Global Update and Trends in Hidden Hunger, 1995‐2011

In order to track progress in reducing the persistent burden of micronutrient deficiencies globally, a Hidden Hunger Index (HHI) was developed in 2013. The index is calculated using an unweighted average of prevalence of iron‐deficiency anemia, vitamin A deficiency and stunting (used as a proxy for zinc deficiency). Using newly available data, we updated the HHI in 2014 and assessed progress globally and in 7 regions between 1995‐2011 using population weighted means. Globally, the burden of hidden hunger declined (‐6.7 net change) from 1995‐2011; improvements were observed for all regions except Africa where the HHI increased (+1.9); East Asia and the Pacific performed exceptionally well (‐13.0). Region n Net HHI change 1995‐2011Mean (SE) HHI 1995Mean (SE) HHI 2000Mean (SE) HHI 2005Mean (SE) HHI 2011Mean (SE) Africa 46 1.90 (0.11) 35.43 (0.76) 36.85 (0.75) 37.61 (0.69) 37.33 (0.58) West and Central Africa 24 2.74 (0.12) 34.58 (0.84) 36.34 (0.87) 37.13 (0.85) 37.32 (0.79) East and Southern Africa 22 1.06 (0.19) 36.29 (1.29) 37.36 (1.24) 38.08 (1.10) 37.34 (0.87) Americas 33 ‐4.83 (0.07) 17.76 (0.68) 15.24 (0.65) 13.85 (0.62) 12.93 (0.53) Central America 8 ‐6.07 (0.11) 20.71 (1.21) 17.63 (1.15) 15.78 (1.18) 14.65 (1.14) South America 11 ‐4.48 (0.10) 16.61 (1.01) 14.25 (1.03) 13.00 (1.41) 12.13 (0.73) Caribbean 14 ‐3.41 (0.06) 17.33 (1.54) 15.38 (1.48) 14.49 (1.41) 13.92 (1.38) Middle East and North Africa 20 ‐3.44 (0.11) 21.67 (1.48) 19.77 (1.61) 19.11 (1.67) 18.23 (1.66) Middle East 14 ‐4.37 (0.07) 20.87 (1.85) 18.67 (1.80) 17.68 (1.84) 16.49 (1.85) North Africa 6 ‐2.47 (0.21) 22.51 (2.70) 20.92 (3.22) 20.60 (3.36) 20.03 (3.24) Central and Eastern Europe 9 ‐4.74 (0.07) 20.06 (1.24) 18.10 (1.41) 16.62 (1.30) 13.33 (1.07) South Asia 8 ‐4.40 (0.21) 40.14 (0.98) 38.63 (1.04) 37.57 (1.08) 35.75 (1.06) East Asia and the Pacific 21 ‐12.97 (0.11) 25.97 (1.42) 19.51 (1.48) 15.17 (1.40) 13.00 (1.18) Global 138 ‐6.72 (0.12) 29.96 (0.81) 26.86 (0.95) 24.81 (1.04) 23.25 (1.04) image Improvements in HHI were mostly attributable to reductions in zinc and vitamin A deficiencies, whereas iron‐deficiency anemia persisted and even increased in some regions. The HHI was also shown to be highly correlated with other global indices of hunger and development such as the Human Development Index and Global Hunger Index (r=0.91 and r=0.83, respectively). The HHI is a useful tool that can help track the impact of programs and policies aimed at reducing micronutrient deficiencies, and monitor achievement of the current and future Millennium Development Goals (MDGs). Sight and Life provided funding to support the preparation of this manuscript.