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Income growth is great, just not for reducing child undernutrition

Nurse in Somalia measures child for malnutrition signs.

One out of every four kids in the world were not growing at the right rate (stunted) in 2011. That is a decrease by one-third over the past two decades. Similar improvements have been made on reducing the number of underweight children, but millions are still at risk.

The solution to the underlying problem of undernutrition in children sounds easy enough. Kids need nutritious foods to provide the vitamins, minerals and calories to help them grow and stay healthy.

Food access can be a barrier, but money is needed to buy it. Hence, the reason for giving food aid or vouchers to people who are struggling. Therefore, it stands to reason that improving the economy of a country can lead to the income increases that will allow families to buy food for their children.

That is what is supposed to happen. The thing is, it doesn’t.

Evidence from 36 countries shows that an improving economy does not help to reduce childhood undernutrition. A paper, published in the British medical journal The Lancet, looked at 121 Demographic and Health Surveys from 36 countries between 1990 and 2011.

The researchers saw that increases in Gross Domestic Product per capita did not decrease the rate of children under three years old who are underweight or wasted. There was a small improvement in stunting, but it was characterized as negligible.

“This finding challenges the assumption that  economic growth will automatically lead to reductions in child undernutrition. Our results therefore emphasise the need to focus on direct investments in health and nutrition and not to rely on the so-called trickle-down approach of a growth-mediated strategy to improve nutrition in children,” conclude the authors.

Not everybody thinks the paper is right. Lawrence Haddad of the International Food Policy Research Institute blogged his disagreement with the findings.

“Economic growth is not sufficient for malnutrition reduction, it may not even be necessary, but it is certainly almost always potentially useful.  Country case studies tend to show the important role economic growth plays in malnutrition reduction (e.g. see this one for Vietnam),” writes Haddad.

He says that a letter further outlining criticisms of the paper by he and his colleagues has been submitted to The Lancet Global Health. He is hopeful that the letter will be published.

He agrees that economic growth alone is not enough, because its benefits are not going to lead to short-term changes. However, economic growth does have long germ benefits for undernutrition and further actions taken to address the issue can make a big impact.

For their part, the authors of the Lancet article point to inequality as one of the reasons that may be behind the lack of improvement in undernutrition. Improved incomes may in fact make things better, but people living at the bottom of the economic pyramid.

Other possibilities include that families are not spending the money that comes from rising incomes on things that would improve the nutrition of their children. Finally, they suggest that public services are not seeing increases in spending.

What is left are more questions than answers about childhood undernutrition. There appears to be agreement regarding the need to take action on the issue, but understanding the extent that income improvements can make are now up for debate.


About Author

Tom Murphy

Tom Murphy is a New Hampshire-based reporter for Humanosphere. Before joining Humanosphere, Tom founded and edited the aid blog A View From the Cave. His work has appeared in Foreign Policy, the Huffington Post, the Guardian, GlobalPost and Christian Science Monitor. He tweets at @viewfromthecave. Contact him at tmurphy[at]