Publication: Feeding of Infants and Young Children in South Asia
Loading...
Files in English
516 downloads
Date
2018-11
ISSN
Published
2018-11
Author(s)
Torlesse, Harriet
Editor(s)
Abstract
Poor breastfeeding and complementary feeding practices predict child stunting and wasting in South Asia, suggesting that initiatives to end undernutrition in the region should focus on improving the diets of young children. This review of the literature finds that South Asia has made relatively good progress in improving breastfeeding practices compared with other regions, but the lack of diversity in complementary foods and low frequency of feeding continue to be problems. Children who are most at risk of experiencing poor feeding include those who are born small, have younger mothers, and live in poorer households or in communities with less access to, or lower uptake of, primary health services. Initiatives to improve feeding practices have not produced substantial improvement, particularly in complementary feeding, because such efforts have lacked the coverage, intensity, comprehensiveness, and continuity needed. Policy, legal, and program actions to protect, promote, and support recommended feeding practices should be informed by situation analyses and formative research on context-specific drivers of poor practices. The actions should involve multiple sectors and stakeholders, including governments, the private sector, communities, and households.
Link to Data Set
Citation
“Torlesse, Harriet; Raju, Dhushyanth. 2018. Feeding of Infants and Young Children in South Asia. Policy Research Working Paper;No. 8655. © World Bank. http://hdl.handle.net/10986/30928 License: CC BY 3.0 IGO.”
Associated URLs
Associated content
Other publications in this report series
Publication The Future of Poverty(Washington, DC: World Bank, 2025-07-15)Climate change is increasingly acknowledged as a critical issue with far-reaching socioeconomic implications that extend well beyond environmental concerns. Among the most pressing challenges is its impact on global poverty. This paper projects the potential impacts of unmitigated climate change on global poverty rates between 2023 and 2050. Building on a study that provided a detailed analysis of how temperature changes affect economic productivity, this paper integrates those findings with binned data from 217 countries, sourced from the World Bank’s Poverty and Inequality Platform. By simulating poverty rates and the number of poor under two climate change scenarios, the paper uncovers some alarming trends. One of the primary findings is that the number of people living in extreme poverty worldwide could be nearly doubled due to climate change. In all scenarios, Sub-Saharan Africa is projected to bear the brunt, contributing the largest number of poor people, with estimates ranging between 40.5 million and 73.5 million by 2050. Another significant finding is the disproportionate impact of inequality on poverty. Even small increases in inequality can lead to substantial rises in poverty levels. For instance, if every country’s Gini coefficient increases by just 1 percent between 2022 and 2050, an additional 8.8 million people could be pushed below the international poverty line by 2050. In a more extreme scenario, where every country’s Gini coefficient increases by 10 percent between 2022 and 2050, the number of people falling into poverty could rise by an additional 148.8 million relative to the baseline scenario. These findings underscore the urgent need for comprehensive climate policies that not only mitigate environmental impacts but also address socioeconomic vulnerabilities.Publication Exports, Labor Markets, and the Environment(Washington, DC: World Bank, 2025-07-14)What is the environmental impact of exports? Focusing on 2000–20, this paper combines customs, administrative, and census microdata to estimate employment elasticities with respect to exports. The findings show that municipalities that faced increased exports experienced faster growth in formal employment. The elasticities were 0.25 on impact, peaked at 0.4, and remained positive and significant even 10 years after the shock, pointing to a long and protracted labor market adjustment. In the long run, informal employment responds negatively to export shocks. Using a granular taxonomy for economic activities based on their environmental impact, the paper documents that environmentally risky activities have a larger share of employment than environmentally sustainable ones, and that the relationship between these activities and exports is nuanced. Over the short run, environmentally risky employment responds more strongly to exports relative to environmentally sustainable employment. However, over the long run, this pattern reverses, as the impact of exports on environmentally sustainable employment is more persistent.Publication The Macroeconomic Implications of Climate Change Impacts and Adaptation Options(Washington, DC: World Bank, 2025-05-29)Estimating the macroeconomic implications of climate change impacts and adaptation options is a topic of intense research. This paper presents a framework in the World Bank's macrostructural model to assess climate-related damages. This approach has been used in many Country Climate and Development Reports, a World Bank diagnostic that identifies priorities to ensure continued development in spite of climate change and climate policy objectives. The methodology captures a set of impact channels through which climate change affects the economy by (1) connecting a set of biophysical models to the macroeconomic model and (2) exploring a set of development and climate scenarios. The paper summarizes the results for five countries, highlighting the sources and magnitudes of their vulnerability --- with estimated gross domestic product losses in 2050 exceeding 10 percent of gross domestic product in some countries and scenarios, although only a small set of impact channels is included. The paper also presents estimates of the macroeconomic gains from sector-level adaptation interventions, considering their upfront costs and avoided climate impacts and finding significant net gross domestic product gains from adaptation opportunities identified in the Country Climate and Development Reports. Finally, the paper discusses the limits of current modeling approaches, and their complementarity with empirical approaches based on historical data series. The integrated modeling approach proposed in this paper can inform policymakers as they make proactive decisions on climate change adaptation and resilience.Publication The Asymmetric Bank Distress Amplifier of Recessions(Washington, DC: World Bank, 2025-07-11)One defining feature of financial crises, evident in U.S. and international data, is asymmetric bank distress—concentrated losses on a subset of banks. This paper proposes a model in which shocks to borrowers’ productivity dispersion lead to asymmetric bank losses. The framework exhibits a “bank distress amplifier,” exacerbating economic downturns by causing costly bank failures and raising uncertainty about the solvency of banks, thereby pushing banks to deleverage. Quantitative analysis shows that the bank distress amplifier doubles investment decline and increases the spread by 2.5 times during the Great Recession compared to a standard financial accelerator model. The mechanism helps explain how a seemingly small shock can sometimes trigger a large crisis.Publication Impact of Heat Waves on Learning Outcomes and the Role of Conditional Cash Transfers(Washington, DC: World Bank, 2025-07-14)This paper evaluates the impact of higher temperatures on learning outcomes in Peru. The results suggest that 1 degree above 20°C is equivalent to 7 and 6 percent of a standard deviation of what a student learns in a year for math and reading tests, respectively. These results hold true when the main specification is changed, splitting the sample, collapsing the data at school level, and using other climate specifications. The paper aims to improve understanding of how to deal with the impacts of climate change on learning outcomes in developing countries. The evidence suggests that conditional cash transfer programs can mitigate the negative effects of higher temperatures on students’ learning outcomes in math and reading.
Journal
Journal Volume
Journal Issue
Collections
Related items
Showing items related by metadata.
Publication Consulting with Caregivers : Using Formative Research to Improve Maternal and Newborn Care and Infant and Young Child Feeding in the Lao People's Democratic Republic(World Bank, Washington, DC, 2004-10)Improving maternal and newborn care and young child feeding will decrease under five mortality and malnutrition in developing countries. To help design interventions in these areas, a study was conducted in the Lao PDR. The study found that washing newborns after delivery and delaying breastfeeding for 1-3 days are common practices that may expose newborns to hypothermia. Few caregivers practice clean cord care and exclusive breastfeeding for the first six months, increasing the risk of infection. Most women deliver at home without assistance from a trained provider. They also restrict what they eat based on traditional beliefs about foods thought to affect mothers' health or breastmilk. Traditional beliefs also determine how young children are fed. Most caregivers, when asked to try four feeding recommendations for young children (add or give more animal food, increase the amount of food, number of feedings, and vegetables and fruits), were willing to try and continue them. Many caregivers were surprised about how much and what types of foods children can consume, if they are encouraged to, and valued receiving new information about how to improve young child feeding. The study conclusions are that newborn care can be improved using low-cost technologies such as keeping newborns warm by deferring washing for 24 hours, and wiping, wrapping and breastfeeding newborns immediately after delivery. Risk of infection can be reduced by proper care of the umbilical cord and by exclusively breastfeeding infants for six months. What women eat can be improved by promoting the consumption of certain foods that improve the quality and quantity of breastmilk. To improve the feeding of young children, messages are needed about how much and what types of foods they require and how to encourage them to eat those foods.Publication How to Protect and Promote the Nutrition of Mothers and Children(World Bank, Washington, DC, 2012-12-10)The nutrition cluster is a very important entity to coordinate actions during emergencies. It is important that the nutrition cluster know in advance which institutions work where and what kind of inputs are pre-positioned. Risk management plans need to be ready at the local level in advance of emergencies. Although emergencies occur every year in Guatemala, the emergency response often fails to incorporate the management of malnutrition among its priority actions. Community programs, like AIN-C (a community- based child care program - atencion integral a la ninez comunitaria), can be an efficient mechanism to protect young children's nutrition and provide an important channel for the government or other assistance agencies to funnel support to communities in need during a period of crisis or emergency. This is because community workers know the families and those who are most vulnerable; they are willing to be called upon to help their community; and they can provide educational support to families to ensure rapid recovery among young children. Community-based growth promotion programs such as AIN-C can be strengthened and scaled up, and they are a good investment, in the aftermath of an emergency or during a time of economic crisis, to swiftly deliver services to affected families. Community agents can carry important information to the community and can distribute food, nutrition and health supplements such as micronutrient powders and oral rehydration salts for young children, as well as hygiene and water purification products. Community kitchens are an efficient approach to reduce hunger among the poor during times of high economic stress. They provide a social safety net and can have a nutrition effect when carefully planned. Community kitchens adjust to the labor market and general economic conditions; hence targeting of the poor and most in need through community kitchens is self-selective. The kitchens can expand and shrink as participants continually assess the trade-off between unpaid work in exchange for free or inexpensive meals and the pursuit of opportunities in the labor market.Publication How to Protect and Promote the Nutrition of Mothers and Children in Latin America and the Caribbean(World Bank, Washington, DC, 2012-12-10)The study includes: glossary; references; and annexes. A number of countries in the Latin America and Caribbean (LAC) region have been severely hit by food-price crises in 2008 and are still very vulnerable to food-price volatility experienced since late 2010. Humanitarian responses to high food prices, crises, shocks, or emergency situations should help the poor avoid the consequences of the reduced affordability of a basic food basket. This is especially crucial in the first 1,000 days of life (that is, children from pregnancy until they reach 2 years of age and breastfeeding women), since most of the physical and cognitive damages due to improper nutrition in this period are irreversible. The World Bank is leading a regional study on how to improve LAC country responses so as to protect the nutritional status of the poorest and most vulnerable in times of crises and emergencies.Publication How to Protect and Promote the Nutrition of Mothers and Children in Latin America and the Caribbean(World Bank, Washington, DC, 2012-12-10)The study covered a wide range of topics, making data collection especially challenging. Key informants were sometimes new to their posts and were unable to provide details on specific programs, policies, or coverage rates. Few countries in Latin America and the Caribbean mainstream into their crisis and emergency plans protection of the nutritional status of mothers and children in the first 1,000 days of life. All countries should reinforce the promotion and protection of breastfeeding in emergencies, notably by providing an enabling space for mothers to safely breastfeed their children and by managing the provision of artificial milk formula. It is concerning that during emergencies most countries provide powdered artificial formula instead of ready-to-use artificial milk formula to infants that cannot breastfeed, greatly increasing the risks of illnesses and malnutrition as a result of inappropriate dilution and unsafe water. All countries need to reinforce their monitoring and evaluation systems, including surveillance of food and nutrition insecurity. While most countries have some form of monitoring system, few of those systems are computerized, which impairs timely and informed decision making. Systematic evaluations of emergency and crisis response are seldom performed. A number of countries would benefit from updating their nutrition policy and protocols based on the latest available evidence. Of particular importance are updates to the prevention and treatment of micronutrient deficiencies with micronutrient powders; treatment of acute malnutrition, notably with the use of ready-to-use supplements; and efficient treatment of diarrhea through the use of oral rehydration solution and zinc. Most countries will benefit from adapting the food and water rations given in emergencies to the specific nutritional needs of pregnant and lactating women and children <2 years of age.Publication Scaling Up Nutrition : What Will it Cost?(Washington, DC: World Bank, 2010)Undernutrition imposes a staggering cost worldwide, both in human and economic terms. It is responsible for the deaths of more than 3.5 million children each year (more than one-third of all deaths among children under five) and the loss of billions of dollars in forgone productivity and avoidable health care spending. Individuals lose more than 10 percent of lifetime earnings, and many countries lose at least 2-3 percent of their gross domestic product to undernutrition. The current economic crisis and its potential impact on the poor make investing in child nutrition more urgent than ever to protect and strengthen human capital in the most vulnerable developing countries. This report offers suggestions on how to raise these resources. It is an investment we must make. It will yield high returns in the form of thriving children, healthier families, and more productive workers. This investment is essential to make progress on the nutrition and child mortality Millennium Development Goals (MDGs) and to protect critical human capital in developing economies. The human and financial costs of further neglect will be high. This call for greater investment in nutrition comes at a time when global efforts to strengthen health systems provide a unique opportunity to scale up integrated packages of health and nutrition interventions, with common delivery platforms, and lower costs. The report has benefited from the expertise of many international agencies, nongovernmental organizations, and research institutions. The cooperation of so many practitioners is evidence of a growing recognition of the need to invest in nutrition interventions, and a growing consensus about how to deliver effective programs.
Users also downloaded
Showing related downloaded files
Publication World Development Report 2014(Washington, DC, 2013-10-06)The past 25 years have witnessed unprecedented changes around the world—many of them for the better. Across the continents, many countries have embarked on a path of international integration, economic reform, technological modernization, and democratic participation. As a result, economies that had been stagnant for decades are growing, people whose families had suffered deprivation for generations are escaping poverty, and hundreds of millions are enjoying the benefits of improved living standards and scientific and cultural sharing across nations. As the world changes, a host of opportunities arise constantly. With them, however, appear old and new risks, from the possibility of job loss and disease to the potential for social unrest and environmental damage. If ignored, these risks can turn into crises that reverse hard-won gains and endanger the social and economic reforms that produced these gains. The World Development Report 2014 (WDR 2014), Risk and Opportunity: Managing Risk for Development, contends that the solution is not to reject change in order to avoid risk but to prepare for the opportunities and risks that change entails. Managing risks responsibly and effectively has the potential to bring about security and a means of progress for people in developing countries and beyond. Although individuals’ own efforts, initiative, and responsibility are essential for managing risk, their success will be limited without a supportive social environment—especially when risks are large or systemic in nature. The WDR 2014 argues that people can successfully confront risks that are beyond their means by sharing their risk management with others. This can be done through naturally occurring social and economic systems that enable people to overcome the obstacles that individuals and groups face, including lack of resources and information, cognitive and behavioral failures, missing markets and public goods, and social externalities and exclusion. These systems—from the household and the community to the state and the international community—have the potential to support people’s risk management in different yet complementary ways. The Report focuses on some of the most pressing questions policy makers are asking. What role should the state take in helping people manage risks? When should this role consist of direct interventions, and when should it consist of providing an enabling environment? How can governments improve their own risk management, and what happens when they fail or lack capacity, as in many fragile and conflict-affected states? Through what mechanisms can risk management be mainstreamed into the development agenda? And how can collective action failures to manage systemic risks be addressed, especially those with irreversible consequences? The WDR 2014 provides policy makers with insights and recommendations to address these difficult questions. It should serve to guide the dialogue, operations, and contributions from key development actors—from civil society and national governments to the donor community and international development organizations.Publication World Development Report 2006(Washington, DC, 2005)This year’s Word Development Report (WDR), the twenty-eighth, looks at the role of equity in the development process. It defines equity in terms of two basic principles. The first is equal opportunities: that a person’s chances in life should be determined by his or her talents and efforts, rather than by pre-determined circumstances such as race, gender, social or family background. The second principle is the avoidance of extreme deprivation in outcomes, particularly in health, education and consumption levels. This principle thus includes the objective of poverty reduction. The report’s main message is that, in the long run, the pursuit of equity and the pursuit of economic prosperity are complementary. In addition to detailed chapters exploring these and related issues, the Report contains selected data from the World Development Indicators 2005‹an appendix of economic and social data for over 200 countries. This Report offers practical insights for policymakers, executives, scholars, and all those with an interest in economic development.Publication Unlocking Blue Carbon Development(Washington, DC: World Bank, 2023-09-11)The purpose of this paper is to provide a practical framework to guide governments in catalyzing and scaling up public and private investment in Blue Carbon as part of their blue economy development. It does this by describing in detail a Blue Carbon Readiness Framework, a step-by-step, well-illustrated guide with simple checklists. Client countries can use the illustrations and checklists to determine their readiness to catalyze and scale up investment in blue carbon credit finance. The Blue Carbon Readiness Framework consists of three pillars: 1. Data and Analytics; 2. Policy and Institutions; 3. Finance.Publication Classroom Assessment to Support Foundational Literacy(Washington, DC: World Bank, 2025-03-21)This document focuses primarily on how classroom assessment activities can measure students’ literacy skills as they progress along a learning trajectory towards reading fluently and with comprehension by the end of primary school grades. The document addresses considerations regarding the design and implementation of early grade reading classroom assessment, provides examples of assessment activities from a variety of countries and contexts, and discusses the importance of incorporating classroom assessment practices into teacher training and professional development opportunities for teachers. The structure of the document is as follows. The first section presents definitions and addresses basic questions on classroom assessment. Section 2 covers the intersection between assessment and early grade reading by discussing how learning assessment can measure early grade reading skills following the reading learning trajectory. Section 3 compares some of the most common early grade literacy assessment tools with respect to the early grade reading skills and developmental phases. Section 4 of the document addresses teacher training considerations in developing, scoring, and using early grade reading assessment. Additional issues in assessing reading skills in the classroom and using assessment results to improve teaching and learning are reviewed in section 5. Throughout the document, country cases are presented to demonstrate how assessment activities can be implemented in the classroom in different contexts.Publication Argentina Country Climate and Development Report(World Bank, Washington, DC, 2022-11)The Argentina Country Climate and Development Report (CCDR) explores opportunities and identifies trade-offs for aligning Argentina’s growth and poverty reduction policies with its commitments on, and its ability to withstand, climate change. It assesses how the country can: reduce its vulnerability to climate shocks through targeted public and private investments and adequation of social protection. The report also shows how Argentina can seize the benefits of a global decarbonization path to sustain a more robust economic growth through further development of Argentina’s potential for renewable energy, energy efficiency actions, the lithium value chain, as well as climate-smart agriculture (and land use) options. Given Argentina’s context, this CCDR focuses on win-win policies and investments, which have large co-benefits or can contribute to raising the country’s growth while helping to adapt the economy, also considering how human capital actions can accompany a just transition.