Introduction to Issue on Malnutrition

Abstract

In poor countries, over a quarter of children under the age of five years are malnourished. The corresponding rate in rich countries is below 3%. Unfortunately, being undernourished as a child is associated with worse economic outcomes as an adult, largely a result of worse adult health. Thus, malnutrition among children creates one of the starkest discrepancies in individual well-being between rich and poor countries. Yet, income growth does not seem to be the solution per se. Despite rapid economic growth in the past 20 years, South Asia, for example, continues to have inordinately high levels of undernourished children. This issue brings together a set of papers on trends, causes, and potential policy solutions related to undernutrition in South Asia. This region deserves special attention both because it accounts for the largest number of malnourished children in the world and because the rates of underweight and stunted children are puzzlingly high—higher than one would predict based on the region’s income or performance on other health indicators such as infant mortality. To give one example, if we use demographic and health surveys from the past 10 years to compare India and Sub-Saharan Africa, we see the incidence of underweight children is roughly twice as high in India, even though its population is significantly richer. In focusing on such anomalies, we believe this issue will present evidence and draw conclusions with applicability to developing countries in regions beyond South Asia. Three overview pieces discuss the links between economic growth and nutrition, and the patterns in malnutrition across South Asia. In examining the relationship between income and malnutrition, Harold Alderman emphasizes the importance of economic conditions while in utero and during early childhood for later well-being including vulnerability to chronic disease, with special attention to the implications for the optimal timing of interventions. Purnima Menon provides a broad and detailed summary of child health patterns across South Asian countries, within India, and across the lifecycle, and summarizes some of the main findings and open puzzles of nutrition literature. She also describes several policy avenues identified in this literature—and it is clear that, as yet, there is no