Malnutrition: Underlying Causes

The main underlying preconditions that determine adequate nutrition are food, health and care: the degree of an individual’s or a household’s access to these preconditions affect how well they are nourished

Food quantity and quality:

Food security exists when, at all times, everyone has access to and control over sufficient quantities and quality of food needed for an active and healthy life. For a household this means the ability to secure adequate food to meet the dietary requirements of all its members, either through their own production or through food purchases. Food production depends on a wide range of factors, including access to fertile land, availability of labour, appropriate seeds and tools and climatic conditions. Factors affecting food purchases include household income and assets as well as food availability and price in local markets. In emergency situations, other factors may come into play including physical security and mobility, the integrity of markets and access to land. (Reference: Measuring and interpreting Malnutrition and Mortality (manual); WFP and CDC; 2005)

On an immediate level, malnutrition results from an imbalance between the required amount of nutrients by the body and the actual amount of nutrients introduced or absorbed by the body.

Adequacy of food intake relates to:

• The quantity of food consumed
• The quality of the overall diet with respect to various macronutrients and micronutrients.
• The energy density and palatability of the food consumed
• How frequently the food is consumed.

Health and Sanitation Environment:

Access to good quality health services including affordability, safe water supplies, adequate sanitation and good housing are preconditions for adequate nutrition. Inadequate sanitation and hygiene is a major contributing factor for anaemia due to the link with intestinal worm infection.

Health and nutrition are closely linked in a “malnutrition-infection cycle” in which diseases contribute to malnutrition, and malnutrition makes an individual more susceptible to disease. Malnutrition is the result of inadequate dietary intake, disease or both. Disease contributes through loss of appetite, malabsorption of nutrients, loss of nutrients through diarrhoea or vomiting. If the body's metabolism is altered the greater the risk is of malnutrition.

Social and Care Environment

The social and care environment within the household and local community also can directly influence malnutrition. Appropriate childcare, which includes infant and young child feeding practices, is an essential element of good nutrition and health. Cultural factors and resources such as income, time and knowledge also influence caring practices as well as attitudes to modern health services, water supplies and sanitation.

While it is true that improving care for young children is vital, the emphasis on behavioural change should be accompanied by an understanding and commitment to addressing the economic constraints placed on caregivers.