(CNN) North Korean food production in 2018 fell to its lowest level for over a decade, leaving millions without enough to eat, according to the United Nations.

An estimated 11 million people inside the country -- nearly 44% -- are undernourished, the UN's 2019 North Korea Needs and Priorities report found.

Food production fell by more than 9% from 5.45 million metric tons in 2017 to 4.95 million metric tons last year, in part due to "shortages of arable land, lack of access to modern agricultural equipment and fertilizers and recurrent natural disasters," it said.

Outlining the "grim" situation for millions of North Koreans, the UN called for $120 million worth of aid to be sent to the country.

"Widespread under-nutrition threatens an entire generation of children," Tapan Mishra, the UN resident coordinator in North Korea, said in a statement, adding that the UN had been unable last year to reach hundreds of thousands of people it planned to help.

Children in the Unryul County Nursery in North Korea's Unryul county.

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