Recent analyses of global child survival underscore the urgent need to accelerate progress in preventing
newborn and child deaths in South Asia and Africa south of the Sahara (SSA), which together account for
four out of five deaths of children under age 5 globally (1). Among all deaths in this age group, 45 percent,
or approximately 3 million deaths a year, are attributable to undernutrition (2, 3). Some critical nutritional
disorders impacting mortality include small for gestational age (SGA) births, moderate and severe
stunting, moderate and severe wasting, micronutrient deficiencies, and suboptimal breastfeeding
practices (4). Some 10 percent of deaths and disability-adjusted life-years (DALYs) in children younger
than 5 years are attributable to micronutrient deficiencies, with nearly all this burden due to deficiencies
of vitamin A and zinc (5). Three-quarters of the world’s stunted children live in South Asia or SSA. A major
portion of these deaths are preventable, and reduction in child mortality at all levels is possible with
scaling up of effective interventions (1).
As requested by the Independent Expert Group (IEG) for the Global Nutrition Report, we assessed the
relationship of under-5 mortality and undernutrition in three high-burden countries of South Asia and SSA
(Bangladesh, Ethiopia, and Pakistan) as well as the impact of select nutrition-sensitive and specific
interventions. We evaluated potential impact of interventions on process indicators including SGA births,
stunting, and wasting on the basis of recent information on intervention coverage available from the
Countdown Report (2014) and the most recent demographic and health surveys of these countries. We
estimated the numbers and proportions of neonatal and postneonatal child deaths that could be averted
in each country by increasing the coverage of effective key nutrition-specific and sensitive interventions
available in the Lived Saved Tool (LiST) on nutrition outcomes (SGA births, stunting, and wasting). These
interventions were selected on the basis of the conceptual framework outlined in latest Lancet nutrition
series (4). At present, the impact of these interventions on maternal mortality is limited and was not
modeled as part of the analysis.