Help Us Create a World Free from Hunger- For Good

Decades of war, conflict, and economic hardship have plunged millions of Afghans into extreme poverty and food insecurity. Among the most vulnerable are infants, who face alarming rates of acute malnutrition. The shortage of professional medical services, combined with rising costs and limited humanitarian aid, leaves many families unable to access lifesaving treatment.

Combatting Infant Malnutrition with Breastfeeding

Action Against Hunger staff meet mothers every day who are desperate to get care for their babies — and the malnutrition situation in Afghanistan is only deteriorating.

The key to reducing malnutrition in infants is to promote exclusive breastfeeding for children under six months. According to the World Health Organization, breastmilk provides all the energy and nutrients that the infant needs for the first months of life, and it continues to provide up to half or more of a child’s nutritional needs during the second half of the first year. Additionally, breastfeeding can help protect babies against short-and long-term illnesses and diseases.

However, data collected by our teams shows that in 2024, about 85% of all children admitted to our therapeutic feeding units for treatment of severe acute malnutrition with complications were under 24 months old. This means most complicated cases occur during infancy, when children should be protected from developing malnutrition through the nutrients they receive via breastfeeding. The fact that infants are overrepresented in complicated cases is an indicator that malnutrition is rising among the general population, including mothers — who then face challenges producing breastmilk.

Barriers to Breastfeeding in Afghanistan

Action Against Hunger has identified four significant barriers to exclusive breastfeeding for children under six months in Afghanistan. All these constraints mean that mothers in Afghanistan may face challenges properly feeding their young children.

Financial Constraints and Labor

Economic hardships leave many families unable to provide enough food to make sure no one needs to go hungry. As mothers usually leave more food for their children, they are often the ones with the least food intake within their households, which can lead to malnutrition. In addition, mothers living in rural areas are often busy with heavy physical work like agriculture and farming, impeding their ability to breastfeed their children.

Lack of Access to Healthcare

Poor coverage of health facilities across Afghanistan contributes to issues in treating babies when they are suffering malnutrition. In fact, 10 million people in Afghanistan live more than a one-hour walking distance away from the nearest health facility. Walking for one hour or more may be impossible for those who are ill or weak. This is made worse in the winter, when high snowfall impedes access. Without public transport or proper road conditions, health facilities can be too far out of reach for some families.

Additionally, women are only allowed travel outside of their homes when accompanied by an immediate male relative, called a “mahram”. If a mahram is not available, for example because they are working, then mothers cannot bring their children to health facilities.

Barriers to Women’s Education and Healthcare Professionals

Education bans on women in Afghanistan have resulted in fewer female nurses, midwives, and doctors available to counsel female patients. This hinders the spread of information about the benefits of exclusive breastfeeding and breastfeeding techniques.

With fewer public spaces are available for women, there are less opportunities for them to learn about family planning, reproductive rights, and professional childcare. Women depend on the knowledge available in their immediate family. However, some have reported not knowing anyone in their immediate community they could ask for guidance.

4. Misinformation about Breastfeeding

Misinformation about breastfeeding is prevalent. Traditional beliefs sometimes discourage mothers from exclusive breastfeeding, and older members of the community often advise mothers to feed their baby with honey or butter.

The reasoning behind this advice varies. Some communities believe that clostrum (the first form of breastmilk released after giving birth) is impure and harmful to the baby, while others believe that a mother’s milk is not sufficient for nourishing the child. Companies promoting formula milks often reiterate the latter piece of misinformation. It is a growing concern for our teams, who have observed increasing numbers of middle-class and educated families using formula milk.

Community Efforts to Fight Malnutrition

Action Against Hunger has been working with communities in Afghanistan to fight malnutrition since 1979. Our teams manage seven Therapeutic Feeding Units and support 40 health centers across the country. In each of Action Against Hunger’s clinics, teams provide screening services for all children and medical treatment for all cases found to suffer from moderate or severe acute malnutrition, providing essential, lifesaving care.

Our teams’ work also extends to community education services:

• Clinics are equipped with child-friendly spaces with painted walls, cushions to sit on, and a variety of toys for children to choose from
• Teams provide health education on optimal breastfeeding practices for caregivers
• Educational sessions cover practices such as bathing, massaging, and proper breastfeeding techniques
• A private consultation room is available for mothers to talk to nutrition and psychosocial counsellors
• Awareness is raised among community elders on the benefits of exclusive breastfeeding for children, facilitating the spread of knowledge amongst the community that will be self-perpetuated in the long term.

With these services, information on the best practices to support breastfeeding and prevent malnutrition become more accessible to communities, helping ensure mothers and babies have the resources they need to thrive.

Links:

• https://www.actionagainsthunger.org/story/addressing-worsening-infant-malnutrition-in-afghanistan/

Malnutrition is caused by more than just a lack of food. There is another essential resource that plays a critical role in whether children get the nutrition they need: clean water.

When water is unsafe to drink, cook with, or wash with, it can trigger a dangerous cycle that prevents the body from absorbing the nutrients it needs to survive and thrive. Understanding how water, disease, and nutrition are connected is key to our fight against hunger.

When Water Makes People Sick

Water is fundamental to the body’s ability to process food and absorb nutrients. But when water sources are contaminated, drinking it can cause serious illness and undermine the body’s ability to use the nutrients it receives.

Common waterborne diseases include:

• Diarrhea
• Cholera
• Typhoid fever
• Intestinal parasites
• Other gastrointestinal infections

These illnesses are especially common in areas where communities lack proper sanitation systems or safe hygiene practices. About 1 in 4 people globally are living without reliable access to safe water and are at risk of illness as a result.

The Vicious Cycle: Illness and Malnutrition Reinforce Each Other

The relationship between disease and malnutrition works in both directions. While illness can cause malnutrition, malnutrition also weakens the immune system, making children more vulnerable to infections. This creates a dangerous cycle: a child becomes sick, then malnourished, then sick again, and so on. The risk is heightened when a child continues to drink unclean water or live in unsanitary conditions. Each time this cycle repeats, the child’s health can decline further.

For some children, repeated illness can lead to chronic malnutrition, also known as stunting. Stunted children are shorter for their age and may face long-term health and developmental challenges.

How Illness Leads to Malnutrition

Continued exposure to unsafe drinking water increases the risk of having recurring sickness, weakening the body over time, and increasing risk of malnutrition and other health challenges. For young children, whose bodies and immune systems are still developing, this risk is particularly severe.

For example, diseases such as diarrhea cause the body to rapidly lose fluids, electrolytes, and essential nutrients. Even if a child has eaten enough food, these nutrients may be flushed out before the body can use them. Children under 5 years old are at a critical growth period and have little reserves to withstand nutrient depletion, so diarrhea can quickly turn dangerous. According to the World Health Organization, diarrhea is the leading cause of malnutrition in children under 5 years old, and the third leading cause of death for children globally.

Illness can also reduce appetite. Children who are sick may refuse food or eat very little for several days. This reduction in food intake means the body receives fewer calories and fewer essential vitamins and minerals needed for growth and recovery. If illness is frequently recurring for reasons like unclean water, malnutrition can occur and cause long-lasting harm to the child’s overall health.

How Malnutrition Leads to Illness

Nutrition plays a vital role in fighting illness. Vitamins and minerals are essential for the immune system to function, and the body depends on a steady intake of nutrients to defend itself against infection. Nutrients like vitamin A, zinc, iron, and protein all play key roles in maintaining immune responses and supporting recovery when illness occurs. When a person is malnourished and lacks those essential vitamins and minerals, their vulnerability to illness is heightened.

Malnutrition also causes inflammation that weakens the immune system, reducing the body’s ability to produce immune cells and antibodies that fight infection. As a result, illnesses that might otherwise be mild can become more severe and longer-lasting. Children who are malnourished are more likely to experience frequent infections, including respiratory illnesses, diarrhea, and other common diseases.

Recovery from illness requires energy, protein, and micronutrients. Malnourished individuals often lack these reserves, making it harder to regain strength after being sick. Even after the initial illness passes, the body may remain weakened, increasing the likelihood of relapse or new infections — especially when unclean water continues to be consumed. This can lead to complications, prolonged illness, and, in severe cases, life-threatening conditions.

Why Children Are Most at Risk

Young children are particularly vulnerable to the effects of unsafe water, disease, and malnutrition.

Children require more nutrients relative to their body size because they are growing quickly. Even short interruptions in nutrient intake or absorption can have lasting consequences. Additionally, a child’s immune system is still maturing, making it harder to fight infections. In many communities, children play on the ground or in areas where sanitation infrastructure is limited. This increases their exposure to harmful bacteria and parasites.

When illness and malnutrition occur during the first 1,000 days (from pregnancy through a child’s second birthday), the impacts can be particularly severe. This time is critical for brain development and physical growth.

Clean Water Is a Powerful Tool for Preventing Malnutrition

Malnutrition is a complex challenge with many causes. But one solution is clear: safe water saves lives.

When communities gain reliable access to safe water and sanitation, rates of diarrhea and other infections decline significantly. Improving access to safe water, sanitation, and hygiene (WASH) can dramatically reduce disease and improve nutrition outcomes.

Action Against Hunger works with communities to improve WASH infrastructure and practices and put an end to the illness-malnutrition cycle.

Key solutions include:

• Safe drinking water systems
• Protected wells and boreholes
• Household water treatment and storage
• Sanitation infrastructure such as latrines
• Hygiene education, including handwashing with soap

Through these activities, children are more likely to stay healthy and absorb the nutrients they need.

Links:

• Water and the Cycle of Illness and Malnutrition