Malnutrition
CAUSES OF DEATH DATA
Malnutrition contributes to approximately 50% of deaths worldwide amongst children aged five and under [1] . The Joint Malnutrition Estimates (JME) released in 2023 revealed 148.1 million children under age 5 are affected by stunting, 45 million children under the age of 5 were affected by stunting, and 37 million children are overweight globally. Most children affected by malnutrition live in Africa and Asia (Graphic 1). While progress has been made to reduce malnutritional worldwide the JME estimates that countries are not on track to meet the 2030 Sustainable Development Goals to reduce all aspects of malnutrition [2] .
MALNUTRITION
Quick Facts
Malnutrition remains a critical challenge, with millions of children suffering from severe wasting, stunting, and overweight. CHAMPS is addressing this huge burden in Africa and Asia by implementing innovative, data-driven strategies to improve nutrition in vulnerable communities, saving lives and creating a healthier future for children.
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Stunted children in Asia
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Severely wasted children in Asia (%)
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Overweight children under 5 in Asia
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Overweight children under 5 in Africa (%)en under 5 in Asia
Most children with malnutrition live in Africa and Asia
In 2022, more than half of all children under 5 affected by stunting lived in Asia and two out of five lived in Africa
In 2022, 70 percent of all children under 5 affected by wasting lived in Asia and more than one quarter lived in Africa.
In 2022, over half of all children affected by overweight lived in Asia and more than one quarter lived in Africa
The CHAMPS Network collects cause of death data for stillbirths and children <5 years of age across seven countries in sub-Saharan Africa and South Asia; Mozambique began enrollment in 2016, South Africa, Kenya, Mali, and Bangladesh began in 2017, and Sierra Leone and Ethiopia began in 2019. Between December 2016 and December 2022.
1,336 had a Cause of Death (CoD) determined through a Determination of Cause of Death (DeCoDe) panel. The World Health Organization’s (WHO) Child Growth Standards were used to calculate z-scores and measure malnutrition at the time of death. Of the 1,336 cases 73.8% had moderate-to-severe malnutrition and 56.4% had severe malnutrition at the time of death. Malnutrition was the underlying cause of death in 319 cases, it was identified in the causal chain of 426 cases, it was noted as another significant condition for 109 cases, and noted as the immediate cause of death for 2 cases. Of the 426 cases where malnutrition was identified as a cause of death, 77 had HIV-related wasting syndrome.
Of 1,601 infant and child deaths, malnutrition was considered a causal or significant condition in 632 (39.5%) cases. This includes including 85 (13.4%) with HIV infection.
Post-mortem measurements indicated 90.1%, 61.2%, and 94.1% of these cases were underweight, stunted, and wasted, respectively.
Fig. Causes of death (A) and pathogens in the causal pathway (B) for infant and child deaths with and without malnutrition in causal chain or as other significant condition. CHAMPS, 2016–2023 (N=1601). CHAMPS, Child Health and Mortality Prevention Surveillance.
Among the 535 cases with malnutrition as a cause or significant condition, 90.3% were underweight, 60.1% were stunted, 82.8% had wasting, and 76.7% had low-MUACZ (Mid-upper arm circumference for age) according to post-mortem measurements. 93.5% of these deaths had one or more infectious diseases in the causal chain. The most frequent conditions in the causal chain, outside of HIV wasting syndrome, included lower respiratory infections, sepsis, diarrheal diseases, malaria, and anemia. DeCoDe panel experts concluded that 92.3% or approximately 494 deaths were preventable, significantly higher than the proportion considered preventable among non-malnutrition deaths.
Fig. Deaths with malnutrition as a cause of significant condition
Source: UNICEF, WHO, World Bank Group Joint Malnutrition Estimates, 2023 edition [2]