The COVID-19 crisis has severely disrupted economic activities in Myanmar. A sharp reduction in economic growth and large increases in poverty and food insecurity are anticipated. In their research, Derek Headey, Ame Cho, Sophie Goudet, Jecinter Akinyi Oketch, and Than Zaw Oo explore the associated risks the crisis poses for maternal and child malnutrition and identify actions to mitigate adverse nutritional impacts.
You can view the full policy note by Derek, Ame Cho, Sophie, Jecinter, and Than Zaw Oo in English here and in Burmese here.
မြန်မာဘာသာဖြင့်ရေးသားထားသော စာတမ်းအပြည့်အစုံကို ဤနေရာတွင် ဖတ်ရှုနိုင်ပါသည်။
Background
The COVID-19 crisis in Myanmar poses a very serious risk to the nutritional status of vulnerable populations, notably women and children, as well as poor urban populations and internally displaced persons. The pandemic will impact these vulnerable groups through the following mechanisms.
- First, we can expect a sharp decline in dietary quality stemming from the income losses related to international shocks to Myanmar’s economy as well as economic contractions resulting from necessary lockdown and physical distancing measures.
- Second, malnutrition could increase due to essential healthcare and nutritional service disruptions. As with food markets, these failures could stem from interruptions to the supply of health and nutritional care, as well as lower demand for services.
- Third, malnutrition could disrupt healthy breastfeeding practices, leading to increased use of inferior breastmilk substitutes.
In recent decades, Myanmar has made significant improvements in reducing child undernutrition and has developed a sound nutrition plan in the Multisectoral National Plan of Action on Nutrition (MS-NPAN). However, prior to COVID-19, many mothers and children were still nutritionally vulnerable. Among children under five years of age, 58 percent were anemic, 29 percent were stunted, and 7 percent were wasted (Figure 1). Twelve percent of women were underweight, but with large variations across regions. On the supply side, access to nutrition services was limited and dietary practices were poor with just 22 percent of children aged 6 to 23 months consuming adequately diverse diets.
Potential impacts of the COVID-19 economic crisis on maternal and child nutrition
Given the importance of household income for child malnutrition, any decline in incomes resulting from COVID-19 can be expected to increase the risk of malnutrition. Until recently, published studies on income and nutrition have almost solely focused on the longer-term effects of economic growth on stunting. However, while COVID-19 related income losses could indeed affect stunting, this process will likely take place over several years. The more immediate impacts are likely to be on weight loss among children and mothers.
A multi-country analysis of Demographic Health Surveys in 52 countries models how declines in economic growth contribute to increases in child wasting. This model predicts that the projected 8.6 percentage-point drop in the rate of national income growth in Myanmar in 2020 may lead to over 110,000 extra under-fives becoming wasted. This would result in an annual caseload of 65,148 children that will need to be treated for severe acute malnutrition (Figure 1).
Potential impacts of the crisis on dietary quality
One of the main mechanisms through which COVID-19 will affect nutrition is through declining dietary quality, which could adversely affect stunting, wasting, and micronutrient deficiencies. In general, people work hard to maintain adequate calorie intake even in the face of severe income shocks to avert hunger and preserve energy for daily activities.
Hence, although income losses could lead to insufficient calorie intake in the very worst circumstances, the more usual response is for households to prioritize purchasing foods that are calorie-dense but contain few micronutrients or high-quality proteins and fats, resulting in a decline in dietary quality. This partially explains the increased risk of wasting, stunting, and micronutrient deficiencies, such as anemia.
Impacts of COVID-19 disruptions to maternal and child health services
Mothers who are pregnant or taking care of young children are vulnerable to COVID-19. However, though there are indeed some direct risks to newborn and young children with other health conditions, it is likely that the indirect effects of COVID-19 on healthcare systems will have much greater consequences for maternal and child health.
Health surveillance data suggest that the COVID-19 lockdown from April 2020 onwards resulted in major disruptions to government maternal and child health services, with vaccination rates almost falling to zero. There are also significant concerns that fear of mother-to-child transmission of COVID-19 could lead to early cessation of breastfeeding, which poses significant health risks for infants.
How can we protect vulnerable groups?
Policymakers and researchers alike are operating in a unique state of uncertainty. It is therefore more critical and ever that agencies identified in the MS-NPAN set forth key actions to protect nutritionally vulnerable groups, with many of these actions also contributing to poverty reduction. These include:
- Expand and adapt social safety net programs to improve dietary quality, not just quantity, to nutritionally at-risk populations.
- Keep agri-food systems functioning.
- Facilitate food system innovations to make it more resilient to COVID-19.
- Support enhanced homestead food production to increase access to nutrient-rich vegetables, fruits, and eggs to improve diet quality.
- Find innovative ways to stimulate demand for nutrient-rich foods.
- Prevent the collapse of basic maternal and child health services.
- Integrate infection prevention and control, WASH, and nutrition, urgently.
- Ramp up support for the integrated management of acute malnutrition.
- Protect women and children.
- Set up or scale up food and nutrition security surveillance systems.
Derek Headey is a Senior Research Fellow with the Food Consumption and Nutrition Division of the International Food Policy Research Institute (IFPRI), based in Yangon. Ame Cho is a Research Analyst with the Development Strategy and Governance Division (DSGD) of IFPRI, based in Yangon. Sophie Goudet is an independent nutrition researcher and consultant to IFPRI, based in Yangon. Jecinter Akinyi Oketch is a Nutrition Specialist with UNICEF, based in Yangon. Than Zaw Oo is a Research Analyst with DSGD of IFPRI, based in Yangon.
This blog post was prepared by Michael Wang, Mickey Leland International Hunger Fellow in DSGD of IFPRI, based in Yangon. The analysis and opinions expressed in this piece are solely those of the authors.
