My friend’s son – let’s call him Mark – proudly shows me the latest line on the door frame of his room, where his height has been recorded since he was two. He is now 120cm tall, and is really excited about it. Every new level recorded on the door over the last couple of years seems to capture a world of potential future achievements. Clearly, he is going to be able to reach for the stars by just lifting himself up on tiptoe.
The gradual reduction of malnutrition in some of the world’s poorest countries is equally exhilarating. Since the last Universal Children’s Day in November 2014, many countries have recorded impressive reductions in the proportion of children affected by stunting, the kind of poor growth which results in children being too short for their age. In Ghana, the latest national survey showed that just 19% of children under five are now stunted, compared to 35% eleven years previously. In India, the government’s latest Rapid Survey on Children found just 39% of children stunted, compared to 48% eight years earlier. The size of India makes this change truly momentous.
Just as for my young friend Mark, these notches of progress open up whole new vistas of opportunity, previously unimaginable. Promoting better growth in childhood – and in the womb – is not about creating nations of giants. We understand that good early nutrition is fundamental to the promotion of health at all ages, to optimising learning, and to attacking poverty at its roots.
The 2010 Global Burden of Disease study found that child and maternal undernutrition risks collectively accounted for 7% of the world’s entire disease burden. And in western, central, and eastern sub-Saharan Africa, being underweight remains the single largest risk factor for a child, with inadequate breastfeeding and iron deficiency coming third and fourth, respectively.
With these kinds of linked risks, it is absolutely impossible that the world could achieve the third Global Goal of ensuring healthy lives for all at all ages without a major focus on nutrition.
The same is true for the fourth Global Goal on quality education. Studies from Brazil, Guatemala, India, the Philippines, and South Africa have shown low birth weight increases the risk of not completing secondary school by 22%, and that, independent of this, better growth in early childhood is associated with a 26% lower risk of leaving school early.
In fact, maternal and early childhood nutrition literally shapes the young infant’s brain, allowing it to benefit from early stimulation and get ahead on the learning ladder. Without early investments in nutrition, hundreds of millions of dollars of investment in education will be wasted, as undernourished children’s brains will be unprepared to learn. Nutrition’s impacts on education also have predictable impacts on poverty. In a study of Guatemalan adults tracked for more than 25 years since the late 1960s, being stunted in childhood was associated with a halving of household spending and a 42% increase in household poverty. As Akinwumi Adesina, president of the African Development Bank once said, an investment in nutrition truly is an investment in the world’s “grey infrastructure”.
Every one of the lines on young Mark’s door frame is a result of the nutritious foods that his parents give him. He is fortunate that the healthy environment he lives in means that most of these nutrients are effectively utilised by his body. For the same opportunities to be seen in the world’s poorer countries, governments and development partners will need to invest in better food, better feeding practices, and protection from illness. With this combination of interventions in place, today’s children will all be able to reach for the stars.
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