Malnutrition alone contributes to more than half of the nearly 12 million under-five deaths in developing countries each year. Statistics reveal that malnourished children often suffer the loss of precious mental capacities. They fall ill more often. If they survive, they may grow up with lasting mental or physical disabilities.

The State of the World’s Children -1998, the annual statement of Unicef on the children of the world, ponders on this silent emergency and many other problems concerning the growth and development of our future citizens.

Malnutrition is rarely regarded as an emergency. The children affected by it do not face famine and betray few or obvious signs of this scourge. Yet, the largely invisible crisis of malnutrition is implicated in more than half of all child deaths world wide and violates children’s rights in profound ways, compromising their physical and mental development and helping perpetuate poverty. More widespread than many suspect - with one out of every three children affected - malnutrition lowers the productivity and ability of entire societies.

Poverty, one of the causes of malnutrition, is also a consequence, a tragic bequest by malnourished parents to the next generation.

Unicef, alongwith other development partners, is fighting this vicious circle of poverty, malnutrition and death with tools like community involvement, food fortification, growth monitoring and promotion and supplementation programmes. These approaches are changing and even saving the lives of children all over the world. Yet we must all pool in to win the war.

The State of the World’s Children-1998 report details the scale of the loss and the steps being taken to stem it. Sentinels of progress are lighting the way : nearly 60 per cent of the world’s salt is now iodized, and millions of children every year are spared mental retardation as a result. Vitamin-A supplementation is helping bolster disease resistance in children and may soon become an important measure in helping reduce maternal deaths around the world. Communities are working together to identify their problems, decide on their options and take action, with women emerging to play leadership roles that spark numerous other changes in people’s lives.

Children have the right, recognized in international law, to good nutrition. The world has the obligation to protect that right, building on both the great experience gained and the scientific knowledge achieved. Action is both possible and imperative, as has been shown by the Unicef Report. The report does not simply pose problems but provides solutions borne out of field experiences of Unicef. Its approach to utilise vitamin-A to provide better nutrition has resulted in reducing maternal death rates by 44 per cent on average. This fact is confirmed through the case study ‘Triple A takes hold in Oman’ in The State of the World’s Children-1998.

Unicef has proved that the ‘triple A’ (Assessment, Action and Analysis) cycle of analysing the causes of a problem and taking action based on this analysis can be used at all levels of society to create processes whereby people’s right to good nutrition is fulfilled. Following this approach, along with the government’s commitment towards improving people’s lives, Oman has made great strides in child survival and development. Child mortality in Oman has dropped from 215 per 1,000 live births in 1970 to 25 in 1995. School enrolment, particularly among girls, has increased dramatically.

Such empowerment of women (through the tool of information) is of central importance to improving nutrition of both women themselves and their children. The often oppressive and demanding patriarchal environment in which millions of women live even in this age and time, must give way to an equal partnership in which women enjoy autonomy and the sense of accomplishment that comes from building skills and capacities. Unicef believes that a number of measures are essential, therefore, to enable women and girls to develop their skills and abilities. These include ensuring their access to family and community resources, such as credit, and to education and information.

Some experts place the major blame for the very high child malnutrition and low birth weight throughout much of South Asia on such factors as women’s poor access to education and low levels of employment, compared with other regions. United Nations reports that child malnutrition rates in Pakistan, for example, are among the highest in the world, as is the proportion of low birth weight infants, at 25 per cent.

On the other hand, women in Thailand, where nutrition has improved remarkably in the last two decades, have very high literacy, high participation in the labour force, and a strong place in social and household-level decision-making.

As a child survival and development measure, Unicef has championed the 20-20 initiative - the allocation of at least 20 per cent of government spending to basic social services to be matched by 20 per cent of donor funding in these areas. The value of such investment is becoming increasingly apparent. For example, there is evidence from Sri Lanka and a number of other countries that increases in spending on public health services are more strongly associated with reduced infant mortality and better nutrition than are overall increases in income.

Unicef’s actions are more directed to nutrition improvement as a principal outcome. Improving the quality of staple foods through fortification, improving local level nutritional surveillance capacity, protecting women’s right to breastfeed, sharing information on better complementary foods may have a more rapid and focused effect on nutrition.

The World Food Summit, organized by the Food and Agricultural Organization in Rome in November 1996, focused on ways of achieving sustainable food security for all. The Summit’s Plan of Action called for an enabling social and economic environment to achieve food security and drew attention to the special contribution that women can make to ensuring family and child nutrition, the importance of breastfeeding and the particular importance of giving priority to children, especially girls. A commitment was made to realise the rights of all to adequate food and the freedom from hunger.

So, if we all believe in ‘thinking globally and acting locally’, we should join hands with Unicef and all other development agencies moving towards the common goal of creating a better world for the children of this planet and all the future generations to come.q