The Cost of Malnutrition

An estimated 180 million children under the age of five years in the world are about 15 cm shorter than their peers. This phenomenon is not caused by genetics or disease, but a condition called stunting. Stunting is caused by chronic nutritional deficiencies during the first 1,000-day window of a child’s life.

According to the World Health Organization, around 35% of children under five in Kenya are stunted through malnutrition, with food insecurity widespread in many rural parts of the country. Similarly, a food security, vulnerability and nutrition assessment conducted by the government of Kenya in 2010 revealed that more than 25% of urban children were stunted while 13% of urban households had unacceptably low levels of food consumption.

A new report, Food for Thought, by Save the Children shows that malnutrition is the underlying cause of 2.3 million children’ deaths a year and contributes to failures in cognitive and educational development for millions more. The report notes that the poorest 40% are 2.8% more likely to suffer long-term effects of malnutrition than the richest 10%.

When you consider that a lack of adequate nutrition can cause a five-year-old to lose up to 15 cm growth, it is hardly surprising that the effects of malnutrition would undermine the immune system and cause permanent cognitive impairment, limiting an individual’s capacities and opportunities throughout life. A report by Uwezo, an education advocacy group, revealed that among standard 3 pupils only 28% from the poorest households had achieved expected numeracy and literacy, compared to 48% in the richest households among grade 3 pupils.

The report by Save the Children identifies for the first time the impact of malnutrition on educational outcomes.  Compared to normal children, stunted children: are 19% less likely to be able to read a simple sentence; score 7% lower grades on math tests; are 13% less likely to be in the appropriate grade for their age at school. The report further argues that the effects of malnutrition on cognitive development, physical stature and ability to do physical work can trap children in poverty and cause enduring social and economic inequality.

The Cost of Hunger in Uganda launched on June 18, 2013 shows that some 15% of all child mortality cases in Uganda are attributable to malnutrition. 7% of repeated school years in Uganda are associated stunting costing the education sector about $9.5 million. The report estimates that premature mortality associated with malnutrition reduced Uganda’s labor force by 3.8%, costing the country $317 million. The study also found that treating diarrhea, anemia, respiratory infections and other diseases related to malnutrition cost Uganda $254 million, while losses in productivity reached $201 million in manual sectors like agriculture and $116 million in non-manual activities. What is most disconcerting, according to the report, is that malnutrition in the first 1,000 days has reduced Uganda’s national income by 5.6%

These depressing statistics are not unique to Uganda. Given the similar prevalence patterns for poverty, hunger, stunting and learning outcomes these statistics represent the broad patterns, which obtain in Kenya and other African countries. Although IMF, the World Bank and AfDB have projected rapid economic growth, malnutrition could be the tripwire that stymies Africa’s growth momentum; stifling human flourishing and undermining long-term equitable economic growth.

The negative effects of malnutrition on education achievement, labor productivity, per capita income, income inequality and life expectancy in our society will in turn generate increased governance problems, reduced economic growth and political instability. Investing now in robust nutrition interventions, along with policy reform to address underlying causes of malnutrition, would enable millions of children in Kenya to develop into healthy and productive members of society.

Malnutrition robs future generations of their earning potential and stands in the way of Kenya’s economic development. All stakeholders must understand the link between nutrition and learning achievement, and ensure that nutrition is integrated as a critical component of both early childhood education and the free primary education program.  Investments in nutrition at the national level are limited and nutrition often falls in the cracks, between agriculture and health, with no political or institutional constituency.

Kenya should introduce a targeted conditional cash transfer program for poor mothers of children younger than 7 years who comply with specific nutrition, health and education-related conditions. These should include prenatal and postnatal visits, immunization, health check-ups, growth monitoring and participation in health educational programs. We must secure the future for posterity, our children.