Early Childhood Nutrition (SDG 2)

Two common metrics to assess hunger and malnutrition in children under five years of age are stunting (low height for age) and wasting (low weight for height), as measured against the WHO Child Growth Standards (CGS) which identify how children should grow in optimal conditions.[1]

Stunting, or shortness, is a sign of long-term insufficient macronutrient intake and is exacerbated by recurrent and chronic illness, leading to a child’s lack of growth. Stunting generally occurs during the 1000-day period that spans from pregnancy to a child’s second birthday. Without interventions, stunting can lead to lifelong consequences including delayed motor development, impaired cognitive function and higher risk of metabolic and chronic diseases.[2] To eliminate stunting, underlying determinants of undernutrition need to be addressed, including poverty, access to health care and services (maternal health, treatment of acute and infectious diseases), improved water sanitation and women’s education and empowerment.[3]

Wasting, or thinness, is a symptom of recent and acute nutritional deficit and/or severe disease, resulting in rapid weight loss or the failure to gain weight normally. It is closely linked to high mortality risk and infectious disease, and can also lead to long-term developmental delays in survivors. Wasting requires urgent interventions and can be reversed with refeeding and timely treatment of severe infections.[4] It shares similar root causes with stunting.

In Yemen, the rates of stunting among children under five reached alarming levels in 2013. In rural areas of the country, a statistically significant difference could be seen between children with and without disabilities, whose respective rates of stunting stood at 64.2 and 51.5 per cent. Regarding wasting, the national rates for children with and without disabilities were 39.2 and 15.9 per cent. An even more pronounced difference could be seen between girls with and without disabilities in the country, as the rate of wasting reached 51.4 per cent among the former, but only 14.7 per cent among the latter. It should be stressed that the continuing conflict in Yemen has with all certainty caused the situation to further deteriorate since 2013. While similar data on stunting and wasting are available for Egypt, there are no statistically significant differences between children with and without disabilities.

Malnutrition can result in disabilities. However, research suggests that the reverse is also true, where disabilities lead to a higher risk of malnutrition due to both the child’s physiological characteristics (reduced ability to consume food, poorer nutrient absorption and increased need of calorie intake to maintain healthy weight and recover from injuries and infections) and other social factors like exclusion from screening and feeding programmes as well as lack of attention from families.[5]

[1] If a child’s height-for-age or weight-for-age measurement is below two standard deviations from the median of the CGS, the child is considered stunted or wasted, respectively. See World Health Organization, 1997, pp. 45-52.

[2] UNICEF, 2013, pp. 5-6; Prendergast and Humphrey, 2014.

[3] See, for instance, Bhutta and others, 2008.

[4] World Health Organization, 2014.

[5] UNICEF, 2013, p. 25; Kerac and others, 2014; Groce and others, 2014.