[mgj-discuss] World Bank Report finds malnutrition...didn't know it
phipco at riseup.net
Fri Mar 3 06:51:47 PST 2006
Some how the World Bank seems to always get what's wrong, just not how
they help perpetuate what's wrong. He's an article from the NY Times
about a new report from the World Bank that apperently warns
"Malnutrition Begins in the Cradle"......Stunning conclusion! Ok as
someone who does media for a living I can honestly say this is a most
unfortunate quote from the lead author of the report "you can get more
bang for your buck without the food."
March 3, 2006
Report Warns Malnutrition Begins in Cradle
By CELIA W. DUGGER
Nutrition education programs for parents would do a better job than
large and politically popular feeding programs in fighting the rampant
malnutrition that is stunting the development of more than 100 million
children worldwide, a new World Bank report says, finding that a lack
of food is usually not the main cause of child malnutrition.
Children are irreversibly damaged by malnutrition by age 2, long before
they begin primary school. The World Bank report contends that aid
efforts must concentrate on the brief window of opportunity before that
age. And in areas not hit by famine or other crises, the report says,
efforts must focus more on teaching mothers to properly feed and care
for babies and toddlers than on school meal programs.
While experts interviewed yesterday generally agreed with the bank's
assessment of the evidence on malnutrition, some of them argued that
feeding programs did have an important role to play in improving the
nutrition of children.
The debate about how to tackle the problem is an important one at a
time when the world is pushing to reduce child mortality by two-thirds
over the coming decade. Malnutrition is implicated in more than half of
the deaths of children globally, "a proportion unmatched by an
infectious disease since the Black Death," the bank's report says.
The World Bank, as the International Bank for Reconstruction and
Development is popularly known, is the largest financier of antipoverty
programs in developing countries. Its report, titled "Repositioning
Nutrition as Central to Development," maintains that countries like
India with staggering rates of malnutrition need to change their
approach to speed up progress.
Outside of regions in crises, nutritionists at the bank say, programs
should shift their emphasis from directly providing food to changing
the behaviors of mothers ? for example, to breast-feed exclusively for
the first six months of life or seek quick treatment for their
children's diarrhea. Improvements to sanitation and health care are
The origins of malnutrition often lie in the way infants and young
children are fed, not the quantity of food available.
In many societies in Africa and South Asia, the first days of thick,
yellowish breast milk, called colostrum, are discarded, though it
contains antimicrobials that can protect children against infection. It
is then replaced with local concoctions that all too often include bad
water that can give children diarrhea. For school-age children,
nutrition education, iron supplements and deworming medicines are
usually better investments for improving nutrition than providing
meals, the report says. It acknowledges that feeding programs increase
school attendance, but emphasizes that they should not come at the
expense of efforts to reach preschool children.
"You get more bang for your buck without the food," said Meera Shekar,
the lead author of the report, who described feeding programs as costly
and vulnerable to corruption. "The food brings in votes for
politicians. We have very little evidence it improves nutrition."
Advocates of feeding programs reply that food can be a magnet that
draws mothers and children to centers where nutrition counseling is
offered ? and that food itself can provide pregnant women and children
under 2 with a richer, more varied diet, while attracting older
children to school and helping them concentrate on learning.
"If you feed the children well, they'll all be there," said Jean Dreze,
an economist and leading advocate of free lunch programs in India,
which now serve more than 100 million primary-school students. "The
response to food is phenomenal."
Some of the facts about malnutrition, familiar to experts but not
widely understood, seem counterintuitive. For example, rates of
malnutrition in South Asia, including India, Bangladesh and Nepal, are
nearly double those in sub-Saharan Africa, which is much poorer.
India's programs to feed children in school have multiplied in recent
years, but its nutrition program for preschool children mainly assists
those between the ages of 3 to 6 ? too late to prevent the stunting and
damage to intellect that occur by age 2, bank nutritionists and other
A spokesman for the Indian Embassy in Washington said yesterday that he
had not yet read the report and could not comment on it.
The problem of malnutrition in India, known for its well-educated,
high-tech workers, is striking. Almost half the children are stunted by
malnutrition, but the problem is not limited to the poor. A quarter of
the children under age 5 in the richest fifth of the population are
also underweight and nearly two-thirds are anemic, the report says.
"Think of the power of India if all these kids were not malnourished
and could participate fully," Ms. Shekar said.
Nutritionists say the implications of the large body of research that
informs the bank's report is clear: countries must intervene before
children turn 2.
"If you miss that period, the damage is irreversible, especially in
cognition, but also in growth," said Marie Ruel, director of the
division of food consumption and nutrition at the International Food
Policy Research Institute.
"If I were a monkey, I would be the baddest monkey in the Jungle!"
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