Market performance and food prices directly influence levels of household consumption. These, in turn, can influence nutrition outcomes. Given the potentially deleterious effects of high food prices on child nutrition outcomes in food-purchasing households, an important pathway to reducing child malnutrition is to increase market efficiency and reduce food prices for the poor

The South Asian countries have reported the highest child stunting rate and by far the highest child wasting rate of any region globally, says the latest Global Hunger Index (GHI) report 2022. The report is significant as more than 33 per cent of the people living in extreme poverty globally lives in south Asia. Moreover, COVID-19 caused millions of people to fall back into the poverty trap in the region, worsening the hunger situation further.

The GHI index includes six South Asian countries with Sri Lanka (64th) followed by Nepal (81th) and Bangladesh (84th). Both Sri Lanka and Nepal are placed in the "moderate" severity level. Afghanistan (109th), India (107th) and Pakistan (99th) are the bottom three countries in South Asia.

The GHI-2022 report is worrying for all south Asian countries as the region, which is home to 600 million children, is facing constant danger of hunger, resulting in increasing stunting rates.

The GHI score has taken four key indicators – undernourishment, child wasting, child stunting and the mortality rate of children under the age of five. Child wasting refers to the share of children under the age of five who have low weight for their height as a result of acute undernutrition. Child stunting measures the proportion of children under the age of five who have low height for their age due to chronic undernutrition.

In South Asia, India ranked 107th in the Global Hunger Index 2022 with its child wasting rate at 19.3 per cent, being the highest in the world, and the level of hunger in India with a score of 29.1 has been labelled "serious". With a score of 19.1, Nepal has a level of hunger that is "moderate". Bangladesh has moved eight notches down to rank 84th among 121 countries in the GHI 2022. It is extremely depressing to see that poverty and hunger continue to diminish South Asia's development progress significantly. All countries in the region need to focus on eradicating hunger with priority to strengthen their respective nutrition management agency.

India, Bangladesh, Pakistan and Nepal have child labour populations of 5.8 million, 5 million, 3.4 million and 2 million respectively, as per a survey by the International Labour Organisation (ILO). The COV- ID-19 pandemic has made the situation much worse in the region. Governments must expand their investment in child-sensitive so-cial protection programmes, especially for the most vulnerable children and their families. There is a stronger need to initiate integrated national health and nutrition systems that protect children from deadly but treatable diseases and reverse the region's child nutrition crisis.

In 2020, disruptionslinked to COVID-19 led to an estimated 228,000 additional child deaths, while an estimated 5.3 million children missed out on vital vaccinations, nearly 1.9 million more than the previous year in the region. An additional 3.85 million children are thought to have suffered from wasting in 2020. So, the vulnerability is more than what is presented in the GHI 2022 andother reports, constantly cautioning the extreme poverty situation in the region.

Thirty-six percent of Nepal's population lives below the national poverty line of US$0.50 per day (WFP 2020). Nepal faces many challenges to nutrition and food security, including mitigating the impact ofCOVID-19 on the health and nutrition status of women and children. It is estimated that an additional 60,000 children need services for acute malnutrition due to COVID-19 and its secondary impacts.

Nepal still ranks 61st globally for highest U5MR, despite high childhood immunisation rates and falling rates of low-birth weight (LBW) infants. Themost recent figures from the Nepal Demographic and Health Surveys (NDHS) show that 36 per cent of children under the age of five were stunted, and 27 per cent were underweight. These measures reflect long-term undernutrition, including through non-adherence to recommended feeding practices.

A majority of Nepali households are net buyers of food and depend on markets for their food purchases. As a result, market performance and food prices directly influence levels of household consumption. These, in turn, can influence nutrition outcomes. Given the potentially deleterious effects of high food prices on child nutrition outcomes in food-purchasing households, one of the important pathways to reducing child malnutrition rates over time is likely to be by increasing market efficiency and reducing food prices for poor consumers.

A number of studies on Nepal have documented negative association between food prices and child nutrition outcomes. Higher dairy prices is closely associated with lowered child height. Since milk is one of the major food items in the diets of children, the government must pay strict attention to milk prices in the marketplace. The price of coarse rice matters for short-term child nutrition outcomes in food-deficit districts. Market interventions that are likely to reduce coarse rice prices can be expected to improve child nutrition outcomes in food deficit districts in Nepal.

According to Nepal Rastra Bank, the annual consumer price-based inflation rose to 7.28 per cent year-on-year from 7.14 per cent the previous month, and from 3.10 per cent a year earlier. Edible oil prices rose 28.36 per cent followed by an 11.56 per cent hike in prices of milk products, eggs and pulses from a year earlier – more than doubling food inflation to 7.4 per cent within a year. Experts believe that such a situation has impacted child nutrition substantially in the country.

Governments in the region, including Nepal, must not ignore such reports and work collectively (sharing good practices among each other) to ensure zero hunger. Zero hunger is possible and doable. What we need is strong political commitment, collaboration and adequate resource allocation towards social protection schemes.

Satapathy is the director, AF Development Care (www., New Delhi, India

A version of this article appears in the print on October 19 2022 of The Himalayan Times.