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Last update: Apr 2013

World Fit For Children Goal Millenium Development Goal
To reduce child malnutrition among children under five years of age by at least one third, with special attention to children under two years of age

Eradicate extreme poverty and hunger

Target: Halve, between 1990 and 2015, the proportion of people who suffer from hunger

The challenge

Good nutrition is the cornerstone for survival, health and development. Well-nourished children perform better in school, grow into healthy adults and in turn give their children a better start in life. Well-nourished women face fewer risks during pregnancy and childbirth, and their children set off on firmer developmental paths, both physically and mentally.


Globally, more than one third of child deaths are attributable to undernutrition
Global distribution of deaths among children under age 5, by cause, 2010


Source: CHERG 2012.


Undernourished children have lowered resistance to infection and are more likely to die from common childhood ailments like diarrhoeal diseases and respiratory infections. Frequent illness saps the nutritional status of those who survive, locking them into a vicious cycle of recurring sickness and faltering growth.


Poverty, low levels of education and poor access to health services are major contributors to childhood undernutrition, a complex issue that requires tackling on a wide number of fronts.



Proportion of under-fives falling below minus 2 standard deviations (moderate and severe) and minus 3 standard deviations (severe) from the median height-for-age of the reference population*

Proportion of under-fives falling below minus 2 standard deviations (moderate and severe) and minus 3 standard deviations (severe) from the median weight-for-age of the reference population*

Proportion of under-fives falling below minus 2 standard deviations (moderate and severe) and minus 3 standard deviations (severe) from the median weight-for-height of the reference population*

Proportion of under-fives above 2 standard deviations from the median weight-for-height of the reference population*


* See Note on Reference Population at the bottom of this page.

To name only a few:

• Ensuring food security for poor households, in both quantity and quality;

• Educating families on the nutritional needs of young children, including the value of breastfeeding and the importance of introducing suitable complementary foods at the right age;

• Protecting children from infection by immunizing them against common childhood diseases and by providing safe water and sanitation;

• Ensuring that children receive quality care when they fall ill;

• Shielding children from micronutrient deficiencies, especially in iodine, iron and vitamin A, that can bring death and disabilities;

• Paying special attention to the nutritional needs of girls and women, since chronically undernourished women tend to bear low-birthweight babies, perpetuating the vicious cycle of undernutrition.


Undernutrition greatly impedes countries’ socio-economic development and the potential to reduce poverty. Many of the Millennium Development Goals (MDGs) – particularly MDG 1, to eradicate extreme poverty and hunger, and MDG 4, to reduce child mortality – will not be reached unless national development programmes and strategies give priority to the nutrition of women and children. With high levels of undernutrition persisting in the developing world, vital opportunities to save millions of lives are being lost, and many more children are not growing and thriving to their full potential.

Cost-effective programming strategies and interventions are available today that can make a significant difference in the health and lives of children and women. These interventions urgently require scaling up, a task that will entail the collective planning and resources of developing country governments at all levels and of the international development community as a whole.


Note on Reference Population: Prevalence of underweight, stunting and wasting among children under five years of age is estimated by comparing actual measurements to an international standard reference population. In April 2006, the World Health Organization (WHO) released the WHO Child Growth Standards to replace the widely used National Center for Health Statistics (NCHS)/WHO reference population, which was based on a limited sample of children from the United States of America. The new standards are the result of an intensive study project involving more than 8,000 children from Brazil, Ghana, India, Norway, Oman and the United States. Overcoming the technical and biological drawbacks of the old reference population, the new standards confirm that children born anywhere in the world and given the optimum start in life have the potential to develop to within the same range of height and weight. This means that differences in children's growth to age five are more influenced by nutrition, feeding practices, environment and health care than by genetics or ethnicity.
The new standards should be used in future assessments of child nutritional status. It should be noted that because of the differences between the old reference population and the new standards, prevalence estimates of child anthropometry indicators based on these two references are not readily comparable. It is essential to have all estimates based on the same reference population (preferably the new standards) when conducting trend analysis.


Black R. et al., for the Child Health Epidemiology Reference Group of WHO and UNICEF, ‘Global, Regional, and National Causes of Child Mortality in 2008: A systematic analysis, The Lancet, 2010, 375(9730): 1969-87.


UNICEF, Tracking Progress on Child and Maternal Nutrition: A survival and development priority, UNICEF, New York, 2009.