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1 中国贫困地区儿童营养状况 Children Nutrition in Poor Areas of China 卢迈秘书长中国发展研究基金会 2007 年 10 月 17 日

2 儿童贫困儿童贫困之所以受到关注 : 一是由于儿童心理和生理尚未成熟, 无法积极地保护和发展自我 ; 二是儿童处于生命周期的早期, 营养教育等因素会影响其一生以官方贫困线 ( 生存贫困线 ) 为标准, 中国的儿童生存贫困发生率在 1995 年为 8.5%, 在 2002 年下降到 4.0% 而同期农村人口整体的贫困发生率分别为 7.1% 和 3.1% 儿童生存贫困 (15 岁及以下人口 ) 的发生率高于农村全部人口的生存贫困发生率根据 2002 年的人口抽样调查数据, 可以推断 2002 年农村处于生存贫困状态的儿童的总规模大约为 700 万

5%, 在 2002 年下降到 4.0% 而同期农村人口整体的贫困发生率分别为 7.1% 和 3.

3 中国农村不同年龄组人群贫困状况

4 中国农村儿童生存贫困状况 :0-6 岁儿童中国农村儿童贫困发生率 ( 年 )

5 中国儿童营养状况 : 地区差异 Regional Differences in Children Nutrition 在中国, 儿童营养问题是社会关注的焦点中国地区辽阔, 自然条件经济社会文化存在巨大差异, 因此各地区经济发展不平衡, 城乡之间各乡村之间的差异均较大儿童营养受经济水平的影响, 也呈现地区差异, 儿童营养不良主要集中在西部农村地区 In China, children nutrition is also a focus of social concern. With her vast area and huge disparity in natural, economical, social and cultural conditions, China sees different levels of economic growth in different regions as well as disparity between urban and rural areas and between different rural areas. Affected by unbalanced economic growth in different regions, children nutrition shows disparity along with regional differences and children malnutrition is mostly found in the rural area of the western region.

With her vast area and huge disparity in natural, economical, social and cultural conditions, China sees different levels of economic growth in different regions as well as disparity between urban

6 图 1 5 岁以下儿童低体重率与生长迟缓率城乡比较 Figure 1 Urban-Rural Comparison of Proportion of Children Underweight or Stunted 40% 35% Cities Countryside 30% 25% 20% 15% 10% 5% 0% 1992a 1995b 1998c 2000c 1992a 1995b 1998c 2000c under-weight rate for children under 5 (%) stunting rate for children under 5 (%)

30% 25% 20% 15% 10% 5% 0% 1992a 1995b 1998c 2000c 1992a 1995b 1998c 2000c

7 图 2 5 岁以下儿童低体重率与生长迟缓率农村地区比较 Figure 2 Regional Comparison of Children Underweight or Stunted 40% 35% Eastern rural area 30% Western rural area 25% 20% 15% 10% 5% 0% 1992a 1998c 2000c 1992a 1998c 2000c under-weight rate for children under 5 (%) stunting rate for children under 5 (%)

30% Western rural area 25% 20% 15% 10% 5% 0% 1992a 1998c 2000c 1992a 1998c

8 中国发展研究基金会在广西都安县的调查 CDRF s Survey in Du an County of Guangxi 分析对象 : 广西试验点学生共约 1200 名 Target: 1,200 students at pilot school in Du an County in Guangxi 分析方法 : 用横断面调查与纵向调查相结合方法 Method: cross-sectional and cohort investigation integrated 参考标准 : 我国城市较发达农村近年相应年龄段男生和女生的体质监测结果 Reference Standard: Results of physical monitoring from boy and girl at the corresponding age at Urban and relatively developed rural area. 初步结果 : 都安县被调查学生的体格情况与较发达地区比较有相当差距, 身高体重肺活量等发育情况大约相差 3-5 年 Preliminary results: students at target schools are physically much worse than the relatively developed area. Their height, weight and vital capacity are 3-5 years less developed.

physical monitoring from boy and girl at the corresponding age at Urban and relatively developed rural area.

9 结果 1 身高 Result 1 Height 被调查学校男生平均身高与城市男生相差厘米, 与农村男生相差厘米 The average height of boys in target schools is cm lower than urban boys, and cm lower than rural boys 城市男生 Urban Boys 农村男生 Rural Boys 广西男生 Guangxi Boys 身高 (cm) Height(cm) 身高年龄 ( 周岁 ) Age (years)

5cm lower than rural boys 城市男生 Urban Boys 农村男生 Rural Boys 广西男生 Guangxi Boys 身高 (cm) Height(cm) 170 160 150

10 结果 1 身高 Result 1 Height 被调查学校女生平均身高与城市女生相差厘米, 与农村女生相差厘米 The average height of girls in target schools is cm lower than urban girls, and cm lower than rural girls. 城市女生 Urban Girls 农村女生 Rural Girls 广西女生 Guangxi Girls 身高 (cm) Height (cm) 年龄 ( 周岁 ) Age (years) 144.3

11 结果 2 体重 Result 2 Weight 被调查学校男生平均体重与城市男生相差公斤, 与农村男生相差公斤 The average weight of boys in target schools is kg lower than urban boys, and kg lower than rural boys 体重 (kg) Weight (kg) 城市男生 Urban Boys 农村男生 Rural Boys 广西男生 Guangxi Boys 年龄 ( 周岁 ) Age (years)

3kg lower than rural boys 体重 (kg) Weight (kg) 50 40 30 20 10 城市男生 Urban Boys 农村男生 Rural Boys 广西男

12 结果 2 体重 Result 2 Weight 被调查学校女生平均体重与城市女生相差公斤, 与农村女生相差公斤 The average weight of girls in target schools is kg lower than urban girls, and kg lower than rural boys 体重 (kg) Weight (kg) 城市女生 Urban Girls 农村女生 Rural Girls 广西女生 Guangxi Girls 年龄 ( 周岁 ) Age (years) 39.6

2kg lower than rural boys 体重 (kg) Weight (kg) 50 45 40 35 30 25 20 15 10 城市女生 Urban Girls 农村女生 Rural

13 结果 3 肺活量 Result 3 Vital Capacity 被调查学校男生平均肺活量是城市男生的 59-77%, 是农村男生的 66-80% The average vital capacity of boys in target schools is percent of urban boys and percent of rural boys. 城市男生 Urban Boys 农村男生 Rural Boys 广西男生 Guangxi Boys 肺活量 (ml) Vital capacity (ml) 年龄 ( 周岁 ) Age(years)

城市男生 Urban Boys 农村男生 Rural Boys 广西男生 Guangxi Boys 肺活量 (ml) Vital capacity (ml) 3500 3000 2500 2000

14 结果 3 肺活量 Result 3 Vital Capacity 被调查学校女生平均肺活量是城市女生的 52-68%, 是农村女生的 54-74% The average vital capacity of girls in target schools is percent of urban girls and percent of rural girls. 城市女生 Urban Girls 农村女生 Rural Girls 广西女生 Guangxi Girls 肺活量 (ml) Vital capacity (ml) 年龄 ( 周岁 ) Age(years)

城市女生 Urban Girls 农村女生 Rural Girls 广西女生 Guangxi Girls 肺活量 (ml) Vital capacity (ml) 3000 2500 2000 1500

15 儿童营养不良的影响 The Effect of Children Malnutrition 据中国疾病预防控制中心测算, 如果年儿童生长迟缓率没有改善, 我国将损失 1594 亿元人民币, 如果儿童生长迟缓率在 10 年内下降 30%, 那么国家可减少损失 197 亿元 ; 如果 0-15 岁儿童贫血率在 10 年内由 21.7% 降至 15.2%, 他们成年后 10 年劳动生产率的收益将是 3484 亿元, 如果不改善, 则 10 年将损失 2178 亿元 As calculated by the Chinese Center for Disease Control and Prevention, in case that no improvement is made in countering children growth retardation from 2001 to 2010, China would have a loss of billion RMB Yuan while a 30% drop of children growth retardation in 10 years will reduce the country s loss by 19.7 billion Yuan; and if the anemia rates of children between 0 15 years old drop from 21.7% to 15.2%, the revenue in productivity of ten years after the children grow up will be billion Yuan wile the loss in ten years will be billion Yuan if no improvement is made.

2%, 他们成年后 10 年劳动生产率的收益将是 3484 亿元, 如果不改善, 则 10 年将损失 2178 亿元 As calculated by the Chinese Center for Disease Control and Prevention, in case that no improvement is made in

16 政府应对营养问题应采取的态度营养问题的影响非常深远, 但市场无法解决营养不良问题, 政府应该主动介入, 进行干预采取营养干预行动是加速减贫的关键, 效益成本比高, 与单纯依赖经济增长相比, 改善营养的速度要快得多 2004 年 5 月的哥本哈根共识上发现, 在 17 项潜在的发展投资中, 营养干预使效益最高的之一据世界银行估计, 总体而言, 营养干预的效益成本比率在 5 到 200 之间 The issue of nutrition has far-reaching implication but can not be addressed by the market mechanism. It is necessary for the government to get involved actively. Intervention in nutrition is a key to poverty reduction with high efficiency cost ratio, which may speed up nutrition improvement compared with pure measures in economic growth. The Copenhagen Consensus of May 2004 identifies nutrition intervention as one of the most efficient of 17 potential investments of development. As estimated by the World Bank, the efficient cost ratio of nutrition intervention is between 5

be addressed by the market mechanism. It is necessary for the government to get involved actively.

17 中国发展研究基金会在儿童营养领域的探索中国发展研究基金会设立的贫困地区寄宿制小学学生营养改善项目, 旨在向中央政府提出符合我国国情的儿童营养改善政策建议和操作方案, 有利于政府制定明确统一的儿童营养改善政策 The program of Nutrition for Children in Poor Families initiated by CDRF is designed to provide suggestions for the policy making of the government, improve the performance and efficiency of government policies, and ultimately establish a nation-wide mechanism based on government policies.

Families initiated by CDRF is designed to provide suggestions for the policy making of the government, improve the

18 项目实施方法 Program Implementation 本项目在中国西南的广西壮族自治区和华北的河北省各选择一个国定贫困县, 每县各选择约 1000 名寄宿制小学生进行营养补贴, 另选择 500 名小学生进行参照 The program choose one county in southwestern China, Guangxi Zhuang Autonomous Region and one in Hebei Province, north of China. In each county, approximately 1000 boarding pupils will receive food allowance on each school day for two years. Meanwhile, 500 boarding pupils that receive no allowance will be used as the controls.

Autonomous Region and one in Hebei Province, north of China.

19 Chongli County in Hebei Beijing CHINA Du an County in Guangxi

20 项目实施方法 Program Implementation 学校名称 Schools 广西壮族自治区 Guangxi Zhuang Autonomous Region 三只羊乡小学 Sanzhiyang Elementary School 古山中心小学 Gushan Elementary School 河北省 Hebei Province 白旗寄宿制小学 Baiqi Boarding School 石夭子寄宿制小学 Shiyaozi Boarding School 狮子沟寄宿制小学 Shizigou Boarding School 场地寄宿制小学 Changdi Boarding School 西沟联校 Xigou Boarding School 大水泉中心小学 Dashuiquan Boarding School 山岔中心小学 Shancha Boarding School 驿马图寄宿制小学 Yimatu Boarding School 寄宿学生人数 Number of Boarding pupils

School 狮子沟寄宿制小学 Shizigou Boarding School 场地寄宿制小学 Changdi Boarding School 西沟联校 Xigou Boarding School 大水泉中心小学

21 项目进展 Program Process 1. 实地调研, 确定试验点 Selected pilot schools after field studies 2. 与地方政府相关部门签署合作协议, 确定试验方案 Signed agreement with related department of the local government, selected pilot plan 3. 完成了对学生的体质体能心理等测试, 取得基线数据分析报告 Accomplished physical, health and psychological test for the boarding pupils, got analyzing report of the base line data 4. 两个县的试点学校均已开始接受营养补贴 The pilot schools have obtained food allowance

22 试验前学生饮食状况

23 实行营养补贴后 Implement food allowance 现在, 孩子们有了干净的水可口的菜肴各种水果鸡蛋 Now, children got clean water, basic meals,fruits and eggs.

24 我们的工作任重道远 We have a long way to go

¹ º ¹ º 农业流动人口是指户口性质为农业户口在流入地城市工作生活居住一个月及以上的流动人口非农流动人口是指户口性质为非农户口在流入地城市工作生活居住一个

¹ º ¹ º 农业流动人口是指户口性质为农业户口在流入地城市工作生活居住一个月及以上的流动人口非农流动人口是指户口性质为非农户口在流入地城市工作生活居住一个 ¹ 改革开放年来人口流动规模持续增加对我国社会经济的持续发展起到了重要作用为全面了解我国流动人口生存状况准确把握流动人口发展规律和趋势不断加强流动人口服务管理引导人口有序流动合理分布国家人口计生委于年月启