UNICEF BACKGROUND GUIDE - IMUNA
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Email: email@example.com Phone: +1 (212) 652-9992 Web: www.nhsmun.nyc Secretary-General Dear Delegates, Ankita Bhat I am thrilled to welcome you all to the United Nations Children’s Fund (UNICEF) at NHSMUN Director-General 2022! My name is Subin Moon, and I am the Director of UNICEF for Session 1. I identify as a Kathy Li third culture kid (and a huge shout out to all my third culture kids!!!). I was born in Seoul, Republic Chiefs of Staff of Korea, and grew up in many different cities, including LA, Dubai, and Toronto. Currently, I live Jon Basile in Boston, where I am in my third year at Boston University. I am double majoring in international Abolee Raut relations and economics and minoring in history. I give MUN major credit for helping me choose Conference Services my field of study! Outside of classes, I’m involved in staffing two amazing MUN conferences Hugo Bordas (BARMUN and BOSMUN) on campus. And as fueled by my passion for writing, researching, and Sofía Fuentes planning (of any sort), I am the Chief Editor of an interdisciplinary publication called the Politica, Delegate Experience the Academic Chair for Delta Delta Delta, and a translator for Good Neighbors, a nonprofit Akanksha Sancheti organization based in ROK. In my spare time (which I do really have), I love to bake and cook, do Beatriz Circelli some cross stitching and embroidery, and explore beaches, parks, and art galleries with my friends. Global Partnerships My love for MUN began in middle school, where I attended nearly every conference my school Katherine Alcantara had to offer. NHSMUN was certainly one of the most memorable conferences I’ve attended as Clare Steiner a student as it allowed me to practice diplomacy and public speaking and form connections with Under-Secretaries- brilliant, amazing students from around the world. This year marks my third year on NHSMUN General staff. In the past two years, I had the pleasure of serving as the Assistant Director of the United James Caracciolo Ana Margarita Gil Nations Environment Assembly and Director of the United Nations Human Rights Council. Ming-May Hu Manuel and I have been working diligently over the past few months to select some of the Brandon Huetter most important discussions in the realm of children’s rights. Topic A, “Preventing and Treating Juliette Kimmins Caleb Kuberiet Malnutrition Among Children,” examines a major health crisis confronting the survival and Victor Miranda well-being of children worldwide. This topic analyzes the various forms of malnutrition crises Anikait Panikker countries confront and the major drivers of childhood malnutrition in the modern world. Topic B, Frances Seabrook “Addressing and Preventing Child Marriage,” draws attention to the many threats child marriage Sharon Tang has on a child’s development and future life. This topic pushes delegates to consider the settings Kylie Watanabe in which children are most vulnerable to child marriage and the many devastating consequences it Sophia Zhukovsky may have on those affected and the communities in which they live. Manuel and I hope that these topics will allow delegates to re-examine the status and severity of such issues and find continuities and divergences from the past. We wish you the best of luck in your preparation for the conference. Please do not hesitate to reach out to Manuel and me if you have any questions regarding the background guide, NHSMUN, or anything else. We look forward to hearing all the brilliant ideas you have for our topics! Best wishes, Subin Moon firstname.lastname@example.org United Nations Children’s Fund Session I
Email: email@example.com Phone: +1 (212) 652-9992 Web: www.nhsmun.nyc Secretary-General Delegates, Ankita Bhat Hello! It’s my honor to welcome you to NHSMUN 2022. My name is Manuel Paredes, and I am Director-General excited to be your Director for Session II. Subin Moon and I have been working tirelessly to bring Kathy Li you the best possible background guide we could develop. We’re very excited to see how you will Chiefs of Staff use the background guide and other materials to spur dialogue in our committee sessions and are Jon Basile looking forward to hearing what you all have to say about our topics! Abolee Raut I’m also excited to once again be a part of the NHSMUN staff. Last year was my first year at Conference Services Hugo Bordas NHSMUN, working as an Assistant Director in NHSMUN’s 2021 Historical Crisis committee. My Sofía Fuentes return to NHSMUN largely derives from my love and passion for Model UN. I have participated in MUN since my sophomore year at Hillcrest High School and started my Model UN career competing Delegate Experience in various local high school conferences around the NYC area, and even attended NHSMUN 2018 Akanksha Sancheti Beatriz Circelli as a delegate! I eventually became Secretary-General for my school’s 2019 conference, HillMUN, which raised enough money for us to keep traveling to other conferences. Now, I am part of Global Partnerships BU’s competitive Model UN team and a vice-chair for BarMUN 2021. I’m currently a sophomore Katherine Alcantara at Boston University (Subin also goes here!!), double majoring in psychology and international Clare Steiner relations. Outside of MUN, I play video games (I’m a console player), play the guitar, and love to Under-Secretaries- travel whenever possible; I got the opportunity to visit Puebla (Mexico), Chicago, and Washington General DC during the summer of 2021! James Caracciolo Ana Margarita Gil We are very excited to feature “Addressing and Preventing Child Marriage” and “Preventing and Ming-May Hu treating Malnutrition in Children” as our topics. Child marriage occurs in most countries and is also Brandon Huetter an issue that COVID-19 and other factors have worsened. Addressing malnutrition in children is Juliette Kimmins Caleb Kuberiet a vital responsibility of UNICEF, one which all members must work on collectively. One of our Victor Miranda goals for these topics is to ensure that all delegations involved can relate to them. Doing so will Anikait Panikker help diversify debate and give everyone a shot at having their voices heard. Beyond the background Frances Seabrook guide and your country’s position, I also recommend looking into these topics to get a better Sharon Tang understanding of their overarching themes and what to expect in the committee room. With that, Kylie Watanabe I look forward to meeting every one of you and wish you all the best of luck in your research and Sophia Zhukovsky preparation. Talk soon! Best, Manuel Paredes firstname.lastname@example.org United Nations Children’s Fund Session II
UNICEF 4| Table of Contents Table of Contents A Note on the NHSMUN Difference 5 A Note on Research and Preparation 7 Committee History 8 Preventing and Treating Malnutrition Among Children 10 Introduction11 History and Description of the Issue 12 Current Status 26 Bloc Analysis 34 Committee Mission 36 Addressing and Preventing Child Marriage 38 Introduction39 History and Description of the Issue 40 Current Status 53 Bloc Analysis 59 Committee Mission 61 Research and Preparation Questions 63 Important Documents 65 Works Cited 66
UNICEF A Note on the NHSMUN Difference |5 A Note on the NHSMUN Difference Esteemed Faculty and Delegates, Welcome to NHSMUN 2022! My name is Kathy Li, and I am this year’s Director-General. Thank you for choosing to attend NHSMUN, the world’s largest and most diverse Model United Nations conference for secondary school students. We are thrilled to welcome you to New York City in March! As a space for collaboration, consensus, and compromise, NHSMUN strives to transform today’s brightest thinkers into tomorrow’s leaders. Our organization provides a uniquely tailored experience for all in attendance through innovative and accessible programming. We believe that an emphasis on education through simulation is paramount to the Model UN experience, and this idea permeates throughout NHSMUN. Realism and accuracy: Although a perfect simulation of the UN is never possible, we believe that one of the core educational responsibilities of MUN conferences is to educate students about how the UN System works. Each NHSMUN committee is a simulation of a real deliberative body so that delegates can research what their country has said in the committee. Our topics are chosen from the issues currently on the agenda of each committee (except historical committees, which take topics from the appropriate time period). This creates incredible opportunities for our delegates to conduct first-hand research by reading the actual statements their country has made and the resolutions they have supported. We also strive to invite real UN, NGO, and field experts into each committee through our committee speakers program. Furthermore, our staff arranges meetings between students and the actual UN Permanent Mission of the country they represent. No other conference goes so far to immerse students into the UN System so deeply. Educational emphasis, even for awards: At the heart of NHSMUN lie education and compromise. As such, when NHSMUN does distribute awards, we de-emphasize their importance compared to the educational value of Model UN as an activity. NHSMUN seeks to reward students who excel in the arts of compromise and diplomacy. More importantly, we seek to develop an environment where delegates can employ their critical thought processes and share ideas with their counterparts from around the world. Part of what makes NHSMUN so special is its diverse delegate base. Given our delegates’ plurality of perspectives and experiences, we center our programming around the values of diplomacy and teamwork. In particular, our daises look for and promote constructive leadership that strives towards consensus, as real delegates do in the United Nations. Debate founded on knowledge: With knowledgeable staff members and delegates from over 70 countries, NHSMUN can facilitate an enriching experience reliant on substantively rigorous debate. To ensure this high quality of debate, our staff members produce extremely detailed and comprehensive topic guides (like the one below) to prepare delegates for the complexities and nuances inherent in each global issue. This process takes over six months, during which the Directors who lead our committees develop their topics with the valuable input of expert contributors. Because these topics are always changing and evolving, NHSMUN also produces update papers intended to bridge the gap of time between when the background guides are published and when committee starts in March. As such, this guide is designed to be a launching point from which delegates should delve further into their topics. The detailed knowledge that our Directors provide in this background guide through diligent research aims to spur critical thought within delegates at NHSMUN. Extremely engaged staff: At NHSMUN, our staffers care deeply about delegates’ experiences and what they take away from their time at NHSMUN. Before the conference, our Directors and Assistant Directors are trained rigorously through copious hours of workshops and exercises to provide the best conference experience possible. At the conference, delegates will have the opportunity to meet their dais members before the first committee session, where they may engage one-on-one to discuss their
UNICEF 6| A Note on the NHSMUN Difference committees and topics. Our Directors and Assistant Directors are trained and empowered to be experts on their topics, and they are eager to share their knowledge with delegates. Our Directors and Assistant Directors read every position paper submitted to NHSMUN and provide thoughtful insight on those submitted by the feedback deadline. Our staff aims not only to tailor the committee experience to delegates’ reflections and research but also to facilitate an environment where all delegates’ thoughts can be heard. Empowering participation: The UN relies on the voices of all of its Member States to create resolutions most likely to make a meaningful impact on the world. That is our philosophy at NHSMUN as well. We believe that to properly delve into an issue and produce fruitful debate, it is crucial to focus the entire energy and attention of the room on the topic at hand. Our Rules of Procedure and our staff focus on empowering every voice in the committee, regardless of each delegate’s country assignment or skill level. Additionally, unlike many other conferences, we also emphasize delegate participation after the conference. MUN delegates are well-researched and aware of the UN’s priorities, and they can serve as the vanguard for action on the Sustainable Development Goals (SDGs). Therefore, we are proud to connect students with other action-oriented organizations to encourage further work on the topics. Focused committee time: We feel strongly that interpersonal connections during debate are critical to producing superior committee experiences and allow for the free flow of ideas. Ensuring policies based on equality and inclusion is one way in which NHSMUN guarantees that every delegate has an equal opportunity to succeed in committee. In order to allow communication and collaboration to be maximized during committee, we have a very dedicated team who work throughout the conference to type, format, and print draft resolutions and working papers. As always, we welcome any questions or concerns about the substantive program at NHSMUN 2022 and would be happy to discuss NHSMUN pedagogy with faculty or delegates. Delegates, it is our sincerest hope that your time at NHSMUN will be thought-provoking and stimulating. NHSMUN is an incredible time to learn, grow, and embrace new opportunities. We look forward to seeing you work both as students and global citizens at the conference. Best, Kathy Li Director-General
UNICEF A Note on Research and Preparation |7 A Note on Research and Preparation Delegate research and preparation is a critical element of attending NHSMUN and enjoying the debate experience. We have provided this Background Guide to introduce the topics that will be discussed in your committee. We encourage and expect each of you to critically explore the selected topics and be able to identify and analyze their intricacies upon arrival to NHSMUN in March. The task of preparing for the conference can be challenging, but to assist delegates, we have updated our Beginner Delegate Guide and Advanced Delegate Guide. In particular, these guides contain more detailed instructions on how to prepare a position paper and excellent sources that delegates can use for research. Use these resources to your advantage. They can help transform a sometimes overwhelming task into what it should be: an engaging, interesting, and rewarding experience. To accurately represent a country, delegates must be able to articulate its policies. Accordingly, NHSMUN requires each delegation (the one or two delegates representing a country in a committee) to write a position paper for each topic on the committee’s agenda. In delegations with two students, we strongly encourage each student to research each topic to ensure that they are prepared to debate no matter which topic is selected first. More information about how to write and format position papers can be found in the NHSMUN Research Guide. To summarize, position papers should be structured into three sections: I: Topic Background – This section should describe the history of the topic as it would be described by the delegate’s country. Delegates do not need to give an exhaustive account of the topic, but rather focus on the details that are most important to the delegation’s policy and proposed solutions. II: Country Policy – This section should discuss the delegation’s policy regarding the topic. Each paper should state the policy in plain terms and include the relevant statements, statistics, and research that support the effectiveness of the policy. Comparisons with other global issues are also appropriate here. III. Proposed Solutions – This section should detail the delegation’s proposed solutions to address the topic. Descriptions of each solution should be thorough. Each idea should clearly connect to the specific problem it aims to solve and identify potential obstacles to implementation and how they can be avoided. The solution should be a natural extension of the country’s policy. Each topic’s position paper should be no more than 10 pages long double-spaced with standard margins and font size. We recommend 3–5 pages per topic as a suitable length. The paper must be written from the perspective of the your assigned country should articulate the policies you will espouse at the conference. Each delegation is responsible for sending a copy of its papers to their committee Directors via myDais on or before March 4, 2022. If a delegate wishes to receive detailed feedback from the committee’s dais, a position must be submitted on or before February 18, 2022. The papers received by this earlier deadline will be reviewed by the dais of each committee and returned prior to your arrival at the conference. Complete instructions for how to submit position papers will be sent to faculty advisers via email. If delegations are unable to submit their position papers on time, please contact us at email@example.com. Delegations that do not submit position papers to directors will be ineligible for awards.
UNICEF 8| Committee History Committee History The United Nations Children’s Fund (UNICEF) was created by the United Nations General Assembly on 11 December 1946 in order to allocate food and healthcare to children and families in countries devastated by World War II.1 UNICEF became a permanent part of the United Nations system in 1953 when its name was shortened from the United Nations International Children’s Emergency Fund to the United Nations Children’s Fund.2 UNICEF is the driving force that helps build a world where the rights of every child are realized. The Fund has the ability to influence decision-makers and a variety of partners from the local to the international level to promote human rights advocacy specifically for children. UNICEF is active in more than 190 countries and territories through country programs and national committees.3 The highest level of management in UNICEF is the Bureau, which consists of a President and four Vice Presidents who are each elected from the Executive Board and represent one of the five global regions.4 The Bureau oversees the UNICEF Executive Board, which is the prominent governing body within the fund. The Board oversees and approves all activities, policies, country programs, and budgets.5 The Executive Board is comprised of 36 Member States who are elected for three-year terms by the Economic and Social Council.6 Membership is allotted into the five regions as follows: Africa (8 seats), Asia (7), Eastern Europe (4), Latin America and Caribbean (5), and Western Europe and Others (12).7 UNICEF’s Executive Board meets three times a year at the UN headquarters in New York for a first regular session in January or February, an annual session in May or June, and a second regular session in September.8 Beyond meeting at the UN headquarters, UNICEF maintains seven regional offices as well as country offices worldwide, including a research center in Florence, a supply operation in Copenhagen, a shared services center in Budapest, and offices in Geneva, Tokyo, and Brussels. UNICEF’s headquarters are located in New York.9 UNICEF attempts to reach every state, as it works within 192 countries with 85 percent of its presence in the form of fieldwork.10 While UNICEF partners most closely with governments, cooperation and collaboration through all sectors are pivotal for the success of UNICEF’s pursuits. By collaborating with intergovernmental organizations, non-governmental organizations, UN agencies, international finance institutions, and private sectors, UNICEF reaches further into communities to advocate for the protection of children, help meet their basic needs, as well as expand their full opportunities.11 Guided by the Convention on the Rights of the Child, UNICEF urges that the endurance, assurance, and development of children are widespread advancement objectives necessary to humanity. The 1989 United Nations Convention on the Rights of the Child (CRC) serves as a guiding document and major step forward for the international community as it set the mandate to protect the rights of every child.12 While UNICEF reminds countries of their commitment to the CRC, it cannot enforce these rules. Ultimately, UNICEF does not have the ability to enact laws or put regulations on countries deemed uncommitted to the cause. Delegates must keep these limitations in mind as they address the committee’s topics. 1 “About UNICEF,” UNICEF, 1 October 2018, accessed 21 September 2019, https://www.unicef.org/about/who/index_introduction. html. 2 “FAQ,” UNICEF, 3 October 2017, accessed 21 September 2019, https://www.unicef.org/about/who/index_faq.html. 3 “UNICEF: The United Nations Children’s Fund - Office of the Secretary-General’s Envoy on Youth,” United Nations, accessed 21 September 2019, https://www.un.org/youthenvoy/2013/09/unicef-the-united-nations-childrens-fund/. 4 “UNICEF Executive Board,” United Nations Children’s Fund, last modified 18 September 2019, accessed 21 September 2019, https://www. unicef.org/about/execboard/. 5 “UNICEF Executive Board.” 6 “UNICEF Executive Board,” United Nations Children’s Fund, last modified 29 January 2019, accessed 21 September 2019, https://www. unicef.org/about/execboard/index_42661.html. 7 “UNICEF Executive Board.” 8 “UNICEF Executive Board,” United Nations Children’s Fund, last modified 18 September 2019. 9 “FAQ,” UNICEF. 10 “About UNICEF,” United Nations Children’s Fund, last modified 3 October 2017, accessed 21 September 2019, https://www.unicef.org/ about/who/index_faq.html. 11 “Our Partners,” United Nations Children’s Fund, accessed 21 September 2019, https://www.unicef.org/eca/what-we-do/our-partners. 12 “UNICEF’s mission statement,” United Nations Children’s Fund, last modified 23 April 2003, accessed 21 September 2019, https://www. unicef.org/about/who/index_mission.html.
UNICEF Committee History |9 While UNICEF’s work is far from done, it is important to recognize what has been accomplished. UNICEF has made significant strides against child mortality, primarily in relation to disease. The Global Polio Eradication Initiative (GPEI) was established as a cooperation between the World Health Organisation (WHO), Rotary International, the US Center of Disease Control and Prevention (CDC), and UNICEF.13 Since its inception in 1988, polio cases have decreased by 99 percent from an average of 350,000 cases per year to 1,651 in 2008.14 These achievements help the international community work towards achieving the Sustainable Development Goals (SDGs), including SDG 3 regarding health. Mortality among children under five have decreased from nearly 12 million in 1990 to 6.9 million in 2011.15 UNICEF is also dedicated to creating an “aids-free generation.” Since 2000, the number of children infected with HIV decreased by 49 percent and 1.8 million new infections in children under five have been averted.16 Furthermore, UNICEF has provided immense support for children involved in humanitarian disasters. The Fund provides relief to the 200,000 refugee children fleeing conflict in Syria as well as helps reunite more than 3,000 separated children in the Democratic Republic of the Congo in 2012.17 In developing states, UNICEF assembles political will and material assets to support countries and frames policies focusing on the well-being of all children. The Fund aims to advance the equal rights of women and children to improve their political, social, and monetary networks. Through collaboration and cooperation with members from all international sectors, UNICEF works towards the accomplishment of the maintainable human advancement objectives received by the international community and the acknowledgment of the social advancements cherished in the Charter of the United Nations.18 13 “Polio,” United Nations Children’s Fund, last modified 25 May 2012, accessed 21 September 2019, https://www.unicef.org/media/ media_45491.html. 14 “Polio.” 15 Chris Niles, “Policy advocacy and partnerships for children’s rights,” United Nations Children’s Fund, last modified 31 December 2012, accessed 21 September 2019, https://www.unicef.org/policyanalysis/index_67099.html. 16 “HIV and AIDS,” United Nations Children’s Fund, accessed 21 September 2019, https://www.unicef.org/hiv. 17 Niles, “Policy advocacy and partnerships for children’s rights.” 18 “UNICEF’s mission statement,” United Nations Children’s Fund.
UNICEF NHSMUN 2022 Topic A: Preventing and Treating Malnutrition Among Children Photo Credit: Senior Airman Rylan Albright
Topic A: Preventing and Treating Malnutrition Among Children Introduction |11 Introduction The United Nations Children’s Fund (UNICEF) was founded in 1946 after the Second World War. The United Nations tasked the agency to deliver the most necessities such as food, clothing, and health care to all children.1 Seven years after the creation of UNICEF, the UN General Assembly extended the mandate of UNICEF to assist vulnerable children worldwide for an indefinite period. The same year, UNICEF was given its first logo featuring an image of a child drinking a cup of milk. This is because the provision of milk to undernourished children was one of its main activities.2 Even today, keeping children well-nourished remains a challenging but important task of UNICEF. Childhood malnutrition occurs when children are either Access to adequate nutrition for children is about more consuming too little or too much food or nutrients.3 than providing them with sufficient food for their survival. Malnutrition presents an obstacle for every child to reach It also implies the ability to deliver healthy, nutritious diets their full growth and developmental potential. In 2019, nearly that fulfill the needs of children at every stage of growth half of all deaths in children under five were attributed and development. The right to adequate nutrition is to undernutrition.4 According to UNICEF, around 3.1 enshrined in the legally binding international agreement of million children die of malnutrition every year, an entirely the Convention on the Rights of the Child. Therefore, UN preventable cause of death.5 At the same time, the number member states are obligated to deliver on their promise and of overweight children has continued to rise in all parts of guarantee that the most vulnerable and disproportionately the world. From 2000–2016, the proportion of overweight affected by malnutrition have equitable access to nutritious children has increased from one in ten to one in five.6 Some foods.8 Good nutrition can significantly help protect children major drivers of child malnutrition in the past, such as food from many treatable diseases in early childhood along with insecurity, conflict, gender roles, lack of health and nutrition obesity and diet-related non-communicable diseases (NCDs) education, and poor governance, continue to shape the poor in adulthood.9 It can also ensure that no child is left behind nutritional status of many children. In addition to these in terms of physical growth and academic performance factors, global forces that characterize the 21st century, like in school.10 In the long-term, well-nourished children can urbanization and globalization, are increasing the accessibility participate and contribute to the communities they grow and of food to communities, but they are also deteriorating the thrive in. UNICEF’s Executive Director Henrietta Fore states, quality of children’s diets worldwide. The one-dimensional “Good nutrition paves the way for a fair chance in life” in image of a severely undernourished child fails to encapsulate the Foreword to The State of the World’s Children Report of the complexities of the child malnutrition crisis we face today, 2019.11 Child malnutrition is much more than a health crisis. where we accept that different forms of malnutrition can It is also one of the most pressing children’s rights concerns, coexist within communities.7 and UNICEF is dedicated to tackling this to allow every child 1 “Children,” United Nations, accessed August 2, 2021, https://www.un.org/en/global-issues/children. 2 United Nations Children’s Fund, 1946–2006 Sixty Years for Children (New York: United Nations Children’s Fund, November 2006): 9, https://www.unicef.org/media/85551/file/1946-2006-Sixty-Years-for-Children.pdf. 3 “Malnutrition,” World Health Organization, June 9, 2021, https://www.who.int/news-room/fact-sheets/detail/malnutrition. 4 “Child Nutrition,” United Nations Children’s Fund, October 2019, https://data.unicef.org/topic/nutrition/child-nutrition/. 5 United Nations Children’s Fund United States of America, “UNICEF: Too Many Children Dying of Malnutrition,” June 6, 2013, https:// www.unicefusa.org/press/releases/unicef-too-many-children-dying-malnutrition/8259. 6 United Nations Children’s Fund, The State of the World’s Children 2019. Children, Food and Nutrition: Growing well in a changing world (New York: United Nations Children’s Fund, 2019): 8, https://www.unicef.org/media/63016/file/SOWC-2019.pdf. 7 United Nations Children’s Fund, “The Changing Face of Malnutrition: The State of the World’s Children 2019,” accessed June 29, 2021, https://features.unicef.org/state-of-the-worlds-children-2019-nutrition/. 8 United Nations Children’s Fund and United Nations Special Rapporteur on the Right to Food. Protecting Children’s Right to a Healthy Food Environment (Geneva: United Nations Children’s Fund and United Nations Human Rights Council, 2019): 5, https://www.unicef.nl/files/ Advocacy-brief-healthy-food-enviro-final.pdf. 9 United Nations Children’s Fund, The State of the World’s Children 2019. 10 Harold Alderman, John Haddinott, and Bill Kinsey, “Long Term Consequences of Early Childhood Malnutrition,” Oxford Economic Papers 58 (July 2006): 450-474, https://www.jstor.org/stable/3876979. 11 United Nations Children’s Fund, The State of the World’s Children 2019.
Topic A: Preventing and Treating Malnutrition Among Children 12|H istory and Description of the Issue the opportunity to reach their full potential.12 also be prescribed the condition of severe acute malnutrition (SAM). If left untreated, SAM can be deadly.18 History and Description of the Issue Direct causes of undernutrition are traced to inadequate dietary intake and disease driven by food insecurity, lack of The Forms of Malnutrition access to healthcare and health education for women and children, and unsanitary living environments.19 In middle and Malnutrition can appear in many different forms and poses low-income countries, where undernutrition tends to be the many threats to the health and well-being of children around most common form of malnutrition in children, poverty is the world. Most broadly, malnutrition is an inclusive term considered its most significant driver.20 The humanitarian that refers to “deficiencies, excesses, or imbalances” in one’s organization Save the Children found that roughly 139 million intake of nutrients. The World Health Organization (WHO) children, or nine in ten stunted children, today live in low and distinguishes the many types of malnutrition into three subcategories: undernutrition, micronutrient deficiencies, and lower-middle-income countries.21 Apart from these direct overnutrition. Every country is affected by at least one form causes, a variety of human rights issues such as the presence of malnutrition, thus rendering it a universal health crisis.13 of conflict, poor governance, climate change, and gender Since children are one of its most vulnerable victims, no inequality are underlying causes for this nutritional crisis by country can afford to overlook this issue.14 negatively impacting the availability of food in a community as well as its accessibility.22 The understanding of these direct The most renowned form of malnutrition in children is and underlying causes is critical to most effectively address undernutrition. Undernutrition is characterized by the lack the issue of undernutrition in children before it seriously of nutrition, which is caused by consuming insufficient affects their health and well-being. Undernutrition can have quantities of food overall or not eating enough food significant consequences for a young child. In unsanitary containing substances necessary to sustain the body.15 Today, conditions or environments, children are susceptible to undernutrition affects 150 million children under the age of diseases such as diarrhea, pneumonia, and malaria.23 Although five worldwide.16 Around 45 percent of deaths for children these diseases are treatable, they may be life-threatening under five years old are traced to undernutrition, rendering in undernourished children who have weakened immune this form of malnutrition more dangerous to children than systems.24 Later in life, undernutrition in early childhood can to other age groups. Undernutrition may appear in three increase one’s susceptibility to become overweight and suffer different subforms: wasting (low weight-for-height), stunting from overnutrition in adolescence and adulthood.25 (low height-for-age), and underweight (low weight-for-age).17 Children who suffer the most extreme form of wasting can Another notorious form of childhood malnutrition is 12 “Nutrition,” United Nations Children’s Fund, accessed June 29, 2021, https://data.unicef.org/topic/nutrition/child-nutrition/. 13 World Health Organization, “Malnutrition.” 14 “Nutrition,” United Nations Children’s Fund, accessed June 29, 2021, https://www.unicef.org/nutrition. 15 “About Malnutrition,” Global Nutrition Report, accessed June 29, 2021, https://globalnutritionreport.org/resources/about-malnutrition/. 16 “Nutrition,” World Food Programme, accessed June 29, 2021, https://www.wfp.org/nutrition. 17 World Health Organization, “Malnutrition.” 18 “Types of Malnutrition,” Action Against Hunger, accessed June 29, 2021, https://actionagainsthunger.ca/what-is-acute-malnutrition/ types-of-acute-malnutrition/. 19 Mawuli Sablah, Causes and Impacts of Undernutrition over the Life Course (New York: United Nations Children’s Fund, September 16, 2019), https://www.un.org/en/development/desa/population/events/pdf/expert/30/presentations/Tuesday/Session4/Causes%20-%20 Consequences%20of%20Undernutrition%20ICPD%20-%20UNICEF.pdf. 20 “4 Causes of Malnutrition in Children,” Save the Children, accessed June 29, 2021, https://www.savethechildren.org/us/charity-stories/ what-is-malnutrition-in-children. 21 Save the Children, “4 Causes of Malnutrition.” 22 Ngianga-Bakwin Kandala et al., “Malnutrition among children under the age of five in the Democratic Republic of Congo (DRC): does geographic location matter?,” BMC Public Health 11, no. 261 (2011), https://doi.org/10.1186/1471-2458-11-261. 23 “Children: improving survival and well-being,” World Health Organization, September 8, 2020, https://www.who.int/news-room/fact- sheets/detail/children-reducing-mortality. 24 World Food Programme, “Nutrition.” 25 Vinicius J. B. Martins et al., “Long-Lasting Effects of Undernutrition,” International journal of environmental research and public health 8, no. 6 (2011), https://doi.org/10.3390/ijerph8061817.
Topic A: Preventing and Treating Malnutrition Among Children History and Description of the Issue |13 micronutrient deficiencies. Micronutrients refer to vitamins also increasing the risk of dying during or immediately after and minerals that the body needs to produce substances such childbirth in pregnant women.32 Accurately understanding the as enzymes and hormones that are critical for the growth and burden and underlying causes of micronutrient deficiencies in development of the human body.26 Micronutrient deficiency children may help prevent and treat them of these preventable is also called the “hidden hunger” as it is harder to visually illnesses before it is too late. identify than normal hunger. As opposed to normal hunger, The third form of malnutrition that has become one of the which may be identified by shortness in height and low most pressing global health challenges in the modern world body weight, it can be very challenging to detect signs of is overnutrition. Overnutrition is a form of malnutrition micronutrient deficiencies without the aid of blood samples characterized by an excessive intake of food or nutrients.33 or urine tests. Even when these health conditions are to be In measuring the excess nutrition in a person, it is very noticed, it is often too late to reverse the damaging impacts challenging to develop a single index for the measurement of it has had on one’s health.27 At present, one in two children overnutrition as it may not necessarily correspond to the same across the globe suffers from hidden hunger.28 Deficiencies body fat percentage in different individuals. This becomes in vitamin A, iron, and iodine are some of the most common even more difficult to measure in children and adolescents among children and pregnant women, and these are identified who undergo many physical changes as they grow.34 The body as the “most important” micronutrients in terms of global mass index (BMI)—an index of expected weight by height— health by the WHO.29 is used to determine overweight and obesity, a more extreme The causes of micronutrient deficiencies largely resemble form of overweight.35 While stunted growth in childhood has those of undernutrition. Although malnutrition is rooted steadily declined and wasting has remained relatively stable since 2000, a worrying upward trend has been observed in in the insufficient consumption of essential nutrients and childhood overweight and obesity.36 In 2019, WHO estimated vitamins typically obtained from food in small quantities, a lack that 378.2 million children and adolescents under the age of of dietary diversity is a significant driver.30 Poor nutrition in 19 were overweight or obese based off data from 2016. To newborns and infants may directly be caused by their mothers’ add to this concern, the WHO finds that most of the world’s poor nutrition and health. In the womb, maternal reserves act population live in countries where overnutrition is more as their only nutritional source for growth and development.31 significant as a cause of death than undernutrition.37 Though micronutrient deficiencies in children are often traced to a few root causes, the effects may largely vary depending Overnutrition may have very different effects on a child’s on the micronutrient a child lacks. For example, a deficiency body and health when compared to the other two forms in vitamin A may cause blindness in children, while anemia, of malnutrition, but it shares some resemblances in its a condition caused by a lack of iron, can cause a range of determinants. In early childhood, children may face an symptoms such as fatigue, weakness, and dizziness while increased risk of being overweight or obese if their parents 26 “Micronutrients,” World Health Organization, accessed June 25, 2021, https://www.who.int/health-topics/micronutrients#tab=tab_1. 27 Morten Wendelbo, “Hidden hunger affects nearly 2 billion worldwide – are solutions in plain sight?,” The Conversation, October 12, 2018, https://theconversation.com/hidden-hunger-affects-nearly-2-billion-worldwide-are-solutions-in-plain-sight-104740. 28 United Nations Children’s Fund, The State of the World’s Children 2019, 13. 29 Save the Children, “Malnutrition.” 30 United Nations Children’s Fund, The State of the World’s Children 2019, 45. 31 United Nations Children’s Fund, “The Changing Face of Malnutrition.” 32 United Nations Children’s Fund, The State of the World’s Children 2019, 44; World Health Organization, “Anaemia,” accessed June 29, 2021, https://www.who.int/health-topics/anaemia#tab=tab_1. 33 Prashant Mathur and Rakesh Pillai, “Overnutrition: Current scenario & combat strategies,” Indian Journal of Medical Research 149, no. 6 (June 2019): 695-705, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6755771/. 34 “Noncommunicable diseases: Childhood overweight and obesity,” World Health Organization, October 19, 2020, https://www.who.int/ news-room/q-a-detail/noncommunicable-diseases-childhood-overweight-and-obesity. 35 Krushnapriya Sahoo et al., “Childhood obesity: causes and consequences,” Journal of family medicine and primary care 4, no. 2 (2015), 187-192, https://doi.org/10.4103/2249-4863.154628. 36 Save the Children, “Malnutrition.” 37 “Obesity and overweight,” World Health Organization, June 9, 2021, https://www.who.int/news-room/fact-sheets/detail/obesity-and- overweight.
Topic A: Preventing and Treating Malnutrition Among Children 14|H istory and Description of the Issue are overweight or if the mother is undernourished before cardiovascular diseases, diabetes, several types of cancer, and or during pregnancy. Similar to undernutrition, non-optimal high blood pressure. Promoting healthy diets among children breastfeeding practices in early childhood may also be a can significantly help to reduce their risk of developing fatal contributing factor. Childhood obesity is especially prevalent health conditions in adulthood.41 in middle childhood and adolescence. It is driven by the Since the founding days of the UN, it has repeatedly sounded introduction of unhealthy foods into a growing child’s diet due to poverty, food insecurity, or lack of access to a wide the alarm regarding the nutritional status of children in various range of nutrients may all contribute to overnutrition.38 More countries, regions, and the world, as a whole. Still, children recent research has uncovered that a variety of indirect factors remain at the center of the world nutrition crisis.42 With serious also increase childhood obesity and obesity in general, such consequences that may extend into later life, governments and as fast-food marketing directed towards children, unhealthy societies must prioritize the task of preventing and treating school food environments, globalization and urbanization, childhood malnutrition. and the widening socioeconomic divide.39 Concerning the overnutrition crisis, the instability of governments and Nutrition in Early Childhood societies to deliver nutritious diets of sufficient quality and From the moment of birth through the age of five, early quantity is compounded by many new social and economic childhood is an important time marked by impressive growth pressures such as aggressive marketing and the provision of and development. During this critical period in which the too much processed, unhealthy foods. This makes this form foundations for the child’s long-term health and development of malnutrition even more widespread and difficult to combat are established, millions of children face many challenges in than the other two forms. realizing their right to nutrition and health.43 Globally, 144 As the trend of overnutrition in children continues to rise, million children under the age of five are affected by stunting, there is increasing concern about the long-term health and nearly 80 percent of those children live in South Asia and consequences childhood obesity may have as children grow Sub-Saharan Africa.44 Another 340 million children suffered into adults. In the long term, overweight and obesity become from micronutrient deficiencies in essential minerals and metabolic risk factors of many diet-related non-communicable vitamins such as iron, vitamin A and iodine.45 On the other diseases (NCDs). NCDs refer to chronic diseases that tend end, the WHO estimates show that 38.2 million children to be long in duration, resulting from a combination of under five years are considered overweight or obese.46 Lori genetic, behavioral, and physiological factors. NCDs account Lake, communication and education specialist at the Children’s for the death of 41 million people annually, or 71 percent Institute at the University of Cape Town, describes childhood of all deaths worldwide.40 Poor nutrition and eating habits malnutrition as a form of “‘slow violence’ that systematically are underlying causes for many diet-related NCDs such as destroys a child.”47 Hence, immediate attention and action 38 United Nations Children’s Fund, Prevention of Overweight and Obesity in Children and Adolescents: UNICEF Advocacy Strategy and Guidance (New York: United Nations Children’s Fund, October 2020): 13, https://www.unicef.org/media/92331/file/Advocacy-Guidance-Overweight- Prevention.pdf. 39 United Nations Children’s Fund, “The Changing Face of Malnutrition.” 40 World Health Organization, “Noncommunicable diseases.” 41 World Cancer Research Fund International, The link between food, nutrition, diet and non-communicable diseases: Why NCDs need to be considered when addressing major nutritional challenges (London: World Cancer Research Fund International, 2014), https://www.wcrf.org/wp-content/ uploads/2021/01/PPA_NCD_Alliance_Nutrition.pdf. 42 Peyvand Khorsandi, “UN agencies: Restore school meals or ‘risk losing a whole generation,’” World Food Programme, January 27, 2021, https://www.wfp.org/stories/school-meals-nutrition-unicef-un-wfp-coronavirus-children-hunger. 43 United Nations Children’s Fund. First 1000 Days: The Critical Window to Ensure that Children Survive and Thrive. Pretoria: United Nations Children’s Fund South Africa, May 2017, https://www.unicef.org/southafrica/media/551/file/ZAF-First-1000-days-brief-2017.pdf. 44 United Nations Children’s Fund. Nutrition, for Every Child: UNICEF Nutrition Strategy 2020–2030. New York: United Nations Children’s Fund, December 2020: 7, https://www.unicef.org/media/92031/file/UNICEF%20Nutrition%20Strategy%202020-2030.pdf. 45 United Nations Children’s Fund. Maternal and Child Nutrition: UNICEF Programming Priorities to Respond to the Socio-economic Impacts of the COVID-19 Pandemic. New York: United Nations Children’s Fund, June 1, 2021, https://www.unscn.org/uploads/web/file/UNICEF- NUTRITION-AND-COVID-19-FINAL-.pdf. 46 World Health Organization, “Obesity and Overweight.” 47 Children’s Institute, “ ‘We are literally taking food out of the mouths of babes,’” University of Cape Town News, June 1, 2021, https://www.
Topic A: Preventing and Treating Malnutrition Among Children History and Description of the Issue |15 are needed to treat the millions of young children who are Steps and introduced safe breast-milk substitutes to ensure currently malnourished and prevent millions more from that infants receive the nutrition they need.52 Despite these falling into this trap of “violence.” efforts, however, less than half of newborns are breastfed in the first hour of life, and only three out of five infants in their From the moment a child is born, nutrition plays an important first six months rely exclusively on breastfeeding.53 Continued role in their health. Immediately after birth, UNICEF efforts are necessary to ensure the nutritional well-being of recommends that the mother feeds their newborn with infants and protect them against preventable diseases driven breastmilk. Breastmilk is not only a food source for an infant. by malnutrition. It also serves as a “potent medicine” that meets the specific needs of the child.48 In the first six months of life, mothers are Past infancy, the nutritional needs of children continue also recommended to exclusively breastfeed their infants as it to grow. When children reach the age of six months, solid lowers the risk of diseases such as diarrhea and pneumonia, foods are introduced into their diets together with continued both major causes of death among children under the age breastfeeding until the age of two. Consequently, the nutrition of five. During this stage of child growth and development, of children becomes greater per kilogram of body weight there is no substitute for breastfeeding. India’s UNICEF between the ages of six and 23 months than at any other office found that an infant who is not breastfed is more than stage in childhood.54 This makes them especially vulnerable 14 times more likely to die from diseases and other health to the consequences of malnutrition, in which many cases and diet-related causes than an infant who had exclusively could have long-term impacts on their brain development and been breastfed.49 Later in life, the lack or absence of exclusive physical growth as these children grow up into adults.55 Recent breastfeeding can also predispose children to overweight, studies have also shown that poor diets in early childhood obesity, and diet-related non-communicable diseases.50 may also explain at least 22 percent of premature mortality Breastfeeding is essential to the lifelong health of a child, and cases in adulthood.56 Over the past 65 years, the World Food the UN has launched many long-term education initiatives Programme (WFP) found that chronic malnutrition has to promote healthy breastfeeding practices globally. In 1989, contributed to more than two million premature deaths in WHO and UNICEF presented “The Ten Steps to Successful Mexico alone.57 Despite these concerns, UNICEF found in Breastfeeding” to raise awareness on the importance of 2019 that one in three children between the ages of six and breastfeeding in early childhood. This guide summarizes 23 months were eating the minimum diverse diet required the ways to support breastfeeding for new mothers and to satisfy their growing needs; many of these children’s diets maternity and newborn services worldwide.51 20 years since consisted of grains or processed foods and snacks high in sugar its introduction, more than 152 countries have established content, lacking a healthy eating pattern—a diet consisting of Baby-Friendly Hospitals that have implemented the Ten a variety of fruits and vegetables, whole grains, protein-rich news.uct.ac.za/article/-2021-06-01-we-are-literally-taking-food-out-of-the-mouths-of-babes. 48 United Nations Children’s Fund. From the First Hour of Life: Making the case for improved infant and young child feeding everywhere. New York: United Nations Children’s Fund, October 2016: 24-30. 49 “Early Childhood Nutrition,” United Nations Children’s Fund India, accessed June 23, 2021, https://www.unicef.org/india/what-we- do/early-childhood-nutrition. 50 United Nations Children’s Fund, Nutrition, for Every Child, 10. 51 “Ten steps to successful breastfeeding,” World Health Organization, accessed June 23, 2021, https://www.who.int/activities/promoting- baby-friendly-hospitals/ten-steps-to-successful-breastfeeding. 52 “Ten Steps to Successful Breastfeeding,” The Mother and Child Health and Education Trust, May 28, 2013, https://www.tensteps.org/ ten-steps-successful-breastfeeding.shtml. 53 “Early childhood nutrition,” United Nations Children’s Fund, accessed June 14, 2021. https://www.unicef.org/nutrition/early-childhood- nutrition. 54 United Nations Children’s Fund, The State of the World’s Children 2019, 74-76. 55 Alderman, Haddinott, and Kinsey, “Long Term Consequences,” 450-474. 56 GBD 2017 Diet Collaborators, “Health effects of dietary risks in 195 countries, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017,” Lancet 393, no. 10184 (May 11, 2019): 1961. https://doi.org/10.1016/s0140-6736(19)30041-8. 57 Economic Commission for Latin America and the Caribbean and World Food Programme, The cost of the double burden of malnutrition. The World Food Programme, April 2017: 8, https://docs.wfp.org/api/documents/WFP-0000110372/download/.
Topic A: Preventing and Treating Malnutrition Among Children 16|H istory and Description of the Issue Mother cradling her baby at a nutrition rehabilitation center in Madhya Pradesh, India foods, oils, fat-free and low-fat dairy products—necessary with the basic nutrients to meet their children’s needs.60 Hence, for sustained growth and development.58 These disparities education in these small, remote settings could help prevent demonstrate the critical need for appropriate nutrition to be and treat child malnutrition by increasing a sense of awareness introduced at each stage of childhood development. on the importance of a balanced diet among the families of young children. In Cambodia, another innovative solution has There are many attributable factors for malnutrition in early been introduced to help alleviate the burden of severe acute childhood. The Global Nutrition Report indicates that the malnutrition in children under five. UNICEF, the French rates of food introduction at each stage of early childhood National Research Institute for Sustainable Development, and diet diversity were typically lower for children in poorer Copenhagen University, and Danish Care Foods partnered households, rural communities, or with mothers who attained with the Royal Government of Cambodia. They developed lower levels of education.59 To illustrate, in the tiny rural a new fish-based snack called Nutrix to treat children who community Akabacuzi Village in Rwanda, 22 children had are suffering from severe acute malnutrition. By making an suffered from severe malnutrition as the mothers in the village affordable food item with locally sourced ingredients, the were unaware of the nutritional needs of their children. To Cambodian government could readily produce and supply remedy this, a local health worker began leading cooking Nutrix to treat young children suffering from severe acute lessons to help local mothers learn to cook balanced meals malnutrition.61 This is an example of a strategy that could be 58 Centers for Disease Control and Prevention, “Childhood Nutrition Facts,” accessed June 25, 2021, https://www.cdc.gov/healthyschools/ nutrition/facts.htm. 59 United Nations Children’s Fund, Nutrition, for Every Child, 14-15. 60 United Nations Children’s Fund, The State of the World’s Children 2019, 77. 61 United Nations Children’s Fund, “New fish-based ready-to-use-therapeutic food to treat children with severe acute malnutrition in
Topic A: Preventing and Treating Malnutrition Among Children History and Description of the Issue |17 applied in other countries where direct, immediate action is 0.85 grades of schooling, and start school six months earlier.67 needed to treat children suffering severe forms of malnutrition. Although direct nutritional intervention could alleviate the consequences of malnutrition in these young children, these Beyond household food insecurity and poverty, recent issues show that early childhood malnutrition is a large-scale reports published by UNICEF have drawn greater attention and complex problem that also requires solutions taking into to some of the larger, systemic drivers of early childhood account underlying factors in a given community or country. malnutrition. External shocks such as wars, natural disasters, and poor governance have resulted in large-scale health crises Despite these many challenges, the international community affecting the nutritional status of many young children around has also made some significant strides towards treating and the world.62 For instance, the WFP has stated that the largest preventing malnutrition in infancy and early childhood. At nutritional program they have launched is in Yemen.63 Since the beginning of 2020, the Global Nutrition Report revealed the outbreak of civil war in 2014, the ongoing armed conflict that the world has successfully reduced the number of has left at least 2.3 million children under five requiring stunted children from 165.8 million in 2012 to 149 million treatment for acute malnutrition.64 In addition, the health in 2018, representing a 10 percent decrease in global cases burden of global climate change has already fallen upon the due to a general increase in awareness and investment focused shoulders of some countries. Since 2014, the southern region on addressing undernutrition.68 These successes should of Madagascar has been severely affected by adverse climate encourage states to continue to ensure good nutrition for conditions, with decreased rainfall making it exceptionally infants and young children around the world. challenging for Malagasy people to grow crops.65 This lack of access to food has left nearly half of all children under Nutrition in Middle Childhood and Adolescence the age of five stunted.66 Children suffering through these various external shocks are stripped of the opportunity to Middle childhood and adolescence are also critical times for grow and develop in the way in which children in conflict- one’s growth and development, as this time is when habits free, stable environments are able. In 2006, a research study that persist into adulthood are formed.69 This demonstrates was commissioned by the World Bank in which researchers that dietary habits formed during middle childhood— studied malnutrition and its effects on capital formation in both healthy and unhealthy—will likely remain until a child rural Zimbabwe. Researchers have analyzed data on preschool becomes an adult.70 Regardless of this significance, there are children’s academic performance and health over a generation relatively limited sources and studies that focus exclusively on to account for children raised during periods of civil war, the prevalence and consequences of malnutrition in children droughts, or relative stability. Results have shown that if a between the ages of five and 18 years compared to child median child in the sample had been raised in a conflict-free malnutrition in early childhood.71 However, the importance environment where food was readily available, by adolescence, of middle childhood cannot be overlooked as there are they would be 3.4 centimeters taller, complete an additional many more complicated reasons why these children eat both Cambodia,” press release, December 17, 2018, https://www.unicef.org/press-releases/new-fish-based-ready-use-therapeutic-food-treat- children-severe-acute-malnutrition. 62 Alderman, Haddinott, and Kinsey, “Long Term Consequences,” 450-451; United Nations Children’s Fund, Nutrition, for Every Child, 26. 63 Symington, Annabel, and Peyvand Khorsandi, “Yemen: Famine around the corner, says World Food Programme,” World Food Programme, March 1, 2021, https://www.wfp.org/stories/yemen-global-development-famine-un-conference-hunger-food-aid. 64 United Nations Children’s Fund, “Acute malnutrition threatens half of children under five in Yemen in 2021: UN,” press release, February 11, 2021, https://www.unicef.org/press-releases/acute-malnutrition-threatens-half-children-under-five-yemen-2021-un. 65 United Nations Children’s Fund Australia, “It’s 2021, so why are there still malnourished children in this world?,” UNICEF, February 16, 2021, https://www.unicef.org.au/blog/news-and-insights/february-2021/malnutrition-children-worldwide. 66 United Nations Children’s Fund Australia, “why are there still malnourished children?”. 67 Alderman, Haddinott, and Kinsey, “Long Term Consequences,” 470-472. 68 United Nations Children’s Fund, Nutrition, for Every Child, 5. 69 Zohra Lassi, Anoosh Moin, and Zulfiqar Bhutta, “Nutrition in Middle Childhood and Adolescence,” Disease Control Priorities 8 (November 2017), 133, http://dcp-3.org/sites/default/files/chapters/DCP3%20CAHD_Ch%2011.pdf. 70 Lassi, Moin, and Bhutta, “Nutrition in Middle Childhood,” 133. 71 Rae Galloway, “Global Nutrition Outcomes at Ages 5 to 19,” Disease Control Priorities 8 (November 2017): 37, http://dcp-3.org/sites/default/ files/chapters/DCP3%20CAHD_Ch%203.pdf.
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