Helping Children Realize Their Potential

The Asian Development Bank prioritizes investments in children and their mothers as the most effective way to promote human development.

Policy Support

• The 1998 policy on gender and development emphasizes that the most effective investment in the health and education of children is an investment in the health and education of their mothers.

• The 1999 Poverty Reduction Strategy requires resources to be targeted at women and children who form the majority of the 900 million very poor people in Asia and the Pacific living on $1 a day or less.

• The 1999 health policy endorses the shift toward primary health care to most benefit poor mothers and children. a proportion of total sector investment rose from 36 percent between 1978 and 1991 to 66 percent since 1992.

Examples of innovative ADB support for children.

• Two loans to Indonesia identify policy reforms that lessen the impact of the financial crisis on the poor and improve the delivery of basic social services. They provide funds to enable midwives in health centers to expand outreach programs, maintain services for pregnant women, and set up feeding programs for pregnant women, infants, and young children.

• Health and education projects include regional public-private initiatives to address iron deficiency anemia, which afflicts 60 percent of the region's pregnant women, half the women of reproductive age, and 40 percent of preschoolers in Asia.

• The response to regional needs for child immunization has been robust. Immunization programs and the control of childhood infectious diseases are being funded in Bangladesh, Cambodia, Indonesia, Philippines, and Viet Nam.

• An early childhood development project in the Philippines and a communicable diseases control project in Indonesia both represent an integrated management approach to killer diseases

• In a pilot project, ADB, regional governments, and food manufacturers are working together to fortify salt and flour.in the republics in Central Asia and the Caucasus. Since the dissolution of Soviet Union, these countries have been unable to produce high-quality essential foods and this has led to a sharp increase in micronutrient malnutrition and stunting of children..

Nutrition Trends

The extent of Asia's nutritional problem is alarming. Most of the world's underweight and stunted children are in Asia.

The Asian Development Bank's 2000 Annual Report reveals in its theme chapter, Develop A Child, some stark facts about the crisis facing Asia's young:

• Six million children under five years of age--more than half of the world's total--die each year in developing Asia. Underweight children account for more than half of these deaths. Of the rest, most die from diseases that could be prevented by vaccination and simple medication.

• Three quarters of the world's underweight and stunted children are in Asia.

• Three quarters of those suffering from vitamin A, iodine, and iron deficiencies--mostly young children and their mothers--are in Asia.

The human body needs only tiny amounts of vitamins and minerals for normal development, yet micronutrient deficiency is a major cause of death and disability. Vitamin A deficiency is implicated in a substantial proportion of maternal and under-five deaths. Major supplement programs are in place to raise vitamin A status in the region. But in South Asia, only one child in four receives them. Read how Asia-wide child mortality could decrease by 40% and IQs improve by 10-15 % by correcting iodine, vitamin A, and iron deficiencies.

Iodine deficiency disorders are the world's leading cause of mental disability. Iodized salt is the cost-effective solution. The Universal Salt Iodization initiative, led by the United Nations Children's Fund (UNICEF), increased the percentage of the world's households using iodized salt from one fourth to over two thirds in the late 1990s. But a billion Asians still lack sufficient iodine in their diets. In Bangladesh and Central Asia, palpable goiter is endemic.

Anemia, a form of iron deficiency, is the most prevalent nutritional problem. In Asia, more than a billion people lack iron. In South Asia, nine out of 10 pregnant women are anemic and at higher risk of dying during pregnancy. An Asian Development Bank (ADB) study showed that at least 65,000 anemic pregnant women die each year in low-income Asia. For half of Asia's infants and school-age children, anemia leads to poor motor skills and delayed speech and reading.

The consequences of malnutrition are staggering: unsafe fertility, premature death, disability, lifelong susceptibility to illness, poor cognitive and learning skills, low achievement in school, low wages, and weak capacity to invest in the quality of the next generation's children.

Economic and social costs are high. Low-cost investments could significantly and sustainable improve the health, nutrition, education, and environment of children. Yet within the region, the share of a national budget allocated to basic education and children's health and nutrition is often low. Political will, and the willingness of public and private sectors to work together, can change this.