Reversal of Progress against Malnutrition in Egypt

Objective To assess trends and determinants of stunting, a monitoring indicator for economic and human development in Egypt, where marked economic and social changes have taken place. Methods WHO global database, Food and Agriculture Organization Food balance sheet and World Bank indicators were used to describe trends in childhood growth, food availability and economic development. Results Neonatal, infant and under five mortality rates decreased between 1995 and 2010. Prematurity and congenital anomalies among children < 5 years of age increased (20% and 30% respectively). Stunting decreased from 35% to 20.3% between 1990 and 2003 and bounced back to 30.7% by 2010. Moreover, the onset of stunting is now earlier (< 6 month of age). Iron deficiency anemia increased from 30 to 60% and from 30 to 46% among preschool girls and boys respectively. Gross domestic product per capita increased and inflation rate decreased between 1990 and 2011. A reverse pattern occurred between 2003 and 2004. Daily calorie availability per capita did not change between 1995 and 2009 while calories from animal sources increased from 6.6% to 8.6%. Per capita protein from milk, eggs, poultry and pulses revealed a marked shortage compared to recommendations for 2–5 year old children. Conclusion Stunting reflects the cumulative effects of inadequate food intake, poor health conditions and projects low levels of human development and economic growth. Congenital anomalies and prematurity may explain the early onset of stunting predicated by maternal poor health. Egypt, post Arab Spring, has a window of opportunity to reform its subsidy food and social programs to target improvement of maternal nutrition, strengthen breastfeeding and develop complementary feeding.