Ending child malnutrition

Sri Lanka has a challenge, that of dealing with child malnutrition. Even though the country has made large strides in dealing with child-related issues, including ensuring vaccinations, lower child and mother mortality rates, and very high school enrolment, rooting out child malnutrition has remained an outlier. This is partly because there needs to be a coordinated approach across multiple sectors, which requires stronger Government and other stakeholder commitment. 

Child malnutrition in Sri Lanka remains a major problem facing the country, with many children experiencing acute malnutrition, otherwise known as wasting, and chronic malnutrition, otherwise known as stunting. Once malnutrition reaches these levels, later intervention cannot really turn back the damage, and the child ends up losing much of their potential. 

According to the Demographic Health Survey 2016, the prevalence of stunting, wasting and underweight among children under five years of age remained static at 17.3%, 15.1% and 20.5%, respectively (a level of 15.1% is categorised as ‘very high.’ The prevalence of wasting in the country places Sri Lanka among the 10 worst low- and middle-income countries in the world, with worse rates than Nepal, Bangladesh and Afghanistan.

The irreversible damage of malnutrition to a child’s health and development is enormous. While the problem of wasting increases the risk of stunted growth in a child, which is usually irreversible even if experienced just once, stunting leads to impaired growth and development, including of the brain. 

This damage is lifelong, and not only hampers a child’s performance in school, but also limits their cognitive abilities, health and work productivity in later life, undermining a country’s sustainable national development.

Over the years, Sri Lanka has evolved many policies, and put programs and interventions in place, but these have proven inadequate to tackle the magnitude of the malnutrition issue, combined with the low financing for nutrition-specific intervention indicating rates lower than other countries in the region.

A multi-sectoral coordination mechanism under the Presidential Secretariat is aiming to convene the technical and financial resources of all crucial sectors including Finance and Planning, Health, Education, Women, Child Affairs and Social Security, Agriculture and Water, given the complexity of the nutrition challenge and inequities prevalent across diverse geographic regions.

Increasing national budget investments in financing for nutrition interventions is an essential part of this. Currently Sri Lanka allocates only 0.49% of total Government expenditure on nutrition-specific interventions, and 1% of GDP on nutrition interventions at large, which is low when compared to other countries in the region, including Bangladesh and Nepal. Implementation of a Multi-Sectoral Action Plan for Nutrition (2018 – 2025) requires funding support from bilateral and multilateral donors, which will help accelerate efforts to address malnutrition. 

It is therefore essential that this multi-pronged approach is successful. Not only is it a tragedy for any child to suffer from malnutrition, but their lost potential is a loss for their families, society, and the entire country. The greatest value that any country can invest in is their own people, and to have over 15% of that resource affected by malnutrition is tragic. The Government has to do better – we have to do better.