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1.2 Preventive and Curative Nutrition Services

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1.2 Preventive and Curative Nutrition Services 1.2 PREVENTIVE AND CURATIVE NUTRITION SERVICES Key issues in East Asia and the Pacific Child malnutrition in all its forms is a major concern in East Asia and the Pacific. Stunting and wasting represent notable unresolved development challenges. Undernutrition blunts cognitive capital development and the socio-economic growth of nations. It is also a stark manifestation of the persistent and sometimes widening inequity in the region. Some countries face a double child malnutrition burden, with large numbers of overweight and obese children. Thirteen countries in the region still have unacceptably high levels of stunting, affecting an estimated 15 million children under 5 years old, including two (Timor-Leste and Papua New Guinea) with a staggering 50 per cent stunting rate. The 2017 Global Nutrition Report rated Mongolia as the only country ‘on track’ to achieve the Sustainable Development Goals target for stunting, and many countries still lack sufficient data to assess progress. The poorest children in rural areas are much more likely to be stunted than their wealthier and urban peers. Each year, an estimated 6 million children suffer from severe wasting – a huge anomaly, considering the rapidly growing economies of the region – and only around 2 per cent receive treatment. Key causes of undernutrition include poor maternal nutrition and health, inadequate infant and young child feeding practices, and poor hygiene and sanitation. Underlying causes include low access to health care, social protection and other services, and food insecurity. It is estimated that almost 9 million children under 5 are overweight in East Asia and the Pacific – a quarter of the global total and the single largest regional burden. The vast majority (85 per cent) live in China and Indonesia. However, numbers are rapidly increasing across the entire region. Prevalence of stunting among children Prevalence of wasting among children under 5 years of age (%) under 5 years of age (%) 2012-17 2007-11 2012-17 2007-11 25 60 20 50 40 15 30 10 20 5 10 0 0 Nauru Nauru Tuvalu Tuvalu China (2013) China (2013) Tonga (2012) Tonga (2012) Samoa (2014) Samoa (2014) Vanuatu (2013) Thailand (2016) Vanuatu (2013) Thailand (2016) Malaysia (2016) Lao PDR (2017) Malaysia (2016) Lao PDR (2017) Viet Nam (2015) Mongolia (2017) Myanmar (2016) Indonesia (2013) Viet Nam (2015) Mongolia (2017) Myanmar (2016) Cambodia (2014) Indonesia (2013) Cambodia (2014) Philippines (2015) DPR Korea (2017) Philippines (2015) DPR Korea (2017) Timor-Leste (2013) Papua New Guinea Timor-Leste (2013) Papua New Guinea Marshall Islands (2017) Solomon Islands (2015) Marshall Islands (2017) Solomon Islands (2015) Source: UNICEF/WHO/World Bank Joint Child Malnutrition Estimates Source: UNICEF/WHO/World Bank Joint Child Malnutrition Estimates (JCME); (JCME); DHS, MICS, NNS/SMART DHS, MICS, NNS/SMART Driving results for children Given the diverse causes of malnutrition, prevention and elimination require the implementation of a multi-sectoral package of nutrition- specific and nutrition-sensitive interventions, ideally during the first 1,000 days of life. UNICEF approach to nutrition prioritizes five delivery systems – food, health, water and sanitation, education and social protection – that are central to achieving its nutrition results and targets. UNICEF prioritizes support to: (1) systems and capacity strengthening to increase investment and accelerate and improve service delivery; (2) better evidence, data and information gathering for decision making; (3) stronger governance and gender-responsive, integrated policies and legislation; (4) enhancing the delivery of nutrition interventions within the five systems; and (5) strategic partnerships and alliances with key institutions and the private sector. Key programme strategies Systems and capacity Data, evidence and knowledge • Support to scale-up and provision of effective • Enhance routine data and household survey data nutrition-specific services, including maternal quality, analysis and use. nutrition, protection, promotion and support for • Conduct analysis of multi-sectoral policies and optimal breastfeeding and complementary feeding, programmes to identify gaps and bottlenecks. treatment of children with moderate and severe • Evaluate multi-sectoral approaches to address acute malnutrition, food and condiment fortification, malnutrition, particularly in WASH, social micro-nutrient supplementation and deworming. protection, Early Childhood Development and • Strengthen human and institutional capacity, education and food systems. including capacity to plan, cost, monitor and • Assess effectiveness of new and improved evaluate for nutrition. interventions to address childhood obesity, • Strengthen supply and information systems, quality women’s nutrition and complementary feeding. criteria, standards, supervision and mentoring, and • Assess and monitor effectiveness of nutrition follow up. interventions in health systems, communication • Expand linkages of nutrition interventions with for development, and emergency preparedness social protection schemes, Early Childhood and response. Development/parenting programmes, education and food systems. • Promote increased access to and diversity of nutritious food. Governance, policy and budget • Strengthen risk analysis and develop capacity for nutrition in emergency preparedness. • Advocate and support the development of nutrition policy and legislation – including adoption, monitoring and enforcement of legislation on marketing, food fortification, Partnerships and alliances labelling, fiscal measures including sugar taxes, maternity protection and workplace • Actively engage with national and regional breastfeeding policies. institutions, international financial institutions, • Advocate for increased budget allocations for nutrition non-governmental organizations and the private and efficiency in public finance management. sector to increase political commitment, • Promote effective multi-sector/stakeholder investment and coordination in nutrition. coordination and governance. • Closely collaborate with UN agencies in coordinating intervention, evidence generation and system strengthening. • Establish strategic partnerships for system Behaviour change strengthening and evidence generation. • Enhance communication for development to promote healthy diet for mothers and children, including through social media. .
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