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The problem

Millenium Development Goal 1 is to eradicate extreme poverty and hunger. Poverty rates were halved between 1990 and 2010, but 1.2 billion people still live in extreme poverty.

It has been estimated by UNICEF that undernutrition contributes to just over half of the 9.7 million deaths in the under 5s in the world each year. 

In Africa it is estimated that 14% of children are born with low birthweight between 2003 and 2008, 14% of children were moderately underweightanad 7% severly underweight during this period. A total of 10% were wasted (very thin) and 40% stunted (very short). 

If treatment is inappropriate, then mortality can be high as high as 50% in severely malnourished children. With good treatment, recovery can be rapid and mortality low. 


Evidence based solutions 

In 2008 the Lancet produced a five part series on nutrition and listed the following evidence based interventions to prevent or treat undernutrition (Scaling Up Nutrition: What will it cost? Horton et al. 2009). 


Promoting good nutritional practices

  • Breast feeding

  • Complementary feeding of infants after the age of 6 months 

  • Improved hygiene practices, including handwashing

Provision of micronutrients for young children and their mothers

  • Periodic vitamin A supplements

  • Therapeutic zinc supplements for diarrhoea management

  • Multiple micro-nutrients powders

  • De-worming drugs for children (to reduce losses of nutrients

  • Iron-folic acid supplements for pregnant women to prevent and treat anaemia

  • Iodized oil capsules where iodized salt is unavailable

Provision of micronutrients through food fortification for all

  • Salt iodization

  • Iron fortification of staple foods

Therapeutic feeding with special foods for malnourished children

  • Prevention or treatment for moderate undernutrition

  • Treatment of severe undernutrition ("severe acute malnutrition") with ready-to-use therapeutic foods


Where to learn more 

The Malnutrition eLearning course "Caring for infants and children with acute malnutrition”, developed and offered by the Southampton University and IMTF, is an online, self-directed training course on the management of childhood severe malnutrition.  The course is suitable for existing and future health professionals and provides contextualised and interactive learning.

The Nutrition Portal at Southampton University gives a description of the course and there is also further information about the malnutrition project

The course complements the longer 'WHO Training Course on the Management of Severe Malnutrition' and the book 'Caring for Severely Malnourished Children' by Ashworth and Burgess, published by Macmillan Education and available from TALC 

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