rwanda, 19 per cent in Burundi and 29 per cent in Kenya.
  • 42 per cent of households consume inadequately iodised or non-iodised salt which puts unborn children at risk of significant irreversible brain damage whereas this is only the case in 2 per cent of Kenyan households and 4 per cent of Ugandan households.
  • What and how much we eat is partly determined by our income and education levels. Tanzania children in the poorest quintile are 80 per cent more likely to be stunted than children in the richest quintile. A child whose mother has secondary education is twice less likely to be stunted than one whose mother has no education.


Nevertheless, wealth and education are no guarantee against malnutrition. One out of four children from the wealthiest families are stunted and children whose mothers have secondary education are just as likely to be anemic as children from the poorest households or whose mothers received no education. A child may end up malnourished despite eating ‘enough’ at every meal every day. This is especially so if the child frequently falls ill e.g. with diarrhea, malaria or pneumonia; if the young infant was given other foods or liquids instead of breast milk before the age of six months, if the infant or young child only eats three or fewer times a day or if the meals do not contain enough nutrient rich foods like fruits, vegetables and animal products such as meat, fish, milk and eggs. Children may also end up malnourished if their mothers were not well fed during pregnancy, were anaemic, ill or did not get enough rest.

Other factors that influence a child's risk of malnutrition include poor access to health services, poor hygiene practices, household food insecurity, and poor access to clean water. Although a decline in poverty levels and improved education outcomes could reduce malnutrition to some extent, these factors will take time and are unlikely to be sufficient. The good news is that malnutrition can be prevented through simple interventions targeted towards women of child bearing age and children within the first two years of life. Even better news is that investments in nutrition, such as the national fortification programme in Tanzania, have proven to have high economic returns at the national level.

  • Are you surprised by the extent of malnutrition in Tanzania which is a predominantly agricultural country with plenty of foods, including fish and livestock?
  • Can malnutrition be reduced without targeted programs?
  • Are Tanzanians sufficiently informed about the consequences of their eating habits? Why do households consume poorly iodised salt?
  • Should public policies to create a more enabling environment for good nutritional practices be enacted and enforced?
  • Who should take the lead? The Government? Households? Communities? Partners? 

Sources: Demographic and Health Survey 2010 


Jacques Morisset

Lead Economist and Program Leader, World Bank

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