Why does malnutrition increases in Sri Lanka

Introduction

Malnutrition is a scarcity, excess or imbalance of nutrients. It has become an urgent global health issue, with
undernutrition killing or disabling millions of children each year. Right now Sri Lanka faces an approaching
child malnutrition crisis and a looming protein deficit as prices of food supplies has been increasing day by
day due to the ongoing economic crisis island wide.

According to a report issued by UNICEF over 5.7 million people, including 2.3 million children, require
humanitarian assistance in Sri Lanka,, making it among top ten countries with the highest number of
malnourished children. The UNICEF expects the numbers to rise further. (UNICEF, 2022)

According to SLPP legislator and former junior health minister Sudarshini Fernandopulle, a medical
consultant by profession, told the parliament, “We are at a time where it is dangerous for the children and
pregnant mothers. People can’t afford protein based products,” in the debate on malnutrition of children
and mothers.

Opposition lawmaker Rohini Wijeratne told the parliament, “Even the children of high-income earners have
malnutrition because Sri Lankans do not have knowledge about nutrition,” on 7 th September 2022 urging to
provide subsides and food programs to protect the children and expectant mothers.

Causes of Malnutrition in Sri Lanka

Poverty amplifies the risk of and risks from malnutrition. People who are poor are more likely to be affected
by different forms of malnutrition.

According to the World Food Programme, 6.3 million people, or over 30 percent of Sri Lanka’s population,
are “food insecure” and require humanitarian assistance. Of these, around 5.3 million people are either
reducing meals or skipping meals, and at least 65,600 people are severely food insecure as prices of essential
food and protein sources have spiked as food inflation hit a record 93.7% in August Due to sharp
depreciation of the rupee, supply disruptions, and food shortages after former president Gotabaya
Rajapaksa banned chemical fertilizer. The UN estimates that half of Sri Lankan children already require
emergency assistance. The report stated “Over half of all children had to eat less preferred food and children
had to reduce their quantity of food intake. About one in ten children had reduced their frequency of food
intake (twice or less)”. (Priyanka Jayawardena, 2018)

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Consequences of Malnutrition in Sri Lanka

The demographic characteristics of the study participants are presented in Table 1. The mean age of the
children ± SD was 7.6 ± 1.5 years. Their mean height and weight were 123.7 ± 9.2 cm and 23.4 ± 6.7 kg,
respectively. The percentages of thinness and overweight (including obese) among children were 19.3% and
13.4%, respectively, while the percentages of thinness and overweight (including obese) in mothers were
5.0% and 36.5%, respectively. Ethnically, the majority of the participants were Sinhala. Regarding religion,
68.1% were Buddhist and 28.2% were Christian. Almost half of the mothers were in their 30s, and about 30%
were in their 40s. Approximately 70% were housewives, whereas 22.1% were employed outside the home.
As to maternal educational status, most (43.1%) had graduated from secondary school or had received
higher education. A total of 23.6% had a monthly household income of less than Rs 15,000; 58.2% had an
income between Rs 15,000 and Rs 49,999; and 11.2% had an income of Rs 50,000 or greater. Regarding the
number of members of the household, 13.8% had three or fewer members, 31.7% had four members, 34.1%
had five members, and 20.2% had six or more members.(Shinsugi C et.al,Journal Pone)(2019).

National Perspectives on Malnutrition

In 2005 Niger’s food crisis triggered the introduction of a new approach to manage most children with acute
malnutrition as outpatients in decentralized care. The demonstrated effectiveness and feasibility of the
approach and the continuing high burden of acute malnutrition, which affects over 1 million children under 5
in Niger, prompted the Ministry of Public Health (MOH) to issue directives in 2007 to integrate acute
malnutrition interventions into routine health care. This policy change came in response to concerns about
government ownership and capacity for implementation. The policy called for delivery of integrated
management of acute malnutrition (IMAM) in all public health facilities. It allowed rapid geographical
expansion and aimed at resolving access, quality and coverage issues. Partners were no longer direct
implementers but continued to support management of acute malnutrition. Despite the countrywide
decentralization of IMAM, less than one-third of children with acute malnutrition were admitted for
treatment in 2013 (United Nations Children’s Fund 2013 ). As in most low-income countries, Niger’s health
system faces important operational capacity and resource challenges to delivering IMAM services.

IMAM assessments were based on by examining:

1. The problem of acute malnutrition

2. Features of the IMAM interventions

3. Characteristics of the adoption system

4. Health system characteristics

5. The board context

The framework was underpinned by the concept of diffusion of innovations (Rogers 2003  ;  Greenhalgh  et
al.  2004  . The framework encouraged systems thinking by examining the interaction of factors within and
between the five components and any synergistic effects that affected or shaped integration. We defined
‘integration’ from a health system perspective as the extent, pattern and rate of adoption and eventual
assimilation of a package of acute malnutrition interventions into the key functions of the health system in
Niger (Atun  et al.  2010a  ). Integrated care of the child with acute malnutrition and other illness resulting
from activities at multiple levels of systemic, organizational, professional, clinical, functional and normative
integration was central to our study, but generalized from a macro level perspective for the country
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(  Goodwin 2013  ).this study provides insight into factors that influenced the integration of acute malnutrition
into the national health services system in Niger. (Hedwig Deconinck et.al, 2016. Health Policy and Planning)

Personal Perspectives about Malnutrition

According to my point of view I specifically consider that achieving good nutrient is important in universal
healthcare, hence a proper adequate knowledge should be provided to the vulnerable society so that they
can alleviate the nutritional challenges they encounter.

Global Perspective on Malnutrition

WHO ( World Health Organization) verifies that in 2018 women, infants, children and adolescents that live in
low and middle income countries are at the highest risk of malnutrition. Optimizing nutrition early in life-
including the 1000 days from conception to a child’s second birthday- ensures the best possible start in life,
with long-term benefits.

The prevalence of undernourishment, as a share of the population, is the main hunger indicator used by the
UN’s Food and Agriculture Organization. It measures the share of the population which has a caloric (dietary
energy) intake which is insufficient to meet the minimum energy requirements defined as necessary for a
given population. The global map of the prevalence of undernourishment is shown – this measures the share
of the population that are defined as undernourished. Countries with a prevalence below 2.5% are not
shown.

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The visualisation shows the prevalence of undernourishment by world region. (Max Roser & Hannah Ritchie,
2019, Our world in Data)

Countries that have affected by Malnourishment

1. Yemen
Yemen remains one of the largest humanitarian crises in the world, with around 23.4 million people in need
of assistance, including almost 13 million children. Yemen has long battled with some of the highest
malnutrition rates in the world. Until now, humanitarian interventions to treat and prevent malnutrition, as
well as provide emergency food assistance, have prevented an even more severe deterioration. But in 2020,
these hard-won gains are at lost due to the escalating conflict and economic decline, plus the overwhelming
impact of the COVID-19 pandemic, has pushed an already exhausted population to the brink. In addition to
this, many aid projects including emergency food assistance and WASH services have been disrupted by
funding shortfalls. Malnutrition treatment programmes are also at risk if additional funds are not received
soon. These points have made Yemen one of the hardest place for mothers and children. Laurent Bukera,
WFP Country Director in Yemen has told that “The vicious cycle of conflict and hunger in Yemen is exacting a
terrible toll on those who are already the most vulnerable," while rising rates of acute malnutrition put too
many women and children at risk while the consequences will be felt by Yemen for generations to come. We
can stop this devastating trend. The time to act is now.”

To save lives and avert a further worsening of the situation, the United Nations and partners need more
than US$50 million to urgently scale up nutrition programmes, including treatment for children suffering
from severe acute malnutrition. At the same time, funding is also needed to scale-up food, water, sanitation
and health programmes including immunization. (UNICEF, 2020)

2. Ethiopia

Malnutrition contributes to more than 50 percent of all infant and child deaths in Ethiopia. The major causes
of malnutrition are persistent food insecurity, poor maternal and child feeding practices, high incidence of
infectious diseases, and limited access to quality nutrition services. Household wealth, education, and family
planning are also key drivers of children’s nutrition. Twenty-seven percent of women in Ethiopia are thin or
malnourished and 38 percent of children suffer from stunting. Ethiopia’s lowland pastoral areas and densely
populated, food-insecure highland districts suffer frequent droughts, complicating access to and
consumption of nutritious foods. A collaboration of nutrition food programmes has been developing in
Ethiopia which focuses on good maternal nutrition, optimal breastfeeding, and appropriate complementary
feeding to reduce the numbers of stunted children and malnourished women. To keep food safe and families
healthy, health advisers educate households about the importance of key hygiene actions. They also invest
in agriculture and food systems to improve the availability, accessibility, and consumption of nutritious food.
If disaster strikes, we are on the ground with our partners delivering therapeutic foods to reduce the
incidents of malnutrition. USAID also provides technical assistance in developing national policy, programs,
guidelines, and improving the quality and access to essential health and nutrition services, and we work with
hospitals and health centres in Ethiopia to provide nutritional assessments and counselling support. We
enhance nutrition-related activities under the Government of Ethiopia's Productive Safety Net Program
(PSNP) with a focus on improving the quality of health services for pregnant and lactating mothers, raising
awareness of healthy nutrition practices, improving water and sanitation status of children, and harmonizing
activities with the Ethiopian Government's health and nutrition initiatives. (USAID, 2021)

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 3. South Sudan

South Sudan has been facing a tremendous food crisis since its independence a decade ago. More than 8.3
million people need humanitarian assistance and protection, and nearly 3.8 million remain displaced in
South Sudan. 1.4 million Children in South Sudan are expected to suffer from acute malnutrition in 2021, the
highest number since independence ten years ago. More than 300,000 children will suffer from severe acute
malnutrition and are at risk of dying. UNICEF and partners are providing therapeutic treatment and saving
their lives. But, wouldn’t it be better to avoid these children becoming malnourished in the first
place? While treating children suffering from acute malnutrition remains critically important, UNICEF calls
for larger, long-term and predictable investments in reduction of malnutrition in children through a
multisector response, linking nutrition, agriculture, health, water, sanitation and hygiene and social
protection services. UNICEF calls the Government of South Sudan, the donor community as well as the
implementing partners to be part of a joint commitment to prioritize the reduction of malnutrition among
children. Throughout South Sudan, UNICEF is rolling out programmes together with its partners to respond
to the nutrition crisis the country is going through, while setting up intervention that can help reduce the
levels of malnutrition in the country. (UNICEF South Sudan, 2020)

This image was taken from https://ourworldindata.org/hunger-and-undernourishment

Conclusion
In this research, Malnutrition is one of the worlds most serious but least-addressed development challenges.
Its human an economic costs are enoroums, falling hardest on the poor, women and childern. Over the last
three decades, the worldwide prevalance of stunting declined from 40 percent in 1990, to 22 percent in
2022. However, the health and food systems disruptions caused by COVID-19 pandemic has rolled back
years of pogress on child undernutrition: it is estimated that, by 2022, an additional 9.3 million childern will
suffer from acute malnutrition and 2.6 million more childern will be stunded. The best way to prevent and
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reduce malnutrition is to eat a balanced diet, improve health care system, seek knowledge about nutrition,
early detection of malnutrition and intervention, nutrition supplemenation, objective of nutrition
supplementation of infants and childern includes, objective of supplementing pregant and lactating women
include. Prevention is better than cure, so always make sure that your child gets his/her daily dose of the
essential vitamins and minerals like vitamin C, A, D, B, iron, and calcium. Prepare healthy meals and exercise
good hand hygiene at home. Sanitize utensils, drinking glasses and cookware to avoid food contamination.
Furthermore, as civilians of our society we should protect our humanism and evaluate the amount of
healthier and better society.
Referencing
 UNICEF (2022) https://www.unicef.org/media/126106/file/ROSA-Humanitarian-SitRep-30-June-
2022.pdf
Accessed date- 25.01.2023
 Priyanka Jayawardena (2018) https://www.ips.lk/talkingeconomics/2018/04/09/malnutrition-in-sri-
lanka-a-persistent-problem/
Accessed date-25.01.2023
 Shinsugi C et.al, (2019) Journal Pone Double burden of maternal and child malnutrition and
socioeconomic status in urban Sri Lanka. PLOS ONE 15(3): e0230785
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0224222
Accessed date- 25.01.2023
 Hedwig Deconinck et.al, (2016). Health Policy and Planning
https://academic.oup.com/heapol/article/25/2/104/641536
Accessed date-25-01.2023
 Max Roser & Hannah Ritchie, (2019) Our world in Data https://ourworldindata.org/hunger-and-
undernourishment
Accessed date-25.01.2023
 UNICEF (2020) https://www.unicef.org/emergencies/yemen-crisis
Accessed date- 25.01.2023
 USAID (2021) https://www.usaid.gov/ethiopia/nutrition
Accessed date-25.01.2023
 UNICEF South Sudan (2020) https://www.unicef.org/southsudan/all-together-prevent-child-
malnutrition
Accessed date 25-01.2023

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