Managing Acute Malnutrition: A Review of the Evidence and Country Experiences in South Asia and a Recommended Approach for Bangladesh

Type Working Paper - Food and Nutrition Technical Assistance III Project
Title Managing Acute Malnutrition: A Review of the Evidence and Country Experiences in South Asia and a Recommended Approach for Bangladesh
Publication (Day/Month/Year) 2014
Malnutrition remains a significant problem in South Asia, affecting nearly 80 million children under the
age of 5. South Asia has the highest burden of malnutrition than any other region in the world. In this
region, as in others, malnutrition manifests itself in different forms—chronic malnutrition or stunting
(short for age), acute malnutrition or wasting (low weight for height), and micronutrient deficiencies.
Each type of malnutrition carries different risks. For example, chronic malnutrition and acute malnutrition
carry a risk of mortality, but the risk for chronically malnourished children is different from the risk for
acutely malnourished children. The risk of mortality is greatest for children who are severely acutely
malnourished; these children are on the brink of death and are 10 times more likely to die than their wellnourished
peers. South Asia is home to 32 million acutely malnourished children under 5— higher than
any other region—and the three countries with the greatest numbers of acutely malnourished children are
India (26 million), Pakistan (3 million), and Bangladesh (2.2 million).
Trends in the prevalence of various forms of malnutrition in South Asia are improving but very slowly. In
fact, while the prevalence of acute malnutrition in South Asia over the past 20 years has declined from 19
to 16 percent, as a result of population growth, the actual numbers of children affected is unchanged. So
why does it matter? Because 42 percent of all malnourished children in the world reside in South Asia,
the global community cannot eradicate all forms of malnutrition until the prevalence of malnutrition in
South Asia is significantly reduced. In short, the world cannot meet its goals for children without South
Asia meeting those goals first.
The high prevalence of chronic and acute malnutrition is in part a result of the weak nutrition policy and
program framework in this region. Sustained programming on preventive nutrition that reaches all
children in need has been limited in this region, and there has been little programming targeted at children
who are moderately or severely wasted.
This report presents a review of the evidence and country experiences in the management of acute
malnutrition—one of the most severe forms of malnutrition— in South Asia, followed by a recommended
approach for the management of acute malnutrition in Bangladesh. This review focuses on the
experiences and available evidence on the management of acute malnutrition in 11 countries in South and
Southeast Asia: Afghanistan, Bangladesh, India, Nepal, Pakistan, Sri Lanka, Cambodia, Indonesia, Laos,
Myanmar, and Vietnam.

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