Eliminate Maternal Malnutrition

ā€œHow dare you complain and question why women have to eat after men. It is up to us whether we want you to eat after men or not to eat at all.ā€

-Bhutan father to daughter

There is a gender gap in malnutrition...

with women accounting for the majority of underweight and overweight adults in the world and disproportionately affected by micronutrient deficiencies - especially iron. 42% of women and 38% of pregnant women in the world suffer from iron-deficiency anemia. As a result, more women than men die from nutritional deficiencies, high body mass index, and iron deficiency, according to the Global Burden of Disease. Malnutrition among women aged 15 to 49 is particularly concerning because of its impact on both women's and children's health, as well as on labor force and educational performance. Women who are malnourished (underweight or obese and/or micronutrient deficient) are more likely to experience birth complications, and give birth to babies born preterm, with low birth weight, and/or congenital defects. These babies have an increased risk of malnutrition and death in early childhood and beyond. Each year, an estimated 144 million children are stunted, 47 million are wasted, and 20 million are born with low birth weight.

Fifteen countries account for the vast majority of nutrition-related deaths among women of reproductive age. Almost half of undernutrition-related deaths among young women occur in just five countries - India, Pakistan, Brazil, Bangladesh, and Indonesia. Similarly, half of all obesity-related deaths among young women occur in a handful of countries, including India, Indonesia, China, Pakistan, and Brazil. Note India, Pakistan, Brazil, and Indonesia appear on both lists, indicating that they are struggling with a "double burden" of female malnutrition. For example, in India, an estimated 1,900 young women aged 15 to 49 died from nutritional deficiencies, while 35,200 died from obesity-related causes in 2019. In Pakistan, an estimated 1,600 young women died from undernutrition, while 10,200 died from obesity-related causes. As deaths from undernutrition fall, deaths from obesity are rising in many countries.

National nutrition strategies should prioritize improving the nutritional status of women of reproductive age, and strengthen womenā€™s capacity to provide nutritious diets for themselves, their children, and their families. Specifically, countries should set targets for halving underweight and anemia among women 15 to 49 years by 2025, and for eliminating both by 2030. To achieve these goals, nutrition stakeholders should work together to simultaneously increase the supply of foods and supplements designed to meet the nutritional needs of younger adult women, with a special focus on iron-folic acid supplements and iron-fortified staple foods, and encourage their use by educating women, by providing cash transfers conditional on their use, by making cash conditional on other healthy behaviors (e.g., childhood vaccination, prenatal care visits, etc.), and by making them available in the places women frequent daily (e.g., schools, workplaces, and shops). Governments should develop plans to close obesity gender gaps and halve obesity rates among women aged 15 to 49 years by 2030.

The United Nations (UN), its agencies, and partners should support this focus on the nutritional status of women aged 15 to 49 years as the key to achieving the Sustainable Development Goals of ending child malnutrition, addressing the nutritional needs of adolescent girls, pregnant, and breastfeeding women, and reducing by one-third deaths from non-communicable diseases. The UN should encourage all development partners with a stake in meeting these goals to increase investments in high-impact interventions with a proven track record of improving womenā€™s own nutritional status and their capacity to reduce childhood malnutrition. New investments should target the largest populations of malnourished young adult women. Full engagement of the private sector is required to achieve these goals as food is a private market transaction in all but the most fragile of humanitarian settings. The UN should also lead the charge in a data revolution to fill the considerable gaps in our knowledge of the nutritional status of women of reproductive age at national and sub-national levels.

Updated August 2022

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One in three people in the world today is malnourished, which means that either the person reading this is malnourished, or knows someone who is. Malnutrition, ranging from underweight to obesity, now impacts almost every country in one form or another. There are few development challenges that can make this claim.