No one wants a child to go hungry. But simply filling bellies doesn’t erase the hidden hunger of nutritional deficiencies.

When pregnant women, infants, children and adolescents don’t have access to the nutrients they need, it can have far-reaching impacts on learning, school attendance and work force participation. On the other hand, access to nutrition-rich foods and key vitamins and minerals at the right time can quite literally save lives and break the cycle of intergenerational poverty.

“Studies show that malnourished children often start school later and, as a result, [enter] the work force later,” says Dylan Walters, health economist at Nutrition International. “They are lower in grade attainment, have lower test scores and are more likely to repeat grades.”

Good nutrition positions a child for success by not only raising their chance for survival but also promoting cognitive development. This contributes to better outcomes in the classroom, supporting stronger human capital and economic development outcomes in a country.

For nearly 30 years, Nutrition International has been leading the global fight against malnutrition. Many of the organization’s projects focus on boosting the nutritional status of pregnant women and their infants and young children for a good start in life, which is important for school readiness. Nutrition International also supports the implementation and technical design of food fortification programs to raise the population-level nutrition status, across all age groups and life stages.

Interventions like these can translate into young people learning better, staying in school and getting fair-paying jobs – all of which stimulates local, and global economies.

“There’s a great return on investment in the nutrition of children if we start early,” Walters says. “People are the most valuable asset for a country’s economic development – good nutrition at the right time for children helps build the foundation for human capital, giving them a healthy start to life and contributing to a better start in their education.”

Nutrition remains one of the best bets in health − global consensus confirms that nutrition’s return on investment is unparalleled, with a benefit ratio of up to $35 per $1 invested according to research done by the World Bank.

Laying the foundation

The most effective work aimed at preventing stunting – not just physical, but intellectual – targets children before they are even born.

Nutrition plays a foundational role in a child’s development, starting in the first 1,000 days between conception and a child’s second birthday. Women need good nutrition during their pregnancy for their own health and the healthy development of their babies, including basic nutrients like iodine, folic acid and iron. Once a child is born, good nutrition remains important; when children don’t get basic nutrients either through diet, including breastfeeding, it slows their physical growth and cognitive abilities.

“Those first few years of life give you a strong foundation,” Walters says. “It’s hard to catch up at a later stage.”

The best way to invest in kids from their early days may be to consider nutrition an integral component in development projects. That’s how the African Development Bank and its Banking on Nutrition partners – Big Win Philanthropy and the Aliko Dangote Foundation – see things.  They created the Bank’s innovative Multisectoral Nutrition Action Plan that embeds nutrition as a priority into development projects in five key sectors (agriculture, education, health, social protection and WASH) across the continent. Nutrition International is the technical partner for implementation of the action plan. Just recently, the Banking on Nutrition partners released their progress report highlighting the allocation of $2.3B to nutrition-smart projects between 2015 and 2020.

“Our work used to concentrate on investments in physical infrastructure, such as roads,” says Babatunde Omilola, manager of public health, security and nutritional division for the Bank. “Now, we’re investing in grey matter infrastructure in our children across all our development priorities. We know that stunted children today are going to lead to stunted economies tomorrow.”

Investing in so-called grey matter infrastructure has multiple benefits, Omilola says. When children’s brains grow properly, they feel energized enough to go to school, pay attention and complete their homework. They graduate sooner and get better jobs, contributing to the local economy. Studies show children who get adequate nutrition in early life earn 20 per cent more and are 33 per cent less likely to live in poor households as adults.

While stunting is on the rise in Africa, the Bank has a commitment to reduce it by 40 per cent by 2025. When it helps a region develop a new crop, for instance, it looks at the ability of the crop to feed the greatest number of people for the lowest price. But the Bank also considers that crop’s nutritional value, Omilola says.

“Instead of just focusing on food security, we focus on nutritional security,” he says.

Thriving in school

Being malnourished affects young people’s ability to concentrate in school; adolescence is the second key time in life for intellectual growth and development. Girls are particularly at risk for developing iron-deficiency anemia, which can cause fatigue and lack of concentration, limiting their ability to succeed in school.

By reaching girls where they are − school − Nutrition International works to reduce adolescent anemia and other conditions. Nutrition International supports the delivery of weekly iron-folic acid tablets through school platforms by working with the Ministries of Education, teachers and health workers. In addition, Nutrition International ensures that this direct intervention is delivered together with nutrition education for adolescents, providing information on how important healthy diets are for growing adolescents. Both of these activities are also helping create and foster adolescent girls as nutrition advocacy champions.

For example, at the Nipania School in Bhopal, India, young nutrition advocacy champions Deepika Mehar and Taniksha Jaat help their teachers in the delivery of weekly iron-folic acid tablets to their peers, and support their communities and families by translating their nutrition knowledge to encourage healthy eating habits at home.

The power of young influencers and nutrition champions like Deepika and Tanishka helps to spread the word about the importance of good nutrition among their network at school, at home and in their communities. Acting as change agents, these young people spark curiosity in others by telling them a simple but compelling fact: when kids fuel their bodies, it allows them to be better focused at school, and sets them up for better and stronger cognitive development.

A time for recovery and renewal

COVID-19 has been devastating to many regions. Health systems have had to curtail their services to reduce the risk of transmission and, in some settings, resources have been diverted away from preventive services such as nutrition to deal with the urgency of COVID-19. In addition, school closures have meant a lagging ability to reach adolescent girls and deliver important interventions like weekly iron folic acid supplements.

The African Development Bank has earmarked billions to help with pandemic recovery and it plans to embed nutrition-related initiatives into its recovery work. Ideally, these kinds of initiatives could happen elsewhere, Walters says. “I hope that some governments will use COVID as an opportunity to rethink current programs and spending and integrate nutrition into health systems.”

After all, talking to students about nutrition, offering supplements and promoting the consumption of fortified foods are surprisingly affordable ways to improve health, nutrition and build brain power among the youngest residents of the world, Walters notes. When children can grow and reach their potential, that potential benefits everyone.

“The United Nations and many countries have, for the last 10 to 20 years, made concerted efforts to scale up investment in nutrition,” he says. “But there’s still a lot of work to do.”

This article was originally published in the Globe and Mail on July 28, 2021.