WHO/NMH/NHD/19.20 Stunting affected an estimated 21.9 per cent or 149 million children under 5 globally in 2018. 149 million Levels and trends in child malnutrition UNICEF / WHO / World Bank Group Joint Child Malnutrition Estimates Key findings of the 2019 edition These new estimates supersede former analyses and results published by UNICEF, WHO and the World Bank Group. In 2018, wasting continued to threaten the lives of an estimated = 1 million 7.3 per cent or 49 million children children under 5 under 5 globally. 49 million An estimated 5.9 per cent or 40 million children under 5 around the world were overweight in 2018. 40 million The ultimate aim is for all children to be free of malnutrition in all its forms Good nutrition allows children to survive, grow, develop, shaped, at least in part, by industry marketing and greater learn, play, participate and contribute – while malnutrition access to processed foods, along with lower levels of robs children of their futures and leaves young lives hanging physical activity. in the balance. While malnutrition can manifest in multiple ways, the path Stunting is the devastating result of poor nutrition in-utero to prevention is virtually identical: adequate maternal and early childhood. Children suffering from stunting may nutrition before and during pregnancy and lactation; optimal never attain their full possible height and their brains may breastfeeding in the first two years of life; nutritious, never develop to their full cognitive potential. Globally, diverse and safe foods in early childhood; and a healthy approximately 149 million children under 5 suffer from environment, including access to basic health, water, hygiene stunting. These children begin their lives at a marked and sanitation services and opportunities for safe physical disadvantage: they face learning difficulties in school, earn activity. These key ingredients can deliver a world where less as adults, and face barriers to participation in their children are free from all forms of malnutrition. communities. Despite this opportunity, the UNICEF, WHO, World Bank Wasting in children is the life-threatening result of poor global and regional child malnutrition estimates reveal that nutrient intake and/or disease. Children suffering from we are still far from a world without malnutrition. The joint wasting have weakened immunity, are susceptible to long estimates, published in March 2019, cover indicators of term developmental delays, and face an increased risk of stunting, wasting, severe wasting and overweight among death, particularly when wasting is severe. These children children under 5, and reveal insufficient progress to reach require urgent feeding, treatment and care to survive. In the World Health Assembly targets set for 2025 and the 2018, over 49 million children under 5 were wasted and Sustainable Development Goals set for 2030. nearly 17 million were severely wasted. Improving children’s nutrition requires effective and There is also an emerging face of malnutrition: childhood sustained multi-sectoral nutrition programming over the long overweight and obesity. There are now over 40 million term, and many countries are moving in the right direction. overweight children globally, an increase of 10 million since Regular data collection is critical to monitor and analyse 2000. The emergence of overweight and obesity has been country, regional and global progress going forward. Forms of malnutrition* highlighted in this key findings report Stunting refers to a child Overweight refers to a child Wasting refers to a child who who is too short for his or her who is too heavy for his or her is too thin for his or her height. age. These children can suffer height. This form of malnutrition Wasting is the result of recent severe irreversible physical results from energy intakes from rapid weight loss or the failure and cognitive damage that food and beverages that exceed to gain weight. A child who is accompanies stunted growth. children’s energy requirements. moderately or severely wasted The devastating effects of Overweight increases the risk of has an increased risk of death, stunting can last a lifetime and diet-related noncommunicable but treatment is possible. even affect the next generation. diseases later in life. Overweight Stunted * Some children suffer from more than one form of malnutrition – such as stunting and and and overweight or stunting and wasting. There are currently no joint global or stunted wasted regional estimates for these combined conditions. 2 UNICEF/WHO/World Bank Group – Joint Child Malnutrition Estimates 2019 edition GLOBAL OVERVIEW Malnutrition rates remain alarming: stunting is declining too slowly while wasting still impacts the lives of far too many young children stunting wasting overweight 95% confidence interval 40 200 35 32.5 198.2 160 30 183.0 170.7 25 157.2 120 149.0 21.9 20 Percentage Number (millions) 80 15 10 49.5‡ 40 7. 3 5.9 5 4.9 40.1 35.2 38.6 30.1 32.0 0 0 2000 2005 2010 2015 2018 2000 2005 2010 2015 2018 Percentage of stunted, overweight and wasted Number (millions) of stunted, overweight and wasted children under 5, global, 2000–2018 children200 under 5, global, 2000–2018 Source: UNICEF, WHO, World Bank Group joint malnutrition estimates, 2019 edition. See Notes on Data on page 14 on why only one time point is presented for wasting on the graphs above. ‡ The total number of wasted children under 5 is 49.48 million; this becomes 49 million when rounded to the nearest integer (as on the cover page), and 49.5 million when rounded to the nearest tenth. 160 198.2 Africa and Asia bear the greatest share of all forms of malnutrition183.0 170.7 157.2 120 149.0 Asia 55% Africa 39% Asia 68% Africa 28% Asia 47% Africa 24% 80 In 2018, more than half of all In 2018, more than two thirdsNumber (millions) of In 2018, almost half of all stunted children under 5 lived all wasted children under 5 lived overweight children under 5 in Asia and more than one third in Asia and more than one quarter lived in Asia and one quarter lived in Africa. lived in Africa. lived in Africa. 49.5 40 UNICEF/WHO/World Bank Group – Joint Child Malnutrition Estimates 2019 edition 3 40.1 35.2 38.6 30.1 32.0 0 2000#2000 #2005 #2010 #2015 2018 #2018 Stunting PREVALENCE In 7 sub-regions, at least one in every four children under 5 is stunted GLOBAL GLOBAL Percentage of stunted children under 5, by United Nations sub-region, 2018 21.9% 149.0 million 2.6 Northern 10.9 America*** Central 4.9 GLOBAL GLOBAL Asia Eastern 7.3% 49.5 17.2 million 15.1 32.7 Asia* 12.9 Northern Africa 8.3 Western Southern 25.0 Central Caribbean 29.2 Asia Asia America Western South-eastern 38.2 Africa 35.2 Asia GLOBAL GLOBAL 7.1 ≥30% (very high) 32.1 Oceania**5.9% 40.1 Eastern million 20 – <30% (high) South Middle Africa Africa 10 – <20% (medium) America 2.5 – <10% (low) 29.3 <2.5% (very low) no data Southern Africa Source: UNICEF, WHO, World Bank Group joint malnutrition estimates, 2019 edition. Note: *Eastern Asia excluding Japan; **Oceania excluding Australia and New Zealand; ***Northern America sub-regional average based on United States data. There is no estimate available for the sub-regions of Europe or Australia and New Zealand due to insufficient population coverage. These maps are stylized and not to scale and do not reflect a position by UNICEF, WHO or World Bank Group on the legal status of any country or territory or the delimitation of any frontiers. Large disparities in stunting reduction exist within regions/between sub-regions Trends in the percentage of stunted children under 5, by United Nations region/sub-region, 2000 – 2018 2000 2018 49.7 50 45.8 39.8 40 38.0 38.2 38.4 38.2 36.4 32.9 36.8 32.5 35.2 32.7 30 32.1 28.0 30.0 29.3 29.2 23.7 23.1 23.7 25.0 Percentage 22.7 19.2 20 21.9 16.7 15.2 17.2 13.6 15.1 10 12.9 10.9 9.0 8.3 7.1 3.0 4.9 0 2.6 † † Latin America Africa Eastern Middle Southern Western Northern Asia* Southern South- Western Central Eastern Central Caribbean South Oceania** Northern Global** Africa† Africa Africa Africa Africa Asia† eastern Asia Asia† Asia*† and the America America America*** Asia Caribbean† Source: UNICEF, WHO, World Bank Group joint malnutrition estimates, 2019 edition. Note: *Asia and Eastern Asia excluding Japan; **Oceania excluding Australia and New Zealand; ***Northern America sub-regional average based on United States data only. There is no estimate available for the More Developed Region or for sub-regions of Europe or Australia and New Zealand due to insufficient population coverage. †represents regions/subregions where the change has been statistically significant; see page 12 for the 95% confidence intervals for graphed estimates. 4 UNICEF/WHO/World Bank Group – Joint Child Malnutrition Estimates 2019 edition Stunting NUMBERS AFFECTED Two160 out of five stunted children in 140 2017 GLOBAL GLOBAL the world live in Southern Asia 149.0 120 -39% 2000 21.9% Asia million Number (millions) of stunted children under 5, 100 81.7 million by United Nations16% sub-region, 2018 80 57.9 4.4 60 0.8 Central Asia Southern Asia Eastern Asia* Number (millions) 40 -47% GLOBAL GLOBAL Western Asia 20 Northern 4.2 7.3% 49.5 0.6 9.7 America*** 5.1 million 0 50.6 58.7 134.6 83.6 0.4 0.5 Africa Asia Latin AmericaAfrica Oceania 14.4 58.8 million Northern South-eastern Asia Africa Latin America and Caribbean 4.9 GLOBALOceania** GLOBAL 0.5 million40.1 4.8 million 0.3 5.9% Caribbean 24.0 million Central 2.1 South Eastern Africa America 2.3 18.5 America Western Africa 2.0 9.4 Middle Africa Southern Africa 9.7 million to 5.1 million 50.6 million 134.6 million to Source: UNICEF, WHO,2000 World Bank Group joint malnutrition estimates, 2019 edition.