Today, around 21,000 children died around the world
Today, around 21,000 children died around the world. How about they give a damn more about all these children first?
That is equivalent to:
1 child dying every 4 seconds
14 children dying every minute
A 2011 Libya conflict-scale death toll every day
A 2010 Haiti earthquake occurring every 10 days
A 2004 Asian Tsunami occurring every 11 days
An Iraq-scale death toll every 19–46 days
Just under 7.6 million children dying every year
Some 92 million children dying between 2000 and 2010
The silent killers are poverty, hunger, easily preventable diseases and illnesses, and other related causes. Despite the scale of this daily/ongoing catastrophe, it rarely manages to achieve, much less sustain, prime-time, headline coverage.
From UNICEF, the world’s premier children’s organization, part of the United Nations:
2.5 billion people lack access to improved sanitation
1 billion children are deprived of one or more services essential to survival and development
148 million under 5s in developing regions are underweight for their age
101 million children are not attending primary school, with more girls than boys missing out
22 million infants are not protected from diseases by routine immunization
7.6 million children worldwide died before their 5th birthday in 2010
4 million newborns worldwide are dying in the first month of life
2 million children under 15 are living with HIV
>500,000 women die each year from causes related to pregnancy and childbirth
Social, Political, Economic and Environmental Issues That Affect Us All
World Child Hunger Facts
Nutritious foods in adequate amounts are essential for everyone but particularly for children. In early childhood, adequate nutrition can ensure healthy growth, proper organ formation and function, a strong immune system, and neurological and cognitive development. Nutrition, too, has increasingly been recognized as a basic pillar for social and economic development. Well-nourished people can learn new skills, think critically and contribute to their communities. Improving child nutrition impacts global, national and regional child survival, primary education, women’s empowerment, and maternal and child health rates.
On the flip side, child malnutrition hurts cognitive function and contributes to poverty by impeding people’s ability to lead productive lives. Poverty is the leading cause of hunger, but poverty also results from hunger, in a cyclical relationship. In spite of the importance of childhood nutrition and significant progress in the last 25 years, global childhood hunger is still rampant.
Overall, 5.6 million children under age five died in 2016, nearly 15,000 daily (World Health Organization [WHO], 2016). The risk of a child dying before five years of age is highest in Africa (76.5 per 1000 live births), about 8 times higher than in Europe (9.6 per 1000 live births) (WHO, 2016).
Approximately 3.1 million children die from undernutrition each year (UNICEF, 2018a). Hunger and undernutrition contribute to more than half of global child deaths, as undernutrition can make children more vulnerable to illness and exacerbate disease (UNICEF, 2018a).
Children who are poorly nourished suffer up to 160 days of illness each year (Glicken, M.D., 2010). Undernutrition magnifies the effect of every disease including measles and malaria. The estimated proportions of deaths in which undernutrition is an underlying cause are roughly similar for diarrhea (61%), malaria (57%), pneumonia (52%), and measles (45%) (Black, Morris, & Bryce, 2003; Bryce et al., 2005). Malnutrition can also be caused by diseases, such as the diseases that cause diarrhea, by reducing the body’s ability to convert food into usable nutrients (Black, Morris, & Bryce, 2003; Bryce et al., 2005)
66 million primary school-age children attend classes hungry across the developing world, 23 million whom live in Africa, which greatly impacts their ability to learn (World Food Programme [WFP], 2012).
Source: Mercy Corps, 2018
UNDERSTANDING CHILDHOOD MALNUTRITION
STUNTING (children significantly below standard height for their age)
Globally, about 151 million under-five-year-olds are estimated to be stunted in 2013.(UNICEF, WHO and The World Bank, 2018).
The global trend in stunting prevalence and numbers affected is decreasing. Between 2000 and 2017, stunting prevalence declined from 33% to 22% and numbers declined from 198 million to 151 million (UNICEF, 2018a). However, the regions of West and Central Africa have actually seen an increase in numbers of stunted children – from about 23 million to 29 million (UNICEF, 2018a).
In 2017, about half of all stunted children lived in Asia and over one third in Africa (UNICEF, WHO & The World Bank, 2018). Stunting is a public health problem but often goes unrecognized.
UNDERWEIGHT (children significantly below standard weight for their age)
Globally, 99 million under-five-year-olds were underweight in 2013, most of whom lived in Asia and Africa (Krasevec et al., 2014). The global trend in underweight prevalence continues to decrease; going from 25% to 13.5% between 1990 and 2017 (The World Bank, 2017).
The underweight prevalence in Africa decreased from 23% in 1990 to 17% in 2013, while in Asia, for the same period, the prevalence was reduced from 32% to 18%. In Latin America and the Caribbean the underweight prevalence decreased from 8% to 3% (Krasevec et al., 2014).
WASTING (children significantly below standard height to weight ratios)
Globally, 51 million under-five-year-olds were wasted and 16 million were severely wasted (UNICEF 2018a)
Wasting prevalence is estimated at 7.5% and severe wasting prevalence at 2.4% (UNICEF, 2018a).
Wasting in the under-five-year-olds group decreased by 13% from 1990 to 2013.
In 2017, approximately two thirds of all wasted children lived in Asia (mostly in South-Central Asia) and about one-quarter in Africa, with similar proportions for severely wasted children (UNICEF, 2018a)
MICRONUTRIENT DEFICIENCIES (Micronutrient – vital minerals and vitamins – deficiencies are caused by disease or inadequate consumption of nutritious foods).
Vitamin A deficiency affects about a third of children in low and middle-income countries, which increase a child’s risk of contracting infectious diseases by weakening the immune system (UNICEF, 2018b).
Zinc deficiency in low-income countries affects the immune and gastrointestinal systems, contributing to a major cause in under-five deaths – diarrhea (UNICEF, 2018b).
About 30% of the world’s population lives in areas where diets do not contain sufficient amounts of iodine, resulting in poor brain development (UNICEF, 2018b). The lack of micronutrients in children can be greatly influenced by the mother’s health, especially during pregnancy. In low-income countries, pregnant women who are malnourished may lack essential micronutrients for fetal development, such as iodine, zinc, iron, folate and vitamin D (Gernand et al., 2016).
For example, low iron in the mother can result in low birthweight of the infant, increasing the infant’s susceptibility to disease, a known contributor in the cycle of malnutrition (Gernand et. al., 2016).
According to UNICEF (2018b), about 40% of pregnant women and 40% of children under five years of age in developing countries are anemic, half of whom are estimated to be iron deficient.
THE DOUBLE BURDEN OF MALNUTRITION (The coexistence of undernutrition and overnutrition within individuals, families or populations)
Malnutrition encompasses both undernutrition and overnutrition. Some countries face this double burden of malnutrition, where undernutrition occurs along with overweight, obesity or diet-related diseases (WHO, 2017).
In some countries, like Egypt, Iraq and Vanuatu, for example, stunting is greater than 20% of their under-five population, while adult obesity is greater than 20% (FAO et al., 2017).
This double burden is becoming increasingly common in low and middle-income countries (WHO, 2017).
Globally, about 41 million children under five years old were overweight or obese (WHO, 2017).
About 155 million children under five years old were chronically undernourished (WHO, 2017). *
Undernourishment is a general term for receiving insufficient food and nutrients for growth (Merriam-Webster, 2018). It may lead to a child being underweight, a term that describes an individual below the median body measurements (weight for age) for a population (UNICEF, n.d.).
Source: WHO, 2018
What are some contributors? Early life nutrition. The amount of nutrition received during the fetal development period can determine much of the child’s future health (WHO, 2017).
o Low birthweight infants are at higher risk for metabolic disease (conditions that include high cholesterol and high blood sugar) (WHO, 2017).
o On the other hand, women who are overweight during pregnancy may have infants with larger weight, placing them at greater risk for obesity later (WHO, 2017).
Socioeconomic status and inequality. Low socioeconomic status impacts a family’s ability to buy adequately nutritious food (WHO, 2017).
While upper and middle-income countries have the highest prevalence of overweight, the prevalence in low and middle-income countries is still sizeable ¬– between 10% and 30% (WHO, 2017).
Food Systems. Diets high in saturated fats, salt and sugar are becoming more prominent, replacing nutritious diets, as they are sometimes more affordable or accessible (WHO, 2017).
Source: (GAIN) https://www.gainhealth.org; Global Nutrition Report 2015 The prevalence of stunting, wasting and underweight among children under-five years of age worldwide has significantly decreased since 1990. This is good news, but overall progress on malnutrition is insufficient, and millions of children remain hungry. Any child suffering from these conditions is at substantial increased risk of severe, acute malnutrition, illness and death.
COMBATING CHILD HUNGER
Medical Treatment of Child Malnutrition
While some hunger prevention practices involve better access to nutritious foods and health care, as well as improving water and sanitation, short-term solutions for severe undernutrition commonly use ready-to-use therapeutic food (RUTF). Used to treat undernourished children under five years of age, RUTF is ideal for treatment at home; it contains micronutrients, does not need to be cooked, and can be stored for a long time (UNICEF, 2015).
Large Scale Approaches
In the 2030 Agenda for Sustainable Development, the United Nations sets global goals to eradicate extreme poverty and hunger (FAO et al., 2017).
Approaches by international organizations and programs to combat child hunger in lower-middle-income countries involve agriculture sustainability; emphasis on maternal health, education and empowerment; community and household education on nutrition; and partnerships with governments to fortify micronutrient levels in food.
Below are examples of some of the work in eradicating child hunger:
UNICEF (UNICEF, 2018b) Community-based approach to promote breastfeeding and encourage diet diversity, involving a variety of local foods; Vitamin A supplementation programs for children under-five-years old; Support of government programs to supplement iron folic acid supplementation during pregnancy to ensure proper fetal development; Support governments in implementing mass food fortification – for example, universal salt iodization.
World Food Programme (WFP, 2018) Invest in the agricultural supply chain and rural infrastructure (roads to transport food and ways to store food); Encourage the expansion of social protection (in some countries, in the form of cash transfers) for the poorest 2 billion in the world, creating the potential for economic growth so that poor households can afford proper food and medical care.
Action Against Hunger (Action Against Hunger, 2017) Provision of local, accessible outpatient treatment for undernourished children (community management of acute malnutrition – CMAM); Educating and supporting mothers in best feeding practices to ensure healthy child development; Ensuring access to supplementary foods for particularly vulnerable populations; Capacity building by training health workers to treat undernutrition and working to strengthen local health care systems. (Updated July 2018 with the assistance of Crystal Lam, George Washington University, MPH candidate) References
Action Against Hunger. (2017).
Nutrition and health. Retrieved from https://www.actionagainsthunger.org/impact/nutrition. Glicken, M. D. (2010). Social work in the 21st century: An introduction to social welfare, social issues, and the profession. Thousand Oaks, CA: Sage. Black, R. E., Morris, S. S., & Bryce, J. (2003).
Where and why are 10 million children dying every year?, The Lancet, 361(9376), 2226-2234. Bryce, J., Boschi-Pinto, C., Shibuya, K., Black, R. E., & WHO Child Health Epidemiology Reference Group. (2005).
WHO estimates of the causes of death in children. The Lancet, 365(9465), 1147-1152. FAO, IFAD, UNICEF, WFP and WHO. (2017).
The State of Food Security and Nutrition in the World 2017. Building resilience for peace and food security. Retrieved from https://docs.wfp.org/api/documents/WFP-0000022419/download/?_ga=2.58209514.1314642926.1528665631-1013504369.1528665631. Gernand, A. D., Schulze, K. J., Stewart, C. P., West Jr, K. P., & Christian, P. (2016).
Micronutrient deficiencies in pregnancy worldwide: Health effects and prevention. Nature Reviews Endocrinology, 12(5), 274. International Food Policy Research Institute. (2015).
Global nutrition report 2015: Actions and accountability to advance nutrition and sustainable development. Retrieved from http://www.thousanddays.org/wp-content/uploads/2015-Global-Nutrition-Report.pdf. Krasevec, J., Thompson, A., Blössner, M., Borghi, E., Feng, J., Serajuddin, U. for The United Nations Children’s Fund, the World Health Organization and the World Bank. (2014).
“Levels & trends in child malnutrition – UNICEF-WHO-The World Bank joint child malnutrition estimates”. Retrieved from http://www.who.int/nutgrowthdb/summary_jme_2013.pdf. Mercy Corps. (2018).
Quick facts: What you need to know about global hunger. Retrieved from https://www.mercycorps.org/articles/quick-facts-what-you-need-know-about-global-hunger. The New York Academy of Sciences. (2014, October 23).
Micronutrients: Supplementation, fortification, and beyond. Retrieved from https://www.nyas.org/podcasts/media/podcast/micronutrients-supplementation-fortification-and-beyond/. The World Bank. (2017).
Prevalence of underweight, weight for age (% of children under 5). Retrieved from https://data.worldbank.org/indicator/SH.STA.MALN.ZS?view=chart.
Undernourished. 2018. In Merriam-Webster.com. Retrieved July 14, 2018 from https://www.merriam-webster.com/dictionary/undernourished.
UNICEF. (2015, December 23). Severe acute malnutrition. Retrieved from https://www.unicef.org/nutrition/index_sam.html. UNICEF. (2018a). Malnutrition rates remain alarming: stunting is declining too slowly while wasting still impacts the lives of far too many young children. Retrieved from http://data.unicef.org/topic/nutrition/malnutrition/#.
UNICEF. (2018b). Micronutrients. Retrieved from https://www.unicef.org/nutrition/index_iodine.html.
UNICEF. (n.d.). Definitions: Nutrition. Retrieved from https://www.unicef.org/infobycountry/stats_popup2.html.
UNICEF, World Health Organization, & The World Bank. (2012, September 20). Key facts and figures. UNICEF/WHO/World Bank Group Joint Child Malnutrition Estimates. Retrieved from http://www.who.int/nutgrowthdb/key_facts_figures.pdf.
UNICEF, World Health Organization & The World Bank. (2018, May 14). Levels and trends in child malnutrition. UNICEF / WHO / World Bank Group Joint Child Malnutrition Estimates Key findings of the 2018 edition. Retrieved from http://data.unicef.org/wp-content/uploads/2018/05/JME-2018-brochure-.pdf.
World Food Programme. (2012). Two minutes to learn about: School Meals. Retrieved from https://documents.wfp.org/stellent/groups/public/documents/communications/wfp220221.pdf?_ga=2.263020492.1314642926.1528665631-1013504369.1528665631.
World Food Programme. (2018). Zero Hunger. Retrieved from http://www1.wfp.org/zero-hunger.
World Health Organization. (2016). Global Health Observatory (GHO) data. Retrieved from http://www.who.int/gho/child_health/mortality/mortality_under_five/en/.
World Health Organization. (2017). Policy brief. Geneva: The double burden of malnutrition. Retrieved from http://apps.who.int/iris/bitstream/handle/10665/255413/WHO-NMH-NHD-17.3-eng.pdf;jsessionid=6CC6C4506E1E43112CD1EF845ACC99A1?sequence=1.
World Health Organization. (2018). Nutrition. Retrieved from http://www.who.int/nutrition/double-burden-malnutrition/infographics/en/.