Category: Global

Making strides towards nutrition and gender equality in Nigeria

By Lilian Okafor, CS-SUNN

In Nigeria, malnutrition not only affects individuals, but also stunts economic growth and human development. The Women and Girls’ Nutrition Project is a collaborative effort implemented by the Civil Society-Scaling Up Nutrition in Nigeria (CS-SUNN), in partnership with FHI360, Alive & Thrive, 1,000 Days, and Intake, supported by the Bill & Melinda Gates Foundation. The project aims to empower women and girls to achieve optimal nutrition and stand as crucial pillars for progress.

The project partnered with federal Ministries, Departments, and Agencies relevant to nutrition to develop a cross-cutting Action Agenda for women and girls’ nutrition in Nigeria that delivers healthy diets, care, gender equality, and a multi-system enabling environment as priorities for a thriving female from girlhood. These include:

  • Support the nutrition department of the Federal Ministry of Women Affairs and Social Development to develop national guidelines on women and girls’ empowerment for optimal nutrition by September 2024.
  • Secure commitments of Federal Ministries, Departments, and Agencies (MDAs) relevant to nutrition (Ministry of Health, Ministry of Women Affairs & Social Development, Ministry of Education, Ministry of Finance, Budget and National Planning, Ministry of Agriculture and Rural Development) to increase the number of women in decision-making positions by at least 10% by 2024.
  • Increase gender equity in the access and utilization of public economic empowerment schemes by at least 10% nationally by 2024.
  • Increase awareness of professionals at the federal level, who have the potential to become champions, on the benefits of girls staying in school beyond basic education and the impact on nutrition outcomes.

Milestones Achieved:

The journey towards this transformative vision has been marked by a series of significant milestones:

  • National Workshop on Women and Girls Nutrition: Leveraging momentum towards the pursuit of gender-inclusive nutrition, the National Workshop on Women and Girls Nutrition proved a pivotal event, uniting stakeholders from across Nigeria in a shared mission. Over two days, a dynamic blend of in-person and online participation brought together 167 virtual attendees with 30 enthusiastic on-site participants. Through a diverse array of activities spanning presentations, group discussions, and brainstorming sessions, participants collaborated to create an advocacy goal and four strategic objectives tailored to Nigeria’s unique context. Following this workshop, the coalition then agreed crafted a comprehensive advocacy strategy delineating actionable pathways towards achieving project objectives and engaging stakeholders across key sectors.
  • National Guideline for Women and Girl’s Nutrition for Optimal Nutrition: CS-SUNN successfully achieved the primary objective of the Women Nutrition Project by supporting the Federal Ministry of Women Affairs and Social Development to develop a National Guideline on Women and Girls’ Empowerment for Optimal Nutrition. This involved convening a crucial gathering of nutrition stakeholders, including government ministries, agencies, and partners, to review and shape the guidelines content and framework. The resulting guideline, spanning six key sections, addresses critical aspects of empowerment principles, program initiatives, policies, coordination mechanisms, and implementation strategies. The Guidelines were recently validated and has been adopted by the  key stakeholders including the Federal Ministry of Women Affairs, representing a key step towards empowering women and girls nationwide. It will be launched before the end of 2024.
  • Women In Power Conference: In May, the coalition hosted the Women in Power Conference for Nutrition, convening women from various spheres of society, including governor’s wives and accomplished professionals. The conference served as a platform to spotlight the pivotal roles women play in driving advancements in women and girls’ nutrition at the state level. Encouragingly, there is strong enthusiasm to establish this conference as an annual fixture in Nigeria, serving as a forum to evaluate the progress and commitments made by governor’s wives in advancing the nutrition agenda.
Governors’ Wives at the maiden Women in Power Conference for Nutrition
  • Media Engagement: Leveraging the power of media, CS-SUNN organized media roundtable sessions to raise awareness, secure media support, and promote discussion on policy actions required on women and girls’ nutrition. The events garnered extensive coverage across prominent media, amplifying the discourse on this critical issue. With series of social media campaigns like; Women and Girl’s Nutrition: Why it Matters, gender equity in accessing public economic empowerment schemes, alongside the importance of girl-child education beyond basic schooling, CS-SUNN elevated awareness and advocacies for empowering women. Collaborating with partners such as Bridge Connect, wcyheIN, and Womenadvocate and leveraging visually appealing social cards and hashtags like #NutritionTuesday, #Nutri4Women, and #Nutri4Girls, trackable metrics underscored the campaigns’ impact, with significant reach and engagement rates observed across platforms.
Media roundtable hosted by CS-SUNN
  • Community Empowerment: Recognizing the importance of grassroots engagement, community town hall meetings were conducted to mobilize support from and empower local leaders. These interactions fostered commitments by community leaders to set up committees headed by cabinet members to sensitize households within their communities on the need to empower women and the girl child through access to quality education and livelihood support.

Looking Ahead

The Women and Girls’ Nutrition Project stands as a testament to the power of collaboration, innovation, and determination. Building on the momentum generated, the project will drive lasting change by: addressing cultural barriers through community involvement; educating mothers on the importance of girl-child education; introducing media study circles to deepen media coverage on women’s nutrition; and shifting an advocacy focus to implementation, ensuring that advocacy efforts translate into tangible policy changes and action.

Through concerted efforts and unwavering commitment, we move closer to a future where every woman and girl in Nigeria has the opportunity to thrive and to contribute to a healthier, more prosperous nation.

From Food Security to Nutrition Security: Bridging the Gap for a Healthier World

Photo: K. Trautmann via Flickr

“Fighting global food insecurity means more than feeding the world – it also means nourishing the world. Calories alone are insufficient to increase individuals’ well-being, fuel economic growth and build resilient, prosperous communities.”

2023 Feed the Future Snapshot

After more than 3 years of worst-case scenario hunger headlines, this year’s plateau in global food insecurity was, relatively, a breath of fresh air. Global hunger remained relatively unchanged this year, and we saw the gender gap in food insecurity, which got worse during the pandemic, decrease by 37%.

But despite these positive-seeming signs, we are not yet out of the woods. Global food insecurity remains far worse than it was in 2019, with 122 million more people facing hunger in 2022 than in 2019. Ongoing conflict, as well as climate and economic shocks, threaten to tip the scales and send food insecurity numbers surging again. In this crisis, it is easy to view the quality of calories as less important than the quantity, but there are millions of vulnerable people who cannot sustain themselves on calories alone. Experts estimate that over half of preschool-aged children and two-thirds of non-pregnant women of reproductive age worldwide have micronutrient deficiencies. Even if we fed every hungry person today, millions of women and children would still be malnourished, jeopardizing their wellbeing and limiting countries’ overall potential and growth. As we focus on the monumental task of addressing these sky-high rates of global hunger, we must ensure achieving nutrition security is a fundamental component of our food security strategy.

Nutrition security means making sure people not only have enough to eat, but that they have sufficient nutrients to ensure they are not malnourished. It means moving beyond solutions focused merely on providing hungry people with starchy staples that may be able to sustain life but are insufficient to meet their nutritional needs. It means ensuring people have access to diverse diets that include fruits, vegetables, legumes, and animal-sourced foods. When healthy diets are unavailable, it means providing stop-gap nutrition interventions, like specialized food supplements and fortified foods, and screening and treating severely malnourished children promptly with ready-to-use therapeutic foods (RUTF).

Nutrition is often sidelined as a secondary component of food security efforts, but for vulnerable groups, it is often the difference between life and death or a barrier to a child developing to their full potential. The most vulnerable of these groups are children in the 1000-day window between pregnancy and a child’s second birthday for whom even a short bout of malnutrition can cause lifelong physical and cognitive consequences leading them to perform less well in school and earn less as adults. We also know that in times of food insecurity, women often bear the brunt of the hunger burdens for their families, eating last and least to help food stretch further. We must ensure these women get the nutrition care they need, both for their own sakes and because malnourished mothers often give birth to malnourished babies, perpetuating an inter-generational cycle of malnutrition.

To build true food security, we must draw from models that build resilience across vulnerable communities. One such model is the U.S. Department of State’s Vision for Adapted Crops and Soils (VACS) which focuses on developing climate-resilient varieties of nutritious, indigenous crops with the potential to diversify diets and reduce rates of malnutrition. Similarly, initiatives that strengthen and embed nutrition interventions into national health systems build community resilience to food shocks by ensuring nutrition care continues even when food availability diminishes.

In the coming years, the world will face numerous threats to global food security, the most serious of which is likely the growing threat climate change poses to the quantity and quality of food that is available. Increasingly frequent climate shocks will make crops harder to grow and livestock harder to raise which will ultimately decrease food supply and incomes for agricultural workers. The food that does grow will be less nutritionally dense. In the face of these challenges, we will need to take concrete steps to shore up global food security. Clear plans to address malnutrition along with hunger will be key to any successful strategy.

This IWD, #InvestInWomen by Closing the Gender Nutrition Gap

Around the world, more than a billion adolescent girls and women suffer from undernutrition, micronutrient deficiencies and/or anemia. Malnutrition is robbing women of their earnings and energy, adolescent girls of their educational opportunities, and young girls of the chance to grow up to reach their full potential. Without tackling malnutrition, we will never reach gender equality.

The Nutrition for Growth (N4G) Summit is a global pledging moment that brings together governments, philanthropies, businesses, and NGOs to accelerate progress against malnutrition. The next N4G Summit will take place in early 2025 in Paris, France and will be a critical opportunity to spotlight women and girls’ nutrition.

This International Women’s Day, we are calling on governments and donors to prioritize women and girls’ futures by investing in closing the gender nutrition gap at N4G 2025.

Here are five key nutrition issues threatening women and girls, and some concrete solutions governments and donors can pledge to scale at the next N4G summit:

1. Women and adolescent girls face unequal burdens of micronutrient deficiencies, especially anemia.

Anemia is the number one threat to the long-term health of adolescent girls and afflicts almost one-third of women of reproductive age. Progress against anemia lags other nutrition achievements, and only one country (Guatemala) is on track to meet the globally agreed 2030 target on anemia. Meanwhile, deficiencies in vitamin and mineral status, particularly of folate, iron, vitamin A, and zinc, affect 67% of all women of reproductive age (WRA) worldwide. Micronutrient deficiencies can be life-threatening and cause extreme fatigue and poor concentration, hindering learning potential, educational attainment, and productivity. By scaling interventions that target anemia, we can cure millions of women and girls of this debilitating condition.

    Here are two actions that can help: 

    • Fortify staple foods with essential nutrients to prevent, reduce, and control micronutrient deficiencies at the population level.
    • Supply all pregnant women with multiple micronutrient supplements (MMS) with a focus on increasing adherence through improving availability combined with nutrition counseling in ANC services and mid and mass media communications.

    2. Climate change poses a disproportionate threat to women’s nutrition and food security.

    Climate change is increasing extreme weather events like heat waves, droughts, and floods, which impact food quantity, quality, and diversity. These climate shocks will put growing stress on food and nutrition security in the years to come. The food that does grow will be less nutritionally dense, which can lead to deficiencies in certain vitamins and minerals. Women are most likely to bear the brunt of this climate-related food insecurity. Not only are women more susceptible to micronutrient deficiencies, but women and girls are more likely to reduce their food intake and eat last and least in their households. Additionally, poorer regions and disadvantaged adolescent girls and women already bear the brunt of undernutrition and anemia and will be least equipped to respond to the climate impacts likely to hit many of these same regions the hardest. By investing in strategies to build resilience to climate-related malnutrition, we can mitigate some of these effects.  

      Here are two actions that can help: 

      • Promote long-term, climate-resilient food and nutrition security and protect the livelihoods of woman farmers by developing diverse, climate-resilient crop varieties. Contribute to initiatives like the Vision for Adapted Crops and Soils (VACS) Multi-Donor Fund hosted by IFAD.
      • Expand conditional cash transfers (CCTs) targeted to women to allow for greater flexibility in the face of humanitarian emergencies like natural disasters.

      3. Every year, millions of girls miss out on the opportunity to grow, learn, and earn to their full potential because of malnutrition they experience in early childhood.

        As we strive to address inequities in adult women’s nutrition, we must keep in mind the life-changing impact good nutrition can have on young girls today. Girls who are well-nourished are healthier, more productive, and more likely to finish and excel in school, be economically independent, and have healthy babies. Targeted nutrition interventions are a cost-effective way to give girls today a bright future and boost their chances of overcoming poverty and reaching their educational goals.  

        Here are three actions that can help: 

        • Protect large-scale Vitamin A supplementation to prevent vision problems, illness, and death.
        • Ensure children and their parents have access to quality nutrition counseling to promote dietary diversity and the consumption of animal-sourced foods.
        • Expand access to specialized foods (eg. RUTF and SQ-LNS) to prevent and treat child wasting 

        4. Women who choose to breastfeed often face workplace barriers and lack the support they need to be successful.

        Breastfeeding provides numerous benefits to both mothers and their babies. Breastfeeding gives all children the healthiest start in life and promotes cognitive development and acts as a baby’s first vaccine, providing critical protection from disease and death. It also reduces the burden of childhood and maternal illness, lowering health care costs, creating healthier families, and strengthening the development of nations. Family-friendly workplace policies promote gender equity and women’s economic participation, while strengthening the economy. By giving women the information and space they need to breastfeed successfully, they can be empowered to make an informed choice about how to feed their children.  

        Here are three actions that can help: 

        • Enact and promote adequate paid family leave, including maternity and parental leave, and breastfeeding breaks for women who chose to breastfeed.
        • Support breastfeeding mothers with one-to-one and group breastfeeding counseling.
        • Promote greater male engagement in infant and young child feeding (IYCF) to lessen the care burden for mothers.

        5. Commitments made at large pledging moments often lack accountability mechanisms.  

        Large pledging moments are critical for raising the profile of nutrition interventions, but they can only be truly successful if governments, philanthropies, businesses, and NGOs are held accountable for the commitments they make. This accountability requires commitment makers to invest in clear, quality data on spending, outputs, and outcomes.

        Here are three actions that can help:

        • Invest in strong nutrition data systems that ensure routine collection of data on girls and women to support effective policies and programs and to advocate for nutrition investment across sectors.
        • Improve accountability by tracking how global and national actors are currently investing in nutrition data and information systems.
        • Invest in global nutrition financing tracking system to improve coordination, resource mobilization, and resource allocation and regularly track progress on commitments made in the Nutrition Accountability Framework.

        Maximizing Potential: The Impact of Multiple Micronutrient Supplementation (MMS) for Improved Maternal and Child Health

        In the quest for improved maternal and child health and gender equality, we often overlook a fundamental intersection with the importance of good nutrition. The unique biological needs of women, gender disparities in access to food and services, and harmful social norms contribute to an ever-growing gender nutrition gap. During pregnancy, increased nutritional needs due to physical changes and the needs of a growing baby further exacerbate this gap. Micronutrient deficiencies during pregnancy put both mothers and babies at risk of birth complications, small vulnerable newborns, and even death, and the lack of nutrients in this critical period can prevent children from reaching their full physical and mental potential. Multiple Micronutrient Supplementation (MMS) during pregnancy provides a transformative solution to mitigating a wide array of harmful micronutrient deficiencies. During #March4Nutrition, we want to highlight MMS as a proven solution to meet the increased nutritional needs of women during pregnancy and further children’s growth, learning, and overall well-being.

        World Health Organization Releases Guidelines on the Prevention of Acute Malnutrition

        World Health Organization Releases Guidelines on the Prevention of Acute Malnutrition

        In November 2023, the World Health Organization released updated guidelines on the prevention of acute malnutrition, also known as wasting. The guidelines followed the release of guidelines specific to the management and treatment of wasting and nutritional oedema that the organization published in July 2023.

        Preventing malnutrition is key to long-term growth, development, and positive economic outcomes. Nutrition interventions, including those that prevent malnutrition, are some of the best buys in global development. Ensuring children have access to good nutrition when it matters most is one of the most powerful and cost-effective ways to create brighter, healthier futures. Leading economists consistently rank nutrition interventions among the most cost-effective ways to save and improve lives around the world with every $1 invested yielding up to $35 in economic returns.

        Malnutrition continues to be one of the leading drivers of child death and disability. Malnutrition is the greatest threat to child survival worldwide and is the underlying cause of half of preventable child deaths. That is roughly 3 million children dying before their fifth birthday every year. Those who do survive severe malnutrition in early childhood are much more likely than their well-nourished peers to suffer from lifelong illnesses and disabilities.

        We continue to see unprecedented rates of malnutrition and nutrition insecurity as the result of conflicts, climate shocks and stressors, and lingering impacts of the pandemic. New child malnutrition estimates from UNICEF released in May 2023 found that stunting (too short for their age) impacted 22.3% of children under 5 (148.1 million) globally and wasting (too thin for his or her height), the deadliest form of malnutrition, threatened the lives of 6.8%, or 45 million children under 5 globally.

        1,000 Days welcomes the two new recommendations specific to the prevention of wasting and nutritional oedema as well as the two new good practice statements:

        • Recommendation 1: In areas of, or during times of high food insecurity, in addition to infant and young child feeding counselling, specially formulated foods (SFFs), including medium-quantity lipid-based nutrient supplements (MQ-LNS) or small-quantity lipid-based nutrient supplements (SQ-LNS), may be considered for the prevention of wasting and nutritional oedema for a limited duration for all infants and children 6-23 months of age, while continuing to enable access to adequate home diets for the whole family; and in areas of, or during times of high food insecurity, children living in the most vulnerable households should be prioritized for SFF interventions through a targeted approach. However, when targeting is not possible, these SFFs may need to be given to all households through a blanket approach for infants and children 6-23 months of age, while continuing to enable access to adequate home diets for the whole family and providing infant and young child feeding counselling. (Conditional recommendation; Grade: Low certainty evidence)
        • Recommendation 2: In contexts where wasting and nutritional oedema occur, multiple micronutrient powders (MNPs) should not be given to infants and children 6-23 months of age for the specific purpose of preventing wasting and nutritional oedema. (Strong recommendation; Grade: Moderate certainty evidence)
        • Good Practice Statement 1: In contexts where wasting and nutritional oedema occur, preventive interventions should ideally be implemented through a multisectoral and multisystem approach (i.e. food, health, safe water, sanitation and hygiene, and social protection systems). These interventions should include access to healthy diets and nutrition and medical services as appropriate, counselling (breastfeeding, health and nutrition related, especially helping families use locally available nutrient-dense foods for a healthy diet), should address maternal and family needs, and should involve psychosocial elements of care to ensure healthy growth and development.
        • Good Practice Statement 2: Infant and young child feeding counselling must be provided as part of routine care especially in contexts where wasting and nutritional oedema occur. In order for this counselling to have the most benefit for the prevention of wasting and for other child health and nutrition outcomes, personnel carrying out the counselling should have comprehensive training and be supervised regularly, with dedicated resources and time within health system strategic planning for this intervention.

        In both the recommendations and in the practice statements, we were pleased to see mention of a multi-sectoral and family approach to these interventions to prevent wasting and nutritional oedema. It is key to provide access to nutritious foods and nutrition support, including breastfeeding counseling and complementary feeding, to whole families to address maternal, infant, and child nutritional needs. The guidelines note that prevention requires a package of interventions to be implemented together rather than focusing on one single intervention. We also support the recommended psychosocial elements of care to ensure healthy growth and development as preventing malnutrition early in life impacts long-term health.

        These guidelines provide organizations with the tools necessary to prevent, manage, and treat malnutrition. WHO also notes that further research is needed for many of the recommendations outlined in the guidelines to be most effective in efforts to prevent and treat wasting. The guidelines provide a critical opportunity to advocate for the essential resources to support good, life-long nutrition, particularly among vulnerable populations, including those in the 1,000-day window.

        World Food Day 2023 Highlights an Opportunity for the US to Lead on Preventing & Treating Malnutrition

        World Food Day 2023 looks similar to recent past food days as the world continues to grapple with high rates of food and nutrition insecurity due to long lasting impacts of the pandemic, climate shocks and stressors, conflict, and inflation. Although much attention has been paid to rising rates of malnutrition, unfortunately, in 2023, malnutrition continues to impact tens of millions of children around the world. New child malnutrition estimates from UNICEF released in May 2023 found that stunting impacted 22.3% or 148.1 million children under 5 globally and wasting threatened the lives of 6.8%, or 45 million children under 5 globally.

        To meet the Sustainable Development Goals related to food security and nutrition, targeted interventions and significant investments must be made to reverse the current malnutrition trends and speed up progress. Due to the compounding crises impacting malnutrition, it is estimated that to stay on track with reaching global nutrition targets, at least $10.8 billion each year from 2022 to 2030 is needed.

        A new study published just last week in The Lancet shows how dire nutrition needs are, specifically within the 1,000-day window. These new data from WHO, UNICEF, and the London School of Hygiene and Tropical Medicine found that 1 in 10 babies worldwide are born early, with major impacts on health, survival, and eventual economic impact. Since prematurity is the leading cause of death in children’s early years, there is an urgent need to strengthen prenatal care for mothers that protect both mom and baby, focus on malnutrition prevention in early life, and provide postpartum care that nurtures mom and supports breastfeeding.

        In addition to the efforts to treat malnutrition, further attention should be paid to prevention of malnutrition in the first place. Over the last year, USAID has not only released the implementation plan for the Global Malnutrition Prevention and Treatment Act (GMPTA), but also released a position paper on child wasting in June 2023 which outlined specific, actionable steps on how the USG will continue its investments and commitments to reduce and prevent malnutrition globally. Some of these steps include: strengthening nutrition as part of primary health care, building a better understanding of the specific pathways through which food systems can most effectively and efficiently prevent child wasting, improving access to RUTF for treatment and SNFs for prevention, supporting the development of sustainable financing strategies for health systems and the procurement of SNFs, and conducting joint cross-sectional and cross-bureau analyses and/or implementation research in nutrition priority countries.  

        Necessary investments would help to close the nutrition insecurity gaps seen in the most vulnerable populations, including women and children. Our advocacy community continues to seek additional monetary investments from the US Government to improve nutrition security. Malnutrition is the underlying cause of nearly half of all childhood deaths under 5, however, it only received under 1.5% of US global health funding in FY2023 while AIDS, malaria, and tuberculosis collectively netted roughly 72%. For FY24 funding requests, our global nutrition advocacy community requested $300M for the nutrition sub-account which would save the lives of 30,303 children annually according to the World Bank’s Nutrition Investment Framework. Efforts to reduce funding for this account undermine progress made to address malnutrition and will put lives at risk.

        As Congress continues to draft FY24 appropriations bills ahead of the November 17th continuing resolution deadline, we urge them to protect and defend investments aimed at improving the health and nutrition of vulnerable populations, like women and children, particularly in the first 1,000 days. In addition, FY25 budgets and appropriations bill should include investments that both prioritize preventing and treating malnutrition. To accelerate progress on preventing and treating malnutrition, Congress and the US Government must solidify their role as a leader in putting health and nutrition first.

        Nutrition is a Feminist Issue

        Nutrition only featured in three of the 75+ sessions and events of the Women Deliver conference which brought over 6,0000 advocates, activists and decisionmakers to Kigali, Rwanda, last week. But what Women Deliver demonstrated is that nutrition is part of a much bigger framework, and an integral component of the feminist agenda. Here are three reasons why maternal nutrition is a feminist issue:

        1. The gender nutrition gap is real, widening, and solvable:  It is the political failure to meet the unique nutritional needs of women and girls and ensure their access to nutritious diets, nutrition services, and nutrition care. More than 1 billion adolescent girls and women worldwide suffer from undernutrition, including detrimental lifelong effects of the consequences of wasting and stunting, micronutrient deficiencies, and anaemia, according to UNICEF’s Undernourished and Overlooked: A Global Nutrition Crisis in Adolescent Girls and Women report. Malnourished mothers give birth to small and vulnerable newborns with immediate and long-term consequences for individual and societal development and growth. Today, approximately 20 million infants are born with low birthweight globally.  Cultural norms, social roles, economic disparities, and discriminatory practices create and sustain this gender nutrition gap. 1,000 Days was among 40+ organizations to launch Closing the Gender Nutrition Gap: An Action Agenda for Women and Girls. It aims to unite stakeholders in the nutrition, health and gender communities to take specific actions that improve women’s and girls’ nutrition while advancing maternal, newborn and child health and gender equality. The Action Agenda prioritizes actions for healthy diets, access to healthcare and social protection, gender equality and creating an enabling policy environment.
        • Adequate nutrition and breastfeeding are part of a woman’s right to bodily autonomy,  which UNFPA defines as  ‘the power and agency of individuals to make choices about their bodies without fear, violence or coercion’. While the concept is often used to advocate for reproductive justice, it goes beyond sexual and reproductive health and services and encompasses access to the wide range of care and services necessary to keep our bodies, minds and spirits healthy and whole – including nutrition – as per the Positive Women’s Network framework. UNFPA announced the Kigali Call to Action: United for Women and Girls’ Bodily Autonomy  for accelerated investments and actions, with women-led organizations and the feminist movement at the centre. Bodily autonomy is a strong platform to call for the right to breastfeed, as well as access to diverse and nutritious foods for all pregnant and lactating women, babies and toddlers. It is also a powerful aggregator to build a solidarity front against regressive forces. 
        • Maternal health is divisive and divided: As advocates calling attention on specific aspects of a woman’s health and wellbeing, we risk positioning women as a set of issues to be solved and competing for attention and space.  This does not only diminish our voice and reduce our impact, but it also leaves a vacuum for the opposition to fill, with clear, unified anti women’s rights messages.  Calling for reproductive justice, access to antenatal care, newborn and child health, respectful care, nutrition services, exclusive breastfeeding are not competing agendas, but all contribute to redressing the systemic inequalities that women face and that prevent them from reaching their full potential. Feminism, as a social justice movement, provides a larger and stronger platform to join forces and advance women’s nutrition, including nutrition for pregnant and lactating women.

        Unpacking the Joint Child Malnutrition Estimates 2023 Edition

        On May 18, 2023, UNICEF, the World Health Organization (WHO), and the World Bank Group released the Joint Child Malnutrition Estimates, which are published every other year. The new report examines progress to reach the 2025 World Health Assembly (WHA) global nutrition targets and Sustainable Development Goal (SDG) target 2.2 to end all forms of malnutrition. Specifically, the 2030 target is to reduce the number of children under 5 who are stunted by 50% and to reduce and maintain childhood wasting to less than 3%. Given the crises that low- and middle-income countries are experiencing, including conflict, disasters from climate change like severe droughts or flooding, and lasting impacts from the COVID-19 pandemic, it is not surprising, but still alarming, to see that tens of millions of children are affected by stunting and wasting:

        • Stunting impacted 148.1 million children under 5 globally in 2022, or 22.3%.
        • Wasting threatened the lives of 45 million children under 5 globally in 2022, or 6.8%.

        Unfortunately, at the midpoint of the SDG period, the stunting target will not be met if the current trajectory of progress continues. The assessment of progress is not even possible for about one quarter of countries as only about one third of all countries are ‘on track’ to halve the number of children affected by stunting by 2030. Similar to stalled levels on stunting but more severe, an assessment of progress towards the wasting target is not possible for almost half of the countries.

        The disparities of stunting and wasting and lack of progress lies predominantly in Africa and Southern Asia. In 2022, more than half of all children under 5 affected by stunting lived in Asia and two out of five lived in Africa. Additionally, 70% of all children under 5 affected by wasting lived in Asia and more than one quarter lived in Africa. If the current trajectory continues, an estimated 128.5 million children will be stunted in 2030, with about half of those living in Western and Middle Africa.

        Globally, the annual average rate of reduction (AARR) for stunting based on the current trend from 2012 to 2022 is only 1.65 percent per year. But an AARR of 6.08 is required from now to 2030 to achieve the global target of reducing the number of children with stunting to 88.9 million. This rate of reduction is almost four-fold higher than what has been achieved in the last decade.

        As countries move further away from the targets, and investments in critical nutrition interventions continue to be limited or reduced, the child malnutrition targets will become more challenging to achieve. Work must now be accelerated to catch up to the lack of progress which in turn is more costly. To compound this issue, the report also highlighted the dire need for addressing reporting and data gaps in countries and regions to measure and indicate progress on child malnutrition.

        The report underscores the importance of reminding  decisionmakers, like legislators and policymakers, and program implementers that all forms of malnutrition are preventable and that it is not too late to get countries and regions on track to meet these critical targets. Nutrition interventions are relatively inexpensive to implement and have an extremely high return on investment (ROI), with every $1 invested yielding up to $35 in economic returns. As malnutrition costs the world $3.5 trillion in lost productivity and healthcare costs each year, smart investments in global nutrition now would support billions of children to reach their full potential and help end the cycle of poverty and malnutrition once and for all. By ensuring all children and families have access to nutritious foods and essential health and nutrition services through proven nutrition interventions, substantial progress can be made to reduce and prevent stunting and wasting.   1

        Undernourished and Overlooked: A Global Nutrition Crisis in Adolescent Girls and Women

        Photo credit: Paula Bronstein/Getty Images/Images of Empowerment

        Published: March 2023 

        Publication: Undernourished and Overlooked: A Global Nutrition Crisis in Adolescent Girls and Women 

        Authors: United Nations Children’s Fund (UNICEF) 


        In the 12 hardest-hit countries, the number of pregnant and breastfeeding women and adolescent girls suffering from acute malnutrition has soared from 5.5 million to 6.9 million – or 25 per cent – since 2020.  

        More than 1 billion adolescent girls and women worldwide suffer from undernutrition which includes underweight and short height, micronutrient deficiencies, and anemia.  

        Globally, 51 million children under 2 are stunted. Almost half of all stunting early childhood originates during pregnancy or in the first six months of life – a time when children are entirely dependent on their mothers for nutrition.  


        The report analyzes the current status, trends and inequities in the nutritional status of adolescent girls and women of reproductive age (15-49 years), the barriers they face in achieving a nutritious diet, utilizing essential nutrition services, and benefiting from nutrition and health-focused practices. Data were analyzed from more than 190 countries and territories, representing more than 90% of adolescent girls and women from around the globe. 


        • Progress on addressing adolescent girls’ and women’s nutrition is not advancing quickly enough and has been deprioritized. The current global food and nutrition crisis may slow progress even further and no region is on track to meet the 2030 global targets to reduce anemia in adolescent girls and women by half and low birthweight in newborns by 30%. 
        • Prevalence of undernutrition and anemia is highest in the lowest income regions and disadvantaged adolescent girls and women are more likely to experience it. The prevalence of underweight among adolescent girls and women belonging to the poorest households is double the prevalence in the wealthiest households (14% v. 7%). 
        • Poor nutrition is generational. The nutritional status of a mother, including weight, height, and low birthweight, are consistent predictors of stunting and wasting in early childhood. Child undernutrition is concentrated in the same regions as maternal undernutrition.  
        • The global food and nutrition crisis is worsening the health and nutrition in adolescent girls and women. Adolescent girls and women have been disproportionately impacted by the COVID-19 pandemic and its impact on livelihoods, income, and access to nutritious food. They are also disproportionately impacted by conflict, climate change, poverty, and other economic shocks.  
        • Diets of adolescent girls and women are not diverse enough to meet nutritional needs. Fewer than 1 in 3 adolescent girls and women have diets meeting the minimum dietary diversity in the Sudan, Burundi, Burkina Faso, and Afghanistan. In other countries, the percentage of women being able to access nutritionally adequate, diverse diets, continues to fall.  
        • Gender and social inequalities have further slowed progress on improving nutrition in adolescent girls and women. Child marriage and adolescent pregnancy have profound negative impacts for nutrition in adolescent girls and their children. Often, women do not have the ability to make their own decisions, including those that would enhance their education and employment opportunities. 
        • The nutrition programs and services designed to address undernutrition have not reached the number of women or adolescent girls impacted or has not met the full nutritional needs of these populations. Only 2 in 5 pregnant women benefit from iron and folic acid supplementation for the prevention of maternal anemia and only 29 low- and middle-income countries provide multiple micronutrient supplements, or prenatal vitamins. Conflict and humanitarian crises like the one in Afghanistan, have made these gaps in coverage grow even larger. 
        • There are policy gaps in addressing undernutrition in adolescent girls and women. Of the eight key policies reviewed that address adolescent girls’ and women’s nutrition, only 8% of countries have all of the policies while 39% have only four or less. 

        Governments, development and humanitarian partners, the private sector, civil society organizations, and research and academia sectors must work together to strengthen nutrition governance, activate the food, health and social protection systems, and transform harmful social and gender norms to deliver nutritious and affordable diets, essential nutrition services and positive nutrition and care practices for adolescent girls and women everywhere. 

        Key Quotes: 

        “Women and girls need access to nutritious and affordable diets, including fortified foods, and essential nutrition services before and during pregnancy and while breastfeeding.” 

        Advocating for Nutrition, Maternal and Child Health Funding

        From left to right: Dorothy Monza (RESULTS), Stephanie Hodges (1,000 Days), Andrew McNamee (Food for the Hungry), John Goetz (Legislative Correspondent for Sen. Tim Scott), Daren Caughron (Bread for the World)

        Each year, there is an appropriations process that determines the budget for the federal government and the programs that it carries out. The President releases a budget, which provides insight into an administration’s priority, but ultimately, it is up to Congress to draft and pass the budget for the federal government each fiscal year. 1,000 Days, an initiative of FHI Solutions, raises awareness of this process and engages every year to advocate for robust funding to support and promote maternal, newborn, and child health and nutrition.

        In partnership with the Maternal, Newborn, and Child Health Roundtable (MNCH RT), and representing the 1,000 Days Advocacy Working Group (AWG), 1,000 Days led and attended Hill meetings in both the House and Senate to advocate for funding increases for the Maternal and Child Health Account and the Nutrition account within the United States Agency for International Development (USAID). We conducted nearly 40 meetings and secured sign-ons to Dear Colleague letters from Democrats and Republicans in the House and Senate supporting these funding increases.

        In FY23, the nutrition account was funded at $160 million, and the maternal and child health account (MCH) was funded at $910 million. To address the malnutrition crisis and to meet the moment of increased health and nutrition needs, our International Non-Governmental Organization (INGO) community is requesting $1.15 billion for the MCH account, which includes $340 million for Gavi, the Vaccine Alliance, and $300 million for the nutrition account within USAID. 

        These additional investments can help close the food and nutrition insecurity gaps and pick up the pace on progress toward ending malnutrition which has slowed over the past 12 years. In 2021, 5 million children under age five died from mainly preventable and treatable diseases, with malnutrition as the underlying cause of roughly half of these deaths. Additionally, 300,000 women die annually of preventable causes related to pregnancy and childbirth. 

        The Nutrition account within USAID supports nutrition programs for women and children, focusing on the 1,000-day window, the time between pregnancy and a child’s second birthday. It is crucial to reach children and their caregivers early in life with interventions like breastfeeding support and vitamin A supplementation to prevent malnutrition. When children are malnourished, early detection and access to therapeutic foods can save lives. Severely malnourished children are much more likely to have weakened immune systems and are at risk of permanent physical and mental stunting, which prevents them from reaching their full educational, social, and earning potential. Malnutrition costs the world $3.5 trillion in lost productivity and healthcare costs each year. The current global food crisis, fueled by conflict, climate shocks and the threat of a global recession, continues to threaten the lives of women and children globally. Full funding of the nutrition account is critical for saving lives and reaching USAID’s goal of ending preventable child and maternal deaths.

        As Congress establishes budget levels for FY24, we urge them to include the increased funding levels for USAID and we will continue to advocate for these funding increases. If investments are not made in preventing and treating malnutrition and improving maternal and child health, we will continue to see backsliding of the progress made and lives lost. Now is the time to act to ensure mothers and children have the health and nutrition supports they need within the first 1,000 days and beyond.