Malnutrition kills over 2.6 million children and renders millions more with lifelong physical and mental impairment each year, mostly in the developing countries. Globally, 171 million children (27% of all children) are stunted, largely due to poor nutrition in the first 1000 days of their lives according to the recent State of the World’s Mothers 2012 report by Save the Children. During this first 1000-day window between the mother’s pregnancy and the child’s second birthday, good nutrition is critical for the development of the child’s brain and body. Investing in prevention of under-nutrition during this critical window can not only save millions of lives, but also usher in generational payoffs by way of ensuring generations of healthy and productive populations contributing to economic prosperity of a country and the world. On the contrary, the lack of good nutrition during this period leads to irreversible mental and physical damage for the children, hindering their ability to reach their full potential and thereby, perpetuating a vicious inter-generational cycle of malnutrition which hinders productivity and growth of nations. Malnutrition costs many developing nations 2-3% of their GDP each year and globally, the direct cost of child malnutrition is estimated at US$20 to US$30 billion per year.

The State of the World’s Mothers 2012 report focuses on this critical first 1000-day window, ranking countries based on success and failure in providing good nutrition during this period. It examines the core factors fanning under-nutrition and through its findings, shares recommendations on how investments in proven, low-cost nutrition solutions can save millions of lives and benefit society as a whole in the long run.

The report throws up some startling and some surprising facts. Out of 73 developing countries which collectively account for 95% of child deaths, more than two thirds are ranked ”fair” or “poor” in providing good nutrition during the first 1000-day window, with Somalia getting the worst ranking. Child stunting rate is over 20% in more than 80 developing countries and above 40% in 30 of them. The report notes that some relatively poorer countries have been tackling malnutrition better than those with greater resources implying that economic growth of nations does not automatically mean lower malnutrition. India, for example, with a per capita income of US$1500 has a child stunting rate of 48% while this rate is much lower at 23% in Vietnam which has a lower per capita income of US$1200. Amongst the developed countries, the report finds the US to have the least favourable environment for mothers who want to breastfeed while Norway tops the list in this regard.

Six simple and inexpensive nutrition interventions, collectively termed the “lifesaving six” which can prevent over 2 million mother and child deaths each year are highlighted. The “lifesaving six” are iron folate, breastfeeding, complementary feeding, vitamin A, zinc and hygiene. Iron supplements strengthen a child’s immunity against disease, lowers maternal mortality and prevents premature births and low birth weight. Exclusive breastfeeding during the first six months leads to a greater than six-fold increase in the chance of a child’s survival. Appropriate complementary feeding reduces the occurrence of stunting. Vitamin A prevents blindness and improves a child’s immunity while zinc and hygiene can save a child from diarrhoea. Although this package of six can be made available at a paltry cost of US$20 per child for the first 1000 days, it is an irony that over 50% of children worldwide do not have access to it.

Investment in health workers, particularly those on the frontline who play the crucial role in reaching and facilitating delivery of the “lifesaving six” to the worst affected mothers and children is absolutely imperative. Overall there is a global shortage of about 3 million health workers with the shortage in frontline health workers being the most acute. An equally important strategy to root out malnutrition is to support girl’s education is every possible way ensuring that more girls go to school and stay in school. Education provides girls with knowledge and confidence, prompting them to marry at appropriate age and have “fewer, healthier and better-nourished children”.

The report gives a clarion call to governments around the world to make fighting malnutrition a national priority and take all steps including the creation of an enabling legal and policy environment, necessary to support the delivery of the proven solutions like the “lifesaving six”. It also strongly recommends promotion of private sector participation and partnerships to increase product choices, improve compliance with standards and promote public awareness about good feeding practices and the “lifesaving six”.

It’s unfortunate to note that many countries are yet to treat addressing issues like malnutrition, child mortality and maternal mortality as a national priority. Only 67% of 121 low and middle income countries had policies to promote breastfeeding. Iron and folic acid supplements and complementary feeding feature in only half the national policies. It is imperative for governments worldwide to realise and accept that malnutrition is the biggest thorn in their efforts towards achieving many of the Millennium Development Goals (MDGs) agreed by UN member states. With just over 3 years left before the 2015 MDG deadline, many countries are falling woefully short of the targets on many counts.

The clock has been ticking and it is high time we act.

Read the report here