Key Terms and Definitions
High Burden (Stunting)
Countries3,4,5
These countries have the highest burden of undernutrition, as defined by high prevalence rates6
of stunting among children younger than 5 (see stunting, below). In many high-burden countries,
malnutrition rates are much higher than would be expected given their national income or economic
growth rate. Examples of such countries include India (which has shown sustained and robust
economic growth for more than a decade but no significant reductions in malnutrition), Guatemala,
Angola, and Pakistan. The following 36 high-burden countries are home to 90 percent of the world’s
178 million stunted children (2008 figure) younger than 5:7,8 Afghanistan (59.3% (prevalence), 2004),
Angola (29.2%, 2007), Bangladesh (43.2%, 2007), Burkina Faso (35.1%, 2009), Burundi (57.7%,
2005), Cambodia (40.9%, 2010-11), Cameroon (36.4%, 2006), Côte d’Ivoire (39%, 2007), Democratic
Republic of the Congo (45.8%, 2007), Egypt (30.7%, 2008), Ethiopia (44.2%, 2010-11), Ghana
(28.6%, 2008), Guatemala (48%, 2008-9), India (47.9%, 2005-6), Indonesia (40.1%, 2007), Iraq
(27.5%, 2006), Kenya (35.2%, 2008-9), Madagascar (49.2%,2008-9), Malawi (47.8%, 2010), Mali
(38.5%,2006), Mozambique (43.7%, 2008), Myanmar (35.1%, 2009-10), Niger (54.8%, 2006), Nigeria
(41%, 2008), Nepal (40.5%, 2011), Pakistan (43%, 2011), Peru (28.2%, 2007-8), Philippines (32.3%,
2008), South Africa (23.9%, 2008), Sudan (37.9%, 2006), United Republic of Tanzania (42.5%, 200910), Turkey (15.6%, 2003-4), Uganda (38.7%, 2006), Vietnam (30.5%, 2008), Yemen (57.7%, 2003),
and Zambia (45.8%, 2007). By 2010, the estimate was that 171 million children (of whom 167 million
live in developing countries) were stunted.9
Nutrition Intervention
A nutrition intervention10 is an action purposely planned and designed to change a nutrition-related
behavior risk factor, environmental condition, or aspect of the health status of an individual, a target
group, or a population at large. Nutrition interventions are generally actions taken within larger nutrition
programs. If implemented at scale, an effective intervention is expected to significantly reduce the
effects of maternal and child undernutrition. Nutrition interventions have been found to be effective in
reducing underweight, stunting, wasting, micronutrient deficiencies, and child deaths.11
Direct Nutrition
Interventions
Direct interventions target the immediate causes of undernutrition: inadequate dietary intake and ill
health. A series of high-impact direct interventions has been identified in peer-reviewed articles in The
Lancet and other scientific publications. The 2008 Lancet Series on Maternal and Child Undernutrition12
recommended 13 direct interventions13 to be implemented at scale in countries with high rates of
undernutrition.
Stunting
Stunting14 is defined as a height-for-age ratio that is more than two standard deviations below the
median for the population. (In other words, children are too short for their age). This is also the
measure used to define chronic undernutrition. Stunting is caused by poor diet and frequent