The price of hunger

The relationship between poverty and food intake

The first Millennium Development Goal – to eradicate extreme poverty and hunger – reflects the fact that undernutrition is both a symptom and a cause of poverty. The first measure of success is well known: to halve the number of people earning less than US$1 a day. The other – to halve the number of people suffering from inadequate food consumption – is equally important but less well known.

Income poverty and inadequate food consumption are firmly linked. Undernutrition, caused in part by poor diets, impairs growth and development. This results in lower achievement in school and lower productivity in adulthood. As a result, poverty is entrenched in the next generation, in part because parents cannot afford to feed their children sufficiently.

The cost of a healthy diet

Research by Save the Children UK compares the cost of a healthy diet for a family of five with what they earn in Bangladesh, Ethiopia, Myanmar and Tanzania. We calculated the cost of a diet made from foods available locally that would meet a family's minimum nutritional needs in each location. Estimates were based on surveys of market prices of foodstuffs over different seasons.

• In Ayeyarwaddy Division, Myanmar, around half of studied families live on about US$1.08, but a healthy diet would cost US$1.15 per family – 1.1 times the daily average salary.
• In Kurigram district, Bangladesh, about 80 percent of households studied cannot afford a minimum healthy diet; for the poorest people, this costs three times what they usually earn.

In all these places, families do not have enough money for a nutritious diet, let alone fuel, clothes, school fees and health costs. They have to eat food that is not nutritious enough for their children to be healthy or protected from sickness.

These figures also put into perspective the struggle to emerge from poverty for families in many developing countries. To improve their livelihoods, they need enough income to invest in productive assets, such as cattle or livestock for a small business, or to invest in their longer term future by providing an education for their children. But what hope do they have if they cannot even afford the food they need to keep themselves and their children healthy and alive?

Figure 1: The cost of a healthy diet in Bangladesh, Ethiopia, Myanmar and Tanzania. Source: Save the Children UK, 2007

The implications are clear: undernutrition and poverty must be tackled together. In some cases, income is the constraint, in some education, and in some both.

• Simply trying to educate the poorest families about good nutrition – a popular approach with development agencies for a long time – will not work if families do not have the money to put this knowledge into practice.
• Putting cash into families' hands can help to improve their diet. Save the Children UK's projects in Ethiopia show that when families are given small sums of cash, they spend it on more food and a better variety of food.
• Although we have not studied this, it is likely that the impacts of cash transfers could be further multiplied if combined with nutrition education.

David Mepham
Save the Children UK, 1 St John's Lane, London EC1M 4AR, UK

Malnutrition

Malnutrition concerns not enough food, too much food, the wrong types of food, and the body's response to a wide range of infections that result in malabsorption of nutrients, or the inability to use nutrients properly to maintain health. Clinically, malnutrition is characterised by inadequate or excess intake of protein, energy, and micronutrients such as vitamins, and the frequent infections and disorders that result.

Source: World Health Organization
www.who.int/water_sanitation_health/diseases/malnutrition/en