Community Eye Health JOURNAL

undernutrition still matter? Children grow and develop well when they have access to affordable, diverse, nutrient-rich food, appropriate maternal and child care, adequate health services and a healthy environment including safe water, sanitation and good hygiene. Children can become undernourished – therefore failing to grow and thrive – for a variety of reasons. The immediate causes of undernutrition are: • inadequate dietary intake, whether as a result of poor maternal diet before, during and after pregnancy, sub-optimal breastfeeding, inadequate complementary foods during weaning or insufficient nutrient-rich foods during early childhood • disease, including parasitic infections, diarrhoeal disease, or other infections such as measles. Underlying these causes are factors such as household food insecurity (due to poverty or other reasons), inadequate care and feeding practices, unhealthy household environments and inadequate health services.1 How these factors inter-relate with each other is shown on page 64. Being undernourished for a long time can lead to stunting. In addition to its most obvious effects on stature (height), stunting has implications for the health and development of children, including their ability to learn. It can also lead to an increased risk of chronic diseases, such as heart disease or diabetes, in adulthood. Although stunting is declining, the rate of decline is too slow. There are now major global initiatives in place to improve the nutritional status of young children – the group most vulnerable to undernutrition and in whom the effects of undernutrition are greatest. Two of the main initiatives are the Scaling Up Nutrition (SUN) movement and the 1,000 Days Partnership, which focuses on the period of that encompasses pregnancy and the first two years of the child’s life. These initiatives have similar aims. Broadly, these are