Julián Suárez Migliozzi
Representante de CAF -banco de desarrollo de América Latina-, Chile
Good nutrition in children up to age 5 is crucial for their survival, physical and cognitive development, learning skills, emotional skills development and motivation to relate and play with other children.
Adequate nutrition, together with early stimulation and suitable care, ensures that children reach their potential for physical growth and intellectual and cognitive development, which are instrumental in their economic and human development in adulthood.
This claim has a biological foundation known for many years, as explained by renowned Chilean nutritionist Fernando Mönckeberg, who made significant contributions to combat the high rate of chronic malnutrition that affected Chile half century ago. Chile boasts today the best child nutrition rates in Latin America and the Caribbean.
Mönckeberg’s thesis assumed that the few atrophied neural connections of a malnourished child’s brain practically condemned their cognitive development. He graphically compared a malnourished child’s brain with that of a well-nourished child, which resembles the contrast between a bare tree in winter and a tree in bloom in spring (Figure 1). This is partly caused by the relative inefficiency of public policies that seek to reverse malnutrition in stages of life after the first 5 years of age. In other words, investment at that age—perhaps too late—is at least a relatively more expensive investment and with a lower social return, compared to investments that focus on early childhood development.
Between 2000 and 2018, Latin America reduced chronic malnutrition in children under the age of 5 from 16.7% to 9%. Despite this progress, there are still 4.8 million children under the age of 5 who are too short for their age, and meeting the global nutrition targets by 2025 seems at this point an unattainable goal.
Similarly, it should be noted that regional averages hide profound inequities that can lead to the design of misguided policies. Chronic malnutrition in children up to 5 years of age in Chile is 1.8%, but it is a whopping 46% in Guatemala. In addition, asymmetries within population groups and sub-regions of the same country are also marked, following inequality patterns in the most inequitable continent on the planet.
To help the region eradicate child malnutrition once and for all, we need to improve the context, particularly through the provision of safe water and basic sanitation, but also actions to promote sustainable practices that are key to early childhood nutrition, care and stimulation.
Chronic malnutrition, understood as low height for age or a height below the international standard for a certain age, suggests that the poor supply of nutrients from insufficient and inadequate food (in quantity and quality) is a determining factor.
In this regard, CAF is implementing a specific agenda to support countries of the region in the fight against chronic malnutrition, based on an effort to promote adequate health, favorable environments and food security; optimize the provision and management of public services, mainly water and sanitation; and strengthen institutional capacities to address the necessary interinstitutional consensus required to overcome this scourge .
Additionally, we are working on building capacities of public officials, in order to help develop effective public policies to address this pending task. In this regard, CAF has just launched a massive, open online course (MOOC) called How to implement programs to reduce chronic malnutrition? A multi-sectoral approach to Latin America”. The course provides tools to address the design and implementation of public policies to address the chronic child malnutrition agenda from a multi-sectoral approach that will pay particular attention to the results-based budget methodology.
The course is currently with open for registration, and will delve into effective mechanisms for defining a sequence of relevant interventions for coordinated multi-sectoral management based on public budgets. It will also guide public officials in promoting measures to reduce chronic child malnutrition from a multi-sectoral approach, incorporating good practices and lessons learned.
Latin America needs these types of initiatives to succeed and be sustained over time, as they lay the foundations for new healthy, active and competent generations that will contribute to sustainable development for all. And we will only achieve this with smart investments in early childhood, which are the most profitable investments for the future of the region.
