Malnutrition has long been recognized as a consequence of poverty. It is widely accepted that higher rates of malnutrition will be found in areas with chronic widespread poverty (ADB, 2001). Malnutrition is the result of marginal dietary intake compounded by infection. In turn, marginal dietary intake is caused by household food insecurity, lack of clean water, lack of knowledge on good sanitation, and lack of alternative sources of income. It is also compounded by, inadequate care, gender inequality, poor health services, and poor environment. While income is not the sum of total of people's lives, health status as reflects by level of malnutrition is.

Because having good health condition is important precondition for escaping poverty and because improved health and sanitation contribute to growth, investment in people's health and nutrition status is fundamental to improving a country’s general welfare, promoting economic growth, and reducing poverty (World Bank, 1993). Meeting primary health care needs and the nutritional requirements of children are fundamental to the achievement of sustainable development. In the United Kingdom and a number of Western European countries about half their economic growth achieved between 1790 and 1980 has been attributed to better nutrition and improved health and sanitation conditions (Fugel, 1994)

Malnutriton in childhood is known to have important long-term effects on the work capacity and intellectual performance of adults. Health consequences of inadequate nutrition are enormous. It was estimated that nearly 30% of infants, children, adolescents, adults and elderly in the developing world are suffering from one or more of the multiple forms of malnutrition, 49% of the 10 million deaths among children less than 5 years old each year in the developing world are associated with malnutrition, another 51% of them associated with infections and other causes (WHO, 1999). Recent studies have also pointed out that women who were malnourished as children are more likely to give birth to low birth-weight children and thus there is an intergenerational effect of child malnutrition.

A practical advantage of using child malnutrition as a poverty indicator over income level is that this measure does not have to be adjusted for inflation and would not be constrained by any inadequacy of price data. Measures of child nutritional status can help capture aspects of welfare, such as distribution within the household which are not adequately reflected in other indicators. Child malnutrition standards are applicable across cultures and ethnicities.

Studies show that the relationship between child nutritional status and poverty is strong at the lower end of the income range. Increasing GNP per capita from $300 to $600 is associated with a decline in the prevalence of underweight children from about 34% to 17% or a reduction of about 50% (U.N. ACC/SCN, 1992). The data assessment of GNP per capita and the prevalence of underweight preschool children from the World Development Report as presented in Figure 1 [ PDF 126.5KB | 1 page ] shows that the countries with the lowest ranking of GNP per capita are more likely to have higher prevalence of underweight children2.

An IFPRI Study in 2000 drawn from the experience of 63 developing countries over this 25- year period on determinants of child malnutrition across different regions found four strong determinants to child malnutrition. The four, ranked by their strength of impact, are women's education, national food availability, women’s status relative to men's, and health environment quality (Smith and Haddad, 2000). The findings of this study support the fact that child malnutrition as a poverty indicator is a comprehensive indicator which is reflective and indicative of other desirable outcomes of development i.e. improvement in gender empowerment, intra-household distribution and equality, and health environment quality.

With all of the above consideration, child malnutrition appears as a highly conceptually relevant candidate for a poverty indicator. The following sections further evaluate other qualifications of child malnutrition as a poverty indicator.