Jigawa is one of the worst places in the world to be born. It is one of the States that make up Nigeria, was founded in 1991 and is the size of the Valencian Community. This particular site is among those with the highest percentage in the world of chronic malnutrition: 64%. It is followed by Karuzi (Burundi), Uttar Pradesh (India) and Houaphan (Laos).
A macroestudio that has just been published in the magazine Nature allows us to observe for the first time with this level of detail the fight against hunger worldwide. And it also leaves a worrying conclusion: only five countries in the world will significantly improve their results in the coming years: Palestine, Peru, Paraguay, Sao Tome and Principe, and Turkmenistan. They are the only ones that will meet in 2025 with the goal set by WHO to reduce chronic malnutrition by 40% and acute, to 5%. “Growth retardation is irreversible if it is not addressed during the first thousand days after conception, while acute malnutrition is associated with high mortality, “explains Damaris Kinyoki, one of the principal investigators of the study.
The group of scientists from the University of Washington collected and analyzed the information by region, province or county between 2010 and 2017 of 105 countries in which 99% of children with stunted growth live. The study was attended by the Institute of Global Health of Barcelona (ISGlobal). “Instead of comparing one place with another at the level of national results, countries can see the differences between each region and try to reduce them,” he says. Kinyoki. In summary, it is now more difficult to hide inequality thanks to the arithmetic mean between provinces.
Thanks to research like this, it is harder to hide the inequality thanks to the arithmetic mean between provinces
The analysis shows for example that between the region of Indonesia with less chronic malnutrition and the one that suffers the most there is a difference of 30 percentage points (between 21% and 51%). In Nigeria, where Jigawa is with a 64% prevalence, there is also Surulere, with a rate of 14%.
“Both countries are large, very populated, and conditions in different areas vary historically, demographically, economically and socially. In talks with former Indonesian health minister Nafsiah Mboi, he pointed out that these conditions make it unfair or, at least, not particularly useful to compare some cities with others. This same argument can surely be used in Nigeria. Understanding why these differences exist, and what perpetuates them, is the next step, ”says Kinyoki.
According Kinyoki, Pakistan and Afghanistan, are those that have had a more disastrous evolution in the seven years studied. A trend that will continue predictably in the coming years due to instability and poverty. These two countries are joined by areas in central Chad, northern Angola, part of the Democratic Republic of the Congo and Madagascar.
In 2017, one in four children under five residents in middle- or low-income countries suffered growth problems and most of these children were concentrated in specific regions within these countries. Unicef’s latest annual report emphasized this problem and stressed that there are 200 million children in the world who suffer from some type of malnutrition. Half of them are concentrated in only four countries: India, Pakistan, Nigeria and China.
The analysis shows for example that between the region of Indonesia with less chronic malnutrition and the one that suffers the most there is a difference of 30 percentage points
The world, however, progresses little by little. If you look at the global picture, the prevalence of stunted child growth in developing economies went from 37% in 2010 to 26% in 2017. Progress has been especially notable in Latin America and the Caribbean.
For experts, Peru is the best example of a country that has done what is necessary to reduce hunger and will in fact meet the objectives of WHO. “The most positive thing the study observed was that there are areas with great progress. By mapping to such a fine scale, we can see that there are many regions, even within countries with high levels of stunting that improved, ”Kinyoki emphasizes. “But there are still regions with levels of countries in sub-Saharan Africa and Southeast Asia,” the study warns in its conclusions.
“In many cases we know what needs to be done. In Mexico, the Mesoamerica program, for example, has been a breakthrough. This shows that many times it is only a matter of providing resources and political will to the solutions that already exist,” says William Savedoff, health expert at the Inter-American Development Bank. “In addition, advances in malnutrition are seen relatively quickly, it is not as with life expectancy data that need a longer term,” says the specialist.
The political and social instability of the region, however, is a great challenge in consolidating progress. “The achievements of the last 20 years have occurred because macroeconomic growth has been accompanied by redistributive policies, in general. What is worrying is not instability in countries with strong institutions, but areas with more social conflict and violence. Venezuela is in a very worrying situation in this regard, “summarizes the expert.
- When experts talk about chronic malnutrition, they refer to children whose height is too low for their age. Suffering it has irreversible consequences: delayed motor development, impaired cognitive function and poor school performance.
- Acute malnutrition occurs when the weight is too low for height. It is one of the main causes of death among children under five. It is usually the result of a severe food shortage or a punctual and serious illness. It occurs mostly in Asia and not necessarily in emergency situations. It is day to day in some regions of the planet.
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