Social and Economic Impact of Child Undernutrition Briefing

Social and Economic Impact of Child Undernutrition Briefing

Social and Economic Impact of Child Undernutrition Briefing at the 3rd Capacity Development Symposium Harare, 3-5 May 2016 Thomas Yanga, Director WFP Office to AU&ECA The Nutrition Challenge Under-nutrition caused 45% of all child deaths in the . world in 2013 > 90% in Asia and Africa. Two billion people suffer from micronutrient deficiencies. 18 of the 20 hardest affected countries are in sub-Saharan Africa. 69-82% of all cases of child under-nutrition are not treated properly. The Nutrition Challenge Globally 162 million children under five years of age are stunted The majority (40%) of the worlds stunted children live in sub-Saharan Africa. Globally, 51 million children are wasted.

28% live in Africa. Stunting and Growth Photo of Twins Photo shows normal growth (taller child) and stunted growth (shorter, thinner child) Cost of Hunger in Africa (COHA) Overview COHA was initiated to raise the profile of malnutrition in Africa demonstrate its far reaching consequences to economic development. COHA was adapted for African Context, from a model developed by the Economic Commission for Latin American Countries - ECLAC. Study is implemented by National Implementation Teams (NITs) comprising multisectoral representation, and uses National Data DHS, Household surveys, National Census etc. It estimates the social and economic impact of child under-nutrition by quantifying costs to 3 sectors - Health, Education and Labour children EffectsUndernourished on HEALTH have lower resistance to infection and are more likely to die of common childhood illnesses such as diarrhea and lower respiratory-tract infections.

For every additional case of child illness, both the families and health system are faced with additional economic costs. Increased cases related pathologies (ADS, How much on Health? Country Egypt Swazilan Burkina Ethiopia d Uganda Faso Ghana Malawi Total (millions of USD) 213 154 7 259

63 199 46 % of costs covered by the families 73% 89% 88% 87% 58% 70% 49% Public costs as % of health public expenditure 1.60% 2.30% 0.60% 11.00%

4.5% 4.1% 19.5% Total health costs as % of GDP 0.10% 0.50% 0.20% 0.60% 0.5% 0.8% 1.60% The economic cost of undernutrition ranged from values equivalent to 0.6% to 20% of government budget allocated to Health and from 0.1% to 1.6% of GDP A child who is undernourished is at risk of suffering from cognitive and physical impairment, which have impact on quality of life as a child and an adult within the society.

Stunted children are more likely to repeat grades in school or even drop out. Effects on EDUCATION How much on Education? Country % Repetitions Economic Cost associated with Local Currency USD (in Stunting millions) Egypt Ethiopia 10% 16% Swaziland Uganda 12% 7% Burkina Faso 5,8% Ghana

10,5% Malawi 18% Rwanda 13,5% Total EGP 271 ETB 93 million SZL 6 million UGX 16.5 billion 853 millions FCFA 14,9 millions GHC 3,4 billions MWK 2,4 billion RWF Proportion covered by the Families 49 8 39%

64% 1 8 70% 45% 1.7 75% 8.3 66% 13.9 35% 3.9 67% 93.8 46% Various studies have shown that when a child is stunted, this will have an impact on him/her when he/she enters the labour force.

In general, stunted workers are less productive in manual and non-manual labour than non-stunted workers, and are less able to contribute to the national economy. Effects on PRODUCTIVITY How much on Productivity? Country Population of Working Age (15-64) Estimated Number of stunting People Prevalence Lost Productivity in Lost Productivity in Non-Manual Activities Manual Activities National Currency USD

% of GDP National Currency USD % GDP Egypt 20 Million 40% 2.7 billion EGP 483 million 0.30% 10.7 billion 2 billion EGP 1.00% Ethiopia 26 Million 67%

616 million ETB 52 Million 0.20% 12.9 billion ETB 1.1 billion 3.80% Swaziland 270 Thousand 40% 251 million SZL 30 million 1.00% 126 million 15 SZL

million 0.50% Uganda 8 Million 54% 218 billion UGX 108 million 0.70% 366 billion UGX 180 million 1.10% Burkina Faso 4,7 million 52% 20,8 billion CFA

40,8 million 0.39% 37,2 billion CFA 73 million 0.70% Ghana 5,5 million 37% 628 million GHC 350 million 0.86% 319 million GHC 178 million 0.44%

Malawi 4,5 million 60% 25 billion MWK 102 million 1.76% 16,5 billion MWK 67 million 1.15% Rwanda 3,0 million 49% 40,4 billion RWF 66 million

0.98% 86,5 billion RWF 141 million 1.98% Economic Impact of Child Undernutrition Losses in Annual . Country Local Losses in Currency USD EGP 20.3 Egypt $3.7 billion BURKINA FASO billion 7.6% of GDP $ 802 million ETB 55.5 Ethiopia $4.5 billion billion Rwanda SZL 783 11.5_% of GDP Swaziland $76 million

million $ 820 million $899 UGX 1.8 Uganda trillion million MALAWI $ 802 FCFA 409 Burkina Faso 10.3% GDP billion million $ 597 GHC 4.6 million Ghana $2.6 billion trillion $ 820 RWF 503 Rwanda billion million $597 MWK 147 Malawi billion million The aggregate cost estimation for Health, Education and

Productivity are equivalent to between 1.9% to 16.5% of GDP What are the potential savings of a reduction in child stunting prevalence? Summary of Savings Scenarios Average Annual Savings Country Scenario #1: Halving the Prevalence of Child Undernutrition by 2025 (in million USD) Scenario #2: The Goal Scenario: 10% Stunting and 5% Underweight by 2025 (in million USD) Egypt 133 165 Ethiopia 376 784

Swaziland 3 Uganda Burkina Faso 88 4 131 851 1,453 Ghana 2,285 2,954 Malawi 814 1,137 Rwanda 149 184

4,700 6,811 Total 10 Findings from from the Cost of Hunger in Africa Study * * based on the results from the first 8 countries countries. Some Concluding Facts Undernutrition is responsible for 45% of all under-five deaths. Stunting is irreversible, but preventable. Prevention is cost-effective: $1 invested can yield $16 A 10% increase in GDP leads to a 6% reduction in stunting. Malnutrition is multi-causal-> must focus on nutritionsensitive, as well as nutrition-specific programming. Governments need support to address the underlying causes. Partnerships are essential for a multi-sector approach. COHA demonstrates the heavy costs governments are paying in terms of GDP and development, but it also has severe consequences for the community, the Going Forward 1. Continued collaboration with Member States and donors to enhance nutrition advocacy efforts. 2. 2016 - Ongoing studies Chad, Ghana, Madagascar, Mauritania, Mozambique, Lesotho, Mali, DRC, Zimbabwe.

3. Complete studies in a few more Countries (2016 -17) including Nigeria, South Africa undertake regional comparisons. Going Forward 5. Online Data repository with a dataset of over 20 Countries, data can be made available for public good - additional analysis and research - inform policy. 6. Expand the continental analytical capacity. 7. With ECLAC adapt the methodology to analyze cost of closing the gap identify and cost nutrition/nutrition- sensitive response. 8. Continue with M&E and progress reviews of the countries to ensure COHA is creating Working together we can make a difference A healthy childhood is an important and vital precondition to development. Addressing stunting is a first and crucial investment to build the foundation of the economic and social transformation of Africa. (Malabo Declaration, SDGs, Agenda 2063) Thank You Merci

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