Cover Image
close this bookOvercoming Child Malnutrition in Developing Countries - Past Achievements and Future Choices. 2020 Vision for Food, Agriculture, and the Environment. Discussion Paper 30 (IFPRI, 2000, 73 p.)
View the document(introduction...)
View the documentForeword
View the documentAcknowledgments
View the document1. Exploring the Causes of Malnutrition
View the document2. Determinants of the Nutritional Status of Children
View the document3. Data and Methods
View the document4. New Evidence from Cross-Country Data, 1970-95
View the document5. How Has Child Malnutrition Been Reduced in the Past?: A Retrospective
View the document6. Projections of Child Malnutrition in the Year 2020
View the document7. Priorities for the Future
View the document8. Conclusions
View the documentAppendix: Cross-Country Studies: Methodological Issues and Past Findings
View the documentReferences
View the documentRecent Food, Agriculture and the Environment Discussion Papers

6. Projections of Child Malnutrition in the Year 2020

Looking forward to the next 25 years, how much is the prevalence of child malnutrition in developing countries likely to decline by the year 2020? How fast is the decline likely to take place? Which regions are likely to experience the greatest improvements in children’s nutritional status? Given population growth, are the numbers of children who are malnourished likely to increase or decrease?

The future prevalence of child malnutrition obviously depends on the degree of effort exerted to reduce it. To answer these questions, the estimation results in Table 6 are applied to three scenarios based on the projected evolution of the underlying determinants of child malnutrition during 1995-2020.17 These are a status quo, or “do-nothing-different” scenario; a pessimistic scenario; and an optimistic scenario.

17 See Smith and Haddad (2000) for a more detailed explanation of the procedure employed for generating projections.

The evolution of the safe water access, female secondary school enrollment, and female-to-male life expectancy ratio variables under the alternative scenarios relies on various assumptions regarding their average annual increases during 1985-95. Per capita dietary energy supplies rely on projections generated by IFPRI’s IMPACT model (Rosegrant, Agcaoili-Sombilla, and Perez 1995).18 These projections are based on assessments of future developments in the world food situation (including changing prices of food and changes in agricultural productivity) and various assumptions about future agricultural research investments, population growth, 19 and growth in nonagricultural incomes. The levels of each explanatory variable in 1995 and under the alternative scenarios are given in Table 12. Figure 6 maps out the past (1970) and expected evolution of the prevalence of child malnutrition (1970-2020) under the alternative scenarios for the developing countries as a whole.

18 The IMPACT model is the International Model for Policy Analysis of Agricultural Commodities and Trade. Developed at IFPRI, it is made up of a set of 35 country or regional models that determine supply, demand, and prices for 17 agricultural commodities.

19 The 1992 medium population growth rates (United Nations 1993) are employed as the basis for population projections in the IMPACT model. The projections of the numbers of children under five years of age in this report are taken from Rosegrant, Agcaoili-Sombilla, and Perez (1995).

Three Scenarios

Status Quo Scenario

In the status quo scenario, safe water access, female secondary school enrollments, and the female-to-male life expectancy ratio improve at the same rates they improved over 1985-95 (see the second column of Table 12). At these rates, the share of the developing-country population with access to safe water would rise from 70 percent in 1995 to 94 percent by the year 2020. The female secondary school enrollment rate would rise from 47 percent to a hefty 87 percent. Corresponding to its slow rate of growth in the previous 10 years, the female-to-male life expectancy ratio would rise only slightly, from 1.047 in 1995 to 1.066 in 2020. Per capita dietary energy supplies would rise from 2,559 to 2,821 kilocalories, which corresponds to current trends in agricultural research investments, population growth, and nonagricultural income growth.

Table 12 - Projections to 2020 of the prevalence and numbers of malnourished children under five in developing countries, alternative scenarios




2020 scenarios

Variable

1995 mean
(1)

Annual increase in variable, 1985-95
(2)

Status quo
(3)

Pessimistic
(4)

Optimistic
(5)

1. Prevalence of child malnutrition (percent)

31

...

18.4

21.8

15.1

2. Number of children malnourished (millions)

167.1

...

140.3

154.8

127.6

3. Access to safe water (percent)

70.2

0.96 a

94.3

88.3

100.0

4. Female secondary school enrollment (percent)

46.6

1.60 a

86.7

76.7

96.7

5. Female-to-male life expectancy ratio

1.047

0.00071

1.066

1.061

1.070

6. Per capita dietary energy supply (DES) (kilocalories)

2,559

...

2,821

2,662

2,978

Notes: The estimates in rows (3) through (5) are based on 1985-95 average annual growth rates (given in column 2) calculated from the reported values of the respective variables given in columns (4) and (6) of Table 14. In the status quo scenario, the growth rates are assumed to remain the same for the period 1995-2020. In the pessimistic scenario they are assumed to fall by 25 percent. In the optimistic scenario they are assumed to increase by 25 percent. The estimates for DES in row (6) are based on IFPRI IMPACT model projections as reported in Rosegrant, Agcaoili-Sombilla, and Perez 1995. The projections correspond to future developments in food prices, agricultural productivity, research investments, population growth, and growth in nonagricultural incomes.

a Percentage points.


Figure 6 - Three scenarios for the evolution of child malnutrition, 1970-2020

Given these trends in the underlying determinants, the share of underweight children under five in the developing countries is projected to fall from 31 percent in 1995 to 18 percent in 2020, a total reduction of 13 percentage points. Roughly one-fifth of developing-country children under five would remain malnourished under this scenario. Given current trends in population growth, the projected reduction in the number of underweight children under five is quite small, only 27 million children (a 16 percent reduction).

Pessimistic Scenario

Under the pessimistic scenario, the rate of improvement in the nonfood underlying determinants is assumed to decline by 25 percent. This scenario might ensue, for example, if growth in per capita national incomes were to decline or governments were to decelerate public investment in social services. In that case the share of the developing-country population with access to safe water rises to only 88 percent by 2020. The female secondary school enrollment rate rises to only 77 percent, leaving almost a quarter of all women without any secondary school education. The female-to-male life expectancy ratio rises to only 1.061, with women’s status relative to men’s improving only slightly.

Per capita dietary energy supplies are assumed to rise to 2,662 kilocalories, an increase of only 4 percent. This latter projection is based on the IMPACT model’s “low-investment/slow growth” scenario in which international donors eliminate public investment in national agricultural research systems and extension services in developing countries and phase out direct core funding of international agricultural research centers. In addition, nonagricultural income growth is reduced by 25 percent from 1990 levels.

The predicted percentage of malnourished children under five in developing countries under this pessimistic scenario is 22 percent. If this scenario were to prevail, only a slight dent in the number of malnourished children would be achieved: a reduction of 12 million, which is only 7 percent below the 1995 numbers.

Optimistic Scenario

In the optimistic scenario the rate of improvement in the percent of the developing-country population having access to safe water is enhanced by 25 percent, leading to universal access by the year 2020. The female secondary school enrollment rate would climb to more than double the 1995 prevalence, reaching 97 percent. The female-to-male life expectancy ratio would rise to 1.07. Corresponding to annual increases of US $750 million in funding for national and international agricultural research and a 25 percent increase in nonagricultural income growth, per capita dietary energy supplies would increase to 2,978 kilocalories (the “high investment/rapid growth” scenario of the IMPACT model).

Under this scenario the prevalence of child malnutrition in the year 2020 would fall to 15 percent. While this rate is still high, it represents substantial progress over the current prevalence, cutting it in half. The number of malnourished children would decline by almost 25 percent, falling to 128 million.

Regional Projections

The projections for the developing countries as a whole mask wide variation across the regions. The regional projections in Table 13 are illustrated in Figure 7 (for prevalence) and Figure 8 (for numbers). There are several points to note.

· Under all scenarios South Asia will continue to be the region with the highest prevalence and numbers of malnourished children. However, both will fall rapidly during the 1995-2020 period. In the status quo scenario - the most likely - prevalence will fall from 49 percent to 37 percent. Despite a slight increase in the total population of children under five (from 174 to 176 million), the number of malnourished children will fall from 86 million to 66 million, a 23 percent decline.

· Little progress in reducing child malnutrition will be made in Sub-Saharan Africa. Under the pessimistic scenario, the prevalence of malnutrition is predicted to increase from a 1995 rate of 31 percent to 32 percent in 2020. Even under the optimistic scenario, prevalence would decline by only 5.4 percentage points. Given slow rates of decrease in prevalence and large expected increases in the total number of children under five (101 to 169 million) under all scenarios, the number of malnourished children is expected to increase in the region, rising as high as 55 million under the pessimistic scenario, a number not far below that for South Asia.

· The prevalence and number of malnourished children are expected to decline the fastest in the East Asia region. Under all scenarios the prevalence of malnutrition is nearly cut in half, falling to about 12 percent of the population. No increase is expected in the total number of children under five over the period. The number of malnourished children thus will fall precipitously from 38 to around 21 million.

· In the Near East and North Africa region, malnutrition will fall to very low levels, except under the pessimistic scenario, in which almost 5 million children under five will be malnourished.

· Malnutrition will almost be eliminated in Latin America and the Caribbean (although some countries within the region will continue to have high rates).

Table 13 - Projections of the prevalence and number of malnourished children in developing countries, alternative scenarios, by region, to 2020

Region

1995

2020
status quo

2020
pessimistic

2020
optimistic


(percent)

Percent underweight


South Asia

49.3

37.4

40.3

34.5


Sub-Saharan Africa

31.1

28.8

32.4

25.7


East Asia

22.9

12.8

13.1

12.6


Near East and North Africa

14.6

5.0

7.4

3.7


Latin America and the Caribbean

9.5

1.9

4.0

0.0


All developing countries

31.0

18.4

21,8

15.1


(millions)

Number underweight


South Asia

86.0

66.0

71.1

60.9


Sub-Saharan Africa

31.4

48.7

54.6

43.3


East Asia

38.2

21.4

21.9

20.9


Near East and North Africa

6.3

3.2

4.8

2.4


Latin America and the Caribbean

5.2

1.1

2.3

0.0


All developing countries

167.1

140.3

154.6

127.6

Notes: The estimates are based on projected future values of the underlying-determinant explanatory variables, defined in Table 3 (see notes to Table 12 and text for further explanation).

In line with these trends, the regional configuration of the locations of malnourished children in the developing world is expected to change considerably by the year 2020 (Figure 9). Under the status quo scenario, South Asia’s share is predicted to remain high, falling from 51 percent to 47 percent. Sub-Saharan Africa’s share is expected to rise from 19 percent in 1995 to almost 35 percent by the year 2020.


Figure 7 - Projections of the percent of malnourished children by region, for three scenarios, to 2020


Figure 8 - Projections of numbers of malnourished children, by region, to 2020


Figure 9 - Regional distribution of malnourished children, 1995 and 2020, status quo scenario