The Nutrition Crisis Hidden Within the Pandemic

We cannot let a generation of children lose their potential or lives to malnutrition due to COVID-19

Jul 28, 2020 · 5 min read
In the West Java region of Indonesia, health workers measure a baby boy as part of a malnutrition screening during a monthly village health day. / Millennium Challenge Corporation

Good nutrition is the foundation for a good life. But in too many places around the world, children never enjoy this healthy start. Now, the COVID-19 pandemic is making it more difficult for families to nourish their children, placing an entire generation at risk. New data shows just how significant this impact could be.

USAID has advanced good nutrition for mothers and children in developing countries for over five decades for two primary reasons. First, almost half of all children who die young die from illnesses related to malnutrition. Second, for those who do survive, malnutrition can still undermine their cognitive and physical development and imperil their future. This ultimately affects entire countries, holding them back from advancing in their development. In other words, the Journey to Self-Reliance starts with good nutrition early in life.

Nutrition relies on many factors and, as such, requires a holistic approach. To promote good nutrition, USAID coordinates investments across health, food and agriculture, humanitarian assistance, and social safety nets. In 2019 alone, we reached more than 27 million children with nutrition programs.

In Sudan, a health worker measures the arm circumference of a child during the pandemic. / USAID & GOAL Global

COVID-19 imperils nutrition gains and makes our work more urgent than ever

The COVID-19 pandemic is an unprecedented threat to nutrition. It is simultaneously disrupting every sector that families rely on to nourish their children. As families’ incomes drop, they can no longer afford nutritious foods. Producers and sellers of nutritious foods are struggling to stay afloat. Health systems are overwhelmed, families are more reluctant to access needed healthcare, and efforts to stop the spread of COVID-19, while necessary, are decreasing coverage of life-saving care. Misinformation and reduced support make it harder for mothers to breastfeed. The need for humanitarian assistance is growing while it is becoming more difficult to deliver it safely. Social safety nets are struggling to expand to meet growing poverty.

In Madagascar, Elena Tantely Rasoarilala, 21, is accompanied by midwife Harivao Ramangorotsoa, 54, while holding her 1-day-old baby girl, Tiphanie Sombiniaina Fanavotantsoa. / Karen Kasmauski, MCSP

These disruptions add up and are being documented by governments, donors, and multiple humanitarian organizations.

New analyses published in The Lancet by the Standing Together for Nutrition consortium estimate that wasting, the deadliest form of malnutrition in which children become too thin and require treatment, could affect an additional 6.7 million children in 2020. Combined with decreased coverage of life-saving nutrition interventions, this increase in wasting could mean an additional 130,000 children die this year. Half of these deaths would be in sub-Saharan Africa alone.

These projections are sobering and are just the tip of the iceberg. The consortium is also developing projections regarding COVID-19’s impact on other forms of malnutrition and their irreversible consequences for children.

In the Satkhira District of Bangladesh, a mother feeds her son milk produced by her family’s dairy cows. / Photo by Asafuzzaman Captain, ACDI/VOCA

Examples of USAID’s current and ongoing actions

These analyses are essential to help the world prioritize action. But projections are not destiny. We firmly believe that, by working together, the world can meet this challenge.

USAID and its partners have already taken action to protect nutrition and prevent more children from falling further into malnutrition. While more needs to be done, we have already seen inspiring examples of our partners innovating to save lives and prevent loss of children’s futures during this crisis.

In Colombia, as part of USAID’s humanitarian response to the Venezuela regional crisis, partners have switched nutrition counseling from in-person to cell phones to help families continue breastfeeding and introduce nutritious foods to their infants.

In Zimbabwe, partners are distributing food through smaller groups that make social distancing possible. They are also sharing nutrition counseling and information about COVID-19 through community radio and social media.

In Zambia, a USAID partner is working with small- and medium-sized food producers to determine consumer need for nutritious foods during the pandemic and adapt operations accordingly.

In Nepal, USAID’s Suaahara (“Good Nutrition”) program is well-established in 40 underserved rural districts. It has quickly adapted to deliver nutrition services while minimizing transmission risk and has added messages on how to reduce transmission into virtual nutrition counseling.

Patricia Dhaka from Musana, Bindura district. Patricia is one of the approximately 1.8 million Zimbabweans receiving USAID-funded food aid, part of efforts to address the dire humanitarian situation and food insecurity during the COVID-19 lockdown. / Tatenda Macheka, WFP

The road ahead

Analyses like the ones by Standing Together for Nutrition and close monitoring of COVID-19’s unfolding impact on nutrition provide us with evidence to guide our actions.

USAID’s immediate priorities regarding nutrition and COVID-19 are to:

  • Safeguard access to safe, nutritious foods, particularly for young children and pregnant and lactating women
  • Promote and protect breastfeeding
  • Maintain delivery of life-saving nutrition interventions through health systems and humanitarian responses while minimizing risk of transmission.
In Kathmandu, Nepal, a community health volunteer in personal protective equipment administers a Vitamin A supplement to a child during the pandemic. / Ashmita Dhungana

As the pandemic hampers existing nutrition strategies, such as child health campaigns, countries must have plans in place for resuming progress as soon as conditions allow to recover lost ground. As we build back, we need to ensure that food systems are producing and delivering safe, affordable nutritious foods and that health and community systems mainstream delivery of critical nutrition interventions. The stronger these systems are both locally and globally, the better able they will be to manage shocks in the future — whether they be pandemics, natural disasters, or other crises. In a word: They can be resilient.

In 1965, the Agency’s pioneer leader on nutrition and our first nutrition programs director, Dr. Martin J. Forman, said: “The task is huge. But the rewards are infinitely greater.” We all need to move forward in that spirit today, so that the legacy of this pandemic does not become a generation of children who have lost their potential or lives to malnutrition.

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About the Authors

Trey Hicks is USAID’s alter ego for the Associate Administrator for Relief, Response, and Resilience; Dr. Alma Golden is USAID’s Assistant Administrator for Global Health; and Shawn Baker is USAID’s Chief Nutritionist.

U.S. Agency for International Development

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