Measuring multiple facets of malnutrition simultaneously: the missing link in setting nutrition targets and policymaking

Attention to nutrition continues to grow. The recent surge in interest has included widening agreement on two major issues: first, nutrition goals cannot be achieved through targeted actions alone; nutrition-sensitive interventions are needed as well. Second, the multiple actions required to address all forms of malnutrition through the lifecycle cannot be proxied by a single target or metric. Although the Millennium Development Goals included one concrete measure of nutrition (children underweight), the post-2015 Sustainable Development Goals will include multiple measures that better inform a diversity of policy and programming actions. This suggests a need for improved understanding of how multiple forms of malnutrition are linked, how public investments may affect one form of malnutrition but possibly not others, and how best to measure progress on multiple nutrition fronts, including through nutrition-sensitive actions, such as investments in agriculture. This paper proposes a composite index that highlights the state of nutrition across six separate nutrition goals endorsed by the World Health Assembly in 2012, allowing for ranking (comparison among countries) and monitoring of change (within countries) over time. Establishing an index that captures gains or losses in nutrition across all six goals simultaneously highlights the complexity of nutrition problems and required solutions. Such an index can be used to track progress towards goals set for 2025, but also support dialogue on the individual index components and how investments should be prioritized for maximum impact.