in the
Republic of

© UNICEF RDC 2012 Pudlowski
Nutrition amongst children less than five years old
in the Democratic Republic of Congo


© UNICEF RDC 2014 Almeras
>6 millions
Of children under 5 years old
Democratic Republic of Congo (DRC): suffer from chronic malnutrition

 One of the countries with the greatest burden (> 90%) of
children with chronic malnutrition and the 15th in terms of
1.9 million
of cases of severe acute
prevalence 43% of children under five suffer from chronic malnutrition
malnutrition, i.e almost 1 child out of 21.
2 million
 6 provinces out of 26 have prevalences exceeding 50% - which is Of cases of moderate acute
considered an emergency threshold - and 14 of the 26 provinces malnutrition are expected in 2017
account for more than 40% of malnourished children.

 The situation of chronic malnutrition in DRC has stagnated in the
last 15 years: the prevalence has changed from 38% of children The causes
under the age of 71 in 2001 to 47% in 2007 and 43% in 2013-2014.

 7.9% of children aged 6 to 59 months suffer from acute malnutrition.
 52% des Of children
under 6 months are not
The prevalence of acute global malnutrition has halved from 16% in exclusively breast-fed.
2001 to 8% in 2013-2014.

 However, by 2016, the data of the alert system and nutritional
 9.3% Only children
aged 6-23 months receive
surveillance revealed 64 situations of extreme severity of acute an acceptable minimum
malnutrition or nutritional alerts in 36 health zones (60 000 diet).
estimated cases of severe acute malnutrition). In total, 18 alerts
were confirmed by nutritional surveys.  38% Of the population
has a poor and limited diet
DRC should make more efforts to reach the 40% target of reducing
chronic malnutrition by 2025 (WHA, SDG argets). Sufficient human
and financial resources should be allocated to achieve this target.
 Half of households
have access to an improved
water source
 A 10% reduction in the proportion of children suffering from chronic
malnutrition (1,947,000 children) seems more realistic. This
scenario will reduce the prevalence of chronic malnutrition in
 18% of households use
appropriate sanitation
the DRC by 15%.

EDS 2013-2014
The nutrition of children less than five years old in the DRC 3

The causes

Fundamentally, malnutrition is a consequence of

© UNICEF RDC 2014 Almeras
diseases and infections and inadequate food intake,
but many other elements also come into play.

Poverty, discrimination and violence against women
are major causes of malnutrition. Inadequate diet
(monotonous, poorly diversified, low in quality, ie,
lacking the necessary vitamins and minerals) of the
mother and her child can have implications for early  Brake on economic development
childhood development.
Poor nutrition perpetuates the cycle of poverty and
Recurrent diseases (diarrhea, malaria, etc.), the malnutrition, as there are:
unhealthy environment, household food insecurity,
 Direct productivity losses due to poor physical
inadequate health and sanitation services and the
condition and losses from malnutrition-related
poor quality of care for children and women are also
causes of malnutrition.
 Indirect losses due to poor cognitive development
and losses in school attendance;
 Losses caused by rising health costs.

The losses are between 3 and 8% of the
Consequences gross domestic product, an annual loss for the DRC of
USD 1.174 billion.
Lost lifes
 160,000 children under five years old die each
year from the consequences of malnutrition.
 It is not only the deaths of children which are
attributable to malnutrition iin its different forms,
but also the ones of women having anemia.
Reduces human capital
Scaling Up Nutrition mouvement in DRC
 Malnutrition affects the growth and maturation of
the brain. A state of malnutrition can cause 1.Bringing actors to work together (42% progress in
irreversible damage. 2016):
 Cognitive deficits are manifested by memory  Donor network : GIBNUT (World Bank)
difficulties, intellectual slowness or specific  Network of scientists: functional
learning disabilities in reading, writing or
 United Nations Network (UNICEF)
 Civil Society Network (Save the Children)
 The child may present behavioral problems, such
 Private Sector Network (ongoing)
as attention deficit hyperactivity, difficulties in
emotional regulation or socialization. In extreme  2. Implementation of policies (41% progress in 2016).
cases, there might be mental retardation.This will  3. Implementation and harmonization of programs
result in 2 to 3 years of schooling less and by 22 to (34% progress in 2016).
45% of individual economic gain losses in  4. Mobilization of resources (42% progress in 2016)

35.24 billion $USD (2015) http://www.worldbank.org/en/country/dr
The nutrition of children less than five years old in the DRC 4
© UNICEF RDC 2015 Dubourthoumieu

Direct high-impact nutrition
Actions interventions to prevent and treat
Coordination and high-level engagement through an  Promotion of adequate nutrition
appropriate institutional framework and feeding practices

The institutional framework was created for multi-stakeholder and  Breastfeeding
 Complementary feeding from the
multisectoral action, through Decree No. 05/042 of 15 December 2015 age of six months
on the Creation, Organization and Functioning of the National  Improved hygiene and sanitation
Multisectoral Nutrition Committee. It is necessary to: practices
 Increase intake of minerals and
1. Make the coordination and the multisectoral committee within the vitamins
Prime Minister operational - the Ministry of Public Health assuming the  Vitamin A supplementation for
vice-chairmanship of the said committee; and adopt the National children (6-59 months)
Multisectoral Nutrition Strategic Plan 2016-2020 and the Operational  Addition of zinc to the treatment of
Plan budgeted for the same period.  Distribution of multiple
micronutrients in powder form
2. Establish a common framework of nutrition outcomes for all  Deworming of children (1-5 years)
stakeholders and sectors involved in the strategic plan, including with  Iron and folic acid supplementation
of pregnant women
humanitarian actors in the nutrition sector.
 Micronutrient intake through food
3. Establish strategic contacts with technical and financial partners that fortification
support nutrition, particularly through funders (GIBNUT).  Iodization of salt
 Food Fortification (Iron)
Choice of good interventions, good targeting of the  Treatment of acute malnutrition
population in need and consistent coverage  Prevention and treatment of
moderate acute malnutrition
These interventions should primarily take place during the first 1,000  Treatment of Severe Acute
days of life, that is from pregnancy to the second birthday of the child. Malnutrition with Ready-to-Use
Therapeutic Foods (ATPE)
These direct nutritional interventions should be complemented by
Scaling Up Nutrition: What will it cost? Horton et al.
contributions from the following areas: 2009

 Nutritionally sensitive agriculture; Sensitive nutrition interventions
 Social Protection ; Coordination with interventions called
 Early childhood development; nutrition-sensitive interventions , is
needed to build the foundations of
 And education and empowerment of women. resilience in times of crisis and for a
healthy and prosperous future
Despite efforts in recent years, coverage of these interventions is not
adequate to have a significant impact in reducing chronic
malnutrition.malnutrition chronique.
The nutrition of children less than five years old in DRC 5

Actions  Over the past decade, the DRC
has succeeded in
supplementing vitamin A with
In order to gradually scale up specific or direct nutrition more than 13 million children
interventions, existing platforms at different levels are to be between the ages of 6 and 59
months, and to dewom nearly
optimized and energized, such as:
12 million children aged 1 to
1. Preschool Consultations in Health Centers 5 twice a year
2. Community based Nutrition approach in communities
 The capacity to manage severe
3. Children's Health Days as a mass activity acute malnutrition increased
7, from 40,000 cases treated in
4. Units services for the management of acute malnutrition in
2007 to close to 300,000
health centers and hospitals.
treated cases in 2014.
5. Antenatal care and consultations for women (prenatal and post-
natal)  The prevalence of anemia in
young children decreased from
6. Schools (gardens, canteens ...)
71% in 2007 to 48% in 2013.
Sufficient financial and human resources
 The proportion of children
There is an inadequate investment in internal government financial benefiting from the benefits of
resources. Specific nutrition interventions are 100% supported by the exclusive breastfeeding
financial partners. increased from 37% in 2007 to
 Allocate more financial resources to the sectors and actors involved.
48% in 2013.
Increase funding for nutrition both within the Ministry of Public Health
and within ministries sensitive to nutrition. Ensure the sensitivity of
programs to nutrition.

USD 371 million to invest annually to scale up 10 direct nutrition interventions (cost effective) in all
provinces, thus break the vicious circle of malnutrition

13% : the return on investment according to the World Bank study, in terms of saved lives (76,000), avoided growth
stops (1 million), Life years saved adjusted for disability (DAL Ys), 4 million) and gain in economic productivity (USD 591

© UNICEF RDC 2014 Dubourthoumieu
© UNICEF RDC 2012 Pudlowski