Hidden hunger in South Asia: a review of recent trends and persistent challenges

Abstract

'Hidden hunger' is a term used to describe human deficiencies of key vitamins and minerals, also known as micronutrients. While global in scale, the prevalence of micronutrient deficiencies is particularly high in South Asia despite recent successes in economic growth, agricultural output and health care. The present paper reviews the most recent evidence on patterns and trends of hidden hunger across the region, with a focus on the most significant deficiencies - iodine, Fe, vitamin A and Zn - and interprets these in terms of health and economic consequences. The challenge for South Asian policy makers is to invest in actions that can cost-effectively resolve chronic nutrient gaps facing millions of households. Appropriate solutions are available today, so governments should build on evidence-based successes that combine targeted health system delivery of quality services with carefully designed multisector actions that help promote healthier diets, reduce poverty and ensure social protection simultaneously.

Keywords: Hidden Hunger; Micronutrients; Policy; South Asia; Undernutrition.

Fig. 1

Trend in inadequate zinc intake between 1990 and 2005 in South Asia, by country: , Afghanistan; , Bangladesh; , Bhutan; , India; , Maldives; , Nepal; , Pakistan; , Sri Lanka. (Data from Wessells and Brown^{( 6 )})

Fig. 2

Percentage of households in South Asia consuming iodized salt in 2012 () and 2015 (), by country. (Data from Andersson et al.^{( 4 )} and the Iodine Global Network’s global iodine scorecard 2014–2015^{( 66 )})

Fig. 3

Prevalence of anaemia across time (1990–2012) among (a) children 6–59 months old and (b) women of reproductive age in South Asia, by country: , Afghanistan; , Bangladesh; , Bhutan; , India; , Nepal; , Pakistan; , Sri Lanka. (Data from Stevens et al.^{( 3 )})

Fig. 4

Prevalence of vitamin A deficiency (VAD) across time (1991–2013) among children 6–59 months old in South Asia, by country: , Afghanistan; , Bangladesh; , Bhutan; , India; , Maldives; , Nepal; , Pakistan; , Sri Lanka. (Data from Stevens et al.^{( 2 )})