Developing strategies to end hunger
 

Stunted Growth: Who's Affected and Does It Matter?

20111219Nobel_Laureates_Oslo
Women play essential roles not only as food producers, workers, and parents, but also as creative international, national, and community leaders. Left to right, the three 2011 Nobel Peace Prize laureates: Tawwakul Karman of Yemen, Leymah Gbowee of Liberia, and President Ellen Johnson Sirleaf of Liberia. Photo by James M. Garresen, II/Executive Mansion of Liberia.

Today, USAID kicked off a three-day Frontiers in Development Forum in Washington, DC. The 9 a.m. panel on "Development, Democracy, and Global Security in the 21st Century" was notable not precisely because of the topic -- critical as it is -- but because of the panelists: the Honorable Joyce Banda, President of Malawi; the Honorable Ellen Johnson Sirleaf, president of Liberia; the Honorable Atifete Jahjaga, president of Kosovo; the Honorable Mary Robinson, founder of Realizing Rights: the Ethical Globalization Initiative and former president of Ireland; and the Honorable Helen Clark, currently Administrator, U.N. Development Program, and former president of New Zealand.

It was a first-ever sight for many members of the audience: five women who have led countries, all in one room. Perhaps almost as remarkably, they weren't asked to speak on "women's issues," but on global political and security issues -- which, of course, include and affect women. 

When I saw the panel via webcast, I thought of all that had needed to converge to enable these leaders to fulfill their potential -- things that were out of reach of most women as recently as a generation ago, and remain out of reach of many today. The list starts with safe pregnancies and deliveries for the leaders' mothers and continues with their own needs in early childhood, such as sufficient nutritious food, clean water, and health care. Then there's access to primary, secondary, and later university education, the ability to enter public life and stand for election... and on and on.

I also thought of the women I met during our recent Bread Institute visit to Bangladesh and Nepal. Because I'm usually the person who can't reach the top shelf, in South Asia I kept noticing that I was quite a bit taller than most women -- taller, even, than a fair number of men.

Height isn't everything, of course. But for people who are much shorter than average, it's often only the most obvious sign that as children, they suffered from a prolonged period of malnutrition. Their growth was stunted by insufficient intake of calories and/or nutrients. Increasingly, the evidence shows that stunting takes place largely in the 1,000-day window between pregnancy and age 2 -- and that it brings a host of problems with it, such as long-term health issues, difficulty learning in school, and even lower lifetime earnings.

In some developing countries, stunting affects nearly half of all children under 5. At Bread, we use generalizations such as this to quickly convey the "big picture" of child malnutrition. But inevitably, generalities obscure specifics.Who is most likely to be stunted?

Girls comprise a large group of particularly vulnerable children. Some of the information we have is startling: for example, among children in an urban slum in Pakistan, girls were three times more likely to be stunted than boys. Equally startling to me is what we don't know. When I asked in Nepal, I was told that statistics on stunting are not broken down by gender. Girls could be 50 percent, 70 percent, or 90 percent of Nepal's stunted children -- we can't tell from the data that's being collected.

Whether girls are more likely to be stunted than boys matters -- to the individuals and families themselves, of course, but also to the prospects for reducing hunger and poverty. The critical roles of women in producing food and feeding children make women's health, education, and empowerment essential for any country to make progress on its development goals. 

In addition, of course, women give birth to children. Stunting in and of itself contributes to maternal mortality because it increases the risk of obstructed labor. A study using data from 54 developing countries found that women shorter than 4 feet 9 inches (145 cm.)  had roughly a 40 percent higher risk of suffering the death of a child than women who were taller than 5 feet 3 inches (160 cm.). A study in Burkina Faso found that women shorter than 5 feet 1 inch (155 cm.) were nearly five times as likely to have a Caesarian section -- not an operation quickly or easily obtained in many parts of developing nations.

In a later post, I'll talk about how a USAID-funded program in Bangladesh lowered child stunting rates dramatically -- and identified women's empowerment as the "game-changer" in this achievement.

  Michele Learner is associate editor for Bread for the World Institute.

 

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