Poor nutrition a major issue


MALAYSIA has succeeded in reducing its incidence of poverty from 5.5% in 2000 to 0.4 % in 2018 (Department of Statistics Malaysia 2018). While it has done remarkably well in reducing poverty, narrowing inequality and uplifting the standard of living of its citizens, there are emerging areas of concern that require urgent attention. One of these is the nutritional status of Malaysians.

The Global Nutrition Report 2018 provided by the Independent Expert Group (IEG), which represents wide-ranging expertise from across the global nutrition community, reported that Malaysia was among 41 countries of the 141 reported which had three burdens of malnutrition – obesity, stunting and anaemia. In fact, Malaysia is the only member of Asean with all three of these burdens.

According to the report, Malaysia is experiencing the paradox of malnutrition: while children under five are increasingly stunted, more adults are overweight.

A 2018 study by Unicef, which collected data on 2,142 children living in low-cost flats across Kuala Lumpur, showed that 23% of children aged four are stunted, with 22% underweight and 32% wasting, or thinner than the average of their peers.

The combination of obesity, stunting and anaemia is an issue that needs to be tackled.

From the economics perspective, the triple burden of malnutrition has resulted in the low income B40 group being caught in the poverty-nutrition trap.

Health economists and nutritionists have long conducted research on the relationship between nutrition intake, wage rates and labour productivity, as expressed in the Efficiency Wage Hypothesis. This hypothesis postulates that low levels of nutrition reduce workers’ productivity and wages, resulting in lower purchasing power and further low levels of nutrition.

Nutritional deficiency indirectly reduces labour productivity by increasing susceptibility to diseases and infections. And without sufficient resources, they become trapped in the vicious cycle of the poverty-nutrition trap.

In Malaysia, the problem is further compounded by the rising cost of living which heavily impacts on consumption and expenditure. The minimum wage of RM1,100 per month or the median household income of RM3,000 for the B40 group can hardly cover basic needs, particularly adequate nutrition.

Studies have shown that good nutrition is critical in the first 1,000 days of life (from conception to a child’s second birthday) because it affects children’s physical and cognitive development and can have other lasting consequences, including on academic performance and productivity.

The World Bank reported that the economic benefits from improving nutrition are substantial:

(a) for individuals, they average at least 10% of lifetime earnings, and

(b) for the country, they can make a difference of 2% to 3% of Gross Domestic Product.

Given that nutrition programmes are fairly inexpensive and increase productivity and growth, their benefit-cost ratios can be as high as 200:1.

Clearly, Malaysia needs urgent action to address the root causes of the triple burden of malnutrition. It needs to invest in nutrition programmes, particularly those which benefit the poor.

Eradicating extreme poverty and providing better nutrition to address hunger were recognised as part of the United Nation’s Sustainable Development Goal 2 (SDG 2). The need for better nutrition aims to “end hunger, achieve food security and improved nutrition, and promote sustainable agriculture.”

The World Bank and Food and Agriculture Organization recognised that good nutrition is a pre-condition for a healthy and productive life whereas malnutrition in all of its forms imposes high economic, social and human development costs on individuals, households, communities and countries.

The following are recommended in the short term, as it is important to meet the immediate needs of vulnerable populations.

The government has introduced the Peka B40 health protection plan, which includes provision of health screening for those aged 50 years and above, medical devices aid, incentive to complete cancer treatment and transport cost for citizens in the low income group. Peka B40 should be extended to include nutrition screening for all children.

An emergency food assistance programme, which involves the establishment of food banks based on needs in housing areas, should be introduced. These food banks would be managed by the community.

A food debit benefit (FDB) system should also be introduced. Each month, the government could deposit the benefits directly into the household’s electronic benefit transfer (EBT) card account. The amount of benefits depends on the household’s size, income, and expenses. Households may use the FDB to pay for food at supermarkets, convenience stores and other food retailers, including certain pasar malam.

DR MADELINE BERMA

Economic analyst and member of the Education Ministry’s National Education Policy Committee

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