Health Starts Before Birth: Malnutrition in South Asia’s Women

Malnutrition remains a persistent and multifaceted challenge among women and girls of reproductive age (WRA) in South Asia. Over one in five WRA are underweight, the highest global proportion, while overweight and obesity are rising rapidly, now affecting up to 52% in some populations. Anaemia effects nearly half of WRA in the region, alongside widespread deficiencies in iron, zinc, folate, and vitamin D. These nutritional deficits are shaped by both dietary and non-dietary factors, including infections, inflammation, and haemoglobinopathies, and are further influenced by socio-demographic variables such as age, education, wealth, and urban–rural residence. The implications extend beyond women's immediate health, contributing to adverse pregnancy outcomes such as low birth weight, stunting, and poor fetal development. Despite the magnitude of the problem, gaps persist in standardized diagnostic methods and longitudinal data linking preconception nutrition to maternal and birth outcomes. Patterns show that underweight is more common among unmarried women, while overweight predominates among married women. Addressing these disparities demands three key actions: early and routine screening of nutritional status beginning in adolescence, harmonization of regional diagnostic criteria for anaemia and micronutrient deficiencies, and investment in large-scale longitudinal studies to guide policy and programs that are population-specific and locally responsive.

Source: Miller, F., Sethi, V., Schoenaker, D., Chowdhury, R., Verma, R. K., Hirst, J., Nair, M., Benedetto, C., Sriram, U., Murira, Z., & Saville, N. M. (2025). Preconception malnutrition among women and girls in south Asia: prevalence, determinants, and association with pregnancy and birth outcomes. The Lancet Regional Health - Southeast Asia, 36, 100573. https://doi.org/10.1016/j.lansea.2025.100573