Mortality of children under five years declined from circa 12 million to less than seven million between 1990 and 2011. Similarly, the number of children enrolled in primary school is up by 40 million worldwide. However, progress in human development is at risk of stalling and even reversing.
According to the ‘Global Burden of Diseases, Injuries and Risk Factors Study’, an estimated 37 per cent of children under five were stunted in sub-Saharan Africa in 2015. Stunted children often endure painful and debilitating cycles of illness, depressed appetite, insufficient food and inadequate care. Children who survive carry long-term deficits in cognitive capacity.
President Yoweri Museveni understands the gravity of the malnutrition crisis. Writing the foreword to Uganda’s Nutrition Action Plan, Museveni notes, “Malnutrition also impairs educational achievements and economic productivity, costing the government and families enormous amounts of money to treat related illnesses.”
In a survey of 350,000 children in Kenya, Uganda and Tanzania, Uwezo, an education advocacy organisation, found that two out of every three children in Grade 3 failed to pass basic tests in English, Kiswahili or numeracy set at the level of Grade 2. The study also revealed that children from poor households, who were more likely to be malnourished, perform worse on all tests at all ages
Similarly, a report by the Save the Children Fund revealed that compared with normal children, stunted children: Score seven per cent lower on math tests; are 19 per cent less likely to be able to read a simple sentence at age eight; are 12 per cent less likely able to write a simple sentence; and are 13 per cent less likely to be in the appropriate grade for their age at school.
Stunted children will suffer myriad maladies associated with stunting. They will underachieve in school and will not achieve their full productivity and earning potential in life. It is also likely that their own children will be malnourished and as adults they will be susceptible to chronic diseases in adulthood.
While there is consensus on the consequences of malnutrition on health and cognitive capacity, our understanding of the aggregate effect on the economy and society is just beginning to emerge.
Poor nutrition in childhood, including in utero, can have long-term impacts on productivity and lifetime earnings. In Ethiopia, according to the ‘Cost of Hunger in Africa’ report, the economic losses due to undernutrition represented about 12 per cent of Ethiopia’s GDP in 2009.
Invariably, stunted underachieving children will contribute to a growing underclass, with all the attendant consequences of inequality, heightening the risk of radicalisation and recruitment into local gangs.
The plight of these underachieving children begins before birth, with a malnourished mother. Undernutrition among pregnant women in developing countries leads to one out of six infants born with low birth weight.
We must take a life cycle approach and pay attention to the importance of adequate nutrition for women, especially adolescents, before they become pregnant to reduce the risks of child growth failure associated with malnutrition. Adequate nutrition must become a birthright of every child.
Alex O. Awiti is the Vice Provost and director of the East Africa Institute at Aga Khan University