A lot of Hungr ymouth

Over the decades, issues of malnutrition and food insecurity have been increasingly receiving high priority for sustainable socio-economic development in most of the developing countries. This is primarily because the number of hungry people in the world remains unacceptably high. As a result, this will have potentially profound impacts on the health and nutrition status of individuals, families and communities.

According to a new report on the state of food insecurity, almost 870 million people have been chronically undernourished from 2010 to 2012. More importantly, a vast majority of them live in developing countries, where about 850 million people, or slightly fewer than 15 percent of the population, are estimated to be undernourished.

The emerging issues of malnutrition and food insecurity are closely linked. There is increasing awareness on the importance of nutrition as a means to a healthy and productive life besides being a route to breaking inter-generational poverty. In a country like ours where poverty, illiteracy and poor health systems are still major challenges in most of the remote districts of the Mid- and Far West regions, severe malnutrition among women and children in particular has been a growing concern in recent years.

Going back to the first International Conference on Nutrition which was held in Rome in 1992, a world declaration and plan of action were strategically adopted. More importantly, this plan of action primarily underlined the need to eliminate, or reduce substantially, widespread chronic hunger and famine and under-nutrition, especially among children, women and the aged.

Despite some progress in reducing malnutrition, there are still challenges to improve the nutritional status of children in the country. According to the Nepal Demographic and Health Survey of 2011, 41 percent of the children were stunted in 2011 compared to 49 percent in 2006. However, there are increasing disparities by wealth quintiles and geographic areas. It is interesting to note that most of the reduction occurred in the richest quintile. In case of the poorest quintile, stunting is still on the rise. Furthermore, 11 percent were still wasted in 2011 compared to 13 percent in 2006. Considering the geographical variations and complexities, 67 percent of the children from the Mid- and Far West regions including the mountains are most affected by chronic malnutrition while 20 percent of the children from the western and central Tarai are most affected by acute malnutrition.

The evidence also implies that about half of the cases of chronic under-nutrition among children occurs before birth due to the mother’s nutrition status during pregnancy, and the remaining half occurs between the child’s birth and up to two years of age. The effects of nutritional deprivation during this early life period are undoubtedly irreversible and, most importantly, are mostly likely to have creeping impacts on child morbidity and mortality. Moreover, under-nutrition is responsible for more than one-third of the incidences of child mortality.

Apart from poor nutrient intake and infections as immediate causes affecting both maternal and infant nutrition, the underlying causes largely include household food insecurity, poor maternal and child caring practices, limited access to health and other social and environmental services. The health sector’s response is primarily to scale up essential

nutrition services while other sectors such as agriculture, education, water and sanitation would have important roles for planning and implementation of nutrition sensitive interventions at all levels. Thus, a multi-sectoral approach is envisaged for scaling up nutrition and food security actions.

In September last year, the National Planning Commission launched a Multi-Sector Nutrition Plan (2013-17). On the occasion, Prime Minister Baburam Bhattarai appreciated the landmark plan and expressed the government’s commitment to support effective implementation in partnership with a range of external development partners and civil society organisations at all levels. Over the next five years, the plan aims to improve maternal and child nutrition by engaging a wide range of stakeholders across the country.

In this context, the role of the National Planning Commission in coordinating and facilitating the multi-sectoral efforts through the Nutrition and Food Security Secretariat (NFSS) is clearly important to ensure that the plans and resource commitments from different sectors are translated into action, and policy directives are in place to decentralise the scaling up of nutrition at the district and community levels. Therefore, one of the key outcomes of the multi-sector nutrition plan is improving nutrition and food security related policies, plans and multi-sector coordination at the national and local levels.

A wide range of capacity gaps and opportunities will have to be realistically experienced in the process of implementation of this ambitious plan as there are still limited trained human resources for public health nutrition across the country. Since the issues of nutrition and food security are closely linked, there is a need to integrate and harmonise the ongoing efforts to improve nutrition and food security in a pragmatic manner.

It is encouraging to note that a global movement on nutrition, Scaling Up Nutrition (SUN), has been instrumental in accelerating the momentum of nutrition interventions. The movement has been stimulated and reinforced by political interest in nutrition among leaders of national governments and development partners alike. Efforts of external development partners and civil society organisations have been important in facilitating country-led processes to scale up nutrition and food security issues at all levels.

Bhandari is with the Nutrition and Food Security Secretariat, National Planning Commission

Posted on: 2013-03-07 09:04

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