Resource

About

The Nutrition International Cost of Inaction Tool is an online, evidence-based and user-friendly analytical tool built for country-level policymakers and advocates. It was created to rapidly generate estimates on the health, human capital and economic costs of inaction on stunting, low birthweight and anaemia (in women and children) for over 140+ countries. The tool was launched in 2024 by Nutrition International in partnership with Limestone Analytics, with funding from the Government of Canada. Evidence generated by the tool will support improved policymaking and investment decisions amongst government, industry and donors, by quantifying the health and human capital implications of the burden of low birthweight, stunting and anaemia in children and women.

Global findings from the Cost Of Inaction Tool

There are 17 million children (13%) born with low birthweight. 146 million children under five (23%) are stunted, and 245 million (41%) suffer from anaemia. Additionally, more than 586 million adolescent girls and women (15-49) (30%) are suffering from anaemia. Each year, this level of stunting, low birthweight, and anaemia result in an estimated:

• US $761 billion in economic costs (or 1% of global gross national income) due to cognitive and mortality losses
• 1.3 million child deaths
• 304 million IQ points lost

Nutrition International’s Cost of Inaction Tool methodology was developed in 2023 by Sakshi Jain, Sameen Ahsan and Dr. Dylan Walters in partnership with Limestone Analytics. The initial version of the tool was based on an economic model developed by Dr. Michelle Gaffey and Dr. Sue Horton for Nutrition International in 2017.

Why undernutrition?

In 2012, the World Health Assembly (WHA) established six targets to reduce the global double burden of malnutrition. The tool prioritizes the first three targets to motivate advocacy, policy and investment actions, as cost-effective interventions are readily available to address these issues. Refer to Nutrition International’s Cost of Not Breastfeeding Tool for more information on target #5. For more information on targets #4 and #6, refer to the WHA policy briefs on childhood overweight and wasting.

Undernutrition refers to deficiencies in nutrient intake, imbalance of essential nutrients or impaired nutrient utilization. It disproportionately impacts certain populations such as children under five, adolescent girls and pregnant women. For example, severely undernourished children are up to nine times more likely to die¹ and anaemia is one of the leading causes of maternal mortality in adolescent girls and women.² Undernutrition affects morbidity and cognitive development as well.

If good nutrition is not protected from the beginning, government budgets will increasingly be spent on costly health care treatments for diseases instead of being invested in prevention and in creating better health which will result in higher human capital and economic development outcomes.

Despite substantial evidence on the health and cognitive benefits of investing in nutrition interventions that address undernutrition, progress remains slow. At present, the world is off course to meet the WHA Global Nutrition Targets by 2025 for stunting, low birthweight and anaemia. Thus, efforts towards ending these forms of malnutrition need to be accelerated.

We’re interested in learning how you’ve used our tool in your work. Please complete this short form to share how you’ve applied the Cost of Inaction Tool.

For help with technical issues with the NI tools, please email healthecon@nutritionintl.org

Nutrition International’s Health Economics unit produces advanced modelling tools and robust data to bolster the organization’s impact in addressing malnutrition. The NI Cost of Inaction Tool equips stakeholders with essential evidence for informed decision-making. For further support, including additional analyses, tool demonstrations and technical assistance in conducting economic analyses and developing and operationalizing costed nutrition actions plans, please contact us at healthecon@nutritionintl.org. 

1 Tracking Progress on Child and Maternal Nutrition – A survival and development priority. UNICEF. 2009

2 Rahman MM. Abe SK. Rahman MS et al. Maternal anemia and risk of adverse birth and health outcomes in low- and middle-income countries: systematic review and meta-analysis. The America Journal of Clinical Nutrition. 2016; 103: 495-504.