Community based, preventative approaches to health care will improve stunting and wasting outcomes for Afghan children. Photo Credit: Rumi Consultancy/ World Bank
Last year, Afghanistan became the 60th country to join Scaling Up Nutrition (SUN), a global movement to end malnutrition, and thus signaled its strong commitment to invest in a better future for its citizens.
This engagement comes at a critical time as more than 40 percent of Afghan children are currently stunted - or of low height for their age.
Stunting in early life is a marker of poor child growth and development and will reduce their potential to contribute toward their country's growth and prosperity.
On the other hand, a well-nourished child tends to complete more years of schooling, learns better, and earns higher wages in adulthood, thereby increasing the odds that he or she will escape a life of poverty.
As such, Afghanistan stands to gain enormous benefits by reducing stunting, which in turn can help boost its economic growth, productivity, and human capital development.
To help the Afghan government invest in better nutrition, the South Asia Food and Nutrition Security Initiative (SAFANSI), the Ministry of Public Health (MoPH), World Bank and UNICEF have partnered to determine what it would take to reach more children, women, and their families and provide them with essential nutrition services that would ultimately reduce stunting and anemia.
To that end, the new Investment Framework for Nutrition in Afghanistan working paper is a start to better understand the cost, impacts and benefits of expanding the nutrition package of the current Basic Package of Health Services (BPHS), a national program which defines and establishes healthcare standards across the country.
Specifically, the study identifies nutrition services that can reach a realistic number of children and women for greatest impact.
Some good practices are easier to implement than others.
For example, breastfeeding is among the most cost-effective things that can be done to decrease stunting.And encouraging mothers to only breastfeed their newborns in their first six months and then feed them appropriate complementary food will benefit their child in the first critical years of his or her life.
These benefits will then carry on throughout the child's life by increasing their chances of survival, improving their brain development, and lowering their risks of contracting chronic diseases as adults.
Further to that, the report outlines key trends.
First, the report notes that the government has made it a priority to expand BPHS to women and children.
Yet, by setting conservative targets to deliver essential nutrition services, the MoPH will only modestly reduce the number of stunted children, albeit at a low cost.
As the Afghan health system strengthens, setting more ambitious targets will lead to substantially greater impacts to reduce stunting, reduce anemia in women, increase the number of exclusively breastfed infants and children fed with appropriate complementary foods, and save lives.
Second, these investments can provide an opportunity to involve communities and reach beyond health facilities.
Case in point: Children are often brought to health facilities when they are already sick and malnourished. By shifting the focus to prevention and delivering essential nutrition services closer to families and communities will lead to greater success in preventing stunting and promoting better growth for more children.
Involving communities also aligns with other strategies, such as the Investing in the Early Years initiative, with greater scope to link activities that improve nutrition with other sectors such as community development and education focusing on the critical early years of a child's life.
These initial steps for Afghanistan will go a long way, as the nation strengthens its ability to expand its nutrition program to reach more communities. Nutrition investments are not only among the best value-for-money development actions, they also lay the groundwork for successful investments in other sectors.
As Afghanistan sees a rise in community outreach for nutrition services, these investments will help build future human capital and provide an equal opportunity for all Afghan children to drive faster economic growth.
 Martorell et al. 2010. Weight gain in the first two years of life is an Important of schooling outcomes in pooled analysis from 5 birth cohorts from low- and middle-income countries. Journal of Nutrition. 140:348-54. Hoddinott et al. 2008. Effects of a nutrition intervention during early childhood on economic productivity in Guatemalan adults. Lancet. 371:411-16. Hoddinott, J., J. Maluccio, J. R. Behrman, R. Martorell, P. Melgar, A. R. Quisumbing, M. Ramirez-Zea, A. D. Stein, and K. M. Yount. 2011. "The Consequences of Early Childhood Growth Failure over the Life Course." Discussion Paper 1073. International Food Policy Research Institute, Washington, DC.