Worldwide, 3.5 million children under the age of five die each year from under nutrition. In the Asia-Pacific region alone around 5 million children five and under are under weight and at risk of developing preventable disease and illness. (Photo courtesy of World Vision)

Healthy Kids, Healthier Nation


APRIL 10, 2015

It took three days to walk to a village in the far western corner of Nepal. At the school playground, children age two to five were surprisingly chubby, their hair a brownish color.

Prior to the trip, I’d been warned. Children had health problems in this area. But the children I watched playing seemed alright. As it turns out, I was being deceived.

A health specialist quickly explained the children’s faded hair and their extended bellies were due to severe malnutrition.

This was my first direct encounter in 2003. Since then, I’ve met countless other malnourished children across Asia and the Pacific. They’ve all left a deep impact on me. It’s critical we explore ways to address this situation that has devastating consequences on their lives.

The problem with malnutrition persists in many developing nations and statistics are showing increasing trends of malnutrition in Asia Pacific countries especially.

And malnutrition among children is not something found only in remote villages.

In my recent trip to Indonesia, I visited an urban settlement in Jakarta. There, I met Rukmiyat Yayat, a grandmother in the neighborhood of Cilincing in North Jakarta, who has monitored children’s health for more than 25 years. She shared that she’s seen the number malnourished children decline in her neighborhood but confirmed that the problem still haunts many families.

Lack of awareness, neglect and a complex web of other issue sallow malnutrition to persist Rukmiyat told me and no single entity can resolve it, despite improved efforts from the government and aid organizations.

Globally, under nutrition is affecting every nation and its effects are staggering. According to the World Health Organization, some 53 million children under five-years-old are under weight in Asia and the Pacific alone in 2013. Globally, 3.5 million children under five die every year due to under nutrition.

In financial terms, the damage to a nation’s wealth is enormous. According to a 2014 paper by the World Bank, individuals who are under nourished in their early years lose more than 10 percent of lifetime earnings, and many countries lose at least two to three percent of their gross domestic product to under nutrition. In terms of health care dollars, under nutrition is placing a heavy burden on governments.

What’s being done about the issue?

Over the past decade, malnutrition has been a highlighted by many governments and UN agencies. Indeed, many nations in Asia-Pacific have made progress in combatting the number of children who are underweight or stunted. However, others are still struggling with high numbers of under nourished children.

What’s worse, Unicef data highlights how child wasting — a more acute form of child under nutrition — has grown in the last 15 years, with higher rates of wasted children detected in Bangladesh, China, India, Indonesia, Nepal, Papua New Guinea, the Philippines, Sri Lanka, Thailand and Vietnam.

The increasing rates are deeply concerning as nearly every nation has experienced growth in gross domestic product in the past 15 years. Simply put, the fast developing world is leaving the most vulnerable children behind.

Can anything be done to stop the trend?

Numerous practices have been established and proven, but most need to be expanded. Increased investment and rights-based policies are important. Still, there are other issues such as education, social norms, and culture that contribute towards this problem and needs to be addressed.

At World Vision, we believe three key measures can be taken to help nations accelerate their response to child undernutrition.

First, it’s vital that governments ensure adequate funding and improved policies are addressing their nation’s children and protecting them from malnutrition.

Second, multisectoral partnerships and people’s participation can help to effectively implement government policies and empower citizens to address issues of malnutrition and its impact on children.

Children and their parents should be able to understand the needs and importance of balanced nutrition. Sometimes, the problems lie in not knowing. Once parents realize that their children need better meals, they can find ways to make it happen according to their capabilities and context.

For example, the Scaling Up Nutrition (SUN) movement unites people—from governments, civil society, the United Nations, donors, businesses and researchers—to improve nutrition.

Within the SUN movement, national leaders prioritize efforts to address malnutrition. Countries are putting the right policies in place, collaborating with partners to implement programs with shared nutrition goals, and mobilizing resources to effectively scale up nutrition, with a core focus on empowering women.

However, local context matters.

A solution in East Nusa Tenggara may not be effective for citizens in Nepal. It is important to involve everyone as a part of the solution based on the food availability in the area. A social accountability approach is adopted by World Vision and being implemented across Asia and the Pacific called Citizen Voice and Action.

It aims to improve dialogue between communities and government to improve services, such as health and education, that impact the daily lives of children and their families. Social accountability refers to civic engagement by communities designed to improve the performance of government.

The third way to address malnutrition is to create targeted programing for the most vulnerable communities. Interventions should target behavior change, micronutrient and deworming interventions and complementary and therapeutic feeding programs.

The heart of World Vision’s global health and nutrition intervention is a package of preventive interventions targeted to mothers and children under two years old.

As the world moves to the end of the Millennium Development Goals, international development organizations are calling for zero-based goals in the next sustainable development goal agenda, including the elimination of preventable maternal, newborn and child deaths and of hunger.

This means that the most vulnerable, especially children, who have been left behind in the MDG era, need to be reached. When countries aspire for growth in development they cannot undermine the well-being of their children.

Innovative solutions exists but there needs to be scaled up. The effort needs to be given more attention to battle child malnutrition. Countries in Asia and the Pacific should invest in ending this horrible condition affecting too many children.

Deepesh Thakur is the regional advocacy lead for World Vision in South Asia and the Pacific. Originally from Nepal, he’s worked in Mongolia and, now, the Philippines, with frequent travel across Asia. He provides strategic leadership in the areas of Advocacy and Justice for South Asia and Pacific countries.