August 15, 2014

Getting to the Root of Malnutrition

Next Generation Delegation 2014 Commentary Series

By Kusum Hachhethu, MS in Food Policy and Applied Nutrition, Tufts Friedman School of Nutrition Science and Policy and 2014 Next Generation Delegate

As a Next Generation Delegate, I was thrilled to see that one of the major themes of The Chicago Council on Global Affairs’ Global Food Security Symposium 2014 in Washington DC was the importance of integrated programs to address the interrelated challenges of climate change, food insecurity, and malnutrition. In my own research, particularly through my experience with the Community Management of Acute Malnutrition in Nepal, I have seen firsthand the need for these integrated programs in the prevention and treatment of malnutrition.

Severe Acute Malnutrition (SAM) remains a significant public health problem in Nepal. In 2011, the prevalence of SAM in Nepal’s Terai region, known as the nation’s breadbasket, was 3.2 percent, notably higher than the national average of 2.6 percent. It is also ironic that Terai, which produces the majority of the nation’s food, has the same prevalence of SAM – or higher prevalence – as other, more food-insecure regions.

I recently traveled to Bardiya, a high-burden district in this Terai region, to shed light on this complex phenomenon. While Bardiya is crippled with the usual peak of food insecurity between growing seasons, their food security is comparatively better than high-burden districts in the mountain and hill regions, according to The Nepal Food Security Monitoring System (NEKSAP) phase classifications. That said, however, hygiene and sanitation practices are extremely poor in Bardiya, leading to rampant diarrheal diseases that hinder children’s ability to absorb nutrients from food. Furthermore, a malnourished child with a weakened immune system is also more prone to diseases.

Another key issue related to malnutrition that I observed in the Bardiya district is the effects of labor migration into neighboring India, which is prevalent in the region. As men migrate to pursue labor opportunities, women are left to care for their children on their own, in addition to performing the majority of the household tasks. As a result, it is important to consider the vexing childrearing challenges for the region’s mothers, as the unintended consequence of labor migration, in order to better understand child malnutrition.

Through my research, I’ve concluded that sanitation and childrearing constraints due to labor migration trends are two important factors that, in devastating combination with food insecurity, lead to and exacerbate child malnutrition in Bardiya. These key contributing factors to child malnutrition must be systematically addressed in comprehensive and integrated manner in order to find a sustainable solution.

As highlighted at the Symposium, stakeholders are becoming increasingly focused on integrated programming, which I feel is the future of the international development field. In the face of a changing climate, we need a diversity of experts working together across sectors to the resolve complex and pervasive problems related to malnutrition, food security, and agriculture.


The Global Food and Agriculture Program aims to inform the development of US policy on global agricultural development and food security by raising awareness and providing resources, information, and policy analysis to the US Administration, Congress, and interested experts and organizations.

The Global Food and Agriculture Program is housed within the Chicago Council on Global Affairs, an independent, nonpartisan organization that provides insight – and influences the public discourse – on critical global issues. The Council on Global Affairs convenes leading global voices and conducts independent research to bring clarity and offer solutions to challenges and opportunities across the globe. The Council is committed to engaging the public and raising global awareness of issues that transcend borders and transform how people, business, and governments engage the world.

Support for the Global Food and Agriculture Program is generously provided by the Bill & Melinda Gates Foundation.


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