Nutrition in Asia-Pacific shows mixed progress

Stunting is declining globally among children under 5 years old. But a few countries in the Asia-Pacific continue to record high rates, with some showing an increase over the past decade. Meanwhile, in some countries in the region where stunting is on the decline, the prevalence of wasting has increased, according to the latest data from the Asian Development Bank’s key indicators for the Asia-Pacific. Here are three data points on nutrition in the region that stand out in the report: 1. Prevalence of stunting is highest in East Timor Data from the ADB report shows stunting rates in East Timor declined from 55.7% in 2002 to 50.9% in 2013. While still high, this reduction is significant given the challenge of addressing stunting due to its inter-generational aspect, said Rukshan Ratnam, communications specialist at UNICEF East Timor. Stunting starts with the nutritional status of a mother, particularly if she becomes pregnant while suffering from anemia and malnutrition. An infant’s poor diet exacerbates their risk for stunting, which Ratnam said becomes irreversible after 2-years-old. “While food insecurity is one of the significant causes of undernutrition, the lack of access to quality water, hygiene, and sanitation leads to diarrhea, also contributing to under-nutrition. For example, in general, 25% of stunting can be attributed to 5 or more episodes of diarrhea among children under-five,” he told Devex. Some of the activities that UNICEF and other partners are working with the government of East Timor to prevent stunting include raising awareness on proper nutrition among parents and caregivers; the promotion of breastfeeding — exclusive for the first 6 months, and then combined with food for at least up to 2 years of age for the child — and the provision of micronutrient supplements. “We also support the expansion of health infrastructure and services and support greater community engagement to address all forms of malnutrition. Importantly, we are coordinating with other sectors — agriculture, public works, education, amongst others — toward addressing the wide range of contributing factors to malnutrition,” Ratnam said. 2. Prevalence of stunting decreased for most countries, except Malaysia, Papua New Guinea, and Vanuatu Stunting prevalence in most countries in Asia-Pacific decreased between 2000 and 2016, with the biggest declines in several countries in Central Asia, as well as China and Mongolia in East Asia. But data showed an increase in stunting prevalence in Malaysia, Papua New Guinea, and Vanuatu. A number of factors contribute to stunted growth and development, including poor maternal health and nutrition during and post-pregnancy, inadequate infant and young child feeding practices, and the presence of severe infections that lead to wasting, said Dr. Juliawati Untoro, technical lead for nutrition at the WHO Regional Office for the Western Pacific. However, further analyses are needed, including possibly at subnational levels, to determine what’s driving the stunting rates in these countries, she said. 3. In contrast, the prevalence of wasting increased in 11 countries While similar factors contribute to wasting and stunting, both issues tend to be addressed separately, Untoro said. “Wasting indicates an acute malnutrition ... while stunting is a chronic malnutrition. The prevalence of wasting can increase during [a] crisis, emergency etc. and if the situation lasts long, it may result [in a] high prevalence of stunting,” she said. “There were cases [of] children exposed to short episodes of wasting from which they quickly recover, to those experiencing much longer periods spanning a number of months,” she added. This focus area, powered by DSM, is exploring innovative solutions to improve nutrition, tackle malnutrition, and influence policies and funding. Visit the Focus on: Improving Nutrition page for more.