Briefing Papers Number 14, February 2012 | Page 11

Figure 4 Relative Odds of Death for Children Under Age 5,
Based on Nutritional Status

Odds ratio

for children under five who are
malnourished than for those who are
not.73 Thus, improving early childhood
nutrition can also help meet MDG 6:
Combat HIV/AIDS, Malaria, and
Other Diseases.
People’s ability to fight diseases and
infections such as HIV and malaria is
also influenced by their nutritional status. Infections and malnutrition exacerbate each other, potentially creating
a vicious spiral into ill health and ultimately death.74 Good nutrition, on the
other hand, may contribute to slowing
the progression of diseases and can optimize the benefits of drugs used to treat
the diseases. For those who are living
with HIV—especially small children—
good nutrition is key to recovery from
opportunistic infections.75

10
9
8
7
6
5
4
3
2
1
0

9.4
8.7

6.3

3

2.9
1.6

1.6

1

all deaths

death from
diarrhea

4.2
3.2
2.1
1 1.3

death from
pneumonia

3.7
2.8

3
2.3

1 1

death from
malaria

1.7
1

death from
measles

■ if properly nourished
■ if stunted (but not severely) ■ if severely stunted
■ if wasted (but not severely) ■ if severely wasted
Source: The Lancet (2008).

Parasite Control
Parasitic infections exacerbate undernutrition, and vice
versa. For example, intestinal worms can cause iron-deficiency anemia by feeding directly on the blood of their host.76
Controlling parasites requires measures such as preventing
malaria and providing education on preventing hookworms,
as well as more direct treatment of parasitic infections. Vaccination campaigns and community outreach health services
provide platforms to deliver deworming treatments.
Pregnant women should benefit from active parasite prevention—especially malaria prevention—since malaria during
pregnancy contributes to infant mortality. Malaria prevention and control programs should prioritize correct diagnosis and treatment of malaria according to national protocols
and ensure availability and adherence to anti-malarial medications for all pregnant women. For example, Intermittent
Preventive Treatment is a full therapeutic dose of an antimalarial drug given to pregnant women at specified intervals
in the second and third trimesters. Insecticide-treated nets
should be promoted and distributed for increased access and
use, especially by pregnant women and young children.

Water, Sanitation, and Hygiene
Water, sanitation, and hygiene programs are key to
preventing intestinal parasites and other diseases associated with contaminated water or poor hygiene. Malnutrition-associated diarrheal infection can be addressed
by integrating such programs with health and nutrition
programs. Facilities providing potable water and good
sanitation can dramatically improve nutrition. Howevwww.bread.org

4.6

4.1

1

6

er, such improvements are significantly undercut when
individual households are unable to store water safely.
The Lancet series on maternal and child undernutrition found
that sanitation and hygiene interventions that reached a high
proportion of the target populations reduced the prevalence
of diarrhea and, in turn, stunting. Diarrheal diseases and related malnutrition account for virtually all of the deaths and
nearly 90 percent of the overall disease burden associated
with unsafe water supplies and inadequate sanitation and
hygiene.

Agriculture, Health, and Nutrition Linkages
Volatile food prices, increased food insecurity, and
hunger emergencies—including famines—have led to an
increased focus on global agriculture interventions. Developing countries generally face seasonal variations in food
availability—“hunger seasons” are common in some areas.
Hunger or risk of hunger is linked, of course, to physical and
emotional suffering. Food insecurity compromises dietary
quality and nutritional status. Hunger and food insecurity
disproportionately affect vulnerable populations such as
women, children, and people living with HIV/AIDS. The
damage to children from food insecurity is particularly worrisome since adequate nutrition is vital to children’s physical and cognitive health and development.
USAID defines food security77 as: “When all people at all
times have both physical and economic access to sufficient
food to meet their dietary needs in order to lead a healthy
and productive life.” This definition of food security has
three components—food must be available, accessible, and
actually consumed. Food security can only be achieved if a
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