TACKLING EXTREMISM: A MUSLIM PERSPECTIVE TAALIB ALEXANDER Director, Alhambra Educational Initiative.
Tackling global nutrition challenges – a WHO perspective
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Transcript of Tackling global nutrition challenges – a WHO perspective
Tackling global nutrition challenges – a WHO perspective
F.Branca
DirectorDepartment of Nutrition
for Health and DevelopmentWHO
Stunting prevalence and number affected in developing countries
Achievement of MDG 1
178 million children under 5are stunted
Prevalence of Stunting
Source: WHO Global database on Anaemia, 2006
293 million children under 5are anemic
Category of public health significance(anaemia prevalence)
Normal (<5.0%)
Mild (5.0-19.9%)
Moderate (20.0-39.9%)
Severe (≥40.0%)
No Data
Exclusive breastfeeding rates in children <6 months are stalling
12
2025
141624
38
14
43
3238
18
3542
21
46
2936
0
10
20
30
40
50
60
70
80
90
100
AFR AMR EMR EUR SEAR WPR GLOBAL
1986-1990
1991-1995
1996-2002
Global Trend
Major causes of death in children under 5 with disease-specific contribution of undernutrition,
2004
Over 500 million adultsare obese
!!
!!
BMI Adult Both Sexes (≥30%)
No data
≥50.00
40.00 - 50.00
30.00 - 40.00
20.00 - 30.00
10.00 - 20.00
5.00 - 10.00
0.00 - 5.00
Why little progress?
• Inadequate investments• Inadequate coordination
among players• Inadequate coverage• Inadequate responses• Life course not addressed• Social determinants not
considered
Implementation of the Code of Marketing Breast milk substitutes
– 63 Member States reported as having Code legislation or regulations in place (65%);
– 22 Member States reported as having adopted only voluntary measures (23%);
– 9 Member States did not complete the questionnaire sent (12%).
Different policy and operational support needed
FACTOR 1:Better Health System Capacity, variable Nutrition Governance
FACTOR 2: Poorest Health System Capacity,
Consistent Good Nutrition Governance
FACTOR 3:Poor Health System Capacity, Variable Nutrition Governance
(High PH Expenditure)
Strong Nutrition Governance
Medium/weak Nutrition
Governance
Strong Nutrition Governance
Medium/weka Nutrition
Governance
MCU 1Best for reduction of both child stunting and maternal anemia
Vietnam Angola (-)Indonesia
KenyaPakistan
South Africa
BangladeshIndia
CambodiaMozambique
MCU 2Best for reduction of child
stunting, and worst for reduction of maternal anemia
EgyptPeru
Philippines
DR Congo* (-) Ethiopia
MCU 3Worst for reduction of child
stunting, and best for reduction of maternal anemia
GhanaYemen (-)
CameroonMyanmarNigeriaSudan*
Burkina Faso GuatemalaMali
NigerZambia
MCU 4Worst for reduction of both child stunting and maternal
anemia
BurundiCote D’Ivoire (-)
MadagascarNepal
Uganda
Malawi U R Tanzânia
* emergency countriesNOTE: countries with good coverage (>70%) of at least 4 antenatal care visits are in bold type; those with medium coverage (30-70%) are shown as underlined text; and those with low coverage (<30%) of at least 4 antenatal care visits are shown as italicised text.
MCU groups(from stunting
and anemia level and trend)
Readiness Factor
Sharp improvements in exclusive breastfeeding rates are possible
8 616
7
383828
34
61
41
54 56
67
43
83
44
23
1010 10
36
88
0102030405060708090
100
Mal
i
Tog
o
Sen
egal
Leso
tho
Zam
bia
Tan
zani
a
Gha
na
Mal
awi
Mad
agas
car
Ben
in
Rw
anda
% o
f in
fan
ts <
6 m
os
ex
clu
siv
ely
bre
as
tfe
d
around 1996 around 2006
Source: UNICEF database; current EBF >25 and increase >10 percentage points; OR EBF >80%
A new political environment
"Given the importance of nutrition to maternal, newborn and child health and other broader development programming, Ministers stressed that nutrition needs to be better integrated in development efforts. Ministers recognized that investments in nutrition could have a catalytic impact on making progress towards the Millennium Development Goals (MDGs)."
G8 Development Ministers' Meeting
28 April 2010, Halifax
Donors' nutrition strategies
• Canadian initiative on maternal and child health
• US Global Health Initiative
• nutrition strategies (France, UK, European Commission, Ireland).
Scaling up nutrition – a framework for action
• focus on country level action;• scale up evidence-based cost-effective interventions to
prevent and treat undernutrition, with highest priority to the minus 9 to 24 months;
• take a multi-sectoral approach that includes integrating nutrition in related sectors;
• provide substantially scaled up domestic and external assistance for country owned nutrition programmes and capacity;
• support major efforts at the national and global levels for strengthening the evidence base through better data, monitoring and evaluation, and research.
Evidenced Based Direct Interventions toPrevent and Treat Undernutrition
• Promoting good nutritional practices ($2.9 billion):– breastfeeding – complementary feeding for infants after the age of six months– improved hygiene practices including handwashing
• Increasing intake of vitamins and minerals ($1.5 billion)• Provision of micronutrients for young children and their mothers:
– periodic Vitamin A supplements – therapeutic zinc supplements for diarrhoea management– multiple micronutrient powders – de-worming drugs for children (to reduce losses of nutrients)– iron-folic acid supplements for pregnant women to prevent and treat anaemia– iodized oil capsules where iodized salt is unavailable
• Provision of micronutrients through food fortification for all: – salt iodization – iron fortification of staple foods
• Therapeutic feeding for malnourished children with special foods ($6.2 billion):– Prevention or treatment for moderate undernutrition – Treatment of severe undernutrition (“severe acute malnutrition”) with ready-to-use therapeutic foods
(RUTF).
Call for action
WHO is calling the attention of MSs to the need of scaling up interventions to address infant and young child nutrition and to increase the investment in nutrition through comprehensive approaches, as part of a global action plan on nutrition.
Draft resolution
A Draft resolution (EB126.R5) on Infant and Young Child Nutrition was proposed by Peru and endorsed by the EB with minor modifications.
Member States commitments(1) to increase political commitment to reducing malnutrition in all its forms;(2) to strengthen and expedite the implementation of the Global Strategy for Infant
and Young Child Feeding with emphasis on giving effect to the International Code of Marketing of Breast-milk Substitutes, adopted in resolution WHA34.22;
(3) to develop or review current policy frameworks addressing the double burden of malnutrition and allocate adequate human and financial resources to ensure its implementation;
(4) to scale up interventions to improve infant and young child nutrition, including the protection and promotion of breastfeeding and timely, safe and appropriate complementary feeding; the implementation of supplementary and therapeutic feeding interventions for severe malnutrition; and the control of vitamin and mineral deficiencies;
(5) to include these strategies in comprehensive maternal and child health services and supporting to the aim of universal coverage and principles of primary health care, including strengthening health systems as outlined in WHA62.12;
(6) to strengthen nutrition surveillance systems and improve use and reporting of agreed Millennium Development Goals indicators to monitor progress;
(7) to implement the WHO Child Growth Standards by their full integration into child health programmes;
Requests to WHO(1) to strengthen the evidence base on effective and safe nutrition actions to
counteract the public health effects of the double burden of malnutrition and describe good practices for successful implementation;
(2) to mainstream nutrition in all WHO’s health policies and strategies and confirm the presence of essential nutrition actions in the context of the reform of primary health care;
(3) to continue and strengthen collaboration with other United Nations agencies and international organizations involved in the process of ensuring improved nutrition including clear identification of leadership, division of labour and outcomes;
(4) to support Member States, on request, in expanding nutritional interventions related to the double burden of malnutrition, monitoring and evaluating impact, strengthening or establishing effective nutrition surveillance systems, and implementing the WHO Child Growth Standards;
(5) to develop a comprehensive implementation plan on infant and young child nutrition as a critical component of a global multisectoral nutrition framework for preliminary discussion at the Sixty-fourth World Health Assembly and for final delivery at the Sixty-fifth World Health Assembly, through the Executive Board and after broad consultation with Member States.
http://www.who.int/nutrition/en/index.html