Younger mothers and widows
Pregnant and lactating women and young children less than three years are most vulnerable to malnutrition.
Scientific evidence has shown that beyond the age of 2-3 years, the effects of chronic malnutrition are irreversible. This means that to break the intergenerational transmission of poverty and malnutrition, children at risk must be reached during their first two years of life.
Child malnutrition is the single biggest contributor to under-five mortality due to greater susceptibility to infections and slow recovery from illness.
Children who do not reach their optimum height or consistently experience bouts of weight loss during childhood are affected in the long term in numerous ways. They do not reach their optimum size as adults (and so may have less physical capacity for work), their brains are affected (resulting in lower IQs) and they are at greater risk of infection (which kills many children during their early years).
Child malnutrition impacts on education attainment. The degree of cognitive impairments is directly related to the severity of stunting and Iron Deficiency Anaemia. Studies show that stunted children in the first two years of life have lower cognitive test scores, delayed enrolment, higher absenteeism and more class repetition compared with non stunted children. Vitamin A deficiency reduces immunity and increases the incidence and gravity of infectious diseases resulting in increased school absenteeism.
Child malnutrition impacts on economic productivity. The mental impairment caused by iodine deficiency is permanent and directly linked to productivity loss. The loss from stunting is calculated as 1.38% reduced productivity for every 1% decrease in height while 1% reduced productivity is estimated for every 1% drop in iron status (source Haddad and Bouis, 1990).
Maternal malnutrition increases the risk of poor pregnancy outcomes including obstructed labour, premature or low-birth-weight babies and postpartum haemorrhage. Severe anaemia during pregnancy is linked to increased mortality at labour.
Low-birth-weight is a significant contributor to infant mortality. Moreover, low birth-weight babies who survive are likely to suffer growth retardation and illness throughout their childhood, adolescence and into adulthood. Growth-retarded adult women are likely to carry on the vicious cycle of malnutrition by giving birth to low birth-weight babies.
Computer software called PROFILES has been created by the Academy for Educational Development (AED) to calculate the magnitude of malnutrition in terms of mortality, morbidity, mental capacity and economic productivity. The impact is calculated over a ten-year period and is based on the prevalence data from National Demographic Health Surveys. Costs and benefits can be quantified to provide the cost-benefit ratio of high impact nutrition interventions. Findings are then used as a basis for advocacy and awareness raising with politicians, institutional providers, donors and the general public.