I have, no doubt, fallen in love with Southeast Asia. Golden stupas, rolling mountainsides, and magnificent sunsets are never far from the bustling cityscapes that dot the region. As one of the most dynamic areas in the world, the region’s recent history has been characterized by remarkable economic growth and rapid reductions in poverty.
Yet, in Southeast Asia, high levels of undernutrition persist.
Chronic undernutrition – an ongoing deficiency in essential nutrients – affects a staggering 17.9 million children in the region’s low- and middle-income countries, roughly a third of children under the age of five. While substantial improvements in nutrition have been made over the past two decades, progress has not been uniform across or within countries. It is clear that more needs to be done.
Good nutrition is critical in the first thousand days of life, from conception to two years of age. During this period, the effects of severe undernutrition – stunted physical growth and impaired intellectual development – are often long-term and irreversible. Undernourished children have a higher risk of mortality and globally, over three million child deaths are attributable to undernutrition every year.
At the same time, the economic consequences are substantial. Studies have documented losses to lifetime earnings in those who survive a childhood characterized by undernutrition, as well as reductions in national Gross Domestic Product in countries where the issue persists.
Last year, I spent three months with UNICEF’s East Asia Pacific office in Thailand, carrying out my dissertation fieldwork and supporting the preparation of the joint UNICEF/ASEAN (Association for Southeast Asian Nations) food and nutrition security report. I also joined the regional parliamentary seminar on child nutrition in Laos and ASEAN’s third annual task force meeting on maternal and child health in northern Thailand.
These activities – the report, the seminar, and the task force meeting – share a common goal: to improve maternal and child nutrition on a large scale. To achieve this, political commitment is needed from national governments in Southeast Asia’s low- and middle-income countries.
Yet, governments vary in their prioritization of maternal and child nutrition on national policy agendas. I find this especially puzzling as simple, cost-effective, evidence-based nutrition interventions exist to treat and prevent undernutrition. Indeed, the range of interventions available is unprecedented.
And so time and again, I come back to the same question. Why don’t all governments put maternal and child nutrition at the top of their national policy agendas – and then follow through with sound policies?
This fall, I have the opportunity to return to Southeast Asia. I will spend two months in Indonesia and the Philippines, countries in the region with the highest burden of chronic undernutrition. My doctoral research looks at these countries, in addition to Laos and Cambodia, to better understand the politics of national policy making.
As national policies are made in an interdependent world, I focus specifically on the impact of an important initiative called the “Scaling up Nutrition (SUN) Movement.” SUN emerged from the UN and donor network in 2009. Since then, over 50 countries have signed on to the agreement and committed to achieving a range of goals for tackling maternal and child undernutrition. Naturally, a number of questions arise.
Do international agreements like SUN work in getting maternal and child nutrition prioritized on national policy agendas? If so, under what conditions do they succeed? And which causal mechanisms link international agreements to policy improvements? I hope my doctoral research will shed light on these questions.
To identify the levers for positive change, a better understanding of the political and policy processes which underpin the reduction of undernutrition is needed. In my next post, I’ll share some ideas on how the classical foundations of political science can contribute to this important area of inquiry.
Carmen Jacqueline Ho is a PhD Candidate in the Department of Political Science at the University of Toronto and a Doctoral Fellow with the Asian Institute at the Munk School of Global Affairs. She is also affiliated with the Centre for Global Child Health at the Hospital for Sick Children (SickKids). She can be reached at firstname.lastname@example.org.