Improving the nutrition of women and girls has the potential to impact so many lives, not just the life of a single woman, but of those she cares for and ultimately those she creates.
One billion girls and women suffer from malnutrition worldwide and the result of this is a constant perpetuating cycle of poverty and compromised health, a major hurdle in global development. They often eat least and last. This can lead to women not receiving enough nutritious food, it also reflects the status of women under males in many cultures. A malnourished woman not only has reduced earning potential, she has a reduced capacity to raise a healthy and well-nourished child. When a malnourished woman becomes pregnant, her malnutrition affects not just her, it affects the growth and development of her unborn baby. When I consider what good nutrition could achieve in vulnerable girls and women the necessity of it seems obvious, It is almost beyond comprehension this has only recently gained more attention in the development of policy.
This year is turning out to be an important year for the recognition and scaling up of global nutrition initiatives, the United Nations has proclaimed 2016 to be the start of a Decade of Action on Nutrition to eradicate world hunger and malnutrition. In early May the 4th Women Deliver conference took place in Copenhagen, bringing together some of the world’s leading humanitarian organisations and experts to advocate for girls and women’s health, human rights and wellbeing. Women Deliver is the biggest global conference focusing on these issues and some 5 500 experts, activists and politicians from 169 countries attended. The aim of this landmark conference was to build upon the new Sustainable Development Goals for 2030 and make women’s issues a central focus to attaining these goals. These new Sustainable Development Goals (SDGs) – as adopted earlier in January – build on the previously named Millennium Development Goals and are a guide for the next 15 years of humanitarian action, with an overarching aim to achieve all 17 of the outlined goals by 2030. The Women Deliver conference highlighted, for the first time, how working towards improving the nutrition status of women and girls can contribute to sustainable global development and achieving many of the SDGs.
- SDG #2 – End hunger, achieve food security and improved nutrition and sustainable agriculture.
In regards to nutrition global development goal #2 is focused on nutrition issues – however, improving nutrition can play a part in achieving many of the other 16 goals. If you are interested to see how good nutrition is vital to attaining many of the new SGDs checkout this fantastic infographic from Sight and Life highlighting how each is interrelated with nutrition.
Why is a focus on Women’s nutrition an important step to achieving the SDGs?
Given the potential impact improving women’s nutrition could have – directly to individuals, the flow on effect in society and on the life cycle of future generations – to me it seems an obvious and vital step in development. Globally the amount of food waste is extraordinary, beyond comprehension, we produce enough food to feed the global population; yet even with our knowledge and abilities within science and technology the prevalence of hunger and malnutrition is still alarmingly high. This leads to the question of where the focus should lie when it comes to global development – would addressing poverty solve hunger – or would improving nutrition be more effective in reducing poverty? While improving the nutrition status of girls and women may not be a magic bullet, it could be a pivotal piece of the puzzle. When you consider the following outcomes of a malnourished women and the consequential effects on her child, nutrition presents as the rational answer.
Micronutrient deficiencies contribute significantly to poor health outcomes in women, take iron deficiency as an example. Adolescent girls and women of childbearing age are susceptible to iron deficiency, which appropriately comes under the banner of hidden hunger (micronutrient deficiencies). I say appropriately because iron deficiency is often hidden and the impact underestimated. Those with iron deficiency anemia can experience reduced school performance, reduced productivity, reduced earning potential, more seriously ill-health or premature death (maternal hemorrhage and reduced recovery from infection).Lopez A, Cacoub P, Macdougall IC, Peyrin-Biroulet L (2016) Iron deficiency anaemia. Lancet; 387, 907-16. Imagine the impact that overcoming just this one nutritional issue could have on quality of life and national productivity.
Now consider this – The first 1,000 days – from conception to the 2nd year of life – represents a critical window in a child’s life; a nutrient deficit during this time can have lifelong consequences on health and development. Poor nutrition during pregnancy can impede the mental and physical growth and of the baby and result in low birth weight.Cusick SE, Georgieff MK (2016) The Role of Nutrition in Brain Development: The Golden Opportunity of the “First 1000 Days”. The Journal of pediatrics. Globally 15% of all babies born are born with a low birth weight (a weight less than 2,500g); low birth weight can increase the risk of disease and infection and hamper recovery.
Sufficient macro and micronutrient intakes in the first 2 years of life are also paramount. In a worst case scenario this could be a child that simply does not have sufficient food to meet their energy requirements, ultimately leading to acute malnutrition and requiring emergency nutrition intervention to survive. In other cases energy requirements may be met, yet a child’s growth is still impaired due to a lack of essential nutrients, such as vitamin A, iodine, iron and calcium. Children deficient in these nutrients may not reach their full cognitive development nor achieve appropriate growth. Eventually resulting in stunting, a child who’s height for age is too low. Stunting and micronutrient deficiencies can also lead to increased risk of developing chronic disease and mortality.Cusick SE, Georgieff MK (2016) The Role of Nutrition in Brain Development: The Golden Opportunity of the “First 1000 Days”. The Journal of pediatrics. While Stunting prevalence has declined 15.8% since 2014, there yet remains a whopping 159 million children suffering from stunting and 50 million children whose lives are still at risk from wasting. The effects of chronic malnutrition are irreversible and these children will not meet their full genetic potential both mentally or physically.
Children with developmental delays and health issues contribute to increased health costs, not only is there an increased burden on health care systems there is a reduction in economic potential at an individual and national level. Thus the cycle of poverty continues, and increasing the health of women through nutrition has the potential to stop this cycle. Healthy mothers produce healthy children who, with continued good nutrition, are able to meet their full potential; they are able to work, contribute to society and begin a new cycle of health and prosperity. Results such as these can affect health, education, economic growth and gender equality, all goals for sustainable development.
Nutrition interventions actioning women’s nutrition now
So what specific interventions are needed to meet the nutritional needs of women and girls? A number of programs are in place globally to to address micronutrient deficiencies in women. Most developing countries have implemented a combined iron and folic acid supplementation program during pregnancy to reduce the risk of neural tube defects in infants and maternal death from post postpartum haemorrhage. A newer recommendation by the World Health Organization is for calcium supplementation to prevent hypertensive disorders and preeclampsia during pregnancy, the second biggest contributor to maternal death. Fortification of staple foods such as salt, grain products and condiments can overcome these issues in some circumstances; In India double fortification of salt with both iodine and iron has been implemented with promising results.
The Micronutrient Initiative are currently conducting a large scale program and study focusing on the provision of antenatal care. For a variety of reasons women often do not attend or have access to antenatal care or heath clinics when they become pregnant. The Community Based Maternal and Newborn Health project is a multidisciplinary approach to providing health care and nutrition to at-risk and hard to reach populations. By providing a comprehensive package of health and nutrition services the project hopes to reduce maternal and newborn morbidity and mortality, while identifying the key areas needed to enhance distribution and compliance of micronutrient supplementation and nutrition education. The program will focus on the key micronutrient supplements of iron, folate, iodine and calcium coupled with breastfeeding promotion and education on delayed cord clamping – delaying the clamping of the umbilical cord for at least 1 minute can ensure the newborn receives adequate iron supplies needed for the first 6 months of life. The results of this study will hopefully be able to provide essential information for a similar programs to be scaled up and adapted in other regions, an exciting prospect for the future.
During the Women Deliver Conference the Micronutrient Initiative rolled out the 1 billion candles campaign using a dim candle as a metaphor for the 1 billion malnourished women and girls and how eradicating malnutrition could ignite their potential and light their candle. They also launched their Right Start Initiative in May with the support of the Canadian government, they will be launching programs across nine countries in Asia and Africa and hope to reach 50 million women and girls. 1,000 days are using the Olympics as a platform to highlight malnutrition and every child’s right to have a #FAIRSTART in life.
If you wish to follow any of these campaigns on twitter or social media here is a guide to some of the key hash tags being used in discussion.
References [ + ]
|1.||⇪||Lopez A, Cacoub P, Macdougall IC, Peyrin-Biroulet L (2016) Iron deficiency anaemia. Lancet; 387, 907-16.|
|2.||⇪ab||Cusick SE, Georgieff MK (2016) The Role of Nutrition in Brain Development: The Golden Opportunity of the “First 1000 Days”. The Journal of pediatrics.|